WorldWideScience

Sample records for profound positive impact

  1. Bioethical Considerations for Teachers of the Severe and Profoundly Retarded: A Position Paper.

    Science.gov (United States)

    Downie, Don; Snart, Fern

    1983-01-01

    The paper reviews bioethical positions regarding the "human-ness" of severely handicapped students, notes that the quality of life for many severely handicapped persons is directly threatened by the utilitarian position which questions the personhood of individuals with limited IQ, and asserts that the deontological postition is more aligned with…

  2. Environmentally profound

    Energy Technology Data Exchange (ETDEWEB)

    Wang, Rushu [China Yangzte Three Gorges Project Development Corp., Yichang Hubei (China)

    1999-09-01

    The Three Gorges dam project on the Yangtze river will have a profound effect on the people, the environment and cultural heritage sites. The dam will be the world's biggest and will provide almost 85 BkWh of hydro power per annum. A noticeable benefit will be a greatly reduced incidence of flooding in the Jingjiang reaches of the river. Additional benefits will be improved local navigation, climate and enhanced water quality. The main unwelcome impacts were loss of farmland and resettlement of people but here the government have been particularly careful to provide the relocated people with a reasonable standard of new accommodation and farmland. The loss of natural vegetation will be small but there are endangered species of birds and animals living in the region. A number of negative environmental affects (dust noise, incidence of certain diseases) and how they are to be mitigated are mentioned. (UK)

  3. Growth-rate regulated genes have profound impact on interpretation of transcriptome profiling in Saccharomyces cerevisiae

    DEFF Research Database (Denmark)

    Regenberg, Birgitte; Grotkjær, Thomas; Winther, Ole

    2006-01-01

    Growth rate is central to the development of cells in all organisms. However, little is known about the impact of changing growth rates. We used continuous cultures to control growth rate and studied the transcriptional program of the model eukaryote Saccharomyces cerevisiae, with generation time...

  4. Health Information Technology Systems profoundly impact users: a case study in a dental school.

    Science.gov (United States)

    Hill, Heather K; Stewart, Denice C L; Ash, Joan S

    2010-04-01

    The purpose of this study was to increase our understanding of the impact of Health Information Technology Systems (HITS) on dental school users when the systems are integrated into chair-side patient care. We used qualitative research methods, including interviews, focus groups, and observations, to capture the experiences of HITS users at a single institution. Users included administrators, clinical faculty members, predoctoral students, support staff, and residents. The data were analyzed using a grounded theory approach, and nine themes emerged: 1) HITS benefits were disproportionate among users; 2) communicating about the HITS was challenging; 3) users experienced a range of strong emotions; 4) the instructor persona diminished; 5) there were shifts in the school's power structure; 6) allocation of end-users' time shifted; 7) the training and support needs of end-users were significant; 8) perceived lack of HITS usability made documentation cumbersome for clinicians; and 9) clinicians' workflow was disrupted. HITS integration into patient care impacts the work of all system users, especially end-users. The themes highlight areas of potential concern for implementers and users in integrating a HITS into patient care.

  5. The impact of visual impairment on the ability to perform activities of daily living for persons with severe/profound intellectual disability.

    Science.gov (United States)

    Dijkhuizen, Annemarie; Hilgenkamp, Thessa I M; Krijnen, Wim P; van der Schans, Cees P; Waninge, Aly

    2016-01-01

    The ability to perform activities of daily living (ADL) as a component of participation is one of the factors that contribute to quality of life. The ability to perform ADL for persons experiencing severe/profound intellectual disability (ID) may be reduced due to their cognitive and physical capacities. However, until recently, the impact of the significantly prevalent visual impairments on the performance of activities of daily living has not yet been revealed within this group. The purpose of this prospective cross-sectional study was to investigate the impact of visual impairment on the performance of activities of daily living for persons with a severe/profound intellectual disability. The Barthel Index (BI) and Comfortable Walking Speed (CWS) were used to measure the ability of performing activities of daily living (ADL) in 240 persons with severe/profound ID and having Gross Motor Functioning Classification System (GMFCS) levels I, II or III; this included 120 persons with visual impairment. The impact of visual impairment on ADL was analyzed with linear regression. The results of the study demonstrated that visual impairment slightly affects the ability of performing activities of daily living (BI) for persons experiencing a severe/profound intellectual disability. GMFCS Levels II or III, profound ID level, and visual impairment each have the effect of lowering BI scores. GMFCS Levels II or III, and profound ID level each have the effect of increasing CWS scores, which indicates a lower walking speed. A main effect of visual impairment is present on CWS, but our results do show a substantive interaction effect between GMFCS level III and visual impairment on Comfortable Walking Speed in persons with a severe/profound intellectual disability. Visual impairment has a slight effect on ability to perform ADL in persons experiencing severe/profound ID. Copyright © 2015 Elsevier Ltd. All rights reserved.

  6. Profound Obstructive Hypotension From Prone Positioning Documented by Transesophageal Echocardiography in a Patient With Scoliosis: A Case Report.

    Science.gov (United States)

    Abcejo, Arnoley S; Diaz Soto, Juan; Castoro, Courtney; Armour, Sarah; Long, Timothy R

    2017-08-01

    In a healthy 12-year-old female with scoliosis, prone positioning resulted in pressor-refractory cardiovascular collapse. Resumption of supine position immediately improved hemodynamics. Intraoperative transesophageal echocardiography (TEE) revealed a collapsed left atrium and biventricular failure. Repeat prone positioning resulted in a recurrence of hypotension. However, hemodynamic stabilization was restored and maintained by repositioning chest pads caudally. The patient successfully underwent a 6-hour scoliosis repair without perioperative morbidity. With this case, we aim to: (1) reintroduce awareness of this mechanical obstructive cause of reversible hypotension; (2) highlight the use of intraoperative TEE during prone hemodynamic collapse; and (3) suggest an alternative prone positioning technique if chest compression results in hemodynamic instability.

  7. Faculty Scholarship Has a Profound Positive Association with Student Evaluations of Teaching--Except When It Doesn't

    Science.gov (United States)

    Carter, Robert E.

    2016-01-01

    Conventional wisdom holds that research-productive faculty are also the finest instructors. But, is this commonly held belief correct? In the current study, the notion that faculty scholarship exhibits a positive association with teaching evaluations is investigated. Reflecting the data structure of faculty nested within university, the current…

  8. Terpene metabolic engineering via nuclear or chloroplast genomes profoundly and globally impacts off-target pathways through metabolite signalling.

    Science.gov (United States)

    Pasoreck, Elise K; Su, Jin; Silverman, Ian M; Gosai, Sager J; Gregory, Brian D; Yuan, Joshua S; Daniell, Henry

    2016-09-01

    The impact of metabolic engineering on nontarget pathways and outcomes of metabolic engineering from different genomes are poorly understood questions. Therefore, squalene biosynthesis genes FARNESYL DIPHOSPHATE SYNTHASE (FPS) and SQUALENE SYNTHASE (SQS) were engineered via the Nicotiana tabacum chloroplast (C), nuclear (N) or both (CN) genomes to promote squalene biosynthesis. SQS levels were ~4300-fold higher in C and CN lines than in N, but all accumulated ~150-fold higher squalene due to substrate or storage limitations. Abnormal leaf and flower phenotypes, including lower pollen production and reduced fertility, were observed regardless of the compartment or level of transgene expression. Substantial changes in metabolomes of all lines were observed: levels of 65-120 unrelated metabolites, including the toxic alkaloid nicotine, changed by as much as 32-fold. Profound effects of transgenesis on nontarget gene expression included changes in the abundance of 19 076 transcripts by up to 2000-fold in CN; 7784 transcripts by up to 1400-fold in N; and 5224 transcripts by as much as 2200-fold in C. Transporter-related transcripts were induced, and cell cycle-associated transcripts were disproportionally repressed in all three lines. Transcriptome changes were validated by qRT-PCR. The mechanism underlying these large changes likely involves metabolite-mediated anterograde and/or retrograde signalling irrespective of the level of transgene expression or end product, due to imbalance of metabolic pools, offering new insight into both anticipated and unanticipated consequences of metabolic engineering. © 2016 The Authors. Plant Biotechnology Journal published by Society for Experimental Biology and The Association of Applied Biologists and John Wiley & Sons Ltd.

  9. What is profound?

    DEFF Research Database (Denmark)

    Sobisch, Jan-Ulrich

    2013-01-01

    Discussing the question, which elements on the path are to be considered profound. While a general view is that the most subtle practises are also the most profound, 'Jig-rten-mgon-po maintains that the most fundamental one's are to be considered the most profound....

  10. The health impacts of women's low control in their living environment: A theory-based systematic review of observational studies in societies with profound gender discrimination.

    Science.gov (United States)

    Pennington, Andy; Orton, Lois; Nayak, Shilpa; Ring, Adele; Petticrew, Mark; Sowden, Amanda; White, Martin; Whitehead, Margaret

    2018-05-01

    We conducted a systematic review of observational evidence on the health impacts of women's low control/autonomy in the living environment in societies with profound gender discrimination and gender bias. Thirty observational studies of varying methodological quality were included. Overall, the evidence suggests that women's lower control or autonomy (for example lack of freedom of movement outside the home, lack of authority to access healthcare for sick children) was associated with poorer mental and physical health for women and higher morbidity and mortality for their children, after adjusting for their socioeconomic circumstances. Further studies are needed to disentangle and understand the pathways between low control and health outcomes in contexts of profound gender discrimination. This systematic review has highlighted the general low quality of the evidence base on this research question. It identifies the pressing need for high quality, longitudinal studies in the future. Crown Copyright © 2018. Published by Elsevier Ltd. All rights reserved.

  11. Scope and profoundness of environmental assessments. A study in the frame of environmental impact assessments. Strategic environmental assessment and FFH (fauna-flora-habitat) impact assessment under specific consideration of the conflict wind energy - bird protection

    International Nuclear Information System (INIS)

    Erb, Mareen

    2013-01-01

    The legal background of environmental impact assessments and the principle regulations and guidelines for this assessment are shortly summarized. The following Issues are discussed in detail: fundamentals of environmental assessments, profoundness and scope in environmental assessments; the conflict wind energy parks and birds.

  12. The profound effects of patient arm positioning on organ doses from CT procedures calculated using Monte Carlo simulations and deformable phantoms

    International Nuclear Information System (INIS)

    Liu, Haikuan; Gao, Yiming; Ding, Aiping; Caracappa, Peter F.; George Xu, X.

    2015-01-01

    The purpose of this study was to evaluate the organ dose differences caused by the arms-raised and arms-lowered postures for multidetector computed tomography procedures. Organ doses were calculated using computational phantoms and Monte Carlo simulations. The arm position in two previously developed adult male and female human phantoms was adjusted to represent 'raised' and 'lowered' postures using advanced BREP-based mesh surface geometries. Organ doses from routine computed tomography (CT) scan protocols, including the chest, abdomen-pelvis, and chest-abdomen-pelvis scans, were simulated at various tube voltages and reported in the unit of mGy per 100 mAs. The CT scanner model was based on previously tested work. The differences in organ dose per unit tube current between raised and lowered arm postures were studied. Furthermore, the differences due to the tube current modulation (TCM) for these two different postures and their impact on organ doses were also investigated. For a given scan parameter, a patient having lowered arms received smaller doses to organs located within the chest, abdomen or pelvis when compared with the patient having raised arms. As expected, this is caused by the attenuation of the primary X rays by the arms. However, the skin doses and bone surface doses in the patient having lowered arms were found to be 3.97-32.12 % larger than those in a patient having raised arms due to the fact that more skin and spongiosa were covered in the scan range when the arms are lowered. This study also found that dose differences become smaller with the increase in tube voltage for most of organs or tissues except the skin. For example, the liver dose differences decreased from -15.01 to -11.33 % whereas the skin dose differences increased from 21.53 to 25.24 % with tube voltage increased from 80 to 140 kVp. With TCM applied, the organ doses of all the listed organs in patient having lowered arms are larger due to the additional tube

  13. The impact of cochlear implantation on speech understanding, subjective hearing performance, and tinnitus perception in patients with unilateral severe to profound hearing loss.

    Science.gov (United States)

    Távora-Vieira, Dayse; Marino, Roberta; Acharya, Aanand; Rajan, Gunesh P

    2015-03-01

    This study aimed to determine the impact of cochlear implantation on speech understanding in noise, subjective perception of hearing, and tinnitus perception of adult patients with unilateral severe to profound hearing loss and to investigate whether duration of deafness and age at implantation would influence the outcomes. In addition, this article describes the auditory training protocol used for unilaterally deaf patients. This is a prospective study of subjects undergoing cochlear implantation for unilateral deafness with or without associated tinnitus. Speech perception in noise was tested using the Bamford-Kowal-Bench speech-in-noise test presented at 65 dB SPL. The Speech, Spatial, and Qualities of Hearing Scale and the Abbreviated Profile of Hearing Aid Benefit were used to evaluate the subjective perception of hearing with a cochlear implant and quality of life. Tinnitus disturbance was measured using the Tinnitus Reaction Questionnaire. Data were collected before cochlear implantation and 3, 6, 12, and 24 months after implantation. Twenty-eight postlingual unilaterally deaf adults with or without tinnitus were implanted. There was a significant improvement in speech perception in noise across time in all spatial configurations. There was an overall significant improvement on the subjective perception of hearing and quality of life. Tinnitus disturbance reduced significantly across time. Age at implantation and duration of deafness did not influence the outcomes significantly. Cochlear implantation provided significant improvement in speech understanding in challenging situations, subjective perception of hearing performance, and quality of life. Cochlear implantation also resulted in reduced tinnitus disturbance. Age at implantation and duration of deafness did not seem to influence the outcomes.

  14. Neuroscientists' classroom visits positively impact student attitudes.

    Directory of Open Access Journals (Sweden)

    Janet L Fitzakerley

    Full Text Available The primary recommendation of the 2010 President's Council of Advisors on Science and Technology report on K-12 education was to inspire more students so that they are motivated to study science. Scientists' visits to classrooms are intended to inspire learners and increase their interest in science, but verifications of this impact are largely qualitative. Our primary goal was to evaluate the impact of a longstanding Brain Awareness classroom visit program focused on increasing learners understanding of their own brains. Educational psychologists have established that neuroscience training sessions can improve academic performance and shift attitudes of students from a fixed mindset to a growth mindset. Our secondary goal was to determine whether short interactive Brain Awareness scientist-in-the-classroom sessions could similarly alter learners' perceptions of their own potential to learn. Teacher and student surveys were administered in 4(th-6(th grade classrooms throughout Minnesota either before or after one-hour Brain Awareness sessions that engaged students in activities related to brain function. Teachers rated the Brain Awareness program as very valuable and said that the visits stimulated students' interest in the brain and in science. Student surveys probed general attitudes towards science and their knowledge of neuroscience concepts (particularly the ability of the brain to change. Significant favorable improvements were found on 10 of 18 survey statements. Factor analyses of 4805 responses demonstrated that Brain Awareness presentations increased positive attitudes toward science and improved agreement with statements related to growth mindset. Overall effect sizes were small, consistent with the short length of the presentations. Thus, the impact of Brain Awareness presentations was positive and proportional to the efforts expended, demonstrating that short, scientist-in-the-classroom visits can make a positive contribution to

  15. The impact of visual impairment on the ability to perform activities of daily living for persons with severe/profound intellectual disability

    NARCIS (Netherlands)

    Dijkhuizen, Annemarie; Hilgenkamp, Thessa I.M.; Krijnen, Wim; van der Schans, Cees; Waninge, Aly

    2015-01-01

    Background The ability to perform activities of daily living (ADL) as a component of participation is one of the factors that contribute to the quality of life. The ability to perform ADL for persons experiencing severe/profound intellectual disability (ID) may be reduced due to their cognitive and

  16. The impact of visual impairment on the ability to perform activities of daily living for persons with severe/profound intellectual disability

    NARCIS (Netherlands)

    Dijkhuizen, Annemarie; Hilgenkamp, Thessa I. M.; Krijnen, Wim P.; Schans, van der Cees P.; Waninge, Aly

    Background: The ability to perform activities of daily living (ADL) as a component of participation is one of the factors that contribute to quality of life. The ability to perform ADL for persons experiencing severe/profound intellectual disability (ID) may be reduced due to their cognitive and

  17. [Physical activity: positive impact on brain plasticity].

    Science.gov (United States)

    Achiron, Anat; Kalron, Alon

    2008-03-01

    The central nervous system has a unique capability of plasticity that enables a single neuron or a group of neurons to undergo functional and constructional changes that are important to learning processes and for compensation of brain damage. The current review aims to summarize recent data related to the effects of physical activity on brain plasticity. In the last decade it was reported that physical activity can affect and manipulate neuronal connections, synaptic activity and adaptation to new neuronal environment following brain injury. One of the most significant neurotrophic factors that is critical for synaptic re-organization and is influenced by physical activity is brain-derived neurotrophic factor (BDNF). The frequency of physical activity and the intensity of exercises are of importance to brain remodeling, support neuronal survival and positively affect rehabilitation therapy. Physical activity should be employed as a tool to improve neural function in healthy subjects and in patients suffering from neurological damage.

  18. Geomagnetic Storm Impact On GPS Code Positioning

    Science.gov (United States)

    Uray, Fırat; Varlık, Abdullah; Kalaycı, İbrahim; Öǧütcü, Sermet

    2017-04-01

    This paper deals with the geomagnetic storm impact on GPS code processing with using GIPSY/OASIS research software. 12 IGS stations in mid-latitude were chosen to conduct the experiment. These IGS stations were classified as non-cross correlation receiver reporting P1 and P2 (NONCC-P1P2), non-cross correlation receiver reporting C1 and P2 (NONCC-C1P2) and cross-correlation (CC-C1P2) receiver. In order to keep the code processing consistency between the classified receivers, only P2 code observations from the GPS satellites were processed. Four extreme geomagnetic storms October 2003, day of the year (DOY), 29, 30 Halloween Storm, November 2003, DOY 20, November 2004, DOY 08 and four geomagnetic quiet days in 2005 (DOY 92, 98, 99, 100) were chosen for this study. 24-hour rinex data of the IGS stations were processed epoch-by-epoch basis. In this way, receiver clock and Earth Centered Earth Fixed (ECEF) Cartesian Coordinates were solved for a per-epoch basis for each day. IGS combined broadcast ephemeris file (brdc) were used to partly compensate the ionospheric effect on the P2 code observations. There is no tropospheric model was used for the processing. Jet Propulsion Laboratory Application Technology Satellites (JPL ATS) computed coordinates of the stations were taken as true coordinates. The differences of the computed ECEF coordinates and assumed true coordinates were resolved to topocentric coordinates (north, east, up). Root mean square (RMS) errors for each component were calculated for each day. The results show that two-dimensional and vertical accuracy decreases significantly during the geomagnetic storm days comparing with the geomagnetic quiet days. It is observed that vertical accuracy is much more affected than the horizontal accuracy by geomagnetic storm. Up to 50 meters error in vertical component has been observed in geomagnetic storm day. It is also observed that performance of Klobuchar ionospheric correction parameters during geomagnetic storm

  19. Microplastics have a more profound impact than elevated temperatures on the predatory performance, digestion and energy metabolism of an Amazonian cichlid.

    Science.gov (United States)

    Wen, Bin; Zhang, Nan; Jin, Shi-Rong; Chen, Zai-Zhong; Gao, Jian-Zhong; Liu, Ying; Liu, Han-Peng; Xu, Zhe

    2018-02-01

    Knowledge on the impacts of microplastics (MPs) pollution on freshwater environments and biota remains limited. Meanwhile, freshwater ecosystems have been threatened by elevated temperatures caused by climate change. To date, no information exists on how MPs-especially under elevated temperature conditions-affect predatory performance, digestive processes and metabolic pathways in freshwater organisms. Here, we examined MPs, elevated temperature and their combined effects on juveniles (0+ group) of an Amazonian cichlid, the discus fish (Symphysodon aequifasciatus). For 30 days, fish were exposed to ambient or elevated temperatures (i.e., 28 or 31 °C) in the absence or presence of MPs (i.e., 0 or 200 μg/L). The following metrics were quantified: MPs accumulation; predatory performance; and biomarkers involved in neurotransmission, digestion and energy production. The results showed that survival rate and body length were not affected by MPs, elevated temperatures or their combination. Elevated temperatures resulted in an increase in MP concentrations in fish bodies. Exposure to MPs decreased the post-exposure predatory performance (PEPP) at ambient temperatures but not at elevated temperatures. Elevated temperatures, however, had no effect on the PEPP but antagonistically interacted with MPs, leading to similar predatory performances under present and future conditions. Acetylcholinesterase (AChE) activity was only affected by MPs and decreased in the presence of MPs, indicating adverse effects in nervous and neuromuscular function and, thus, potentially in predatory performance. Trypsin activity was only influenced by MPs and decreased during exposure to MPs. Elevated temperatures or MPs alone increased the amylase activity but interacted antagonistically. Lipase activity was not influenced by either of the two stressors. In contrast, alkaline phosphatase (ALP) activity was affected by MPs or elevated temperatures alone and decreased with both stressors

  20. Thinking back about a positive event: The impact of processing style on positive affect

    Directory of Open Access Journals (Sweden)

    Sabine eNelis

    2015-03-01

    Full Text Available The manner in which individuals recall an autobiographical positive life event has affective consequences. Two studies addressed the processing styles during positive memory recall in a non-clinical sample. Participants retrieved a positive memory which was self-generated (Study 1, n = 70 or experimenter-chosen (i.e., academic achievement, Study 2, n = 159, followed by the induction of one of three processing styles (between-subjects: In Study 1, a ‘concrete/imagery’ vs. ‘abstract/verbal’ processing style was compared. In Study 2, a ‘concrete/imagery’, ‘abstract/verbal’, and ‘comparative/verbal’ processing style were compared. The processing of a personal memory in a concrete/imagery-based way led to a larger increase in positive affect compared to abstract/verbal processing in Study 1, as well as compared to comparative/verbal thinking in Study 2. Results of Study 2 further suggest that it is making unfavourable verbal comparisons that may hinder affective benefits to positive memories (rather then general abstract/verbal processing per se. The comparative/verbal thinking style failed to lead to improvements in positive affect, and with increasing levels of depressive symptoms it had a more negative impact on change in positive affect. We found no evidence that participant’s tendency to have dampening thoughts in response to positive affect in daily life contributed to the affective impact of positive memory recall. The results support the potential for current trainings in boosting positive memories and mental imagery, and underline the search for parameters that determine at times deleterious outcomes of abstract/verbal memory processing in the face of positive information.

  1. Allied health research positions: a qualitative evaluation of their impact.

    Science.gov (United States)

    Wenke, Rachel J; Ward, Elizabeth C; Hickman, Ingrid; Hulcombe, Julie; Phillips, Rachel; Mickan, Sharon

    2017-02-06

    Research positions embedded within healthcare settings have been identified as an enabler to allied health professional (AHP) research capacity; however, there is currently limited research formally evaluating their impact. In 2008, a Health Practitioner industrial agreement funded a research capacity building initiative within Queensland Health, Australia, which included 15 new allied health research positions. The present project used a qualitative and realist approach to explore the impact of these research positions, as well as the mechanisms which facilitated or hindered their success within their respective organisations. Forty-four AHP employees from six governmental health services in Queensland, Australia, participated in the study. Individual interviews were undertaken, with individuals in research positions (n = 8) and their reporting line managers (n = 8). Four stakeholder focus groups were also conducted with clinicians, team leaders and professional heads who had engaged with the research positions. Nine key outcomes of the research positions were identified across individual, team/service and organisational/community levels. These outcomes included clinician skill development, increased research activity, clinical and service changes, increased research outputs and collaborations, enhanced research and workplace culture, improved profile of allied health, development of research infrastructure, and professional development of individuals in the research positions. Different mechanisms that influenced these outcomes were identified. These mechanisms were grouped by those related to the (1) research position itself, (2) organisational factors and (3) implementation factors. The present findings highlight the potential value of the research positions for individuals, teams and clinical services across different governmental healthcare services, and demonstrate the impact of the roles on building the internal and external profile of allied health

  2. Impacts of GNSS position offsets on global frame stability

    Science.gov (United States)

    Griffiths, Jake; Ray, Jim

    2014-05-01

    Positional offsets appear in Global Navigation Satellite System (GNSS) time series for a variety of reasons. Antenna or radome changes are the most common cause for these discontinuities. Many others are from earthquakes, receiver changes, and different anthropogenic modifications at or near the stations. Some jumps appear for unknown or undocumented reasons. The accurate determination of station velocities, and therefore geophysical parameters and terrestrial reference frames, requires that positional offsets be correctly found and compensated. Williams (2003) found that undetected offsets introduce a random walk error component in individual station time series. The topic of detecting positional offsets has received considerable attention in recent years (e.g., Detection of Offsets in GPS Experiment; DOGEx), and most research groups using GNSS have adopted a combination of manual and automated methods for finding them. The removal of a positional offset is usually handled by estimating the average station position on both sides of the discontinuity, assuming a constant, continuous velocity. This is sufficient in the absence of time-correlated errors. However, GNSS time series contain systematic and power-law errors (white to random walk noise). In this paper, we aim to evaluate the impact to both individual station results and the overall stability of the global reference frame from adding increasing numbers of positional discontinuities. We use the International GNSS Service (IGS) weekly SINEX files, and iteratively insert positional offset parameters at the midpoint of each data segment. Each iteration includes a restacking of the modified SINEX files using the CATREF software from Institut National de l'Information Géographique et Forestière (IGN) to estimate: regularized station positions, secular velocities, Earth orientation parameters, Helmert frame alignment parameters, and the empirical shifts across all positional discontinuities. A comparison of the

  3. Human dignity and the profoundly disabled: a theological perspective.

    Science.gov (United States)

    Matthews, Pia

    2011-01-01

    One challenge to the concept of human dignity is that it is a rootless notion invoked simply to mask inequalities that inevitably exist between human beings. This privileging of humans is speciesist and its weak point is the profoundly disabled human being. This article argues that far from being a weak point, the profoundly disabled person is a source of strength and witness to the intrinsic dignity that all human beings have by virtue of being human. The disabled represent the reality of human existence that is both strong and fragile. Although human dignity can be understood philosophically its depth is rooted in Christian theological insights. The profoundly disabled occupy a privileged position and share in a theology of mission since they testify to the interdependence of every human being and human dependence on God to a myopic world that only values strength, autonomy and independence.

  4. Tourism's impacts on natural resources: A positive case from China.

    Science.gov (United States)

    Li, Wenjun; Zhang, Qian; Liu, Chunyan; Xue, Qifu

    2006-10-01

    Tourism development may result in negative impacts on natural resources owing to overuse and mismanagement. However, tourism may also play positive roles in natural resource conservation, which has rarely been verified in practice, although some researchers have demonstrated this in theory. In this article, taking the Jiuzhaigou Biosphere Reserve as a case study area, we conducted an analysis for the environmental impacts from tourism development based on social survey and interpretation of remote sensing images. The results show that the natural environment was not degraded and some indicators are even improving because all the residents have participated in tourism and given up farming and hunting. It is concluded that it is possible to use tourism as a way to balance natural resource conservation and economic development under the preconditions of making effective policies to encourage and help local people participate in tourism business and to benefit from it.

  5. Tourism's Impacts on Natural Resources: A Positive Case from China

    Science.gov (United States)

    Li, Wenjun; Zhang, Qian; Liu, Chunyan; Xue, Qifu

    2006-10-01

    Tourism development may result in negative impacts on natural resources owing to overuse and mismanagement. However, tourism may also play positive roles in natural resource conservation, which has rarely been verified in practice, although some researchers have demonstrated this in theory. In this article, taking the Jiuzhaigou Biosphere Reserve as a case study area, we conducted an analysis for the environmental impacts from tourism development based on social survey and interpretation of remote sensing images. The results show that the natural environment was not degraded and some indicators are even improving because all the residents have participated in tourism and given up farming and hunting. It is concluded that it is possible to use tourism as a way to balance natural resource conservation and economic development under the preconditions of making effective policies to encourage and help local people participate in tourism business and to benefit from it.

  6. Impact of emotion on consciousness: positive stimuli enhance conscious reportability.

    Directory of Open Access Journals (Sweden)

    Kristine Rømer Thomsen

    2011-04-01

    Full Text Available Emotion and reward have been proposed to be closely linked to conscious experience, but empirical data are lacking. The anterior cingulate cortex (ACC plays a central role in the hedonic dimension of conscious experience; thus potentially a key region in interactions between emotion and consciousness. Here we tested the impact of emotion on conscious experience, and directly investigated the role of the ACC. We used a masked paradigm that measures conscious reportability in terms of subjective confidence and objective accuracy in identifying the briefly presented stimulus in a forced-choice test. By manipulating the emotional valence (positive, neutral, negative and the presentation time (16 ms, 32 ms, 80 ms we measured the impact of these variables on conscious and subliminal (i.e. below threshold processing. First, we tested normal participants using face and word stimuli. Results showed that participants were more confident and accurate when consciously seeing happy versus sad/neutral faces and words. When stimuli were presented subliminally, we found no effect of emotion. To investigate the neural basis of this impact of emotion, we recorded local field potentials (LFPs directly in the ACC in a chronic pain patient. Behavioural findings were replicated: the patient was more confident and accurate when (consciously seeing happy versus sad faces, while no effect was seen in subliminal trials. Mirroring behavioural findings, we found significant differences in the LFPs after around 500 ms (lasting 30 ms in conscious trials between happy and sad faces, while no effect was found in subliminal trials. We thus demonstrate a striking impact of emotion on conscious experience, with positive emotional stimuli enhancing conscious reportability. In line with previous studies, the data indicate a key role of the ACC, but goes beyond earlier work by providing the first direct evidence of interaction between emotion and conscious experience in the human

  7. Continuing Education Workshops in Bioinformatics Positively Impact Research and Careers.

    Science.gov (United States)

    Brazas, Michelle D; Ouellette, B F Francis

    2016-06-01

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

  8. Instrumented Impact Testing: Influence of Machine Variables and Specimen Position

    Energy Technology Data Exchange (ETDEWEB)

    Lucon, E.; McCowan, C. N.; Santoyo, R. A.

    2008-09-15

    An investigation has been conducted on the influence of impact machine variables and specimen positioning on characteristic forces and absorbed energies from instrumented Charpy tests. Brittle and ductile fracture behavior has been investigated by testing NIST reference samples of low, high and super-high energy levels. Test machine variables included tightness of foundation, anvil and striker bolts, and the position of the center of percussion with respect to the center of strike. For specimen positioning, we tested samples which had been moved away or sideways with respect to the anvils. In order to assess the influence of the various factors, we compared mean values in the reference (unaltered) and altered conditions; for machine variables, t-test analyses were also performed in order to evaluate the statistical significance of the observed differences. Our results indicate that the only circumstance which resulted in variations larger than 5 percent for both brittle and ductile specimens is when the sample is not in contact with the anvils. These findings should be taken into account in future revisions of instrumented Charpy test standards.

  9. Instrumented Impact Testing: Influence of Machine Variables and Specimen Position

    International Nuclear Information System (INIS)

    Lucon, E.; McCowan, C. N.; Santoyo, R. A.

    2008-01-01

    An investigation has been conducted on the influence of impact machine variables and specimen positioning on characteristic forces and absorbed energies from instrumented Charpy tests. Brittle and ductile fracture behavior has been investigated by testing NIST reference samples of low, high and super-high energy levels. Test machine variables included tightness of foundation, anvil and striker bolts, and the position of the center of percussion with respect to the center of strike. For specimen positioning, we tested samples which had been moved away or sideways with respect to the anvils. In order to assess the influence of the various factors, we compared mean values in the reference (unaltered) and altered conditions; for machine variables, t-test analyses were also performed in order to evaluate the statistical significance of the observed differences. Our results indicate that the only circumstance which resulted in variations larger than 5 percent for both brittle and ductile specimens is when the sample is not in contact with the anvils. These findings should be taken into account in future revisions of instrumented Charpy test standards.

  10. Achieving profound anesthesia using the intraosseous technique.

    Science.gov (United States)

    Coury, K A

    1997-10-01

    The intraosseous technique has been described as a useful adjunct to primary anesthetic administration. It has several advantages (Table 3) over other supplemental techniques in that it is relatively simple to implement into routine practice, it affords fast, predictable results, and it is relatively painless. The technique has been shown to be very successful in achieving profound pulpal anesthesia when administered as a supplement to the inferior alveolar nerve block and is effective in achieving profound anesthesia in irreversibly inflamed teeth, especially mandibular molars.

  11. Impact of selected troposphere models on Precise Point Positioning convergence

    Science.gov (United States)

    Kalita, Jakub; Rzepecka, Zofia

    2016-04-01

    The Precise Point Positioning (PPP) absolute method is currently intensively investigated in order to reach fast convergence time. Among various sources that influence the convergence of the PPP, the tropospheric delay is one of the most important. Numerous models of tropospheric delay are developed and applied to PPP processing. However, with rare exceptions, the quality of those models does not allow fixing the zenith path delay tropospheric parameter, leaving difference between nominal and final value to the estimation process. Here we present comparison of several PPP result sets, each of which based on different troposphere model. The respective nominal values are adopted from models: VMF1, GPT2w, MOPS and ZERO-WET. The PPP solution admitted as reference is based on the final troposphere product from the International GNSS Service (IGS). The VMF1 mapping function was used for all processing variants in order to provide capability to compare impact of applied nominal values. The worst case initiates zenith wet delay with zero value (ZERO-WET). Impact from all possible models for tropospheric nominal values should fit inside both IGS and ZERO-WET border variants. The analysis is based on data from seven IGS stations located in mid-latitude European region from year 2014. For the purpose of this study several days with the most active troposphere were selected for each of the station. All the PPP solutions were determined using gLAB open-source software, with the Kalman filter implemented independently by the authors of this work. The processing was performed on 1 hour slices of observation data. In addition to the analysis of the output processing files, the presented study contains detailed analysis of the tropospheric conditions for the selected data. The overall results show that for the height component the VMF1 model outperforms GPT2w and MOPS by 35-40% and ZERO-WET variant by 150%. In most of the cases all solutions converge to the same values during first

  12. Signal processing for the profoundly deaf.

    Science.gov (United States)

    Boothyroyd, A

    1990-01-01

    Profound deafness, defined here as a hearing loss in excess of 90 dB, is characterized by high thresholds, reduced hearing range in the intensity and frequency domains, and poor resolution in the frequency and time domains. The high thresholds call for hearing aids with unusually high gains or remote microphones that can be placed close to the signal source. The former option creates acoustic feedback problems for which digital signal processing may yet offer solutions. The latter option calls for carrier wave technology that is already available. The reduced frequency and intensity ranges would appear to call for frequency and/or amplitude compression. It might also be argued, however, that any attempts to compress the acoustic signal into the limited hearing range of the profoundly deaf will be counterproductive because of poor frequency and time resolution, especially when the signal is present in noise. In experiments with a 2-channel compression system, only 1 of 9 subjects showed an improvement of perception with the introduction of fast-release (20 ms) compression. The other 8 experienced no benefit or a slight deterioration of performance. These results support the concept of providing the profoundly deaf with simpler, rather than more complex, patterns, perhaps through the use of feature extraction hearing aids. Data from users of cochlear implants already employing feature extraction techniques also support this concept.

  13. Teaching Positive Networking for Life-Long Impact

    Science.gov (United States)

    Addams, Lon; Woodbury, Denise; Addams, Lindsey

    2010-01-01

    As college communication instructors, we could further assist students by teaching the value of positive networking. This article provides (1) a foundation for positive networking and (2) several successful ways in which students can begin building a strong long-lasting network of professional relationships during the semester…and for their entire…

  14. The power of Nutrition Impact and Positive Practice (NIPP) Circles

    African Journals Online (AJOL)

    family members we identify existing, positive behaviours of mothers or caretakers in ..... foods is practice to reinforce that idea. In order to help the volunteer ... exercises are only covered in theory, whereas the women's groups need to practice ...

  15. Impact evaluation of positive deviance hearth in Migori County, Kenya

    African Journals Online (AJOL)

    based nutrition program for children who are at risk for protein-energy malnutrition in a low resource community. The intervention uses the 'Positive Deviance' approach to identify those behaviors practiced by the mothers or caretakers of ...

  16. Profound bradycardia associated with NIV removal.

    Science.gov (United States)

    Echevarria, C; Bourke, S C; Gibson, G J

    2012-01-01

    A patient with lower-limb onset ALS presented with a one-month history of vasovagal episodes and a one-week history of cough productive of green sputum and lethargy. She was drowsy and in acute on chronic type-two respiratory failure. She responded to non-invasive ventilation, however she suffered recurrent episodes of profound bradycardia on removal of the mask, which gradually resolved over ten days. We have reviewed the literature and offer a potential explanation for these events.

  17. Asystole Following Profound Vagal Stimulation During Hepatectomy

    Directory of Open Access Journals (Sweden)

    Preeta John

    2008-01-01

    Full Text Available Asystole in a non laparoscopic upper abdominal surgery following intense vagal stimulation is a rare event. This case report highlights the need for awareness of such a complication when a thoracic epidural anaesthetic has been given in addition to a general anaesthetic for an upper abdominal procedure. A combined thoracic epidural and general anaesthetic was given. The anterior abdominal wall was retracted forty minutes after administration of the epidural bolus. This maneuver resulted in a profound vagal response with bradycardia and asystole. The patient was resuscitated successfully with a cardiac massage, atropine and adrenaline and the surgery was resumed. Surgery lasted eleven hours and was uneventful.

  18. Student Attitudes towards Enterprise Education in Poland: A Positive Impact

    Science.gov (United States)

    Jones, Paul; Jones, Amanda; Packham, Gary; Miller, Christopher

    2008-01-01

    Purpose: This paper aims to appraise the delivery of an enterprise education course to a cohort of Polish students evaluating its impact in encouraging entrepreneurial activity. The Polish economy continues its expansion with adoption of free market economies post communism. To encourage this growth, entrepreneurial activity must be encouraged…

  19. 10578 IMPACT EVALUATION OF POSITIVE DEVIANCE HEARTH IN ...

    African Journals Online (AJOL)

    Charles Anino

    nutrition program for children who are at risk for protein-energy malnutrition in a low ... method was used to collect data and perform statistical analyses. ... Studies have identified Positive Deviance (PD) Hearth approach as the most .... Germany). ... The questionnaire was tested for internal reliability using Cronbach.

  20. Positive and negative impacts of agricultural production of liquid biofuels

    NARCIS (Netherlands)

    Reijnders, L.; Hester, R.E.; Harrison, R.M.

    2012-01-01

    Agricultural production of liquid biofuels can have positive effects. It can decrease dependence on fossil fuels and increase farmers’ incomes. Agricultural production of mixed perennial biofuel crops may increase pollinator and avian richness. Most types of agricultural crop-based liquid biofuel

  1. Determination of global positioning system (GPS) receiver clock errors: impact on positioning accuracy

    International Nuclear Information System (INIS)

    Yeh, Ta-Kang; Hwang, Cheinway; Xu, Guochang; Wang, Chuan-Sheng; Lee, Chien-Chih

    2009-01-01

    Enhancing the positioning precision is the primary pursuit of global positioning system (GPS) users. To achieve this goal, most studies have focused on the relationship between GPS receiver clock errors and GPS positioning precision. This study utilizes undifferentiated phase data to calculate GPS clock errors and to compare with the frequency of cesium clock directly, to verify estimated clock errors by the method used in this paper. The frequency stability calculated from this paper (the indirect method) and measured from the National Standard Time and Frequency Laboratory (NSTFL) of Taiwan (the direct method) match to 1.5 × 10 −12 (the value from this study was smaller than that from NSTFL), suggesting that the proposed technique has reached a certain level of quality. The built-in quartz clocks in the GPS receivers yield relative frequency offsets that are 3–4 orders higher than those of rubidium clocks. The frequency stability of the quartz clocks is on average two orders worse than that of the rubidium clock. Using the rubidium clock instead of the quartz clock, the horizontal and vertical positioning accuracies were improved by 26–78% (0.6–3.6 mm) and 20–34% (1.3–3.0 mm), respectively, for a short baseline. These improvements are 7–25% (0.3–1.7 mm) and 11% (1.7 mm) for a long baseline. Our experiments show that the frequency stability of the clock, rather than relative frequency offset, is the governing factor of positioning accuracy

  2. Irrigation in the Lower Durance: positive impacts of the agriculture

    International Nuclear Information System (INIS)

    Lacroix, M.; Blavoux, B.

    1995-01-01

    The water of river Durance is used to produce hydroelectricity and as stretch of water for tourism and since the thirteenth century for irrigation. The inherited situation is a well extended network of gravitation irrigation canals. This system is spendthrift of water, the water supplies are roughly 5 times the farming needs. The impact of this irrigation on the alluvial aquifer of the Lower Durance is the generalisation of the highest level of the water table in summer on the plain though the water budget has an average deficit of 550 mm. In addition, the nitrate concentration is maintained to an average of 17 mg/l in groundwater and 5 mg/l in streams by dilution. In fact, the irrigation dictates an average input of water with 25.4 mg/l of NO 3- . The natural isotopic tracing (oxygen 18) allows to say that 50 to 75% of the water of the alluvial aquifer come from irrigation. To improve the knowledge about the efficiency of irrigation, a mathematical groundwater model has been created. As a result, 53% of the water is lost while reaching the agricultural parcels, 19% is infiltrated during watering at the parcel and only 28% are used to satisfy the needs of plants. The realisation of this model has allowed to simulate the impact on groundwater of changes in irrigation practices which would lead to reduce the consummation of water. In the case of Lower Durance, the reduction of irrigation losses would have a strong impact on the quantity and quality of water in the alluvial aquifer. (J.S.). 10 refs., 9 figs., 2 tabs

  3. Positioned for impact: Haiti's first baccalaureate nursing program.

    Science.gov (United States)

    Burger, Jeanne M

    2011-01-01

    Haiti's first baccalaureate nursing programn the Faculty of Nursing Science of the Episcopal University of Haiti (FSIL), educates professional nurses as clinicians, leaders, and change agents, preparing graduates to a global standard set by the World Health Organization. FSIL was founded on Christian principles, expressing a vision of nursing as a ministry of Jesus Christ. Near the epicenter of the 2010 Haiti earthquake, the remarkable response of FSIL students and faculty saved lives, gave hope to a community in need, and demonstrated the impact of well-educated nurses on the health of a nation.

  4. Misperceiving Bullshit as Profound Is Associated with Favorable Views of Cruz, Rubio, Trump and Conservatism.

    Directory of Open Access Journals (Sweden)

    Stefan Pfattheicher

    Full Text Available The present research investigates the associations between holding favorable views of potential Democratic or Republican candidates for the US presidency 2016 and seeing profoundness in bullshit statements. In this contribution, bullshit is used as a technical term which is defined as communicative expression that lacks content, logic, or truth from the perspective of natural science. We used the Bullshit Receptivity scale (BSR to measure seeing profoundness in bullshit statements. The BSR scale contains statements that have a correct syntactic structure and seem to be sound and meaningful on first reading but are actually vacuous. Participants (N = 196; obtained via Amazon Mechanical Turk rated the profoundness of bullshit statements (using the BSR and provided favorability ratings of three Democratic (Hillary Clinton, Martin O'Malley, and Bernie Sanders and three Republican candidates for US president (Ted Cruz, Marco Rubio, and Donald Trump. Participants also completed a measure of political liberalism/conservatism. Results revealed that favorable views of all three Republican candidates were positively related to judging bullshit statements as profound. The smallest correlation was found for Donald Trump. Although we observe a positive association between bullshit and support for the three Democrat candidates, this relationship is both substantively small and statistically insignificant. The general measure of political liberalism/conservatism was also related to judging bullshit statements as profound in that individuals who were more politically conservative had a higher tendency to see profoundness in bullshit statements. Of note, these results were not due to a general tendency among conservatives to see profoundness in everything: Favorable views of Republican candidates and conservatism were not significantly related to profoundness ratings of mundane statements. In contrast, this was the case for Hillary Clinton and Martin O

  5. Misperceiving Bullshit as Profound Is Associated with Favorable Views of Cruz, Rubio, Trump and Conservatism.

    Science.gov (United States)

    Pfattheicher, Stefan; Schindler, Simon

    2016-01-01

    The present research investigates the associations between holding favorable views of potential Democratic or Republican candidates for the US presidency 2016 and seeing profoundness in bullshit statements. In this contribution, bullshit is used as a technical term which is defined as communicative expression that lacks content, logic, or truth from the perspective of natural science. We used the Bullshit Receptivity scale (BSR) to measure seeing profoundness in bullshit statements. The BSR scale contains statements that have a correct syntactic structure and seem to be sound and meaningful on first reading but are actually vacuous. Participants (N = 196; obtained via Amazon Mechanical Turk) rated the profoundness of bullshit statements (using the BSR) and provided favorability ratings of three Democratic (Hillary Clinton, Martin O'Malley, and Bernie Sanders) and three Republican candidates for US president (Ted Cruz, Marco Rubio, and Donald Trump). Participants also completed a measure of political liberalism/conservatism. Results revealed that favorable views of all three Republican candidates were positively related to judging bullshit statements as profound. The smallest correlation was found for Donald Trump. Although we observe a positive association between bullshit and support for the three Democrat candidates, this relationship is both substantively small and statistically insignificant. The general measure of political liberalism/conservatism was also related to judging bullshit statements as profound in that individuals who were more politically conservative had a higher tendency to see profoundness in bullshit statements. Of note, these results were not due to a general tendency among conservatives to see profoundness in everything: Favorable views of Republican candidates and conservatism were not significantly related to profoundness ratings of mundane statements. In contrast, this was the case for Hillary Clinton and Martin O'Malley. Overall, small

  6. Create positive contraceptive images for strongest impact in single lesson.

    Science.gov (United States)

    1987-05-01

    Health educators attempting to deliver contraceptive information to adolescents in the classroom must seek ways to make a major impact in a very short period of time. A Planned Parenthood professional from New Jersey has developed a single-shot birth control lesson that, rather than presenting the pros and cons of various contraceptive methods, has teenagers identify themselves as at high, low, or no risk of pregnancy. Students estimate the number of classmates who are in each category and then assess whether they personally are at risk of an unintended pregnancy. In general, teens overestimate the number of classmates who are sexually active. This approach seems to make the ensuing discussion of contraceptive methods more meaningful. This discussion presents the condom and foam, the sponge, and visiting a family planning clinic. After this 40 minute presentation, fewer adolescents report being afraid of contraceptive side effects; they also have more knowledge about the efficacy and availability of different methods. A lesson in preparation is centered around a videotape entitled "Swept Away is Not Okay." It shows a teen couple going to a family planning clinic before they ever have intercourse. This strategy of encouraging adolescents to seek contraception before sexual involvement begins is considered more realistic than pressuring teens to abstain from sex. School officials and teachers have been receptive to this educational approach, viewing it as presenting important public health information.

  7. Exercise in obese pregnant women: positive impacts and current perceptions

    Directory of Open Access Journals (Sweden)

    Sui Z

    2013-07-01

    Full Text Available Zhixian Sui,1 Jodie M Dodd1,21The University of Adelaide, Robinson Institute, Discipline of Obstetrics and Gynaecology, Women’s and Children’s Hospital, 2Department of Perinatal Medicine, Women’s and Babies Division, Women’s and Children’s Hospital, Adelaide, SA, AustraliaAbstract: Overweight and obesity have significant implications during pregnancy and childbirth. The objective of this review was to provide a comprehensive overview of the effect of physical activity on pregnancy outcomes, the change of physical activity during pregnancy, and women’s perception of being physically active during pregnancy, with a particular focus on women who are overweight or obese. Many studies have investigated the beneficial effect of exercise during pregnancy, including reduced risk of gestational diabetes, preeclampsia, and operative birth, in addition to improved cardiovascular function, overall fitness, psychological well-being, and mood stability. Benefits for the infant include reduced risks of prematurity and improved fetal growth, although there is more limited information about longer-term health benefits for both women and infants. The existing literature examining physical activity patterns during pregnancy has generally focused on women of all body mass index categories, consistently indicating a reduction in activity over the course of pregnancy. However, the available literature evaluating physical activity during pregnancy among women who are overweight or obese is more limited and contradictory. A number of studies identified barriers preventing women from being active during pregnancy, including pregnancy symptoms, lack of time, access to child care, and concerns about their safety and that of their unborn baby. Conversely, significant enablers included positive psychological feelings, family influence, and receiving advice from health professionals. Very few studies have provided insights about perceptions of being active during

  8. Staffs' documentation of participation for adults with profound intellectual disability or profound intellectual and multiple disabilities.

    Science.gov (United States)

    Talman, Lena; Gustafsson, Christine; Stier, Jonas; Wilder, Jenny

    2017-06-21

    This study investigated what areas of International Classification of Functioning, Disability and Health were documented in implementation plans for adults with profound intellectual disability or profound intellectual and multiple disabilities with focus on participation. A document analysis of 17 implementation plans was performed and International Classification of Functioning, Disability and Health was used as an analytic tool. One hundred and sixty-three different codes were identified, especially in the components Activities and participation and Environmental factors. Participation was most frequently coded in the chapters Community, social and civic life and Self-care. Overall, the results showed that focus in the implementation plans concerned Self-care and Community, social and civic life. The other life areas in Activities and participation were seldom, or not at all, documented. A deeper focus on participation in the implementation plans and all life areas in the component Activities and participation is needed. It is important that the documentation clearly shows what the adult wants, wishes, and likes in everyday life. It is also important to ensure that the job description for staff contains both life areas and individual preferences so that staff have the possibility to work to fulfill social and individual participation for the target group. Implications for rehabilitation There is a need for functioning working models to increase participation significantly for adults with profound intellectual disability or profound intellectual and multiple disabilities. For these adults, participation is achieved through the assistance of others and support and services carried out must be documented in an implementation plan. The International Classification of Functioning, Disability and Health can be used to support staff and ensure that information about the most important factors in an individual's functioning in their environment is not omitted in

  9. Impacts of a book reading club intervention on enhancing parents' positive thinking.

    Science.gov (United States)

    Hong, Zuway-R; Lin, Huann-shyang

    2012-03-01

    This study investigated the effects of participating in a book reading club on improving parents' positive interactions with children and positive thinking. A total of 85 parent volunteers were randomized into the experimental or comparison group. The Parent Questionnaire was used to measure positive thinking and interaction with children. Additionally interview results were used to triangulate and elucidate the findings. The findings revealed a positive impact on parents' positive thinking and interaction with children and that these were significant predictors of parents' positive thinking. Implications and recommendations are presented.

  10. The impact of shifting vantage perspective when recalling and imagining positive events.

    Science.gov (United States)

    Vella, Nicholas C; Moulds, Michelle L

    2014-01-01

    The vantage perspective from which memories are recalled influences their emotional impact. To date, however, the impact of vantage perspective on the emotions elicited by positive memories and images of positive future events has been minimally explored. We experimentally manipulated the vantage perspective from which a sample of undergraduate students (n =80) recalled positive memories and imagined positive future events. Participants who naturally recalled their positive memories from a field perspective reported decreased vividness and positive affect (i.e., happiness, optimism, hopefulness) when they were instructed to shift to an observer perspective. The same pattern of emotionality ratings was observed when participants' vantage perspective of imagined future events was manipulated. In contrast, shifting participants from observer to field perspective recall of positive memories did not result in changes in ratings of memory-related emotion, although we found an unexpected trend towards reduced vividness. For positive future events, shifting from an observer to a field perspective resulted in decreased vividness but did not lead to any changes in positive emotion. Our findings confirm that vantage perspective plays a key role in determining the emotional impact of positive memories, and demonstrate that this relationship is also evident for images of future positive events.

  11. Impact of knee support and shape of tabletop on rectum and prostate position

    NARCIS (Netherlands)

    Steenbakkers, Roel J. H. M.; Duppen, Joop C.; Betgen, Anja; Lotz, Heidi Th; Remeijer, Peter; Fitton, Isabelle; Nowak, Peter J. C. M.; van Herk, Marcel; Rasch, Coen R. N.

    2004-01-01

    PURPOSE: To evaluate the impact of different tabletops with or without a knee support on the position of the rectum, prostate, and bulb of the penis; and to evaluate the effect of these patient-positioning devices on treatment planning. METHODS AND MATERIALS: For 10 male volunteers, five MRI scans

  12. A Contingency Approach to Communication Skill Importance: The Impact of Occupation, Direction, and Position.

    Science.gov (United States)

    Di Salvo, Vincent S.; Larsen, Janet K.

    1987-01-01

    Examines the impact of direction and occupation on the importance of communication skills for entry-level positions in finance, management, engineering, and law. Results substantiate a three-dimensional model (based on direction, occupation, and position) for the examination and application of communication skill importance in organization. (JD)

  13. Teacher Burnout: Stylish Fad or Profound Problem.

    Science.gov (United States)

    Cunningham, William G.

    1982-01-01

    Evidence suggests that teacher burnout has significant impact on the quality of education and on teacher job satisfaction. Its causes include job stress and organizational structures or professional relationships. Reduction of burnout may come from such strategies as increased teacher role differentiation, greater teacher support, and improved…

  14. Speech perception, production and intelligibility in French-speaking children with profound hearing loss and early cochlear implantation after congenital cytomegalovirus infection.

    Science.gov (United States)

    Laccourreye, L; Ettienne, V; Prang, I; Couloigner, V; Garabedian, E-N; Loundon, N

    2015-12-01

    To analyze speech in children with profound hearing loss following congenital cytomegalovirus (cCMV) infection with cochlear implantation (CI) before the age of 3 years. In a cohort of 15 children with profound hearing loss, speech perception, production and intelligibility were assessed before and 3 years after CI; variables impacting results were explored. Post-CI, median word recognition was 74% on closed-list and 48% on open-list testing; 80% of children acquired speech production; and 60% were intelligible for all listeners or listeners attentive to lip-reading and/or aware of the child's hearing loss. Univariate analysis identified 3 variables (mean post-CI hearing threshold, bilateral vestibular areflexia, and brain abnormality on MRI) with significant negative impact on the development of speech perception, production and intelligibility. CI showed positive impact on hearing and speech in children with post-cCMV profound hearing loss. Our study demonstrated the key role of maximizing post-CI hearing gain. A few children had insufficient progress, especially in case of bilateral vestibular areflexia and/or brain abnormality on MRI. This led us to suggest that balance rehabilitation and speech therapy should be intensified in such cases. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  15. Frequency of head-impact-related outcomes by position in NCAA division I collegiate football players.

    Science.gov (United States)

    Baugh, Christine M; Kiernan, Patrick T; Kroshus, Emily; Daneshvar, Daniel H; Montenigro, Philip H; McKee, Ann C; Stern, Robert A

    2015-03-01

    Concussions and subconcussive impacts sustained in American football have been associated with short- and long-term neurological impairment, but differences in head impact outcomes across playing positions are not well understood. The American Medical Society for Sports Medicine has identified playing position as a key risk factor for concussion in football and one for which additional research is needed. This study examined variation in head impact outcomes across primary football playing positions in a group of 730 National Collegiate Athletic Association Division I Football Championship Series athletes, using a self-report questionnaire. Although there were no significant differences between position groups in the number of diagnosed concussions during the 2012 football season, there were significant differences between groups in undiagnosed concussions (p=0.008) and "dings" (pfootball season, with offensive linemen reporting significantly more symptoms compared to most other groups. There were also positional differences in frequency of returning to play while symptomatic (p<0.001) and frequency of participating in full-contact practice (p<0.001). Offensive linemen reported having returned to play while experiencing symptoms more frequently and participating in more full-contact practices than other groups. These findings suggest that offensive linemen, a position group that experiences frequent, but low-magnitude, head impacts, develop more postimpact symptoms than other playing positions, but do not report these symptoms as a concussion.

  16. Informal social networks of people with profound intellectual and multiple disabilities : Relationship with age, communicative abilities and current living arrangements

    NARCIS (Netherlands)

    Kamstra, A.; van der Putten, A.A.J.; Post, W.J.; Vlaskamp, C.

    2015-01-01

    BACKGROUND: People with profound intellectual and multiple disabilities (PIMD) have limited informal social contacts. Research to determine the factors which can positively influence establishing sound informal social contacts is required. MATERIALS AND METHODS: Regression analysis for 200 people

  17. A technique for position sensing and improved momentum evaluation of microparticle impacts in space.

    Science.gov (United States)

    Mcdonnell, J. A. M.; Abellanas, C.

    1972-01-01

    The design of a three element piezoelectric microparticle impact sensing diaphragm is described which is sensitive to the detection of momentum propagated by the bending wave. The design achieves a sensitivity of .03 microdyn/sec and optimizes the detection of the direct-path pulse from impact relative to secondary reflections and interference from discontinuities. Measurement of the relative arrival times and the maximum amplitudes of the outputs from the three piezoelectric sensors leads to the determination of the impact position and the normally resolved impact momentum exchange. Coincidence of the signals and a partial redundancy of data leads to a very high noise discrimination.

  18. Social Peer Interactions in Persons with Profound Intellectual and Multiple Disabilities: A Literature Review

    Science.gov (United States)

    Nijs, Sara; Maes, Bea

    2014-01-01

    Social interactions may positively influence developmental and quality of life outcomes. Research in persons with profound intellectual and multiple disabilities (PIMD) mostly investigated interactions with caregivers. This literature review focuses on peer interactions of persons with PIMD. A computerized literature search of three databases was…

  19. What determines positive, neutral, and negative impacts of Solidago canadensis invasion on native plant species richness?

    Science.gov (United States)

    Dong, Li-Jia; Yu, Hong-Wei; He, Wei-Ming

    2015-11-17

    Whether plant invasions pose a great threat to native plant diversity is still hotly debated due to conflicting findings. More importantly, we know little about the mechanisms of invasion impacts on native plant richness. We examined how Solidago canadensis invasion influenced native plants using data from 291 pairs of invaded and uninvaded plots covering an entire invaded range, and quantified the relative contributions of climate, recipient communities, and S. canadensis to invasion impacts. There were three types of invasion consequences for native plant species richness (i.e., positive, neutral, and negative impacts). Overall, the relative contributions of recipient communities, S. canadensis and climate to invasion impacts were 71.39%, 21.46% and 7.15%, respectively; furthermore, the roles of recipient communities, S. canadensis and climate were largely ascribed to plant diversity, density and cover, and precipitation. In terms of direct effects, invasion impacts were negatively linked to temperature and native plant communities, and positively to precipitation and soil microbes. Soil microbes were crucial in the network of indirect effects on invasion impacts. These findings suggest that the characteristics of recipient communities are the most important determinants of invasion impacts and that invasion impacts may be a continuum across an entire invaded range.

  20. Control of secondary electrons from ion beam impact using a positive potential electrode

    Energy Technology Data Exchange (ETDEWEB)

    Crowley, T. P., E-mail: tpcrowley@xanthotechnologies.com; Demers, D. R.; Fimognari, P. J. [Xantho Technologies, LLC, Madison, Wisconsin 53705 (United States)

    2016-11-15

    Secondary electrons emitted when an ion beam impacts a detector can amplify the ion beam signal, but also introduce errors if electrons from one detector propagate to another. A potassium ion beam and a detector comprised of ten impact wires, four split-plates, and a pair of biased electrodes were used to demonstrate that a low-voltage, positive electrode can be used to maintain the beneficial amplification effect while greatly reducing the error introduced from the electrons traveling between detector elements.

  1. Impacts of Satellite Orbit and Clock on Real-Time GPS Point and Relative Positioning.

    Science.gov (United States)

    Shi, Junbo; Wang, Gaojing; Han, Xianquan; Guo, Jiming

    2017-06-12

    Satellite orbit and clock corrections are always treated as known quantities in GPS positioning models. Therefore, any error in the satellite orbit and clock products will probably cause significant consequences for GPS positioning, especially for real-time applications. Currently three types of satellite products have been made available for real-time positioning, including the broadcast ephemeris, the International GNSS Service (IGS) predicted ultra-rapid product, and the real-time product. In this study, these three predicted/real-time satellite orbit and clock products are first evaluated with respect to the post-mission IGS final product, which demonstrates cm to m level orbit accuracies and sub-ns to ns level clock accuracies. Impacts of real-time satellite orbit and clock products on GPS point and relative positioning are then investigated using the P3 and GAMIT software packages, respectively. Numerical results show that the real-time satellite clock corrections affect the point positioning more significantly than the orbit corrections. On the contrary, only the real-time orbit corrections impact the relative positioning. Compared with the positioning solution using the IGS final product with the nominal orbit accuracy of ~2.5 cm, the real-time broadcast ephemeris with ~2 m orbit accuracy provided <2 cm relative positioning error for baselines no longer than 216 km. As for the baselines ranging from 574 to 2982 km, the cm-dm level positioning error was identified for the relative positioning solution using the broadcast ephemeris. The real-time product could result in <5 mm relative positioning accuracy for baselines within 2982 km, slightly better than the predicted ultra-rapid product.

  2. Impacts of Satellite Orbit and Clock on Real-Time GPS Point and Relative Positioning

    Directory of Open Access Journals (Sweden)

    Junbo Shi

    2017-06-01

    Full Text Available Satellite orbit and clock corrections are always treated as known quantities in GPS positioning models. Therefore, any error in the satellite orbit and clock products will probably cause significant consequences for GPS positioning, especially for real-time applications. Currently three types of satellite products have been made available for real-time positioning, including the broadcast ephemeris, the International GNSS Service (IGS predicted ultra-rapid product, and the real-time product. In this study, these three predicted/real-time satellite orbit and clock products are first evaluated with respect to the post-mission IGS final product, which demonstrates cm to m level orbit accuracies and sub-ns to ns level clock accuracies. Impacts of real-time satellite orbit and clock products on GPS point and relative positioning are then investigated using the P3 and GAMIT software packages, respectively. Numerical results show that the real-time satellite clock corrections affect the point positioning more significantly than the orbit corrections. On the contrary, only the real-time orbit corrections impact the relative positioning. Compared with the positioning solution using the IGS final product with the nominal orbit accuracy of ~2.5 cm, the real-time broadcast ephemeris with ~2 m orbit accuracy provided <2 cm relative positioning error for baselines no longer than 216 km. As for the baselines ranging from 574 to 2982 km, the cm–dm level positioning error was identified for the relative positioning solution using the broadcast ephemeris. The real-time product could result in <5 mm relative positioning accuracy for baselines within 2982 km, slightly better than the predicted ultra-rapid product.

  3. Characterization and management trends of negative and positive impacts of tourism in show caves

    Directory of Open Access Journals (Sweden)

    Heros Augusto Santos Lobo

    2015-08-01

    Full Text Available Caves are one of the most fragile environments on Earth ’s surface, in function of physical, atmospheric and biological specificities. The natural characteristics associated with cultural aspects of local people are the reasons to tourist potential of caves. However, the tourist use of caves can generate negative impacts on the environment. This consequence happens when inappropriate procedures of planning and management of tourism are used. Negative impacts are described in this review, as also indications of management techniques to avoid, decrease or eliminate the negative consequences of tourism in caves. Positive impacts are also presented, in order to achieve a sustainable tourism in show caves. The conclusion argues that the negative impacts should not be considered as impediments to tourism in caves. It is important to know these impacts and use it as a key to get previous answers which allow to raise the sustainability of show caves.

  4. The Impact of a Positive Environment and Shared Leadership to Empower Collegial School Culture

    Science.gov (United States)

    Pretz, Benjamin

    2017-01-01

    The purpose of this study is to develop an empowered collegial school culture to systemically improve the function of the academic institution through the impact of a positive environment and shared leadership. When compared to the other middle schools in the district, Eagle Middle School had the lowest math achievement growth index during the…

  5. The Impact of Budget Cutbacks on Music Teaching Positions and District Funding in Three Midwestern States

    Science.gov (United States)

    Burrack, Frederick William; Payne, Phillip; Bazan, Dale E.; Hellman, Daniel S.

    2014-01-01

    The purpose of this study was to investigate the existence and impact of budgetary cutbacks to music teaching positions and district funding in three Midwestern states, namely Kansas, Nebraska, and Missouri. The results revealed cuts to staffing and district funding of music programs without a reduction in student enrollments in 2011-2012…

  6. Impact of socioeconomic position and distance on mental health care utilization

    DEFF Research Database (Denmark)

    Packness, Aake; Waldorff, Frans Boch; Christensen, René dePont

    2017-01-01

    Purpose: To determine the impact of socioeconomic position (SEP) and distance to provider on outpatient mental health care utilization among incident users of antidepressants. Method: A nationwide register-based cohort study of 50,374 person-years. Results: Persons in low SEP were more likely...

  7. Proximal processes of children with profound multiple disabilities

    OpenAIRE

    Wilder, Jenny

    2008-01-01

    In this thesis four empirical studies dealt with children with profound multiple disabilities and their parents with regard to: (a) how parents perceived interaction with their children (b) how observed child/parent interaction was linked to behavior style of the children as perceived by the parents (c) how parents of children with profound multiple disabilities perceived child/parent interaction and behavior style of their children in comparison to parents to children without disabilities ma...

  8. Family matters: The experiences and opinions of family members of persons with (severe) or profound intellectual disabilities

    OpenAIRE

    Luijkx, Jorien

    2016-01-01

    “I love my sister, but sometimes I don’t”. This is one of the statements made in the study focused on the experiences of family members of people with (profound) intellectual (and multiple) disabilities (both of individuals living in a residential facility as persons living at home). In recent years, there has been greater recognition of the important position of parents and siblings of people with (profound) intellectual (and multiple) disabilities and the importance of the wellbeing of all ...

  9. Business Organizations’ Positive Socio-Economic Impact on Society - a Step Beyond CSR

    Directory of Open Access Journals (Sweden)

    Mirela POPA

    2015-12-01

    Full Text Available In this article the authors argue the necessity of taking a step beyond CSR and tackling the issue of measuring the impact businesses have on society, in general. Even if CSR points out the idea that organizations have responsibilities regarding the well-being of the entire society, it has certain limitations listed in this article. Furthermore, the authors briefly present the socio-economic impact of business organizations including (1 some basic concepts, (2 the most relevant areas/fields for measuring the impact, and (3 the main advantages regarding the development and implementation of effective impact measurement practices. The general purpose of the empirical study refers to the identification of perceptions related to the Romanian business organizations’ socio-economic impact. In this regard, we set the following main objectives: (1 identifying the extent to which Romanian organizations undertake a process of measuring, assessing and managing their impacts on society, (2 analyzing clients, managers and owners’ perceptions regarding the positive impact of seven Romanian organizations’ activities, and (3 identifying the perceptional differences between clients and managers plus owners. The empirical results show that in the managers’ plus owners’ opinions the areas in which the organization’s activities always or almost always have a positive impact are: collecting and paying taxes, keeping a strict control over the costs, and fulfilling government regulations plus obeying laws. The highest differences in clients’ and managers’ plus owners’ perceptions refer to creating jobs and improving people’s personal security and the general well-being of society.

  10. Impact of Surface Type, Wheelchair Weight, and Axle Position on Wheelchair Propulsion by Novice Older Adults

    Science.gov (United States)

    Cowan, Rachel E.; Nash, Mark S.; Collinger, Jennifer L.; Koontz, Alicia M.; Boninger, Michael L.

    2009-01-01

    Objective To examine the impact of surface type, wheelchair weight, and rear axle position on older adult propulsion biomechanics. Design Crossover trial. Setting Biomechanics laboratory. Participants Convenience sample of 53 ambulatory older adults with minimal wheelchair experience (65−87y); men = 20, women = 33. Intervention Participants propelled 4 different wheelchair configurations over 4 surfaces; tile, low carpet, high carpet, and an 8% grade ramp (surface, chair order randomized). Chair configurations included: (1) unweighted chair with an anterior axle position, (2) 9.05kg weighted chair with an anterior axle position, (3) unweighted chair with a posterior axle position (Δ0.08m), and (4) 9.05kg weighted chair with a posterior axle position (Δ0.08m). Weight was added to a titanium folding chair, simulating the weight difference between very light and depot wheelchairs. Instrumented wheels measured propulsion kinetics. Main Outcome Measures Average self-selected velocity, push-frequency, stroke length, peak resultant and tangential force. Results Velocity decreased as surface rolling resistance or chair weight increased. Peak resultant and tangential forces increased as chair weight increased, surface resistance increased, and with a posterior axle position. The effect of a posterior axle position was greater on high carpet and the ramp. The effect of weight was constant, but more easily observed on high carpet and ramp. The effects of axle position and weight were independent of one another. Conclusion Increased surface resistance decreases self-selected velocity and increases peak forces. Increased weight decreases self-selected velocity and increases forces. Anterior axle positions decrease forces, more so on high carpet. Effects of weight and axle position are independent. Greatest reductions in peak forces occur in lighter chairs with anterior axle positions. PMID:19577019

  11. Positive and Negative Impacts of Non-Native Bee Species around the World.

    Science.gov (United States)

    Russo, Laura

    2016-11-28

    Though they are relatively understudied, non-native bees are ubiquitous and have enormous potential economic and environmental impacts. These impacts may be positive or negative, and are often unquantified. In this manuscript, I review literature on the known distribution and environmental and economic impacts of 80 species of introduced bees. The potential negative impacts of non-native bees include competition with native bees for nesting sites or floral resources, pollination of invasive weeds, co-invasion with pathogens and parasites, genetic introgression, damage to buildings, affecting the pollination of native plant species, and changing the structure of native pollination networks. The potential positive impacts of non-native bees include agricultural pollination, availability for scientific research, rescue of native species, and resilience to human-mediated disturbance and climate change. Most non-native bee species are accidentally introduced and nest in stems, twigs, and cavities in wood. In terms of number of species, the best represented families are Megachilidae and Apidae, and the best represented genus is Megachile . The best studied genera are Apis and Bombus , and most of the species in these genera were deliberately introduced for agricultural pollination. Thus, we know little about the majority of non-native bees, accidentally introduced or spreading beyond their native ranges.

  12. Positive and Negative Impacts of Non-Native Bee Species around the World

    Directory of Open Access Journals (Sweden)

    Laura Russo

    2016-11-01

    Full Text Available Though they are relatively understudied, non-native bees are ubiquitous and have enormous potential economic and environmental impacts. These impacts may be positive or negative, and are often unquantified. In this manuscript, I review literature on the known distribution and environmental and economic impacts of 80 species of introduced bees. The potential negative impacts of non-native bees include competition with native bees for nesting sites or floral resources, pollination of invasive weeds, co-invasion with pathogens and parasites, genetic introgression, damage to buildings, affecting the pollination of native plant species, and changing the structure of native pollination networks. The potential positive impacts of non-native bees include agricultural pollination, availability for scientific research, rescue of native species, and resilience to human-mediated disturbance and climate change. Most non-native bee species are accidentally introduced and nest in stems, twigs, and cavities in wood. In terms of number of species, the best represented families are Megachilidae and Apidae, and the best represented genus is Megachile. The best studied genera are Apis and Bombus, and most of the species in these genera were deliberately introduced for agricultural pollination. Thus, we know little about the majority of non-native bees, accidentally introduced or spreading beyond their native ranges.

  13. IMPACT OF MEDICAL AND SOCIAL FACTORS ON SURGICAL OUTCOMES OF PULMONARY TUBERCULOSIS IN HIV POSITIVE PATIENTS

    Directory of Open Access Journals (Sweden)

    D. V. Аlkаz

    2018-01-01

    Full Text Available The article presents the study of the impact of social and medical factors and bad habits on the outcomes of planned surgery in 95 patients with concurrent respiratory tuberculosis and HIV infection The correlation analysis was performed which discovered the factors providing a positive impact on treatment outcomes The following factors have the strongest association with treatment outcome: patient's regular job, family, no alcohol or nicotine addiction, a form of tuberculosis, and administration of antiretroviral therapy It was noted that surgery outcome could be predicted and potential complications prevented 

  14. Impact of patient positioning on radiotherapy dose distribution: An assessment in parotid tumor

    Directory of Open Access Journals (Sweden)

    Seema Sharma

    2016-03-01

    Full Text Available Purpose: We intended to study the impact of patient positioning on the dose distribution within target volume and organs at risk in patients with parotid malignancies treated with 3D conformal radiotherapy (3D-CRT with photon wedge pair (WP or intensity modulated radiotherapy (IMRT.Methods: Three patients with a non-Hodgkin’s lymphoma of the right parotid gland were consecutively immobilized using thermoplastic cast in 2 positions: supine with head in neutral position (HN and with head turned 90° to the left side (HT. Images for treatment planning purpose were acquired in both positions. For both positions, photon WP plans and 5 field IMRT plans were generated, after contouring clinical target volume (CTV, planning target volume (PTV= CTV + 5 mm margin and organs at risk (OAR. All plans were evaluated for target coverage and dose to OARs.Results: Both CTV and PTV were apparently larger in HN compared with HT (31.76±8.89 cc, 30.31±7.83 cc and 62.49±19.01 cc, 58.89±15.33 cc respectively. The CI value for PTV was slightly better for HT compared to HN position in both the WP and IMRT plans. The homogeneity was comparable in both the head positions in case of WP plan. The mean HI of PTV was increased in case of IMRT plan at HT versus HN position (1.108 vs. 1.097. A change in head position from HN to HT with wedge pair plan resulted in a reduction of brainstem Dmax and Dmean. Lesser dose was observed in HN position for contralateral parotid. A difference of 0.9 Gy in the average Dmax to spinal cord was seen. The values of Dmean to mandible, oral cavity, ipsilateral and contralateral cochlea were higher in the HT position. A change in head position from HN to HT with IMRT plan resulted in a dose reduction in average Dmax to brainstem. The spinal cord Dmax increased at the HT position by 1.2 Gy. The dose to contralateral parotid and cochlea was comparable in both the positions. However, the Dmean to oral cavity was reduced at HT position. Whereas

  15. A prospective study of the psychosocial impact of a positive Chlamydia trachomatis laboratory test.

    Science.gov (United States)

    Gottlieb, Sami L; Stoner, Bradley P; Zaidi, Akbar A; Buckel, Christina; Tran, Molly; Leichliter, Jami S; Berman, Stuart M; Markowitz, Lauri E

    2011-11-01

    Few data exist on potential harms of chlamydia screening. We assessed the psychosocial impact of receiving a positive Chlamydia trachomatis test result. We prospectively studied women ≥16 years of age undergoing chlamydia testing in 2 Midwestern family planning clinics. We surveyed women at baseline and about 1 month after receiving test results, using 9 validated psychosocial scales/subscales and chlamydia-specific questions. Changes in scale scores were calculated for each woman. Mean percent changes in scores for chlamydia-positive and -negative women were compared using a t test. We enrolled 1807 women (response rate, 84%). Of the 1688 women with test results, 149 (8.8%) tested positive. At follow-up, chlamydia-positive women (n = 71) had a 75% increase in anxiety about sexual aspects of their life on the Multidimensional Sexual Self-Concept Questionnaire (P < 0.001), significantly greater than the 26% increase among 280 randomly selected chlamydia-negative women (P = 0.02). There were no differences for the other 8 scales/subscales, including general measures of anxiety, depression, and self-esteem. Chlamydia-positive women were more likely than chlamydia-negative women to be "concerned about chlamydia" (80% vs. 40%, P < 0.001) and to report breaking up with a main partner (33% vs. 11%, P < 0.001) at follow-up. Women testing positive reported a range of chlamydia-specific concerns. Chlamydia-positive women had significant increases in anxiety about sex and concern about chlamydia, but did not have marked changes in more general measures of psychosocial well-being about 1 month after diagnosis. Chlamydia diagnoses were associated with some disruption of relationships with main partners. Chlamydia-specific concerns may guide counseling messages to minimize psychosocial impact.

  16. Impact of Positive Emotions Enhancement on Physiological Processes and Psychological Functioning in Military Pilots

    Science.gov (United States)

    2009-10-01

    behavioral therapy for bulimia nervosa: time course and mechanisms of change. Journal of Clinical consulting Psychology 2002, 20, 267-274. [44...RTO-MP-HFM-181 14 - 1 Impact of Positive Emotions Enhancement on Physiological Processes and Psychological Functioning in Military Pilots...practical tool using different techniques in order to improve regulation of emotions before, during and after actions [3]. This psychological training is

  17. Electron impact excitation of positive ions calculated in the Coulomb-Born approximation

    International Nuclear Information System (INIS)

    Nakazaki, Shinobu; Hashino, Tasuke

    1979-08-01

    Theoretical results on the electron impact excitation of positive ions are surveyed through the end of 1978. As a guide to the available data, a list of references is made. The list shows ion species, transitions, energy range and methods of calculation for the respective data. Based on the literature survey, the validity of the Coulomb-Born approximation is investigated. Comparisons with the results of the close-coupling and the distorted-wave methods are briefly summarized. (author)

  18. How organisational behaviours and human factors can positively impact contractors to nuclear power plants

    International Nuclear Information System (INIS)

    Arnaldos Gonzalez, A.; Walker-Sutton, J.; Shannon, M.; Mendoza Garcia, J.

    2012-01-01

    Organisational behaviours have a significant impact on individual and group behaviours but are frequently ignored during the design, planning and scheduling of work or when conducting an investigation of events. Why should it matter? It is important to calculate the personal and organisational impact and cost of those elements which contribute to organisational safety. We look at two nuclear contractor organisations (one in Spain and one in the UK) that are actively making a positive difference to their behaviours in a commercial nuclear environment. They are creating a better business environment for their staff, and a robust business differentiator for future work with their clients. We consider what the cost and impact is of the changes they have made to their organisational behaviours.

  19. Transitions in the Swedish school system and the impact on student's positive self-reported-health.

    Science.gov (United States)

    Holmström, Malin Rising; Olofsson, Niclas; Asplund, Kenneth; Kristiansen, Lisbeth

    2014-10-07

    To explore three school based transitions and their impact on positive self-reported-health (SRH), pre-school to elementary school (6-10 y), elementary school to junior high school (10-13 y), and junior high school to upper secondary school/high school (13-16 y), in a long-term longitudinal population based study. The study followed three cohorts through one school transition each. A longitudinal study with data from 6693 Health Dialogue questionnaires were used. Data were collected in the middle of Sweden during 2007-2012 with school children age 6-16 years old. Several significant factors were identified with an impact for a positive self-reported-health among children age 6-16 y; not feeling sad or depressed, afraid or worried, positive school environment (schoolyard and restrooms), not bullied, good sleep, daily physical activity and ability to concentrate. There was no single factor identified, the factors differed according to gender and age. The study have identified several gender and age specific factors for successful school transitions relevant for a positive SRH. This is valuable information for school staff, parents and school children and provides a possibility to provide support and assistance when needed.

  20. The Impact of Positive and Negative Affect and Issue Framing on Issue Interpretation and Risk Taking.

    Science.gov (United States)

    Mittal; Ross

    1998-12-01

    Two studies examined the influence of transient affective states and issue framing on issue interpretation and risk taking within the context of strategic decision making. In Study 1, participants in whom transient positive or negative affective states were induced by reading a short story showed systematic differences in issue interpretation and risk taking in a strategic decision making context. Compared to negative mood participants, those in a positive mood were more likely to interpret the strategic issue as an opportunity and displayed lower levels of risk taking. Study 2 replicated and extended these results by crossing affective states with threat and opportunity frames. Results showed that framing an issue (as a threat or an opportunity) had a stronger impact on issue interpretation among negative affect participants than among positive affect participants. Affective states also moderated the impact of issue framing on risk taking: the effect of framing on risk-taking was stronger under negative rather than positive affect. These results are interpreted via information-processing and motivational effects of affect on a decision maker. Copyright 1998 Academic Press.

  1. Implementation and impact of in-class physical activities in a positive mental health perspective

    DEFF Research Database (Denmark)

    Christiansen, Lars Breum Skov; Holt, Anne-Didde; Smedegaard, Søren

    Introduction School physical activity and other activities with the body in focus hold the potential to benefit student’s positive mental health and psychosocial well-being. In-class activities (ICAs) (e.g. energizers, active breaks, brain breaks) can positively influence social connectedness......, physical self-perception, motivation and emotions. However, if all students are to benefit from the potential qualities of ICA, an inclusive environment is crucial. The purpose of this study was to investigate the implementation and impact of ICA in Danish public schools. Methods ICA is one of three...... tool to promote positive mental health and well-being in schools for all students. For many teachers, ICA is a challenging task, which calls for both competence development, supportive structures, materials and local school leadership....

  2. Positive and negative psychological impact after secondary exposure to politically motivated violence among body handlers and rehabilitation workers.

    Science.gov (United States)

    Shiri, Shimon; Wexler, Isaiah D; Alkalay, Yasmin; Meiner, Zeev; Kreitler, Shulamith

    2008-12-01

    The positive and negative psychological impact of secondary exposure to politically motivated violence was examined among body handlers and hospital rehabilitation workers, 2 groups that differed in their proximity and immediacy to violent events. Survivors of politically motivated violence served as a comparison group. Body handlers experienced high levels of positive psychological impact and traumatic stress symptoms. Levels of positive psychological impact among on-scene body handlers were higher than those experienced by rehabilitation workers. Traumatic stress symptoms predicted positive psychological impact among body handlers. These findings indicate that proximity to stressors is associated with higher levels of positive and negative psychological impact. Physical proximity is a major contributory factor to both positive and negative psychological effects of secondary exposure to trauma.

  3. Creativity as an Attribute of Positive Psychology: The Impact of Positive and Negative Affect on the Creative Personality

    Science.gov (United States)

    Charyton, Christine; Hutchison, Shannon; Snow, Lindsay; Rahman, Mohammed A.; Elliott, John O.

    2009-01-01

    Positive psychology explores how optimism can lead to health, happiness, and creativity. However, questions remain as to how affective states influence creativity. Data on creative personality, optimism, pessimism, positive and negative affect, and current and usual happiness ratings were collected on 161 college students enrolled in an…

  4. Piezosurgery for the Lingual Split Technique in Lingual Positioned Impacted Mandibular Third Molar Removal

    Science.gov (United States)

    Ge, Jing; Yang, Chi; Zheng, Jiawei; Qian, Wentao

    2016-01-01

    Abstract The aim of this study was to evaluate the effect and safety of lingual split technique using piezosurgery for the extraction of lingual positioned impacted mandibular 3rd molars with the goal of proposing a more minimally invasive choice for this common surgery. Eighty-nine consecutive patients with 110 lingual positioned impacted mandibular 3rd molars requiring extraction were performed the lingual split technique using piezosurgery. One sagittal osteotomy line and 2 transverse osteotomy line were designed for lingual and occlusal bone removal. The success rate, operative time, postoperative outcome, and major complications (including nerve injury, mandible fracture, severe hematoma or edema, and severe pyogenic infection) were documented and analyzed. All impacted mandibular 3rd molars were successfully removed (110/110). The average time of operation was 14.6 minutes (ranged from 7 to 28 minutes). One hundred and seven extraction sites (97.3%) were primary healing. Pain, mouth opening, swelling, and PoSSe scores on postoperative 7-day were 0.34 ± 0.63, 3.88 ± 0.66(cm), 2.4 ± 0.2(cm), and 23.7 ± 5.9, respectively. There were 6 cases (5.5%) had lingual nerve disturbance and 3 cases (2.7%) developed inferior alveolar nerve impairment, and achieved full recovery within 2 months by neurotrophic drug treatment. Our study suggested piezosurgery for lingual split technique provided an effective way for the extraction of lingual positioned and deeply impacted mandibular 3rd molar. PMID:27015214

  5. Negative and positive impact of internet addiction on young adults: Empericial study in Malaysia

    Directory of Open Access Journals (Sweden)

    Syed Shah Alam

    2014-05-01

    Full Text Available Purpose: The purpose of this study is to explore and identify the impact of internet addictions of young adults in Malaysia. There are six impacts identified, of which five are negative impacts and one is positive impact.Design/methodology/approach: This study comprised sample of 200 young adults in Malaysia. A cross-sectional research design was used to examine the impact of Internet addiction. Data were gathered based on personal administered questionnaire.Findings and Originality/value: This study results show that five negative impacts of excessive internet usages such as interpersonal problem, behavioural problem, physical problem, psychological problem, and work problem of young adults.The young adults believed that the internet usage can help them to improve their skills for doing their work better. This study also reveals that males have a great impact on working problems, psychological problems, behavioural problems and interpersonal problems than female adults. On the other hand, females are leading with their physical problems by getting Internet addiction.Research limitations/implications: The data for this study are collected by self-administered questionnaire, a method with well-known shortcomings. Secondly, this study done only on young adults from only two universities in Malaysia.Practical implications: An important implication of this research is that the interesting findings give some insight to the Internet users to focus on improving Internet usage habits. Originality/value: The findings are original and unique and are based on the literature from different western researches. The results are based on a sample of young adults in Malaysia. The research findings are useful to academics and heavy Internet users those are hooked with Internet to their everyday life.

  6. Positive media portrayals of obese persons: impact on attitudes and image preferences.

    Science.gov (United States)

    Pearl, Rebecca L; Puhl, Rebecca M; Brownell, Kelly D

    2012-11-01

    The purpose of this research was to assess the impact of nonstereotypical, positive media portrayals of obese persons on biased attitudes, as well as propose a change in media practices that could reduce public weight bias and consequent negative health outcomes for those who experience weight stigma. Two online experiments were conducted in which participants viewed either a stigmatizing or a positive photograph of an obese model. In Experiment 1 (N = 146), participants viewed a photograph of either a Caucasian or African American obese woman; in Experiment 2 (N = 145), participants viewed either a Caucasian male or female obese model. Multiple linear regression models were used to analyze outcomes for social distance attitudes toward the obese models depicted in the images, in addition to other negative attitudes and image preferences. Participants who viewed the stigmatizing images endorsed stronger social distance attitudes and more negative attitudes toward obese persons than participants who viewed the positive images, and there was a stronger preference for the positive images than the stigmatizing images. These results were consistent regardless of the race or gender of the obese model pictured. The findings indicate that more positive media portrayals of obese individuals may help reduce weight stigma and its associated negative health outcomes.

  7. Impact of ART on the fertility of HIV-positive women in sub-Saharan Africa.

    Science.gov (United States)

    Yeatman, Sara; Eaton, Jeffrey W; Beckles, Zosia; Benton, Lorna; Gregson, Simon; Zaba, Basia

    2016-09-01

    Understanding the fertility of HIV-positive women is critical to estimating HIV epidemic trends from surveillance data and to planning resource needs and coverage of prevention of mother-to-child transmission services in sub-Saharan Africa. In the light of the considerable scale-up in antiretroviral therapy (ART) coverage over the last decade, we conducted a systematic review of the impact of ART on the fertility outcomes of HIV-positive women. We searched Medline, Embase, Popline, PubMed and African Index Medicus. Studies were included if they were conducted in sub-Saharan Africa and provided estimates of fertility outcomes (live births or pregnancies) among women on ART relative to a comparison group. Of 2070 unique references, 18 published papers met all eligibility criteria. Comparisons fell into four categories: fertility of HIV-positive women relative to HIV-negative women; fertility of HIV-positive women on ART compared to those not yet on ART; fertility differences by duration on ART; and temporal trends in fertility among HIV-positive women. Evidence indicates that fertility increases after approximately the first year on ART and that while the fertility deficit of HIV-positive women is shrinking, their fertility remains below that of HIV-negative women. These findings, however, were based on limited data mostly during the period 2005-2010 when ART scaled up. Existing data are insufficient to characterise how ART has affected the fertility of HIV-positive women in sub-Saharan Africa. Improving evidence about fertility among women on ART is an urgent priority for planning HIV resource needs and understanding HIV epidemic trends. Alternative data sources such as antenatal clinic data, general population cohorts and population-based surveys can be harnessed to understand the issue. © 2016 John Wiley & Sons Ltd.

  8. Towards evidence-based classification in wheelchair sports: impact of seating position on wheelchair acceleration.

    Science.gov (United States)

    Vanlandewijck, Yves C; Verellen, Joeri; Tweedy, Sean

    2011-07-01

    In most Paralympic wheelchair sports, active trunk range of movement is assessed by observing shoulder girdle excursion during active trunk movements and is a key determinant of an athlete's class. However, to date research evaluating the impact of reduced trunk range of movement on wheelchair sports performance has not been conducted. In the present study, 15 non-disabled male participants performed two 20-s sprints on a wheelchair ergometer in each of three seating positions. Positions were typical of those used to enhance sitting stability in wheelchair sport and each impacted available trunk range of movement differently: condition-90 (seated with thighs horizontal; unrestricted range of movement) condition-45 (seated with thighs in 45°), and condition-0 (seated with hips maximally flexed; minimum range of movement). In condition-90, the trunk only actively contributed to the first push; for the remainder of the sprint, the trunk was held almost isometrically at 48.2° to the horizontal (range 42.1-56.4°). Similar patterns were observed for both condition-45 and condition-0. Compared with condition-90, participants in condition-0 had reduced capacity to accelerate of statistical (P sports performance, including strapping, seating position, and impairments of trunk muscle power and coordination.

  9. Impact of positive thyroid autoimmunity on pregnant women with subclinical hypothyroidism.

    Science.gov (United States)

    López-Tinoco, Cristina; Rodríguez-Mengual, Amparo; Lara-Barea, Almudena; Barcala, Julia; Larrán, Laura; Saez-Benito, Ana; Aguilar-Diosdado, Manuel

    2018-03-01

    The impact of subclinical hypothyroidism (SH) and thyroid autoimmunity on obstetric and perinatal complications continues to be a matter of interest and highly controversial. To assess the impact of SH and autoimmunity in early pregnancy on the obstetric and perinatal complications in our population. A retrospective cohort study in 435 women with SH (TSH ranging from 3.86 and 10 μIU/mL and normal FT4 values) in the first trimester of pregnancy. Epidemiological and clinical parameters were analyzed and were related to obstetric and perinatal complications based on the presence of autoimmunity (thyroid peroxidase antibodies [TPO] > 34 IU/mL). Mean age was 31.3 years (SD 5.2). Seventeen percent of patients had positive TPO antibodies. Presence of positive autoimmunity was associated to a family history of hypothyroidism (P=.04) and a higher chance of miscarriage (P=.009). In the multivariate analysis, positive TPO antibodies were associated to a 10.25-fold higher risk of miscarriage. No statistically significant associations were found with all other obstetric and perinatal complications. In our region, pregnant women with SH and thyroid autoimmunity had a higher risk of miscarriage but not of other obstetric and perinatal complications. Copyright © 2017 SEEN y SED. Publicado por Elsevier España, S.L.U. All rights reserved.

  10. The relation between gastro-oesophageal reflux, sleeping-position and sudden infant death and its impact on positional therapy

    NARCIS (Netherlands)

    Vandenplas, Y.; Belli, D. C.; Dupont, C.; Kneepkens, C. M.; Heymans, H. S.

    1997-01-01

    Many infants do regurgitate. The recommended therapeutic approach starts with postural and dietary measures, followed by antacids and prokinetics. However, the recent findings regarding the increased risk for sudden infant death (SID) in the prone sleeping position challenge the current

  11. Music Training for Severely and Profoundly Retarded Individuals.

    Science.gov (United States)

    Kesler, Buford; Richmond, Bert O.

    Investigated were the effects of sex, ability and training method on the musical instrument playing ability of 16 institutionalized severely and profoundly retarded persons ages 7 to 20 years. Ss were randomly assigned to one of four treatment groups, and the time required to reach criterion playing a familiar tune was recorded. Data indicated…

  12. Acceleration of Object Permanence with Severely and Profoundly Retarded Children.

    Science.gov (United States)

    Kahn, James V.

    Examined was the effectiveness of training four severely and profoundly retarded children (3-6 years old) to improve their level of functioning on a measure of object permanence and to demonstrate generalization to other areas of sensorimotor intelligence. Ss were given a pretest and posttest on the I. Uzgiris and J. Hunt instrument which consists…

  13. Factors which Motivate Job Acceptance and Profoundly Mentally Retarded Children.

    Science.gov (United States)

    Marozas, Donald S.; May, Deborah C.

    1980-01-01

    The study involving 360 Pennsylvania teachers was designed to identify factors which motivate job acceptance among teachers of severely and profoundly mentally retarded children. The responses of 235 teachers indicated that challenge and practicum experiences were the two most prevalent motivational factors underlying job acceptance. (Author)

  14. Pre-Language Activities for the Profoundly Mentally Retarded.

    Science.gov (United States)

    Poole, Marilyn R.; And Others

    Provided are sample lesson plans for a program to develop pre-language skills in profoundly retarded children and adults. Characteristic of the suggested activities is the stimulation of all sensory channels through structured infant-like play activities in five general areas: oral stimulation, sensory arousal, motor stimulation, vocal play, and…

  15. A Grounded Theory of Effective Reading by Profoundly Deaf Adults

    Science.gov (United States)

    Silvestri, Julia; Wang, Ye

    2018-01-01

    The purpose of the study was to uncover and describe psycholinguistic and sociocognitive factors facilitating effective reading by signing adults who are profoundly deaf and do not use hearing technology. The sample comprised four groups, each consisting of 15 adults, for a total of 60 participants. The four groups were "deaf…

  16. Deming's System of Profound Knowledge: An Overview for International Educators.

    Science.gov (United States)

    Evans, Thomas J.

    W. Edwards Deming called for the transformation to a new style of organizational management based on greater cooperation between managers and employees. This transformation could be achieved by introducing "profound knowledge" into the system. This paper is a presentation outline that was used to introduce the basics of Deming's theory…

  17. Exploring the impact of positive and negative emotions on cooperative behaviour in a Prisoner's Dilemma Game.

    Science.gov (United States)

    Kjell, Oscar N E; Thompson, Sam

    2013-12-19

    Objective. To explore the influences of discrete positive and negative emotions on cooperation in the context of a social dilemma game. Design. Two controlled studies were undertaken. In Study 1, 69 participants were randomly assigned to an essay emotion manipulation task designed to induce either guilt, joy or no strong emotion. In Study 2, 95 participants were randomly assigned to one of the same three tasks, and the impact of emotional condition on cooperation was explored using a repeated Prisoner's Dilemma Game. Results. Study 1 established that the manipulation task was successful in inducing the specified emotions. The analysis from Study 2 revealed no significant main effects for emotions, in contrast to previous research. However, there was a significant effect for participants' pre-existing tendency to cooperate (social value orientation; SVO). Conclusion. Methodological explanations for the result are explored, including the possible impact of trial-and-error strategies, different cooperation games and endogenous vs exogenous emotions.

  18. Impact of positive psychological capital on employee well-being over time.

    Science.gov (United States)

    Avey, James B; Luthans, Fred; Smith, Ronda M; Palmer, Noel F

    2010-01-01

    The recently recognized core construct of psychological capital or PsyCap (consisting of the positive psychological resources of efficacy, hope, optimism, and resilience) has been demonstrated to be related to various employee attitudinal, behavioral, and performance outcomes. However, to date, the impact of this positive core construct over time and on important employee well-being outcomes has not been tested. This study meets this need by analyzing the relationship between a broad cross-section of employees' (N = 280) level of PsyCap and two measures of psychological well-being over time. The results indicated that employees' PsyCap was related to both measures of well-being and, importantly, that PsyCap explained additional variance in these well-being measures over time. The limitations, needed future research, and practical implications conclude the article.

  19. The impact of arm position on the measurement of orthostatic blood pressure.

    Science.gov (United States)

    Guss, David A; Abdelnur, Diego; Hemingway, Thomas J

    2008-05-01

    Blood pressure is a standard vital sign in patients evaluated in an Emergency Department. The American Heart Association has recommended a preferred position of the arm and cuff when measuring blood pressure. There is no formal recommendation for arm position when measuring orthostatic blood pressure. The objective of this study was to assess the impact of different arm positions on the measurement of postural changes in blood pressure. This was a prospective, unblinded, convenience study involving Emergency Department patients with complaints unrelated to cardiovascular instability. Repeated blood pressure measurements were obtained using an automatic non-invasive device with each subject in a supine and standing position and with the arm parallel and perpendicular to the torso. Orthostatic hypotension was defined as a difference of >or= 20 mm Hg systolic or >or= 10 mm Hg diastolic when subtracting standing from supine measurements. There were four comparisons made: group W, arm perpendicular supine and standing; group X, arm parallel supine and standing; group Y, arm parallel supine and perpendicular standing; and group Z, arm perpendicular supine and parallel standing. There were 100 patients enrolled, 55 men, mean age 44 years. Four blood pressure measurements were obtained on each patient. The percentage of patients meeting orthostatic hypotension criteria in each group was: W systolic 6% (95% CI 1%, 11%), diastolic 4% (95% CI 0%, 8%), X systolic 8% (95% CI 3%, 13%), diastolic 9% (95% CI 3%, 13%), Y systolic 19% (95% CI 11%, 27%), diastolic 30% (95% CI 21%, 39%), Z systolic 2% (95% CI 0%, 5%), diastolic 2% (95% CI 0%, 5%). Comparison of Group Y vs. X, Z, and W was statistically significant (p postural changes in blood pressure. The combination of the arm parallel when supine and perpendicular when standing may significantly overestimate the orthostatic change. Arm position should be held constant in supine and standing positions when assessing for orthostatic

  20. Impact of Audio-Coaching on the Position of Lung Tumors

    International Nuclear Information System (INIS)

    Haasbeek, Cornelis J.A.; Spoelstra, Femke; Lagerwaard, Frank J.; Soernsen de Koste, John R. van; Cuijpers, Johan P.; Slotman, Ben J.; Senan, Suresh

    2008-01-01

    Purpose: Respiration-induced organ motion is a major source of positional, or geometric, uncertainty in thoracic radiotherapy. Interventions to mitigate the impact of motion include audio-coached respiration-gated radiotherapy (RGRT). To assess the impact of coaching on average tumor position during gating, we analyzed four-dimensional computed tomography (4DCT) scans performed both with and without audio-coaching. Methods and Materials: Our RGRT protocol requires that an audio-coached 4DCT scan is performed when the initial free-breathing 4DCT indicates a potential benefit with gating. We retrospectively analyzed 22 such paired scans in patients with well-circumscribed tumors. Changes in lung volume and position of internal target volumes (ITV) generated in three consecutive respiratory phases at both end-inspiration and end-expiration were analyzed. Results: Audio-coaching increased end-inspiration lung volumes by a mean of 10.2% (range, -13% to +43%) when compared with free breathing (p = 0.001). The mean three-dimensional displacement of the center of ITV was 3.6 mm (SD, 2.5; range, 0.3-9.6mm), mainly caused by displacement in the craniocaudal direction. Displacement of ITV caused by coaching was more than 5 mm in 5 patients, all of whom were in the subgroup of 9 patients showing total tumor motion of 10 mm or more during both coached and uncoached breathing. Comparable ITV displacements were observed at end-expiration phases of the 4DCT. Conclusions: Differences in ITV position exceeding 5 mm between coached and uncoached 4DCT scans were detected in up to 56% of mobile tumors. Both end-inspiration and end-expiration RGRT were susceptible to displacements. This indicates that the method of audio-coaching should remain unchanged throughout the course of treatment

  1. Impact of Vertical Canopy Position on Leaf Spectral Properties and Traits across Multiple Species

    Directory of Open Access Journals (Sweden)

    Tawanda W. Gara

    2018-02-01

    Full Text Available Understanding the vertical pattern of leaf traits across plant canopies provide critical information on plant physiology, ecosystem functioning and structure and vegetation response to climate change. However, the impact of vertical canopy position on leaf spectral properties and subsequently leaf traits across the entire spectrum for multiple species is poorly understood. In this study, we examined the ability of leaf optical properties to track variability in leaf traits across the vertical canopy profile using Partial Least Square Discriminatory Analysis (PLS-DA. Leaf spectral measurements together with leaf traits (nitrogen, carbon, chlorophyll, equivalent water thickness and specific leaf area were studied at three vertical canopy positions along the plant stem: lower, middle and upper. We observed that foliar nitrogen (N, chlorophyll (Cab, carbon (C, and equivalent water thickness (EWT were higher in the upper canopy leaves compared with lower shaded leaves, while specific leaf area (SLA increased from upper to lower canopy leaves. We found that leaf spectral reflectance significantly (P ≤ 0.05 shifted to longer wavelengths in the ‘red edge’ spectrum (685–701 nm in the order of lower > middle > upper for the pooled dataset. We report that spectral bands that are influential in the discrimination of leaf samples into the three groups of canopy position, based on the PLS-DA variable importance projection (VIP score, match with wavelength regions of foliar traits observed to vary across the canopy vertical profile. This observation demonstrated that both leaf traits and leaf reflectance co-vary across the vertical canopy profile in multiple species. We conclude that canopy vertical position has a significant impact on leaf spectral properties of an individual plant’s traits, and this finding holds for multiple species. These findings have important implications on field sampling protocols, upscaling leaf traits to canopy level

  2. Positive Correlation Between Academic Library Services and High-Impact Practices for

    Directory of Open Access Journals (Sweden)

    Saori Wendy Herman, MLIS, AHIP

    2016-03-01

    Full Text Available Objective – To investigate the perceived alignment between academic library services and high-impact practices (HIPs that affect student retention. Design – Survey questionnaire. Setting – Public comprehensive universities in the United States of America with a Carnegie classification of master’s level as of January 2013. Subjects – 68 library deans or directors out of the 271 who were originally contacted. Methods – The author used Qualtrics software to create a survey based on the HIPs, tested the survey for reliability, and then distributed it to 271 universities. Library services were grouped into 1 of 3 library scales: library collection, library instruction, or library facilities. The survey consisted of a matrix of 10 Likert-style questions addressing the perceived level of alignment between the library scales and the HIPs. Each question provided an opportunity for the respondent to enter a “brief description of support practices” (p 477. Additional demographic questions addressed the years of experience of the respondent, undergraduate student enrollment of the university, and whether librarians held faculty rank. Main Results – The author measured Pearson correlation coefficients and found a positive correlation between the library scales and the HIPs. All three library scales displayed a moderately strong positive correlation between first-year seminars and experiences (HIP 1, common intellectual experiences (HIP 2, writing-intensive courses (HIP 4, undergraduate research (HIP 6, diversity and global learning (HIP 7, service learning and community-based learning (HIP 8, internships (HIP 9, and capstone courses and projects (HIP 10. The library collections scale and library facilities scale displayed a moderately strong correlation with learning communities (HIP 3 and collaborative assignments and projects (HIP 5. The library instruction scale displayed a strong positive correlation with HIP 3 and a very strong

  3. The impact of E-Marketing in the positioning of Kosovo Banks

    Directory of Open Access Journals (Sweden)

    Dr.Sc. Shpresa Mehmeti

    2015-06-01

    Full Text Available The following thesis will present the results of a study on the impact of electronic marketing in bank positioning in Kosovo. As a case study we have selected ProCredit Bank and Raiffeisen Bank which are operating in Kosovo for several years now. Development of information technology has brought changes in every day work offering various opportunities to the clients and its activities in particular to financial institutions In this study we have surveyed customers of the banks that operate in Kosovo. For data collection an electronic questionnaire has been used, which was sent to the clients of both banks which are subject of study. The purpose of this paper is to reveal how these banks apply electronic systems for the provision of services and how this service has impact on their position in the banking market in Kosovo. Findings from this study have enabled us to understand that the banking sector still suffers deficiencies regarding Internet usage by customers to perform banking transactions.

  4. Stratification of antibody-positive subjects by antibody level reveals an impact of immunogenicity on pharmacokinetics.

    Science.gov (United States)

    Zhou, Lei; Hoofring, Sarah A; Wu, Yu; Vu, Thuy; Ma, Peiming; Swanson, Steven J; Chirmule, Narendra; Starcevic, Marta

    2013-01-01

    The availability of highly sensitive immunoassays enables the detection of antidrug antibody (ADA) responses of various concentrations and affinities. The analysis of the impact of antibody status on drug pharmacokinetics (PK) is confounded by the presence of low-affinity or low-concentration antibody responses within the dataset. In a phase 2 clinical trial, a large proportion of subjects (45%) developed ADA following weekly dosing with AMG 317, a fully human monoclonal antibody therapeutic. The antibody responses displayed a wide range of relative concentrations (30 ng/mL to >13 μg/mL) and peaked at various times during the study. To evaluate the impact of immunogenicity on PK, AMG 317 concentration data were analyzed following stratification by dose group, time point, antibody status (positive or negative), and antibody level (relative concentration). With dose group as a stratifying variable, a moderate reduction in AMG 317 levels (AMG 317 levels was revealed when antibody data was stratified by both time point and antibody level. In general, high ADA concentrations (>500 ng/mL) and later time points (week 12) were associated with significantly (up to 97%) lower trough AMG 317 concentrations. The use of quasi-quantitative antibody data and appropriate statistical methods was critical for the most comprehensive evaluation of the impact of immunogenicity on PK.

  5. Adopting the international financial reporting standards: a positive impact on 2004 income and consolidated equity

    International Nuclear Information System (INIS)

    Mallet, O.

    2005-03-01

    This document provides preliminary information on the quantitative impact of transition to the International Financial Reporting Standards (IFRS) on AREVA 2004 financial position, in accordance with AMF recommendations regarding financial communications during the transition period.The basis for preparing 2004 information on transition to the IFRS comes from: the International Accounting Standards (IAS)/IFRS, as approved by the European Union. The impact of IAS 32/39 and IFRS 4 will not be recognized in shareholders equity until January 1, 2005; AREVA anticipation of the resolution of technical issues and ongoing projects under discussion by the International Accounting Standards Board (IASB) and the International Financial Reporting Interpretations Committee (IFRIC). Uncertainty factors on practical methods for applying certain standards and ongoing interpretations by IFRIC and regulatory organizations could impact the exactness of restatements identified at this stage. For all of these reasons, it is conceivable that the opening balance sheet at January 1, 2004, as presented in this document, will not be the balance sheet actually used to establish the consolidated financial statements for 2005. (author)

  6. Do colors exist? and other profound physics questions

    CERN Document Server

    Cottrell, Seth Stannard

    2018-01-01

    Why do polished stones look wet? How does the Twin Paradox work? Why are orbits ellipses? How can we be sure that pi never repeats? How does a quantum computer break encryption? Discover the answers to these, and other profound physics questions! This fascinating book presents a collection of articles based on conversations and correspondences between the author and complete strangers about physics and math. The author, a researcher in mathematical physics, responds to dozens of questions posed by inquiring minds from all over the world, ranging from the everyday to the profound. Rather than unnecessarily complex explanations mired in mysterious terminology and symbols, the reader is presented with the reasoning, experiments, and mathematics in a casual, conversational, and often comical style. Neither over-simplified nor over-technical, the lucid and entertaining writing will guide the reader from the each innocent question to a better understanding of the weird and beautiful universe around us. Advance prai...

  7. The Sweet and the Bitter: Intertwined Positive and Negative Social Impacts of a Biodiversity Offset

    Directory of Open Access Journals (Sweden)

    Cécile Bidaud

    2017-01-01

    Full Text Available Major developments, such as mines, will often have unavoidable environmental impacts. In such cases, investors, governments, or even a company's own standards increasingly require implementation of biodiversity offsets (investment in conservation with a measurable outcome with the aim of achieving 'no net loss' or even a 'net gain' of biodiversity. Where conservation is achieved by changing the behaviour of people directly using natural resources, the offset might be expected to have social impacts but such impacts have received very little attention. Using the case study of Ambatovy, a major nickel mine in the eastern rainforests of Madagascar and a company at the vanguard of developing biodiversity offsets, we explore local perceptions of the magnitude and distribution of impacts of the biodiversity offset project on local wellbeing. We used both qualitative (key informant interviews and focus group discussions and quantitative (household survey methods. We found that the biodiversity offsets, which comprise both conservation restrictions and development activities, influenced wellbeing in a mixture of positive and negative ways. However, overall, respondents felt that they had suffered a net cost from the biodiversity offset. It is a matter of concern that benefits from development activities do not compensate for the costs of the conservation restrictions, that those who bear the costs are not the same people as those who benefit, and that there is a mismatch in timing between the immediate restrictions and the associated development activities which take some time to deliver benefits. These issues matter both from the perspective of environmental justice, and for the long-term sustainability of the biodiversity benefits the offset is supposed to deliver.

  8. Observations on Working Psychoanalytically with a Profoundly Amnesic Patient

    Directory of Open Access Journals (Sweden)

    Paul A. Moore

    2017-08-01

    Full Text Available Individuals with profound amnesia are markedly impaired in explicitly recalling new episodic events, but appear to preserve the capacity to use information from other sources. Amongst these preserved capacities is the ability to form new memories of an emotional nature – a skill at the heart of developing and sustaining interpersonal relationships. The psychoanalytic study of individuals with profound amnesia might contribute to the understanding the importance of each memory system, including effects on key analytic processes such as transference and countertransference. However, psychoanalytic work in the presence of profound amnesia might also require important technical modifications. In the first report of its kind, we describe observations from a long term psychoanalytic process (72 sessions with an individual (JL who has profound amnesia after an anoxic episode. The nature of therapy was shaped by JL’s impairment in connecting elements that belong to distant (and even relatively close moments in the therapeutic process. However, we were also able to document areas of preservation, in what appears to be a functioning therapeutic alliance. As regards transference, the relationship between JL and his analyst can be viewed as the evolution of a narcissistic transference, and case material is provided that maps this into three phases: (i rejecting; (ii starting to take in; and (iii full use of the analytic space – where each phase exhibits differing degrees of permeability between JL and the analyst. This investigation appears to have important theoretical implications for psychoanalytic practice, and for psychotherapy in general – and not only with regard to brain injured populations. We especially note that it raises questions concerning the mechanism of therapeutic action in psychoanalysis and psychotherapy, and the apparent unimportance of episodic memory for many elements of therapeutic change.

  9. Foveal Processing Under Concurrent Peripheral Load in Profoundly Deaf Adults

    Science.gov (United States)

    2016-01-01

    Development of the visual system typically proceeds in concert with the development of audition. One result is that the visual system of profoundly deaf individuals differs from that of those with typical auditory systems. While past research has suggested deaf people have enhanced attention in the visual periphery, it is still unclear whether or not this enhancement entails deficits in central vision. Profoundly deaf and typically hearing adults were administered a variant of the useful field of view task that independently assessed performance on concurrent central and peripheral tasks. Identification of a foveated target was impaired by a concurrent selective peripheral attention task, more so in profoundly deaf adults than in the typically hearing. Previous findings of enhanced performance on the peripheral task were not replicated. These data are discussed in terms of flexible allocation of spatial attention targeted towards perceived task demands, and support a modified “division of labor” hypothesis whereby attentional resources co-opted to process peripheral space result in reduced resources in the central visual field. PMID:26657078

  10. Like cognitive function, decision making across the life span shows profound age-related changes.

    Science.gov (United States)

    Tymula, Agnieszka; Rosenberg Belmaker, Lior A; Ruderman, Lital; Glimcher, Paul W; Levy, Ifat

    2013-10-15

    It has long been known that human cognitive function improves through young adulthood and then declines across the later life span. Here we examined how decision-making function changes across the life span by measuring risk and ambiguity attitudes in the gain and loss domains, as well as choice consistency, in an urban cohort ranging in age from 12 to 90 y. We identified several important age-related patterns in decision making under uncertainty: First, we found that healthy elders between the ages of 65 and 90 were strikingly inconsistent in their choices compared with younger subjects. Just as elders show profound declines in cognitive function, they also show profound declines in choice rationality compared with their younger peers. Second, we found that the widely documented phenomenon of ambiguity aversion is specific to the gain domain and does not occur in the loss domain, except for a slight effect in older adults. Finally, extending an earlier report by our group, we found that risk attitudes across the life span show an inverted U-shaped function; both elders and adolescents are more risk-averse than their midlife counterparts. Taken together, these characterizations of decision-making function across the life span in this urban cohort strengthen the conclusions of previous reports suggesting a profound impact of aging on cognitive function in this domain.

  11. The Impact of Eclipsing GNSS Satellites on the Precise Point Positioning

    Directory of Open Access Journals (Sweden)

    Xinyun Cao

    2018-01-01

    Full Text Available When satellites enter into the noon maneuver or the shadow crossing regimes, the actual attitudes will depart from their nominal values. If improper attitude models are used, the induced-errors due to the wind-up effect and satellite antenna PCO (Phase Center Offset will deteriorate the positioning accuracy. Because different generations of satellites adopt different attitude control models, the influences on the positioning performances deserve further study. Consequently, the impact of three eclipsing strategies on the single-system and multi-GNSS (Global Navigation Satellite System Precise Point Positioning (PPP are analyzed. According to the results of the eclipsing monitor, 65 globally distributed MGEX (Multi-GNSS EXperiment stations for 31-day period in July 2017 are selected to perform G/R/E/C/GR/GREC PPP in both static and kinematic modes. The results show that the influences of non-nominal attitudes are related to the magnitude of the PCO values, maximum yaw angle differences, the duration of maneuver, the value of the sun angle and the satellite geometric strength. For single-system, using modeled attitudes rather than the nominal ones will greatly improve the positioning accuracy of GLONASS-only and BDS-only PPP while slightly contributions to the GPS-only and GALILEO-only PPP. Deleting the eclipsing satellites may sometimes induce a longer convergence time and a worse solution due to the poor satellite geometry, especially for GLONASS kinematic PPP when stations are located in the low latitude and BDS kinematic PPP. When multi-GNSS data are available, especially four navigation systems, the accuracy improvements of using the modeled attitudes or deleting eclipsing satellites are non-significant.

  12. Catch the wave! Time-window sequential analysis of alertness stimulation in individuals with profound intellectual and multiple disabilities

    NARCIS (Netherlands)

    Munde, V. S.; Vlaskamp, C.; Maes, B.; Ruijssenaars, A. J. J. M.

    BackgroundWhile optimally activities are provided at those moments when the individual with profound intellectual and multiple disabilities (PIMD) is focused on the environment' or alert', detailed information about the impact that the design and timing of the activity has on alertness is lacking.

  13. Reduction of in utero lead exposures in South African populations: Positive impact of unleaded petrol.

    Directory of Open Access Journals (Sweden)

    Halina B Röllin

    Full Text Available Prenatal exposure to lead (Pb has been shown to have negative and irreversible health impacts on foetal and early childhood development, affecting morbidity and mortality in adulthood. This study aimed to assess in utero Pb exposure, examine birth outcomes, and identify confounding factors in the large cohort of South African population, following the legislated removal of Pb from petrol.Lead was measured in the maternal blood, urine and cord blood using Inductive Coupled Plasma Mass spectrometry (ICP-MS. The statistical analyses included Spearman's correlation, Wilcoxon rank sum (Mann Whitney, Kruskal-Wallis rank tests and multivariate linear regression.Overall, the geometric mean (GM of Pb in maternal blood (PbB was 1.32 μg/dL (n = 640; 95% CI, 1.24-1.40. In the subset cohort, the GM of paired maternal PbB and cord blood (PbC was 1.73 μg/dL (n = 350; 95% CI, 1.60-1.86 and 1.26 μg/dL (n = 317; 95% CI, 1.18-1.35, respectively with a positive correlation between the log PbB and the log PbC (rho = 0.65, p = <0.001. Birth outcomes showed geographical differences in the gestational age (p<0.001, birth length (p = 0.028 and head circumference (p<0.001, Apgar score at 5 min (p<0.001 and parity (p<0.002. In female neonates, a positive association was found between PbC and head circumference (rho = 0.243; p<0.016. The maternal PbB levels were positively correlated with race, educational status, water sources, cooking fuels and use of pesticides at home.This study has demonstrated not only the positive impact that the introduction of unleaded petrol and lead-free paint has had on in utero exposure to Pb in South Africa, but has also contributed new data on the topic, in a region where such data and scientific investigations in this field are lacking. Future research should evaluate if similar effects can be detected in young children and the adult population.

  14. Position paper on the impact of including methane number in natural gas regulation

    International Nuclear Information System (INIS)

    2014-01-01

    GIIGNL has developed a position paper to describe methane number and the possible impact on the LNG market of a future regulation/specification for this parameter which is linked to natural gas quality. Currently, there are several standards describing calculation methods of natural gas methane number, but there are doubts about their reliability and the results differ from each other. No official regulation which states a minimum value for methane number of natural gas has been identified. A methane number of 80, as recommended by some organisations in Europe, would endanger the LNG supply to the market, limiting acceptable LNG sources, or would require expensive gas treatment. In the long term, if there is a market for high methane number natural gas, this may be an opportunity for LNG terminals able to adjust or manage supplies to the desired methane number

  15. Non-parametric adaptive importance sampling for the probability estimation of a launcher impact position

    International Nuclear Information System (INIS)

    Morio, Jerome

    2011-01-01

    Importance sampling (IS) is a useful simulation technique to estimate critical probability with a better accuracy than Monte Carlo methods. It consists in generating random weighted samples from an auxiliary distribution rather than the distribution of interest. The crucial part of this algorithm is the choice of an efficient auxiliary PDF that has to be able to simulate more rare random events. The optimisation of this auxiliary distribution is often in practice very difficult. In this article, we propose to approach the IS optimal auxiliary density with non-parametric adaptive importance sampling (NAIS). We apply this technique for the probability estimation of spatial launcher impact position since it has currently become a more and more important issue in the field of aeronautics.

  16. Informal Social Networks of People with Profound Intellectual and Multiple Disabilities: Relationship with Age, Communicative Abilities and Current Living Arrangements

    Science.gov (United States)

    Kamstra, A.; van der Putten, A. A. J.; Post, W. J.; Vlaskamp, C.

    2015-01-01

    Background: People with profound intellectual and multiple disabilities (PIMD) have limited informal social contacts. Research to determine the factors which can positively influence establishing sound informal social contacts is required. Materials and Methods: Regression analysis for 200 people with PIMD was used to analyse how age,…

  17. The positive impact of radiologic imaging on high-stage cutaneous squamous cell carcinoma management.

    Science.gov (United States)

    Ruiz, Emily Stamell; Karia, Pritesh S; Morgan, Frederick C; Schmults, Chrysalyne D

    2017-02-01

    There is limited evidence on the utility of radiologic imaging for prognostic staging of cutaneous squamous cell carcinoma (CSCC). Review utilization of radiologic imaging of high-stage CSCCs to evaluate whether imaging impacted management and outcomes. Tumors classified as Brigham and Women's Hospital (BWH) tumor (T) stage T2B or T3 over a 13-year period were reviewed to identify whether imaging was performed and whether results affected treatment. Disease-related outcomes (DRO: local recurrence, nodal metastasis, death from disease) were compared between patients by type of imaging used. 108 high-stage CSCCs in 98 patients were included. Imaging (mostly computed tomography, 79%) was utilized in 45 (46%) patients and management was altered in 16 (33%) patients who underwent imaging. Patients that received no imaging were at higher risk of developing nodal metastases (nonimaging, 30%; imaging, 13%; P = .041) and any DRO (nonimaging, 42%; imaging, 20%; P = .028) compared to the imaging group. Imaging was associated with a lower risk for DRO (subhazard ratio, 0.5; 95% CI 0.2-0.9; P = .046) adjusted for BWH T stage, sex, and location. Single institution retrospective design and changes in technology overtime. Radiologic imaging of high-stage CSCC may influence management and appears to positively impact outcomes. Further prospective studies are needed to establish which patients benefit from imaging. Copyright © 2016 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

  18. Health impact assessment research and practice: A place for paradigm positioning?

    International Nuclear Information System (INIS)

    Haigh, Fiona; Harris, Patrick; Haigh, Neil

    2012-01-01

    In this article, we provide a critical review of the place of paradigm in health impact assessment (HIA) research and practice. We contend that most HIA practitioners have given insufficient attention to paradigm positioning when developing and applying HIA methodologies and that some concerns about current HIA practice can be attributed to this. We review HIA literature to assess the extent and nature of attention given to paradigm positioning and these related concerns. We then respond to our critique by exploring the implications, opportunities and challenges of adopting a critical realist paradigm, which we believe has the potential to help HIA practitioners to develop HIA methodology in a way that addresses these issues. - Highlights: ► We provide a critical review of the place of paradigm in HIA. ► We demonstrate that HIA practitioners give insufficient attention to paradigm. ► The implications, opportunities and challenges of adopting a critical realist paradigm are explored. ► This is the first paper, to our knowledge, that discusses a critical realist approach to HIA.

  19. Reporting instructions significantly impact false positive rates when reading chest radiographs

    Energy Technology Data Exchange (ETDEWEB)

    Robinson, John W.; Brennan, Patrick C.; Mello-Thoms, Claudia; Lewis, Sarah J. [The University of Sydney, Medical Image Optimisation and Perception Group, Discipline of Medical Radiation Sciences, Faculty of Health Sciences, Lidcombe, NSW (Australia)

    2016-10-15

    To determine the impact of specific reporting tasks on the performance of radiologists when reading chest radiographs. Ten experienced radiologists read a set of 40 postero-anterior (PA) chest radiographs: 21 nodule free and 19 with a proven solitary nodule. There were two reporting conditions: an unframed task (UFT) to report any abnormality and a framed task (FT) reporting only lung nodule/s. Jackknife free-response operating characteristic (JAFROC) figure of merit (FOM), specificity, location sensitivity and number of true positive (TP), false positive (FP), true negative (TN) and false negative (FN) decisions were used for analysis. JAFROC FOM for tasks showed a significant reduction in performance for framed tasks (P = 0.006) and an associated decrease in specificity (P = 0.011) but no alteration to the location sensitivity score. There was a significant increase in number of FP decisions made during framed versus unframed tasks for nodule-containing (P = 0.005) and nodule-free (P = 0.011) chest radiographs. No significant differences in TP were recorded. Radiologists report more FP decisions when given specific reporting instructions to search for nodules on chest radiographs. The relevance of clinical history supplied to radiologists is called into question and may induce a negative effect. (orig.)

  20. Cooperation for a competitive position: The impact of hospital cooperation behavior on organizational performance.

    Science.gov (United States)

    Büchner, Vera Antonia; Hinz, Vera; Schreyögg, Jonas

    2015-01-01

    Several public policy initiatives, particularly those involving managed care, aim to enhance cooperation between partners in the health care sector because it is expected that such cooperation will reduce costs and generate additional revenue. However, empirical evidence regarding the effects of cooperation on hospital performance is scarce, particularly with respect to creating a comprehensive measure of cooperation behavior. The aim of this study is to investigate the impact of hospital cooperation behavior on organizational performance. We differentiate between horizontal and vertical cooperation using two alternative measures-cooperation depth and cooperation breadth-and include the interaction effects between both cooperation directions. Data are derived from a survey of German hospitals and combined with objective performance information from annual financial statements. Generalized linear regression models are used. The study findings provide insight into the nature of hospitals' cooperation behavior. In particular, we show that there are negative synergies between horizontal administrative cooperation behavior and vertical cooperation behavior. Whereas the depth and breadth of horizontal administrative cooperation positively affect financial performance (when there is no vertical cooperation), vertical cooperation positively affects financial performance (when there is no horizontal administrative cooperation) only when cooperation is broad (rather than deep). Horizontal cooperation is generally more effective than vertical cooperation at improving financial performance. Hospital managers should consider the negative interaction effect when making decisions about whether to recommend a cooperative relationship in a horizontal or vertical direction. In addition, managers should be aware of the limited financial benefit of cooperation behavior.

  1. Impact of employment instability on socio-economic position of employees

    Directory of Open Access Journals (Sweden)

    Vyacheslav Nikolaevich Bobkov

    2013-12-01

    Full Text Available The subject of the article is the relationships in labor utilization. The article analyzes the impact of employment instability on the socio-economic situation of employees in Russia. Questions revealing the concept content of employment instability, its real forms and socio-economic consequences for employees are considered. Methods of statistical and sociological data analysis are applied. Indicators to measure the scope and level of employment instability of employees are calculated. The dynamics in the time of the size of employment instability in Russia are analyzed. The obtained results can be applied within national economic and social policy. The findings indicate that employment instability is high, and it threatens socio-economic position of the great number of employees in Russia. It is argued that, in these conditions, the most appropriate in the fight against the spread of employment instability are the set of government initiatives, proactive position of the Russian society and the expansion of societal forms of control over the government.

  2. Reporting instructions significantly impact false positive rates when reading chest radiographs

    International Nuclear Information System (INIS)

    Robinson, John W.; Brennan, Patrick C.; Mello-Thoms, Claudia; Lewis, Sarah J.

    2016-01-01

    To determine the impact of specific reporting tasks on the performance of radiologists when reading chest radiographs. Ten experienced radiologists read a set of 40 postero-anterior (PA) chest radiographs: 21 nodule free and 19 with a proven solitary nodule. There were two reporting conditions: an unframed task (UFT) to report any abnormality and a framed task (FT) reporting only lung nodule/s. Jackknife free-response operating characteristic (JAFROC) figure of merit (FOM), specificity, location sensitivity and number of true positive (TP), false positive (FP), true negative (TN) and false negative (FN) decisions were used for analysis. JAFROC FOM for tasks showed a significant reduction in performance for framed tasks (P = 0.006) and an associated decrease in specificity (P = 0.011) but no alteration to the location sensitivity score. There was a significant increase in number of FP decisions made during framed versus unframed tasks for nodule-containing (P = 0.005) and nodule-free (P = 0.011) chest radiographs. No significant differences in TP were recorded. Radiologists report more FP decisions when given specific reporting instructions to search for nodules on chest radiographs. The relevance of clinical history supplied to radiologists is called into question and may induce a negative effect. (orig.)

  3. Impact of knee support and shape of tabletop on rectum and prostate position

    International Nuclear Information System (INIS)

    Steenbakkers, Roel; Duppen, Joop C.; Betgen, Anja; Lotz, Heidi; Remeijer, Peter; Fitton, Isabelle; Nowak, Peter; Herk, Marcel van; Rasch, Coen

    2004-01-01

    Purpose: To evaluate the impact of different tabletops with or without a knee support on the position of the rectum, prostate, and bulb of the penis; and to evaluate the effect of these patient-positioning devices on treatment planning. Methods and materials: For 10 male volunteers, five MRI scans were made in four different positions: on a flat tabletop with knee support, on a flat tabletop without knee support, on a rounded tabletop with knee support, and on a rounded tabletop without knee support. The fifth scan was in the same position as the first. With image registration, the position differences of the rectum, prostate, and bulb of the penis were measured at several points in a sagittal plane through the central axis of the prostate. A planning target volume was generated from the delineated prostates with a margin of 10 mm in three dimensions. A three-field treatment plan with a prescribed dose of 78 Gy to the International Commission on Radiation Units and Measurements point was automatically generated from each planning target volume. Dose-volume histograms were calculated for all rectal walls. Results: The shape of the tabletop did not affect the rectum and prostate position. Addition of a knee support shifted the anterior and posterior rectal walls dorsally. For the anterior rectal wall, the maximum dorsal shift was 9.9 mm (standard error of the mean [SEM] 1.7 mm) at the top of the prostate. For the posterior rectal wall, the maximum dorsal shift was 10.2 mm (SEM 1.5 mm) at the middle of the prostate. Therefore, the rectal filling was pushed caudally when a knee support was added. The knee support caused a rotation of the prostate around the left-right axis at the apex (i.e., a dorsal rotation) by 5.6 deg (SEM 0.8 deg ) and shifts in the caudal and dorsal directions of 2.6 mm (SEM 0.4 cm) and 1.4 mm (SEM 0.6 mm), respectively. The position of the bulb of the penis was not influenced by the use of a knee support or rounded tabletop. The volume of the

  4. The effects of positive versus negative impact reflection on change in job performance and work-life conflict.

    Science.gov (United States)

    Cardador, M Teresa

    2014-01-01

    Research on task significance and relational job design suggests that information from beneficiaries of one's work fosters perceptions of impact, and thus improved work outcomes. This paper presents results from a longitudinal field experiment examining the effect of another strategy for fostering perceptions of impact - engaging employees in regular reflection about how their work benefits others. With a sample of professionals from multiple organizations, this longitudinal study examined the effect on job performance and work-life conflict of both positive and negative impact reflection. Results show that negative impact reflection had a pronounced negative effect on job performance, but no effect on work-life conflict. Positive impact reflection had a weak positive effect on work-life conflict, but no significant effect on job performance. The direction of effects seen in the no intervention condition mirrored that of the negative impact reflection condition, suggesting a possible buffering effect for positive impact reflection. This research provides empirical and theoretical contributions to the literatures on relational job design and task significance.

  5. Satellite remote sensing reveals a positive impact of living oyster reefs on microalgal biofilm development

    Directory of Open Access Journals (Sweden)

    C. Echappé

    2018-02-01

    Full Text Available Satellite remote sensing (RS is routinely used for the large-scale monitoring of microphytobenthos (MPB biomass in intertidal mudflats and has greatly improved our knowledge of MPB spatio-temporal variability and its potential drivers. Processes operating on smaller scales however, such as the impact of benthic macrofauna on MPB development, to date remain underinvestigated. In this study, we analysed the influence of wild Crassostrea gigas oyster reefs on MPB biofilm development using multispectral RS. A 30-year time series (1985–2015 combining high-resolution (30 m Landsat and SPOT data was built in order to explore the relationship between C. gigas reefs and MPB spatial distribution and seasonal dynamics, using the normalized difference vegetation index (NDVI. Emphasis was placed on the analysis of a before–after control-impact (BACI experiment designed to assess the effect of oyster killing on the surrounding MPB biofilms. Our RS data reveal that the presence of oyster reefs positively affects MPB biofilm development. Analysis of the historical time series first showed the presence of persistent, highly concentrated MPB patches around oyster reefs. This observation was supported by the BACI experiment which showed that killing the oysters (while leaving the physical reef structure, i.e. oyster shells, intact negatively affected both MPB biofilm biomass and spatial stability around the reef. As such, our results are consistent with the hypothesis of nutrient input as an explanation for the MPB growth-promoting effect of oysters, whereby organic and inorganic matter released through oyster excretion and biodeposition stimulates MPB biomass accumulation. MPB also showed marked seasonal variations in biomass and patch shape, size and degree of aggregation around the oyster reefs. Seasonal variations in biomass, with higher NDVI during spring and autumn, were consistent with those observed on broader scales in other European mudflats. Our

  6. Satellite remote sensing reveals a positive impact of living oyster reefs on microalgal biofilm development

    Science.gov (United States)

    Echappé, Caroline; Gernez, Pierre; Méléder, Vona; Jesus, Bruno; Cognie, Bruno; Decottignies, Priscilla; Sabbe, Koen; Barillé, Laurent

    2018-02-01

    Satellite remote sensing (RS) is routinely used for the large-scale monitoring of microphytobenthos (MPB) biomass in intertidal mudflats and has greatly improved our knowledge of MPB spatio-temporal variability and its potential drivers. Processes operating on smaller scales however, such as the impact of benthic macrofauna on MPB development, to date remain underinvestigated. In this study, we analysed the influence of wild Crassostrea gigas oyster reefs on MPB biofilm development using multispectral RS. A 30-year time series (1985-2015) combining high-resolution (30 m) Landsat and SPOT data was built in order to explore the relationship between C. gigas reefs and MPB spatial distribution and seasonal dynamics, using the normalized difference vegetation index (NDVI). Emphasis was placed on the analysis of a before-after control-impact (BACI) experiment designed to assess the effect of oyster killing on the surrounding MPB biofilms. Our RS data reveal that the presence of oyster reefs positively affects MPB biofilm development. Analysis of the historical time series first showed the presence of persistent, highly concentrated MPB patches around oyster reefs. This observation was supported by the BACI experiment which showed that killing the oysters (while leaving the physical reef structure, i.e. oyster shells, intact) negatively affected both MPB biofilm biomass and spatial stability around the reef. As such, our results are consistent with the hypothesis of nutrient input as an explanation for the MPB growth-promoting effect of oysters, whereby organic and inorganic matter released through oyster excretion and biodeposition stimulates MPB biomass accumulation. MPB also showed marked seasonal variations in biomass and patch shape, size and degree of aggregation around the oyster reefs. Seasonal variations in biomass, with higher NDVI during spring and autumn, were consistent with those observed on broader scales in other European mudflats. Our study provides the

  7. Type of mask may impact on continuous positive airway pressure adherence in apneic patients.

    Science.gov (United States)

    Borel, Jean Christian; Tamisier, Renaud; Dias-Domingos, Sonia; Sapene, Marc; Martin, Francis; Stach, Bruno; Grillet, Yves; Muir, Jean François; Levy, Patrick; Series, Frederic; Pepin, Jean-Louis

    2013-01-01

    In obstructive sleep apnea patients (OSA), continuous positive airway pressure (CPAP) adherence is crucial to improve symptoms and cardiometabolic outcomes. The choice of mask may influence CPAP adherence but this issue has never been addressed properly. To evaluate the impact of nasal pillows, nasal and oronasal masks on CPAP adherence in a cohort of OSA. Newly CPAP treated OSA participating in "Observatoire Sommeil de la Fédération de Pneumologie", a French national prospective cohort, were included between March 2009 and December 2011. Anthropometric data, medical history, OSA severity, sleepiness, depressive status, treatment modalities (auto-CPAP versus fixed pressure, pressure level, interface type, use of humidifiers) and CPAP-related side effects were included in multivariate analysis to determine independent variables associated with CPAP adherence. 2311 OSA (age = 57(12) years, apnea+hypopnea index = 41(21)/h, 29% female) were included. Nasal masks, oronasal masks and nasal pillows were used by 62.4, 26.2 and 11.4% of the patients, respectively. In univariate analysis, oronasal masks and nasal pillows were associated with higher risk of CPAP non-adherence. CPAP non-adherence was also associated with younger age, female gender, mild OSA, gastroesophageal reflux, depression status, low effective pressure and CPAP-related side effects. In multivariate analysis, CPAP non-adherence was associated with the use of oronasal masks (OR = 2.0; 95%CI = 1.6; 2.5), depression, low effective pressure, and side effects. As oronasal masks negatively impact on CPAP adherence, a nasal mask should be preferred as the first option. Patients on oronasal masks should be carefully followed.

  8. Type of mask may impact on continuous positive airway pressure adherence in apneic patients.

    Directory of Open Access Journals (Sweden)

    Jean Christian Borel

    Full Text Available RATIONALE: In obstructive sleep apnea patients (OSA, continuous positive airway pressure (CPAP adherence is crucial to improve symptoms and cardiometabolic outcomes. The choice of mask may influence CPAP adherence but this issue has never been addressed properly. OBJECTIVE: To evaluate the impact of nasal pillows, nasal and oronasal masks on CPAP adherence in a cohort of OSA. METHODS: Newly CPAP treated OSA participating in "Observatoire Sommeil de la Fédération de Pneumologie", a French national prospective cohort, were included between March 2009 and December 2011. Anthropometric data, medical history, OSA severity, sleepiness, depressive status, treatment modalities (auto-CPAP versus fixed pressure, pressure level, interface type, use of humidifiers and CPAP-related side effects were included in multivariate analysis to determine independent variables associated with CPAP adherence. RESULTS: 2311 OSA (age = 57(12 years, apnea+hypopnea index = 41(21/h, 29% female were included. Nasal masks, oronasal masks and nasal pillows were used by 62.4, 26.2 and 11.4% of the patients, respectively. In univariate analysis, oronasal masks and nasal pillows were associated with higher risk of CPAP non-adherence. CPAP non-adherence was also associated with younger age, female gender, mild OSA, gastroesophageal reflux, depression status, low effective pressure and CPAP-related side effects. In multivariate analysis, CPAP non-adherence was associated with the use of oronasal masks (OR = 2.0; 95%CI = 1.6; 2.5, depression, low effective pressure, and side effects. CONCLUSION: As oronasal masks negatively impact on CPAP adherence, a nasal mask should be preferred as the first option. Patients on oronasal masks should be carefully followed.

  9. Have a little faith: measuring the impact of illness on positive and negative aspects of faith.

    Science.gov (United States)

    Salsman, John M; Garcia, Sofia F; Lai, Jin-Shei; Cella, David

    2012-12-01

    The importance of faith and its associations with health are well documented. As part of the Patient Reported Outcomes Measurement Information System, items tapping positive and negative impact of illness (PII and NII) were developed across four content domains: Coping/Stress Response, Self-Concept, Social Connection/Isolation, and Meaning and Spirituality. Faith items were included within the concept of meaning and spirituality. This measurement model was tested on a heterogeneous group of 509 cancer survivors. To evaluate dimensionality, we applied two bi-factor models, specifying a general factor (PII or NII) and four local factors: Coping/Stress Response, Self-Concept, Social Connection/Isolation, and Meaning and Spirituality. Bi-factor analysis supported sufficient unidimensionality within PII and NII item sets. The unidimensionality of both PII and NII item sets was enhanced by extraction of the faith items from the rest of the questions. Of the 10 faith items, nine demonstrated higher local than general factor loadings (range for local factor loadings = 0.402 to 0.876), suggesting utility as a separate but related 'faith' factor. The same was true for only two of the remaining 63 items across the PII and NII item sets. Although conceptually and to a degree empirically related to Meaning and Spirituality, Faith appears to be a distinct subdomain of PII and NII, better handled by distinct assessment. A 10-item measure of the impact of illness upon faith (II-Faith) was therefore assembled. Copyright © 2011 John Wiley & Sons, Ltd.

  10. Three dimensional analysis of impacted maxillary third molars: A cone-beam computed tomographic study of the position and depth of impaction

    Energy Technology Data Exchange (ETDEWEB)

    De Andrade, Priscila Ferreira; Silva, Jesca Neftali Nogueira; Sotto-Maior, Bruno Sales; Devito, Karina Lopes; Assis, Neuza Maria Souza Picorelli [Faculty of Dentistry, Federal University of Juiz de Fora, Juiz de Fora (Brazil); Ribeiro, CleideGisele [Faculty of Medical and Health Sciences - SUPREMA, Juiz de Fora (Brazil)

    2017-09-15

    The classification of impacted maxillary third molars (IMTMs) facilitates interdisciplinary communication and helps estimate the degree of surgical difficulty. Thus, this study aimed to develop a 3-dimensional classification of the position and depth of impaction of IMTMs and to estimate their prevalence with respect to gender and age. This cross-sectional retrospective study analyzed images in sagittal and coronal cone-beam computed tomography (CBCT) sections of 300 maxillary third molars. The proposed classification was based on 3 criteria: buccolingual position (buccal, lingual, or central), mesial-distal position (mesioangular, vertical, or distoangular), and depth of impaction (low, medium, or high). CBCT images of IMTMs were classified, and the associations of the classifications with gender and age were examined using analysis of variance with the Scheffé post-hoc test. To determine the associations among the 3 classifications, the chi-square test was used (P<.05). No significant association of the classifications with gender was observed. Age showed a significant relationship with depth of impaction (P=.0001) and mesial-distal position (P=.005). The most common positions were buccal (n=222), vertical (n=184), and low (n=124). Significant associations among the 3 tested classifications were observed. CBCT enabled the evaluation of IMTMs in a 3-dimensional format, and we developed a proposal for a new classification of the position and depth of impaction of IMTMs.

  11. The positive impact of a facilitated peer mentoring program on academic skills of women faculty

    Directory of Open Access Journals (Sweden)

    Varkey Prathibha

    2012-03-01

    Full Text Available Abstract Background In academic medicine, women physicians lag behind their male counterparts in advancement and promotion to leadership positions. Lack of mentoring, among other factors, has been reported to contribute to this disparity. Peer mentoring has been reported as a successful alternative to the dyadic mentoring model for women interested in improving their academic productivity. We describe a facilitated peer mentoring program in our institution's department of medicine. Methods Nineteen women enrolled in the program were divided into 5 groups. Each group had an assigned facilitator. Members of the respective groups met together with their facilitators at regular intervals during the 12 months of the project. A pre- and post-program evaluation consisting of a 25-item self-assessment of academic skills, self-efficacy, and academic career satisfaction was administered to each participant. Results At the end of 12 months, a total of 9 manuscripts were submitted to peer-reviewed journals, 6 of which are in press or have been published, and another 2 of which have been invited to be revised and resubmitted. At the end of the program, participants reported an increase in their satisfaction with academic achievement (mean score increase, 2.32 to 3.63; P = 0.0001, improvement in skills necessary to effectively search the medical literature (mean score increase, 3.32 to 4.05; P = 0.0009, an improvement in their ability to write a comprehensive review article (mean score increase, 2.89 to 3.63; P = 0.0017, and an improvement in their ability to critically evaluate the medical literature (mean score increased from 3.11 to 3.89; P = 0.0008. Conclusions This facilitated peer mentoring program demonstrated a positive impact on the academic skills and manuscript writing for junior women faculty. This 1-year program required minimal institutional resources, and suggests a need for further study of this and other mentoring programs for women faculty.

  12. The positive impact of a facilitated peer mentoring program on academic skills of women faculty.

    Science.gov (United States)

    Varkey, Prathibha; Jatoi, Aminah; Williams, Amy; Mayer, Anita; Ko, Marcia; Files, Julia; Blair, Janis; Hayes, Sharonne

    2012-03-23

    In academic medicine, women physicians lag behind their male counterparts in advancement and promotion to leadership positions. Lack of mentoring, among other factors, has been reported to contribute to this disparity. Peer mentoring has been reported as a successful alternative to the dyadic mentoring model for women interested in improving their academic productivity. We describe a facilitated peer mentoring program in our institution's department of medicine. Nineteen women enrolled in the program were divided into 5 groups. Each group had an assigned facilitator. Members of the respective groups met together with their facilitators at regular intervals during the 12 months of the project. A pre- and post-program evaluation consisting of a 25-item self-assessment of academic skills, self-efficacy, and academic career satisfaction was administered to each participant. At the end of 12 months, a total of 9 manuscripts were submitted to peer-reviewed journals, 6 of which are in press or have been published, and another 2 of which have been invited to be revised and resubmitted. At the end of the program, participants reported an increase in their satisfaction with academic achievement (mean score increase, 2.32 to 3.63; P = 0.0001), improvement in skills necessary to effectively search the medical literature (mean score increase, 3.32 to 4.05; P = 0.0009), an improvement in their ability to write a comprehensive review article (mean score increase, 2.89 to 3.63; P = 0.0017), and an improvement in their ability to critically evaluate the medical literature (mean score increased from 3.11 to 3.89; P = 0.0008). This facilitated peer mentoring program demonstrated a positive impact on the academic skills and manuscript writing for junior women faculty. This 1-year program required minimal institutional resources, and suggests a need for further study of this and other mentoring programs for women faculty.

  13. The Impact of Childhood Bullying among HIV-Positive Men: Psychosocial Correlates and Risk Factors

    Science.gov (United States)

    Kamen, Charles; Bergstrom, Jessica; Vorasarun, Chaniga; Mardini, Mona; Patrick, Rudy; Lee, Susanne; Lazar, Rachael; Koopman, Cheryl; Gore-Felton, Cheryl

    2012-01-01

    Objectives While some studies have examined the deleterious effects of childhood bullying on adults, no studies to date have focused on the effects of bullying on Persons Living with HIV (PLH), a particularly at-risk population. PLH experience higher rates of childhood and adulthood physical and sexual abuse than the population at large, and experience of childhood abuse appears to be predictive of sexual and other risk behaviors in this population. Thus it remains critical to examine rates of childhood bullying and correlates of bullying in adult PLH. Methods A sample of 171 HIV-positive men over 18 years of age were recruited from the San Francisco Bay Area. All participants reported experiencing symptoms of traumatic stress. The participants were recruited as part of a larger study assessing a group intervention for individuals with HIV and symptoms of trauma. Self-report questionnaires were administered to assess participants’ exposure to bullying in childhood and trauma symptoms in adulthood. Results Bullying was commonly reported by men in the current sample, with 91% of the sample endorsing having experienced some level of bullying before age 18. Having been bullied in childhood was significantly (p bullying in childhood predicted additional, unique variance in trauma symptoms in adulthood above and beyond the effect of exposure to other forms of trauma, resulting in a better-fitting model. Conclusions The current study highlights the association between rate of childhood bullying and symptoms of trauma in adulthood, accounting for the effect of exposure to other forms of trauma. Given the impact of trauma symptoms on disease progression in PLH, exposure to bullying must be considered in any intervention aiming to reduce trauma symptoms or improve mental or physical health among HIV-positive populations. PMID:23294606

  14. Bipolar Affective Disorder in a Patient of Profound Deafness.

    Science.gov (United States)

    Zubair, Usama Bin; Mumtaz, Humza; Mansoor, Sawera

    2018-03-01

    Profound deafness is a lifelong impairment, leading to the physical disability as well as poor psychological adjustment. We herein present a mental health disorder rarely seen among the patients of profound deafness. A 16-year deaf and dumb girl, previously treated for depression, presented with unusual laughter, irritability, flight of ideas, decreased sleep, ideas of self importance, and decreased social functioning and educational performance. These problems were understood by the parents via sign language, who interpreted them to the interviewer. Her Young Mania Rating Scale (YMRS) score was 19 and Brief Psychiatric Rating Scale (BPRS) score was 52. She was diagnosed as a case of bipolar affective disorder (BPAD). Marked improvement in the symptoms and social and educational performance was noted after two weeks of the treatment with sodium valproate, resperidone and clonazepam. Treatment options were explained to the patient with risks and benefits, and she was involved in the decision-making. This case report highlights the importance of accurately diagnosing and managing a rare mental health disorder among the physically handicapped people, especially those who cannot communicate effectively and explain their unusual subjective experiences.

  15. Interfraction Liver Shape Variability and Impact on GTV Position During Liver Stereotactic Radiotherapy Using Abdominal Compression

    International Nuclear Information System (INIS)

    Eccles, Cynthia L.; Dawson, Laura A.; Moseley, Joanne L.; Brock, Kristy K.

    2011-01-01

    Purpose: For patients receiving liver stereotactic body radiotherapy (SBRT), abdominal compression can reduce organ motion, and daily image guidance can reduce setup error. The reproducibility of liver shape under compression may impact treatment delivery accuracy. The purpose of this study was to measure the interfractional variability in liver shape under compression, after best-fit rigid liver-to-liver registration from kilovoltage (kV) cone beam computed tomography (CBCT) scans to planning computed tomography (CT) scans and its impact on gross tumor volume (GTV) position. Methods and Materials: Evaluable patients were treated in a Research Ethics Board-approved SBRT six-fraction study with abdominal compression. Kilovoltage CBCT scans were acquired before treatment and reconstructed as respiratory sorted CBCT scans offline. Manual rigid liver-to-liver registrations were performed from exhale-phase CBCT scans to exhale planning CT scans. Each CBCT liver was contoured, exported, and compared with the planning CT scan for spatial differences, by use of in house-developed finite-element model-based deformable registration (MORFEUS). Results: We evaluated 83 CBCT scans from 16 patients with 30 GTVs. The mean volume of liver that deformed by greater than 3 mm was 21.7%. Excluding 1 outlier, the maximum volume that deformed by greater than 3 mm was 36.3% in a single patient. Over all patients, the absolute maximum deformations in the left-right (LR), anterior-posterior (AP), and superior-inferior directions were 10.5 mm (SD, 2.2), 12.9 mm (SD, 3.6), and 5.6 mm (SD, 2.7), respectively. The absolute mean predicted impact of liver volume displacements on GTV by use of center of mass displacements was 0.09 mm (SD, 0.13), 0.13 mm (SD, 0.18), and 0.08 mm (SD, 0.07) in the left-right, anterior-posterior, and superior-inferior directions, respectively. Conclusions: Interfraction liver deformations in patients undergoing SBRT under abdominal compression after rigid liver

  16. The creation of special economic zones in China: Positive and negative impacts in its implementation

    Directory of Open Access Journals (Sweden)

    José Manuel Orozco Plascencia

    2011-08-01

    Full Text Available At the end of seventies, Deng Xioaping, President applied a modernization policy in China, that during more than 30 years allow to reach high economic growth rates above 8% average per year. This reform included the instauration of four Special Economic Zones (SEZ in the southeast of the country, three in Guangdong (Shenzhen, Zhuhai and Shantao and one in Xiamen, Fujian.The purpose of this paper is to analyze the backgrounds of SEZ, the reasons of Chinese Government to implement its and the positive impacts and barriers to become operational.The conclusion in this article is that sez arise like an experiment of the Chinese central government economic policy to apply capitalist measures in design previous regions, the most important benefit has been the strong attraction of Foreing Direct Investment, explained in a surplus trade balance, sustanaible economic growht and technological transference. However, the most significative operational barrier has been the legal rigidity in the imported overseas products, a change of nacional politicideology system and problem asociated with burocracy and corruption.

  17. Adaptation to the waste anesthesia gas system: Gaps in knowledge and opportunities for positive environmental impact

    Directory of Open Access Journals (Sweden)

    John Palmisano

    2015-12-01

    Full Text Available Canisters containing activated charcoal are commonly used in the laboratory setting to collect waste anesthetic gas (WAG. This requires the weighing of the WAG canister after each use and for investigators to maintain an accurate time log of anesthesia duration. A typical rodent anesthesia station may include the use of 3 WAG canisters; one for the anesthesia induction box, one for the operative table, and one for gas monitoring. To simplify the anesthesia breathing circuit, we have developed a “T” connector that replaces the need for having multiple WAG canisters. The “T” connector directs the waste anesthetic from multiple sources; the anesthesia induction box, operative table and gas monitor into a single WAG canister. Use of the “T” connector appears to be a safe, acceptable device that conveniently directs waste gas while improving charcoal adsorption within the canister. In addition, this device may have a positive impact on the environment with a secondary benefit of possible cost savings associated with the purchase and disposal of the hazardous waste contents.

  18. Positive and Negative Impacts of Cross-border M&A

    Institute of Scientific and Technical Information of China (English)

    裴长洪; 林江

    2007-01-01

    Mergers and acquisitions of Chinese enterprises by foreign investors have moved onto the public radar in recent years.To date,the M&A frenzy has drawn widespread attention,with a mixed reaction from proponents and opponents.Proponents consider such mergers and acquisitions conducive to realizing strategic readjustment of the national economic structure,optimizing resource allocation and improving the corporate governance structure.Opponents,however,are concerned that foreign mergers and acquisitions may jeopardize China’s industrial security and erode the executive power of the central government in undertaking industrial development planning.Are the benefits of M&A outweighed by the costs,or vice versa? The focus column of this edition features two articles which debate this issue from opposing viewpoints.In the article"Positive and Negative Impacts of Cross-border M&A",the authors consider foreign M(?)A to be a new way of boosting the level of foreign investment utilization,and advocate China taking full advantage of this approach.The authors of the article"Self-Improvement Or Self-Mutilation",meanwhile,hold foreign M&A to blame for state-owned asset erosion,and insist that China should oppose mergers and acquisitions of key state- owned enterprises by foreign investors at fire-sale prices.

  19. Persistent Thalamic Sound Processing Despite Profound Cochlear Denervation

    Directory of Open Access Journals (Sweden)

    Anna R. Chambers

    2016-08-01

    Full Text Available Neurons at higher stages of sensory processing can partially compensate for a sudden drop in input from the periphery through a homeostatic plasticity process that increases the gain on weak afferent inputs. Even after a profound unilateral auditory neuropathy where > 95% of synapses between auditory nerve fibers and inner hair cells have been eliminated with ouabain, central gain can restore the cortical processing and perceptual detection of basic sounds delivered to the denervated ear. In this model of profound auditory neuropathy, cortical processing and perception recover despite the absence of an auditory brainstem response (ABR or brainstem acoustic reflexes, and only a partial recovery of sound processing at the level of the inferior colliculus (IC, an auditory midbrain nucleus. In this study, we induced a profound cochlear neuropathy with ouabain and asked whether central gain enabled a compensatory plasticity in the auditory thalamus comparable to the full recovery of function previously observed in the auditory cortex (ACtx, the partial recovery observed in the IC, or something different entirely. Unilateral ouabain treatment in adult mice effectively eliminated the ABR, yet robust sound-evoked activity persisted in a minority of units recorded from the contralateral medial geniculate body (MGB of awake mice. Sound-driven MGB units could decode moderate and high-intensity sounds with accuracies comparable to sham-treated control mice, but low-intensity classification was near chance. Pure tone receptive fields and synchronization to broadband pulse trains also persisted, albeit with significantly reduced quality and precision, respectively. MGB decoding of temporally modulated pulse trains and speech tokens were both greatly impaired in ouabain-treated mice. Taken together, the absence of an ABR belied a persistent auditory processing at the level of the MGB that was likely enabled through increased central gain. Compensatory

  20. Profound vision loss impairs psychological well-being in young and middle-aged individuals.

    Science.gov (United States)

    Garcia, Giancarlo A; Khoshnevis, Matin; Gale, Jesse; Frousiakis, Starleen E; Hwang, Tiffany J; Poincenot, Lissa; Karanjia, Rustum; Baron, David; Sadun, Alfredo A

    2017-01-01

    The aim of this study was to evaluate the effects of profound vision loss on psychological well-being in adolescents, young adults, and middle-aged adults with regard to mood, interpersonal interactions, and career-related goals. In addition, we assessed the significance of the resources that may be used to enhance psychological well-being in cases of profound vision loss, and in particular, examined the utility of low vision aids and the role of the ophthalmologist as a provider of emotional support. A questionnaire was issued to individuals aged 13-65 years with profound vision loss resulting from Leber's hereditary optic neuropathy (LHON). Depression prevalence was evaluated with questions regarding major depressive disorder symptomatology. Participants appraised the effects of vision loss on their interpersonal interactions and career goals by providing an impact rating (IR) on a 21-point psychometric scale from -10 to +10. Social well-being index was defined as the average of interpersonal IR and career IR. Subjects were additionally asked about the use of low vision aids and sources of emotional support. A total of 103 participants (mean age =26.4±11.2 years at LHON diagnosis; mean ± standard deviation) completed the questionnaire. Nearly half (49.5%) met the depression criteria after vision loss. Negative impacts on interpersonal interactions (median IR = -5) and career goals (median IR = -6) were observed; both ratings were worse ( P negative interpersonal IR and career IR. Sixty-eight percent of subjects used electronic vision aids; controlling for age, social well-being index was higher among these individuals than for those who did not use electronic aids ( P =0.03). Over half of the participants (52.4%) asserted that they derived emotional support from their ophthalmologist. Profound vision loss in adolescents, young adults, and middle-aged adults is associated with significant negative psychological and psychosocial effects, which are influenced by

  1. Parents as experts : the position of parents of children with profound multiple disabilities

    NARCIS (Netherlands)

    de Geeter, K.I.; Poppes, P.; Vlaskamp, C.

    2002-01-01

    Background Parents of children with disabilities are increasingly considered as experts in the field of care. Their expertise can deliver an important contribution towards planning their child's care and education. The law is increasingly taking this factor into consideration. On the one hand,

  2. Profound hyper natremia due to central diabetes insipidus

    International Nuclear Information System (INIS)

    Vaqar, A.; Javaid, K.H.; Parveen, R.; Sadaf, R.

    2012-01-01

    Diabetes insipidus is a rare endocrine disorder in paediatric patients. Polyuria is a cardinal manifestation that is extremely difficult to recognize in diapered infants. Careful urine quantification is the key to diagnosis in appropriate clinical setting. We report a case of a 4 months old infant presenting with an acute life threatening event following an episode of vomiting and decreased oral intake. She had profound hyper natremia which persisted after stabilization. Polyuria unrecognized by the mother was revealed by 24-hour urine output measurement. A diagnosis of diabetes insipidus was made after appropriate laboratory investigations including serum and urine osmolality. The central nature of the disease was confirmed by neuroimaging which showed holoprosencephaly. (author)

  3. Impact of CD133 positive stem cell proportion on survival in patients with glioblastoma multiforme

    International Nuclear Information System (INIS)

    Kase, Marju; Minajeva, Ave; Niinepuu, Kristi; Kase, Sandra; Vardja, Markus; Asser, Toomas; Jaal, Jana

    2013-01-01

    The aim of the study was to assess the impact of CD133-positive (CD133+) cancer stem cell proportions on treatment results of glioblastoma multiforme (GBM) patients. Patients with GBM (n = 42) received postoperative radiotherapy (± chemotherapy). Surgically excised GBM tissue sections were immunohistochemically examined for CD133 expression. The proportions of CD133+ GBM cells were determined (%). The proportion of CD133+ GBM stem cells was established by 2 independent researchers whose results were in good accordance (R = 0.8, p < 0.01). Additionally, CD133 expression levels were correlated with patients overall survival. The proportion of CD133+ cells varied between patients, being from 0.5% to 82%. Mean and median proportions of CD133+ cells of the entire study group were 33% ± 24% (mean ± SD) and 28%, respectively. Clinical data do not support the association between higher proportion of stem cells and the aggressiveness of GBM. Median survival time of the study group was 10.0 months (95% CI 9.0–11.0). The survival time clearly depended on the proportion of CD133+ cells (log rank test, p = 0.02). Median survival times for patients with low (< median) and high (≥ median) proportion of CD133+ cells were 9.0 months (95% CI 7.6–10.5) and 12.0 months (95% CI 9.3–14.7), respectively. In multivariate analysis, the proportion of CD133+ cells emerged as a significant independent predictor for longer overall survival (HR 2.0, 95% CI 1.0–3.8, p = 0.04). In patients with higher stem cell proportion, significantly longer survival times after postoperative radiotherapy were achieved. Underlying reasons and possible higher sensitivity of GBM stem cells to fractionated radio-therapy should be clarified in further studies

  4. Impact of heated humidification with automatic positive airway pressure in obstructive sleep apnea therapy.

    Science.gov (United States)

    Salgado, Sara Moreira da Silva Trindade; Boléo-Tomé, José Pedro Correia Fernandes; Canhão, Cristina Maria Sardinha; Dias, Ana Rita Tavares; Teixeira, Joana Isaac; Pinto, Paula Maria Gonçalves; Caetano, Maria Cristina de Brito Eusébio Bárbara Prista

    2008-09-01

    To study the impact that heated humidification instituted in the beginning of automatic positive airway pressure (APAP) therapy has on compliance with and the side effects of the treatment. Thirty-nine treatment-naïve patients with obstructive sleep apnea were randomized into two groups to receive APAP using one of two modalities: with heated humidification (APAPwith group); and without heated humidification (APAPw/o group).Patients were evaluated at 7 and 30 days after APAP initiation. The following parameters were analyzed: compliance with treatment (mean number of hours/night); side effects (dry nose or mouth, nasal obstruction and rhinorrhea); daytime sleepiness (Epworth sleepiness scale score) and subjective comfort (visual analog scale score). Patients were also evaluated in terms of residual apnea-hypopnea index (AHI), as well as mean pressures and leaks registered in the ventilators. There were no differences between the two groups in terms of mean age (APAPwith: 57.4 +/- 9.2; APAPw/o: 56.5 +/- 10.7 years), AHI (APAPwith: 28.1 +/- 14.0; APAPw/o: 28.8 +/- 20.5 events/hour of sleep), baseline Epworth score (APAPwith: 11.2 +/- 5.8; APAPw/o: 11.9 +/- 6.3) and initial nasal symptoms. Compliance was similar in both groups (APAPwith: 5.3 +/- 2.4; APAPw/o: 5.2 +/- 2.3 h/night). There were no differences in any of the other parameters analyzed. The introduction of heated humidification at the beginning of APAP therapy provided no advantage in terms of treatment compliance or side effects of treatment.

  5. The Differential Effects of Attentional Focus in Children with Moderate and Profound Visual Impairments

    Directory of Open Access Journals (Sweden)

    Scott W. T. McNamara

    2017-10-01

    Full Text Available It has been consistently reported that an external focus of attention leads to better motor performance than an internal focus, but no research to date has explored this effect in a population with visual impairments (VI. External focus statements typically reference something in the environment (e.g., target that may be difficult to conceptualize for people with VI since they cannot generate a visual representation of the object of focus. Internal focus statements could be more closely identifiable with proprioception that is not impaired in this population. Recent studies have reported that sighted adults with temporarily obstructed vision are able to receive an external focus benefit when performing discrete tasks (i.e., golf putt and vertical jump, however, it is unclear if those with VI would experience the same benefit. The purpose of this investigation was to compare how an internal focus and external focus impact the balance of children with VI. Eighteen children with VI were grouped into a moderate (n = 11 and a profound VI group (n = 7. Participants completed a familiarization trial, an internal focus trial (i.e., focusing on feet and an external focus trial (i.e., focusing on markers in a counterbalanced order. The moderate VI group had a lower root mean square error while using an external focus (p = 0.04, while the profound VI group did not differ between conditions (p > 0.05. These results suggest that while performing a task reliant on sensory feedback, an external focus benefit may be dependent on the severity of VI. Further research is needed to examine whether external focus statements can be presented in a way that may be more intuitive to those with profound VI. These findings may help to influence how professionals in health-related fields (e.g., physical therapist and physical educators give instructions on motor performance to populations with VI.

  6. The impact of reorienting cone-beam computed tomographic images in varied head positions on the coordinates of anatomical landmarks

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jae Hun; Jeong, Ho Gul; Hwang, Jae Joon; Lee, Jung Hee; Han, Sang Sun [Dept. of Oral and Maxillofacial Radiology, Yonsei University, College of Dentistry, Seoul (Korea, Republic of)

    2016-06-15

    The aim of this study was to compare the coordinates of anatomical landmarks on cone-beam computed tomographic (CBCT) images in varied head positions before and after reorientation using image analysis software. CBCT images were taken in a normal position and four varied head positions using a dry skull marked with 3 points where gutta percha was fixed. In each of the five radiographic images, reference points were set, 20 anatomical landmarks were identified, and each set of coordinates was calculated. Coordinates in the images from the normally positioned head were compared with those in the images obtained from varied head positions using statistical methods. Post-reorientation coordinates calculated using a three-dimensional image analysis program were also compared to the reference coordinates. In the original images, statistically significant differences were found between coordinates in the normal-position and varied-position images. However, post-reorientation, no statistically significant differences were found between coordinates in the normal-position and varied-position images. The changes in head position impacted the coordinates of the anatomical landmarks in three-dimensional images. However, reorientation using image analysis software allowed accurate superimposition onto the reference positions.

  7. The illusion of the positive: the impact of natural and induced mood on older adults' false recall.

    Science.gov (United States)

    Emery, Lisa; Hess, Thomas M; Elliot, Tonya

    2012-11-01

    Recent research suggests that affective and motivational processes can influence age differences in memory. In the current study, we examine the impact of both natural and induced mood state on age differences in false recall. Older and younger adults performed a version of the Deese-Roediger-McDermott (DRM; Roediger & McDermott, 1995 , Journal of Experimental Psychology: Learning, Memory, and Cognition, 21, 803) false memory paradigm in either their natural mood state or after a positive or negative mood induction. Results indicated that, after accounting for age differences in basic cognitive function, age-related differences in positive mood during the testing session were related to increased false recall in older adults. Inducing older adults into a positive mood also exacerbated age differences in false memory. In contrast, veridical recall did not appear to be systematically influenced by mood. Together, these results suggest that positive mood states can impact older adults' information processing and potentially increase underlying cognitive age differences.

  8. [Rare earth magnets in conjunction with fixed orthodontics. An "attractive" solution for the positioning of impacted teeth].

    Science.gov (United States)

    Dereudre, B

    2001-11-01

    Two rare earth permanent magnets are used to align impacted teeth: one is bonded on the crown of the ectopic tooth, the other, intraoral, guides the impacted tooth to the desired place by its attractive power. The intraoral magnet is fixed to an edgewise arch. The adjustments allowed by fixed appliance create better final tooth position than with removable appliance. Our experience depicts an improvement of stability in results and a diminution of periodontal breakdown.

  9. Interventions that facilitate sustainable jobs and have a positive impact on workers’ health: an overview of systematic reviews

    Directory of Open Access Journals (Sweden)

    Michelle M. Haby

    Full Text Available ABSTRACT Objective To identify interventions that facilitate sustainable jobs and have a positive impact on the health of workers in health sector workplaces. Methods This overview utilized systematic review methods to synthesize evidence from multiple systematic reviews and economic evaluations. A comprehensive search was conducted based on a predefined protocol, including specific inclusion criteria. To be classified as “sustainable,” interventions needed to aim (explicitly or implicitly to 1 have a positive impact on at least two key dimensions of the integrated framework for sustainable development and 2 include measures of health impact. Only interventions conducted in, or applicable to, health sector workplaces were included. Results Fourteen systematic reviews and no economic evaluations met the inclusion criteria for the overview. The interventions that had a positive impact on health included 1 enforcement of occupational health and safety regulations; 2 use of the “degree of experience rating” feature of workers’ compensation; 3 provision of flexible working arrangements that increase worker control and choice; 4 implementation of certain organizational changes to shift work schedules; and 5 use of some employee participation schemes. Interventions with negative impacts on health included 1 downsizing/restructuring; 2 temporary and insecure work arrangements; 3 outsourcing/home-based work arrangements; and 4 some forms of task restructuring. Conclusions What is needed now is careful implementation, in health sector workplaces, of interventions likely to have positive impacts, but with careful evaluation of their effects including possible adverse impacts. Well-evaluated implementation of the interventions (including those at the pilot-study stage will contribute to the evidence base and inform future action. Interventions with negative health impacts should be withdrawn from practice (through regulation, where possible. If

  10. Interventions that facilitate sustainable jobs and have a positive impact on workers' health: an overview of systematic reviews.

    Science.gov (United States)

    Haby, Michelle M; Chapman, Evelina; Clark, Rachel; Galvão, Luiz A C

    2016-11-01

    To identify interventions that facilitate sustainable jobs and have a positive impact on the health of workers in health sector workplaces. This overview utilized systematic review methods to synthesize evidence from multiple systematic reviews and economic evaluations. A comprehensive search was conducted based on a predefined protocol, including specific inclusion criteria. To be classified as "sustainable," interventions needed to aim (explicitly or implicitly) to 1) have a positive impact on at least two key dimensions of the integrated framework for sustainable development and 2) include measures of health impact. Only interventions conducted in, or applicable to, health sector workplaces were included. Fourteen systematic reviews and no economic evaluations met the inclusion criteria for the overview. The interventions that had a positive impact on health included 1) enforcement of occupational health and safety regulations; 2) use of the "degree of experience rating" feature of workers' compensation; 3) provision of flexible working arrangements that increase worker control and choice; 4) implementation of certain organizational changes to shift work schedules; and 5) use of some employee participation schemes. Interventions with negative impacts on health included 1) downsizing/restructuring; 2) temporary and insecure work arrangements; 3) outsourcing/home-based work arrangements; and 4) some forms of task restructuring. What is needed now is careful implementation, in health sector workplaces, of interventions likely to have positive impacts, but with careful evaluation of their effects including possible adverse impacts. Well-evaluated implementation of the interventions (including those at the pilot-study stage) will contribute to the evidence base and inform future action. Interventions with negative health impacts should be withdrawn from practice (through regulation, where possible). If use of these interventions is necessary, for other reasons

  11. The impact of financial position on investment: an analysis for non-financial corporations in the euro area

    OpenAIRE

    Carmen Martínez-Carrascal; Annalisa Ferrando

    2008-01-01

    This paper analyses the impact that firms financial position has on investment decisions using panel data from a large sample of non-financial corporations(around 120,000 firms) in six euro area countries(Belgium, Germany, France, Italy, the Netherlands and Spain). The results indicate that financial position is important to explain capital expenditures, as financial pressure appears relevant in explaining investment dynamics when it is proxied by cash flow, indebtedness and debt burden. The ...

  12. The impact of sensor errors and building structures on particle filter-based inertial positioning

    DEFF Research Database (Denmark)

    Toftkjær, Thomas; Kjærgaard, Mikkel Baun

    2012-01-01

    Positioning systems that do not depend on in-building infrastructures are critical for enabling a range of applications within pervasive computing. Particle filter-based inertial positioning promises infrastructure-less positioning, but previous research has not provided an understanding of how t...

  13. SU-F-T-24: Impact of Source Position and Dose Distribution Due to Curvature of HDR Transfer Tubes

    Energy Technology Data Exchange (ETDEWEB)

    Khan, A; Yue, N [Rutgers University, New Brunswick, NJ (United States)

    2016-06-15

    Purpose: Brachytherapy is a highly targeted from of radiotherapy. While this may lead to ideal dose distributions on the treatment planning system, a small error in source location can lead to change in the dose distribution. The purpose of this study is to quantify the impact on source position error due to curvature of the transfer tubes and the impact this may have on the dose distribution. Methods: Since the source travels along the midline of the tube, an estimate of the positioning error for various angles of curvature was determined using geometric properties of the tube. Based on the range of values a specific shift was chosen to alter the treatment plans for a number of cervical cancer patients who had undergone HDR brachytherapy boost using tandem and ovoids. Impact of dose to target and organs at risk were determined and checked against guidelines outlined by radiation oncologist. Results: The estimate of the positioning error was 2mm short of the expected position (the curved tube can only cause the source to not reach as far as with a flat tube). Quantitative impact on the dose distribution is still in the process of being analyzed. Conclusion: The accepted positioning tolerance for the source position of a HDR brachytherapy unit is plus or minus 1mm. If there is an additional 2mm discrepancy due to tube curvature, this can result in a source being 1mm to 3mm short of the expected location. While we do always attempt to keep the tubes straight, in some cases such as with tandem and ovoids, the tandem connector does not extend as far out from the patient so the ovoid tubes always contain some degree of curvature. The dose impact of this may be significant.

  14. Impact of educational strategies in positioning Samarium-153 EDTMP as a treatment for metastatic bone pain

    International Nuclear Information System (INIS)

    Seminario, C.; Morales, R.; Castro, M.; Cano, R.A.; Mendoza, G.

    2005-01-01

    , which has finished in December 2004. Three television spots were delivered to public: 'Hello, Doctor', which has a morning audience and in two interviews in news programs, with high rating performance. Five interviews were given in radio programs, one of them was for a feminine audience, three for general public and the other two with national impact. In every program a web page, an e-mail and a telephone number were given for consultation. In Nuclear Medicine Centers in Lima telephone calls have been received since the beginning of the campaign every day, up to date. In a year, a monthly conference was delivered to physicians. Samarium EDTMP treatment increased substantially after the campaign. The more significant means in mass media for changing management were patient education, continuous meetings with specialists and one of the television spots used ('Hello, doctor'), which continues to be delivered in the closed circuit TV network of the social security system. We conclude that repetitive educational strategies have a positive impact in delivering radiopharmaceuticals for bone pain palliation to patients with bone metastases

  15. Field evaluation of personal digital assistant enabled by global positioning system : impact on quality of activity and diary data

    NARCIS (Netherlands)

    Bellemans, T.; Kochan, B.; Janssens, D.; Wets, G.; Timmermans, H.J.P.; Stopher, P.

    2016-01-01

    Tom Bellemans, Bruno Kochan, Davy Janssens, Geert Wets and Harry Timmermans (2008), ‘Field Evaluation of Personal Digital Assistant Enabled by Global Positioning System: Impact on Quality of Activity and Diary Data’, Transportation Research Record: Journal of the Transportation Research Board, No.

  16. The Impact of Personal and Program Characteristics on the Placement of School Leadership Preparation Program Graduates in School Leader Positions

    Science.gov (United States)

    Fuller, Edward J.; Hollingworth, Liz; An, Brian P.

    2016-01-01

    Purpose: The purpose of this study is to examine the impact of personal and program characteristics on the placement of graduates of principal preparation programs in assistant principal, principal, and school leadership positions. Research Design: This study relies on Texas principal production data from 1993 through 2007 matched to employment…

  17. Position statement on 'Economic Impact of Oil and Gas Development within the Province of Newfoundland and Labrador

    International Nuclear Information System (INIS)

    1998-01-01

    This document contains the statement outlining the official position of the Newfoundland Ocean Industries Association (NOIA) concerning the report on the 'Economic Impact of Oil and Gas Development within the Province of Newfoundland and Labrador'. NOIA's position reflects the concern that Newfoundland businesses and individuals be involved in this emerging industry. Not unexpectedly, the statement is directed primarily towards improving economic opportunity for its members, but it also argues in favour of increasing economic activity within the province as whole. The Position Statement addresses six major issues of concern. These are: a full and fair opportunity for Newfoundland-resident supply and service companies to bid on an internationally competitive basis; a level playing field for all those who submit bids for contracts; enhancement of Newfoundland technology, expertise and facilities, as well as support of technology transfer to interested and capable Newfoundland businesses or companies; a life-of-field approach to planning, or linking capital expenditure and operational expenditure in order to achieve long-term positive economic impact within Newfoundland and Labrador; a supplier development program to encourage the development of an internationally competitive Newfoundland supply community; and the encouragement of operators and major contractors to fulfill specific requirements for positive economic impact within the province

  18. Otolithic organ function in patients with profound sensorineural hearing loss

    Directory of Open Access Journals (Sweden)

    Yujuan Zhou

    2016-06-01

    Full Text Available Profound sensorineural hearing loss (PSHL is not uncommonly encountered in otology. In clinics, there is a high incidence of otolithic damage in patients with PSHL, but relevant reports are few. Sharing a continuous membranous structure and similar receptor cell ultrastructures, the cochlea and vestibule may be susceptible to the same harmful factors. Disorders of the inner ear may result in a variety of manifestations, including vertigo, spatial disorientation, blurred vision, impaired articulation, and hearing impairment. Considering the diversity of clinical symptoms associated with PSHL with otolithic dysfunction, it may be frequently misdiagnosed, and objective means of testing the function of otolithic organs should be recommended for hearing-impaired patients. Vestibular-evoked myogenic potentials (VEMPs via air-conducted sound are of great importance for the diagnosis of otolithic function. Hearing devices such as cochlear implants are commonly accepted treatments for PSHL, and early identification and treatment of vestibular disorders may increase the success rate of cochlear implantation. Therefore, it is necessary to increase awareness of otolithic functional states in patients with PSHL.

  19. Cancer prevention knowledge of people with profound hearing loss.

    Science.gov (United States)

    Zazove, Philip; Meador, Helen E; Reed, Barbara D; Sen, Ananda; Gorenflo, Daniel W

    2009-03-01

    Deaf persons, a documented minority population, have low reading levels and difficulty communicating with physicians. The effect of these on their knowledge of cancer prevention recommendations is unknown. A cross-sectional study of 222 d/Deaf persons in Michigan, age 18 and older, chose one of four ways (voice, video of a certified American Sign Language interpreter, captions, or printed English) to complete a self-administered computer video questionnaire about demographics, hearing loss, language history, health-care utilization, and health-care information sources, as well as family and social variables. Twelve questions tested their knowledge of cancer prevention recommendations. The outcome measures were the percentage of correct answers to the questions and the association of multiple variables with these responses. Participants averaged 22.9% correct answers with no gender difference. Univariate analysis revealed that smoking history, types of medical problems, last physician visit, and women having previous cancer preventive tests did not affect scores. Improved scores occurred with computer use (p = 0.05), higher education (p internet (p = 0.02), and believing that smoking is bad (p bad (p = 0.05) were associated with improved scores. Persons with profound hearing loss have poor knowledge of recommended cancer prevention interventions. English use in multiple settings was strongly associated with increased knowledge.

  20. Histones induce rapid and profound thrombocytopenia in mice

    Science.gov (United States)

    Bhandari, Ashish A.

    2011-01-01

    Histones are released from dying cells and contribute to antimicrobial defense during infection. However, extracellular histones are a double-edged sword because they also damage host tissue and may cause death. We studied the interactions of histones with platelets. Histones bound to platelets, induced calcium influx, and recruited plasma adhesion proteins such as fibrinogen to induce platelet aggregation. Hereby fibrinogen cross-linked histone-bearing platelets and triggered microaggregation. Fibrinogen interactions with αIIbβ3 integrins were not required for this process but were necessary for the formation of large platelet aggregates. Infused histones associated with platelets in vivo and caused a profound thrombocytopenia within minutes after administration. Mice lacking platelets or αIIbβ3 integrins were protected from histone-induced death but not from histone-induced tissue damage. Heparin, at high concentrations, prevented histone interactions with platelets and protected mice from histone-induced thrombocytopenia, tissue damage, and death. Heparin and histones are evolutionary maintained. Histones may combine microbicidal with prothrombotic properties to fight invading microbes and maintain hemostasis after injury. Heparin may provide an innate counter mechanism to neutralize histones and diminish collateral tissue damage. PMID:21700775

  1. Impact of emotional intelligence on risk behaviour with mediating effect of positive and negative affect

    OpenAIRE

    Khan, I. (Iqra)

    2017-01-01

    Abstract Emotional intelligence and risk taking behaviour are considered as significant factors through which people engage in organizations and in daily life. This dissertation formulates the linkage between emotional intelligence, positive affect, negative affect and risk taking behavior. The underlying principle of this study was to develop a sense of relationship between emotional intelligence, positive affect, negative...

  2. Longitudinal Models of Socio-Economic Status: Impact on Positive Parenting Behaviors

    Science.gov (United States)

    Azad, Gazi; Blacher, Jan; Marcoulides, George

    2014-01-01

    Parenting research is frequently conducted without a thorough examination of socio-economic characteristics. In this study, longitudinal observations of positive parenting were conducted across six time points. Participants were 219 mothers of children with and without developmental delays. Mothers' positive parenting increased during early and…

  3. Positive Youth Development Interventions Impacting the Sexual Health of Young Minority Adolescents: A Systematic Review

    Science.gov (United States)

    Harris, LaNita W.; Cheney, Marshall K.

    2018-01-01

    A systematic literature review was conducted to assess the utility of Positive Youth Development (PYD) concepts in promoting positive sexual health behaviors in young minority adolescents (n = 12 studies). Interventions reported significant associations between PYD-focused interventions and ever having sex, sexual partners in the last 30 days,…

  4. The impact of positive affect on health cognitions and behaviours: a meta-analysis of the experimental evidence.

    Science.gov (United States)

    Cameron, David S; Bertenshaw, Emma J; Sheeran, Paschal

    2015-01-01

    Several reviews suggest that positive affect is associated with improved longevity, fewer physical symptoms, and biological indicators of good health. It is possible that positive affect could influence these outcomes by promoting healthful cognitions and behaviours. The present review identified conceptual pathways from positive affect to health cognitions and behaviour, and used random effects meta-analysis to quantify the impact of positive affect inductions (versus neutral affect conditions) on these outcomes. Literature searches located 54 independent tests that could be included in the review. Across all studies, the findings revealed no reliable effects on intentions (d+ = -.12, 95% CI = -.32 to .08, k = 15) or behaviour (d+ = .15, 95% CI = -.03 to .33, k = 23). There were four reliable effects involving specific cognitions and behaviours, but little clear evidence for generalised benefits or adverse effects of positive emotions on health-related cognitions or actions. Conclusions must be cautious given the paucity of tests available for analysis. The review offers suggestions about research designs that might profitably be deployed in future studies, and calls for additional tests of the impact of discrete positive emotions on health cognitions and behaviour.

  5. AllergoOncology - the impact of allergy in oncology: EAACI position paper

    Czech Academy of Sciences Publication Activity Database

    Jensen-Jarolim, E.; Bax, H. J.; Bianchini, R.; Capron, M.; Corrigan, C.; Castells, M.; Dombrowicz, D.; Daniels-Wells, T. R.; Fazekas, J.; Fiebiger, E.; Gatault, S.; Gould, H. J.; Janda, Jozef; Josephs, D. H.; Karagiannis, P.; Levi-Schaffer, F.; Meshcheryaková, A.; Mechtcheriakova, D.; Mekori, Y.; Mungenast, F.; Nigro, E. A.; Penichet, M. L.; Redegeld, F.; Saul, L.; Singer, J.; Spicer, J. F.; Siccardi, A. G.; Spillner, E.; Turner, M. C.; Untersmayr, E.; Vangelista, L.; Karagiannis, S. N.

    2017-01-01

    Roč. 72, č. 6 (2017), s. 866-887 ISSN 0105-4538 Institutional support: RVO:67985904 Keywords : allergooncology * allergy * atopy Subject RIV: FP - Other Medical Disciplines OBOR OECD: Allergy Impact factor: 7.361, year: 2016

  6. Study of the Impact of the Global Positioning System on Army Survey

    Science.gov (United States)

    1976-09-01

    be introduced to those who will be in positions of leadership and/or decision making at the time of system implementation. This is particularly true...These officers may well be in positions of decision making relative to methods, techniques and unit missions employing GPS. Maintenance, and...the time cf measurement with the aid of auxillary equipment. . TeU2wometeA MRA-1) - This is the oldest type of microwave instrument is the Army

  7. Impact of asymmetric lamp positioning on the performance of a closed-conduit UV reactor

    Directory of Open Access Journals (Sweden)

    Tipu Sultan

    2017-06-01

    Full Text Available Computational fluid dynamics (CFD analyses for the performance improvement of a closed-conduit ultraviolet (UV reactor were performed by changing the lamp positions from symmetric to asymmetric. The asymmetric lamp positioning can be useful for UV reactor design and optimization. This goal was achieved by incorporating the two performance factors, namely reduction equivalent dose (RED and system dose performance. Four cases were carried out for asymmetric lamp positioning within the UV reactor chamber and each case consisted of four UV lamps that were simulated once symmetrically and four times asymmetrically. The results of the four asymmetric cases were compared with the symmetric one. Moreover, these results were evaluated by using CFD simulations of a closed-conduit UV reactor. The fluence rate model, UVCalc3D was employed to validate the simulations results. The simulation results provide detailed information about the dose distribution, pathogen track modeling and RED. The RED value was increased by approximately 15% by using UVCalc3D fluence rate model. Additionally, the asymmetric lamp positioning of the UV lamps had more than 50% of the pathogens received a better and a higher UV dose than in the symmetric case. Consequently, the system dose performance was improved by asymmetric lamp positioning. It was concluded that the performance parameters (higher RED and system dose performance were improved by using asymmetric lamp positioning.

  8. Impact on reproducibility of the treatment position by improving immobilization device in image guided radiation therapy

    International Nuclear Information System (INIS)

    Morita, Yuko; Sasaki, Junichi; Shiomi, Hiroya; Oh, Ryoongjin; Inoue, Toshihiko; Tajiri, Shingo

    2012-01-01

    The immobilization device for treatment becomes important to obtain fixation and reproducibility of the treatment position. It was confirmed that reproducibility of the treatment position obtains higher accuracy by the method of using immobilization device. We divided into three terms by the methods of immobilization. An infrared reflective marker performs the setup of a position at the start of treatment, and setup of the patient in a fixed implement is performed by ExacTrac. Difference between coordinates of the immobilization device and the patient position was calculated by the vector in three directions. We estimated the position error index (PE index ) by using the square root of the sum of square of each vectors, and evaluated the amount of differences of patient position at three terms. Mean and standard deviation of index values were 9.53±7.21, 8.50±5.93, and 6.42±3.80 at each three terms. With every passing year, the amount of gap and difference of the patient fixation has decreased. By the improvement of the use of the immobilization device, gap and difference of fixation has decreased. Accordingly, we could obtain better accuracy of fixation. (author)

  9. Cochlear implantation in autistic children with profound sensorineural hearing loss.

    Science.gov (United States)

    Lachowska, Magdalena; Pastuszka, Agnieszka; Łukaszewicz-Moszyńska, Zuzanna; Mikołajewska, Lidia; Niemczyk, Kazimierz

    2016-11-19

    Cochlear implants have become the method of choice for the treatment of severe-to-profound hearing loss in both children and adults. Its benefits are well documented in the pediatric and adult population. Also deaf children with additional needs, including autism, have been covered by this treatment. The aim of this study was to assess the benefits from cochlear implantation in deafened children with autism as the only additional disability. This study analyzes data of six children. The follow-up time was at least 43 months. The following data were analyzed: medical history, reaction to music and sound, Ling's six sounds test, onomatopoeic word test, reaction to spoken child's name, response to requests, questionnaire given to parents, sound processor fitting sessions and data. After cochlear implantation each child presented other communication skills. In some children, the symptoms of speech understanding were observed. No increased hyperactivity associated with daily use cochlear implant was observed. The study showed that in autistic children the perception is very important for a child's sense of security and makes contact with parents easier. Our study showed that oral communication is not likely to be a realistic goal in children with cochlear implants and autism. The implantation results showed benefits that varied among those children. The traditional methods of evaluating the results of cochlear implantation in children with autism are usually insufficient to fully assess the functional benefits. These benefits should be assessed in a more comprehensive manner taking into account the limitations of communication resulting from the essence of autism. It is important that we share knowledge about these complex children with cochlear implants. Copyright © 2016 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

  10. Basic life support and children with profound and multiple learning disabilities.

    Science.gov (United States)

    Cash, Stefan; Shinnick-Page, Andrea

    2008-10-01

    Nurses and other carers of people with learning disabilities must be able to manage choking events and perform basic life support effectively. UK guidelines for assessment of airway obstruction and for resuscitation do not take account of the specific needs of people with profound multiple learning disability. For example, they fail to account for inhibited gag and coughing reflexes, limited body movements or chest deformity. There are no national guidelines to assist in clinical decisions and training for nurses and carers. Basic life support training for students of learning disability nursing at Birmingham City University is supplemented to address these issues. The authors ask whether such training should be provided for all nurses including those caring for children and young people. They also invite comment and discussion on questions related to chest compression and training in basic life support for a person in a seated position.

  11. Attachment style impacts behavior and early oculomotor response to positive, but not negative, pictures.

    Science.gov (United States)

    Silva, Catarina; Chaminade, Thierry; David, Da Fonseca; Santos, Andreia; Esteves, Francisco; Soares, Isabel; Deruelle, Christine

    2015-06-01

    The present study investigated whether oculomotor behavior is influenced by attachment styles. The Relationship Scales Questionnaire was used to assess attachment styles of forty-eight voluntary university students and to classify them into attachment groups (secure, preoccupied, fearful, and dismissing). Eye-tracking was recorded while participants engaged in a 3-seconds free visual exploration of stimuli presenting either a positive or a negative picture together with a neutral picture, all depicting social interactions. The task consisted in identifying whether the two pictures depicted the same emotion. Results showed that the processing of negative pictures was impermeable to attachment style, while the processing of positive pictures was significantly influenced by individual differences in insecure attachment. The groups highly avoidant regarding to attachment (dismissing and fearful) showed reduced accuracy, suggesting a higher threshold for recognizing positive emotions compared to the secure group. The groups with higher attachment anxiety (preoccupied and fearful) showed differences in automatic capture of attention, in particular an increased delay preceding the first fixation to a picture of positive emotional valence. Despite lenient statistical thresholds induced by the limited sample size of some groups (p < 0.05 uncorrected for multiple comparisons), the current findings suggest that the processing of positive emotions is affected by attachment styles. These results are discussed within a broader evolutionary framework. © 2015 Scandinavian Psychological Associations and John Wiley & Sons Ltd.

  12. The impact of whole-hand vibration exposure on the sense of angular position about the wrist joint.

    Science.gov (United States)

    Radovanovic, Sasa; Day, Scott Jason; Johansson, Håkan

    2006-02-01

    The purpose of this research is to determine the impact of whole-hand vibration on the capacity of subjects to identify previously presented positions of the hand in both wrist flexion and extension. In each movement direction, targets of 15 or 30 degrees were presented with an imposed passive movement from the start position. During the second imposed movement, subjects were required to identify when the target position had been reached. For the vibration condition, 15 s of whole-hand vibration exposure was repeated immediately prior to each target position trial. Proprioceptive capacity was assessed by comparing the identified angular position with the reference position-angular distance expressed in terms of absolute error (AE), constant error (CE), and variable error (VE). For three of the four target positions (15 and 30 degrees flexion and 15 degrees extension), the absolute, constant, and VEs of target identification were insensitive to vibration, whereas for the 30 degrees extension target, both the absolute and CE were significantly different before and after the vibration application, showing the subjects overshooting previously presented target position. All three error measures were larger for the long targets than the short targets. Short-duration exposure to whole-hand vibration is insufficient to compromise post-vibration position sense in the wrist joint, except near the end range of joint movement in wrist extension. Complement contribution of different proprioceptive receptors (muscle, joint, and skin receptors) seems to be crucial for accuracy to reproduce passive movements, since the capacity of any individual class of receptor to deliver information about movement and position of the limbs is limited.

  13. An evaluation of CPD learning and impact upon positive practice change.

    Science.gov (United States)

    Lee, Nancy-Jane

    2011-05-01

    This paper explores positive practice change in nursing and health care practice following continuing professional development (CPD). It is derived from a commissioned evaluation study within the United Kingdom (UK). Evaluation data was gathered using semi structured discussions with CPD participants, a convenience sample of line managers and University module leaders. Findings suggest that professional peer attitudes and support, when harnessed effectively in the practice setting, strongly enhance positive change. Conversely a lack of engagement with practice peers, a lack of strategic support and not knowing how to access support hinder change. The study found that learning need was often explored through personal development planning and appraisal, however there was little systematic follow up, review and support following learning. Interestingly the individual personal drive and enthusiasm of practitioners was perceived as the strongest factor helping practice change, while policy drivers and national health targets were secondary. Possible strategies to enhance positive practice change are explored. Copyright © 2010 Elsevier Ltd. All rights reserved.

  14. Impact and characteristics of positive and fearful emotional messages during infant social referencing.

    Science.gov (United States)

    Kim, Geunyoung; Walden, Tedra A; Knieps, Linda J

    2010-04-01

    Studies of infant social referencing have indicated that infants might be more influenced by vocal information contained in emotional messages than by facial expression, especially during fearful message conditions. The present study investigated the characteristics of emotional channels that parents used during social referencing, and corresponding infants' behavioral changes. Results of Study 1 indicated that parents used more vocal information during positive message conditions. Unlike previous findings, infants' behavioral change was related to the frequency of vocal information during positive condition. For fearful messages, infants were more influenced by the number of multi-modal channels used and the frequency of visual information. Study 2 further showed that the intensity of vocal tone was related to infant regulation only during positive message conditions. The results imply that understanding of social context is important to make sense of parent-infant's emotional interaction. Copyright 2010 Elsevier Inc. All rights reserved.

  15. Correlational study of impacted and non-functional lower third molar position with occurrence of pathologies

    Directory of Open Access Journals (Sweden)

    Igor Batista Camargo

    2016-09-01

    Full Text Available Abstract Background Lower third molar (M3 eruption is unpredictable. The purpose of this study was to correlate radiographic position of M3 on a preexistent film with the current clinical, histopathological, and radiographic findings. Methods A retrospective cohort study was performed. The sample was collected from a database of patients covered by Medical Fund of Brazilian Army. Radiographs were obtained a minimum of 5 years prior to the presurgical visit and after their clinical exam. The primary outcome variables were the teeth positions using Pell and Gregory/Winter classifications on panoramic X-rays. Those variables were analyzed at both the beginning (T0 and end of the study (T1. Clinical assessments and histopathological study of the thirds that were extracted were performed only at T1. Correlation between the teeth positions were related to the clinical, histopathological, and radiographic parameters using statistical analysis tests with significance set at p < 0.05. Results Twenty-six patients with 49 M3 were assessed over 10 months. Mean age was 14.92 years at T0 and 21.87 years at T1. The average time between T0 and T1 was 6.77 years. A significant relationship (p = 0.024 was found between the presences of root resorption on the second molar if M3 presented in an IB horizontal position at T1. There was also a significant correlation (p = 0.039 between dental crowding of the anterior lower teeth with IIIB position at T0 and if the patient finished orthodontic treatment without lingual retainers. Conclusions Lower M3 in position IIIB seen in a teenager and IB seen in an adult is more likely to have negative consequences and should be followed closely.

  16. Toward an Optimal Position for IVC Filters: Computational Modeling of the Impact of Renal Vein Inflow

    Energy Technology Data Exchange (ETDEWEB)

    Wang, S L; Singer, M A

    2009-07-13

    The purpose of this report is to evaluate the hemodynamic effects of renal vein inflow and filter position on unoccluded and partially occluded IVC filters using three-dimensional computational fluid dynamics. Three-dimensional models of the TrapEase and Gunther Celect IVC filters, spherical thrombi, and an IVC with renal veins were constructed. Hemodynamics of steady-state flow was examined for unoccluded and partially occluded TrapEase and Gunther Celect IVC filters in varying proximity to the renal veins. Flow past the unoccluded filters demonstrated minimal disruption. Natural regions of stagnant/recirculating flow in the IVC are observed superior to the bilateral renal vein inflows, and high flow velocities and elevated shear stresses are observed in the vicinity of renal inflow. Spherical thrombi induce stagnant and/or recirculating flow downstream of the thrombus. Placement of the TrapEase filter in the suprarenal vein position resulted in a large area of low shear stress/stagnant flow within the filter just downstream of thrombus trapped in the upstream trapping position. Filter position with respect to renal vein inflow influences the hemodynamics of filter trapping. Placement of the TrapEase filter in a suprarenal location may be thrombogenic with redundant areas of stagnant/recirculating flow and low shear stress along the caval wall due to the upstream trapping position and the naturally occurring region of stagnant flow from the renal veins. Infrarenal vein placement of IVC filters in a near juxtarenal position with the downstream cone near the renal vein inflow likely confers increased levels of mechanical lysis of trapped thrombi due to increased shear stress from renal vein inflow.

  17. Unconditional Positive Regard, Empathetic Listening, and the Impact of Digital Text Driven Communication

    Science.gov (United States)

    Cuny, Kimberly M.

    2012-01-01

    Generally speaking, Generation N students are known to enjoy working in groups yet they often do not communicate effectively when measured by traditional expectations. This activity calls into question the impact that our daily nonvocal digital communicating has on our ability to empathetically listen.

  18. Assessing Input Enhancement as Positive Factor and Its Impact on L2 Vocabulary Learning

    Science.gov (United States)

    Motlagh, Seyyed Fariborz Pishdadi; Nasab, Mahdiyeh Seyed Beheshti

    2015-01-01

    Input enhancement's role to promote learners' awareness in L2 contexts has caused a tremendous amount of research. Conspicuously, by regarding all aspects of input enhancement, the study aimed to find out how differently many kinds of input enhancement factors such as bolding, underlining, and capitalizing impact on L2 learners' vocabulary…

  19. Conventional treatment of functional constipation has a positive impact on the behavioural difficulties in children with and without faecal incontinence

    DEFF Research Database (Denmark)

    Modin, Line; Jakobsen, Ida Skytte; Jakobsen, Marianne Skytte

    2016-01-01

    AIM: Constipation studies have only evaluated behavioural difficulties in children with faecal incontinence. This study evaluated changes in behavioural difficulties in childhood with functional constipation (FC) with and without faecal incontinence, based on treatment outcomes. METHODS: Children...... treatment of FC had a positive impact on behavioural difficulties in constipated children with and without faecal incontinence. This study highlights the importance of proactive detection and treatment of FC in paediatric patients....

  20. Prognostic Impact of Adjuvant Radiotherapy in Breast Cancer Patients with One to Three Positive Axillary Lymph Nodes

    OpenAIRE

    Mansour Ansari; Behnam Kadkhodaei; Mehdi Shariat; Abdolrasoul Talei; Majid Akrami; Vahid Zangouri; Niloofar Ahmadloo; Mohammad Mohammadianpanah; Sayed Hasan Hamedi; Hamid Nasrolahi; Shapour Omidvari; Ahmad Mosalaei

    2018-01-01

    Background: Radiotherapy, as an adjuvant treatment, plays a well-known role in prevention of locoregional recurrence in breast cancer patients. This study aims to investigate the impact of radiotherapy in patients with N1 disease. Methods: In this retrospective study, we reviewed the characteristics and treatment outcomes of 316 patients with a biopsy proven diagnosis of breast carcinoma and 1-3 positive axillary lymph nodes. The patients received treatment between 1995 and 201...

  1. Impact of ultrasound probe pressure on uterine positional displacement in gynecologic cancer patients

    DEFF Research Database (Denmark)

    Baker, Mariwan; Juhler-Nøttrup, Trine; Behrens, Claus F.

    2014-01-01

    Aim: The aim of this study was to quantify the uterine positional displacement induced by ultrasound probe pressure on a phantom and address the daily uterine motion in a healthy volunteer. Materials & methods: The phantom mimics the female pelvic region. The incorporated organs were subjected to...

  2. Meetings as a positive boost? How and when meeting satisfaction impacts employee empowerment

    NARCIS (Netherlands)

    Allen, J.A.; Lehmann-Willenbrock, N.K.; Sands, S.

    2016-01-01

    Meetings constitute an important context for understanding organizational behavior and employee attitudes. Employees spend ever-increasing time in meetings and often complain about their meetings. In contrast, we explore the positive side of meetings and argue that satisfying meetings can empower

  3. Meta-Analysis of the Impact of Positive Psychological Capital on Employee Attitudes, Behaviors, and Performance

    Science.gov (United States)

    Avey, James B.; Reichard, Rebecca J.; Luthans, Fred; Mhatre, Ketan H.

    2011-01-01

    The positive core construct of psychological capital (or simply PsyCap), consisting of the psychological resources of hope, efficacy, resilience, and optimism, has recently been demonstrated to be open to human resource development (HRD) and performance management. The research stream on PsyCap has now grown to the point that a quantitative…

  4. Nanotechnological Inventions and Nanomaterials Produce A Profound Effect

    Directory of Open Access Journals (Sweden)

    VLASOV Vladimir Alexeevich

    2015-02-01

    Full Text Available The inventions in the area of nanotechnologies and nanomaterials produce a profound effect in construction, housing and communal services and adjacent economic fields as they allow us: to increase mechanical strength, coefficient of elasticity, alkali resistance and temperature of products vitrification; to obtain nanostructured coatings with the property of shape memory on the steel; to raise the dynamics of coal burning and its full burnout in the boilers of thermoelectric power station; to produce metal nanopowders with increased stored energy 10–15% etc. For example, the invention «Epoxy composition for high strength, alkali resistant structures» refers to epoxy composition used as a binder for production of high strength, thermal- and alkali-resistant glass-fiber material which can be applied in the manufacture process of construction reinforcement to strengthen concrete structures. The invention «The method to produce nanostructured reaction foil» can be used to join different materials including metal alloys, ceramics, amorphous materials and elements of microelectronic devices that are sensible to the heating. This process provides decreased labour-output ratio and energy consumption as well as the condition to manufacture foil with specified stored energy and high mechanical properties. The invention «The method of intensification of burning lowreactionary coal in the boilers of thermoelectric power station» refers to the thermal energy and can be implemented at the thermal plants. The increased dynamics of inflaming and burning leads to full burnout of powdered-coal low-reactionary fuel and decreased mechanical underfiring. The specialists may be also interested in the following inventions: fine dispersed organic suspension of carbon metal-containing nanostructures and the method to produce it; the dispersion of carbon nanotubes; the composition for reinforcement of building structures; the reinforced plate element made of

  5. The impact of the microphone position on the frequency analysis of snoring sounds.

    Science.gov (United States)

    Herzog, Michael; Kühnel, Thomas; Bremert, Thomas; Herzog, Beatrice; Hosemann, Werner; Kaftan, Holger

    2009-08-01

    Frequency analysis of snoring sounds has been reported as a diagnostic tool to differentiate between different sources of snoring. Several studies have been published presenting diverging results of the frequency analyses of snoring sounds. Depending on the position of the used microphones, the results of the frequency analysis of snoring sounds vary. The present study investigated the influence of different microphone positions on the outcome of the frequency analysis of snoring sounds. Nocturnal snoring was recorded simultaneously at six positions (air-coupled: 30 cm middle, 100 cm middle, 30 cm lateral to both sides of the patients' head; body contact: neck and parasternal) in five patients. The used microphones had a flat frequency response and a similar frequency range (10/40 Hz-18 kHz). Frequency analysis was performed by fast Fourier transformation and frequency bands as well as peak intensities (Peaks 1-5) were detected. Air-coupled microphones presented a wider frequency range (60 Hz-10 kHz) compared to contact microphones. The contact microphone at cervical position presented a cut off at frequencies above 300 Hz, whereas the contact microphone at parasternal position revealed a cut off above 100 Hz. On an exemplary base, the study demonstrates that frequencies above 1,000 Hz do appear in complex snoring patterns, and it is emphasised that high frequencies are imported for the interpretation of snoring sounds with respect to the identification of the source of snoring. Contact microphones might be used in screening devices, but for a natural analysis of snoring sounds the use of air-coupled microphones is indispensable.

  6. An Analysis of Impact Factors for Positioning Performance in WLAN Fingerprinting Systems Using Ishikawa Diagrams and a Simulation Platform

    Directory of Open Access Journals (Sweden)

    Keqiang Liu

    2017-01-01

    Full Text Available Many factors influence the positioning performance in WLAN RSSI fingerprinting systems, and summary of these factors is an important but challenging job. Moreover, impact analysis on nonalgorithm factors is significant to system application and quality control but little research has been conducted. This paper analyzes and summarizes the potential impact factors by using an Ishikawa diagram considering radio signal transmitting, propagating, receiving, and processing. A simulation platform was developed to facilitate the analysis experiment, and the paper classifies the potential factors into controllable, uncontrollable, nuisance, and held-constant factors considering simulation feasibility. It takes five nonalgorithm controllable factors including APs density, APs distribution, radio signal propagating attenuation factor, radio signal propagating noise, and RPs density into consideration and adopted the OFAT analysis method in experiment. The positioning result was achieved by using the deterministic and probabilistic algorithms, and the error was presented by RMSE and CDF. The results indicate that the high APs density, signal propagating attenuation factor, and RPs density, with the low signal propagating noise level, are favorable to better performance, while APs distribution has no particular impact pattern on the positioning error. Overall, this paper has made great potential contribution to the quality control of WLAN fingerprinting solutions.

  7. Scientific journals in the SciELO database, indicators of impact and the relative position of Ambiente & Água

    Directory of Open Access Journals (Sweden)

    Nelson Wellausen Dias

    2010-12-01

    Full Text Available This editorial describes the process of periodic evaluation by CAPES, based on commercial indices proposed by companies such as the ISI FI by Thomson Reuters and SCImago by Scopus and public indices as proposed by SciELO and other freely calculated indices based on Google Scholar and investigates the impact position of the journal Ambiente & Agua compared with journals from the SciELO base. Results show that Ambiente & Agua is in the right path in the search for quality. Its editorial board strongly recommends that Brazilian public scientific agencies consider tools that are cost free and have large coverage for impact evaluation to allow the impact assessment of a range of emerging journals in a common and wide basis for all scientific journals.

  8. Musical training and empathy positively impact adults’ sensitivity to infant distress

    Directory of Open Access Journals (Sweden)

    Christine E Parsons

    2014-12-01

    Full Text Available Crying is the most powerful auditory signal of infant need. Adults’ ability to perceive and respond to crying is important for infant survival and in the provision of care. This study investigated a number of listener variables that might impact on adults’ perception of infant cry distress, namely parental status, musical training and empathy. Sensitivity to infant distress was tested using a previously validated task, which experimentally manipulated distress by varying the pitch of infant cries. Parents with musical training showed a significant advantage on this task when compared with parents without. The extent of the advantage was correlated with the amount of self-reported musical training. For non-parents, individual differences in empathy were associated with task performance, with higher empathy scores corresponding to greater sensitivity to infant distress. We suggest that sensitivity to infant distress can be impacted by a number of listener variables, and may be amenable to training.

  9. THE IMPACT OF FINANCIAL OPERATIONS OF UTILITY COMPANIES ON THE FINANCIAL POSITION OF THE CITY

    Directory of Open Access Journals (Sweden)

    Milan Stanić

    2015-12-01

    Full Text Available In this paper, the main topic will be the financing of utility companies and the financial impact on the budget of the local business units. A special emphasis will be placed on the financing of utility companies in Slavonski Brod. The paper defines each area of utility services and presents the utilities as services of public interest as well their privatization in general. The paper reports on the financing of these services and on the European Union regulations and directives concerning them. In addition, the paper includes an overview of the sources of funding of utility companies and loan opportunities. Guarantees and subsidies are included as financing measures of the activities of communal companies. The practical part presents an interview with key individuals of the city of Slavonski Brod with regard to the impact of the budget on the financing of utility services of the utility company in this city – “Komunalac Ltd.”.

  10. The positive impact of women's employment on divorce: Context, selection, or anticipation?

    OpenAIRE

    Daniele Vignoli; Anna Matysiak; Marta Styrc; Valentina Tocchioni

    2018-01-01

    Background: Empirical findings regarding the impact of women's employment on divorce are mixed. One explanation is that the effects are moderated by the country context. Another is that previous studies have failed to account for unobserved factors that introduce bias into the estimated effects. Studies also rarely consider possible anticipatory employment behavior on the part of women who are thinking of divorce. Objective: The aim of this study is to deepen our understanding of the nexus...

  11. Stratification of Antibody-Positive Subjects by Antibody Level Reveals an Impact of Immunogenicity on Pharmacokinetics

    OpenAIRE

    Zhou, Lei; Hoofring, Sarah A.; Wu, Yu; Vu, Thuy; Ma, Peiming; Swanson, Steven J.; Chirmule, Narendra; Starcevic, Marta

    2012-01-01

    The availability of highly sensitive immunoassays enables the detection of antidrug antibody (ADA) responses of various concentrations and affinities. The analysis of the impact of antibody status on drug pharmacokinetics (PK) is confounded by the presence of low-affinity or low-concentration antibody responses within the dataset. In a phase 2 clinical trial, a large proportion of subjects (45%) developed ADA following weekly dosing with AMG 317, a fully human monoclonal antibody therapeutic....

  12. Impact of relative position vehicle-wind blower in a roller test bench under climatic chamber

    International Nuclear Information System (INIS)

    Fernández-Yáñez, P.; Armas, O.; Martínez-Martínez, S.

    2016-01-01

    Highlights: • Air simulation model was developed for a vehicle test bench under climatic chamber. • Good accuracy between experimental data and simulated values were obtained. • Wind blower-vehicle relative position alters external cooling of after-treatment devices. • Vehicle emission certification can be affected by wind blower-vehicle relative position. - Abstract: In terms of energy efficiency and exhaust emissions control, an appropriate design of cooling systems of climatic chambers destined to vehicle certification and/or perform scientific research is becoming increasingly important. European vehicle emissions certification (New European Driving Cycle, NEDC) establishes the position of the wind-simulation blower at 200 mm above floor level. This height is fixed and kept constant independently of the vehicle tested. The position of the blower with respect to the vehicle can modify the external forced convection under the car, where after-treatment devices are located. Consequently, the performance of such devices could be modified and emission results during the certification cycle could be non-representative of real-world driving conditions. The aim of this work is to study the influence of different wind blower-vehicle relative heights on the air velocity and temperature profiles under the car by means of a simple computational fluid dynamics (CFD) approach. A steady state three-dimensional CFD model was developed and applied to the estimation of the air velocity and temperature profiles inside of a climatic chamber equipped with a vehicle roller (chassis dyno) test bench. The simulations reproduce one steady-state condition from NEDC, specifically the EU17 mode (120 km/h, maximum velocity during the cycle). The cool air propelling temperature was 20 °C (minimum temperature in the NEDC range). Simulations were performed employing the Reynolds-Averaged Navier-Stokes (RANS) approach with the realizable k-ε model to provide closure. Air velocity and

  13. Impact of variation in the BDNF gene on social stress sensitivity and the buffering impact of positive emotions: replication and extension of a gene-environment interaction.

    Science.gov (United States)

    van Winkel, Mark; Peeters, Frenk; van Winkel, Ruud; Kenis, Gunter; Collip, Dina; Geschwind, Nicole; Jacobs, Nele; Derom, Catherine; Thiery, Evert; van Os, Jim; Myin-Germeys, Inez; Wichers, Marieke

    2014-06-01

    A previous study reported that social stress sensitivity is moderated by the brain-derived-neurotrophic-factor(Val66Met) (BDNF rs6265) genotype. Additionally, positive emotions partially neutralize this moderating effect. The current study aimed to: (i) replicate in a new independent sample of subjects with residual depressive symptoms the moderating effect of BDNF(Val66Met) genotype on social stress sensitivity, (ii) replicate the neutralizing impact of positive emotions, (iii) extend these analyses to other variations in the BDNF gene in the new independent sample and the original sample of non-depressed individuals. Previous findings were replicated in an experience sampling method (ESM) study. Negative Affect (NA) responses to social stress were stronger in "Val/Met" carriers of BDNF(Val66Met) compared to "Val/Val" carriers. Positive emotions neutralized the moderating effect of BDNF(Val66Met) genotype on social stress sensitivity in a dose-response fashion. Finally, two of four additional BDNF SNPs (rs11030101, rs2049046) showed similar moderating effects on social stress-sensitivity across both samples. The neutralizing effect of positive emotions on the moderating effects of these two additional SNPs was found in one sample. In conclusion, ESM has important advantages in gene-environment (GxE) research and may attribute to more consistent findings in future GxE research. This study shows how the impact of BDNF genetic variation on depressive symptoms may be explained by its impact on subtle daily life responses to social stress. Further, it shows that the generation of positive affect (PA) can buffer social stress sensitivity and partially undo the genetic susceptibility. Copyright © 2014 Elsevier B.V. and ECNP. All rights reserved.

  14. Street connectivity and obesity in Glasgow, Scotland: impact of age, sex and socioeconomic position.

    Science.gov (United States)

    Ball, Kylie; Lamb, Karen; Travaglini, Noemi; Ellaway, Anne

    2012-11-01

    This study investigated associations of street connectivity with body mass index (BMI), and whether these associations varied by sex, age and socioeconomic position, amongst adults in Glasgow, Scotland. Data on socio-demographic variables, height and weight were collected from 1062 participants in the Greater Glasgow Health and Well-being Study, and linked with neighbourhood-level census and geo-referenced data on area level deprivation and street connectivity. Results of multilevel models showed that, after adjustment for individual level covariates, street connectivity was not significantly associated with either BMI or BMI category; nor were there any significant interactions between age, sex or socioeconomic position and street connectivity. Copyright © 2012 Elsevier Ltd. All rights reserved.

  15. The positive impact of structured surfing courses on the wellbeing of vulnerable young people.

    Science.gov (United States)

    Godfrey, Cath; Devine-Wright, Hannah; Taylor, Joe

    2015-01-01

    Involvement in positive leisure activities is a key way for young people to develop resilience and social and emotional skills. This paper outlines the evaluation of a six-week surfing intervention, the Wave Project, which aimed to boost wellbeing and confidence among 84 young people aged eight to 18, all of whom faced mental health issues or social exclusion. The intervention resulted in a significant and sustained increase in wellbeing. One year later, 70% of clients regularly attend a surf club and many have become trained as session volunteers. Parents and referrers noticed an increase in positive attitude and better communication, as well as improved self-management and behaviour at both home and school It is concluded that the Wave Project provides a demonstrable and cost-effective way to deliver mental health care, mentoring and social integration of young people. Further service evaluation of accessibility and long-term outcomes is also recommended.

  16. Profound vision loss impairs psychological well-being in young and middle-aged individuals

    Directory of Open Access Journals (Sweden)

    Garcia GA

    2017-02-01

    Full Text Available Giancarlo A Garcia,1,2 Matin Khoshnevis,1,3 Jesse Gale,1,4 Starleen E Frousiakis,1,5 Tiffany J Hwang,1,6 Lissa Poincenot,1 Rustum Karanjia,1,7–9 David Baron,6 Alfredo A Sadun1,7 1Doheny Eye Institute, Los Angeles, CA, USA; 2University of California, Irvine School of Medicine, Irvine, CA, USA; 3Department of Ophthalmology, Temple University, Philadelphia, PA, USA; 4Wellington School of Medicine and Health Sciences, University of Otago, Wellington, NZ; 5Department of Ophthalmology, New York Medical College, Valhalla, NY, USA; 6Department of Psychiatry & The Behavioral Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA; 7Doheny Eye Centers, Department of Ophthalmology, David Geffen School of Medicine at UCLA, Los Angeles California, CA, USA; 8Department of Ophthalmology, University of Ottawa, Ottawa, ON, Canada; 9Ottawa Hospital Health Research Institute, Ottawa, ON, Canada Purpose: The aim of this study was to evaluate the effects of profound vision loss on psychological well-being in adolescents, young adults, and middle-aged adults with regard to mood, interpersonal interactions, and career-related goals. In addition, we assessed the significance of the resources that may be used to enhance psychological well-being in cases of profound vision loss, and in particular, examined the utility of low vision aids and the role of the ophthalmologist as a provider of emotional support.Methods: A questionnaire was issued to individuals aged 13–65 years with profound vision loss resulting from Leber’s hereditary optic neuropathy (LHON. Depression prevalence was evaluated with questions regarding major depressive disorder symptomatology. Participants appraised the effects of vision loss on their interpersonal interactions and career goals by providing an impact rating (IR on a 21-point psychometric scale from −10 to +10. Social well-being index was defined as the average of interpersonal IR and career IR

  17. COMPETITIVE STATE ANXIETY: IMPACT OF POSITIVE SELF TALK TRAINING ON JUNIOR LEVEL FOOTBALL PLAYERS

    OpenAIRE

    Abdussalam Kanniyan

    2015-01-01

    During the last few decades, coaches and athletes from a wide variety of sports have begun to realize the importance of the mental side of athletic performance. Sport specialists agree that athletic performance is influenced not only by physical skills but also by psychological ones. In order to achieve peak performance athletes need a “total package” including physical skills, psychological skills, fitness and injury prevention (Singh 2011). Study was aimed to examine the effect of Positive ...

  18. Node-positive cervical cancer: impact of pelvic irradiation and patterns of failure

    International Nuclear Information System (INIS)

    Stock, Richard G.; Chen, Alex S. J.; Flickinger, John C.; Kalnicki, Shalom; Seski, Jan

    1995-01-01

    Purpose: The roles of postoperative pelvic and prophylactic paraaortic irradiation in pelvic node positive cervical cancer are currently controversial. A retrospective study was undertaken to examine the effect of pelvic irradiation on pelvic control and survival and to analyze the patterns of recurrence to determine whether indications exist for prophylactic paraaortic irradiation. Methods and Materials: From 1964 to 1991, 143 cases of FIGO Stage I and II cervical cancer undergoing exploratory laparotomy, pelvic lymph node dissection, and radical hysterectomy had positive pelvic lymph nodes. Postoperatively, 108 cases were treated with whole pelvic irradiation while 35 patients were observed. Prophylactic paraaortic irradiation was not given. Results: Patients who received postoperative whole pelvic irradiation compared with those treated with radical hysterectomy alone had a significantly improved pelvic control rate, disease-free survival (DFS), and overall survival. The 5-year actuarial pelvic control rate was 78% vs. 45% (p = <0.0001), respectively. The 5-year actuarial DFS was 65% vs. 41% (p = 0.0004). The 5-year actuarial overall survival was 58% vs. 46% (p 0.02). In multivariate analysis, pelvic irradiation continued to show a positive effect on DFS (p = 0.0001) and overall survival (p = 0.0035). Lymphatic invasion and the total number of positive lymph nodes were the only other independent predictors of overall survival and DFS. The actuarial 5-year pelvic, paraaortic, and distant failure rates were 30%, 10%, and 28%, respectively. An isolated first recurrence in the paraaortic nodes occurred in only three cases. Conclusion: Postoperative pelvic irradiation significantly improves pelvic control, DFS, and overall survival, and should be used in patients with early stage cervical cancer and pathologically proven pelvic nodal metastases. The low incidence of isolated paraaortic nodal failure calls into question the value of routine prophylactic paraaortic

  19. Node-positive cervical cancer: impact of pelvic irradiation and patterns of failure

    Energy Technology Data Exchange (ETDEWEB)

    Stock, Richard G; Chen, Alex S. J.; Flickinger, John C; Kalnicki, Shalom; Seski, Jan

    1995-01-01

    Purpose: The roles of postoperative pelvic and prophylactic paraaortic irradiation in pelvic node positive cervical cancer are currently controversial. A retrospective study was undertaken to examine the effect of pelvic irradiation on pelvic control and survival and to analyze the patterns of recurrence to determine whether indications exist for prophylactic paraaortic irradiation. Methods and Materials: From 1964 to 1991, 143 cases of FIGO Stage I and II cervical cancer undergoing exploratory laparotomy, pelvic lymph node dissection, and radical hysterectomy had positive pelvic lymph nodes. Postoperatively, 108 cases were treated with whole pelvic irradiation while 35 patients were observed. Prophylactic paraaortic irradiation was not given. Results: Patients who received postoperative whole pelvic irradiation compared with those treated with radical hysterectomy alone had a significantly improved pelvic control rate, disease-free survival (DFS), and overall survival. The 5-year actuarial pelvic control rate was 78% vs. 45% (p = <0.0001), respectively. The 5-year actuarial DFS was 65% vs. 41% (p = 0.0004). The 5-year actuarial overall survival was 58% vs. 46% (p 0.02). In multivariate analysis, pelvic irradiation continued to show a positive effect on DFS (p = 0.0001) and overall survival (p = 0.0035). Lymphatic invasion and the total number of positive lymph nodes were the only other independent predictors of overall survival and DFS. The actuarial 5-year pelvic, paraaortic, and distant failure rates were 30%, 10%, and 28%, respectively. An isolated first recurrence in the paraaortic nodes occurred in only three cases. Conclusion: Postoperative pelvic irradiation significantly improves pelvic control, DFS, and overall survival, and should be used in patients with early stage cervical cancer and pathologically proven pelvic nodal metastases. The low incidence of isolated paraaortic nodal failure calls into question the value of routine prophylactic paraaortic

  20. The Marketing & Positive Impacts of Behavioral Control System on Societies & Countries

    OpenAIRE

    Ahmad Adel Mostafa; Ahmed Mohamed Tawfik

    2015-01-01

    Behavioral control systems are one of the most prominent tools used by managers and marketers for different internal and external purposes. One of the most important external purposes they have been used for is influencing consumer behavior. This paper explores the positive effects of implementing such systems on societies. It discusses consumer perception of the systems, their influence on their financial behavior in different contexts, how can they create order and how as well ...

  1. The Impact of the Application of IFRS on Reporting the Financial Position

    Directory of Open Access Journals (Sweden)

    Mihaela-Cristina ONICA

    2012-11-01

    Full Text Available The application of IFRS in an economic entity’s accounting imposes the paying of special attention to not necessarily the similarities but most importantly to the differences which appear between the national referential and the IASB one. As regards the financial position of the entity, we may say that, more or less, all standards influence it, but some impose differences which must be mentioned.

  2. The Marketing & Positive Impacts of Behavioral Control System on Societies & Countries

    Directory of Open Access Journals (Sweden)

    Ahmad Adel Mostafa

    2015-03-01

    Full Text Available Behavioral control systems are one of the most prominent tools used by managers and marketers for different internal and external purposes. One of the most important external purposes they have been used for is influencing consumer behavior. This paper explores the positive effects of implementing such systems on societies. It discusses consumer perception of the systems, their influence on their financial behavior in different contexts, how can they create order and how as well as to what extent should it be implemented and finally how can minimize negative consumer behavior. A judgment based sample of typical consumers was surveyed using questionnaires for collecting primary data on these aspects. Secondary data from Egypt, Singapore and Malaysia was also used as an example of using behavioral control systems. Results show that consumers in general have a positive attitude towards imposing such systems. However, there were worries about misuse, abuse and overuse of theses systems’ policies. Consequently, data shows that behavioral control systems can positively enhance and influence consumer behavior as long as it is used to balance both consumer and retailer interests in a moderate, risk free manner.

  3. The impact of HIV-related stigma on the lives of HIV-positive women: an integrated literature review.

    Science.gov (United States)

    Ho, Szu-Szu; Holloway, Aisha

    2016-01-01

    To critically explore how Human Immunodeficiency Virus-related stigma impacts on the lives of Human Immunodeficiency Virus-positive women through an integrative review of the literature. Throughout history Human Immunodeficiency Virus infection has been associated with sex trade, injecting drug use and other deviant behaviours within society. These historical associations can lead to the generation of negative perceptions of Human Immunodeficiency Virus-positive women. As such, women who contract Human Immunodeficiency Virus infection can be susceptible to societal stigma. An integrative literature review. To identify the publications on the impact of Human Immunodeficiency Virus-related stigma among women, a search was performed using the following databases: CINAHL, Medline, PsycINFO, EMBASE, and Applied Social Sciences Index and Abstract covering the period from 2000-2014. The following key words were included in the search: 'women', 'Human Immunodeficiency Virus', and 'stigma'. Twenty-six articles were retrieved and reviewed. From the results, four key themes merged in relation to the impact of Human Immunodeficiency Virus-related stigma on Human Immunodeficiency Virus-positive women's lives: the individual, relationships, work and the community. Despite great advances in the management and treatment of those who are Human Immunodeficiency Virus positive, it appears the lives of many women living with Human Immunodeficiency Virus remain greatly affected by their Human Immunodeficiency Virus infection with gender-specific stigma and stereotypes. Having a holistic understanding of this impact offers the potential for those responsible for the funding and draws the attention of researchers and policy makers on promoting medical services specifically for Human Immunodeficiency Virus-positive women, minimising social stigmatisation towards this client group, and optimising their health outcomes. In an attempt to amplify Human Immunodeficiency Virus-positive women

  4. The impact of a focally positive resection margin on the local control in patients treated with breast-conserving therapy

    International Nuclear Information System (INIS)

    Park, Seho; Park, Hyung-Seok; Kim, Seung-ll; Koo, Ja-Seung; Park, Byeong-Woo; Lee, Kyong-Sik

    2011-01-01

    The aim of the study was to investigate the parameters affecting positive margin and the impact of positive margin on outcomes after breast-conserving therapy in patients with breast cancer. Characteristics and survival of 705 patients attempted breast-conserving therapy between January 1994 and December 2004 were retrospectively analyzed using χ 2 tests, the Kaplan-Meier methods and multivariate analyses. Ninety-five (13.5%) showed positive margins at initial resection. Among them, 28 (4.0%) had negative margin on the initial frozen section; however, they finally turned out a focally positive margin with intraductal carcinoma on the permanent pathology. Positive margin at initial resection was significantly associated with lobular histology (P=0.001), four or more involved lymph nodes (P=0.015) and the presence of extensive intraductal component (P<0.001). A focally positive margin did not influence local (P=0.250; 95% confidence interval, 0.612-6.592) or regional failure (P=0.756; 95% confidence interval, 0.297-5.311). Patients with a focally positive margin showed an advanced nodal stage and received a higher dose of irradiation and more systemic therapy. Nodal involvements were the most significant factor for locoregional failure. Although the achievement of negative margins is the best way to reduce local failure, patients with a focally positive margin and favorable risk factors such as node negativity and older age could have an option of close follow-up with adequate boost irradiation and adjuvant therapy instead of conversion to total mastectomy. (author)

  5. Impact of Close and Positive Margins in Transoral Laser Microsurgery for Tis-T2 Glottic Cancer.

    Science.gov (United States)

    Fiz, Ivana; Mazzola, Francesco; Fiz, Francesco; Marchi, Filippo; Filauro, Marta; Paderno, Alberto; Parrinello, Giampiero; Piazza, Cesare; Peretti, Giorgio

    2017-01-01

    Transoral laser microsurgery (TLM) represents one of the most effective treatment strategies for Tis-T2 glottic squamous cell carcinomas (SCC). The prognostic influence of close/positive margins is still debated, and the role of narrow band imaging (NBI) in their intraoperative definition is still to be validated on large cohort of patients. This study analyzed the influence of margin status on recurrence-free survival (RFS) and disease-specific survival (DSS). We retrospectively studied 507 cases of pTis-T1b (Group A) and 127 cases of pT2 (Group B) glottic SCC. We identified the following margin status: negative ( n  = 232), close superficial ( n  = 79), close deep (CD) ( n  = 35), positive single superficial ( n  = 146), positive multiple superficial ( n  = 94), and positive deep ( n  = 48) and analyzed their impact on RFS and DSS. Close margins were defined by tumor-margin distance <1 mm. Pre-TLM margins were defined by white light in 323 patients, whereas NBI was employed in 311 patients. In Group A, DSS and RFS were reduced in positive multiple superficial and positive deep margins (DSS = 96.1 and 97%, both p  < 0.05; RFS = 72%, p  < 0.001 and 75.8%, p  < 0.01). In Group B, DSS was reduced in positive multiple superficial margins (82.4%, p  < 0.05). RFS was reduced in positive single superficial, positive multiple superficial, and positive deep margins (62.5, 41.2, and 53.3%, p  < 0.01). In the entire population, RFS was reduced in CD margins (77.1%, p  < 0.05). Use of NBI led to improvement in RFS and DSS. The study indicates that close and positive single superficial margins do not affect DSS. By contrast, all types of margin positivity predict the occurrence of relapses, albeit with different likelihood, depending on stage/margin type. CD margins should be considered as a single risk factor. Use of NBI granted better intraoperative margins definition.

  6. Impact of Close and Positive Margins in Transoral Laser Microsurgery for Tis–T2 Glottic Cancer

    Directory of Open Access Journals (Sweden)

    Ivana Fiz

    2017-10-01

    Full Text Available IntroductionTransoral laser microsurgery (TLM represents one of the most effective treatment strategies for Tis–T2 glottic squamous cell carcinomas (SCC. The prognostic influence of close/positive margins is still debated, and the role of narrow band imaging (NBI in their intraoperative definition is still to be validated on large cohort of patients. This study analyzed the influence of margin status on recurrence-free survival (RFS and disease-specific survival (DSS.MethodsWe retrospectively studied 507 cases of pTis–T1b (Group A and 127 cases of pT2 (Group B glottic SCC. We identified the following margin status: negative (n = 232, close superficial (n = 79, close deep (CD (n = 35, positive single superficial (n = 146, positive multiple superficial (n = 94, and positive deep (n = 48 and analyzed their impact on RFS and DSS. Close margins were defined by tumor-margin distance <1 mm. Pre-TLM margins were defined by white light in 323 patients, whereas NBI was employed in 311 patients.ResultsIn Group A, DSS and RFS were reduced in positive multiple superficial and positive deep margins (DSS = 96.1 and 97%, both p < 0.05; RFS = 72%, p < 0.001 and 75.8%, p < 0.01. In Group B, DSS was reduced in positive multiple superficial margins (82.4%, p < 0.05. RFS was reduced in positive single superficial, positive multiple superficial, and positive deep margins (62.5, 41.2, and 53.3%, p < 0.01. In the entire population, RFS was reduced in CD margins (77.1%, p < 0.05. Use of NBI led to improvement in RFS and DSS.ConclusionThe study indicates that close and positive single superficial margins do not affect DSS. By contrast, all types of margin positivity predict the occurrence of relapses, albeit with different likelihood, depending on stage/margin type. CD margins should be considered as a single risk factor. Use of NBI granted better intraoperative margins definition.

  7. Positive Impact of Art as a Communication Instrument on Economical Productivity

    Directory of Open Access Journals (Sweden)

    Sedat Cereci

    2013-08-01

    Full Text Available There are many factors that affect economical productivity like climate, or like raw materials or like international relationships or like physchology of employers. Professional organisations or companies use different instruments to increase producticity on economy. Spiritual conditions of employers and employees are especially regarded for economical productivity recently. Though economy is mostly a concrete area, main component of economy is human and human need spiritual support and impacts in his life. It is known that spiritual support always feed human and provide him much energy. Employers or companies who are interested in art and who participate in artistic activities become more productive than others and attract people to their productions.

  8. Piezosurgery for the Lingual Split Technique in Lingual Positioned Impacted Mandibular Third Molar Removal: A Retrospective Study.

    Science.gov (United States)

    Ge, Jing; Yang, Chi; Zheng, Jiawei; Qian, Wentao

    2016-03-01

    The aim of this study was to evaluate the effect and safety of lingual split technique using piezosurgery for the extraction of lingual positioned impacted mandibular 3rd molars with the goal of proposing a more minimally invasive choice for this common surgery.Eighty-nine consecutive patients with 110 lingual positioned impacted mandibular 3rd molars requiring extraction were performed the lingual split technique using piezosurgery. One sagittal osteotomy line and 2 transverse osteotomy line were designed for lingual and occlusal bone removal. The success rate, operative time, postoperative outcome, and major complications (including nerve injury, mandible fracture, severe hematoma or edema, and severe pyogenic infection) were documented and analyzed.All impacted mandibular 3rd molars were successfully removed (110/110). The average time of operation was 14.6 minutes (ranged from 7 to 28 minutes). One hundred and seven extraction sites (97.3%) were primary healing. Pain, mouth opening, swelling, and PoSSe scores on postoperative 7-day were 0.34 ± 0.63, 3.88 ± 0.66(cm), 2.4 ± 0.2(cm), and 23.7 ± 5.9, respectively. There were 6 cases (5.5%) had lingual nerve disturbance and 3 cases (2.7%) developed inferior alveolar nerve impairment, and achieved full recovery within 2 months by neurotrophic drug treatment.Our study suggested piezosurgery for lingual split technique provided an effective way for the extraction of lingual positioned and deeply impacted mandibular 3rd molar.

  9. Vital mitochondrial functions show profound changes during yeast culture ageing

    Czech Academy of Sciences Publication Activity Database

    Volejníková, Andrea; Hlousková, Jana; Sigler, Karel; Pichová, Alena

    2013-01-01

    Roč. 13, č. 1 (2013), s. 7-15 ISSN 1567-1356 R&D Projects: GA ČR GA301/07/0339; GA MŠk ME09043; GA MŠk 1M0570 Institutional support: RVO:61388971 Keywords : Saccharomyces cerevisiae * chronological ageing * mitochondria Subject RIV: EE - Microbiology, Virology Impact factor: 2.436, year: 2013

  10. COMPETITIVE STATE ANXIETY: IMPACT OF POSITIVE SELF TALK TRAINING ON JUNIOR LEVEL FOOTBALL PLAYERS

    Directory of Open Access Journals (Sweden)

    Abdussalam Kanniyan

    2015-05-01

    Full Text Available During the last few decades, coaches and athletes from a wide variety of sports have begun to realize the importance of the mental side of athletic performance. Sport specialists agree that athletic performance is influenced not only by physical skills but also by psychological ones. In order to achieve peak performance athletes need a “total package” including physical skills, psychological skills, fitness and injury prevention (Singh 2011. Study was aimed to examine the effect of Positive Self-Talk training on the Competition anxiety and self-confidence of junior level football players. 36 junior level football players, aged 18.7 ± 2.8 years, were randomly assigned into experimental group and control group. Competitive State Anxiety Inventory-2 (CSAI-2 was used to assess cognitive and somatic anxiety and self-confidence. Positive Self-Talk training was given to the experimental group for 8 weeks. Results of ANOVA revealed significant difference between the pre- test and post test scores of cognitive and somatic anxiety and self- confidence in the experimental group while no significant difference in the control group.

  11. The Position of Slovakia in Competitiveness Ranking – the Causes, Impacts and Prospects

    Directory of Open Access Journals (Sweden)

    Lucia Stredná

    2012-06-01

    Full Text Available A country’s competitiveness could be translated as its ability to successfully compete within international comparison also as a prosperity which is expressed by productivity growth of economy and living standards. Is Slovakia competitive? What are its strengths and weaknesses? What are the leading countries of the European Union in competitiveness ranking? In what aspects is Slovakia falling behind countries of V4? Strengthening of which competitive advantages is perspective for the Slovak Republic? We will try to find answers to these questions in an analysis of competitiveness based on the Global Competitiveness Reports. This thesis focuses on definition of the competitiveness in general, apprises of measuring methodology based on multicriterial evaluation and summarises pros and cons of this benchmark. The main focus is on the Slovak Republic and its position in the international ranking. In detail we will focus on comparison of the Slovak Republic with countries of V4 region. It is the authors’ ambition to bring critical view on position of the Slovak Republic in the international comparison and to formulate recommendations for the future that could contribute to strengthening of competitiveness and success of our country.

  12. The impact of structured support groups for pregnant South African women recently diagnosed HIV positive.

    Science.gov (United States)

    Mundell, Jonathan P; Visser, Maretha J; Makin, Jennifer D; Kershaw, Trace S; Forsyth, Brian W C; Jeffery, Bridget; Sikkema, Kathleen J

    2011-08-31

    The authors of this study evaluated a structured 10-session psychosocial support group intervention for newly HIV-diagnosed pregnant South African women. Participants were expected to display increases in HIV disclosure, self-esteem, active coping and positive social support, and decreases in depression, avoidant coping, and negative social support. Three hundred sixty-one pregnant HIV-infected women were recruited from four antenatal clinics in Tshwane townships from April 2005 to September 2006. Using a quasi-experimental design, assessments were conducted at baseline and two and eight months post-intervention. A series of random effects regression analyses were conducted, with the three assessment points treated as a random effect of time. At both follow-ups, the rate of disclosure in the intervention group was significantly higher than that of the comparison group (p<0.001). Compared to the comparison group at the first follow-up, the intervention group displayed higher levels of active coping (t=2.68, p<0.05) and lower levels of avoidant coping (t=-2.02, p<0.05), and those who attended at least half of the intervention sessions exhibited improved self-esteem (t=2.11, p<0.05). Group interventions tailored for newly HIV positive pregnant women, implemented in resource-limited settings, may accelerate the process of adjusting to one's HIV status, but may not have sustainable benefits over time.

  13. Impact of MLC leaf position errors on simple and complex IMRT plans for head and neck cancer

    International Nuclear Information System (INIS)

    Mu, G; Ludlum, E; Xia, P

    2008-01-01

    The dosimetric impact of random and systematic multi-leaf collimator (MLC) leaf position errors is relatively unknown for head and neck intensity-modulated radiotherapy (IMRT) patients. In this report we studied 17 head and neck IMRT patients, including 12 treated with simple plans ( 100 segments). Random errors (-2 to +2 mm) and systematic errors (±0.5 mm and ±1 mm) in MLC leaf positions were introduced into the clinical plans and the resultant dose distributions were analyzed based on defined endpoint doses. The dosimetric effect was insignificant for random MLC leaf position errors up to 2 mm for both simple and complex plans. However, for systematic MLC leaf position errors, we found significant dosimetric differences between the simple and complex IMRT plans. For 1 mm systematic error, the average changes in D 95% were 4% in simple plans versus 8% in complex plans. The average changes in D 0.1cc of the spinal cord and brain stem were 4% in simple plans versus 12% in complex plans. The average changes in parotid glands were 9% in simple plans versus 13% for the complex plans. Overall, simple IMRT plans are less sensitive to leaf position errors than complex IMRT plans

  14. On the Impact of a Quadratic Acceleration Term in the Analysis of Position Time Series

    Science.gov (United States)

    Bogusz, Janusz; Klos, Anna; Bos, Machiel Simon; Hunegnaw, Addisu; Teferle, Felix Norman

    2016-04-01

    The analysis of Global Navigation Satellite System (GNSS) position time series generally assumes that each of the coordinate component series is described by the sum of a linear rate (velocity) and various periodic terms. The residuals, the deviations between the fitted model and the observations, are then a measure of the epoch-to-epoch scatter and have been used for the analysis of the stochastic character (noise) of the time series. Often the parameters of interest in GNSS position time series are the velocities and their associated uncertainties, which have to be determined with the highest reliability. It is clear that not all GNSS position time series follow this simple linear behaviour. Therefore, we have added an acceleration term in the form of a quadratic polynomial function to the model in order to better describe the non-linear motion in the position time series. This non-linear motion could be a response to purely geophysical processes, for example, elastic rebound of the Earth's crust due to ice mass loss in Greenland, artefacts due to deficiencies in bias mitigation models, for example, of the GNSS satellite and receiver antenna phase centres, or any combination thereof. In this study we have simulated 20 time series with different stochastic characteristics such as white, flicker or random walk noise of length of 23 years. The noise amplitude was assumed at 1 mm/y-/4. Then, we added the deterministic part consisting of a linear trend of 20 mm/y (that represents the averaged horizontal velocity) and accelerations ranging from minus 0.6 to plus 0.6 mm/y2. For all these data we estimated the noise parameters with Maximum Likelihood Estimation (MLE) using the Hector software package without taken into account the non-linear term. In this way we set the benchmark to then investigate how the noise properties and velocity uncertainty may be affected by any un-modelled, non-linear term. The velocities and their uncertainties versus the accelerations for

  15. Positive outcomes influence the rate and time to publication, but not the impact factor of publications of clinical trial results.

    Directory of Open Access Journals (Sweden)

    Pilar Suñé

    Full Text Available OBJECTIVES: Publication bias may affect the validity of evidence based medical decisions. The aim of this study is to assess whether research outcomes affect the dissemination of clinical trial findings, in terms of rate, time to publication, and impact factor of journal publications. METHODS AND FINDINGS: All drug-evaluating clinical trials submitted to and approved by a general hospital ethics committee between 1997 and 2004 were prospectively followed to analyze their fate and publication. Published articles were identified by searching Pubmed and other electronic databases. Clinical study final reports submitted to the ethics committee, final reports synopses available online and meeting abstracts were also considered as sources of study results. Study outcomes were classified as positive (when statistical significance favoring experimental drug was achieved, negative (when no statistical significance was achieved or it favored control drug and descriptive (for non-controlled studies. Time to publication was defined as time from study closure to publication. A survival analysis was performed using a Cox regression model to analyze time to publication. Journal impact factors of identified publications were recorded. Publication rate was 48·4% (380/785. Study results were identified for 68·9% of all completed clinical trials (541/785. Publication rate was 84·9% (180/212 for studies with results classified as positive and 68·9% (128/186 for studies with results classified as negative (p<0·001. Median time to publication was 2·09 years (IC95 1·61-2·56 for studies with results classified as positive and 3·21 years (IC95 2·69-3·70 for studies with results classified as negative (hazard ratio 1·99 (IC95 1·55-2·55. No differences were found in publication impact factor between positive (median 6·308, interquartile range: 3·141-28·409 and negative result studies (median 8·266, interquartile range: 4·135-17·157. CONCLUSIONS

  16. Enhancing student engagement to positively impact mathematics anxiety, confidence and achievement for interdisciplinary science subjects

    Science.gov (United States)

    Everingham, Yvette L.; Gyuris, Emma; Connolly, Sean R.

    2017-11-01

    Contemporary science educators must equip their students with the knowledge and practical know-how to connect multiple disciplines like mathematics, computing and the natural sciences to gain a richer and deeper understanding of a scientific problem. However, many biology and earth science students are prejudiced against mathematics due to negative emotions like high mathematical anxiety and low mathematical confidence. Here, we present a theoretical framework that investigates linkages between student engagement, mathematical anxiety, mathematical confidence, student achievement and subject mastery. We implement this framework in a large, first-year interdisciplinary science subject and monitor its impact over several years from 2010 to 2015. The implementation of the framework coincided with an easing of anxiety and enhanced confidence, as well as higher student satisfaction, retention and achievement. The framework offers interdisciplinary science educators greater flexibility and confidence in their approach to designing and delivering subjects that rely on mathematical concepts and practices.

  17. Reducing the environmental impact of hydraulic fracturing through design optimisation of positive displacement pumps

    International Nuclear Information System (INIS)

    Josifovic, Aleksandar; Roberts, Jennifer J.; Corney, Jonathan; Davies, Bruce; Shipton, Zoe K.

    2016-01-01

    The current approach to hydraulic fracturing requires large amounts of industrial hardware to be transported, installed and operated in temporary locations. A significant proportion of this equipment is comprised of the fleet of pumps required to provide the high pressures and flows necessary for well stimulation. Studies have shown that over 90% of the emissions of CO_2 and other pollutants that occur during a hydraulic fracturing operation are associated with these pumps. Pollution and transport concerns are of paramount importance for the emerging hydraulic fracturing industry in Europe, and so it is timely to consider these factors when assessing the design of high pressure pumps for the European resources. This paper gives an overview of the industrial plant required to carry out a hydraulic fracturing operation. This is followed by an analysis of the pump's design space that could result in improved pump efficiency. We find that reducing the plunger diameter and running the pump at higher speeds can increase the overall pump efficiency by up to 4.6%. Such changes to the pump's parameters would results in several environmental benefits beyond the obvious economic gains of lower fuel consumption. The paper concludes with a case study that quantifies these benefits. - Highlights: • We develop a parameterized model of hydraulic fracturing pumps. • We explore performance variation to optimise pump efficiency and performance. • New design could increase pump energy efficiency up to 4.6% and improve reliability. • The new design could also reduce environmental and social impacts of pumping. • This illustrates how optimised mechanical design can lower impacts and cost.

  18. Performance of Reinforced Concrete Beam with Differently Positioned Replacement Zones of Block Infill under Low Impact Loads

    Directory of Open Access Journals (Sweden)

    Mokhatar Shahrul Niza

    2017-01-01

    Full Text Available This paper reveals a study performed on reinforced concrete with artificial aggregate concrete block infill composite beams to innovate a lightweight reinforced concrete utilizing polyethylene (PE waste materials, such as waste plastic bags. Six beam specimens of normal reinforced concrete (NRC and different block infill replacement zone positions RCAI (RZ1 beams containing 100% MAPEA with 50, 95, and 1,000 mm width, height, and length, respectively, were provided for the block infill, whereas RCAI (RZ2 with different block infill positions containing a 100% MAPEA with 50, 115, and 1000 mm width, height, and length were provided and tested under low impact load. The steel impactor with blunt nose dropped at 0.6 m height which equivalent to 3.5 m/s. The behaviors of the beams were studied relative to the impact force-time and displacement-time histories, the flexural/ bending cracks, and the impact failure. Results show that the overall failure modes of all the beam specimens were successfully recorded. In addition, the residual displacements of the RZ2 was almost same than those of the RZ1 and the significantly lower than those of the NRC. In the reinforced concrete beams, less stressed concrete near the neutral axis can be replaced by certain light weight material like waste plastic bags as modified artificial polyethylene aggregates to serve as an artificial aggregate.

  19. Impact of floating mass transducer coupling and positioning in round window vibroplasty.

    Science.gov (United States)

    Rajan, Gunesh P; Lampacher, Peter; Ambett, Ranjeeta; Dittrich, Gregor; Kuthubutheen, Jafri; Wood, Bradley; McArthur, Anne; Marino, Roberta

    2011-02-01

    The round window application of the Vibrant Sound bridge, the so-called round window vibroplasty, is gaining increasing popularity for hearing rehabilitation of patients with mixed hearing loss or conductive hearing loss. In these patients, conventional hearing amplification and/or surgical restoration is either not possible or has failed because of chronic ear disease, extensive otosclerosis, or malformations. The exact mechanisms of direct cochlear stimulation via the round window membrane are not yet completely understood. It is unclear what kind and what degree of contact is required between the floating mass transducer (FMT) and the round window membrane (RWM) to elicit a functional hearing perception with the implant. We investigated the coupling efficiency between the FMT and the RWM and how the efficiency is altered by the FMT position, the degree of FMT-RWM contact, and the use of a soft tissue coupler. Prospective cohort study. Tertiary referral center in Western Australia. Patients undergoing round window vibroplasty for a mixed or conductive hearing loss otherwise not aidable. Patients underwent round window vibroplasty and received audiological and coupling analysis in the follow-up. These data were then correlated with FMT positioning and the extent of FMT-RWM interface as determined by postoperative high-resolution temporal bone computed tomography. Coupling and hearing levels in relation to FMT positioning and degree of FMT-RWM contact. Of 10 patients, 8 were available for vibroplasty behavioral threshold testing. In 2 patients, testing could not be done because of wound breakdown requiring device explantation in 1 case, and in the other case, the bone conduction thresholds dropped 2 months after implantation, thus falling out of the performance range of the device. Postoperative FMT migration occurred in 50% of the patients (3/6) with recurrent chronic ear disease and status after multiple previous ear operations. All patients, including the 3

  20. Impact of low-energy CT imaging on selection of positive oral contrast media concentration.

    Science.gov (United States)

    Patino, Manuel; Murcia, Diana J; Iamurri, Andrea Prochowski; Kambadakone, Avinash R; Hahn, Peter F; Sahani, Dushyant V

    2017-05-01

    To determine to what extent low-energy CT imaging affects attenuation of gastrointestinal tract (GIT) opacified with positive oral contrast media (OCM). Second, to establish optimal OCM concentrations for low-energy diagnostic CT exams. One hundred patients (38 men and 62 women; age 62 ± 11 years; BMI 26 ± 5) with positive OCM-enhanced 120-kVp single-energy CT (SECT), and follow-up 100-kVp acquisitions (group A; n = 50), or 40-70-keV reconstructions from rapid kV switching-single-source dual-energy CT (ssDECT) (group B; n = 50) were included. Luminal attenuation from different GIT segments was compared between exams. Standard dose of three OCM and diluted solutions (75%, 50%, and 25% concentrations) were introduced serially in a gastrointestinal phantom and scanned using SECT (120, 100, and 80 kVp) and DECT (80/140 kVp) acquisitions on a ssDECT scanner. Luminal attenuation was obtained on SECT and DECT images (40-70 keV), and compared to 120-kVp scans with standard OCM concentrations. Luminal attenuation was higher on 100-kVp (328 HU) and on 40-60-keV images (410-924 HU) in comparison to 120-kVp scans (298 HU) in groups A and B (p < 0.05). Phantom: There was an inverse correlation between luminal attenuation and X-ray energy, increasing up to 527 HU on low-kVp and 999 HU on low-keV images (p < 0.05). 25% and 50% diluted OCM solutions provided similar or higher attenuation than 120 kVp, at low kVp and keV, respectively. Low-energy CT imaging increases the attenuation of GIT opacified with positive OCM, permitting reduction of 25%-75% OCM concentration.

  1. Impact of positive and negative lesion site remodeling on clinical outcomes: insights from PROSPECT.

    Science.gov (United States)

    Inaba, Shinji; Mintz, Gary S; Farhat, Naim Z; Fajadet, Jean; Dudek, Dariusz; Marzocchi, Antonio; Templin, Barry; Weisz, Giora; Xu, Ke; de Bruyne, Bernard; Serruys, Patrick W; Stone, Gregg W; Maehara, Akiko

    2014-01-01

    This study investigated coronary artery remodeling patterns associated with clinical outcomes. In the prospective, multicenter PROSPECT (Providing Regional Observations to Study Predictors of Events in the Coronary Tree: An Imaging Study in Patients With Unstable Atherosclerotic Lesions) study, reported predictors of nonculprit lesion (NCL) major adverse cardiac events (MACE) were an intravascular ultrasound (IVUS) minimal lumen area (MLA) ≤4 mm(2), a plaque burden ≥70%, and a IVUS-virtual histology (VH) thin-cap fibroatheroma (TCFA), but not lesion site remodeling. Overall, 697 consecutive patients with an acute coronary syndrome were enrolled and underwent 3-vessel gray-scale and IVUS-VH; 3,223 NCLs were identified by IVUS. The remodeling index (RI) was calculated as the external elastic membrane area at the MLA site divided by the average of the proximal and distal reference external elastic membrane areas. First, one third of the patients were randomly selected to determine RI cutoffs related to NCL MACE (development cohort). Receiver-operating characteristic analysis showed that there were 2 separate cut points that predicted NCL MACE: RI = 0.8789 and RI = 1.0046 (area under the curve = 0.663). These cut points were used to define negative remodeling as an RI 1.00. Second, we used the remaining two-thirds of patients to validate these cut points with respect to lesion morphology and clinical outcomes (validation cohort). Kaplan-Meier curve analysis in the validation cohort showed that NCL MACE occurred more frequent (and equally) in negative and positive remodeling lesions compared with intermediate remodeling lesions. In this cohort, negative remodeling lesions had the smallest MLA, positive remodeling lesions had the largest plaque burden, and VH TCFA, especially VH TCFA with multiple necrotic cores, was most common in negatively remodeling lesions. The present study showed the novel concept that positive and negative lesion site remodeling was

  2. Autotransplantation of a Strange Positioned Impacted Central Incisor in a surgically Prepared Socket: A Miracle Esthetic Concept.

    Science.gov (United States)

    Jaiswara, Chandresh; Srivastava, Vinay K; Dhiman, Neeraj

    2016-01-01

    Esthetics is a prime concern for a young lady. Any anomaly in the anterior tooth may create anxiety and depression. This anxiety and depression may hamper her married life and overall personality. This case report reveals an unerupted right central incisor situated in a strange position, creating space in the maxillary anterior region and giving an unesthetic appearance. Autotransplantation is a method of choice for a strangely positioned impacted central incisor in a new appropriate site. This method offers a new treatment option for some clinical situations if orthodontic approach is not possible. It permits tooth movement to a distant or the opposite side of the same dental arch as well as to the opposite jaw. This procedure also offers potential benefits of reestablishment of normal alveolar process development, esthetics, functions, and arch integrity. This procedure has the potential to become a viable alternative treatment plan for young patients of low socioeconomic status, allowing the reestablish-ment and restoration of a missing tooth and their functions. This article discusses methods of auto-reimplantation of a tooth in a fresh surgically prepared socket, its biological principle, and establishment of functions, esthetics, and phonetics. Jaiswara C, Srivastava VK, Dhiman N. Autotransplantation of a Strange Positioned Impacted Central Incisor in a surgically Prepared Socket: A Miracle Esthetic Concept. Int J Clin Pediatr Dent 2016;9(3):269-272.

  3. Positive impact of infection prevention on the management of nosocomial outbreaks at an academic hospital.

    Science.gov (United States)

    Dik, Jan-Willem H; Sinha, Bhanu; Lokate, Mariëtte; Lo-Ten-Foe, Jerome R; Dinkelacker, Ariane G; Postma, Maarten J; Friedrich, Alexander W

    2016-10-01

    Infection prevention (IP) measures are vital to prevent (nosocomial) outbreaks. Financial evaluations of these are scarce. An incremental cost analysis for an academic IP unit was performed. On a yearly basis, we evaluated: IP measures; costs thereof; numbers of patients at risk for causing nosocomial outbreaks; predicted outbreak patients; and actual outbreak patients. IP costs rose on average yearly with €150,000; however, more IP actions were undertaken. Numbers of patients colonized with high-risk microorganisms increased. The trend of actual outbreak patients remained stable. Predicted prevented outbreak patients saved costs, leading to a positive return on investment of 1.94. This study shows that investments in IP can prevent outbreak cases, thereby saving enough money to earn back these investments.

  4. The impact of positive and negative intraoperative surgeons' leadership behaviors on surgical team performance.

    Science.gov (United States)

    Barling, Julian; Akers, Amy; Beiko, Darren

    2018-01-01

    The effects of surgeons' leadership on team performance are not well understood. The purpose of this study was to examine the simultaneous effects of transformational, passive, abusive supervision and over-controlling leadership behaviors by surgeons on surgical team performance. Trained observers attended 150 randomly selected operations at a tertiary care teaching hospital. Observers recorded instances of the four leadership behaviors enacted by the surgeon. Postoperatively, team members completed validated questionnaires rating team cohesion and collective efficacy. Multiple regression analyses were computed. Data were analyzed using the complex modeling function in MPlus. Surgeons' abusive supervision was negatively associated with psychological safety (unstandardized B = -0.352, p leadership (unstandardized B = -0.230, p leadership behaviors on intraoperative team performance. Significant effects only surfaced for negative leadership behaviors; transformational leadership did not positively influence team performance. Copyright © 2017 Elsevier Inc. All rights reserved.

  5. Young Investigator Perspectives. Teaching and the postdoctoral experience: impact on transition to faculty positions.

    Science.gov (United States)

    Uno, Jennifer; Walton, Kristen L W

    2014-05-01

    This editorial continues with our Young Investigator Perspectives series. Drs. Uno and Walton are young investigators who hold faculty positions. They completed a K12 postdoctoral program through the IRACDA (Individual Research and Career Development Award) program sponsored through the NIGMS institute at NIH. IRACDA programs exist at multiple institutions in the USA to combine postdoctoral training with formal training in academic skills and teaching at partner institutions. I thank Drs. Walton and Uno for a thoughtful perspective on how this experience shaped their career goals to combine teaching and research and inspire undergraduates to science careers. Given the current national dialog on broadening career paths and outcomes for PhD scientists, this is a timely perspective. -P. Kay Lund.

  6. Measures of Physical and Mental Independence Among HIV-Positive Individuals: Impact of Substance Use Disorder.

    Science.gov (United States)

    Christensen, Bianca; Qin, Zijian; Byrd, Desiree A; Yu, Fang; Morgello, Susan; Gelman, Benjamin B; Moore, David J; Grant, Igor; Singer, Elyse J; Fox, Howard S; Baccaglini, Lorena

    2017-10-01

    With the transition of HIV infection from an acute to a chronic disease after the introduction of antiretroviral medications, there has been an increased focus on long-term neurocognitive and other functional outcomes of HIV patients. Thus, we assessed factors, particularly history of a substance use disorder, associated with time to loss of measures of physical or mental independence among HIV-positive individuals. Data were obtained from the National NeuroAIDS Tissue Consortium. Kaplan-Meier and Cox proportional hazards regression analyses were used to estimate the time since HIV diagnosis to loss of independence, and to identify associated risk factors. HIV-positive participants who self-identified as physically (n = 698) or mentally (n = 616) independent on selected activities of daily living at baseline were eligible for analyses. A history of substance use disorder was associated with a higher hazard of loss of both physical and mental independence [adjusted hazard ratio (HR) = 1.71, 95% confidence interval (95% CI): 1.07-2.78; adjusted HR = 1.67, 95% CI: 1.11-2.52, respectively]. After adjusting for substance use disorder and other covariates, older age at diagnosis and female gender were associated with higher hazards of loss of both physical and mental independence, non-white participants had higher hazards of loss of physical independence, whereas participants with an abnormal neurocognitive diagnosis and fewer years of education had higher hazards of loss of mental independence. In summary, history of substance use disorder was associated with loss of measures of both physical and mental independence. The nature of this link and the means to prevent such loss of independence need further investigation.

  7. Relabelling behaviour : The effects of psycho-education on the perceived severity and causes of challenging behaviour in people with profound intellectual and multiple disabilities

    NARCIS (Netherlands)

    Poppes, P.; Putten, van der Annette; Post, W.; Frans, N.; ten Brug, A.; van Es, A.; Vlaskamp, C.

    2016-01-01

    BackgroundPrevalence rates of challenging behaviour are high in children and adults with profound intellectual and multiple disabilities (PIMD). Moreover, many of these behaviours are observed daily. Direct support staff report that most challenging behaviour identified has little impact on the

  8. Relabelling Behaviour. The Effects of Psycho-Education on the Perceived Severity and Causes of Challenging Behaviour in People with Profound Intellectual and Multiple Disabilities

    Science.gov (United States)

    Poppes, P.; van der Putten, A.; Post, W.; Frans, N.; ten Brug, A.; van Es, A.; Vlaskamp, C.

    2016-01-01

    Background: Prevalence rates of challenging behaviour are high in children and adults with profound intellectual and multiple disabilities (PIMD). Moreover, many of these behaviours are observed daily. Direct support staff report that most challenging behaviour identified has little impact on the person with PIMD and attribute challenging…

  9. High-protein intake enhances the positive impact of physical activity on BMC in prepubertal boys.

    Science.gov (United States)

    Chevalley, Thierry; Bonjour, Jean-Philippe; Ferrari, Serge; Rizzoli, René

    2008-01-01

    In 232 healthy prepubertal boys, increased physical activity was associated with greater BMC at both axial and appendicular sites under high-protein intake. Physical activity is an important lifestyle determinant of bone mineral mass acquisition. Its impact during childhood can be modulated by nutrition, particularly by protein and calcium intakes. We analyzed the relationship between physical activity levels and protein compared with calcium intake on BMC. In 232 healthy prepubertal boys (age: 7.4 +/- 0.4 [SD] yr; standing height: 125.7 +/- 5.9 cm; body weight: 25.3 +/- 4.6 kg), physical activity and protein and calcium intakes were recorded. BMC was measured by DXA at the radial metaphysis, radial diaphysis, total radius, femoral neck, total hip, femoral diaphysis, and L(2)-L(4) vertebrae. In univariate analysis, the correlation coefficients r with BMC of the various skeletal sites were as follows: physical activity, from 0.26 (p = 0.0001) to 0.40 (p = 0.0001); protein intake, from 0.18 (p = 0.005) to 0.27 (p = 0.0001); calcium intake, from 0.09 (p = 0.181) to 0.17 (p = 0.007). By multiple regression analysis, the beta-adjusted values remained correlated with BMC, ranging as follows: physical activity, from 0.219 (p = 0.0007) to 0.340 (p BMC Z-score (+0.6, p = 0.0005). In contrast with protein intake (mean = 1.5 g/kg body weight/d) below the median, increased physical activity from 167 to 312 kcal/d was not associated with a significantly greater mean BMC Z-score (+0.2, p = 0.371). The interaction between physical activity and protein intake was close to statistical significance for mean BMC Z-score (p = 0.055) and significant for femoral neck BMC (p = 0.012). In keeping with the results derived from multiple regression analysis, the increased physical activity on mean BMC Z-score was not influenced by difference in calcium intake above (mean = 945 mg/d) and below (mean = 555 mg/d) the median. In healthy prepubertal boys, the impact in increased physical activity

  10. The positive impact of women's employment on divorce: Context, selection, or anticipation?

    Directory of Open Access Journals (Sweden)

    Daniele Vignoli

    2018-03-01

    Full Text Available Background: Empirical findings regarding the impact of women's employment on divorce are mixed. One explanation is that the effects are moderated by the country context. Another is that previous studies have failed to account for unobserved factors that introduce bias into the estimated effects. Studies also rarely consider possible anticipatory employment behavior on the part of women who are thinking of divorce. Objective: The aim of this study is to deepen our understanding of the nexus between women's employment and divorce in a comparative perspective. Methods: We adopt an analytical strategy that allows us to account for selection and anticipation mechanisms. Namely, we estimate marital disruption and employment jointly, and monitor the timing of divorce after employment entry. This approach is implemented using micro-level data for Germany, Hungary, Italy, and Poland. Results: We find that women's employment facilitates marital disruption in Italy and Poland, but not in Germany and Hungary. We also show that selection effects play out differently in different contexts. Finally, we notice traces of anticipatory behavior in Italy. Contribution: We conclude that women's employment is less likely to be linked to divorce in countries with easier access to divorce and in countries with more generous financial support for families and single mothers, which in turn makes women less reliant on the market. With this study we hope to encourage future researchers to consider the potentially distorting effects of selection and anticipation strategies in (comparative divorce research.

  11. Impact of faculty development programs for positive behavioural changes among teachers: a case study

    Directory of Open Access Journals (Sweden)

    Shuh Shing Lee

    2018-03-01

    Full Text Available Purpose Faculty development (FD is essential to prepare faculty members to become effective teachers to meet the challenges in medical education. Despite the growth of FD programmes, most evaluations were often conducted using short questionnaires to assess participants’ satisfaction immediately after they attended a programme. Consequently, there were calls for more rigorous evaluations based on observed changes in participants’ behaviours. Hence, this study aims to explore how the FD workshops run by the Centre for Medical Education, Yong Loo Lin School of Medicine, National University of Singapore have impacted behavioural changes in the educators. Methods We followed up with the educators at least half a year after they have attended the workshops. With limited literature as reference, we initiated a small-scale case-study research design involving semi-structured interviews with six educators which was triangulated with three focus group discussions with their students. This allowed us to explore behavioural changes among the educators as well as evaluate the feasibility of this research methodology. Results We identified three emerging categories among the educators: ignorance to awareness, from intuition to confirmation and expansion, and from individualism to community of practice. Conclusion Although FD have placed much emphasis on teaching and learning approaches, we found that the teacher-student interaction or human character components (passionate, willing to sacrifice, are open to feedback in becoming a good educator are lacking in our FD workshops.

  12. A Replication to Increase Happiness Indices among Some People with Profound Multiple Disabilities.

    Science.gov (United States)

    Ivancic, Martin T.; And Others

    1997-01-01

    The happiness indices in a Fun Time activity were systematically increased for three of four people with profound multiple disabilities by providing their preferred stimuli. The fourth showed decreased unhappiness. However, three people with profound disabilities and minimal movement failed to show any indices of happiness or unhappiness.…

  13. Teaching Individuals with Profound Multiple Disabilities to Access Preferred Stimuli with Multiple Microswitches

    Science.gov (United States)

    Tam, Gee May; Phillips, Katrina J.; Mudford, Oliver C.

    2011-01-01

    We replicated and extended previous research on microswitch facilitated choice making by individuals with profound multiple disabilities. Following an assessment of stimulus preferences, we taught 6 adults with profound multiple disabilities to emit 2 different responses to activate highly preferred stimuli. All participants learnt to activate…

  14. Ventilator-associated pneumonia in ARDS patients: the impact of prone positioning. A secondary analysis of the PROSEVA trial.

    Science.gov (United States)

    Ayzac, L; Girard, R; Baboi, L; Beuret, P; Rabilloud, M; Richard, J C; Guérin, C

    2016-05-01

    The goal of this study was to assess the impact of prone positioning on the incidence of ventilator-associated pneumonia (VAP) and the role of VAP in mortality in a recent multicenter trial performed on patients with severe ARDS. An ancillary study of a prospective multicenter randomized controlled trial on early prone positioning in patients with severe ARDS. In suspected cases of VAP the diagnosis was based on positive quantitative cultures of bronchoalveolar lavage fluid or tracheal aspirate at the 10(4) and 10(7) CFU/ml thresholds, respectively. The VAP cases were then subject to central, independent adjudication. The cumulative probabilities of VAP were estimated in each position group using the Aalen-Johansen estimator and compared using Gray's test. A univariate and a multivariate Cox model was performed to assess the impact of VAP, used as a time-dependent covariate for mortality hazard during the ICU stay. In the supine and prone position groups, the incidence rate for VAP was 1.18 (0.86-1.60) and 1.54 (1.15-2.02) per 100 days of invasive mechanical ventilation (p = 0.10), respectively. The cumulative probability of VAP at 90 days was estimated at 46.5 % (27-66) in the prone group and at 33.5 % (23-44) in the supine group. The difference between the two cumulative probability curves was not statistically significant (p = 0.11). In the univariate Cox model, VAP was associated with an increase in the mortality rate during the ICU stay [HR 1.65 (1.05-2.61), p = 0.03]. HR increased to 2.2 (1.39-3.52) (p position group, age, SOFA score, McCabe score, and immunodeficiency. In severe ARDS patients prone positioning did not reduce the incidence of VAP and VAP was associated with higher mortality.

  15. Diagnostic impact of thallium scintigraphy and cardiac fluoroscopy when the exercise ECG is strongly positive

    International Nuclear Information System (INIS)

    Chaitman, B.R.; Brevers, G.; Dupras, G.; Lesperance, J.; Bourassa, M.G.

    1984-01-01

    We studied 83 men, who had a chest pain syndrome, no prior history of myocardial infarction, and exercise-induced horizontal or downsloping ST segment depression greater than or equal to 0.2 mV. The 38 patients unable to complete Bruce stage II had a significant increased risk of coronary (0.97 vs 0.71) and multivessel (0.88 vs 0.61) disease (p less than 0.01) compared to the pretest risk; data obtained from exercise-reperfusion thallium scintigraphy and cardiac fluoroscopy did not alter the risk of coronary or multivessel disease. The 45 patients who had ST depression greater than or equal to 0.2 mV and a peak work capacity greater than or equal to Bruce stage III did not have a significant increased risk of coronary (0.76) or multivessel disease (0.44). When both exercise-reperfusion thallium scintigraphy and cardiac fluoroscopy were abnormal in this latter patient subgroup, the post-test risk of multivessel disease was increased from 0.44 to 0.82 (p less than 0.03); when both tests were normal, none of the patients had multivessel disease (p less than 0.03) and only 0.18 had coronary artery disease. Thus, cardiac fluoroscopy and exercise thallium scintigraphy increase the diagnostic content of the strongly positive exercise ECG, particularly in men who have a peak work capacity greater than or equal to Bruce stage III

  16. Impact of continuous positive airway pressure on the pulmonary changes promoted by immersion in water

    Directory of Open Access Journals (Sweden)

    Danize Aparecida Rizzetti

    Full Text Available ABSTRACT Objective: To determine whether different levels of CPAP improve the lung volumes and capacities of healthy subjects immersed in water. Methods: This was a randomized clinical trial, conducted between April and June of 2016, involving healthy female volunteers who were using oral contraceptives. Three 20-min immersion protocols were applied: control (no CPAP; CPAP5 (CPAP at 5 cmH2O; and CPAP10 (CPAP at 10 cmH2O. We evaluated HR, SpO2, FVC, FEV1, the FEV1/FVC ratio, peak expiratory flow rate (PEFR, and FEF25-75% at three time points: pre-immersion; 10 min after immersion; and 10 min after the end of each protocol. Results: We evaluated 13 healthy volunteers. The CPAP10 protocol reversed the restrictive pattern of lung function induced by immersion in water, maintaining pulmonary volumes and capacities for a longer period than did the CPAP5 protocol. Conclusions: When the hemodynamic change causing a persistent lung disorder, only the application of higher positive pressures is effective in maintaining long-term improvements in the pulmonary profile.

  17. Impact of continuous positive airway pressure on the pulmonary changes promoted by immersion in water.

    Science.gov (United States)

    Rizzetti, Danize Aparecida; Quadros, Janayna Rodembuch Borba; Ribeiro, Bruna Esmerio; Callegaro, Letícia; Veppo, Aline Arebalo; Wiggers, Giulia Alessandra; Peçanha, Franck Maciel

    2017-01-01

    To determine whether different levels of CPAP improve the lung volumes and capacities of healthy subjects immersed in water. This was a randomized clinical trial, conducted between April and June of 2016, involving healthy female volunteers who were using oral contraceptives. Three 20-min immersion protocols were applied: control (no CPAP); CPAP5 (CPAP at 5 cmH2O); and CPAP10 (CPAP at 10 cmH2O). We evaluated HR, SpO2, FVC, FEV1, the FEV1/FVC ratio, peak expiratory flow rate (PEFR), and FEF25-75%) at three time points: pre-immersion; 10 min after immersion; and 10 min after the end of each protocol. We evaluated 13 healthy volunteers. The CPAP10 protocol reversed the restrictive pattern of lung function induced by immersion in water, maintaining pulmonary volumes and capacities for a longer period than did the CPAP5 protocol. When the hemodynamic change causing a persistent lung disorder, only the application of higher positive pressures is effective in maintaining long-term improvements in the pulmonary profile.

  18. [The positive psychological impact of rich childbirth experiences on child-rearing].

    Science.gov (United States)

    Takehara, Kenji; Noguchi, Makiko; Shimane, Takuya; Misago, Chizuru

    2009-05-01

    The purpose of this study was to investigate the psychological implications of emotionally enriching childbirth experiences for problems such as awareness of motherhood, postnatal depression, and parenting stress among women after childbirth. All women who gave birth at five study centers (four birthing homes and one maternity hospital) during May 2002 and August 2003 were asked to participate in the cohort study. All 2314 women were approached and 1004 eligible women agreed to take part. Analyses were conducted using a baseline survey and four follow-up surveys conducted at 4 months, 9 months, 2 and a half years, and 3 years after childbirth. The questionnaire included four scales to evaluate the subjects' childbirth experiences, awareness of motherhood, postnatal depression, and parenting stress and difficulties. Data were collected via structured interviews and transcription from medical records. Bivariate and multivariate analysis indicated that women who had good childbirth experiences had positive feelings concerning motherhood and parenting stress and anxiety were lower. Bivariate analysis also indicated that childbirth experience had an inverse relationship with postnatal depression. This study revealed that having good childbirth experiences inhibits negative awareness of motherhood and abusive behavior towards children. These results show that it is important for mothers to be provided with appropriate care during pregnancy and labor for preventing child abuse and parenting stress and anxiety. More research is needed to identify the determinants of childbirth

  19. Fiction reading has a small positive impact on social cognition: A meta-analysis.

    Science.gov (United States)

    Dodell-Feder, David; Tamir, Diana I

    2018-02-26

    Scholars from both the social sciences and the humanities have credited fiction reading with a range of positive real-world social effects. Research in psychology has suggested that readers may make good citizens because fiction reading is associated with better social cognition. But does fiction reading causally improve social cognition? Here, we meta-analyze extant published and unpublished experimental data to address this question. Multilevel random-effects meta-analysis of 53 effect sizes from 14 studies demonstrated that it does: compared to nonfiction reading and no reading, fiction reading leads to a small, statistically significant improvement in social-cognitive performance (g = .15-.16). This effect is robust across sensitivity analyses and does not appear to be the result of publication bias. We recommend that in future work, researchers use more robust reading manipulations, assess whether the effects transfer to improved real-world social functioning, and investigate mechanisms. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

  20. Positive benefits: preventive impact of post-exposure prophylaxis awareness among those with diagnosed HIV.

    Science.gov (United States)

    Dodds, C

    2008-04-01

    To consider the extent to which those presenting for post-exposure prophylaxis (PEP) after sexual risk had been encouraged to do so by their PEP-aware partners with (diagnosed) HIV. Thirty men who had completed the 2005 UK Gay Men's Sex Survey who said they had ever tried to get PEP took part in a 30 minute telephone interview. Fifteen men in the sample described a sexual exposure incident where they had knowledge that their partner was diagnosed with having HIV. Of these, only five knew about their partner's HIV diagnosis prior to sexual contact. The remaining 10 sought PEP because their sexual partner revealed his positive status following potential sexual exposure. Our analysis revealed that word of mouth from friends, sexual partners and health professionals played a key role in men's knowledge about the existence of PEP. It is important for HIV and sexual health specialists to ensure that PEP information is not only targeted at those who are tested negative for HIV or are untested but also to people with diagnosed HIV.

  1. Both preparing to teach and teaching positively impact learning outcomes for peer teachers.

    Science.gov (United States)

    Gregory, Alexander; Walker, Ian; McLaughlin, Kevin; Peets, Adam D

    2011-01-01

    We sought to evaluate the independent effects of preparing to teach and teaching on peer teacher learning outcomes. To evaluate the independent contributions of both preparing to teach and teaching to the learning of peer teachers in medical education. In total, 17 third-year medical students prepared to teach second-year students Advanced Cardiac Life Support algorithms and electrocardiogram (ECG) interpretation. Immediately prior to teaching they were randomly allocated to not teach, to teach algorithms, or to teach ECG. Peer teachers were tested on both topics prior to preparation, immediately after teaching and 60 days later. Compared to baseline, peer teachers' mean examination scores (±SD) demonstrated the greatest gains for content areas they prepared for and then taught (43.0% (13.9) vs. 66.3% (8.8), p teach but did not teach, less dramatic gains were evident (43.6% (8.3) vs. 54.7% (9.4), p teaching were greater than those for preparation (23.3% (10.9) vs. 8% (9.6), p teach and actively teaching may have independent positive effects on peer teacher learning outcomes.

  2. Transitions in the Swedish school system and the impact on student’s positive self-reported-health

    OpenAIRE

    Holmström, Malin Rising; Olofsson, Niclas; Asplund, Kenneth; Kristiansen, Lisbeth

    2014-01-01

    Background To explore three school based transitions and their impact on positive self- reported- health (SRH), pre-school to elementary school (6–10 y), elementary school to junior high school (10-13y), and junior high school to upper secondary school/high school (13-16y), in a long-term longitudinal population based study. Methods The study followed three cohorts through one school transition each. A longitudinal study with data from 6693 Health Dialogue questionnaires were used. Data were ...

  3. Dosimetric impact of systematic MLC positional errors on step and shoot IMRT for prostate cancer: a planning study

    International Nuclear Information System (INIS)

    Ung, N.M.; Harper, C.S.; Wee, L.

    2011-01-01

    Full text: The positional accuracy of multileaf collimators (MLC) is crucial in ensuring precise delivery of intensity-modulated radiotherapy (IMRT). The aim of this planning study was to investigate the dosimetric impact of systematic MLC positional errors on step and shoot IMRT of prostate cancer. A total of 12 perturbations of MLC leaf banks were introduced to six prostate IMRT treatment plans to simulate MLC systematic positional errors. Dose volume histograms (DVHs) were generated for the extraction of dose endpoint parameters. Plans were evaluated in terms of changes to the defined endpoint dose parameters, conformity index (CI) and healthy tissue avoidance (HTA) to planning target volume (PTV), rectum and bladder. Negative perturbations of MLC had been found to produce greater changes to endpoint dose parameters than positive perturbations of MLC (p 9 5 of -1.2 and 0.9% respectively. Negative and positive synchronised MLC perturbations of I mm in one direction resulted in median changes in D 9 5 of -2.3 and 1.8% respectively. Doses to rectum were generally more sensitive to systematic MLC en-ors compared to bladder (p < 0.01). Negative and positive synchronised MLC perturbations of I mm in one direction resulted in median changes in endpoint dose parameters of rectum and bladder from 1.0 to 2.5%. Maximum reduction of -4.4 and -7.3% were recorded for conformity index (CI) and healthy tissue avoidance (HT A) respectively due to synchronised MLC perturbation of 1 mm. MLC errors resulted in dosimetric changes in IMRT plans for prostate. (author)

  4. The positive impact of European subsidies on soil erosion rates in orange plantations

    Science.gov (United States)

    Keesstra, Saskia; Jordán, Antonio; Novara, Agata; Taguas, Tani; Pereira, Paulo; Brevik, Eric C.; Cerdà, Artemi

    2017-04-01

    Soil erosion in orchards and vineyards has been found non-sustainable due to bare soils due to the use of herbicides and tillage (Novara et al., 2011; Taguas et al., 2015; Ochoa et al., 2016; Rodrigo Comino et al., 2016a; 2016b; 2016c). Citrus plantations in sloping terrains are also non-sustainable from the soil erosion point of view due high erosion rates and the damage caused on infra-structures (Cerdà et al., 2009; 2009b; Cerdà et al., 2011; Pereira et al., 2015). This is not uncommon in Mediterranean type Ecosystems (Cerdà et al., 2010) but there is a need to reduce the soil and water losses to achieve sustainability (Brevik et al., 2015; Keesstra et al., 2016). The use of mulches, geotextiles, catch crops, and vegetation was found to be very successful as a sustainable strategy to reduce the soil losses (Giménez Morera et al., 2010; Mwango et al., 2016; Nawaz et al., 2016; Nishigaki et al., 2016; Prosdocimi et al., 2016). Nowadays, chipped branches are applied in orchards and vineyards because of European subsidies; however little scientific data is available on the impact of the chipped branches mulch on soil erosion. In an orange plantation in Eastern Valencia, at the L'Alcoleja experimental station the impact of these chipped branches was tested under 45 mm h-1 rainfall simulations on laboratory plots of 0.5 m2 under with different covers of chipped branches. The results show that with a cover of 20 % with chipped branches soil erosion reduces by 78 %. Acknowledgements The research leading to these results has received funding from the European Union Seventh Framework Programme (FP7/2007-2013) under grant agreement 603498 (RECARE project) and the CGL2013- 47862-C2-1-R and CGL2016-75178-C2-2-R national research projects. References Brevik, E. C., Cerdà, A., Mataix-Solera, J., Pereg, L., Quinton, J. N., Six, J., and Van Oost, K. 2015. The interdisciplinary nature of SOIL, SOIL, 1, 117-129, doi:10.5194/soil-1-117-2015, Cerdà, A. and M. F. Jurgensen

  5. Positive Impacts of a Vegetable Cooking Skills Program among Low-Income Parents and Children.

    Science.gov (United States)

    Overcash, Francine; Ritter, Allison; Mann, Traci; Mykerezi, Elton; Redden, Joseph; Rendahl, Aaron; Vickers, Zata; Reicks, Marla

    2017-12-12

    To evaluate the impact of a vegetable-focused cooking skills and nutrition program on parent and child psychosocial measures, vegetable liking, variety, and home availability. Baseline and postcourse surveys collected 1-week after the course. Low-income communities in Minneapolis-St Paul. Parent-child dyads (n = 89; one third each Hispanic, African American, and white) with complete pre-post course data; flyer and e-mail recruitment. Six 2-hour-weekly sessions including demonstration, food preparation, nutrition education lessons, and a meal. Parental cooking confidence and barriers, food preparation/resource management, child self-efficacy and cooking attitudes, vegetable liking, vegetable variety, and vegetable home availability. Pre-post changes analyzed with paired t test or Wilcoxon signed-rank tests. Results were significant at P cooking confidence (4.0 to 4.4/5.0), healthy food preparation (3.6 to 3.9/5.0), child self-efficacy (14.8 to 12.4; lower score = greater self-efficacy), parent liking of vegetables used in the course (7.8 to 8.1/10.0), vegetable variety (30 to 32/37 for parent, 22 to 24/37 for child), and home vegetable availability (16 to 18/35) (all P cooking and nutrition program for parents and children showed improvements in psychosocial factors, vegetable liking, variety, and home availability. Copyright © 2017 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

  6. Relations Between Positive Impacts Of CSR, External Support, CSR Knowledge And The Degree Of CSR Practices In Thai Small And Medium Enterprises

    OpenAIRE

    Pornpimon Eua-anant; Dusadee Ayuwat; Buapun Promphakping

    2011-01-01

    This article investigates the relations between positive impacts from Corporate Social Responsibility (CSR), external support, knowledge about CSR and the degree of CSR practices according to international standards in the viewpoint of small and medium enterprises in Thailand. The survey among 262 small and medium enterprises in five sections in the northeastern region of Thailand reveals that positive impacts of CSR on internal issues have shown to be positively related to the degree of CSR ...

  7. Expecting the unexpected: applying the Develop-Distort Dilemma to maximize positive market impacts in health.

    Science.gov (United States)

    Peters, David H; Paina, Ligia; Bennett, Sara

    2012-10-01

    Although health interventions start with good intentions to develop services for disadvantaged populations, they often distort the health market, making the delivery or financing of services difficult once the intervention is over: a condition called the 'Develop-Distort Dilemma' (DDD). In this paper, we describe how to examine whether a proposed intervention may develop or distort the health market. Our goal is to produce a tool that facilitates meaningful and systematic dialogue for practitioners and researchers to ensure that well-intentioned health interventions lead to productive health systems while reducing the undesirable distortions of such efforts. We apply the DDD tool to plan for development rather than distortions in health markets, using intervention research being conducted under the Future Health Systems consortium in Bangladesh, China and Uganda. Through a review of research proposals and interviews with principal investigators, we use the DDD tool to systematically understand how a project fits within the broader health market system, and to identify gaps in planning for sustainability. We found that while current stakeholders and funding sources for activities were easily identified, future ones were not. The implication is that the projects could raise community expectations that future services will be available and paid for, despite this actually being uncertain. Each project addressed the 'rules' of the health market system differently. The China research assesses changes in the formal financing rules, whereas Bangladesh and Uganda's projects involve influencing community level providers, where informal rules are more important. In each case, we recognize the importance of building trust between providers, communities and government officials. Each project could both develop and distort local health markets. Anyone intervening in the health market must recognize the main market perturbations, whether positive or negative, and manage them so

  8. Osteochondritis Dissecans Lesions in Family Members: Does a Positive Family History Impact Phenotypic Potency?

    Science.gov (United States)

    Gornitzky, Alex L; Mistovich, R Justin; Atuahuene, Brittany; Storey, Eileen P; Ganley, Theodore J

    2017-06-01

    Although repetitive microtrauma and athletic overuse patterns are most commonly associated with osteochondritis dissecans (OCD), recent studies have identified a potential genetic predisposition for OCD. Several case series have documented family pedigrees that support autosomal-dominant inheritance, but the families in these studies were all selected as a result of unique histories that may not accurately represent OCD inheritance patterns at large. Because there has been little investigation beyond these case reports, we aimed to describe a broader, more representative pattern of OCD inheritance applicable to all affected patients. (1) What proportion of patients treated for OCD of the knee have one or more immediate and/or extended family members with a history of OCD lesions? (2) Do patients with more phenotypically potent lesions, which we defined as patients with bilateral OCD lesions or patients who have undergone multiple procedures for OCD, have a higher frequency of affected relatives than those with less potent lesions? This retrospective study queried patient databases, diagnosis codes (International Classification of Diseases, 9th Revision), and surgical logs at a regional, tertiary care children's hospital to identify all patients treated over a 10-year period (March 2004-March 2014) by the senior author for OCD of the knee. All patients aged 0-18 years at the time of diagnosis were included. At our institution, patients with intact lesions are treated with a trial of conservative therapy; conversely, patients with a break in the articular cartilage and/or loose fragments of bone/cartilage are treated surgically. There were no OCD-specific contraindications to surgery. This search identified 543 patients. After patient identification, a questionnaire was designed that asked for the number, age, and gender of all immediate family members and the history of OCD lesions in any family member (immediate or extended). For all positive family members

  9. Policies to contend with climate change : positive impacts on employment in Europe and France

    International Nuclear Information System (INIS)

    Gaudin, T.; Bouchereau, J.M.

    2007-01-01

    The impact of climate change on the evolution of our society and economy was discussed. Studies have shown that the fight against climate change could result in the creation of many jobs. This article proposed several strategies to undertake, with particular reference to investment in energy conservation and the use of renewable energy. It promoted the frugal use of energy resources, notably fossil fuels, which are becoming scare. It also argued that investment in energy conservation and renewable energy sources is no long a luxury, but a necessity. It provided examples of how these investments are guided by profitability. For example, an investment to insulate a house in 1998 will be completely recuperated by 2005 due to savings in energy costs, after which time energy savings will continue. In addition to environmental protection and energy conservation, another benefit associated with the fight against climate change is job creation in areas such as insulating houses or the production of biofuels. By nature, renewable energy is local and decentralized. As such, it offers the opportunity for local jobs at or near the site of consumption. Examples of direct employment were depicted. In the transportation sector, half the amount of energy is needed to move in mass transit compared to individual cars, while creating twice the employment. Although the initial investment in mass transit is costly, the advantages are far from limited to energy conservation and employment. They include security, and improved health of people in cities which results in lower social costs. In France, the insulation of old buildings constructed before the introduction of new laws on thermal standards also generated employment. It is expected that 20,000 to 30,000 perennial jobs in agriculture and industrial manufacturing will been created in France by 2010 for the biofuel industry alone. Energy conservation will result in a drop in traditional energy consumption, this being the first goal

  10. Innovation in retail: impact on creating a positive experience when buying fashion products

    Directory of Open Access Journals (Sweden)

    Cristinel Vasiliu

    2015-05-01

    Full Text Available Innovation in fashion retail is critical in order to ensure competitive advantage in a constantly evolving market, in terms of consumer expectations. The modern customer is mobile, permanently connected to the Internet, well-informed about international trends, mindful of the quality of products, but more price sensitive and less loyal to a brand. The shopping experience provided by retailers is a crucial factor in purchase decision, encompassing all these variables in a complex concept of exogenous variable. As retailers’ efforts to provide excellence in shopping experience are focused on operating costs and thus on the profit margins, it is important to consider and identify which are the most relevant variables that form the perception of excellence for Romanian customers, so that retailers can innovate according to their expectations. The purpose of this article was to highlight the role of innovation in creating a positive experience for consumers buying clothes, shoes and accessories. The approach was based on the conduct of exploratory research. The research ? represented by five original objectives and as many different working scenarios ? resulted in the identification of thematic outlined exploratory opinions, exploiting a first investigation of its kind in Romania, less Pearson coefficients used in the analysis of ordinal variables or hierarchical, but quickly assessed using SPSS, version 21. As a pioneering research emphasis was on identifying potential associations and quantified correlations and less on rigorous delimitation of exogenous or endogenous quality in general, leaving room for future studies, sharper and with a higher degree of representation. Thus, we could highlight some useful aspects of the investigated retailers, by the dominant character of interested customers’ opinions according to their volunteer responses. Consumers are accustomed to using the Internet to obtain information; they rarely express opinions on

  11. River food webs: an integrative approach to bottom-up flow webs, top-down impact webs, and trophic position.

    Science.gov (United States)

    Benke, Arthur C

    2018-03-31

    The majority of food web studies are based on connectivity, top-down impacts, bottom-up flows, or trophic position (TP), and ecologists have argued for decades which is best. Rarely have any two been considered simultaneously. The present study uses a procedure that integrates the last three approaches based on taxon-specific secondary production and gut analyses. Ingestion flows are quantified to create a flow web and the same data are used to quantify TP for all taxa. An individual predator's impacts also are estimated using the ratio of its ingestion (I) of each prey to prey production (P) to create an I/P web. This procedure was applied to 41 invertebrate taxa inhabiting submerged woody habitat in a southeastern U.S. river. A complex flow web starting with five basal food resources had 462 flows >1 mg·m -2 ·yr -1 , providing far more information than a connectivity web. Total flows from basal resources to primary consumers/omnivores were dominated by allochthonous amorphous detritus and ranged from 1 to >50,000 mg·m -2 ·yr -1 . Most predator-prey flows were much lower (1,000  mg·m -2 ·yr -1 . The I/P web showed that 83% of individual predator impacts were weak (90%). Quantitative estimates of TP ranged from 2 to 3.7, contrasting sharply with seven integer-based trophic levels based on longest feeding chain. Traditional omnivores (TP = 2.4-2.9) played an important role by consuming more prey and exerting higher impacts on primary consumers than strict predators (TP ≥ 3). This study illustrates how simultaneous quantification of flow pathways, predator impacts, and TP together provide an integrated characterization of natural food webs. © 2018 by the Ecological Society of America.

  12. Prevalence of positive gated myocardial SPECT in diabetic and non-diabetic women and impact of other factors; KIHD perspective

    International Nuclear Information System (INIS)

    Maseeh-uz-Zaman; Fatima, N.; Samad, A.; Rasheed, S.Z.; Ishaq, M.; Rehman, K.; Wali, A.

    2009-01-01

    The objective of the present study was to assess the prevalence of coronary artery disease (CAD) among diabetic (DM) and nondiabetic (NDM) women using Gated SPECT (GSPECT) and to study the impact of other. risk factors like hypertension (HTN), dyslipidemia, family history and menopause. This is a prospective cross-sectional study on a consecutive sample of 287 women referred to Nuclear Cardiology Department of Karachi Institute of Heart Diseases (KIHD) for GSPECT for evaluation of known or suspected CAD (from January 2009 till June 2009). Women with a history of DM diagnosed less than 5 years were excluded. Same day (reststress) GSPECT study was conducted and fixed or reversible perfusion defects were considered positive GSPECT for CAD. GSPECT was positive for CAD in 41/115 (36%, P 0.002) diabetic women and 37/172 (21 %, P 0.005) non-diabetic cohort. In diabetic cohort, GSPECT was positive in 5/9 (56%, P 0.013) women with diabetes only, 17/35 (48%, P 0.02) DM with HTN, 12/15 (80%, P value 0.02) DM with dyslipidemia and 11/43 (26%, P 0.001) DM with >2 risk factors. GSPECT was normal in all 3 diabetic women with positive family history for CAD. In nondiabetic cohort, GSPECT was positive in 9/32 (28%, P value 0.739) women with no risk factor, 5/58 (26%, P 0.866) HTN only, 2/5 (40%, P value 0.655) only dyslipidemic women, 1/12. (8%, P 0.004) with family history only and 4/23 (17%, P value 0.166) non-diabetic with >2 risk factors. Interestingly, 35/93 post-menopausal diabetic (38%, p value 0.017) had positive GSPECT while 33/123 non-diabetic postmenopausal women (27%, p 0.03) had positive perfusion scans. GSPECT was positive in 6/26 (23%, P 0.006) and 4/49 (8%, P 0.05) in diabetic and non-diabetic pre-menopausal women. The prevalence of CAD in our diabetic women is as high as internationally reported and diabetes is a strong risk factor for CAD. Dyslipidemia with diabetes is a major contributor to CAD than HTN and F/H. Diabetes erases the protective effect of estrogen

  13. Prevalence of positive gated myocardial SPECT in diabetic and non-diabetic women and impact of other factors; KIHD perspective

    Energy Technology Data Exchange (ETDEWEB)

    Maseeh-uz-Zaman,; Fatima, N; Samad, A; Rasheed, S Z; Ishaq, M; Rehman, K; Wali, A [Karachi, Inst. of Heart Diseases, Karachi (Pakistan)

    2009-07-15

    The objective of the present study was to assess the prevalence of coronary artery disease (CAD) among diabetic (DM) and nondiabetic (NDM) women using Gated SPECT (GSPECT) and to study the impact of other. risk factors like hypertension (HTN), dyslipidemia, family history and menopause. This is a prospective cross-sectional study on a consecutive sample of 287 women referred to Nuclear Cardiology Department of Karachi Institute of Heart Diseases (KIHD) for GSPECT for evaluation of known or suspected CAD (from January 2009 till June 2009). Women with a history of DM diagnosed less than 5 years were excluded. Same day (reststress) GSPECT study was conducted and fixed or reversible perfusion defects were considered positive GSPECT for CAD. GSPECT was positive for CAD in 41/115 (36%, P 0.002) diabetic women and 37/172 (21 %, P 0.005) non-diabetic cohort. In diabetic cohort, GSPECT was positive in 5/9 (56%, P 0.013) women with diabetes only, 17/35 (48%, P 0.02) DM with HTN, 12/15 (80%, P value 0.02) DM with dyslipidemia and 11/43 (26%, P 0.001) DM with >2 risk factors. GSPECT was normal in all 3 diabetic women with positive family history for CAD. In nondiabetic cohort, GSPECT was positive in 9/32 (28%, P value 0.739) women with no risk factor, 5/58 (26%, P 0.866) HTN only, 2/5 (40%, P value 0.655) only dyslipidemic women, 1/12. (8%, P 0.004) with family history only and 4/23 (17%, P value 0.166) non-diabetic with >2 risk factors. Interestingly, 35/93 post-menopausal diabetic (38%, p value 0.017) had positive GSPECT while 33/123 non-diabetic postmenopausal women (27%, p 0.03) had positive perfusion scans. GSPECT was positive in 6/26 (23%, P 0.006) and 4/49 (8%, P 0.05) in diabetic and non-diabetic pre-menopausal women. The prevalence of CAD in our diabetic women is as high as internationally reported and diabetes is a strong risk factor for CAD. Dyslipidemia with diabetes is a major contributor to CAD than HTN and F/H. Diabetes erases the protective effect of estrogen

  14. SU-E-T-459: Impact of Source Position and Traveling Time On HDR Skin Surface Applicator Dosimetry

    International Nuclear Information System (INIS)

    Jeong, J; Barker, C; Zaider, M; Cohen, G

    2015-01-01

    Purpose: Observed dosimetric discrepancy between measured and treatment planning system (TPS) predicted values, during applicator commissioning, were traced to source position uncertainty in the applicator. We quantify the dosimetric impact of this geometric uncertainty, and of the source traveling time inside the applicator, and propose corrections for clinical use. Methods: We measured the dose profiles from the Varian Leipzig-style (horizontal) HDR skin applicator, using EBT3 film, photon diode, and optically stimulated luminescence dosimeter (OSLD) and three different GammaMed HDR afterloders. The dose profiles and depth dose of each aperture were measured at several depths (up to about 10 mm, depending on the dosimeter). The measured dose profiles were compared with Acuros calculated profiles in BrachyVision TPS. For the impact of the source position, EBT3 film measurements were performed with applicator, facing-down and facing-up orientations. The dose with and without source traveling was measured with diode detector using HDR timer and electrometer timer, respectively. Results: Depth doses measured using the three dosimeters were in good agreement, but were consistently higher than the Acuros dose calculations. Measurements with the applicator facing-up were significantly lower than those in the facing-down position with maximum difference of about 18% at the surface, due to source sag inside the applicator. Based on the inverse-square law, the effective source sag was evaluated to be about 0.5 mm from the planned position. The additional dose from the source traveling was about 2.8% for 30 seconds with 10 Ci source, decreasing with increased dwelling time and decreased source activity. Conclusion: Due to the short source-to-surface distance of the applicator, the small source sag inside the applicator has significant dosimetric impact, which should be considered before the clinical use of the applicator. Investigation of the effect for other applicators

  15. The Anticipated Positive Psychosocial Impact of Present Web-Based E-Health Services and Future Mobile Health Applications: An Investigation among Older Swedes.

    Science.gov (United States)

    Wiklund Axelsson, S; Nyberg, L; Näslund, A; Melander Wikman, A

    2013-01-01

    This study investigates the anticipated psychosocial impact of present web-based e-health services and future mobile health applications among older Swedes. Random sample's of Swedish citizens aged 55 years old and older were given a survey containing two different e-health scenarios which respondents rated according to their anticipated psychosocial impact by means of the PIADS instrument. Results consistently demonstrated the positive anticipation of psychosocial impacts for both scenarios. The future mobile health applications scored more positively than the present web-based e-health services. An increase in age correlated positively to lower impact scores. These findings indicate that from a psychosocial perspective, web-based e-health services and mobile health applications are likely to positively impact quality of life. This knowledge can be helpful when tailoring and implementing e-health services that are directed to older people.

  16. The Clinical Impact of Rapid, Direct MALDI-ToF Identification of Bacteria from Positive Blood Cultures.

    Science.gov (United States)

    French, Kathryn; Evans, Jason; Tanner, Hannah; Gossain, Savita; Hussain, Abid

    2016-01-01

    Faster identification of bacterial isolates from blood cultures can enable earlier clinical intervention for patients with sepsis. We evaluated the clinical impact of direct identification of micro-organisms from positive blood cultures using MALDI-ToF. Positive blood cultures with organisms seen on Gram stain were included over a four week period. For each patient case, comparison was made between the clinical advice given on day one with only a Gram stain result, and the follow up advice given on day two with the benefit of organism identification. Culture results were then compared with direct MALDI-ToF identification. For 73 of 115 cases (63.5%), direct organism identification was obtained by MALDI-ToF. Of those 73, 70 (95.5%) had a result concordant with that of the plate culture. In 28 of the 115 cases (24.3%) direct MALDI-ToF identification on day one would have had a clear clinical benefit. In 11 cases it would have helped to identify the potential source of bacteraemia. In 11 cases it would have indicated a different antibiotic regimen on day one, with five patients receiving appropriate antibiotics 24 hours earlier. For 14 cases the blood culture isolate could have been designated as unlikely to be clinically significant. We have demonstrated that organism identification on day one of blood culture positivity can have a direct clinical impact. Faster identification using MALDI-ToF assists the clinician in assessing the significance of a blood culture isolate on day one. It can allow earlier appropriate choice of antimicrobial agent, even in the absence of susceptibility testing, and help narrow down the potential source of infection providing a focus for further investigation in a more timely way than conventional techniques alone.

  17. The Clinical Impact of Rapid, Direct MALDI-ToF Identification of Bacteria from Positive Blood Cultures.

    Directory of Open Access Journals (Sweden)

    Kathryn French

    Full Text Available Faster identification of bacterial isolates from blood cultures can enable earlier clinical intervention for patients with sepsis. We evaluated the clinical impact of direct identification of micro-organisms from positive blood cultures using MALDI-ToF.Positive blood cultures with organisms seen on Gram stain were included over a four week period. For each patient case, comparison was made between the clinical advice given on day one with only a Gram stain result, and the follow up advice given on day two with the benefit of organism identification. Culture results were then compared with direct MALDI-ToF identification.For 73 of 115 cases (63.5%, direct organism identification was obtained by MALDI-ToF. Of those 73, 70 (95.5% had a result concordant with that of the plate culture. In 28 of the 115 cases (24.3% direct MALDI-ToF identification on day one would have had a clear clinical benefit. In 11 cases it would have helped to identify the potential source of bacteraemia. In 11 cases it would have indicated a different antibiotic regimen on day one, with five patients receiving appropriate antibiotics 24 hours earlier. For 14 cases the blood culture isolate could have been designated as unlikely to be clinically significant.We have demonstrated that organism identification on day one of blood culture positivity can have a direct clinical impact. Faster identification using MALDI-ToF assists the clinician in assessing the significance of a blood culture isolate on day one. It can allow earlier appropriate choice of antimicrobial agent, even in the absence of susceptibility testing, and help narrow down the potential source of infection providing a focus for further investigation in a more timely way than conventional techniques alone.

  18. Massive radiological releases profoundly differ from controlled releases

    International Nuclear Information System (INIS)

    Pascucci-Cahen, Ludivine; Patrick, Momal

    2013-01-01

    In this article, the authors report identification and assessment of different types of costs associated with nuclear accidents. They first outline that these cost assessments must be as exhaustive or comprehensive as possible. While referring to past accidents, they define the different categories of costs: on-site costs (decontamination and dismantling, electricity not produced on the site), off-site costs (health costs, psychological costs, farming losses), image-related costs (impact on food and farm product exports, decrease of other exports), costs related to energy production, costs related to contaminated areas (refugees, lands). They give an assessment of a severe nuclear accident (i.e. an accident with important but controlled radiological releases) in France and outline that it would be a national catastrophe which could be however managed. They discuss the possible variations of the estimated costs. Then, they show that a major accident (i.e. an accident with massive radiological releases) in France would be an unmanageable European catastrophe because of the radiological consequences, of high economic costs, and of huge losses

  19. Interpersonal conflict strategies and their impact on positive symptom remission in persons aged 55 and older with schizophrenia spectrum disorders.

    Science.gov (United States)

    Cohen, Carl I; Solanki, Dishal; Sodhi, Dimple

    2013-01-01

    Although interpersonal interactions are thought to affect psychopathology in schizophrenia, there is a paucity of data about how older adults with schizophrenia manage interpersonal conflicts. This paper examines interpersonal conflict strategies and their impact on positive symptom remission in older adults with schizophrenia spectrum disorders. The schizophrenia group consisted of 198 persons aged 55 years and over living in the community who developed schizophrenia before age 45. A community comparison group (n = 113) was recruited using randomly selected block-groups. Straus' Conflict Tactics Scale (CTS) was used to assess the ways that respondents handled interpersonal conflicts. Seven conflict management subscales were created based on a principal component analysis with equamax rotation of items from the CTS. The order of the frequency of the tactics that was used was similar for both the schizophrenia and community groups. Calm and Pray tactics were the most commonly used, and the Violent and Aggressive tactics were rarely utilized. In two separate logistic regression analysis, after controlling for confounding variables, positive symptom remission was found to be associated significantly with both the Calm and Pray subscales. The findings suggest that older persons with schizophrenia approximate normal distribution patterns of conflict management strategies and the most commonly used strategies are associated with positive symptom remission.

  20. Impact of antibiotic administration on blood culture positivity at the beginning of sepsis: a prospective clinical cohort study.

    Science.gov (United States)

    Scheer, Christian S; Fuchs, Christian; Gründling, Matthias; Vollmer, Marcus; Bast, Juliane; Bohnert, Jürgen A; Zimmermann, Kathrin; Hahnenkamp, Klaus; Rehberg, Sebastian; Kuhn, Sven-Olaf

    2018-06-04

    Sepsis guidelines recommend obtaining blood cultures before starting anti-infective therapy in patients with sepsis. However, little is known how antibiotic treatment prior to sampling affects bacterial growth. The aim of this study was to compare the results of blood cultures drawn prior to and under antibiotic therapy. Prospective clinical cohort study of septic patients. Adult ICU patients with 2 or 3 blood culture (BC) sets at the beginning of sepsis between 2010 and 2017 were included. Patients with blood culture samplings obtained prior to antibiotic therapy were compared to patients with samplings under antibiotic therapy. Blood culture positivity, defined as microbiological pathogen finding, was compared between the groups. Logistic regression was performed to adjust the impact of different factors with respect to blood culture positivity. In total, 559 patients with 1364 blood culture sets at the beginning of sepsis were analyzed. BC positivity was 50.6% (78/154) among septic patients who did not receive antibiotics and only 27.7% (112/405) in those who were already under antibiotics (Pcultures under antibiotic therapy is associated with a significant loss of pathogen detection. This strongly emphasizes the current recommendation to obtain blood cultures prior to antibiotic administration in patients with sepsis. Copyright © 2018. Published by Elsevier Ltd.

  1. Clinical impact of culture-positive preservation fluid on solid organ transplantation: A systematic review and meta-analysis.

    Science.gov (United States)

    Oriol, Isabel; Sabé, N; Tebé, C; Veroux, M; Boin, I F S F; Carratalà, J

    2018-04-01

    Contamination of the preservation fluid (PF) used for donated organs is a potential source of post-transplant infection. However, the information on this issue is scarce. We therefore conducted a systematic review and meta-analysis to assess the incidence of culture-positive PF and its impact on solid organ transplant (SOT) recipients. Seventeen studies were identified and included. The overall incidence of culture-positive PF was 37% (95% CI: 27% to 49%), and the incidence of PF-related infections among SOT recipients with PF cultures that grew pathogenic microorganisms was 10% (95% CI: 7% to 15%). There were differences in the rates of infections due to pathogenic microorganisms between SOT recipients who received pre-emptive treatment and those who did not, but without statistical significance. The mortality rate among SOT recipients with PF-related infection was 35% (95% CI: 21% to 53%). In conclusion, although contamination of the PF of donated organs is frequent, the incidence of PF-related infection is relatively low. A closely clinical and microbiologic monitoring of the SOT recipient in case of culture-positive PF, regardless of the type of microorganism isolated might be do in order to establish a prompt diagnosis of PF-related infection. Copyright © 2017 Elsevier Inc. All rights reserved.

  2. The management of children with Down syndrome and profound hearing loss.

    Science.gov (United States)

    Phelan, E; Pal, R; Henderson, L; Green, K M J; Bruce, I A

    2016-01-01

    Although, the association between Down syndrome (DS) and conductive hearing loss is well recognized, the fact that a small proportion of these children may have a severe to profound sensorineural hearing loss that could benefit from cochlear implantation (CI) is less well understood. The management of significant co-morbidities in children with DS can delay initial diagnosis of hearing impairment and assessment of suitability for CI can likewise be challenging, due to difficulties conditioning to behavioural hearing tests. We performed a retrospective case note review of three children with DS referred to the Manchester Cochlear Implant Programme. Three illustrative cases are described including CI in a 4 years old. Using conventional outcome measurement instruments, the outcome could be considered to be suboptimal with a Categories of Auditory Performance score of 4 at 6 months post-op and at last follow up. In part, this is likely to reflect the delay in implantation, but the role of cognitive impairment must be considered. The cases described emphasize the importance of comprehensive radiological and audiological assessment in children with DS being considered for CI. The influence of cognitive impairment upon outcome of CI must be taken into account, but should not be considered a contra-indication to implantation in children with DS. Benefit that might be considered limited when quantified using existing general outcome measurement instruments, may have a significant impact upon psychosocial development and quality of life in children with significant cognitive impairment, or other additional needs.

  3. Impact of bowtie filter and object position on the two-dimensional noise power spectrum of a clinical MDCT system

    Energy Technology Data Exchange (ETDEWEB)

    Gomez-Cardona, Daniel; Cruz-Bastida, Juan Pablo [Department of Medical Physics, University of Wisconsin-Madison School of Medicine and Public Health, 1111 Highland Avenue, Madison, Wisconsin 53705 (United States); Li, Ke; Chen, Guang-Hong, E-mail: gchen7@wisc.edu [Department of Medical Physics, University of Wisconsin-Madison School of Medicine and Public Health, 1111 Highland Avenue, Madison, Wisconsin 53705 and Department of Radiology, University of Wisconsin-Madison School of Medicine and Public Health, 600 Highland Avenue, Madison, Wisconsin 53792 (United States); Budde, Adam; Hsieh, Jiang [Department of Medical Physics, University of Wisconsin-Madison School of Medicine and Public Health, 1111 Highland Avenue, Madison, Wisconsin 53705 and GE Healthcare, 3000 N Grandview Boulevard, Waukesha, Wisconsin 53188 (United States)

    2016-08-15

    Purpose: Noise characteristics of clinical multidetector CT (MDCT) systems can be quantified by the noise power spectrum (NPS). Although the NPS of CT has been extensively studied in the past few decades, the joint impact of the bowtie filter and object position on the NPS has not been systematically investigated. This work studies the interplay of these two factors on the two dimensional (2D) local NPS of a clinical CT system that uses the filtered backprojection algorithm for image reconstruction. Methods: A generalized NPS model was developed to account for the impact of the bowtie filter and image object location in the scan field-of-view (SFOV). For a given bowtie filter, image object, and its location in the SFOV, the shape and rotational symmetries of the 2D local NPS were directly computed from the NPS model without going through the image reconstruction process. The obtained NPS was then compared with the measured NPSs from the reconstructed noise-only CT images in both numerical phantom simulation studies and experimental phantom studies using a clinical MDCT scanner. The shape and the associated symmetry of the 2D NPS were classified by borrowing the well-known atomic spectral symbols s, p, and d, which correspond to circular, dumbbell, and cloverleaf symmetries, respectively, of the wave function of electrons in an atom. Finally, simulated bar patterns were embedded into experimentally acquired noise backgrounds to demonstrate the impact of different NPS symmetries on the visual perception of the object. Results: (1) For a central region in a centered cylindrical object, an s-wave symmetry was always present in the NPS, no matter whether the bowtie filter was present or not. In contrast, for a peripheral region in a centered object, the symmetry of its NPS was highly dependent on the bowtie filter, and both p-wave symmetry and d-wave symmetry were observed in the NPS. (2) For a centered region-ofinterest (ROI) in an off-centered object, the symmetry of

  4. Impact of bowtie filter and object position on the two-dimensional noise power spectrum of a clinical MDCT system

    International Nuclear Information System (INIS)

    Gomez-Cardona, Daniel; Cruz-Bastida, Juan Pablo; Li, Ke; Chen, Guang-Hong; Budde, Adam; Hsieh, Jiang

    2016-01-01

    Purpose: Noise characteristics of clinical multidetector CT (MDCT) systems can be quantified by the noise power spectrum (NPS). Although the NPS of CT has been extensively studied in the past few decades, the joint impact of the bowtie filter and object position on the NPS has not been systematically investigated. This work studies the interplay of these two factors on the two dimensional (2D) local NPS of a clinical CT system that uses the filtered backprojection algorithm for image reconstruction. Methods: A generalized NPS model was developed to account for the impact of the bowtie filter and image object location in the scan field-of-view (SFOV). For a given bowtie filter, image object, and its location in the SFOV, the shape and rotational symmetries of the 2D local NPS were directly computed from the NPS model without going through the image reconstruction process. The obtained NPS was then compared with the measured NPSs from the reconstructed noise-only CT images in both numerical phantom simulation studies and experimental phantom studies using a clinical MDCT scanner. The shape and the associated symmetry of the 2D NPS were classified by borrowing the well-known atomic spectral symbols s, p, and d, which correspond to circular, dumbbell, and cloverleaf symmetries, respectively, of the wave function of electrons in an atom. Finally, simulated bar patterns were embedded into experimentally acquired noise backgrounds to demonstrate the impact of different NPS symmetries on the visual perception of the object. Results: (1) For a central region in a centered cylindrical object, an s-wave symmetry was always present in the NPS, no matter whether the bowtie filter was present or not. In contrast, for a peripheral region in a centered object, the symmetry of its NPS was highly dependent on the bowtie filter, and both p-wave symmetry and d-wave symmetry were observed in the NPS. (2) For a centered region-ofinterest (ROI) in an off-centered object, the symmetry of

  5. Partial neuroprotection by nNOS inhibition during profound asphyxia in preterm fetal sheep.

    Science.gov (United States)

    Drury, Paul P; Davidson, Joanne O; van den Heuij, Lotte G; Tan, Sidhartha; Silverman, Richard B; Ji, Haitao; Blood, Arlin B; Fraser, Mhoyra; Bennet, Laura; Gunn, Alistair Jan

    2013-12-01

    Preterm brain injury is partly associated with hypoxia-ischemia starting before birth. Excessive nitric oxide production during HI may cause nitrosative stress, leading to cell membrane and mitochondrial damage. We therefore tested the hypothesis that therapy with a new, selective neuronal nitric oxide synthase (nNOS) inhibitor, JI-10 (0.022mg/kg bolus, n=8), given 30min before 25min of complete umbilical cord occlusion was protective in preterm fetal sheep at 101-104day gestation (term is 147days), compared to saline (n=8). JI-10 had no effect on fetal blood pressure, heart rate, carotid and femoral blood flow, total EEG power, nuchal activity, temperature or intracerebral oxygenation on near-infrared spectroscopy during or after occlusion. JI-10 was associated with later onset of post-asphyxial seizures compared with saline (p<0.05), and attenuation of the subsequent progressive loss of cytochrome oxidase (p<0.05). After 7days recovery, JI-10 was associated with improved neuronal survival in the caudate nucleus (p<0.05), but not the putamen or hippocampus, and more CNPase positive oligodendrocytes in the periventricular white matter (p<0.05). In conclusion, prophylactic nNOS inhibition before profound asphyxia was associated with delayed onset of seizures, slower decline of cytochrome oxidase and partial white and gray matter protection, consistent with protection of mitochondrial function. © 2013.

  6. Open table-top device positioning technique to reduce small bowel obstruction. Positioning accuracy and impact on conformal radiation therapy techniques

    International Nuclear Information System (INIS)

    Rudat, V.; Flentje, M.; Engenhart, R.; Metzger, M.; Wannenmacher, M.

    1995-01-01

    The immobilization error of patients positioned on the opern table-top device in prone prosition as well as the movement of the small bowel out of the pelvis by this positioning technique was determined. The positioning error is of special importance for the 3-dimensional treatment planning for conformal radiotherapy. The positioning error was determined by superposing 106 portal films with the corresponding simultor films from 21 patients with carcinoma of the rectum who received 3D-planned conformal radiotherapy (o-field technique with irregular blocks). The movement of the small bowel out of the pelvis was studied by comparing simulator films after barium swallow in supine and open table-top position as well with 3D-treatment plans of the same patient in both positions in 3 cases. The positioning error along the medio-lateral, dorso-ventral und cranio-caudal axis was 1.4/-0.6/1.8 mm and the standard deviation 4.4/6.8/6.3 mm, respectively. In comparison to the supine position more rotation errors in the sagittal view were observed (37% and 9% respectively) with a media of 5.1 . Six out of 22 patients showed no adhesions of the small bowel and a complete movement out of the tratment field was achieved. 14 out of 16 Patients with adhesions revealed a partial movement of the small bowel out of the treatment field. Comparing 3D-treatment plans in both positions again demonstrated a marked reduction of the irradiated small bowel volume with the use of the open table-top decive. (orig.) [de

  7. The impact of diabetes on mobility, balance, and recovery after repositioning maneuvers in individuals with benign paroxysmal positional vertigo.

    Science.gov (United States)

    D'Silva, Linda J; Whitney, Susan L; Santos, Marcio; Dai, Hongying; Kluding, Patricia M

    2017-06-01

    The prevalence of benign paroxysmal positional vertigo (BPPV) is higher in people with type 2 diabetes (DM). The impact of DM on mobility, balance, and management of BPPV is unknown. This prospective study compared symptom severity, mobility and balance before and after the canalith repositioning maneuver (CRM) in people with posterior canal BPPV canalithiasis, with and without DM. Fifty participants, BPPV (n=34) and BPPV+DM (n=16) were examined for symptom severity (dizziness handicap inventory, DHI), mobility (functional gait assessment, FGA), and postural sway (using an accelerometer in five conditions) before and after the CRM. The number of maneuvers required for symptom resolution was recorded. At baseline, no differences in DHI or FGA scores were seen between groups, however, people with BPPV+DM had higher sway velocity in the medio-lateral direction in tandem stance (pdiabetes, as well as the influence of diabetic peripheral neuropathy on functional performance are essential. Copyright © 2017 Elsevier Inc. All rights reserved.

  8. Impact of sitting position on the formation of spinal curvatures in the sagittal plane of taxi drivers - preliminary report

    Directory of Open Access Journals (Sweden)

    Agnieszka Turon-Skrzypinska

    2018-04-01

    Results: The average work time in the examined group was 57.7 and the control group 6.8 hours per week. The mean values of thoracic kyphosis and lumbar lordosis in the examined group were 36.3 and 17.9 degrees, respectively, versus 30.3 and 20.8 in the control group. Age and length of service had an impact on the shaping of the spinal curvatures. Greater value of BMI was associated with deeper thoracic kyphosis, but not with shallower lumbar lordosis. Conclusions: Adverse changes in shaping spinal curvatures progress with increasing age and length of the employment performed in the sitting position. Body mass index and body weight above the normal level contribute to deepening thoracic kyphosis.

  9. Evaluating dosage effects for the positive action program: How implementation impacts internalizing symptoms, aggression, school hassles, and self-esteem.

    Science.gov (United States)

    Smokowski, Paul R; Guo, Shenyang; Wu, Qi; Evans, Caroline B R; Cotter, Katie L; Bacallao, Martica

    2016-01-01

    Positive Action (PA) is a school-based intervention for elementary-, middle-, and high-school students that aims to decrease problem behaviors (e.g., violence, substance use) and increase positive behaviors (e.g., academic achievement, school engagement). PA has a long history of documented success achieving these aims, making it an Evidence Based Practice (EBP). Intervention research on EBP's has established the importance of implementation fidelity, especially with regard to program dosage; failure to properly implement an EBP can have negative consequences on targeted outcomes, especially if participants are exposed to a low dosage of the program (e.g., fewer lessons than specified). Much of the current research on PA has neglected to examine how program dosage impacts PA's effect on targeted outcomes. Using propensity score models, multiple imputation, and a 2-level hierarchical linear model, the current study fills this gap and examines how different dosages of PA as measured by years participating in PA and number of PA lessons, impacts adolescent internalizing symptoms, aggression, perceptions of school hassles, and self-esteem over a 3-year period. The current sample included middle school students in grades 6, 7, and 8 (N = 5,894). The findings indicate that students who received 3 years of the PA intervention and a high number of PA lessons had a significantly higher self-esteem score than those who received 0 years of PA or zero lessons. Participants who received 1 year of PA also reported significantly lower school hassle scores than those who received 0 years. Dosage had no statistically significant effects on aggression or internalizing score. Implications are discussed. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  10. Reversal of profound rocuronium neuromuscular blockade by sugammadex in anesthetized rhesus monkeys.

    NARCIS (Netherlands)

    Boer, H.D. de; Egmond, J. van; Pol, F. van de; Bom, A.; Booij, L.H.D.J.

    2006-01-01

    BACKGROUND: Reversal of neuromuscular blockade can be accomplished by chemical encapsulation of rocuronium by sugammadex, a synthetic gamma-cyclodextrin derivative. The current study determined the feasibility of reversal of rocuronium-induced profound neuromuscular blockade with sugammadex in the

  11. Analyses of direct and indirect impacts of a positive list system on pharmaceutical R&D investments.

    Science.gov (United States)

    Han, Euna; Kim, Tae Hyun; Jeung, Myung Jin; Lee, Eui-Kyung

    2013-07-01

    The South Korean government recently enacted a Positive List System (PLS) as a major change of the national formulary listing system and reimbursed prices for pharmaceutical products. Regardless of the primary goal of the PLS, its implementation might have spillover effects by influencing the pharmaceutical industry's research and development (R&D), potentially leading to a variety of responses by firms in relation to their R&D activities. We investigated the spillover effect of the PLS on R&D investments of the pharmaceutical industry in Korea through both direct and indirect channels, examining the influence of the PLS on sales profit and cash flow. Data from 9 years (5 before and 4 after PLS implementation) were drawn from the financial statements of firms whose stocks were exchanged in 2 official stock markets in Korea (526 firms) and additional pharmaceutical firms whose financial performance was officially audited by external reviewers (263 firms). Longitudinal analyses were conducted, using the panel nature of the data to control for permanent unobserved firm heterogeneity. Our results showed that the PLS was directly associated with R&D investments. In contrast, its indirect impacts stemming from the influence on sales profit and cash flow were minimal and statistically nonsignificant. The gross impact of the PLS on R&D investments increased moving further from the enactment year; R&D investments were reduced by 18.3% to 25.8% in 2009-2010 (compared with before PLS implementation) in the firm fixed-effects model. We also found that such negative direct and gross impacts of the PLS on R&D investments were significant only in firms without newly developed chemical entities. Considering the gross negative impact of the PLS on R&D investments of pharmaceutical firms and the heterogeneous response of these firms by the R&D activities, governmental efforts of cost-containment may need to consider the spillover impact of the PLS on pharmaceutical innovation

  12. Positive predictive value and impact of misdiagnosis of a heart failure diagnosis in administrative registers among patients admitted to a University Hospital cardiac care unit

    DEFF Research Database (Denmark)

    Mard, Shan; Nielsen, Finn Erland

    2010-01-01

    To evaluate the positive predictive value (PPV) of a diagnosis of heart failure (HF) in the Danish National Registry of Patients (NRP) among patients admitted to a University Hospital cardiac care unit, and to evaluate the impact of misdiagnosing HF.......To evaluate the positive predictive value (PPV) of a diagnosis of heart failure (HF) in the Danish National Registry of Patients (NRP) among patients admitted to a University Hospital cardiac care unit, and to evaluate the impact of misdiagnosing HF....

  13. Vicious circles of gender bias, lower positions, and lower performance: Gender differences in scholarly productivity and impact.

    Science.gov (United States)

    van den Besselaar, Peter; Sandström, Ulf

    2017-01-01

    It is often argued that female researchers publish on average less than male researchers do, but male and female authored papers have an equal impact. In this paper we try to better understand this phenomenon by (i) comparing the share of male and female researchers within different productivity classes, and (ii) by comparing productivity whereas controlling for a series of relevant covariates. The study is based on a disambiguated Swedish author dataset, consisting of 47,000 researchers and their WoS-publications during the period of 2008-2011 with citations until 2015. As the analysis shows, in order to have impact quantity does make a difference for male and female researchers alike-but women are vastly underrepresented in the group of most productive researchers. We discuss and test several possible explanations of this finding, using a data on personal characteristics from several Swedish universities. Gender differences in age, authorship position, and academic rank do explain quite a part of the productivity differences.

  14. Exploring the impact of positive and negative emotions on cooperative behaviour in a Prisoner’s Dilemma Game

    Directory of Open Access Journals (Sweden)

    Oscar N.E. Kjell

    2013-12-01

    Full Text Available Objective. To explore the influences of discrete positive and negative emotions on cooperation in the context of a social dilemma game.Design. Two controlled studies were undertaken. In Study 1, 69 participants were randomly assigned to an essay emotion manipulation task designed to induce either guilt, joy or no strong emotion. In Study 2, 95 participants were randomly assigned to one of the same three tasks, and the impact of emotional condition on cooperation was explored using a repeated Prisoner’s Dilemma Game.Results. Study 1 established that the manipulation task was successful in inducing the specified emotions. The analysis from Study 2 revealed no significant main effects for emotions, in contrast to previous research. However, there was a significant effect for participants’ pre-existing tendency to cooperate (social value orientation; SVO.Conclusion. Methodological explanations for the result are explored, including the possible impact of trial-and-error strategies, different cooperation games and endogenous vs exogenous emotions.

  15. Impact of body size, nutrition and socioeconomic position in early life on the epigenome: a systematic review protocol.

    Science.gov (United States)

    Maddock, Jane; Wulaningsih, Wahyu; Hardy, Rebecca

    2017-07-05

    Body size, nutrition and socioeconomic position (SEP) in early life have been associated with a range of later life health outcomes. Epigenetic regulation is one mechanism through which these early life factors may impact later life health. The aim of this review protocol is to outline procedures to document the influence of body size, nutrition and SEP in early life on the epigenome. MEDLINE, Embase and BIOSIS will be systematically searched using pre-defined keywords. Additional studies will be identified through manual searching of reference lists. Two independent researchers will assess the eligibility and quality of each study, with disagreements being resolved through discussion or a third reviewer. Studies will be included if they have epigenetic markers measured either at the same time as, or after, the early life exposure and, have a measure of body size, nutrition or SEP in early life (up to 12 years), are in the English language and are from a sample of community-dwelling participants. This protocol will be used to collate the evidence for the effect of early life factors on the epigenome. Findings will form a component of a wider research study examining epigenetic responses to exposures in early life and over the life course and its impact on healthy ageing using data from population-based cohort studies. PROSPERO CRD42016050193.

  16. Threat appeals in health communication: messages that elicit fear and enhance perceived efficacy positively impact on young male drivers.

    Science.gov (United States)

    Carey, Rachel N; Sarma, Kiran M

    2016-07-27

    Health communications often present graphic, threat-based representations of the potential consequences of health-risk behaviours. These 'threat appeals' feature prominently in public health campaigns, but their use is controversial, with studies investigating their efficacy reporting inconsistent, and often negative, findings. This research examined the impact of a threat-based road safety advertisement on the driving behaviour of young male drivers. To address limitations of previous research, we first identified a road safety advertisement that objectively and subjectively elicited fear using physiological and subjective measures. Study 1 (n = 62) examined the effect of this advertisement, combined with a manipulation designed to increase perceived efficacy, on speed choice. Study 2 (n = 81) investigated whether a state emotion, anger, impacts on the effectiveness of the advertisement in changing four distinct driving behaviours. Both studies examined short-term effects only. Study 1 findings indicated that a high threat message, when combined with high perceived efficacy, can lead to a decrease in speed choice. Study 2 results suggested that increased levels of state anger may counteract the potential value of combining fear-arousing threats and efficacy-building messages. Findings suggest that threat-based road safety communications that target affective (fear) and cognitive (perceived efficacy) mechanisms can positively affect driving behaviours. State emotions, such as anger, may negatively impact on the effectiveness of the message. Taken together, these findings provide additional support for the use of efficacy-building messages in threat-based communications, but highlight the need for further research into the complex array of affective influences on driving.

  17. Threat appeals in health communication: messages that elicit fear and enhance perceived efficacy positively impact on young male drivers

    Directory of Open Access Journals (Sweden)

    Rachel N. Carey

    2016-07-01

    Full Text Available Abstract Background Health communications often present graphic, threat-based representations of the potential consequences of health-risk behaviours. These ‘threat appeals’ feature prominently in public health campaigns, but their use is controversial, with studies investigating their efficacy reporting inconsistent, and often negative, findings. This research examined the impact of a threat-based road safety advertisement on the driving behaviour of young male drivers. Methods To address limitations of previous research, we first identified a road safety advertisement that objectively and subjectively elicited fear using physiological and subjective measures. Study 1 (n = 62 examined the effect of this advertisement, combined with a manipulation designed to increase perceived efficacy, on speed choice. Study 2 (n = 81 investigated whether a state emotion, anger, impacts on the effectiveness of the advertisement in changing four distinct driving behaviours. Both studies examined short-term effects only. Results Study 1 findings indicated that a high threat message, when combined with high perceived efficacy, can lead to a decrease in speed choice. Study 2 results suggested that increased levels of state anger may counteract the potential value of combining fear-arousing threats and efficacy-building messages. Conclusions Findings suggest that threat-based road safety communications that target affective (fear and cognitive (perceived efficacy mechanisms can positively affect driving behaviours. State emotions, such as anger, may negatively impact on the effectiveness of the message. Taken together, these findings provide additional support for the use of efficacy-building messages in threat-based communications, but highlight the need for further research into the complex array of affective influences on driving.

  18. Impact of intermediate mammography assessment on the likelihood of false-positive results in breast cancer screening programmes

    Energy Technology Data Exchange (ETDEWEB)

    Ascunce, Nieves [Public Health Institute, CIBERESP, Navarra Breast Cancer Screening Programme, Pamplona (Spain); Instituto de Salud Publica, Navarra Breast Cancer Screening Programme, Pamplona (Spain); Ederra, Maria; Delfrade, Josu; Erdozain, Nieves [Public Health Institute, CIBERESP, Navarra Breast Cancer Screening Programme, Pamplona (Spain); Baroja, Araceli [Fundacion Rioja Salud, Logrono (Spain); Zubizarreta, Raquel [Public Health and Planning Directorate, Health Office, Galician Breast Cancer Screening Programme, Galicia (Spain); Salas, Dolores [General Directorate Public Health and Centre for Public Health Research (CSISP), Valencia (Spain); Castells, Xavier [Mar Teaching Hospital, CIBERESP, Department of Clinical Epidemiology, Barcelona (Spain)

    2012-02-15

    Breast cancer screening is offered to 100% of the target population in Spain and intermediate mammograms (IMs) are sometimes indicated. This study was aimed at analysing the frequency of IMs, the factors determining their recommendation, and their impact on the risk of false-positive results and the detection rate. Data from 3,471,307 mammograms from Spanish breast cancer screening programmes were included. 3.36% of the mammograms were IMs. The factors associated with the use of IMs were age, initial screening, previous invasive tests, a familial history of breast cancer and use of hormone replacement therapy. In screening episodes with an IM, the probability of a false-positive result was 13.74% (95% CI: 13.43-14.05), almost double that in episodes without IMs (6.02%, 95% CI 5.99-6.05). In young women with previous invasive procedures, a familial history of breast cancer or hormone replacement therapy use who were undergoing their initial screen, this probability was lower when IMs were performed. IMs always increased the detection rate. The factors prompting IMs should be characterised so that radiologists can systematise their recommendations according to the presence of the factors maximising the benefits and minimising the adverse effects of this procedure. (orig.)

  19. Impact of intermediate mammography assessment on the likelihood of false-positive results in breast cancer screening programmes

    International Nuclear Information System (INIS)

    Ascunce, Nieves; Ederra, Maria; Delfrade, Josu; Erdozain, Nieves; Baroja, Araceli; Zubizarreta, Raquel; Salas, Dolores; Castells, Xavier

    2012-01-01

    Breast cancer screening is offered to 100% of the target population in Spain and intermediate mammograms (IMs) are sometimes indicated. This study was aimed at analysing the frequency of IMs, the factors determining their recommendation, and their impact on the risk of false-positive results and the detection rate. Data from 3,471,307 mammograms from Spanish breast cancer screening programmes were included. 3.36% of the mammograms were IMs. The factors associated with the use of IMs were age, initial screening, previous invasive tests, a familial history of breast cancer and use of hormone replacement therapy. In screening episodes with an IM, the probability of a false-positive result was 13.74% (95% CI: 13.43-14.05), almost double that in episodes without IMs (6.02%, 95% CI 5.99-6.05). In young women with previous invasive procedures, a familial history of breast cancer or hormone replacement therapy use who were undergoing their initial screen, this probability was lower when IMs were performed. IMs always increased the detection rate. The factors prompting IMs should be characterised so that radiologists can systematise their recommendations according to the presence of the factors maximising the benefits and minimising the adverse effects of this procedure. (orig.)

  20. Impact on Congestion and Fuel Consumption of a Cooperative Adaptive Cruise Control System with Lane-Level Position Estimation

    Directory of Open Access Journals (Sweden)

    Edgar Talavera

    2018-01-01

    Full Text Available In recent years, vehicular communications systems have evolved and allowed for the improvement of adaptive cruise control (ACC systems to make them cooperative (cooperative adaptive cruise control, CACC. Conventional ACC systems use sensors on the ego-vehicle, such as radar or computer vision, to generate their behavioral decisions. However, by having vehicle-to-X (V2X onboard communications, the need to incorporate perception in the vehicle is drastically reduced. Thus, in this paper a CACC solution is proposed that only uses communications to make its decisions with the help of previous road mapping. At the same time, a method to develop these maps is presented, combining the information of a computer vision system to correct the positions obtained from the navigation system. In addition, the cut-in and cut-out maneuvers for a CACC platoon are taken into account, showing the tests of these situations in real environments with instrumented vehicles. To show the potential of the system in a larger-scale implementation, simulations of the behavior are provided under dense traffic conditions where the positive impact on the reduction of traffic congestion and fuel consumption is appreciated.

  1. NATURE FACILITATES CONNECTION WITH THE PROFOUND SELF: NEEDS, GOALS AND RESOURCE AWARENESS

    Directory of Open Access Journals (Sweden)

    Nicoleta Răban-Motounu

    2014-11-01

    Full Text Available The present study is based on Kaplan and Kaplan’s (1989 theory explaining the restorative effects that nature has on a person’s psychic. According to this theory, nature exerts a “soft fascination” combining the activation of involuntary attention mechanisms with the reflexive awareness, allowing a spontaneous detachment from stress factors and automatic functioning, and also the feeling of compatibility between personal purposes, and the possibilities for action offered by the environment (a sense of meaning. Our objective was to investigate the effects of nature on Self awareness: the immediate, emotional experience; needs awareness and organization; plans for action, and availability of resources, both personal, and external. We conducted an experiment with an experimental group (persons watching a video with life in nature and an active control group (involved in a psychotherapeutic technique focused on confronting and solving personal difficulties by creative means, accompanied by a short psychological analysis. The effects were assessed in terms of “here and now” emotions and available resources according to a self-evaluation scale, and with open-ended questions regarding personal needs and goals. The results showed that, for the experimental group, the relaxation effects and the awareness of long term goals were stronger, while all the other effects were the same as for the control group. The results suggest that indeed, nature helps a person get in contact with her profound Self, allowing the access to both “here and now” basic needs, and also long term goals (inner sources of meaning, the sense of connection between internal tendencies, personal, and external resources, resulting in increased positive emotions, and decreased negative emotions. Nature contemplation may facilitate a meditative state whit all its positive effects.

  2. Dosimetric impact of systematic MLC positional errors on step and shoot IMRT for prostate cancer: a planning study

    International Nuclear Information System (INIS)

    Ung, N.M.; Wee, L.; Harper, C.S.

    2010-01-01

    Full text: The positional accuracy of multi leaf collimators (MLC) is crucial in ensuring precise delivery of intensity-modulated radiotherapy (IMRT). The aim of this planning study was to investigate the dosimetric impact of systematic MLC errors on step and shoot IMRT of prostate cancer. Twelve MLC leaf banks perturbations were introduced to six prostate IMRT treatment plans to simulate MLC systematic errors. Dose volume histograms (OYHs) were generated for the extraction of dose endpoint parameters. Plans were evaluated in terms of changes to the defined endpoint dose parameters, conformity index (CI) and healthy tissue avoidance (HTA) to planning target volume (PTY), rectum and bladder. Negative perturbations of MLC had been found to produce greater changes to endpoint dose parameters than positive perturbations of MLC (p < 0.05). Negative and positive synchronized MLC perturbations of I mm resulted in median changes of -2.32 and 1.78%, respectively to 095% of PTY whereas asynchronized MLC perturbations of the same direction and magnitude resulted in median changes of 1.18 and 0.90%, respectively. Doses to rectum were generally more sensitive to systematic MLC errors compared to bladder. Synchronized MLC perturbations of I mm resulted in median changes of endpoint dose parameters to both rectum and bladder from about I to 3%. Maximum reduction of -4.44 and -7.29% were recorded for CI and HTA, respectively, due to synchronized MLC perturbation of I mm. In summary, MLC errors resulted in measurable amount of dose changes to PTY and surrounding critical structures in prostate LMRT. (author)

  3. Assessment of shoulder position variation and its impact on IMRT and VMAT doses for head and neck cancer

    Directory of Open Access Journals (Sweden)

    Neubauer Emily

    2012-02-01

    Full Text Available Abstract Background For radiotherapy of the head and neck, 5-point mask immobilization is used to stabilize the shoulders. Still, the daily position of the shoulders during treatment may be different from the position in the treatment plan despite correct isocenter setup. The purpose of this study was to determine the interfractional displacement of the shoulders relative to isocenter over the course of treatment and the associated dosimetric effect of this displacement. Methods The extent of shoulder displacements relative to isocenter was assessed for 10 patients in 5-point thermoplastic masks using image registration and daily CT-on-rails scans. Dosimetric effects on IMRT and VMAT plans were evaluated in Pinnacle based on simulation CTs modified to represent shoulder shifts between 3 and 15 mm in the superior-inferior, anterior-posterior, and right-left directions. The impact of clinically observed shoulder shifts on the low-neck dose distributions was examined. Results Shoulder motion was 2-5 mm in each direction on average but reached 20 mm. Superior shifts resulted in coverage loss, whereas inferior shifts increased the dose to the brachial plexus. These findings were generally consistent for both IMRT and VMAT plans. Over a course of observed shifts, the dose to 99% of the CTV decreased by up to 101 cGy, and the brachial plexus dose increased by up to 72 cGy. Conclusions he position of the shoulder affects target coverage and critical structure dose, and may therefore be a concern during the setup of head and neck patients, particularly those with low neck primary disease.

  4. The impact of socioeconomic position on severe maternal morbidity outcomes among women in Australia: a national case-control study.

    Science.gov (United States)

    Lindquist, A; Noor, N; Sullivan, E; Knight, M

    2015-11-01

    Studies in other developed countries have suggested that socioeconomic position may be a risk factor for poorer pregnancy outcomes. This analysis aimed to explore the independent impact of socioeconomic position on selected severe maternal morbidities among women in Australia. A case-control study using data on severe maternal morbidities associated with direct maternal death collected through the Australasian Maternity Outcomes Surveillance System. Australia. 623 cases, 820 controls. Logistic regression analysis to investigate differences in outcomes among different socioeconomic groups, classified by Socio-Economic Indexes for Areas (SEIFA) quintile. Severe maternal morbidity (amniotic fluid embolism, placenta accreta, peripartum hysterectomy, eclampsia or pulmonary embolism). SEIFA quintile was statistically significantly associated with maternal morbidity, with cases being twice as likely as controls to reside in the most disadvantaged areas (adjusted OR 2.00, 95%CI 1.29-3.10). Maternal age [adjusted odds ratio (aOR) 2.20 for women aged 35 or over compared with women aged 25-29, 95%CI 1.64-3.15] and previous pregnancy complications (aOR 1.30, 95%CI 1.21-1.87) were significantly associated with morbidity. A parity of 1 or 2 was protective (aOR 0.58, 95%CI 0.43-0.79), whereas previous caesarean delivery was associated with maternal morbidity (aOR 2.20 for women with one caesarean delivery, 95%CI 1.44-2.85, compared with women with no caesareans). The risk of severe maternal morbidity among women in Australia is significantly increased by social disadvantage. This study suggests that future efforts in improving maternity care provision and maternal outcomes in Australia should include socioeconomic position as an independent risk factor for adverse outcome. © 2014 Royal College of Obstetricians and Gynaecologists.

  5. Impact of ambiguity resolution and application of transformation parameters obtained by regional GNSS network in Precise Point Positioning

    Science.gov (United States)

    Gandolfi, S.; Poluzzi, L.; Tavasci, L.

    2012-12-01

    Precise Point Positioning (PPP) is one of the possible approaches for GNSS data processing. As known this technique is faster and more flexible compared to the others which are based on a differenced approach and constitute a reliable methods for accurate positioning of remote GNSS stations, even in some remote area such as Antarctica. Until few years ago one of the major limits of the method was the impossibility to resolve the ambiguity as integer but nowadays many methods are available to resolve this aspect. The first software package permitting a PPP solution was the GIPSY OASIS realized, developed and maintained by JPL (NASA). JPL produce also orbits and files ready to be used with GIPSY. Recently, using these products came possible to resolve ambiguities improving the stability of solutions. PPP permit to estimate position into the reference frame of the orbits (IGS) and when coordinate in others reference frames, such al ITRF, are needed is necessary to apply a transformation. Within his products JPL offer, for each day, a global 7 parameter transformation that permit to locate the survey into the ITRF RF. In some cases it's also possible to create a costumed process and obtain analogous parameters using local/regional reference network of stations which coordinates are available also in the desired reference frame. In this work some tests on accuracy has been carried out comparing different PPP solutions obtained using the same software packages (GIPSY) but considering the ambiguity resolution, the global and regional transformation parameters. In particular two test area have been considered, first one located in Antarctica and the second one in Italy. Aim of the work is the evaluation of the impact of ambiguity resolution and the use of local/regional transformation parameter in the final solutions. Tests shown how the ambiguity resolution improve the precision, especially in the EAST component with a scattering reduction about 8%. And the use of global

  6. Specific needs of families of young adults with profound intellectual disability during and after transition to adulthood: What are we missing?

    Science.gov (United States)

    Gauthier-Boudreault, Camille; Gallagher, Frances; Couture, Mélanie

    2017-07-01

    At the age of 21, the trajectory of services offered to youth with profound intellectual disability (ID) change significantly since access to specialised services is more limited. Despite the desire of parents to avoid any impact on their child, several factors can influence the course of this transition. However, there is little research on facilitators and obstacles to the transition to adulthood, and impacts on people with a profound ID. It is therefore difficult to provide solutions that meet their specific needs. The study aimed to document the needs of parents and young adults with profound ID during and after the transition to adulthood by exploring their transitioning experience and factors that influenced it. Using a descriptive qualitative design, two individual semi-structured interviews were conducted with fourteen (14) parents of young adults aged between 18 and 26 with a profound ID. At this point, many material, informative, cognitive and emotional needs of young adults and their parents are not met. Obstacles, mainly organisational, persist and result in a particularly difficult transition to adulthood experience. By knowing the specific needs of these families, it is possible to develop and implement solutions tailored to their reality. WHAT THE PAPERS ADDS?: The transition to adulthood is a critical period for families with young adults with an intellectual disability (ID), a reality observed internationally. Current literature on all levels of ID suggests some barriers to transition that lead to negative impacts on both parents and young adults with ID. However, presently, very little research exists on the reality of families of young adults with profound ID and factors influencing transition to adult life. Most of studies target people with mild to moderate ID. Considering the significant disabilities of people with profound ID, it is possible to imagine that their experience of transition will be even more difficult and they will present

  7. Budget impact analysis of antiretroviral less drug regimen simplification in HIV-positive patients on the Italian National Health Service

    Directory of Open Access Journals (Sweden)

    Restelli U

    2014-09-01

    Full Text Available Umberto Restelli,1,2 Massimo Andreoni,3 Andrea Antinori,4 Marzia Bonfanti,2 Giovanni Di Perri,5 Massimo Galli,6 Adriano Lazzarin,7 Giuliano Rizzardini,8,9 Davide Croce1,2 1Department of Community Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; 2Centro di Ricerca in Economia e Management in Sanità e nel Sociale (CREMS, Università Carlo Cattaneo – LIUC, Castellanza (VA, Italy; 3Clinical Infectious Diseases, Tor Vergata University (PTV, Rome, Italy; 4Clinical Department, National Institute for Infectious Diseases "L. Spallanzani," Rome, Italy; 5Department of Medical Sciences, Infectious Diseases, Amedeo di Savoia Hospital, Turin, Italy; 6Third Division of Infectious Diseases, "Luigi Sacco" Hospital, Milan, Italy; 7Department of Infectious Diseases, San Raffaele Scientific Institute, Milan, Italy; 8First and Second Divisions of Infectious Diseases, "Luigi Sacco" Hospital, Milan, Italy; 9School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa Background: Deintensification and less drug regimen (LDR antiretroviral therapy (ART strategies have proved to be effective in terms of maintaining viral suppression in human immunodeficiency virus (HIV-positive patients, increasing tolerability, and reducing toxicity of antiretroviral drugs administered to patients. However, the economic impact of these strategies have not been widely investigated. The aim of the study is to evaluate the economic impact that ART LDR could have on the Italian National Health Service (INHS budget. Methods: A budget impact model was structured to assess the potential savings for the INHS by the use of ART LDR for HIV-positive patients with a 3 year perspective. Data concerning ART cost, patient distribution within different ARTs, and probabilities for patients to change ART on a yearly basis were collected within four Italian infectious diseases departments, providing

  8. Deliberate Rumination and Positive Reappraisal as Serial Mediators Between Life Impact and Posttraumatic Growth in Victims of State Terrorism in Chile (1973-1990).

    Science.gov (United States)

    Cárdenas Castro, Manuel; Arnoso Martínez, Maitane; Faúndez Abarca, Ximena

    2016-04-06

    This study examines the role of coping strategies related to positive reappraisal versus other cognitive strategies (deliberate rumination) as mediators between life impact and posttraumatic growth in survivors of the military dictatorship in Chile between 1973 and 1990 (tortured political prisoners and family members of political prisoners executed and missing). Survey data from 251 political violence survivors were analyzed using the SPSS PROCESS macro for bootstrapping indirect effects (Hayes, 2013). Results indicated that positive reappraisal (or reframing) coping mediated the relationship between life impact and posttraumatic growth. A serial multiple mediation model indicates that in the life impact to growth moderation process, rumination must be followed by positive reappraisal to drive this growth. These findings suggest that positive reappraisal of the traumatic experience is essential to achieve growth reports. Implications of these more complex relations are discussed for both counseling interventions and further research. © The Author(s) 2016.

  9. Prognostic Impact of Adjuvant Radiotherapy in Breast Cancer Patients with One to Three Positive Axillary Lymph Nodes

    Directory of Open Access Journals (Sweden)

    Mansour Ansari

    2018-01-01

    Full Text Available Background: Radiotherapy, as an adjuvant treatment, plays a well-known role in prevention of locoregional recurrence in breast cancer patients. This study aims to investigate the impact of radiotherapy in patients with N1 disease. Methods: In this retrospective study, we reviewed the characteristics and treatment outcomes of 316 patients with a biopsy proven diagnosis of breast carcinoma and 1-3 positive axillary lymph nodes. The patients received treatment between 1995 and 2014. The patients had a median follow-up of 60 (range: 6-182 months. Results: This study was conducted on 316 patients with a median age of 48 (range: 26-86 years. Among patients, 215 underwent modified radical mastectomy and 101 had breast-conserving surgery before adjuvant treatment. Indeed, 259 patients received radiotherapy (radiation group and 57 did not (control group. There was locoregional recurrence in one control group patient and two patients in the radiation group. Multivariate analysis results indicated hormone receptor status as an independent prognostic factor for the 5-year disease-free survival rate. Estrogen and progesterone receptor negativity (HR = 1.80, 95% CI: 1.02-3.19, P=0.043 also had a negative influence on the 5-year disease-free survival rate. However, radiotherapy had no significant effect on disease-free survival (P=0.446 and overall survival (P=0.058 rates. Conclusion: The results showed that adjuvant radiotherapy had no prognostic impacts on locoregional and distant disease control in breast cancer patients with N1 disease.

  10. MDEP Common Position No DICWG08. Common position on the impact of cyber security features on digital I and C safety systems

    International Nuclear Information System (INIS)

    2012-01-01

    Cyber security measures are generally implemented at nuclear facilities to protect against cyber-attacks that may compromise safety. The implementation of such cyber security measures may vary based on site specific requirements and each country's regulatory frameworks. Safety measures and cyber security measures for a nuclear power plant should be designed and implemented so that they do not compromise one another. This common position is intended to only apply to systems classified to the highest level of safety. The Digital Instrumentation and Controls Working Group (DICWG) has agreed that a common position on this topic is warranted given the increase of use of Digital I and C in new reactor designs, its safety implications, and the need to develop a common understanding from the perspectives of regulatory authorities. This action follows the DICWG examination of the regulatory requirements of the participating members and of relevant industry standards and IAEA documents. The DICWG proposes a common position based on its recent experience with the new reactor application reviews and operating plant issues

  11. DMPD: Gram-negative endotoxin: an extraordinary lipid with profound effects oneukaryotic signal transduction. [Dynamic Macrophage Pathway CSML Database

    Lifescience Database Archive (English)

    Full Text Available 1916089 Gram-negative endotoxin: an extraordinary lipid with profound effects oneuk...ep;5(12):2652-60. (.png) (.svg) (.html) (.csml) Show Gram-negative endotoxin: an extraordinary lipid with profound effects...tive endotoxin: an extraordinary lipid with profound effects oneukaryotic signal transduction. Authors Raetz

  12. Positive and negative affect mediate the bidirectional relationship between emotional processing and symptom severity and impact in irritable bowel syndrome.

    Science.gov (United States)

    Sibelli, Alice; Chalder, Trudie; Everitt, Hazel; Chilcot, Joseph; Moss-Morris, Rona

    2018-02-01

    Individuals with IBS report higher levels of psychological distress compared to healthy controls. Distress has been associated with emotional processing difficulties but studies have not explored how the relationship between distress and emotional processing affects IBS. There is little research on the role of positive affect (PA) in IBS. (a) If difficulties in self-reported emotional processing are associated with affect and IBS measures (i.e., symptom severity, interference in life roles) (b1) If affect mediates the relationship between emotional processing and IBS measures (b2) Alternative model: if affect mediates the relationship between IBS and emotional processing (c) If PA moderates the relationship between distress and IBS. Participants with a confirmed diagnosis of IBS (n=558) completed a questionnaire including measures of emotional processing (i.e., unhelpful beliefs about negative emotions, impoverished emotional experience), distress, PA, and IBS symptoms/interference. Mediation and moderation analyses were conducted with Maximum Likelihood Estimation. Distress and PA mediated or partly mediated the relationship between unhelpful beliefs about negative emotions/impoverished emotional experience and both IBS measures. The alternative models were also valid, suggesting a two-way relationship between emotional processing and IBS through affect. PA did not moderate the relationship between distress and IBS. Future interventions in IBS may benefit from not only targeting the management of physical symptoms and their daily impact but also aspects related to the experience of both negative and positive affect, and the acceptance and expression of negative emotions. Longitudinal studies are needed to confirm causal relationships within the explored models. Copyright © 2017 Elsevier Inc. All rights reserved.

  13. Moderating effects of sex on the impact of diagnosis and amyloid positivity on verbal memory and hippocampal volume.

    Science.gov (United States)

    Caldwell, Jessica Z K; Berg, Jody-Lynn; Cummings, Jeffrey L; Banks, Sarah J

    2017-09-12

    Alzheimer's disease (AD) impacts men and women differently, but the effect of sex on predementia stages is unclear. The objective of this study was to examine whether sex moderates the impact of florbetapir positron emission tomography (PET) amyloid positivity (A + ) on verbal learning and memory performance and hippocampal volume (HV) in normal cognition (NC) and early mild cognitive impairment (eMCI). Seven hundred forty-two participants with NC and participants with eMCI from the Alzheimer's Disease Neuroimaging Initiative (second cohort [ADNI2] and Grand Opportunity Cohort [ADNI-GO]) were included. All had baseline florbetapir PET measured, and 526 had screening visit HV measured. Regression moderation models were used to examine whether A + effects on Rey Auditory Verbal Learning Test learning and delayed recall and right and left HV (adjusted for total intracranial volume) were moderated by diagnosis and sex. Age, cognition at screening, education, and apolipoprotein E ε4 carrier status were controlled. Women with A + , but not those with florbetapir PET amyloid negative (A-),eMCI showed poorer learning. For women with NC, there was no relationship of A + with learning. In contrast, A + men trended toward poorer learning regardless of diagnosis. A similar trend was found for verbal delayed recall: Women with A + , but not A-, eMCI trended toward reduced delayed recall; no effects were observed for women with NC or for men. Hippocampal analyses indicated that women with A + , but not those with A - , eMCI, trended toward smaller right HV; no significant A + effects were observed for women with NC. Men showed similar, though nonsignificant, patterns of smaller right HV in A + eMCI, but not in men with A - eMCI or NC. No interactive effects of sex were noted for left HV. Women with NC showed verbal learning and memory scores robust to A + , and women with A + eMCI lost this advantage. In contrast, A + impacted men's scores less significantly or not at all, and

  14. Profound tumor-specific Th2 bias in patients with malignant glioma

    International Nuclear Information System (INIS)

    Shimato, Shinji; Maier, Lisa M; Maier, Richard; Bruce, Jeffrey N; Anderson, Richard CE; Anderson, David E

    2012-01-01

    Vaccination against tumor-associated antigens is one promising approach to immunotherapy against malignant gliomas. While previous vaccine efforts have focused exclusively on HLA class I-restricted peptides, class II-restricted peptides are necessary to induce CD4 + helper T cells and sustain effective anti-tumor immunity. In this report we investigated the ability of five candidate peptide epitopes derived from glioma-associated antigens MAGE and IL-13 receptor α2 to detect and characterize CD4 + helper T cell responses in the peripheral blood of patients with malignant gliomas. Primary T cell responses were determined by stimulating freshly isolated PBMCs from patients with primary glioblastoma (GBM) (n = 8), recurrent GBM (n = 5), meningioma (n = 7), and healthy controls (n = 6) with each candidate peptide, as well as anti-CD3 monoclonal antibody (mAb) and an immunodominant peptide epitope derived from myelin basic protein (MBP) serving as positive and negative controls, respectively. ELISA was used to measure IFN-γ and IL-5 levels, and the ratio of IFN-γ/IL-5 was used to determine whether the response had a predominant Th1 or Th2 bias. We demonstrate that novel HLA Class-II restricted MAGE-A3 and IL-13Rα2 peptides can detect T cell responses in patients with GBMs as well as in healthy subjects. Stimulation with a variety of peptide antigens over-expressed by gliomas is associated with a profound reduction in the IFN-γ/IL-5 ratio in GBM patients relative to healthy subjects. This bias is more pronounced in patients with recurrent GBMs. Therapeutic vaccine strategies to shift tumor antigen-specific T cell response to a more immunostimulatory Th1 bias may be needed for immunotherapeutic trials to be more successful clinically

  15. Recurrent Vestibular Migraine Vertigo Attacks Associated With the Development of Profound Bilateral Vestibulopathy: A Case Series.

    Science.gov (United States)

    Wester, Jacob L; Ishiyama, Akira; Ishiyama, Gail

    2017-09-01

    Bilateral vestibulopathy (BVP) is a debilitating condition characterized by gait ataxia, oscillopsia, and imbalance. Case series of patients with migraine-linked vertigo spells and profound BVP. PATIENT 1:: A 69-year-old man presented with a history of recurrent severe vertigo spells lasting up to 3 days in duration associated with prostrating migraine headaches starting at age 60. His symptoms were misdiagnosed as an anxiety syndrome. At age 68, electronystagmography (ENG) revealed bilaterally absent caloric responses and complete BVP. His hearing was normal. PATIENT 2:: A 51-year-old man presented with a history of "earthquake-like" vertigo, sharp head pain, and phonophobia. These episodes occurred a handful of times over a 7-year period. Previous ENG testing at age 43 was normal. However, his ENG at age 48 revealed complete BVP. He was started on acetazolamide and noted improved balance, although subsequent ENG was unchanged. PATIENT 3:: A 49-year-old woman presented with a history of recurrent migraines with visual aura associated with vertigo lasting 1 hour. ENG at age 50 revealed complete BVP. Subjectively, she noted improved balance with acetazolamide and subsequent ENG demonstrated mild improvement. PATIENT 4:: A 43-year-old man presented with a 5-year history of optical migraines and recurrent vertigo spells, lasting 30 seconds, which was misdiagnosed as positional vertigo. He additionally had a 10-year history of oscillopsia. ENG at age 61 revealed complete BVP. In these cases, vestibular migraine was linked to recurrent vertigo spells that eventually led to complete bilateral vestibulopathy.

  16. RhoE deficiency produces postnatal lethality, profound motor deficits and neurodevelopmental delay in mice.

    Directory of Open Access Journals (Sweden)

    Enric Mocholí

    Full Text Available Rnd proteins are a subfamily of Rho GTPases involved in the control of actin cytoskeleton dynamics and other cell functions such as motility, proliferation and survival. Unlike other members of the Rho family, Rnd proteins lack GTPase activity and therefore remain constitutively active. We have recently described that RhoE/Rnd3 is expressed in the Central Nervous System and that it has a role in promoting neurite formation. Despite their possible relevance during development, the role of Rnd proteins in vivo is not known. To get insight into the in vivo function of RhoE we have generated mice lacking RhoE expression by an exon trapping cassette. RhoE null mice (RhoE gt/gt are smaller at birth, display growth retardation and early postnatal death since only half of RhoE gt/gt mice survive beyond postnatal day (PD 15 and 100% are dead by PD 29. RhoE gt/gt mice show an abnormal body position with profound motor impairment and impaired performance in most neurobehavioral tests. Null mutant mice are hypoactive, show an immature locomotor pattern and display a significant delay in the appearance of the hindlimb mature responses. Moreover, they perform worse than the control littermates in the wire suspension, vertical climbing and clinging, righting reflex and negative geotaxis tests. Also, RhoE ablation results in a delay of neuromuscular maturation and in a reduction in the number of spinal motor neurons. Finally, RhoE gt/gt mice lack the common peroneal nerve and, consequently, show a complete atrophy of the target muscles. This is the first model to study the in vivo functions of a member of the Rnd subfamily of proteins, revealing the important role of Rnd3/RhoE in the normal development and suggesting the possible involvement of this protein in neurological disorders.

  17. From position-specific isotope labeling towards soil fluxomics: a novel toolbox to assess the microbial impact on biogeochemical cycles

    Science.gov (United States)

    Apostel, C.; Dippold, M. A.; Kuzyakov, Y.

    2015-12-01

    Understanding the microbial impact on C and nutrient cycles is one of the most important challenges in terrestrial biogeochemistry. Transformation of low molecular weight organic substances (LMWOS) is a key step in all biogeochemical cycles because 1) all high molecular substances pass the LMWOS pool during their degradation and 2) only LMWOS can be taken up by microorganisms intact. Thus, the transformations of LMWOS are dominated by biochemical pathways of the soil microorganisms. Thus, understanding fluxes and transformations in soils requires a detailed knowledge on the microbial metabolic network and its control mechanism. Tracing C fate in soil by isotopes became on of the most applied and promising biogeochemistry tools but studies were nearly exclusively based on uniformly labeled substances. However, such tracers do not allow the differentiation of the intact use of the initial substances from its transformation to metabolites. The novel tool of position-specific labeling enables to trace molecule atoms separately and thus to determine the cleavage of molecules - a prerequisite for metabolic tracing. Position-specific labeling of basic metabolites and quantification of isotope incorporation in CO2 and bulk soil enabled following the basic metabolic pathways of microorganisms. However, the combination of position-specific 13C labeling with compound-specific isotope analysis of microbial biomarkers and metabolites like phospholipid fatty acids (PLFA) or amino sugars revealed new insights into the soil fluxome: First, it enables tracing specific anabolic pathways in diverse microbial communities in soils e.g. carbon starvation pathways versus pathways reflecting microbial growth. Second, it allows identification of specific pathways of individual functional microbial groups in soils in situ. Tracing metabolic pathways and understanding their regulating factors are crucial for soil C fluxomics i.e. the unravaling of the complex network of C transformations

  18. Impact of organic Rankine cycle system installation on light duty vehicle considering both positive and negative aspects

    International Nuclear Information System (INIS)

    Usman, Muhammad; Imran, Muhammad; Yang, Youngmin; Park, Byung-Sik

    2016-01-01

    Highlights: • Positive and negative effects of waste heat recovery unit on vehicle were studied. • Organic Rankine cycle based power system for waste heat recovery. • Relationship of ORC unit weight and power was developed. • Impact of added weight, Part load operation and back pressure are presented. • Power enhancement of 5.82% of engine when positive & negative effects considered. - Abstract: This paper presents the analysis of organic Rankine cycle (ORC) based waste heat recovery system. Both the positive and negative effects of ORC system installation on a light duty vehicle were evaluated. Engine exhaust data for a light duty vehicle was used to design an ORC based system. Optimum cycle design suggests that ORC system installation is feasible. Results presented that for the vehicle operation at 100 km/h, engine power can be enhanced by 10.88% which is 5.92 kW of additional power and at the lower speed of 23.5 km/h, the engine power enhancement was 2.34%. ORC component weight data from manufacturers were used to estimate the weight of the designed system. The performance decline due to added weight is calculated. Effects of added back pressure and performance decline due to the part-load operation of ORC unit were also calculated and an overall effect of waste heat recovery system was evaluated. The results then suggested that maximum power enhancement is 5.82% at the vehicle speed of 100 km/h instead of previously mentioned 10.88% can be achieved if negative effects are also considered. Furthermore, it was concluded that at speeds lower than 48 km/h the waste heat recovery system was not beneficial at all and low-speed operation was in fact not preferable as it results in additional power demand from the engine by 6.39% at 23.5 km/h. The vehicles for city driving cycles are not recommended for ORC installation. Another finding revealed that if exhaust heat recovery heat exchanger is designed for maximum heat recovery, at part load operation, the

  19. ProFound: Source Extraction and Application to Modern Survey Data

    Science.gov (United States)

    Robotham, A. S. G.; Davies, L. J. M.; Driver, S. P.; Koushan, S.; Taranu, D. S.; Casura, S.; Liske, J.

    2018-05-01

    We introduce PROFOUND, a source finding and image analysis package. PROFOUND provides methods to detect sources in noisy images, generate segmentation maps identifying the pixels belonging to each source, and measure statistics like flux, size, and ellipticity. These inputs are key requirements of PROFIT, our recently released galaxy profiling package, where the design aim is that these two software packages will be used in unison to semi-automatically profile large samples of galaxies. The key novel feature introduced in PROFOUND is that all photometry is executed on dilated segmentation maps that fully contain the identifiable flux, rather than using more traditional circular or ellipse-based photometry. Also, to be less sensitive to pathological segmentation issues, the de-blending is made across saddle points in flux. We apply PROFOUND in a number of simulated and real-world cases, and demonstrate that it behaves reasonably given its stated design goals. In particular, it offers good initial parameter estimation for PROFIT, and also segmentation maps that follow the sometimes complex geometry of resolved sources, whilst capturing nearly all of the flux. A number of bulge-disc decomposition projects are already making use of the PROFOUND and PROFIT pipeline, and adoption is being encouraged by publicly releasing the software for the open source R data analysis platform under an LGPL-3 license on GitHub (github.com/asgr/ProFound).

  20. A Prognostic Model for Development of Profound Shock among Children Presenting with Dengue Shock Syndrome.

    Directory of Open Access Journals (Sweden)

    Phung Khanh Lam

    Full Text Available To identify risk factors and develop a prediction model for the development of profound and recurrent shock amongst children presenting with dengue shock syndrome (DSS.We analyzed data from a prospective cohort of children with DSS recruited at the Paediatric Intensive Care Unit of the Hospital for Tropical Disease in Ho Chi Minh City, Vietnam. The primary endpoint was "profound DSS", defined as ≥2 recurrent shock episodes (for subjects presenting in compensated shock, or ≥1 recurrent shock episodes (for subjects presenting initially with decompensated/hypotensive shock, and/or requirement for inotropic support. Recurrent shock was evaluated as a secondary endpoint. Risk factors were pre-defined clinical and laboratory variables collected at the time of presentation with shock. Prognostic model development was based on logistic regression and compared to several alternative approaches.The analysis population included 1207 children of whom 222 (18% progressed to "profound DSS" and 433 (36% had recurrent shock. Independent risk factors for both endpoints included younger age, earlier presentation, higher pulse rate, higher temperature, higher haematocrit and, for females, worse hemodynamic status at presentation. The final prognostic model for "profound DSS" showed acceptable discrimination (AUC=0.69 for internal validation and calibration and is presented as a simple score-chart.Several risk factors for development of profound or recurrent shock among children presenting with DSS were identified. The score-chart derived from the prognostic models should improve triage and management of children presenting with DSS in dengue-endemic areas.

  1. Relationship between Joint Position Sense, Force Sense, and Muscle Strength and the Impact of Gymnastic Training on Proprioception

    Directory of Open Access Journals (Sweden)

    Bartłomiej Niespodziński

    2018-01-01

    Full Text Available The aims of this study were (1 to assess the relationship between joint position (JPS and force sense (FS and muscle strength (MS and (2 to evaluate the impact of long-term gymnastic training on particular proprioception aspects and their correlations. 17 elite adult gymnasts and 24 untrained, matched controls performed an active reproduction (AR and passive reproduction (PR task and a force reproduction (FR task at the elbow joint. Intergroup differences and the relationship between JPS, FS, and MS were evaluated. While there was no difference in AR or PR between groups, absolute error in the control group was higher during the PR task (7.15 ± 2.72° than during the AR task (3.1 ± 1.93°. Mean relative error in the control group was 61% higher in the elbow extensors than in the elbow flexors during 50% FR, while the gymnast group had similar results in both reciprocal muscles. There was no linear correlation between JPS and FS in either group; however, FR was negatively correlated with antagonist MS. In conclusion, this study found no evidence for a relationship between the accuracy of FS and JPS at the elbow joint. Long-term gymnastic training improves the JPS and FS of the elbow extensors.

  2. Positive and Negative Impacts of Oil Palm Expansion in Indonesia and the Prospect to Achieve Sustainable Palm Oil

    Science.gov (United States)

    Shahputra, M. A.; Zen, Z.

    2018-02-01

    The aim of the study is to deepen understanding the role of palm oil on Indonesian economy, poverty elevation and to investigate the positive and negative impacts of oil palm expansion, due to the burden of GHG emissions; and prospect to be more sustainable palm oil industry. The statistics show that average rural poverty tends to be lower and Gross Regional Product tends to be higher in provinces which have greater levels of oil palm cultivation. Indonesian oil palm will grow from 10.6 in 2013 to 13.7 million ha by 2020. This will release 135.59 million tons of CO2 if nothing is done to mitigate BAU emissions. Unless there are sustained efforts to redirect development and expansion of oil palm, plantation growth will continue to encroach on intact forest and peat land.. In fact Indonesia has large areas of degraded land, an estimated total 19,144,000 ha is available for planting oil palm and other crops. A large-scale expansion program driven by estate companies needs to be accompanied by effective smallholder development program in order to achieve the best outcome for local farmers and avoid the conflicts.

  3. Women's participation in rural credit programmes in Bangladesh and their demand for formal health care: is there a positive impact?

    Science.gov (United States)

    Nanda, P

    1999-08-01

    Within the overall aim of poverty alleviation, development efforts have included credit and self-employment programmes. In Bangladesh, the major beneficiaries of such group-based credit programmes are rural women who use the loans to initiate small informal income-generating activities. This paper explores the benefits of women's participation in credit programmes on their own health seeking. Using data from a sample of 1798 households from rural Bangladesh, conducted in 1991-1992 through repeated random sampling of 87 districts covered by Grameen Bank, Bangladesh Rural Advancement Committee (BRAC) and Bangladesh Rural Development Board (BRDB), this paper addresses the question: does women's participation in credit programmes significantly affect their use of formal health care? A non-unitary household preference model is suggested to test the hypothesis that women's empowerment through participation in these programmes results in greater control of resources for their own demand for formal health care. The analysis controls for endogeneity due to self-selection and other unobserved village level factors through the use of a weighted two stage instrumental variable approach with village level fixed effects. The findings indicate a positive impact of women's participation in credit programmes on their demand for formal health care. The policy simulations on the results of this study highlight the importance of credit programmes as a health intervention in addition to being a mechanism for women's economic empowerment.

  4. The impact of tamoxifen on breast recurrence, cosmesis, complications, and survival in estrogen receptor positive early stage breast cancer

    Energy Technology Data Exchange (ETDEWEB)

    Fowble, B; Fein, D A; Hanlon, A L; Eisenberg, B L; Hoffman, J P; Sigurdson, E R; Daly, M B; Goldstein, L J

    1995-07-01

    Purpose: In the NSABP B14 trial evaluating tamoxifen (tam) in axillary node negative, estrogen receptor positive tumors fewer breast recurrences were observed in patients treated with conservative surgery and radiation who received tam compared to the observation arm. An additional series, however, has suggested that tam adversely impacts on the cosmetic result. To further address these issues we compared the outcome of estrogen receptor positive tumors treated with conservative surgery and radiation with or without tam. Materials and Methods: From 1982 to 1991, 491 women with estrogen receptor positive stage I-II breast cancer underwent excisional biopsy, axillary dissection and radiation. The median age of the patient population was 60 years (range 39-85). The median followup was 5.3 years (range .1-12.8). 69% had T1 tumors and 83% had histologically negative axillary nodes. Reexcision was performed in 49%. The final margin of resection was negative in 64%, unknown in 18%, and close or positive in 19%. None of the patients received adjuvant chemotherapy. 154 patients received tam and 337 received no adjuvant therapy. Patients who received tam were more often axillary node positive (44% tam vs 5% no tam) and less often had unknown margins (9% tam vs 22% no tam). There were no significant differences for the 2 groups for median age, primary tumor size, histology, race, or use of reexcision. Results: The 5 yr act rate of breast recurrence was 4% for the tam patients compared to 7% for patients not receiving tam (p=.21). At 8 yrs, the breast recurrence rates were 4% for the tam patients compared to 11% for the no tam patients (p=.05). However, at 9 years the rates were 17% tam vs 14% no tam (p=.21). The benefit from tam in terms of a decreased 5 year actuarial breast recurrence rate was most evident for patients who did not have a reexcision (3% tam vs 10% no tam, p=.15), had unknown margins (7% tam vs 13% no tam, p=.37) or close margins (0% tam vs 11% no tam, p=.34

  5. The impact of tamoxifen on breast recurrence, cosmesis, complications, and survival in estrogen receptor positive early stage breast cancer

    International Nuclear Information System (INIS)

    Fowble, B.; Fein, D.A.; Hanlon, A.L.; Eisenberg, B.L.; Hoffman, J.P.; Sigurdson, E.R.; Daly, M.B.; Goldstein, L.J.

    1995-01-01

    Purpose: In the NSABP B14 trial evaluating tamoxifen (tam) in axillary node negative, estrogen receptor positive tumors fewer breast recurrences were observed in patients treated with conservative surgery and radiation who received tam compared to the observation arm. An additional series, however, has suggested that tam adversely impacts on the cosmetic result. To further address these issues we compared the outcome of estrogen receptor positive tumors treated with conservative surgery and radiation with or without tam. Materials and Methods: From 1982 to 1991, 491 women with estrogen receptor positive stage I-II breast cancer underwent excisional biopsy, axillary dissection and radiation. The median age of the patient population was 60 years (range 39-85). The median followup was 5.3 years (range .1-12.8). 69% had T1 tumors and 83% had histologically negative axillary nodes. Reexcision was performed in 49%. The final margin of resection was negative in 64%, unknown in 18%, and close or positive in 19%. None of the patients received adjuvant chemotherapy. 154 patients received tam and 337 received no adjuvant therapy. Patients who received tam were more often axillary node positive (44% tam vs 5% no tam) and less often had unknown margins (9% tam vs 22% no tam). There were no significant differences for the 2 groups for median age, primary tumor size, histology, race, or use of reexcision. Results: The 5 yr act rate of breast recurrence was 4% for the tam patients compared to 7% for patients not receiving tam (p=.21). At 8 yrs, the breast recurrence rates were 4% for the tam patients compared to 11% for the no tam patients (p=.05). However, at 9 years the rates were 17% tam vs 14% no tam (p=.21). The benefit from tam in terms of a decreased 5 year actuarial breast recurrence rate was most evident for patients who did not have a reexcision (3% tam vs 10% no tam, p=.15), had unknown margins (7% tam vs 13% no tam, p=.37) or close margins (0% tam vs 11% no tam, p=.34

  6. Attuning: A Communication Process between People with Severe and Profound Intellectual Disability and Their Interaction Partners.

    Science.gov (United States)

    Griffiths, Colin; Smith, Martine

    2016-03-01

    People with severe and profound intellectual disability typically demonstrate a limited ability to communicate effectively. Most of their communications are non-verbal, often idiosyncratic and ambiguous. This article aims to identify the process that regulates communications of this group of people with others and to describe the methodological approach that was used to achieve this. In this qualitative study, two dyads consisting of a person with severe or profound intellectual and multiple disability and a teacher or carer were filmed as they engaged in school-based activities. Two 1-hour videotapes were transcribed and analysed using grounded theory. Attuning was identified within the theory proposed here as a central process that calibrates and regulates communication. Attuning is conceptualized as a bidirectional, dyadic communication process. Understanding this process may support more effective communication between people with severe or profound intellectual and multiple disability and their interaction partners. © 2015 John Wiley & Sons Ltd.

  7. Prevalence of Auditory Neuropathy in a Population of Children with Severe to Profound Hearing Loss

    Directory of Open Access Journals (Sweden)

    Nader Saki

    2013-04-01

    Full Text Available Background: The purpose of this investigation is to determine auditory neuropathy in the students with severe to profound hearing losses in Ahwaz.Materials and Methods: In this cross-sectional study, 212 children of 7-11 year old with severe to profound hearing loss performed ordinary audiometric evaluations as well as ABR and OAE. The patients with normal DPOAE who had no record of acoustic reflex having normal ABR, were considered as the patients with auditory neuropathy. Results: The neuropathic complication found in 14 children was appeared in 8 ones as one-sided (57.14% and in 6 ones (42.86% as two-sided. 68% of the patients as diagnosed had a very low Speech Discrimination Score (SDS.Conclusion: we must be very vigilant in auditory neuropathy diagnosis for the purpose to be successful in appropriate treatment of severe to profound hearing losses.

  8. Positive impact of child feeding training program for primary care health professionals: a cluster randomized field trial.

    Science.gov (United States)

    Vitolo, Márcia Regina; Louzada, Maria Laura da Costa; Rauber, Fernanda

    2014-12-01

    To assess the impact of a child feeding training program for primary care health professionals about breastfeeding and complementary feeding practices. Cluster-randomized field trial conducted in the city of Porto Alegre, (RS), Brazil. Twenty primary health care centers (HCC) were randomized into intervention (n = 9) and control (n = 11) groups. The health professionals (n = 200) at the intervention group centers received training about healthy feeding practices. Pregnant women were enrolled at the study. Up to six months of child's age, home visits were made to obtain variables related to breastfeeding and introduction of foods. 619 children were evaluated: 318 from the intervention group and 301 from the control group. Exclusive breastfeeding prevalence in the first (72.3 versus 59.4%; RR = 1.21; 95%CI 1.08 - 1.38), second (62.6 versus 48.2%; RR = 1.29; 95%CI 1.10 - 1.53), and third months of life (44.0% versus 34.6%; RR = 1.27; 95%CI 1.04 - 1.56) was higher in the intervention group compared to the control group. The prevalence of children who consumed meat four or five times per week was higher in the intervention group than in the control group (36.8 versus 22.6%; RR = 1.62; 95%CI 1.32 - 2.03). The prevalence of children who had consumed soft drinks (34.9 versus 52.5%; RR = 0.66; 95%CI 0.54 - 0.80), chocolate (24.5 versus 36.7% RR = 0.66 95%CI 0.53 - 0.83), petit suisse (68.9 versus 79.7; 95%CI 0.75 - 0.98) and coffee (10.4 versus 20.1%; RR = 0.51; 95%CI 0.31 - 0.85) in their six first months of life was lower in the intervention group. The training of health professionals had a positive impact on infant feeding practices, contributing to the promotion of child health.

  9. Positive impact of child feeding training program for primary care health professionals: a cluster randomized field trial

    Directory of Open Access Journals (Sweden)

    Márcia Regina Vitolo

    2014-12-01

    Full Text Available OBJECTIVE: To assess the impact of a child feeding training program for primary care health professionals about breastfeeding and complementary feeding practices. METHODS: Cluster-randomized field trial conducted in the city of Porto Alegre, (RS, Brazil. Twenty primary health care centers (HCC were randomized into intervention (n = 9 and control (n = 11 groups. The health professionals (n = 200 at the intervention group centers received training about healthy feeding practices. Pregnant women were enrolled at the study. Up to six months of child's age, home visits were made to obtain variables related to breastfeeding and introduction of foods. RESULTS: 619 children were evaluated: 318 from the intervention group and 301 from the control group. Exclusive breastfeeding prevalence in the first (72.3 versus 59.4%; RR = 1.21; 95%CI 1.08 - 1.38, second (62.6 versus 48.2%; RR = 1.29; 95%CI 1.10 - 1.53, and third months of life (44.0% versus 34.6%; RR = 1.27; 95%CI 1.04 - 1.56 was higher in the intervention group compared to the control group. The prevalence of children who consumed meat four or five times per week was higher in the intervention group than in the control group (36.8 versus 22.6%; RR = 1.62; 95%CI 1.32 - 2.03. The prevalence of children who had consumed soft drinks (34.9 versus 52.5%; RR = 0.66; 95%CI 0.54 - 0.80, chocolate (24.5 versus 36.7% RR = 0.66 95%CI 0.53 - 0.83, petit suisse (68.9 versus 79.7; 95%CI 0.75 - 0.98 and coffee (10.4 versus 20.1%; RR = 0.51; 95%CI 0.31 - 0.85 in their six first months of life was lower in the intervention group. CONCLUSION: The training of health professionals had a positive impact on infant feeding practices, contributing to the promotion of child health.

  10. Position encoder

    International Nuclear Information System (INIS)

    Goursky, Vsevolod

    1975-01-01

    A circuitry for deriving the quotient of signal delivered by position-sensitive detectors is described. Digital output is obtained in the form of 10- to 12-bit words. Impact position may be determined with 0.25% accuracy when the dynamic range of the energy signal is less 1:10, and 0.5% accuracy when the dynamic range is 1:20. The division requires an average time of 5μs for 10-bit words

  11. Position encoder

    International Nuclear Information System (INIS)

    Goursky, V.

    1975-05-01

    This paper describes circuitry for deriving the quotient of signals delivered by position-sensitive detectors. Digital output is obtained in the form of 10 to 12 bit words. Impact position may be determined with 0.25% accuracy when the dynamic range of the energy signal is less than 1:10, and 0.5% accuracy when the dynamic range is 1:20. The division requires an average time of 5μs for 10-bit words [fr

  12. How musical engagement promotes well-being in education contexts: The case of a young man with profound and multiple disabilities

    Science.gov (United States)

    McFerran, Katrina S.; Shoemark, Helen

    2013-01-01

    Students with profound intellectual disabilities disorders (IDDs) have the right to participate in educational opportunities that recognize their unique resources and needs, as do all children. Because of their specific communication challenges, positive relationships with attentive communication partners are critical for success. In fact, the power of positive relationships in schools is recognized to be connected to student well-being more broadly. This article examines the case of one young man with profound IDD and his relationship with his music therapist using a duo-ethnographic informed paradigmatic case study. Video analysis based on multi-voice perspectives is used to generate hermeneutic phenomenological findings to closely examine the relationship between a young man with profound IDD and a music therapist. The voices of four allied health researchers were also gathered to inform the authors’ construction of an informed commentary on the phenomenon. The results suggest that the essence lay in a combination of attentive, responsive and creative being with the other person over time. Four principles of musical engagement were identified in the video footage as critical to the meaningful relationships through music: the music therapist listens; the music therapist takes responsibility for structure; spontaneous initiation is sought from the young person; and the relationship is built over time. These concepts are contextualized within a discussion of student well-being that is underpinned by positive relationships and leads to students achieving their full potential within diverse school contexts. PMID:23930986

  13. How musical engagement promotes well-being in education contexts: the case of a young man with profound and multiple disabilities.

    Science.gov (United States)

    McFerran, Katrina S; Shoemark, Helen

    2013-08-07

    Students with profound intellectual disabilities disorders (IDDs) have the right to participate in educational opportunities that recognize their unique resources and needs, as do all children. Because of their specific communication challenges, positive relationships with attentive communication partners are critical for success. In fact, the power of positive relationships in schools is recognized to be connected to student well-being more broadly. This article examines the case of one young man with profound IDD and his relationship with his music therapist using a duo-ethnographic informed paradigmatic case study. Video analysis based on multi-voice perspectives is used to generate hermeneutic phenomenological findings to closely examine the relationship between a young man with profound IDD and a music therapist. The voices of four allied health researchers were also gathered to inform the authors' construction of an informed commentary on the phenomenon. The results suggest that the essence lay in a combination of attentive, responsive and creative being with the other person over time. Four principles of musical engagement were identified in the video footage as critical to the meaningful relationships through music: the music therapist listens; the music therapist takes responsibility for structure; spontaneous initiation is sought from the young person; and the relationship is built over time. These concepts are contextualized within a discussion of student well-being that is underpinned by positive relationships and leads to students achieving their full potential within diverse school contexts.

  14. The impact of mindfulness-based interventions on symptom burden, positive psychological outcomes, and biomarkers in cancer patients

    Directory of Open Access Journals (Sweden)

    Rouleau CR

    2015-06-01

    Full Text Available Codie R Rouleau,1 Sheila N Garland,2 Linda E Carlson3 1Department of Psychology, Faculty of Arts, University of Calgary, Calgary, AB, Canada; 2Department of Family Medicine and Community Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA; 3Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada Abstract: Research on the use of mindfulness-based stress reduction and related mindfulness-based interventions (MBIs in cancer care has proliferated over the past decade. MBIs have aimed to facilitate physical and emotional adjustment to life with cancer through the cultivation and practice of mindfulness (ie, purposeful, nonjudgmental, moment-to-moment awareness. This descriptive review highlights three categories of outcomes that have been evaluated in MBI research with cancer patients – namely, symptom reduction, positive psychological growth, and biological outcomes. We also examine the clinical relevance of each targeted outcome, while describing recently published original studies to highlight novel applications of MBIs tailored to individuals with cancer. Accumulating evidence suggests that participation in a MBI contributes to reductions in psychological distress, sleep disturbance, and fatigue, and promotes personal growth in areas such as quality of life and spirituality. MBIs may also influence markers of immune function, hypothalamic–pituitary–adrenal axis regulation, and autonomic nervous system activity, though it remains unclear whether these biological changes translate to clinically important health benefits. We conclude by discussing methodological limitations of the extant literature, and implications of matching MBIs to the needs and preferences of cancer patients. Overall, the growing popularity of MBIs in cancer care must be balanced against scientific evidence for their impact on specific clinical outcomes. Keywords: mindfulness-based intervention

  15. The positive impact of red palm oil in school meals on vitamin A status: study in Burkina Faso

    Directory of Open Access Journals (Sweden)

    Somé Issa T

    2006-07-01

    Full Text Available Abstract Background Vitamin A (VA deficiency is widespread in sub-Saharan Africa and school-age children are a vulnerable group. In Burkina Faso, the production and consumption of red palm oil (RPO is being promoted as a food supplement for VA. The objective of the study was to assess the impact on serum retinol of adding RPO to school lunch in two test zones of Burkina Faso. Methods Over one school year, 15 ml RPO was added to individual meals 3 times a week in selected primary schools in two sites. Serum retinol was measured with HPLC at baseline and exactly 12 months later to take account of seasonality. A simple pre-post test design was used in the Kaya area (north-central Burkina, where 239 pupils from 15 intervention schools were randomly selected for the evaluation. In Bogandé (eastern Burkina, 24 schools were randomised for the controlled intervention trial: 8 negative controls (G1 with only the regular school lunch; 8 positive controls (G2 where the pupils received a single VA capsule (60 mg at the end of the school year; and 8 schools with RPO through the school year (G3. A random sample of 128 pupils in each school group took part in the evaluation. Results In Kaya, serum retinol went from 0.77 ± 0.37 μmol/L at baseline to 1.07 ± 0.40 μmol/L one year later (p Conclusion RPO given regularly in small amounts appears highly effective in the reduction of VA deficiency. RPO deserves more attention as a food supplement for VA and as a potential source of rural income in Sahelian countries.

  16. Impact of socioeconomic position and distance on mental health care utilization: a nationwide Danish follow-up study.

    Science.gov (United States)

    Packness, Aake; Waldorff, Frans Boch; Christensen, René dePont; Hastrup, Lene Halling; Simonsen, Erik; Vestergaard, Mogens; Halling, Anders

    2017-11-01

    To determine the impact of socioeconomic position (SEP) and distance to provider on outpatient mental health care utilization among incident users of antidepressants. A nationwide register-based cohort study of 50,374 person-years. Persons in low SEP were more likely to have outpatient psychiatrist contacts [odds ratio (OR) 1.25; confidence interval (CI) 1.17-1.34], but less likely to consult a co-payed psychologist (OR 0.49; CI 0.46-0.53) and to get mental health service from a GP (MHS-GP) (OR 0.81; CI 0.77-0.86) compared to persons in high SEP after adjusting for socio-demographics, comorbidity and car ownership. Furthermore, persons in low SEP who had contact to any of these therapists tended to have lower rates of visits compared to those in high SEP. When distance to services increased by 5 km, the rate of visits to outpatient psychiatrist tended to decrease by 5% in the lowest income group (IRR 0.95; CI 0.94-0.95) and 1% in the highest (IRR 0.99; CI 0.99-1.00). Likewise, contact to psychologists decreased by 11% in the lowest income group (IRR 0.89; CI 0.85-0.94), whereas rate of visits did not interact. Patients in low SEP have relatively lower utilization of mental health services even when services are free at delivery; co-payment and distance to provider aggravate the disparities in utilization between patients in high SEP and patients in low SEP.

  17. Researcher positioning

    DEFF Research Database (Denmark)

    Mørck, Line Lerche; Khawaja, Iram

    2009-01-01

    abstract  This article focuses on the complex and multi-layered process of researcher positioning, specifically in relation to the politically sensitive study of marginalised and ‘othered' groups such as Muslims living in Denmark. We discuss the impact of different ethnic, religious and racial...... political and personal involvement by the researcher, which challenges traditional perspectives on research and researcher positioning. A key point in this regard is the importance of constant awareness of and reflection on the multiple ways in which one's positioning as a researcher influences the research...

  18. The tell-tale: what do heart rate; skin temperature and skin conductance reveal about emotions of people with severe and profound intellectual disabilities?

    Science.gov (United States)

    Vos, Pieter; De Cock, Paul; Munde, Vera; Petry, Katja; Van Den Noortgate, Wim; Maes, Bea

    2012-01-01

    Identifying emotions in people with severe and profound intellectual disabilities is a difficult challenge. Since self-reports are not available, behaviour is the most used source of information. Given the limitations and caveats associated with using behaviour as the sole source of information about their emotions, it is important to supplement behavioural information with information from another source. As it is accepted that emotions consist of language, behaviour and physiology, in this article we investigated if physiology could give information about the emotions of people with severe and profound intellectual disabilities. To this aim we tested hypotheses derived from the motivational model of Bradley, Codispoti, Cuthbert, and Lang (2001) about the relation between heart rate and the valence of emotions and between heart rate, skin conductance and skin temperature and behavioural expressions of emotions of people with severe and profound intellectual disability. We presented 27 participants with 4 staff-selected negative and 4 staff-selected positive stimuli. The situations were videotaped and their heart rate, skin conductance and skin temperature was measured. Each behaviour of the participant was coded using the observational method developed by Petry and Maes (2006). As hypothesized, we found a lower heart rate when participants were presented with negative stimuli than when they were presented with positive stimuli in the first 6s of stimuli presentation. Their skin temperature was higher for the expression of low intensity negative emotions compared to the expression of low intensity positive emotions. The results suggest that, as with people without disability, heart rate and skin temperature can give information about the emotions of persons with severe and profound ID. Copyright © 2012 Elsevier Ltd. All rights reserved.

  19. Classroom Procedures for the Measurement of Behavior State among Students with Profound Disabilities.

    Science.gov (United States)

    Guy, Barbara; And Others

    1993-01-01

    This study examined whether teacher-implemented classroom measurement procedures of short duration are as reliable as methods used in research studies to determine behavior state (e.g., awake active, awake inactive, asleep, drowsed) of six students with profound mental disabilities. Results indicated that more frequent but briefer measurements…

  20. The Role of Sound in Residential Facilities for People With Profound Intellectual and Multiple Disabilities

    NARCIS (Netherlands)

    van den Bosch, Kirsten A.; Andringa, Tjeerd C.; Baskent, Deniz; Vlaskamp, Carla

    2016-01-01

    Attention to the auditory environment of people with profound intellectual and multiple disabilities (PIMD) is limited, both in research and practice. As there is a dynamic interplay between the quality of the auditory environment and well-being, a study was undertaken to test the validity of the

  1. The Influence of Phonological Mechanisms in Written Spelling of Profoundly Deaf Children

    Science.gov (United States)

    Colombo, Lucia; Arfe, Barbara; Bronte, Tiziana

    2012-01-01

    In the present study, the effect of phonological and working memory mechanisms involved in spelling Italian single words was explored in two groups of children matched for grade level: a group of normally hearing children and a group of pre-verbally deaf children, with severe-to-profound hearing loss. Three-syllable and four-syllable familiar…

  2. Self-Concept of Severely to Profoundly Hearing-Impaired Children.

    Science.gov (United States)

    Warren, Charlotte; Hasenstab, Suzanne

    1986-01-01

    A study examined demographic, impairment-related, and parental variables that best predicted self-concept among 49 severely to profoundly hearing-impaired 5- to 11-year-olds. A strong relationship was observed between self-concept and parental indulgence, parental rejection, parental protection, parental discipline, and extent of language…

  3. A Data Based Multidimensional Oral Hygiene Curriculum for the Severely and Profoundly Handicapped.

    Science.gov (United States)

    Feldman, David; Elliott, Thomas A.

    A multidimensional oral hygiene curriculum appropriate for the moderately to profoundly retarded and composed of tooth brushing, flossing, and gum stimulation/massage is proposed. Task analyses are included for manual tooth brushing, utilizing an oral irrigation appliance, manual flossing, and use of an adaptive aid for flossing. Also provided are…

  4. Operationalizing quality of life for people with profound multiple disabilities : a Delphi study

    NARCIS (Netherlands)

    Petry, K.; Maes, B.; Vlaskamp, C.

    Background: In a recent study, we constructed an item pool that contains items on the quality of life (QOL) and related aspects of support of people with profound multiple disabilities (PMD). In the present study, a panel of experts assessed the content and the structure of this item pool in order

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

    Science.gov (United States)

    Rayner, Matthew

    2011-01-01

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

  6. Reversal of rocuronium-induced profound neuromuscular block by sugammadex in Duchenne muscular dystrophy.

    NARCIS (Netherlands)

    Boer, H.D. de; Egmond, J. van; Booij, L.H.D.J.; Driessen, J.J.

    2009-01-01

    A case is reported in which a child with Duchenne muscular dystrophy received a dose of sugammadex to reverse a rocuronium-induced profound neuromuscular block. Sugammadex is the first selective relaxant binding agent and reverses rocuronium- and vecuronium-induced neuromuscular block. A fast and

  7. Connections that Count: Brain-Computer Interface Enables the Profoundly Paralyzed to Communicate

    Science.gov (United States)

    ... Home Current Issue Past Issues Connections that Count: Brain-Computer Interface Enables the Profoundly Paralyzed to Communicate Past Issues / ... of this page please turn Javascript on. A brain-computer interface (BCI) system This brain-computer interface (BCI) system ...

  8. A Preliminary Investigation of the Suitability of Aquatics for People with Severe and Profound Intellectual Disabilities

    Science.gov (United States)

    Aherne, Cian; Coughlan, Barry

    2017-01-01

    Background: Aquatics is an under-researched but possibly appropriate form of activity for people with severe to profound intellectual disabilities (SPIDs). Aim: The current pilot study investigates the suitability of an aquatics programme for service users with SPIDs. Method: Four service users with SPID completed an 8-12-session aquatics…

  9. Determining alertness in individuals with profound intellectual and multiple disabilities : the reliability of an observation list

    NARCIS (Netherlands)

    Munde, V.S.; Vlaskamp, C.; Ruijssenaars, A.J.J.M.; Nakken, H.

    In the support of individuals with profound intellectual and multiple disabilities (PIMD), assessing the level of alertness is a recurring issue for parents and other direct support persons. Although observations show clear advantages above and beyond other assessment methods, there are problems

  10. Normality and Impairment following Profound Early Institutional Deprivation: A Longitudinal follow-up into Early Adolescence

    Science.gov (United States)

    Kreppner, Jana M.; Rutter, Michael; Beckett, Celia; Castle, Jenny; Colvert, Emma; Groothues, Christine; Hawkins, Amanda; O'Connor, Thomas G.; Stevens, Suzanne; Sonuga-Barke, Edmund J. S.

    2007-01-01

    Longitudinal analyses on normal versus impaired functioning across 7 domains were conducted in children who had experienced profound institutional deprivation up to the age of 42 months and were adopted from Romania into U.K. families. Comparisons were made with noninstitutionalized children adopted from Romania and with nondeprived within-U.K.…

  11. The pros and cons of inclusive education for children with Profound Intellectual and Multiple Disabilities

    NARCIS (Netherlands)

    Everaarts, Sanne; de Boer, Anke; van der Putten, Annette; Minnaert, Alexander

    2016-01-01

    Aim: Although children with disabilities have the right to be included into the school system, children with Profound Intellectual and Multiple Disabilities (PIMD) are often not included. The aim of this study is to gather knowledge about inclusive education for children with PIMD by identifying

  12. Bereavement and Loss: Developing a Memory Box to Support a Young Woman with Profound Learning Disabilities

    Science.gov (United States)

    Young, Hannah; Garrard, Brenda

    2016-01-01

    Supporting bereaved people with profound learning disabilities still remains an under-researched area. Moreover, the barriers of communication and disenfranchised grief mean that they often do not receive the support they require, leading to emotional and behavioural difficulties. This article describes research using a case study design, which…

  13. Visual impairments in people with severe and profound multiple disabilities: An inventory of visual functioning

    NARCIS (Netherlands)

    van den Broek, E.G.C.; Janssen, C.G.C.; van Ramshorst, T.; Deen, L.

    2006-01-01

    Background: The prevalence of visual impairments in people with severe and profound multiple disabilities (SPMD) is the subject of considerable debate and is difficult to assess. Methods: In a typical Dutch care organization, all clients with SPMD (n = 76) participated in the study and specific

  14. Is more profound knowledge in the field of radiation nece--ssary for doctors

    International Nuclear Information System (INIS)

    Klener, V.

    1981-01-01

    Reasons are listed why doctors should have more profound knowledge in the field of radiation. Despite imperceptibility by human senses of ionizing radiation, the parameters characterizing irradiation can accurately be measured. The units of the said parameters are listed and characterized and the relationships are explained of the radiation dose and non-stochastic and stochastic radiation effects. (Ha)

  15. HEART RATE AND PHYSICAL ACTIVITY PATTERNS IN PERSONS WITH PROFOUND INTELLECTUAL AND MULTIPLE DISABILITIES

    NARCIS (Netherlands)

    Waninge, Aly; van der Putten, Annette A. J.; Stewart, Roy E.; Steenbergen, Bert; van Wijck, Ruud; van der Schans, Cees P.

    2013-01-01

    Because physical fitness and health are related to physical activity, it is important to gain an insight into the physical activity levels of persons with profound intellectual and multiple disabilities (PIMD). The purpose of this study was to examine heart rate patterns to measure the activity

  16. Attentional Processes in Interactions between People with Profound Intellectual and Multiple Disabilities and Direct Support Staff

    Science.gov (United States)

    Ine, Hostyn; Heleen, Neerinckx; Bea, Maes

    2011-01-01

    Few studies have examined joint attention in interactions with persons with profound intellectual and multiple disabilities (PIMD), despite its important role in high-quality interaction. The purpose of this study is to describe the attention-directing behaviours of persons with PIMD and their direct support staff and the attention episodes…

  17. Interaction between Persons with Profound Intellectual and Multiple Disabilities and Their Partners: A Literature Review

    Science.gov (United States)

    Hostyn, Ine; Maes, Bea

    2009-01-01

    Background: High quality interactions are of crucial importance for quality of life of persons with profound intellectual and multiple disabilities (PIMD). This literature review describes and synthesises studies addressing the interaction between persons with PIMD and their partners. Method: A computerised literature search using defined…

  18. A Vibrotactile Interface to Motivate Movement for Children with Severe to Profound Disabilities

    DEFF Research Database (Denmark)

    Manresa-Yee, Cristina; Morrison, Ann; Larsen, Jeppe Veirum

    2014-01-01

    V-Sense is a vibrotactile interface that encourages children with severe or profound cognitive, sensory and physical impairments to move. The interface makes use of touch, in particular vibrations, as a supportive function to motivate users' actions. Specifically, we propose a vibrotactile...

  19. Attuning: A Communication Process between People with Severe and Profound Intellectual Disability and Their Interaction Partners

    Science.gov (United States)

    Griffiths, Colin; Smith, Martine

    2016-01-01

    Background: People with severe and profound intellectual disability typically demonstrate a limited ability to communicate effectively. Most of their communications are non-verbal, often idiosyncratic and ambiguous. This article aims to identify the process that regulates communications of this group of people with others and to describe the…

  20. Binaural auditory outcomes in patients with postlingual profound unilateral hearing loss: 3 years after cochlear implantation.

    Science.gov (United States)

    Mertens, Griet; Kleine Punte, Andrea; De Bodt, Marc; Van de Heyning, Paul

    2015-01-01

    The value of cochlear implants (CI) in patients with profound unilateral hearing loss (UHL) and tinnitus has recently been investigated. The authors previously demonstrated the feasibility of CI in a 12- month outcome study in a prospective UHL cohort. The aim of this study was to investigate the binaural auditory outcomes in this cohort 36 months after CI surgery. The 36-month outcome was evaluated in 22 CI users with postlingual UHL and severe tinnitus. Twelve subjects had contralateral normal hearing (single-sided deafness - SSD group) and 10 subjects had a contralateral, mild to moderate hearing loss and used a hearing aid (asymmetric hearing loss - AHL group). Speech perception in noise was assessed in two listening conditions: the CIoff and the CIon condition. The binaural summation effect (S0N0), binaural squelch effect (S0NCI) and the combined head shadow effect (SCIN0) were investigated. Subjective benefit in daily life was assessed by means of the Speech, Spatial and Qualities of Hearing Scale (SSQ). At 36 months, a significant binaural summation effect was observed for the study cohort (2.00, SD 3.82 dB; p binaural effect was not significant 12 months after CI surgery. A binaural squelch effect was significant for the AHL subgroup at 12 months (2.00, SD 4.38 dB; p < 0.05). A significant combined head shadow and squelch effect was also noted in the spatial configuration SCIN0 for the study cohort (4.00, SD 5.89 dB; p < 0.01) and for the AHL subgroup (5.67, SD 6.66 dB; p < 0.05). The SSQ data show that the perceived benefit in daily life after CI surgery remains stable up to 36 months at CIon. CI can significantly improve speech perception in noise in patients with UHL. The positive effects of CIon speech perception in noise increase over time up to 36 months after CI surgery. Improved subjective benefit in daily life was also shown to be sustained in these patients. © 2015 S. Karger AG, Basel.

  1. The impact of lifecourse socioeconomic position on cardiovascular disease events in African Americans: the Jackson Heart Study.

    Science.gov (United States)

    Gebreab, Samson Y; Diez Roux, Ana V; Brenner, Allison B; Hickson, DeMarc A; Sims, Mario; Subramanyam, Malavika; Griswold, Michael E; Wyatt, Sharon B; James, Sherman A

    2015-05-27

    Few studies have examined the impact of lifecourse socioeconomic position (SEP) on cardiovascular disease (CVD) risk among African Americans. We used data from the Jackson Heart Study (JHS) to examine the associations of multiple measures of lifecourse SEP with CVD events in a large cohort of African Americans. During a median of 7.2-year follow-up, 362 new or recurrent CVD events occurred in a sample of 5301 participants aged 21 to 94. Childhood SEP was assessed by using mother's education, parental home ownership, and childhood amenities. Adult SEP was assessed by using education, income, wealth, and public assistance. Adult SEP was more consistently associated with CVD risk in women than in men: age-adjusted hazard ratios for low versus high income (95% CIs), 2.46 (1.19 to 5.09) in women and 1.50 (0.87 to 2.58) in men, P for interaction=0.1244, and hazard ratio for low versus high wealth, 2.14 (1.39 to 3.29) in women and 1.06 (0.62 to 1.81) in men, P for interaction=0.0224. After simultaneous adjustment for all adult SEP measures, wealth remained a significant predictor of CVD events in women (HR=1.73 [1.04, 2.85] for low versus high). Education and public assistance were less consistently associated with CVD. Adult SEP was a stronger predictor of CVD events in younger than in older participants (HR for high versus low summary adult SEP score 3.28 [1.43, 7.53] for participants ≤50 years, and 1.90 (1.36 to 2.66) for participants >50 years, P for interaction 0.0846). Childhood SEP was not associated with CVD risk in women or men. Adult SEP is an important predictor of CVD events in African American women and in younger African Americans. Childhood SEP was not associated with CVD events in this population. © 2015 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.

  2. Be kind to your eating disorder patients: the impact of positive and negative feedback on the explicit and implicit self-esteem of female patients with eating disorders

    NARCIS (Netherlands)

    Vanderlinden, J.; Kamphuis, J.H.; Slagmolen, C.; Wigboldus, D.; Pieters, G.; Probst, M.

    2009-01-01

    OBJECTIVE: Lack of self-esteem may play an important role in the development of eating disorders (ED). This study investigated the differential impact of positive and negative feedback on implicit and explicit self-esteem in women with an ED (N=25) as compared to women without an ED (N=29). METHOD:

  3. Be kind to your eating disorder patients: The impact of positive and negative feedback on the explicit and implicit self-esteem of female patients with eating disorders

    NARCIS (Netherlands)

    Vanderlinden, J.; Kamphuis, J.H.; Slagmolen, C.J.J.; Wigboldus, D.H.J.; Pieters, G.; Probst, M.

    2009-01-01

    OBJECTIVE: Lack of self-esteem may play an important role in the development of eating disorders (ED). This study investigated the differential impact of positive and negative feedback on implicit and explicit self-esteem in women with an ED (N=25) as compared to women without an ED (N=29). METHOD:

  4. Positive impacts in soil and water conservation in an Andean region of South America: Case scenarios from a USAID multidisciplinary cooperative project

    Science.gov (United States)

    The USAID-SANREM-Virginia Polytechnic Institute project has made and continues to make an excellent impact, specifically showcasing the positive results of soil and water conservation (Barrera et al. 2010a; 2010b). This project has strong international cooperation between the USA, Ecuador and Bolivi...

  5. Impact of comorbidity and ageing on health-related quality of life in HIV-positive and HIV-negative individuals

    NARCIS (Netherlands)

    Langebeek, Nienke; Kooij, Katherine W.; Wit, Ferdinand W.; Stolte, Ineke G.; Sprangers, Mirjam A. G.; Reiss, Peter; Nieuwkerk, Pythia T.

    2017-01-01

    HIV-infected individuals may be at risk for the premature onset of age-associated noncommunicable comorbidities. Being HIV-positive, having comorbidities and being of higher age may adversely impact health-related quality of life (HRQL). We investigated the possible contribution of HIV infection,

  6. Positive predictive value and impact of misdiagnosis of a heart failure diagnosis in administrative registers among patients admitted to a University Hospital cardiac care unit

    DEFF Research Database (Denmark)

    Mard, Shan; Nielsen, Finn Erland

    2010-01-01

    OBJECTIVE: To evaluate the positive predictive value (PPV) of a diagnosis of heart failure (HF) in the Danish National Registry of Patients (NRP) among patients admitted to a University Hospital cardiac care unit, and to evaluate the impact of misdiagnosing HF. DESIGN: The NRP was used to identify...

  7. Impact of positive chest X-ray findings and blood cultures on adverse outcomes following hospitalized pneumococcal lower respiratory tract infection

    DEFF Research Database (Denmark)

    Skovgaard, Marlene; Schønheyder, Henrik Carl; Benfield, Thomas

    2013-01-01

    Little is known about the clinical presentation and outcome of pneumococcal lower respiratory tract infection (LRTI) without positive chest X-ray findings and blood cultures. We investigated the prognostic impact of a pulmonary infiltrate and bacteraemia on the clinical course of hospitalized...

  8. The impact of positive and negative emotions on loyalty intentions and their interactions with customer equity drivers

    OpenAIRE

    Ou, Yi-Chun; Verhoef, Peter C.

    2017-01-01

    Customer equity drivers (CEDs) include value, brand, and relationship equity, which have a strong link with loyalty intentions. This study aims to examine the incremental effects of positive and negative emotions on loyalty intentions and to determine whether these emotions moderate the positive link between CEDs and loyalty intentions. We use customer data with 102 leading firms across eighteen services industries in the Netherlands. The results show that (1) positive and negative emotions h...

  9. Impact of right-ventricular apical pacing on the optimal left-ventricular lead positions measured by phase analysis of SPECT myocardial perfusion imaging

    International Nuclear Information System (INIS)

    Hung, Guang-Uei; Huang, Jin-Long; Lin, Wan-Yu; Tsai, Shih-Chung; Wang, Kuo-Yang; Chen, Shih-Ann; Lloyd, Michael S.; Chen, Ji

    2014-01-01

    The use of SPECT phase analysis to optimize left-ventricular (LV) lead positions for cardiac resynchronization therapy (CRT) was performed at baseline, but CRT works as simultaneous right ventricular (RV) and LV pacing. The aim of this study was to assess the impact of RV apical (RVA) pacing on optimal LV lead positions measured by SPECT phase analysis. This study prospectively enrolled 46 patients. Two SPECT myocardial perfusion scans were acquired under sinus rhythm with complete left bundle branch block and RVA pacing, respectively, following a single injection of 99m Tc-sestamibi. LV dyssynchrony parameters and optimal LV lead positions were measured by the phase analysis technique and then compared between the two scans. The LV dyssynchrony parameters were significantly larger with RVA pacing than with sinus rhythm (p ∝0.01). In 39 of the 46 patients, the optimal LV lead positions were the same between RVA pacing and sinus rhythm (kappa = 0.861). In 6 of the remaining 7 patients, the optimal LV lead positions were along the same radial direction, but RVA pacing shifted the optimal LV lead positions toward the base. The optimal LV lead positions measured by SPECT phase analysis were consistent, no matter whether the SPECT images were acquired under sinus rhythm or RVA pacing. In some patients, RVA pacing shifted the optimal LV lead positions toward the base. This study supports the use of baseline SPECT myocardial perfusion imaging to optimize LV lead positions to increase CRT efficacy. (orig.)

  10. Impact of patient position on the incidence of ventilator-associated pneumonia: a meta-analysis of randomized controlled trials.

    Science.gov (United States)

    Alexiou, Vangelis G; Ierodiakonou, Vrettos; Dimopoulos, George; Falagas, Matthew E

    2009-12-01

    The aim of this study is to summarize the effect of position (prone and semirecumbent 45 degrees ) of mechanically ventilated patients on the incidence of ventilator-associated pneumonia (VAP) and other outcomes. A systematic search for randomized control trials (RCTs) was done. We estimated pooled odds ratios (ORs) and 95% confidence intervals (CIs) using fixed effects model or random effects model, where appropriate. For continuous variables, we calculated the estimation of weighted mean differences. We analyzed data extracted from 3 RCTs studying the semirecumbent 45 degrees and 4 RCTs studying the prone position with a total of 337 and 1018 patients, respectively. The odds of developing clinically diagnosed VAP were significantly lower among patients in the semirecumbent 45 degrees position compared to patients in the supine position (OR = 0.47; 95% CI, 0.27-0.82; 337 patients). The comparison of prone vs supine position group showed a moderate trend toward better outcomes regarding the incidence of clinically diagnosed VAP among patients in the prone position (OR = 0.80; 95% CI, 0.60-1.08; 1018 patients). The subanalysis regarding the incidence of microbiologically documented VAP, the length of intensive care unit stay, and the duration of mechanical ventilation showed that patients in the semirecumbent 45 degrees position have a moderate trend toward better clinical outcomes. This meta-analysis provides additional evidence that the usual practice of back-rest elevation of 15 degrees to 30 degrees is not sufficient to prevent VAP in mechanically ventilated patients. Patients positioned semirecumbently 45 degrees have significantly lower incidence of clinically diagnosed VAP compared to patients positioned supinely. On the other hand, the incidence of clinically diagnosed VAP among patients positioned pronely does not differ significantly from the incidence of clinically diagnosed VAP among patients positioned supinely.

  11. The impact of positive and negative emotions on loyalty intentions and their interactions with customer equity drivers

    NARCIS (Netherlands)

    Ou, Yi-Chun; Verhoef, Peter C.

    2017-01-01

    Customer equity drivers (CEDs) include value, brand, and relationship equity, which have a strong link with loyalty intentions. This study aims to examine the incremental effects of positive and negative emotions on loyalty intentions and to determine whether these emotions moderate the positive

  12. The impact of positive and negative emotions on loyalty intentions and their interactions with customer equity drivers

    NARCIS (Netherlands)

    Ou, Yi-Chun; Verhoef, Peter C.

    Customer equity drivers (CEDs) include value, brand, and relationship equity, which have a strong link with loyalty intentions. This study aims to examine the incremental effects of positive and negative emotions on loyalty intentions and to determine whether these emotions moderate the positive

  13. Oral Communication Development in Severe to Profound Hearing Impaired Children After Receiving Aural Habilitation

    Directory of Open Access Journals (Sweden)

    Soleimani Farin

    2009-10-01

    Full Text Available Communication, cognition, language, and speech are interrelated and develop together. It should come as no surprise to us that the key to intervention with deaf children is to establish, as early as possible, a functional communication system for the child and the parents. Early intervention programs need to be multidisciplinary, technologically sound and most important, it should take cognizance of the specific context (community, country in which the child and family function. The main aim of this study was to obtain oral communication development regarding current status of the intervention (aural habilitation and speech therapyfor children with severe to profound hearing impairment in Iran. A prospective longitudinal study was undertaken on a consecutive group of children with severe to profound deafness. Nine severe to profound hearing-impaired children out of the primer 42 cases, who were detected below two years old, had been selected in the previous study to receive aural habilitation. The average of their speech intelligibility scores was near 70% at age 6, which was accounted as poor oral communication and only two of them were able to communicate by spoken language. An integrated intervention services continued again for one year and their oral communication skill was assessed by their speech intelligibility. The intelligibility test of children was recorded on audio-tape, when they read 10 questions such as where is your home. This can be answered only in one word. Each tape was presented to10 normal hearing listeners, and their task was to write down, the answers in Persian orthography. At the beginning (at age 6 the average speech intelligibility score of these children was 72% and only two of them had score of 90% and 100%. At age 7, all of the severe groups were over 90%, and only two profound ones achieved the score of 48% and 62%. All of severe groups develop oral communication, but profound ones had a semi-intelligible speech

  14. Infrastructure and automobile shifts: positioning transit to reduce life-cycle environmental impacts for urban sustainability goals

    International Nuclear Information System (INIS)

    Chester, Mikhail; Pincetl, Stephanie; Elizabeth, Zoe; Eisenstein, William; Matute, Juan

    2013-01-01

    Public transportation systems are often part of strategies to reduce urban environmental impacts from passenger transportation, yet comprehensive energy and environmental life-cycle measures, including upfront infrastructure effects and indirect and supply chain processes, are rarely considered. Using the new bus rapid transit and light rail lines in Los Angeles, near-term and long-term life-cycle impact assessments are developed, including consideration of reduced automobile travel. Energy consumption and emissions of greenhouse gases and criteria pollutants are assessed, as well the potential for smog and respiratory impacts. Results show that life-cycle infrastructure, vehicle, and energy production components significantly increase the footprint of each mode (by 48–100% for energy and greenhouse gases, and up to 6200% for environmental impacts), and emerging technologies and renewable electricity standards will significantly reduce impacts. Life-cycle results are identified as either local (in Los Angeles) or remote, and show how the decision to build and operate a transit system in a city produces environmental impacts far outside of geopolitical boundaries. Ensuring shifts of between 20–30% of transit riders from automobiles will result in passenger transportation greenhouse gas reductions for the city, and the larger the shift, the quicker the payback, which should be considered for time-specific environmental goals. (letter)

  15. Infrastructure and automobile shifts: positioning transit to reduce life-cycle environmental impacts for urban sustainability goals

    Science.gov (United States)

    Chester, Mikhail; Pincetl, Stephanie; Elizabeth, Zoe; Eisenstein, William; Matute, Juan

    2013-03-01

    Public transportation systems are often part of strategies to reduce urban environmental impacts from passenger transportation, yet comprehensive energy and environmental life-cycle measures, including upfront infrastructure effects and indirect and supply chain processes, are rarely considered. Using the new bus rapid transit and light rail lines in Los Angeles, near-term and long-term life-cycle impact assessments are developed, including consideration of reduced automobile travel. Energy consumption and emissions of greenhouse gases and criteria pollutants are assessed, as well the potential for smog and respiratory impacts. Results show that life-cycle infrastructure, vehicle, and energy production components significantly increase the footprint of each mode (by 48-100% for energy and greenhouse gases, and up to 6200% for environmental impacts), and emerging technologies and renewable electricity standards will significantly reduce impacts. Life-cycle results are identified as either local (in Los Angeles) or remote, and show how the decision to build and operate a transit system in a city produces environmental impacts far outside of geopolitical boundaries. Ensuring shifts of between 20-30% of transit riders from automobiles will result in passenger transportation greenhouse gas reductions for the city, and the larger the shift, the quicker the payback, which should be considered for time-specific environmental goals.

  16. Impact of antiretroviral therapy on tuberculosis incidence among HIV-positive patients in high-income countries

    NARCIS (Netherlands)

    del Amo, Julia; Moreno, Santiago; Bucher, Heiner C.; Furrer, Hansjakob; Logan, Roger; Sterne, Jonathan; Pérez-Hoyos, Santiago; Jarrín, Inma; Phillips, Andrew; Lodi, Sara; van Sighem, Ard; de Wolf, Frank; Sabin, Caroline; Bansi, Loveleen; Justice, Amy; Goulet, Joseph; Miró, José M.; Ferrer, Elena; Meyer, Laurence; Seng, Rémonie; Toulomi, Giota; Gargalianos, Panagiotis; Costagliola, Dominique; Abgrall, Sophie; Hernán, Miguel A.; Ainsworth, J.; Anderson, J.; Babiker, A.; Delpech, V.; Dunn, D.; Easterbrook, P.; Fisher, M.; Gazzard, B.; Gilson, R.; Gompels, M.; Hill, T.; Johnson, M.; Leen, C.; Orkin, C.; Phillips, A.; Pillay, D.; Porter, K.; Sabin, C.; Schwenk, A.; Walsh, J.; Bansi, L.; Glabay, A.; Thomas, R.; Jones, K.; Perry, N.; Pullin, A.; Churchill, D.; Nelson, M.; Asboe, D.; Bulbeck, S.; Mandalia, S.; Clarke, J.; Munshi, S.; Post, F.; Khan, Y.; Patel, P.; Karim, F.; Duffell, S.; Man, S.-L.; Williams, I.; Dooley, D.; Youle, M.; Lampe, F.; Smith, C.; Grabowska, H.; Chaloner, C.; Ismajani Puradiredja, D.; Weber, J.; Kemble, C.; Mackie, N.; Winston, A.; Wilson, A.; Bezemer, D. O.; Gras, L. A. J.; Kesselring, A. M.; van Sighem, A. I.; Smit, C.; Zhang, S.; Zaheri, S.; Prins, J. M.; Boer, K.; Bos, J. C.; Geerlings, S. E.; Godfried, M. H.; Haverkort, M. E.; Kuijpers, T. W.; Lange, J. M. A.; van der Meer, J. T. M.; Nellen, F. J. B.; Pajkrt, D.; van der Poll, T.; Reiss, P.; Scherpbier, H. J.; van der Valk, M.; Wit, F. W. M. N.; Vrouenraets, S. M. E.; van Vugt, M.; Schreij, G.; Lowe, S.; Oude Lashof, A.; Bravenboer, B.; Pronk, M. J. H.; van der Ende, M. E.; van der Feltz, M.; Gelinck, L. B. S.; Nouwen, J. L.; Rijnders, B. J. A.; de Ruiter, E. D.; Slobbe, L.; Schurink, C. A. M.; Verbon, A.; de Vries-Sluijs, T. E. M. S.; Driessen, G.; Hartwig, N. G.; Branger, J.; Kauffmann, R. H.; Schippers, E. F.; Groeneveld, P. H. P.; Alleman, M. A.; Bouwhuis, J. W.; ten Kate, R. W.; Soetekouw, R.; Kroon, F. P.; Arend, S. M.; de Boer, M. G. J.; van den Broek, P. J.; van Dissel, J. T.; Jolink, H.; van Nieuwkoop, C.; den Hollander, J. G.; Pogany, K.; Bronsveld, W.; Kortmann, W.; van Twillert, G.; Vriesendorp, R.; Leyten, E. M. S.; van Houte, D.; Polée, M. B.; van Vonderen, M. G. A.; ten Napel, C. H. H.; Kootstra, G. J.; Brinkman, K.; van den Berk, G. E. L.; Blok, W. L.; Frissen, P. H. J.; Schouten, W. E. M.; van Eeden, A.; Verhagen, D. W. M.; Mulder, J. W.; van Gorp, E. C. M.; Smit, P. M.; Weijer, S.; Juttmann, J. R.; Brouwer, A. E.; van Kasteren, M. E. E.; Veenstra, J.; Lettinga, K. D.; Koopmans, P. P.; Brouwer, A. M.; Dofferhoff, A. S. M.; van der Flier, M.; de Groot, R.; ter Hofstede, H. J. M.; Keuter, M.; van der Ven, A. J. A. M.; Sprenger, H. G.; van Assen, S.; Doedens, R.; Scholvinck, E. H.; Stek, C. J.; Hoepelman, A. I. M.; Arends, J. E.; Ellerbroek, P. M.; van der Hilst, J. C. H.; Jaspers, C. A. J. J.; Maarschalk-Ellerbroek, L. J.; Oosterheert, J. J.; Peters, E. J. G.; Mudrikova, T.; Schneider, M. M. E.; Wassenberg, M. W. M.; Geelen, S. P. M.; Wolfs, T. F. W.; Danner, S. A.; van Agtmael, M. A.; Bierman, W. F. W.; Claessen, F. A. P.; de Jong, E. V.; Perenboom, R. M.; bij de Vaate, E. A.; Richter, C.; van der Berg, J.; Gisolf, E. H.; van den Berge, M.; Stegeman, A.; Duits, A. J.; Winkel, K.; Abgrall, S.; Barin, F.; Bentata, M.; Billaud, E.; Boué, F.; Burty, C.; Cabié, A.; Costagliola, D.; Cotte, L.; de Truchis, P.; Duval, X.; Duvivier, C.; Enel, P.; Fredouille-Heripret, L.; Gasnault, J.; Gaud, C.; Gilquin, J.; Grabar, S.; Katlama, C.; Khuong, M. A.; Lang, J. M.; Lascaux, A. S.; Launay, O.; Mahamat, A.; Mary-Krause, M.; Matheron, S.; Meynard, J. L.; Pavie, J.; Pialoux, G.; Pilorgé, F.; Poizot-Martin, I.; Pradier, C.; Reynes, J.; Rouveix, E.; Simon, A.; Tattevin, P.; Tissot-Dupont, H.; Viard, J. P.; Viget, N.; Jacquemet, N.; Guiguet, M.; Lanoy, E.; Lièvre, L.; Selinger-Leneman, H.; Lacombe, J. M.; Potard, V.; Bricaire, F.; Herson, S.; Desplanque, N.; Girard, P. M.; Meyohas, M. C.; Picard, O.; Cadranel, J.; Mayaud, C.; Clauvel, J. P.; Decazes, J. M.; Gerard, L.; Molina, J. M.; Diemer, M.; Sellier, P.; Honoré, P.; Jeantils, V.; Tassi, S.; Mechali, D.; Taverne, B.; Bouvet, E.; Crickx, B.; Ecobichon, J. L.; Picard-Dahan, C.; Yeni, P.; Berthé, H.; Dupont, C.; Chandemerle, C.; Mortier, E.; Tisne-Dessus, D.; Weiss, L.; Salmon, D.; Auperin, I.; Roudière, L.; Fior, R.; Delfraissy, J. F.; Goujard, C.; Jung, C.; Lesprit, Ph; Vittecoq, D.; Fraisse, P.; Rey, D.; Beck-Wirth, G.; Stahl, J. P.; Lecercq, P.; Gourdon, F.; Laurichesse, H.; Fresard, A.; Lucht, F.; Bazin, C.; Verdon, R.; Chavanet, P.; Arvieux, C.; Michelet, C.; Choutet, P.; Goudeau, A.; Maître, M. F.; Hoen, B.; Eglinger, P.; Faller, J. P.; Borsa-Lebas, F.; Caron, F.; Daures, J. P.; May, T.; Rabaud, C.; Berger, J. L.; Rémy, G.; Arlet-Suau, E.; Cuzin, L.; Massip, P.; Thiercelin Legrand, M. F.; Pontonnier, G.; Yasdanpanah, Y.; Dellamonica, P.; Pugliese, P.; Aleksandrowicz, K.; Quinsat, D.; Ravaux, I.; Delmont, J. P.; Moreau, J.; Gastaut, J. A.; Retornaz, F.; Soubeyrand, J.; Galinier, A.; Ruiz, J. M.; Allegre, T.; Blanc, P. A.; Bonnet-Montchardon, D.; Lepeu, G.; Granet-Brunello, P.; Esterni, J. P.; Pelissier, L.; Cohen-Valensi, R.; Nezri, M.; Chadapaud, S.; Laffeuillade, A.; Raffi, F.; Boibieux, A.; Peyramond, D.; Livrozet, J. M.; Touraine, J. L.; Trepo, C.; Strobel, M.; Saint-Martin, C. H.; Bissuel, F.; Pradinaud, R.; Sobesky, M.; Contant, M.; Aebi, C.; Battegay, M.; Bernasconi, E.; Böni, J.; Brazzola, P.; Bucher, H. C.; Bürgisser, Ph; Calmy, A.; Cattacin, S.; Cavassini, M.; Cheseaux, J.-J.; Drack, G.; Dubs, R.; Egger, M.; Elzi, L.; Fischer, M.; Flepp, M.; Fontana, A.; Francioli, P.; Furrer, H. J.; Fux, C.; Gayet-Ageron, A.; Gerber, S.; Gorgievski, M.; Günthard, H.; Gyr, Th; Hirsch, H.; Hirschel, B.; Hösli, I.; Hüsler, M.; Kaiser, L.; Kahlert, Ch; Karrer, U.; Kind, C.; Klimkait, Th; Ledergerber, B.; Martinetti, G.; Martinez, B.; Müller, N.; Nadal, D.; Paccaud, F.; Pantaleo, G.; Raio, L.; Rauch, A.; Regenass, S.; Rickenbach, M.; Rudin, C.; Schmid, P.; Schultze, D.; Schüpbach, J.; Speck, R.; Taffé, P.; Telenti, A.; Trkola, A.; Vernazza, P.; Weber, R.; Wyler, C.-A.; Yerly, S.; Casabona, J.; Miró, J. M.; Alquézar, A.; Isern, V.; Esteve, A.; Podzamczer, D.; Murillas, J.; Gatell, J. M.; Agüero, F.; Tural, C.; Clotet, B.; Ferrer, E.; Segura, F.; Riera, M.; Navarro, G.; Force, L.; Vilaró, J.; Masabeu, A.; García, I.; Guadarrama, M.; Romero, A.; Agustí, C.; Montoliu, A.; Ortega, N.; Lazzari, E.; Puchol, E.; Sanchez, M.; Blanco, J. L.; Garcia-Alcaide, F.; Mallolas, J.; Martínez, E.; López-Dieguez, M.; García-Goez, J. F.; Sirera, G.; Romeu, J.; Jou E Negredo, A.; Miranda, C.; Capitan, M. C.; Olmo, M.; Barragan, P.; Saumoy, M.; Bolao, F.; Cabellos, C.; Peña, C.; Sala, M.; Cervantes, M.; Navarro, M.; Jose Amengual, M.; Penelo, E.; Barrufet, P.; Berenguer, J.; del Amo, J.; García, F.; Gutiérrez, F.; Labarga, P.; Moreno, S.; Muñoz, M. A.; Sobrino, P.; Alejos, B.; Monge, S.; Hernando, V.; Alvarez, D.; Jarrín, I.; Gómez Sirvent, J. L.; Rodríguez, P.; Alemán, M. R.; Alonso, M. M.; López, A. M.; Hernández, M. I.; Soriano, V.; Barreiro, P.; Medrano, J.; Rivas, P.; Herrero, D.; Blanco, F.; Vispo, M. E.; Martín, L.; Ramírez, G.; de Diego, M.; Rubio, R.; Pulido, F.; Moreno, V.; Cepeda, C.; Hervás, R. l; Iribarren, J. A.; Arrizabalaga, J.; Aramburu, M. J.; Camino, X.; Rodríguez-Arrondo, F.; von Wichmann, M. A.; Pascual, L.; Goenaga, M. A.; Masiá, M.; Ramos, J. M.; Padilla, S.; Sánchez-Hellín, V.; Bernal, E.; Escolano, C.; Montolio, F.; Peral, Y.; López, J. C.; Miralles, P.; Cosín, J.; Sánchez, M.; Gutiérrez, I.; Ramírez, M.; Padilla, B.; Vidal, F.; Sanjuan, M.; Peraire, J.; Veloso, S.; Viladés, C.; López-Dupla, M.; Olona, M.; Vargas, M.; Aldeguer, J. L.; Blanes, M.; Lacruz, J.; Salavert, M.; Montero, M.; Cuéllar, S.; de los Santos, I.; Sanz, J.; Oteo, J. A.; Blanco, J. R.; Ibarra, V.; Metola, L.; Sanz, M.; Pérez-Martínez, L.; Sola, J.; Uriz, J.; Castiello, J.; Reparaz, J.; Arriaza, M. J.; Irigoyen, C.; Antela, A.; Casado, J. L.; Dronda, F.; Moreno, A.; Pérez, M. J.; López, D.; Gutiérrez, C.; Hernández, B.; Pumares, M.; Martí, P.; García, L.; Page, C.; Hernández, J.; Peña, A.; Muñoz, L.; Parra, J.; Viciana, P.; Leal, M.; López-Cortés, L. F.; Trastoy, M.; Mata, R.; Justice, A. C.; Fiellin, D. A.; Rimland, D.; Jones-Taylor, C.; Oursler, K. A.; Titanji, R.; Brown, S.; Garrison, S.; Rodriguez-Barradas, M.; Masozera, N.; Goetz, M.; Leaf, D.; Simberkoff, M.; Blumenthal, D.; Leung, J.; Butt, A.; Hoffman, E.; Gibert, C.; Peck, R.; Mattocks, K.; Braithwaite, S.; Brandt, C.; Bryant, K.; Cook, R.; Conigliaro, J.; Crothers, K.; Chang, J.; Crystal, S.; Day, N.; Erdos, J.; Freiberg, M.; Kozal, M.; Gandhi, N.; Gaziano, M.; Gerschenson, M.; Good, B.; Gordon, A.; Goulet, J. L.; Hernán, M. A.; Kraemer, K.; Lim, J.; Maisto, S.; Miller, P.; Mole, L.; O'Connor, P.; Papas, R.; Robins, J. M.; Rinaldo, C.; Roberts, M.; Samet, J.; Tierney, B.; Whittle, J.; Brettle, R.; Darbyshire, J.; Fidler, S.; Goldberg, D.; Hawkins, D.; Jaffe, H.; Johnson, A.; McLean, K.; Porter, Kholoud; Cursley, Adam; Ewings, Fiona; Fairbrother, Keith; Gnatiuc, Louisa; Murphy, Brendan; Douglas, G.; Kennedy, N.; Pritchard, J.; Andrady, U.; Rajda, N.; Maw, R.; McKernan, S.; Drake, S.; Gilleran, G.; White, D.; Ross, J.; Toomer, S.; Hewart, R.; Wilding, H.; Woodward, R.; Dean, G.; Heald, L.; Horner, P.; Glover, S.; Bansaal, D.; Eduards, S.; Carne, C.; Browing, M.; Das, R.; Stanley, B.; Estreich, S.; Magdy, A.; O'Mahony, C.; Fraser, P.; Hayman, B.; Jebakumar, S. P. R.; Joshi, U.; Ralph, S.; Wade, A.; Mette, R.; Lalik, J.; Summerfield, H.; El-Dalil, A.; France, A. J.; White, C.; Robertson, R.; Gordon, S.; McMillan, S.; Morris, S.; Lean, C.; Vithayathil, K.; McLean, L.; Winter, A.; Gale, D.; Jacobs, S.; Tayal, S.; Short, L.; Green, S.; Williams, G.; Sivakumar, K.; Bhattacharyya, D. N.; Monteiro, E.; Minton, J.; Dhar, J.; Nye, F.; DeSouza, C. B.; Isaksen, A.; McDonald, L.; Franca, A.; William, L.; Jendrulek, I.; Peters, B.; Shaunak, S.; El-Gadi, S.; Easterbrook, P. J.; Mazhude, C.; Johnstone, R.; Fakoya, A.; Mchale, J.; Waters, A.; Kegg, S.; Mitchell, S.; Byrne, P.; Rice, P.; Mullaney, S. A.; McCormack, S.; David, D.; Melville, R.; Phillip, K.; Balachandran, T.; Mabey-Puttock, S.; Sukthankar, A.; Murphy, C.; Wilkins, E.; Ahmad, S.; Haynes, J.; Evans, E.; Ong, E.; Grey, R.; Meaden, J.; Bignell, C.; Loay, D.; Peacock, K.; Girgis, M. R.; Morgan, B.; Palfreeman, A.; Wilcox, J.; Tobin, J.; Tucker, L.; Saeed, A. M.; Chen, F.; Deheragada, A.; Williams, O.; Lacey, H.; Herman, S.; Kinghorn, D.; Devendra, S. V.; Wither, J.; Dawson, S.; Rowen, D.; Harvey, J.; Bridgwood, A.; Singh, G.; Chauhan, M.; Kellock, D.; Young, S.; Dannino, S.; Kathir, Y.; Rooney, G.; Currie, J.; Fitzgerald, M.; Devendra, S.; Keane, F.; Booth, G.; Green, T.; Arumainayyagam, J.; Chandramani, S.; Rajamanoharan, S.; Robinson, T.; Curless, E.; Gokhale, R.; Tariq, A.; Luzzi, G.; Fairley, I.; Wallis, F.; Smit, E.; Ward, F.; Loze, B.; Morlat, P.; Bonarek, M.; Bonnet, F.; Nouts, C.; Louis, I.; Reliquet, V.; Sauser, F.; Biron, C.; Mounoury, O.; Hue, H.; Brosseau, D.; Ghosn, J.; Rannou, M. T.; Bergmann, J. F.; Badsi, E.; Rami, A.; Parrinello, M.; Samanon-Bollens, D.; Campa, P.; Tourneur, M.; Desplanques, N.; Jeanblanc, F.; Chiarello, P.; Makhloufi, D.; Blanc, A. P.; Allègre, T.; Baillat, V.; Lemoing, V.; Merle de Boever, C.; Tramoni, C.; Sobesky, G.; Abel, S.; Beaujolais, V.; Slama, L.; Chakvetadze, C.; Berrebi, V.; Fournier, I.; Gerbe, J.; Koffi, K.; Augustin-Normand, C.; Miailhes, P.; Thoirain, V.; Brochier, C.; Souala, F.; Ratajczak, M.; Beytoux, J.; Jacomet, C.; Montpied, G.; Morelon, S.; Olivier, C.; Lortholary, O.; Dupont, B.; Maignan, A.; Ragnaud, J. M.; Raymond, I.; Leport, C.; Jadand, C.; Jestin, C.; Longuet, P.; Boucherit, S.; Sereni, D.; Lascoux, C.; Prevoteau, F.; Sobel, A.; Levy, Y.; Lelièvre, J. D.; Dominguez, S.; Dumont, C.; Aumaître, H.; Delmas, B.; Saada, M.; Medus, M.; Guillevin, L.; Tahi, T.; Yazdanpanah, Y.; Pavel, S.; Marien, M. C.; Drenou, B.; Beck, C.; Benomar, M.; Muller, E.; Tubiana, R.; Ait Mohand, H.; Chermak, A.; Ben Abdallah, S.; Touam, F.; Drobacheff, C.; Folzer, A.; Obadia, M.; Prudhomme, L.; Bonnet, E.; Balzarin, F.; Pichard, E.; Chennebault, J. M.; Fialaire, P.; Loison, J.; Galanaud, P.; Bornarel, D.; Six, M.; Ferret, P.; Batisse, D.; Gonzales-Canali, G.; Devidas, A.; Chevojon, P.; Turpault, I.; Lafeuillade, A.; Cheret, A.; Philip, G.; Morel, P.; Timsit, J.; Amirat, N.; Brancion, C.; Cabane, J.; Tredup, J.; Stein, A.; Ravault, I.; Chavanet, C.; Buisson, M.; Treuvetot, S.; Nau, P.; Bastides, F.; Boyer, L.; Wassoumbou, S.; Oksenhendeler, E.; Gérard, L.; Bernard, L.; Poincaré, R.; Domart, Y.; Merrien, D.; Greder Belan, A.; Mignot, A.; Gayraud, M.; Bodard, L.; Meudec, A.; Beuscart, C.; Daniel, C.; Pape, E.; Vinceneux, P.; Simonpoli, A. M.; Zeng, A.; Mourier, L.; Fournier, L.; Jacquet, M.; Fuzibet, J. G.; Sohn, C.; Rosenthal, E.; Quaranta, M.; Chaillou, S.; Sabah, M.; Audhuy, B.; Schieber, A.; Pasteur, L.; Moreau, P.; Niault, M.; Vaillant, O.; Huchon, G.; Compagnucci, A.; de Lacroix Szmania, I.; Richier, L.; Lamaury, I.; Saint-Dizier, F.; Garipuy, D.; Drogoul, M. P.; Poizot Martin, I.; Fabre, G.; Lambert, G.; Abraham, B.; Perino, C.; Lagarde, P.; David, F.; Roche-Sicot, J.; Saraux, J. L.; Leprêtre, A.; Veil, S.; Fampin, B.; Uludag, A.; Morin, A. S.; Bletry, O.; Zucman, D.; Regnier, A.; Girard, J. J.; Quinsat, D. T.; Heripret, L.; Grihon, F.; Houlbert, D.; Ruel, M.; Chemlal, K.; Debab, Y.; Tremollieres, F.; Perronne, V.; Slama, B.; Perré, P.; Miodovski, C.; Guermonprez, G.; Dulioust, A.; Boudon, P.; Malbec, D.; Patey, O.; Semaille, C.; Deville, J.; Remy, G.; Béguinot, I.; Boue, F.; Chambrin, V.; Pignon, C.; Estocq, G. A.; Levy, A.; Duracinsky, M.; Le Bras, P.; Ngussan, M. S.; Peretti, D.; Medintzeff, N.; Lambert, T.; Segeral, O.; Lezeau, P.; Laurian, Y.; Piketty, C.; Karmochkine, M.; Eliaszewitch, M.; Jayle, D.; Tisne, D.; Kazatchkine, M.; Colasante, U.; Nouaouia, W.; Vilde, J. L.; Bollens, D.; Binet, D.; Diallo, B.; Fonquernie, L.; Lagneau, J. L.; Pietrie, M. P.; Sicard, D.; Stieltjes, N.; Michot, J.; Bourdillon, F.; Lelievre, J. D.; Obenga, G.; Escaut, L.; Bolliot, C.; Schneider, L.; Iguertsira, M.; Tomei, C.; Dhiver, C.; Tissot Dupont, H.; Vallon, A.; Gallais, J.; Gallais, H.; Durant, J.; Mondain, V.; Perbost, I.; Cassuto, J. P.; Karsenti, J. M.; Venti, H.; Ceppi, C.; Krivitsky, J. A.; Bouchaud, O.; Honore, P.; Delgado, J.; Rouzioux, C.; Burgard, M.; Boufassa, L.; Peynet, J.; Ferreros, I.; Hurtado, I.; González, C.; Caro, A. M.; Muga, R.; Sanvicens, A.; Tor, J.; del Romero, J.; Raposo, P.; Rodríguez, C.; Vera, M.; Garcia de Olalla, P.; Cayla, J.; Alastrue, I.; Belda, J.; Trullen, P.; Fernández, E.; Santos, C.; Tasa, T.; Zafra, T.; Guerrero, R.; Marco, A.; Quintana, M.; Ruiz, I.; Nuñez, R.; Pérez, R.; Castilla, J.; Guevara, M.; de Mendoza, C.; Zahonero, N.; Antoniadou, A.; Chrysos, G.; Daikos, G.; Gargalianos-Kakolyris, P.; Gogos, H. A.; Katsarou, O.; Kordossis, T.; Lazanas, M.; Nikolaidis, P.; Panos, G.; Paparizos, V.; Paraskevis, D.; Sambatakou, H.; Skoutelis, A.; Touloumi, G.; Pantazis, N.; Bakoyannis, G.; Vourli, G.; Gioukari, V.; Papadopoulos, A.; Petrikkos, G.; Paraskeva, D.; Hatziastros, P.; Psichogiou, M.; Xylomenos, G.; Maragos, M. N.; Kouramba, A.; Ioannidou, P.; Kontos, A.; Chini, M.; Tsogas, N.; Kolaras, P.; Metallidis, S.; Haratsis, G.; Leuow, K.; Kourkounti, S.; Mariolis, I.; Papastamopoulos, V.; Baraboutis, I.

    2012-01-01

    The lower tuberculosis incidence reported in human immunodeficiency virus (HIV)-positive individuals receiving combined antiretroviral therapy (cART) is difficult to interpret causally. Furthermore, the role of unmasking immune reconstitution inflammatory syndrome (IRIS) is unclear. We aim to

  17. Impact of body position on central and peripheral hemodynamic contributions to movement-induced hyperemia: implications for rehabilitative medicine

    OpenAIRE

    Trinity, Joel D.; McDaniel, John; Venturelli, Massimo; Fjeldstad, Anette S.; Ives, Stephen J.; Witman, Melissa A. H.; Barrett-O'Keefe, Zachary; Amann, Markus; Wray, D. Walter; Richardson, Russell S.

    2011-01-01

    This study used alterations in body position to identify differences in hemodynamic responses to passive exercise. Central and peripheral hemodynamics were noninvasively measured during 2 min of passive knee extension in 14 subjects, whereas perfusion pressure (PP) was directly measured in a subset of 6 subjects. Movement-induced increases in leg blood flow (LBF) and leg vascular conductance (LVC) were more than twofold greater in the upright compared with supine positions (LBF, supine: 462 ±...

  18. Reversal of profound vecuronium-induced neuromuscular block under sevoflurane anesthesia: sugammadex versus neostigmine.

    Directory of Open Access Journals (Sweden)

    Lemmens Hendrikus JM

    2010-09-01

    Full Text Available Abstract Background Acetylcholinesterase inhibitors cannot rapidly reverse profound neuromuscular block. Sugammadex, a selective relaxant binding agent, reverses the effects of rocuronium and vecuronium by encapsulation. This study assessed the efficacy of sugammadex compared with neostigmine in reversal of profound vecuronium-induced neuromuscular block under sevoflurane anesthesia. Methods Patients aged ≥18 years, American Society of Anesthesiologists class 1-4, scheduled to undergo surgery under general anesthesia were enrolled in this phase III, multicenter, randomized, safety-assessor blinded study. Sevoflurane anesthetized patients received vecuronium 0.1 mg/kg for intubation, with maintenance doses of 0.015 mg/kg as required. Patients were randomized to receive sugammadex 4 mg/kg or neostigmine 70 μg/kg with glycopyrrolate 14 μg/kg at 1-2 post-tetanic counts. The primary efficacy variable was time from start of study drug administration to recovery of the train-of-four ratio to 0.9. Safety assessments included physical examination, laboratory data, vital signs, and adverse events. Results Eighty three patients were included in the intent-to-treat population (sugammadex, n = 47; neostigmine, n = 36. Geometric mean time to recovery of the train-of-four ratio to 0.9 was 15-fold faster with sugammadex (4.5 minutes compared with neostigmine (66.2 minutes; p Conclusions Recovery from profound vecuronium-induced block is significantly faster with sugammadex, compared with neostigmine. Neostigmine did not rapidly reverse profound neuromuscular block (Trial registration number: NCT00473694.

  19. Speech timing and working memory in profoundly deaf children after cochlear implantation

    OpenAIRE

    Burkholder, Rose A.; Pisoni, David B.

    2003-01-01

    Thirty-seven profoundly deaf children between 8- and 9-years-old with cochlear implants and a comparison group of normal-hearing children were studied to measure speaking rates, digit spans, and speech timing during digit span recall. The deaf children displayed longer sentence durations and pauses during recall and shorter digit spans compared to the normal-hearing children. Articulation rates, measured from sentence durations, were strongly correlated with immediate memory span in both norm...

  20. Epidemiology of fractures in people with severe and profound developmental disabilities

    Science.gov (United States)

    Glick, N.R.; Fischer, M.H.; Heisey, D.M.; Leverson, G.E.; Mann, D.C.

    2005-01-01

    Fractures are more prevalent among people with severe and profound developmental disabilities than in the general population. In order to characterize the tendency of these people to fracture, and to identify features that may guide the development of preventive strategies, we analyzed fracture epidemiology in people with severe and profound developmental disabilities who lived in a stable environment. Data from a 23-year longitudinal cohort registry of 1434 people with severe and profound developmental disabilities were analyzed to determine the effects of age, gender, mobility, bone fractured, month of fracture, and fracture history upon fracture rates. Eighty-five percent of all fractures involved the extremities. The overall fracture rate increased as mobility increased. In contrast, femoral shaft fracture risk was substantially higher in the least mobile [relative risk (RR), 10.36; 95% confidence interval (CI), 3.29-32.66] compared with the most mobile group. Although the overall fracture rate was not associated with age, the femoral shaft fractures decreased but hand/foot fractures increased with age. Overall fracture risk declined in August and September (RR, 0.70; 95% CI, 0.55-0.89), being especially prominent for tibial/fibular fractures (RR, 0.31; 95% CI, 0.13-0.70). Gender was not a factor in fracture risk. Two primary fracture mechanisms are apparent: one, largely associated with lack of weight-bearing in people with the least mobility, is exemplified by femoral fractures during non-traumatic events as simple as diapering or transfers; the other, probably due to movement- or fall-related trauma, is exemplified by hand/foot fractures in people who ambulate. The fracture experience of people with severe and profound developmental disabilities is unique and, because it differs qualitatively from postmenopausal osteoporosis, may require population-specific methods for assessing risk, for improving bone integrity, and for reduction of falls and accidents

  1. Impact of body position on central and peripheral hemodynamic contributions to movement-induced hyperemia: implications for rehabilitative medicine.

    Science.gov (United States)

    Trinity, Joel D; McDaniel, John; Venturelli, Massimo; Fjeldstad, Anette S; Ives, Stephen J; Witman, Melissa A H; Barrett-O'Keefe, Zachary; Amann, Markus; Wray, D Walter; Richardson, Russell S

    2011-05-01

    This study used alterations in body position to identify differences in hemodynamic responses to passive exercise. Central and peripheral hemodynamics were noninvasively measured during 2 min of passive knee extension in 14 subjects, whereas perfusion pressure (PP) was directly measured in a subset of 6 subjects. Movement-induced increases in leg blood flow (LBF) and leg vascular conductance (LVC) were more than twofold greater in the upright compared with supine positions (LBF, supine: 462 ± 6, and upright: 1,084 ± 159 ml/min, P different between positions (supine: 8 ± 1, and upright: 10 ± 1 beats/min, P = 0.22); however, the elevated HR was maintained for a longer duration when upright. Stroke volume contributed to the increase in cardiac output (CO) during the upright movement only. CO increased in both positions; however, the magnitude and duration of the CO response were greater in the upright position. Mean arterial pressure and PP were higher at baseline and throughout passive movement when upright. Thus exaggerated central hemodynamic responses characterized by an increase in stroke volume and a sustained HR response combined to yield a greater increase in CO during upright movement. This greater central response coupled with the increased PP and LVC explains the twofold greater and more sustained increase in movement-induced hyperemia in the upright compared with supine position and has clinical implications for rehabilitative medicine.

  2. Static and Dynamic Balance in Congenital Severe to Profound Hearing-Impaired Children

    Directory of Open Access Journals (Sweden)

    Farideh HajiHeydari

    2011-09-01

    Full Text Available Background and Aim: Research conducted since the early 1900s has consistently identified differences between deaf and hearing children on performance of a wide variety of motor tasks, most notably balance. Our study was performed to test static and dynamic balance skills in congenital severe to profound hearing impaired children in comparison with normal age-matched children.Methods: This cross-sectional study was conducted on 30 severe to profound hearing impaired and 40 normal children with age 6 to 10 years old. Bruininks-Oseretsky test of motor proficiency 2, balance subset with 9 parts was used for evaluation of balance skills.Results: Hearing-impaired children showed 16.7 to 100% fail results in 7 parts of the balance subset. In normal children fail result was revealed just in 3 parts of the balance subset from 2.5 to 57.5%, and differences between two groups were significant (p<0.0001. There was a significant difference between two groups in two static balance skills of standing on one leg on a line and standing on one leg on a balance beam with eyes closed (p<0.0001.conclusion: It seems that development of static balance skills are longer than dynamic ones. Because severe to profound hearing-impaired children showed more weakness than normal children in both static and dynamic balance abilities, functional tests of balance proficiency can help to identify balance disorders in these children.

  3. Maintaining positive

    OpenAIRE

    Gheorghe Gh. IONESCU; Adina Letitia NEGRUSA

    2004-01-01

    Maintaining positive work-force relationships includes in effective labor-management relations and making appropriate responses to current employee issues. Among the major current employee issues are protection from arbitrary dismissal, drug and alcohol abuse, privacy rights and family maters and they impact work. In our paper we discus two problems: first, the meanings of industrial democracy; second, the three principal operational concepts of industrial democracy (1) industrial democracy t...

  4. The impact of the initial stance position on lower limb joint kinetics in the taekwondo roundhouse kick

    Directory of Open Access Journals (Sweden)

    Daniel Jandačka

    2013-06-01

    Full Text Available BACKGROUND: To achieve good performance, taekwondo athletes should optimize the stance position of the foot on the ground. OBJECTIVE: The aim of this study is to compare generated net joint power (hip, knee and ankle during stance phase, magnitude of peak foot velocity of the attacking lower extremity and execution stance time produced from three stance positions (forward "0°", diagonal "45°", orthogonal "90°" in the taekwondo roundhouse kick. METHODS: Ten taekwondo athletes participated in the study; their experience of practicing taekwondo ranged between 13.8 ± 5.8 years. The kinetics and kinematics of the athletes’ movement during the roundhouse kick were recorded. The execution stance time and the magnitude of peak foot velocity were determined. The net joint power of the kicking lower extremity during the stance phase was calculated using the inverse dynamics method. Then the peak net joint power was determined. RESULTS: The analysis of variance for repeated measures showed that there is a significant main effect of the stance position on the peak net hip joint power in the three planes. In addition, the stance position does not affect the magnitude of the peak foot velocity of the kicking lower extremity and execution stance time. CONCLUSIONS: The necessity to produce a higher net hip joint power in the stance phase of the roundhouse kick from the position when the feet are placed orthogonal to the target of the kick, compared with the execution of the kick from the forward or diagonal position, must be taken into account for purposes of rationalizing strength training of taekwondo athletes or for selecting the technique of the roundhouse kick.

  5. Impact of habitat-specific GPS positional error on detection of movement scales by first-passage time analysis.

    Directory of Open Access Journals (Sweden)

    David M Williams

    Full Text Available Advances in animal tracking technologies have reduced but not eliminated positional error. While aware of such inherent error, scientists often proceed with analyses that assume exact locations. The results of such analyses then represent one realization in a distribution of possible outcomes. Evaluating results within the context of that distribution can strengthen or weaken our confidence in conclusions drawn from the analysis in question. We evaluated the habitat-specific positional error of stationary GPS collars placed under a range of vegetation conditions that produced a gradient of canopy cover. We explored how variation of positional error in different vegetation cover types affects a researcher's ability to discern scales of movement in analyses of first-passage time for white-tailed deer (Odocoileus virginianus. We placed 11 GPS collars in 4 different vegetative canopy cover types classified as the proportion of cover above the collar (0-25%, 26-50%, 51-75%, and 76-100%. We simulated the effect of positional error on individual movement paths using cover-specific error distributions at each location. The different cover classes did not introduce any directional bias in positional observations (1 m≤mean≤6.51 m, 0.24≤p≤0.47, but the standard deviation of positional error of fixes increased significantly with increasing canopy cover class for the 0-25%, 26-50%, 51-75% classes (SD = 2.18 m, 3.07 m, and 4.61 m, respectively and then leveled off in the 76-100% cover class (SD = 4.43 m. We then added cover-specific positional errors to individual deer movement paths and conducted first-passage time analyses on the noisy and original paths. First-passage time analyses were robust to habitat-specific error in a forest-agriculture landscape. For deer in a fragmented forest-agriculture environment, and species that move across similar geographic extents, we suggest that first-passage time analysis is robust with regard to

  6. Family influences on the cognitive development of profoundly deaf children: exploring the effects of socioeconomic status and siblings.

    Science.gov (United States)

    Macaulay, Catrin E; Ford, Ruth M

    2013-10-01

    We evaluated the cognitive development of 48 profoundly deaf children from hearing families (born 1994-2002, mean age M = 8.0 years at time of test, none of whom had received early auditory-verbal therapy) as a function of family socioeconomic status and number of siblings. Overall, the deaf children matched a younger group of 47 hearing controls (M = 4.6 years) on verbal ability, theory of mind, and cognitive inhibition. Partial correlations (controlling for age) revealed positive relations in the hearing group between maternal education and inhibition, between number of younger siblings and references to emotions, and between number of close-in-age siblings and references to desires and false beliefs. In the deaf group, there were positive relations between household income and memory span, between maternal education and references to false beliefs, and between number of younger siblings and nonverbal ability. In contrast, deaf children with a greater number of older siblings aged ≤12 years showed inferior memory span, inhibition, belief understanding, picture-sequencing accuracy, and mental-state language, suggesting that they failed to compete successfully with older siblings for their parents' attention and material resources. We consider the implications of the findings for understanding birth-order effects on deaf and language-impaired children.

  7. The Impact of School-Wide Positive Behavioral Interventions and Supports (PBIS) on the Organizational Health of Elementary Schools

    Science.gov (United States)

    Bradshaw, Catherine P.; Koth, Christine W.; Bevans, Katherine B.; Ialongo, Nicholas; Leaf, Philip J.

    2008-01-01

    Positive Behavioral Interventions and Supports (PBIS) is a universal, school-wide prevention strategy that is currently implemented in over 7,500 schools across the nation to reduce disruptive behavior problems through the application of behavioral, social learning, and organizational behavioral principles. PBIS aims to alter school environments…

  8. How to position ‘mildly sustainable’ products: The joint impact of assortment display and price setting

    NARCIS (Netherlands)

    Herpen, van H.W.I.; Fischer, A.R.H.; Trijp, van J.C.M.

    2015-01-01

    To tempt consumers towards more sustainable food choices, ‘intermediately’ sustainable products (i.e., in between conventional and organic) have been introduced. This poses the managerial question how to best position this range of products. In an experiment with intermediately sustainable meat

  9. Positive Impacts of Social Media at Work: Job Satisfaction, Job Calling, and Facebook Use among Co-Workers

    Directory of Open Access Journals (Sweden)

    Hanna Brittany

    2017-01-01

    Full Text Available The number of Facebook users grew rapidly since its conception. Within today’s workplace, employees are increasingly connecting with each other on Facebook for interpersonal reasons. Due to sensational reports by media outlets of inappropriate social media use, many organizations are taking extreme measures about how their employees who utilize Facebook to connect with colleagues. Contrary to the negative assumptions, McAfee [1] states that social media within the workplace can promote positive dynamics. The present study uses McAfee’s argument to examine if a positive connection exists between colleagues who use Facebook to connect with each other. An online survey with questions involving Facebook use with co-workers, job satisfaction, and perceived job calling was completed by employees (N=70 at two high-tech companies in Northern California, USA. Results revealed that job satisfaction is positively correlated with intensity of Facebook use among co-workers. Furthermore, feeling called to one’s line of work was statistically significantly higher for the group of employees who spent the most amount of time interacting on Facebook with their co-workers than the group that spent the least amount of time. These results suggest that companies could begin to explore the positive benefits of social media use within the workplace.

  10. Impact of the lower third molar presence and position on the fragility of mandibular angle and condyle: A Three-dimensional finite element study.

    Science.gov (United States)

    Antic, Svetlana; Vukicevic, Arso M; Milasinovic, Marko; Saveljic, Igor; Jovicic, Gordana; Filipovic, Nenad; Rakocevic, Zoran; Djuric, Marija

    2015-07-01

    The aim of the present study was to investigate the influences of the presence and position of a lower third molar (M3) on the fragility of mandibular angle and condyle, using finite element analysis. From computed tomographic scans of a human mandible with normally erupted M3, two additional virtual models were generated: a mandibular model with partially impacted M3 and a model without M3. Two cases of impact were considered: a frontal and a lateral blow. The results are based on the chromatic analysis of the distributed von Mises and principal stresses, and calculation of their failure indices. In the frontal blow, the angle region showed the highest stress in the case with partially impacted M3, and the condylar region in the case without M3. Compressive stresses were dominant but caused no failure. Tensile stresses were recorded in the retromolar areas, but caused failure only in the case with partially impacted M3. In the lateral blow, the stress concentrated at the point of impact, in the ipsilateral and contralateral angle and condylar regions. The highest stresses were recorded in the case with partially impacted M3. Tensile stresses caused the failure on the ipsilateral side, whereas compressive stresses on the contralateral side. Copyright © 2015 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

  11. Impact of Polysomnographic Parameters on Continuous Positive Airway Pressure in Patient with Obstructive Sleep Apnea in 2012

    Directory of Open Access Journals (Sweden)

    Abolfazl Mozafari

    2014-06-01

    Full Text Available Background & objectives : O bstructive sleep apnea is a preventable and prevalent major health hazard with serious health consequences including excessive daytime sleepiness, cognitive disturbances, depression, cardiovascular diseases and hypertension. Obstructive sleep apnea is a disorder affecting 2 to 4% of the adult population. The continuous positive airway pressur e (CPAP i s the most efficacious therapy and is often the first option for these patients. The pressure titration during laboratory polysomnography is required for treatment by CPAP.   Methods: The patients with obstructive sleep apnea requiring continuous positive airway pressure treatment were selected . CPAP titration was done according to American Academy of Sleep Medicine protocol. Comparison among continuous positive airway pressure with polysomnographic parameters was performed and analyzed with Pearson correlation coefficient. For analysis of qualitative parameters, we used chi-square and then checked with SPSS version 18 software.   Results: From 125 patients with obstructive sleep apnea, there were 112 cases with inclusion criteria. Mean age of participants was 55.07 ± 12, male frequency was 59.2%, apnea hypopnea index was 43.62 and mean continuous positive airway pressure was 12.50 . There was significant relationship among the pressure of continuous positive airway pressure with apnea hypopnea index (P=0.028, arousal index (P=0.011, body mass index (P=0.041 and O2 desaturation index (P=0.022, although age was not significantly related.   Conclusion: In accordance to this data, we found out a prediction equation for optimal CPAP in our patients

  12. Evaluating the impacts of landscape positions and nitrogen fertilizer rates on dissolved organic carbon on switchgrass land seeded on marginally yielding cropland.

    Science.gov (United States)

    Lai, Liming; Kumar, Sandeep; Mbonimpa, Eric G; Hong, Chang Oh; Owens, Vance N; Neupane, Ram P

    2016-04-15

    Dissolved organic carbon (DOC) through leaching into the soils is another mechanism of net C loss. It plays an important role in impacting the environment and impacted by soil and crop management practices. However, little is known about the impacts of landscape positions and nitrogen (N) fertilizer rates on DOC leaching in switchgrass (Panicum virgatum L.). This experimental design included three N fertilizer rates [0 (low); 56 (medium); 112 (high) kg N ha(-1)] and three landscape positions (shoulder, backslope and footslope). Daily average DOC contents at backslope were significantly lower than that at shoulder and footslope. The DOC contents from the plots that received medium N rate were also significantly lower than the plots that received low N rates. The interactions of landscape and N rates on DOC contents were different in every year from 2009 to 2014, however, no significant consistent trend of DOC contents was observed over time. Annual average DOC contents from the plots managed with low N rate were higher than those with high N rate. These contents at the footslope were higher than that at the shoulder position. Data show that there is a moderate positive relationship between the total average DOC contents and the total average switchgrass biomass yields. Overall, the DOC contents from leachate in the switchgrass land were significantly influenced by landscape positions and N rates. The N fertilization reduced DOC leaching contents in switchgrass field. The switchgrass could retain soil and environment sustainability to some extent. These findings will assist in understanding the mechanism of changes in DOC contents with various parameters in the natural environment and crop management systems. However, use of long-term data might help to better assess the effects of above factors on DOC leaching contents and loss in the switchgrass field in the future. Copyright © 2016 Elsevier Ltd. All rights reserved.

  13. Cerebral oxygenation in the beach chair position for shoulder surgery in regional anesthesia: impact on cerebral blood flow and neurobehavioral outcome.

    Science.gov (United States)

    Aguirre, José A; Märzendorfer, Olivia; Brada, Muriel; Saporito, Andrea; Borgeat, Alain; Bühler, Philipp

    2016-12-01

    Beach chair position is considered a potential risk factor for central neurological events particularly if combined with low blood pressure. The aim of this study was to assess the impact of regional anesthesia on cerebral blood flow and neurobehavioral outcome. This is a prospective, assessor-blinded observational study evaluating patients in the beach chair position undergoing shoulder surgery under regional anesthesia. University hospital operating room. Forty patients with American Society of Anesthesiologists classes I-II physical status scheduled for elective shoulder surgery. Cerebral saturation and blood flow of the middle cerebral artery were measured prior to anesthesia and continued after beach chair positioning until discharge to the postanesthesia care unit. The anesthesiologist was blinded for these values. Controlled hypotension with systolic blood pressure≤100mm Hg was maintained during surgery. Neurobehavioral tests and values of regional cerebral saturation, bispectral index, the mean maximal blood flow of the middle cerebral artery, and invasive blood pressure were measured prior to regional anesthesia, and measurements were repeated after placement of the patient on the beach chair position and every 20 minutes thereafter until discharge to postanesthesia care unit. The neurobehavioral tests were repeated the day after surgery. The incidence of cerebral desaturation events was 5%. All patients had a significant blood pressure drop 5 minutes after beach chair positioning, measured at the heart as well as the acoustic meatus levels, when compared with baseline values (Psurgery (Pshoulder surgery had no major impact on cerebral blood flow and cerebral oxygenation. However, some impact on neurobehavioral outcome 24 hours after surgery was observed. Copyright © 2016 Elsevier Inc. All rights reserved.

  14. The Use of Cone Beam Computed Tomography (CBCT to Determine Supernumerary and Impacted Teeth Position in Pediatric Patients: A Case Report

    Directory of Open Access Journals (Sweden)

    Hossein Nematolahi

    2013-03-01

    Full Text Available A case of a compound odontoma which caused delayed eruption of right maxillary central incisor in a ten year old girl is presented with clinical and radiographic findings. The patient presented with complaint of a hard painless swelling in the right anterior region of the maxilla and absence of right maxillary central incisor. After clinical examination, periapical and occlusal radiographs of the mentioned region were taken. Impacted maxillary right central incisor was seen malformed shape on the intraoral radiographs. After taking a cone beam computed tomography (CBCT a compound odontoma associated with the labial aspect of impacted maxillary right central incisor was diagnosed and then removed by simple local excision under local anesthesia. The removal of the odontoma was followed by forced eruption of the impacted central incisor. After three months the tooth returned to its original position.

  15. Looking back at Facebook content and the positive impact upon wellbeing: Exploring reminiscing as a tool for self soothing

    OpenAIRE

    Good, Alice; Sambhanthan, Arunasalam; Panjganj, Vahid

    2013-01-01

    The premise of this paper is to explore the potential of reminiscing in facilitating self soothing. The research presented looks at people’s activities on Facebook and whether these particular activities impact upon their perceived sense of wellbeing, furthermore, whether specific Facebook activities enable a self –soothing effect when feeling low in mood. A survey was distributed amongst Facebook users. The results from the study appear to indicate that in comparison to other Facebook activi...

  16. Threat appeals in health communication: messages that elicit fear and enhance perceived efficacy positively impact on young male drivers

    OpenAIRE

    Carey, R. N.; Sarma, K. M.

    2016-01-01

    BACKGROUND: Health communications often present graphic, threat-based representations of the potential consequences of health-risk behaviours. These 'threat appeals' feature prominently in public health campaigns, but their use is controversial, with studies investigating their efficacy reporting inconsistent, and often negative, findings. This research examined the impact of a threat-based road safety advertisement on the driving behaviour of young male drivers. METHODS: To address limitati...

  17. Threat appeals in health communication: messages that elicit fear and enhance perceived efficacy positively impact on young male drivers

    OpenAIRE

    Rachel N. Carey; Kiran M. Sarma

    2016-01-01

    Background Health communications often present graphic, threat-based representations of the potential consequences of health-risk behaviours. These ?threat appeals? feature prominently in public health campaigns, but their use is controversial, with studies investigating their efficacy reporting inconsistent, and often negative, findings. This research examined the impact of a threat-based road safety advertisement on the driving behaviour of young male drivers. Methods To address limitations...

  18. The impact of IFRS 16 on the financial position of selected companies from the WIG30 index

    Directory of Open Access Journals (Sweden)

    Mateusz Krawczak

    2018-05-01

    Full Text Available The main purpose of this article is to analyze the impact of changes in accounting for leases, defined in IFRS 16, on the financial situation of selected Polish entities listed on the Warsaw Stock Exchange. The following qualitative research methods were used to accomplish the goal: analysis of the literature of the subject and analysis of international reporting standards regarding accounting for leases. In the empirical part of the article, a simulation was carried out. It analyzed the impact of capitalization of operating lease on the selected parts of the balance sheet and changes in profitability of four entities listed on the Warsaw Stock Exchange. The results of empirical research indicate an increase in the value of assets and liabili- ties, a decline in the financial results, and an increase in profitability and debt ratios. The largest changes pertained to the equity and asset debt ratio, which confirms that the application of IFRS 16 will show corporate indebtedness, thus increasing investors' knowledge of the actual risk with which the company is burdened. The main value of this article is the originality of the pilot study carried out. To the best of the authors’ knowledge, these are the first practical measurements of the impact of capitalization of operating lease on the changes in profitability and indebtedness of the reporting entities.

  19. The impact of induced positive mood on symptomatic behaviour in eating disorders. An experimental, AB/BA crossover design testing a multimodal presentation during a test-meal.

    Science.gov (United States)

    Cardi, Valentina; Esposito, Mirko; Clarke, Ariana; Schifano, Sylvia; Treasure, Janet

    2015-04-01

    The aim of this study was to test the impact of a multimodal positive mood vodcast including pleasant images, background uplifting music and a script designed to elicit positive mood on eating disorders-related symptoms in participants suffering from an Eating Disorder (ED) and healthy controls (HCs). Forty-two women with an ED (Anorexia Nervosa [AN]: N = 19; Bulimia Nervosa [BN]: N = 23) and 36 HCs were included in an AB/BA cross-over design which compared the use of a positive mood induction procedure ("positive mood vodcast") with a control condition (i.e. blue static background, neutral music, and script describing objective facts) during a test-meal. Self-report measures and behavioural tasks were completed before and after the test-meal. The positive mood vodcast was associated with greater consumption of the test meal in the AN group; reduced vigilance to food stimuli and lower anxiety in the BN sample; and no significant changes in the HC group. The use of a positive mood vodcast was associated with some beneficial effects in the context of an experimental test-meal in participants with an ED. Copyright © 2014 Elsevier Ltd. All rights reserved.

  20. Impact of implant–abutment connection and positioning of the machined collar/microgap on crestal bone level changes: a systematic review

    Science.gov (United States)

    Schwarz, Frank; Hegewald, Andrea; Becker, Jürgen

    2014-01-01

    Objectives To address the following focused question: What is the impact of implant–abutment configuration and the positioning of the machined collar/microgap on crestal bone level changes? Material and methods Electronic databases of the PubMed and the Web of Knowledge were searched for animal and human studies reporting on histological/radiological crestal bone level changes (CBL) at nonsubmerged one-/two-piece implants (placed in healed ridges) exhibiting different abutment configurations, positioning of the machined collar/microgap (between 1992 and November 2012: n = 318 titles). Quality assessment of selected full-text articles was performed according to the ARRIVE and CONSORT statement guidelines. Results A total of 13 publications (risk of bias: high) were eligible for the review. The weighted mean difference (WMD) (95% CI) between machined collars placed either above or below the bone crest amounted to 0.835 mm favoring an epicrestal positioning of the rough/smooth border (P abutment configurations. Due to a high heterogeneity, a meta-analysis was not feasible. Conclusions While the positioning of the machined neck and microgap may limit crestal bone level changes at nonsubmerged implants, the impact of the implant–abutment connection lacks documentation. PMID:23782338

  1. Cerebral oxygenation in patients undergoing shoulder surgery in beach chair position: comparing general to regional anesthesia and the impact on neurobehavioral outcome.

    Science.gov (United States)

    Aguirre, J; Borgeat, A; Trachsel, T; Cobo Del Prado, I; De Andrés, J; Bühler, P

    2014-02-01

    Ischemic brain damage has been reported in healthy patients after beach chair position for surgery due to cerebral hypoperfusion. Near-infrared spectroscopy has been described as a non-invasive, continuous method to monitor cerebral oxygen saturation. However, its impact on neurobehavioral outcome comparing different anesthesia regimens has been poorly described. In this prospective, assessor-blinded study, 90 patients undergoing shoulder surgery in beach chair position following general (G-group, n=45) or regional anesthesia (R-group; n=45) were enrolled to assess the prevalence of cerebral desaturation events comparing anesthesia regimens and their impact on neurobehavioral and neurological outcome. Anesthesiologists were blinded to regional cerebral oxygen saturation values. Baseline data assessed the day before surgery included neurological and neurobehavioral tests, which were repeated the day after surgery. The baseline data for regional cerebral oxygen saturation/bispectral index and invasive blood pressure both at heart and auditory meatus levels were taken prior to anesthesia, 5 min after induction of anesthesia, 5 min after beach chair positioning, after skin incision and thereafter all 20 min until discharge. Patients in the R-group showed significantly less cerebral desaturation events (psurgery (pshoulder surgery in beach chair position influencing neurobehavioral test results at 24h. Copyright © 2013 Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor. Published by Elsevier España. All rights reserved.

  2. Osseous changes and condyle position in TMJ tomograms: impact of RDC/TMD clinical diagnoses on agreement between expected and actual findings.

    Science.gov (United States)

    Wiese, Mie; Wenzel, Ann; Hintze, Hanne; Petersson, Arne; Knutsson, Kerstin; Bakke, Merete; List, Thomas; Svensson, Peter

    2008-08-01

    The objective of this study was to evaluate the impact of clinical TMJ diagnosis, gender, and age on the agreement between expected and actual radiographic findings. A total of 204 patients with TMJ symptoms were examined using the Research Diagnostic Criteria (RDC/TMD). Expected radiographic findings were recorded. TMJ tomograms in closed and open mouth position were assessed for osseous changes and condyle position. Expected and actual findings were compared. Logistic regression analyses were performed with agreement on radiographic findings as the dependent variable and with clinical RDC/TMD diagnoses, gender and age as the independent variables. The number of radiographic findings was mostly underestimated. A clinical diagnosis of osteoarthritis and age increased the chance of overestimating osseous changes. Disc displacement and age decreased the chance of agreement on certain condyle positions. Tomography often revealed unexpected findings. It was not possible to select particular patient groups who would benefit more or less from a radiographic examination.

  3. The Impact of Gender Norms on Condom Use among HIV-Positive Adults in KwaZulu-Natal, South Africa

    Science.gov (United States)

    Fladseth, Kristin; Gafos, Mitzy; Newell, Marie Louise; McGrath, Nuala

    2015-01-01

    Critical to preventing the spread of HIV is promoting condom use among HIV-positive individuals. Previous studies suggest that gender norms (social and cultural constructions of the ways that women and men are expected to behave) may be an important determinant of condom use. However, the relationship has not been evaluated among HIV-positive women and men in South Africa. We examined gender norms and condom use at last sex among 550 partnerships reported by 530 sexually-active HIV-positive women (372) and men (158) who had sought care, but not yet initiated antiretroviral therapy in a high HIV-prevalence rural setting in KwaZulu-Natal, South Africa between January 2009 and March 2011. Participants enrolled in the cohort study completed a baseline questionnaire that detailed their socio-demographic characteristics, socio-economic circumstances, religion, HIV testing history and disclosure of HIV status, stigma, social capital, gender norms and self-efficacy. Gender norms did not statistically differ between women and men (p = 0.18). Overall, condoms were used at last sex in 58% of partnerships. Although participants disclosed their HIV status in 66% of the partnerships, 60% did not have knowledge of their partner’s HIV status. In multivariable logistic regression, run separately for each sex, women younger than 26 years with more equitable gender norms were significantly more likely to have used a condom at last sex than those of the same age group with inequitable gender norms (OR = 8.88, 95% CI 2.95–26.75); the association between condom use and gender norms among women aged 26+ years and men of all ages was not statistically significant. Strategies to address gender inequity should be integrated into positive prevention interventions, particularly for younger women, and supported by efforts at a societal level to decrease gender inequality. PMID:25853870

  4. The impact of gender norms on condom use among HIV-positive adults in KwaZulu-Natal, South Africa.

    Science.gov (United States)

    Fladseth, Kristin; Gafos, Mitzy; Newell, Marie Louise; McGrath, Nuala

    2015-01-01

    Critical to preventing the spread of HIV is promoting condom use among HIV-positive individuals. Previous studies suggest that gender norms (social and cultural constructions of the ways that women and men are expected to behave) may be an important determinant of condom use. However, the relationship has not been evaluated among HIV-positive women and men in South Africa. We examined gender norms and condom use at last sex among 550 partnerships reported by 530 sexually-active HIV-positive women (372) and men (158) who had sought care, but not yet initiated antiretroviral therapy in a high HIV-prevalence rural setting in KwaZulu-Natal, South Africa between January 2009 and March 2011. Participants enrolled in the cohort study completed a baseline questionnaire that detailed their socio-demographic characteristics, socio-economic circumstances, religion, HIV testing history and disclosure of HIV status, stigma, social capital, gender norms and self-efficacy. Gender norms did not statistically differ between women and men (p = 0.18). Overall, condoms were used at last sex in 58% of partnerships. Although participants disclosed their HIV status in 66% of the partnerships, 60% did not have knowledge of their partner's HIV status. In multivariable logistic regression, run separately for each sex, women younger than 26 years with more equitable gender norms were significantly more likely to have used a condom at last sex than those of the same age group with inequitable gender norms (OR = 8.88, 95% CI 2.95-26.75); the association between condom use and gender norms among women aged 26+ years and men of all ages was not statistically significant. Strategies to address gender inequity should be integrated into positive prevention interventions, particularly for younger women, and supported by efforts at a societal level to decrease gender inequality.

  5. The impact of gender norms on condom use among HIV-positive adults in KwaZulu-Natal, South Africa.

    Directory of Open Access Journals (Sweden)

    Kristin Fladseth

    Full Text Available Critical to preventing the spread of HIV is promoting condom use among HIV-positive individuals. Previous studies suggest that gender norms (social and cultural constructions of the ways that women and men are expected to behave may be an important determinant of condom use. However, the relationship has not been evaluated among HIV-positive women and men in South Africa. We examined gender norms and condom use at last sex among 550 partnerships reported by 530 sexually-active HIV-positive women (372 and men (158 who had sought care, but not yet initiated antiretroviral therapy in a high HIV-prevalence rural setting in KwaZulu-Natal, South Africa between January 2009 and March 2011. Participants enrolled in the cohort study completed a baseline questionnaire that detailed their socio-demographic characteristics, socio-economic circumstances, religion, HIV testing history and disclosure of HIV status, stigma, social capital, gender norms and self-efficacy. Gender norms did not statistically differ between women and men (p = 0.18. Overall, condoms were used at last sex in 58% of partnerships. Although participants disclosed their HIV status in 66% of the partnerships, 60% did not have knowledge of their partner's HIV status. In multivariable logistic regression, run separately for each sex, women younger than 26 years with more equitable gender norms were significantly more likely to have used a condom at last sex than those of the same age group with inequitable gender norms (OR = 8.88, 95% CI 2.95-26.75; the association between condom use and gender norms among women aged 26+ years and men of all ages was not statistically significant. Strategies to address gender inequity should be integrated into positive prevention interventions, particularly for younger women, and supported by efforts at a societal level to decrease gender inequality.

  6. Supraglottic carcinoma: Impact of radiation therapy on outcome of patients with positive margins and extracapsular nodal disease

    International Nuclear Information System (INIS)

    Devineni, V.R.; Simpson, J.R.; Sessions, D.; Spector, J.G.; Hayden, R.; Fredrickson, J.; Fineberg, B.

    1991-01-01

    Seventy-nine patients with supraglottic carcinoma treated between 1966 and 1985 are reviewed. All patients were treated with surgery and postoperative radiation therapy. Thirty-five percent of the patients had positive margins at the site of resection of the primary tumor. Of the 25 patients who had positive nodal disease, 13 patients (52%) had either extracapsular extension or soft-tissue or adjacent organ invasion, referred to in composite as grave signs. The median follow-up of the patients was 4.9 years and all patients were followed for a minimum of 3 years. The disease-free survival for all patients was 76% at 2 years and 71% at 3 years. The locoregional control rate for all patients was 70%. This study demonstrates that there is no difference in local recurrence or disease-free survival, or time to recurrence relative to the status of the surgical margins, which may be a benefit of the postoperative radiation therapy. This study also demonstrates that there is an increase in the number of patients with grave signs with increasing nodal stage. The rate of neck recurrence in patients with grave signs was substantially higher (54%) than in patients without grave signs (8%), even though these patients also had positive lymph nodes. Interestingly, there was also a higher rate of local recurrence among patients who had grave signs. Patients receiving doses higher than 6000 cGy to the primary site had fewer local failures, although within each group of patients with positive or negative surgical margins the differences in survival were minimal

  7. Into the Woods or a Stroll in the Park: How Virtual Contact with Nature Impacts Positive and Negative Affect.

    Science.gov (United States)

    McAllister, Elizabeth; Bhullar, Navjot; Schutte, Nicola S

    2017-07-14

    This study examined the effects of virtual contact with nature on positive and negative affect, and investigated the psychological process of perceived restorativeness as a mediator of this relationship. A sample of 220 Australians aged between 18 and 75 years (M = 49.07, SD = 14.34, female = 72%) participated in the study. Participants were randomly allocated to one of the three experimental conditions experienced through video presentations: (1) 'wild' nature, (2) 'urban' nature, and (3) non-nature control. They then completed measures of perceived restorativeness as well as positive and negative affect. Compared to the non-nature control condition, the experience of wild nature resulted in significantly higher levels of positive affect and lower levels of negative affect. The experience of urban nature resulted in significantly lower levels of negative affect only compared to the non-nature control video. Experience of wild and urban nature resulted in greater perceptions of restorativeness as compared to the non-nature control video. Restorativeness was a significant underlying psychological mediating path through which nature experience exerted its influence on affect. These results have the potential to inform nature-based green care interventions for mental health as well as for urban planning to maximize beneficial effects of natural environments.

  8. Maturation of the mitochondrial redox response to profound asphyxia in fetal sheep.

    Directory of Open Access Journals (Sweden)

    Paul P Drury

    Full Text Available Fetal susceptibility to hypoxic brain injury increases over the last third of gestation. This study examined the hypothesis that this is associated with impaired mitochondrial adaptation, as measured by more rapid oxidation of cytochrome oxidase (CytOx during profound asphyxia.Chronically instrumented fetal sheep at 0.6, 0.7, and 0.85 gestation were subjected to either 30 min (0.6 gestational age (ga, n = 6, 25 min (0.7 ga, n = 27 or 15 min (0.85 ga, n = 17 of complete umbilical cord occlusion. Fetal EEG, cerebral impedance (to measure brain swelling and near-infrared spectroscopy-derived intra-cerebral oxygenation (ΔHb = HbO(2 - Hb, total hemoglobin (THb and CytOx redox state were monitored continuously. Occlusion was associated with profound, rapid fall in ΔHb in all groups to a plateau from 6 min, greatest at 0.85 ga compared to 0.6 and 0.7 ga (p<0.05. THb initially increased at all ages, with the greatest rise at 0.85 ga (p<0.05, followed by a progressive fall from 7 min in all groups. CytOx initially increased in all groups with the greatest rise at 0.85 ga (p<0.05, followed by a further, delayed increase in preterm fetuses, but a striking fall in the 0.85 group after 6 min of occlusion. Cerebral impedance (a measure of cytotoxic edema increased earlier and more rapidly with greater gestation. In conclusion, the more rapid rise in CytOx and cortical impedance during profound asphyxia with greater maturation is consistent with increasing dependence on oxidative metabolism leading to earlier onset of neural energy failure before the onset of systemic hypotension.

  9. Impact of event positioning algorithm on performance of a whole-body PET scanner using one-to-one coupled detectors

    Science.gov (United States)

    Surti, S.; Karp, J. S.

    2018-03-01

    The advent of silicon photomultipliers (SiPMs) has introduced the possibility of increased detector performance in commercial whole-body PET scanners. The primary advantage of these photodetectors is the ability to couple a single SiPM channel directly to a single pixel of PET scintillator that is typically 4 mm wide (one-to-one coupled detector design). We performed simulation studies to evaluate the impact of three different event positioning algorithms in such detectors: (i) a weighted energy centroid positioning (Anger logic), (ii) identifying the crystal with maximum energy deposition (1st max crystal), and (iii) identifying the crystal with the second highest energy deposition (2nd max crystal). Detector simulations performed with LSO crystals indicate reduced positioning errors when using the 2nd max crystal positioning algorithm. These studies are performed over a range of crystal cross-sections varying from 1  ×  1 mm2 to 4  ×  4 mm2 as well as crystal thickness of 1 cm to 3 cm. System simulations were performed for a whole-body PET scanner (85 cm ring diameter) with a long axial FOV (70 cm long) and show an improvement in reconstructed spatial resolution for a point source when using the 2nd max crystal positioning algorithm. Finally, we observe a 30-40% gain in contrast recovery coefficient values for 1 and 0.5 cm diameter spheres when using the 2nd max crystal positioning algorithm compared to the 1st max crystal positioning algorithm. These results show that there is an advantage to implementing the 2nd max crystal positioning algorithm in a new generation of PET scanners using one-to-one coupled detector design with lutetium based crystals, including LSO, LYSO or scintillators that have similar density and effective atomic number as LSO.

  10. Correlation between audiovestibular function tests and hearing outcomes in severe to profound sudden sensorineural hearing loss.

    Science.gov (United States)

    Wang, Chi-Te; Huang, Tsung-Wei; Kuo, Shih-Wei; Cheng, Po-Wen

    2009-02-01

    This study investigated whether audiovestibular function tests, namely auditory brain stem response (ABR) and vestibular-evoked myogenic potential (VEMP) tests were correlated to hearing outcomes after controlling the effects of other potential confounding factors in severe to profound sudden sensorineural hearing loss (SSHL). Eighty-eight patients with severe to profound SSHL were enrolled in this study. Pretreatment hearing levels, results of audiovestibular function tests, and final hearing outcomes were recorded from retrospective chart reviews. Other factors, including age, gender, delay of treatment, vertigo, diabetes mellitus, and hypertension, were collected as well. Comparative analysis between multiple variables and hearing outcomes was conducted using the cumulative logits model in overall subjects. Further, multivariate analysis of prognostic factors was conducted in the stratified groups of severe (70 dB HL 90 dB HL) SSHL. Multivariate analysis showed that pretreatment hearing levels, presence of vertigo, and results of ABR and VEMP testing were significant outcome predictors in the overall subjects. Stratification analysis demonstrated that both the presence of ABR and VEMP waveforms were significantly correlated with better hearing outcomes in the group of severe SSHL [ABR: adjusted odds ratio (aOR) = 14.7, 95% confidence interval (CI) = 1.78 to 122, p = 0.01; VEMP: aOR = 5.91, 95% CI = 1.18 to 29.5, p = 0.03], whereas the presence of vertigo was the only significant negative prognostic factor in the group of profound SSHL (aOR = 0.24, 95% CI = 0.06 to 0.95, p = 0.04). Other variables, including age, gender, diabetes mellitus, hypertension, and delay of treatment, were not significantly related to hearing outcomes in both groups (p > 0.05). A predictive hearing recovery table with the combined ABR and VEMP results was proposed for the group of severe SSHL. ABR and VEMP tests should be included in the battery of neurootological examinations in

  11. Spider Silk Violin Strings with a Unique Packing Structure Generate a Soft and Profound Timbre

    Science.gov (United States)

    Osaki, Shigeyoshi

    2012-04-01

    We overcome the difficulties in pulling long draglines from spiders, twist bundles of dragline filaments, and succeed in preparing violin strings. The twisting is found to change the cross section shapes of filaments from circular to polygonal and to optimize the packing structure with no openings among filaments providing mechanically strong and elastic strings. The spider string signal peaks of overtones for the violin are relatively large at high frequencies, generating a soft and profound timbre. Such a preferable timbre is considered to be due to the unique polygonal packing structure which provides valuable knowledge for developing new types of materials.

  12. Experience with cochlear implants in Greenlanders with profound hearing loss living in Greenland

    DEFF Research Database (Denmark)

    Homøe, Preben; Andersen, Ture; Grøntved, Aksel

    2013-01-01

    OBJECTIVE: Cochlear implant (CI) treatment was introduced to the world in the 1980s and has become a routine treatment for congenital or acquired severe-to-profound hearing loss. CI treatment requires access to a highly skilled team of ear, nose and throat specialists, audiologists and speech...... years are in need of a CI every second year in Greenland often due to sequelae from meningitis, which may cause postinfectious deafness. Screening of new-borns for hearing has been started in Greenland establishing the basis for early diagnosis of congenital hearing impairment and subsequent...

  13. Developmental dysgraphia with profound hearing impairment: intervention by auditory methods enabled by cochlear implant.

    Science.gov (United States)

    Fukushima, Kunihiro; Kawasaki, Akihiro; Nagayasu, Rie; Kunisue, Kazuya; Maeda, Yukihide; Kariya, Shin; Kataoka, Yuko; Nishizaki, Kazunori

    2008-06-01

    Learning disability combined with hearing impairment (LDHI) is a poor prognostic factor for the language development of hearing impaired children after educational intervention. A typical example of a child with LDHI and effective interventions provided by cochlear implants are presented in this report. A case of congenital cytomegaloviral infection that showed dysgraphia as well as profound deafness was reported and an underlying visual processing problem diagnosed in the present case caused the patient's dysgraphia. The dysgraphia could be circumvented by the use of auditory memory fairly established by a cochlear implant.

  14. Positive and Negative Impacts of a Continuing Professional Development Intervention on Pharmacist Practice: A Balanced Measure Evaluation.

    Science.gov (United States)

    Sidhu, Sukhjinder; Gorman, Sean K; Slavik, Richard S; Ramsey, Tasha; Bruchet, Nicole; Murray, Sarah

    2017-01-01

    Evaluations of behavior change interventions aimed at improving professional practice are increasingly focused on impacts at the practice and patient outcome levels. Many of these evaluations assume that if the intended changes occur, the result represents an improvement. However, given the systemic nature of clinical practice, a change in one area can produce changes in other areas as well, some of which may adversely affect the patient. Balancing measures are used to determine whether unintended consequences of an intervention have been introduced into other areas of the system. The aims of this study were to evaluate the impact of behavior change intervention-based continuing professional development (CPD) on pharmacist interventions (resolution of drug therapy problems-DTPs) and resolution of quality indicator DTPs and knowledge change for urinary tract infections (UTI) and pneumonia. As a balancing measure, we aimed to determine whether delivery of behavior change interventions targeting pneumonia and UTI practice results in a negative impact on other important pharmacist interventions, specifically the resolution of heart failure DTPs. A quasiexperimental study was conducted at a Canadian health authority that evaluated the impacts of an 8-week multifaceted behavior change intervention delivered to 58 ward-based pharmacists. The primary outcome was change in proportion of UTI and pneumonia DTPs resolved from the 6-month preintervention to 6-month postintervention phase. Secondary outcomes were changes in proportion of UTI and pneumonia quality indicator DTPs resolved, knowledge quiz scores, and proportion of quality indicator DTPs resolved for heart failure as a balancing measure. A total of 58 pharmacists were targets of the intervention. The proportion of resolved UTI and pneumonia DTPs increased from 17.8 to 27.2% (relative risk increase 52.8%, 95% confidence interval [CI] 42.8-63.6%; P UTI and pneumonia quality indicator DTPs increased from 12.2% to 18

  15. Strategies to Mitigate the Negative and Accentuate the Positive Impacts of International Service-Learning on Host Communities

    Directory of Open Access Journals (Sweden)

    Shari Galiardi

    2012-04-01

    Full Text Available International service-learning can have a transformative effect on student participants, but little research has been done on the impact of these experiences on host communities. The authors make the case that an emphasis on intentional personal, cultural, and group preparation is imperative to have the best possible impact on both the student and host community. Overarching strategies include: 1 preparing students for their experience prior to departure from both an individual and group development perspective; 2 designing reflection activities and discussions that include members of the host community; 3 facilitating open conversations about equitable relationships, international perspectives of Americans, and potential negative effects the group could have on the host community; 4 providing opportunities for post-travel dialogue and personal action plans for re-engaging with the local community upon return. The authors draw from both theoretical frameworks and many years of experience traveling abroad with students to underpin the strategies outlined in this article. KEYWORDSservice-learning; group development; international

  16. Changes in the MEG background activity in patients with positive symptoms of schizophrenia: spectral analysis and impact of age

    International Nuclear Information System (INIS)

    Escudero, Javier; Ifeachor, Emmanuel; Fernández, Alberto; López-Ibor, Juan José; Hornero, Roberto

    2013-01-01

    The frequency spectrum of the magnetoencephalogram (MEG) background activity was analysed in 15 schizophrenia (SCH) patients with predominant positive symptoms and 17 age-matched healthy control subjects using the following variables: median frequency (MF), spectral entropy (SpecEn) and relative power in delta (RPδ), theta (RPθ), lower alpha (RPα1), upper alpha (RPα2), beta (RPβ) and gamma (RPγ) bands. We found significant differences between the two subject groups in the average level of MF and RPγ in some regions of the scalp. Additionally, the MF, SpecEn, RPβ and RPγ values of SCH patients with positive symptoms had a different dependence on age as compared with the results of control subjects, suggesting that SCH affects the way in which the brain activity evolves with age. Moreover, we also classified the MEG signals by means of a cross-validated feature selection process followed by a logistic regression. The subjects were classified with 71.3% accuracy and an area under the ROC curve of 0.741. Thus, the spectral and classification analysis of the MEG in SCH may provide insights into how this condition affects the brain activity and may help in its early detection. (paper)

  17. Be kind to your eating disorder patients: the impact of positive and negative feedback on the explicit and implicit self-esteem of female patients with eating disorders.

    Science.gov (United States)

    Vanderlinden, J; Kamphuis, J H; Slagmolen, C; Wigboldus, D; Pieters, G; Probst, M

    2009-12-01

    Lack of self-esteem may play an important role in the development of eating disorders (ED). This study investigated the differential impact of positive and negative feedback on implicit and explicit self-esteem in women with an ED (N=25) as compared to women without an ED (N=29). False feedback (positive or negative) was given on participant's performance on a specifically developed intellectual test. Before and after the performance, explicit and implicit self-esteem was measured. On the explicit measure ED patients reacted congruently with the nature of the feedback. On the implicit measure only ED patients responded to the positive feedback with an improvement of self-esteem, with no effect for negative feedback. The control group was unaffected by either feedback. Furthermore, no correlation was observed between the explicit and implicit measures, a finding suggesting that these measurements tap different constructs. Positive feedback affects implicit self-esteem of female patients with eating disorders. The results underline the importance of positively approaching women with ED.

  18. Assumptions of Decision-Making Capacity: The Role Supporter Attitudes Play in the Realisation of Article 12 for People with Severe or Profound Intellectual Disability

    Directory of Open Access Journals (Sweden)

    Joanne Watson

    2016-02-01

    supporters having positive assumptions of decision-making capacity as a factor affecting supported decision-making. This commentary aims to give a focus for practice and policy efforts for ensuring people with severe or profound cognitive disability receive appropriate support in decision-making, a clear obligation of signatory nations of the UNCRPD. A focus on changing supporter attitudes rather than placing the onus of change on people with disability is consistent with the social model of disability, a key driver of the UNCRPD.

  19. Can 4-H Involvement Have a Positive Impact on 4-H Youth’s Bullying Beliefs and Behaviors?

    Directory of Open Access Journals (Sweden)

    Dennis W. Duncan

    2016-12-01

    Full Text Available Bullying has negative emotional and physical effects on youth which often continues into adulthood. Bullying can contribute to emotional distress which is often more difficult to detect in victims.  Documented effects of bullying include depression, anxiety, bitterness, elevated levels of stress, as well as negative feelings of self-image and low self-esteem. The purpose of this study was to examine the impact that involvement in the state 4-H program has on bullying beliefs and behaviors. This study found that 94% of the participants (senior high students agreed that 4-H helped them to shape their belief towards bullying; 84% either agreed or strongly agreed that 4-H has helped them be more confident around strangers; and 93% indicated that 4-H helped them to gain confidence in situations so they could speak up for themselves.

  20. Reproduction Alters Hydration State but Does Not Impact the Positive Effects of Dehydration on Innate Immune Function in Children's Pythons (Antaresia childreni).

    Science.gov (United States)

    Brusch, George A; Billy, Gopal; Blattman, Joseph N; DeNardo, Dale F

    Resource availability can impact immune function, with the majority of studies of such influences focusing on the allocation of energy investment into immune versus other physiological functions. When energy is a limited resource, performance trade-offs can result, compromising immunity. Dehydration is also considered a physiological challenge resulting from the limitation of a vital resource, yet previous research has found a positive relationship between dehydration and innate immune performance. However, these studies did not examine the effects of dehydration on immunity when there was another concurrent, substantial physiological challenge. Thus, we examined the impact of reproduction and water deprivation, individually and in combination, on immune performance in Children's pythons (Antaresia childreni). We collected blood samples from free-ranging A. childreni to evaluate osmolality and innate immune function (lysis, agglutination, bacterial growth inhibition) during the austral dry season, when water availability is limited and this species is typically reproducing. To examine how reproduction and water imbalance, both separately and combined, impact immune function, we used a laboratory-based 2 × 2 experiment. Our results demonstrate that A. childreni experience significant dehydration during the dry season and that, overall, osmolality, regardless of the underlying cause (seasonal rainfall, water deprivation, or reproduction), is positively correlated with increased innate immune performance.

  1. Whole exome sequencing identifies mutations in Usher syndrome genes in profoundly deaf Tunisian patients.

    Science.gov (United States)

    Riahi, Zied; Bonnet, Crystel; Zainine, Rim; Lahbib, Saida; Bouyacoub, Yosra; Bechraoui, Rym; Marrakchi, Jihène; Hardelin, Jean-Pierre; Louha, Malek; Largueche, Leila; Ben Yahia, Salim; Kheirallah, Moncef; Elmatri, Leila; Besbes, Ghazi; Abdelhak, Sonia; Petit, Christine

    2015-01-01

    Usher syndrome (USH) is an autosomal recessive disorder characterized by combined deafness-blindness. It accounts for about 50% of all hereditary deafness blindness cases. Three clinical subtypes (USH1, USH2, and USH3) are described, of which USH1 is the most severe form, characterized by congenital profound deafness, constant vestibular dysfunction, and a prepubertal onset of retinitis pigmentosa. We performed whole exome sequencing in four unrelated Tunisian patients affected by apparently isolated, congenital profound deafness, with reportedly normal ocular fundus examination. Four biallelic mutations were identified in two USH1 genes: a splice acceptor site mutation, c.2283-1G>T, and a novel missense mutation, c.5434G>A (p.Glu1812Lys), in MYO7A, and two previously unreported mutations in USH1G, i.e. a frameshift mutation, c.1195_1196delAG (p.Leu399Alafs*24), and a nonsense mutation, c.52A>T (p.Lys18*). Another ophthalmological examination including optical coherence tomography actually showed the presence of retinitis pigmentosa in all the patients. Our findings provide evidence that USH is under-diagnosed in Tunisian deaf patients. Yet, early diagnosis of USH is of utmost importance because these patients should undergo cochlear implant surgery in early childhood, in anticipation of the visual loss.

  2. Profound microcephaly, primordial dwarfism with developmental brain malformations: a new syndrome.

    Science.gov (United States)

    Abdel-Salam, Ghada M H; Abdel-Hamid, Mohamed S; Saleem, Sahar N; Ahmed, Mahmoud K H; Issa, Mahmoud; Effat, Laila K; Kayed, Hisham F; Zaki, Maha S; Gaber, Khaled R

    2012-08-01

    We describe two sibs with a lethal form of profound congenital microcephaly, intrauterine and postnatal growth retardation, subtle skeletal changes, and poorly developed brain. The sibs had striking absent cranial vault with sloping of the forehead, large beaked nose, relatively large ears, and mandibular micro-retrognathia. Brain magnetic resonance imaging (MRI) revealed extremely simplified gyral pattern, large interhemispheric cyst and agenesis of corpus callosum, abnormally shaped hippocampus, and proportionately affected cerebellum and brainstem. In addition, fundus examination showed foveal hypoplasia with optic nerve atrophy. No abnormalities of the internal organs were found. This profound form of microcephaly was identified at 17 weeks gestation by ultrasound and fetal brain MRI helped in characterizing the developmental brain malformations in the second sib. Molecular analysis excluded mutations in potentially related genes such as RNU4ATAC, SLC25A19, and ASPM. These clinical and imaging findings are unlike that of any recognized severe forms of microcephaly which is believed to be a new microcephalic primordial dwarfism (MPD) with developmental brain malformations with most probably autosomal recessive inheritance based on consanguinity and similarly affected male and female sibs. Copyright © 2012 Wiley Periodicals, Inc.

  3. Profound neonatal hypoglycemia and lactic acidosis caused by pyridoxine-dependent epilepsy.

    Science.gov (United States)

    Mercimek-Mahmutoglu, Saadet; Horvath, Gabriella A; Coulter-Mackie, Marion; Nelson, Tanya; Waters, Paula J; Sargent, Michael; Struys, Eduard; Jakobs, Cornelis; Stockler-Ipsiroglu, Sylvia; Connolly, Mary B

    2012-05-01

    Pyridoxine-dependent epilepsy (PDE) was first described in 1954. The ALDH7A1 gene mutations resulting in α-aminoadipic semialdehyde dehydrogenase deficiency as a cause of PDE was identified only in 2005. Neonatal epileptic encephalopathy is the presenting feature in >50% of patients with classic PDE. We report the case of a 13-month-old girl with profound neonatal hypoglycemia (0.6 mmol/L; reference range >2.4), lactic acidosis (11 mmol/L; reference range A (p.Val278Val), and a novel putative pathogenic missense mutation c.1192G>C (p.Gly398Arg) in the ALDH7A1 gene. She has been seizure-free since 1.5 months of age on treatment with pyridoxine alone. She has motor delay and central hypotonia but normal language and social development at the age of 13 months. This case is the first description of a patient with PDE due to mutations in the ALDH7A1 gene who presented with profound neonatal hypoglycemia and lactic acidosis masquerading as a neonatal-onset gluconeogenesis defect. PDE should be included in the differential diagnosis of hypoglycemia and lactic acidosis in addition to medically refractory neonatal seizures.

  4. Quantification of structural changes in the corpus callosumin children with profound hypoxic-ischaemic brain injury

    Energy Technology Data Exchange (ETDEWEB)

    Stivaros, Stavros M. [Manchester Academic Health Science Centre, Academic Unit of Paediatric Radiology, Royal Manchester Children' s Hospital, Central Manchester University Hospitals NHS Foundation Trust, Manchester (United Kingdom); University of Manchester, Centre for Imaging Sciences, Institute of Population Health, Manchester (United Kingdom); Radon, Mark R. [The Walton Centre NHS Foundation Trust, Department of Neuroradiology, Liverpool (United Kingdom); Mileva, Reneta; Gledson, Ann; Keane, John A. [University of Manchester, School of Computer Science, Manchester (United Kingdom); Connolly, Daniel J.A.; Batty, Ruth [Sheffield Children' s Hospital NHS Foundation Trust, Department of Neuroradiology, Sheffield (United Kingdom); Cowell, Patricia E. [University of Sheffield, Department of Human Communication Sciences, Sheffield (United Kingdom); Hoggard, Nigel; Griffiths, Paul D. [University of Sheffield, Academic Unit of Radiology, Sheffield (United Kingdom); Wright, Neville B.; Tang, Vivian [Manchester Academic Health Science Centre, Academic Unit of Paediatric Radiology, Royal Manchester Children' s Hospital, Central Manchester University Hospitals NHS Foundation Trust, Manchester (United Kingdom)

    2016-01-15

    Birth-related acute profound hypoxic-ischaemic brain injury has specific patterns of damage including the paracentral lobules. To test the hypothesis that there is anatomically coherent regional volume loss of the corpus callosum as a result of this hemispheric abnormality. Study subjects included 13 children with proven acute profound hypoxic-ischaemic brain injury and 13 children with developmental delay but no brain abnormalities. A computerised system divided the corpus callosum into 100 segments, measuring each width. Principal component analysis grouped the widths into contiguous anatomical regions. We conducted analysis of variance of corpus callosum widths as well as support vector machine stratification into patient groups. There was statistically significant narrowing of the mid-posterior body and genu of the corpus callosum in children with hypoxic-ischaemic brain injury. Support vector machine analysis yielded over 95% accuracy in patient group stratification using the corpus callosum centile widths. Focal volume loss is seen in the corpus callosum of children with hypoxic-ischaemic brain injury secondary to loss of commissural fibres arising in the paracentral lobules. Support vector machine stratification into the hypoxic-ischaemic brain injury group or the control group on the basis of corpus callosum width is highly accurate and points towards rapid clinical translation of this technique as a potential biomarker of hypoxic-ischaemic brain injury. (orig.)

  5. Validation of the Spanish version of the Baylor Profound Mental Status Examination.

    Science.gov (United States)

    Salmerón, Sergio; Huedo, Isabel; López-Utiel, Melisa; Soler-Moratalla, Isabel; Flores-Ruano, Teresa; Fernández-Sánchez, Miguel; Noguerón, Alicia; Doody, Rachelle S; Abizanda, Pedro

    2016-01-01

    There are no short valid instruments to evaluate cognitive status in severe Alzheimer's disease (AD) patients in the Spanish language. To validate the Spanish version of the Baylor Profound Mental Status Examination (BPMSE-Sp). The Baylor Profound Mental Status Examination (BPMSE) was translated to Spanish and back translated. Validation was conducted in 100 patients with severe probable AD with a Mini-Mental State Examination (MMSE) reliability. The mean age of patients was 84.9; 74% were female; 64% were institutionalized. The mean MMSE was 5.6; the mean BPMSE-Sp was 13.6; the mean BPMSE-Sp behavior was 1.2; the mean SIB was 42.2; and the mean NPI-Q was 4.7. BPMSE-Sp presented good internal consistency (Cronbach α= 0.84). There were significant correlations between the BPMSE-Sp and MMSE (r = 0.86, p reliability were in both cases excellent, ranging between 0.96 and 0.99 (p <  0.001). BPMSE-Sp had fewer floor and ceiling effects than the MMSE. The BPMSE-Sp is a valid tool for use in daily practice and research in the evaluation of cognitive function of patients with severe AD.

  6. Loss of CIB2 Causes Profound Hearing Loss and Abolishes Mechanoelectrical Transduction in Mice

    Directory of Open Access Journals (Sweden)

    Yanfei Wang

    2017-12-01

    Full Text Available Calcium and integrin-binding protein 2 (CIB2 belongs to a protein family with four known members, CIB1 through CIB4, which are characterized by multiple calcium-binding EF-hand domains. Among the family members, the Cib1 and Cib2 genes are expressed in mouse cochlear hair cells, and mutations in the human CIB2 gene have been associated with nonsyndromic deafness DFNB48 and syndromic deafness USH1J. To further explore the function of CIB1 and CIB2 in hearing, we established Cib1 and Cib2 knockout mice using the clustered regularly interspaced short palindromic repeat (CRISPR-associated Cas9 nuclease (CRISPR/Cas9 genome editing technique. We found that loss of CIB1 protein does not affect auditory function, whereas loss of CIB2 protein causes profound hearing loss in mice. Further investigation revealed that hair cell stereocilia development is affected in Cib2 knockout mice. Noticeably, loss of CIB2 abolishes mechanoelectrical transduction (MET currents in auditory hair cells. In conclusion, we show here that although both CIB1 and CIB2 are readily detected in the cochlea, only loss of CIB2 results in profound hearing loss, and that CIB2 is essential for auditory hair cell MET.

  7. Whole exome sequencing identifies mutations in Usher syndrome genes in profoundly deaf Tunisian patients.

    Directory of Open Access Journals (Sweden)

    Zied Riahi

    Full Text Available Usher syndrome (USH is an autosomal recessive disorder characterized by combined deafness-blindness. It accounts for about 50% of all hereditary deafness blindness cases. Three clinical subtypes (USH1, USH2, and USH3 are described, of which USH1 is the most severe form, characterized by congenital profound deafness, constant vestibular dysfunction, and a prepubertal onset of retinitis pigmentosa. We performed whole exome sequencing in four unrelated Tunisian patients affected by apparently isolated, congenital profound deafness, with reportedly normal ocular fundus examination. Four biallelic mutations were identified in two USH1 genes: a splice acceptor site mutation, c.2283-1G>T, and a novel missense mutation, c.5434G>A (p.Glu1812Lys, in MYO7A, and two previously unreported mutations in USH1G, i.e. a frameshift mutation, c.1195_1196delAG (p.Leu399Alafs*24, and a nonsense mutation, c.52A>T (p.Lys18*. Another ophthalmological examination including optical coherence tomography actually showed the presence of retinitis pigmentosa in all the patients. Our findings provide evidence that USH is under-diagnosed in Tunisian deaf patients. Yet, early diagnosis of USH is of utmost importance because these patients should undergo cochlear implant surgery in early childhood, in anticipation of the visual loss.

  8. Quantification of structural changes in the corpus callosumin children with profound hypoxic-ischaemic brain injury

    International Nuclear Information System (INIS)

    Stivaros, Stavros M.; Radon, Mark R.; Mileva, Reneta; Gledson, Ann; Keane, John A.; Connolly, Daniel J.A.; Batty, Ruth; Cowell, Patricia E.; Hoggard, Nigel; Griffiths, Paul D.; Wright, Neville B.; Tang, Vivian

    2016-01-01

    Birth-related acute profound hypoxic-ischaemic brain injury has specific patterns of damage including the paracentral lobules. To test the hypothesis that there is anatomically coherent regional volume loss of the corpus callosum as a result of this hemispheric abnormality. Study subjects included 13 children with proven acute profound hypoxic-ischaemic brain injury and 13 children with developmental delay but no brain abnormalities. A computerised system divided the corpus callosum into 100 segments, measuring each width. Principal component analysis grouped the widths into contiguous anatomical regions. We conducted analysis of variance of corpus callosum widths as well as support vector machine stratification into patient groups. There was statistically significant narrowing of the mid-posterior body and genu of the corpus callosum in children with hypoxic-ischaemic brain injury. Support vector machine analysis yielded over 95% accuracy in patient group stratification using the corpus callosum centile widths. Focal volume loss is seen in the corpus callosum of children with hypoxic-ischaemic brain injury secondary to loss of commissural fibres arising in the paracentral lobules. Support vector machine stratification into the hypoxic-ischaemic brain injury group or the control group on the basis of corpus callosum width is highly accurate and points towards rapid clinical translation of this technique as a potential biomarker of hypoxic-ischaemic brain injury. (orig.)

  9. Beneficios económicos del implante coclear para la hipoacusia sensorineural profunda Economic benefits of the cochlear implant for treating profound sensorineural hearing loss

    Directory of Open Access Journals (Sweden)

    Augusto Peñaranda

    2012-04-01

    Full Text Available OBJETIVO: Evaluar el costo-beneficio (CB, costo-utilidad (CU y costo-efectividad (CE de la implantación coclear, comparándola con el uso de audífonos en niños con hipoacusia sensorineural profunda bilateral. MÉTODOS: Se empleó la técnica no paramétrica Propensity Score Matching (PSM para realizar la evaluación de impacto económico del implante y así llevar a cabo los análisis CB, CU y CE. Se utilizó información primaria, tomada aleatoriamente a 100 pacientes: 62 intervenidos quirúrgicamente con el implante coclear (grupo de tratamiento y 38 pertenecientes al grupo de control o usuarios de audífono para tratar la hipoacusia sensorineural profunda. RESULTADOS: Se halló un diferencial de costos económicos -en beneficio del implante coclear- cercano a US$ 204 000 entre el implante y el uso de audífonos durante la esperanza de vida de los pacientes analizados. Dicha cifra indica los mayores gastos que deben cubrir los pacientes con audífono. Con este valor descontado, el indicador costo-beneficio señala que por cada dólar invertido en el implante coclear, para tratar al paciente, el retorno de la inversión es US$ 2,07. CONCLUSIONES: El implante coclear genera beneficios económicos para el paciente. También produce utilidades en salud dado que se encontró una relación positiva de CU (ganancia en decibeles y CE (ganancia en discriminación del lenguaje.OBJECTIVE: Evaluate the cost-benefit, cost-utility, and cost-effectiveness of cochlear implantation, comparing it to the use of hearing aids in children with profound bilateral sensorineural hearing loss. METHODS: The nonparametric propensity score matching method was used to carry out an economic and impact assessment of the cochlear implant and then perform cost-benefit, cost-utility, and cost-effectiveness analyses. Primary information was used, taken randomly from 100 patients: 62 who received cochlear implants (treatment group and 38 belonging to the control group who used

  10. The positive cognitive impact of aerobic fitness is associated with peripheral inflammatory and brain-derived neurotrophic biomarkers in young adults.

    Science.gov (United States)

    Hwang, Jungyun; Castelli, Darla M; Gonzalez-Lima, F

    2017-10-01

    There is ample evidence for supporting the positive impact of aerobic fitness on cognitive function, but little is known about the physiological mechanisms. The objective of this study was to investigate whether the positive cognitive impact of aerobic fitness is associated with inflammatory and neurotrophic peripheral biomarkers in young adults aged 18 to 29years (n=87). For the objective assessment of aerobic fitness, we measured maximal oxygen uptake (VO 2 max) as a parametric measure of cardiorespiratory capacity. We demonstrated that young adults with the higher levels of VO 2 max performed better on computerized cognitive tasks assessing sustained attention and working memory. This positive VO 2 max-cognitive performance association existed independently of confounders (e.g., years of education, intelligence scores) but was significantly dependent on resting peripheral blood levels of inflammatory (C-reactive protein, CRP) and neurotrophic (brain-derived neurotrophic factor, BDNF) biomarkers. Statistical models showed that CRP was a mediator of the effect of VO 2 max on working memory. Further, BDNF was a moderator of the effect of VO 2 max on working memory. These mediating and moderating effects occurred in individuals with higher levels of aerobic fitness. The results suggest that higher aerobic fitness, as measured by VO 2 max, is associated with enhanced cognitive functioning and favorable resting peripheral levels of inflammatory and brain-derived neurotrophic biomarkers in young adults. Copyright © 2017 Elsevier Inc. All rights reserved.

  11. The impact of initialization procedures on unsupervised unmixing of hyperspectral imagery using the constrained positive matrix factorization

    Science.gov (United States)

    Masalmah, Yahya M.; Vélez-Reyes, Miguel

    2007-04-01

    The authors proposed in previous papers the use of the constrained Positive Matrix Factorization (cPMF) to perform unsupervised unmixing of hyperspectral imagery. Two iterative algorithms were proposed to compute the cPMF based on the Gauss-Seidel and penalty approaches to solve optimization problems. Results presented in previous papers have shown the potential of the proposed method to perform unsupervised unmixing in HYPERION and AVIRIS imagery. The performance of iterative methods is highly dependent on the initialization scheme. Good initialization schemes can improve convergence speed, whether or not a global minimum is found, and whether or not spectra with physical relevance are retrieved as endmembers. In this paper, different initializations using random selection, longest norm pixels, and standard endmembers selection routines are studied and compared using simulated and real data.

  12. Reflections on Researcher Identity and Power: The Impact of Positionality on Community Based Participatory Research (CBPR) Processes and Outcomes.

    Science.gov (United States)

    Muhammad, Michael; Wallerstein, Nina; Sussman, Andrew L; Avila, Magdalena; Belone, Lorenda; Duran, Bonnie

    2015-11-01

    The practice of community based participatory research (CBPR) has evolved over the past 20 years with the recognition that health equity is best achieved when academic researchers form collaborative partnerships with communities. This article theorizes the possibility that core principles of CBPR cannot be realistically applied unless unequal power relations are identified and addressed. It provides theoretical and empirical perspectives for understanding power, privilege, researcher identity and academic research team composition, and their effects on partnering processes and health disparity outcomes. The team's processes of conducting seven case studies of diverse partnerships in a national cross-site CBPR study are analyzed; the multi-disciplinary research team's self-reflections on identity and positionality are analyzed, privileging its combined racial, ethnic, and gendered life experiences, and integrating feminist and post-colonial theory into these reflections. Findings from the inquiry are shared, and incorporating academic researcher team identity is recommended as a core component of equalizing power distribution within CBPR.

  13. Butyrate induces profound changes in gene expression related to multiple signal pathways in bovine kidney epithelial cells

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    Li CongJun

    2006-09-01

    Full Text Available Abstract Background Global gene expression profiles of bovine kidney epithelial cells regulated by sodium butyrate were investigated with high-density oligonucleotide microarrays. The bovine microarray with 86,191 distinct 60mer oligonucleotides, each with 4 replicates, was designed and produced with Maskless Array Synthesizer technology. These oligonucleotides represent approximately 45,383 unique cattle sequences. Results 450 genes significantly regulated by butyrate with a median False Discovery Rate (FDR = 0 % were identified. The majority of these genes were repressed by butyrate and associated with cell cycle control. The expression levels of 30 selected genes identified by the microarray were confirmed using real-time PCR. The results from real-time PCR positively correlated (R = 0.867 with the results from the microarray. Conclusion This study presented the genes related to multiple signal pathways such as cell cycle control and apoptosis. The profound changes in gene expression elucidate the molecular basis for the pleiotropic effects of butyrate on biological processes. These findings enable better recognition of the full range of beneficial roles butyrate may play during cattle energy metabolism, cell growth and proliferation, and possibly in fighting gastrointestinal pathogens.

  14. Are Auditory Steady-State Responses Useful to Evaluate Severe-to-Profound Hearing Loss in Children?

    Science.gov (United States)

    Grasel, Signe Schuster; de Almeida, Edigar Rezende; Beck, Roberto Miquelino de Oliveira; Goffi-Gomez, Maria Valéria Schmidt; Ramos, Henrique Faria; Rossi, Amanda Costa; Koji Tsuji, Robinson; Bento, Ricardo Ferreira; de Brito, Rubens

    2015-01-01

    To evaluate Auditory Steady-State Responses (ASSR) at high intensities in pediatric cochlear implant candidates and to compare the results to behavioral tests responses. This prospective study evaluated 42 children with suspected severe-to-profound hearing loss, aged from 3 to 72 months. All had absent ABR and OAE responses. ASSR were evoked using binaural single frequency stimuli at 110 dB HL with a 10 dB down-seeking procedure. ASSR and behavioral test results were compared. Forty-two subjects completed both ASSR and behavioral evaluation. Eleven children (26.2%) had bilateral responses. Four (9.5%) showed unilateral responses in at least two frequencies, all confirmed by behavioral results. Overall 61 ASSR responses were obtained, most (37.7%) in 500 Hz. Mean thresholds were between 101.3 and 104.2 dB HL. Among 27 subjects with absent ASSR, fifteen had no behavioral responses. Seven subjects showed behavioral responses with absent ASSR responses. No spurious ASSR responses were observed at 100 or 110 dB HL. ASSR is a valuable tool to detect residual hearing. No false-positive ASSR results were observed among 42 children, but in seven cases with absent ASSR, the test underestimated residual hearing as compared to the behavioral responses.

  15. Are Auditory Steady-State Responses Useful to Evaluate Severe-to-Profound Hearing Loss in Children?

    Directory of Open Access Journals (Sweden)

    Signe Schuster Grasel

    2015-01-01

    Full Text Available Objective. To evaluate Auditory Steady-State Responses (ASSR at high intensities in pediatric cochlear implant candidates and to compare the results to behavioral tests responses. Methods. This prospective study evaluated 42 children with suspected severe-to-profound hearing loss, aged from 3 to 72 months. All had absent ABR and OAE responses. ASSR were evoked using binaural single frequency stimuli at 110 dB HL with a 10 dB down-seeking procedure. ASSR and behavioral test results were compared. Results. Forty-two subjects completed both ASSR and behavioral evaluation. Eleven children (26.2% had bilateral responses. Four (9.5% showed unilateral responses in at least two frequencies, all confirmed by behavioral results. Overall 61 ASSR responses were obtained, most (37.7% in 500 Hz. Mean thresholds were between 101.3 and 104.2 dB HL. Among 27 subjects with absent ASSR, fifteen had no behavioral responses. Seven subjects showed behavioral responses with absent ASSR responses. No spurious ASSR responses were observed at 100 or 110 dB HL. Conclusion. ASSR is a valuable tool to detect residual hearing. No false-positive ASSR results were observed among 42 children, but in seven cases with absent ASSR, the test underestimated residual hearing as compared to the behavioral responses.

  16. Large impacted upper ureteral calculi: A comparative study between retrograde ureterolithotripsy and percutaneous antegrade ureterolithotripsy in the modified lateral position.

    Science.gov (United States)

    Moufid, Kamal; Abbaka, Najib; Touiti, Driss; Adermouch, Latifa; Amine, Mohamed; Lezrek, Mohammed

    2013-07-01

    The treatment for patients with large impacted proximal ureteral stone remains controversial, especially at institutions with limited resources. The aim of this study is to compare and to evaluate the outcome and complications of two main treatment procedures for impacted proximal ureteral calculi, retrograde ureterolithotripsy (URS), and percutaneous antegrade ureterolithotripsy (Perc-URS). Our inclusion criteria were solitary, radiopaque calculi, >15 mm in size in a functioning renal unit. Only those patients in whom the attempt at passing a guidewire or catheter beyond the calculus failed were included in this study. Between January 2007 and July 2011, a total of 52 patients (13 women and 39 men) with large impacted upper-ureteral calculi >15 mm and meeting the inclusion criteria were selected. Of these, Perc-URS was done in 22 patients (group 1) while retrograde ureteroscopy was performed in 30 patients (group 2). We analyzed operative time, incidence of complications during and after surgery, the number of postoperative recovery days, median total costs associated per patient per procedure, and the stone-free rate immediately after 5 days and after 1 month. Bivariate analysis used the Student t-test and the Mann-Whitney test to compare two means and Chi-square and Fisher's exact tests to compare two percentages. The significance level was set at 0.05. The mean age was 42.3 years (range 22-69). The mean stone sizes (mm) were 34 ± 1.2 and 29.3 ± 1.8 mm in group 1 and 2, respectively. In the Perc-URS group, 21 patients (95.45%) had complete calculus clearance through a single tract in one session of percutaneous surgery, whereas in the URS group, only 20 patients (66.7%) had complete stone clearance (P = 0.007). The mean operative time was higher in the Perc-URS group compared to group 2 (66.5 ± 21.7 vs. 52.13 ± 17.3 min, respectively; P = 0.013). Complications encountered in group 1 included transient postoperative fever (2 pts) and simple urine outflow (2

  17. Impact of palbociclib combinations on treatment of advanced estrogen receptor-positive/human epidermal growth factor 2-negative breast cancer

    Directory of Open Access Journals (Sweden)

    Boér K

    2016-10-01

    Full Text Available Katalin Boér Department of Medical Oncology, Szent Margit Hospital, Budapest, Hungary Abstract: Breast cancer is a heterogeneous disease with multiple subgroups based on clinical and molecular characteristics. For the largest subgroup of breast cancers, hormone receptor-positive/human epidermal growth factor 2 (HER2-negative tumors, hormone treatment is the mainstay of therapy and is likely to result in significant improvement in disease outcomes. However, some of these cancers demonstrate de novo or acquired resistance to endocrine therapy. Despite intensive research to develop new strategies to enhance the efficacy of currently available treatment options for hormone receptor-positive breast cancer, progress has been slow, and there were few advances for a period of 10 years. In 2012, a new molecularly targeted therapeutic strategy, inhibition of mammalian target of rapamycin with everolimus, was introduced into clinical practice. Everolimus, in combination with a steroidal aromatase inhibitor, exemestane, resulted in an increase in progression-free survival, but not overall survival in patients with estrogen receptor (ER+ve advanced disease who had progressed on hormone therapy. In 2015, the first cyclin-dependent kinases 4/6 (CDK4/6 inhibitor, palbociclib, received accelerated US Food and Drug Administration approval for use in combination with letrozole for the treatment of postmenopausal ER+ve/HER2-ve advanced breast cancer as initial, endocrine-based therapy. The addition of palbociclib to endocrine therapy resulted in longer progression-free survival than letrozole alone. One year later, palbociclib received a new indication, use in combination with fulvestrant, in both premenopausal and postmenopausal females with advanced breast cancer of the same subtype with disease progression following endocrine therapy. Adding palbociclib to fulvestrant resulted in a significantly increased median progression-free survival compared to fulvestrant

  18. Impact of helminth diagnostic test performance on estimation of risk factors and outcomes in HIV-positive adults.

    Directory of Open Access Journals (Sweden)

    Michael B Arndt

    Full Text Available BACKGROUND: Traditional methods using microscopy for the detection of helminth infections have limited sensitivity. Polymerase chain reaction (PCR assays enhance detection of helminths, particularly low burden infections. However, differences in test performance may modify the ability to detect associations between helminth infection, risk factors, and sequelae. We compared these associations using microscopy and PCR. METHODS: This cross-sectional study was nested within a randomized clinical trial conducted at 3 sites in Kenya. We performed microscopy and real-time multiplex PCR for the stool detection and quantification of Ascaris lumbricoides, Necator americanus, Ancylostoma duodenale, Strongyloides stercoralis, and Schistosoma species. We utilized regression to evaluate associations between potential risk factors or outcomes and infection as detected by either method. RESULTS: Of 153 HIV-positive adults surveyed, 55(36.0% and 20(13.1% were positive for one or more helminth species by PCR and microscopy, respectively (p<0.001. PCR-detected infections were associated with farming (Prevalence Ratio 1.57, 95% CI: 1.02, 2.40, communal water source (PR 3.80, 95% CI: 1.01, 14.27, and no primary education (PR 1.54, 95% CI: 1.14, 2.33, whereas microscopy-detected infections were not associated with any risk factors under investigation. Microscopy-detected infections were associated with significantly lower hematocrit and hemoglobin (means of -3.56% and -0.77 g/dl and a 48% higher risk of anemia (PR 1.48, 95% CI: 1.17, 1.88 compared to uninfected. Such associations were absent for PCR-detected infections unless infection intensity was considered, Infections diagnosed with either method were associated with increased risk of eosinophilia (PCR PR 2.42, 95% CI: 1.02, 5.76; microscopy PR 2.92, 95% CI: 1.29, 6.60. CONCLUSION: Newer diagnostic methods, including PCR, improve the detection of helminth infections. This heightened sensitivity may improve the

  19. Positive impact of bio-stimulators on growth and physiological activity of willow in climate change conditions

    Science.gov (United States)

    Piotrowski, Krzysztof; Romanowska-Duda, Zdzisława

    2018-04-01

    The aim of this research was to evaluate the physiological activity and growth of willow (Salix viminalis L.) plants cultivated under the conditions of adverse temperature and soil moisture content, and to assess the effect of the foliar application of Biojodis (1.0%) and Asahi SL (0.03%) bio-stimulators, or a mixture of Microcistis aeruginosa MKR 0105 and Anabaena PCC 7120 cyanobacteria under such changing growth conditions. The obtained results showed different reactions to the applied constant or periodically changed temperature and soil moisture content. The plants which grew at periodically changed adverse temperature (from -5 to 40oC) or in scantily (20% m.c.) or excessively (60% m.c.) watered soils, grew slowly, in comparison with those growing at 20oC and in optimally moistened soil (30% m.c.). Foliar application of Biojodis and Asahi SL cyanobacteria increased the growth of willow at optimal and adverse temperature or in scantily and excessively moistened soil. The changes in plant growth were associated with the changes in electrolyte leakage, activity of acid or alkaline phosphatases, RNase, index of chlorophyll content in leaves and gas exchange. The above indicates that the foliar application of the studied cyanobacteria and bio-stimulators partly alleviates the harmful impact of adverse temperature and water stress on growth and physiological activity of willow plants

  20. Maternal DHA Status during Pregnancy Has a Positive Impact on Infant Problem Solving: A Norwegian Prospective Observation Study.

    Science.gov (United States)

    Braarud, Hanne Cecilie; Markhus, Maria Wik; Skotheim, Siv; Stormark, Kjell Morten; Frøyland, Livar; Graff, Ingvild Eide; Kjellevold, Marian

    2018-04-24

    Docosahexaenoic acid (DHA, 22:6, n -3) is a long-chain polyunsaturated fatty acid necessary for normal brain growth and cognitive development. Seafood and dietary supplements are the primary dietary sources of DHA. This study addresses the associations between DHA status in pregnant women and healthy, term-born infant problem-solving skills assessed using the Ages and Stages Questionnaire. The fatty acid status of maternal red blood cells (RBCs) was assessed in the 28th week of gestation and at three months postpartum. The infants’ fatty acid status (RBC) was assessed at three, six, and twelve months, and problem-solving skills were assessed at six and twelve months. Maternal DHA status in pregnancy was found to be positively associated with infants’ problem-solving skills at 12 months. This association remained significant even after controlling for the level of maternal education, a surrogate for socio-economic status. The infants’ DHA status at three months was associated with the infants’ problem solving at 12 months. The results accentuate the importance for pregnant and lactating women to have a satisfactory DHA status from dietary intake of seafood or other sources rich in DHA.

  1. Maternal DHA Status during Pregnancy Has a Positive Impact on Infant Problem Solving: A Norwegian Prospective Observation Study

    Directory of Open Access Journals (Sweden)

    Hanne Cecilie Braarud

    2018-04-01

    Full Text Available Docosahexaenoic acid (DHA, 22:6, n-3 is a long-chain polyunsaturated fatty acid necessary for normal brain growth and cognitive development. Seafood and dietary supplements are the primary dietary sources of DHA. This study addresses the associations between DHA status in pregnant women and healthy, term-born infant problem-solving skills assessed using the Ages and Stages Questionnaire. The fatty acid status of maternal red blood cells (RBCs was assessed in the 28th week of gestation and at three months postpartum. The infants’ fatty acid status (RBC was assessed at three, six, and twelve months, and problem-solving skills were assessed at six and twelve months. Maternal DHA status in pregnancy was found to be positively associated with infants’ problem-solving skills at 12 months. This association remained significant even after controlling for the level of maternal education, a surrogate for socio-economic status. The infants’ DHA status at three months was associated with the infants’ problem solving at 12 months. The results accentuate the importance for pregnant and lactating women to have a satisfactory DHA status from dietary intake of seafood or other sources rich in DHA.

  2. Positional cloning of the PIS mutation in goats and its impact on understanding mammalian sex-differentiation

    Directory of Open Access Journals (Sweden)

    Pailhoux Eric

    2005-12-01

    Full Text Available Abstract In goats, the PIS (polled intersex syndrome mutation is responsible for both the absence of horns in males and females and sex-reversal affecting exclusively XX individuals. The mode of inheritance is dominant for the polled trait and recessive for sex-reversal. In XX PIS-/- mutants, the expression of testis-specific genes is observed very precociously during gonad development. Nevertheless, a delay of 4–5 days is observed in comparison with normal testis differentiation in XY males. By positional cloning, we demonstrate that the PIS mutation is an 11.7-kb regulatory-deletion affecting the expression of two genes, PISRT1 and FOXL2 which could act synergistically to promote ovarian differentiation. The transcriptional extinction of these two genes leads, very early, to testis-formation in XX homozygous PIS-/- mutants. According to their expression profiles and bibliographic data, we propose that FOXL2 may be an ovary-differentiating gene, and the non-coding RNA PISRT1, an anti-testis factor repressing SOX9, a key regulator of testis differentiation. Under this hypothesis, SRY, the testis-determining factor would inhibit these two genes in the gonads of XY males, to ensure testis differentiation.

  3. A new positive pressure ventilation delivery system: its impact on lung ventilation studies that are technically inadequate or non diagnostic

    International Nuclear Information System (INIS)

    Bui, C.; Leiper, C.; Lee, K.; Saunders, C.; Dixson, H.; Elison, B.; Bennett, G.; Gibian, T.; Rutland, J.; Tse, V.; Elzein, H.; Babicheva, R.

    2000-01-01

    Full text: The objective of this study was to evaluate the efficacy and safety of an improved Positive Pressure Ventilation Delivery System (PVDS) in the investigation of Pulmonary Embolism (PE). The major component of PVDS is a commercially available, self-inflating 1.6L Hudson Resuscitator Bag, filled with either oxygen or air (if the patient has CO 2 retention), which is squeezed by the operator to push Technegas from the Technegas Generator Chamber to the patient via the Patient Administration Set synchronously with patient inspiration. 27 spontaneously breathing in-patients (12 males, 15 females, age range 64-89, 21 with chronic airflow limitation), whose conventional lung ventilation images were technically inadequate or non diagnostic, were re-scanned using PVDS within four days after the conventional ventilation study. Randomised blinded visual interpretation of conventional ventilation/perfusion scan vs. PVDS-assisted ventilation/perfusion scan was performed by consensus reading with two experienced observers. In conclusion PVDS was safe and well tolerated. PVDS improved the image quality of the lung ventilation scans in this cohort of patients. This technique has the potential to improve the accuracy of lung scanning in patients with severe lung disease. Copyright (2000) The Australian and New Zealand Society of Nuclear Medicine Inc

  4. Use of Anthropogenic Sea Floor Structures by Australian Fur Seals: Potential Positive Ecological Impacts of Marine Industrial Development?

    Science.gov (United States)

    Arnould, John P Y; Monk, Jacquomo; Ierodiaconou, Daniel; Hindell, Mark A; Semmens, Jayson; Hoskins, Andrew J; Costa, Daniel P; Abernathy, Kyler; Marshall, Greg J

    2015-01-01

    Human-induced changes to habitats can have deleterious effects on many species that occupy them. However, some species can adapt and even benefit from such modifications. Artificial reefs have long been used to provide habitat for invertebrate communities and promote local fish populations. With the increasing demand for energy resources within ocean systems, there has been an expansion of infrastructure in near-shore benthic environments which function as de facto artificial reefs. Little is known of their use by marine mammals. In this study, the influence of anthropogenic sea floor structures (pipelines, cable routes, wells and shipwrecks) on the foraging locations of 36 adult female Australian fur seals (Arctocephalus pusillus doriferus) was investigated. For 9 (25%) of the individuals, distance to anthropogenic sea floor structures was the most important factor in determining the location of intensive foraging activity. Whereas the influence of anthropogenic sea floor structures on foraging locations was not related to age and mass, it was positively related to flipper length/standard length (a factor which can affect manoeuvrability). A total of 26 (72%) individuals tracked with GPS were recorded spending time in the vicinity of structures (from 75% of the foraging trip duration) with pipelines and cable routes being the most frequented. No relationships were found between the amount of time spent frequenting anthropogenic structures and individual characteristics. More than a third (35%) of animals foraging near anthropogenic sea floor structures visited more than one type of structure. These results further highlight potentially beneficial ecological outcomes of marine industrial development.

  5. Coaching to vision versus coaching to improvement needs: a preliminary investigation on the differential impacts of fostering positive and negative emotion during real time executive coaching sessions.

    Science.gov (United States)

    Howard, Anita R

    2015-01-01

    Drawing on intentional change theory (ICT; Boyatzis, 2006), this study examined the differential impact of inducing coaching recipients' vision/positive emotion versus improvement needs/negative emotion during real time executive coaching sessions. A core aim of the study was to empirically test two central ICT propositions on the effects of using the coached person's Positive Emotional Attractor (vision/PEA) versus Negative Emotional Attractor (improvement needs/NEA) as the anchoring framework of a onetime, one-on-one coaching session on appraisal of 360° feedback and discussion of possible change goals. Eighteen coaching recipients were randomly assigned to two coaching conditions, the coaching to vision/PEA condition and the coaching to improvement needs/NEA condition. Two main hypotheses were tested. Hypothesis1 predicted that participants in the vision/PEA condition would show higher levels of expressed positive emotion during appraisal of 360° feedback results and discussion of change goals than recipients in the improvement needs/NEA condition. Hypothesis2 predicted that vision/PEA participants would show lower levels of stress immediately after the coaching session than improvement needs/NEA participants. Findings showed that coaching to vision/the PEA fostered significantly lower levels of expressed negative emotion and anger during appraisal of 360° feedback results as compared to coaching to improvements needs/the NEA. Vision-focused coaching also fostered significantly greater exploration of personal passions and future desires, and more positive engagement during 360° feedback appraisal. No significant differences between the two conditions were found in emotional processing during discussion of change goals or levels of stress immediately after the coaching session. Current findings suggest that vision/PEA arousal versus improvement needs/NEA arousal impact the coaching process in quite different ways; that the coach's initial framing of the

  6. Developing a questionnaire on physical activity support of people with (profound) intellectual (and multiple) disabilities : Experiences from the Netherlands

    NARCIS (Netherlands)

    Bossink, Leontien; van der Putten, Annette; Vlaskamp, Carla

    2017-01-01

    Introduction: People with intellectual disabilities (ID) undertake extremely low levels of physical activity, which is even more true in people with profound intellectual and multiple disabilities (PIMD). Physical activity approaches, particularly for people with PIMD, are more likely to be

  7. Early reversal of profound rocuronium-induced neuromuscular blockade by sugammadex in a randomized multicenter study - Efficacy, safety, and pharmacokinetics

    NARCIS (Netherlands)

    Sparr, Harald J.; Vermeyen, Karel M.; Beaufort, Anton M.; Rietbergen, Henk; Proost, Johannes H.; Saldien, Vera; Velik-Salchner, Corinna; Wierda, J. Mark K. H.

    Background: Sugammadex reverses the neuromuscular blocking effects of rocuronium by chemical encapsulation. The efficacy, safety, and pharmacokinetics of sugammadex for reversal of profound rocuronium-induced neuromuscular blockade were evaluated. Methods: Ninety-eight male adult patients were

  8. Examining relationships between staff attributions of soundscapes and core affect in people with severe or profound intellectual and visual disabilities

    NARCIS (Netherlands)

    van den Bosch, Kirsten A.; Vlaskamp, Carla; Andringa, Tjeerd C.; Post, Wendy J.; Ruijssenaars, Wied A.J.J.M.

    Background: People with profound intellectual disabilities experience a high prevalence of visual disabilities, making them more dependent on sound. However, research addressing the influence of the auditory environment is scarce. Method: Observations of the auditory environments (soundscapes) and

  9. An atypical case of successful resuscitation of an accidental profound hypothermia patient, occurring in a temperate climate.

    LENUS (Irish Health Repository)

    Coleman, E

    2010-03-01

    Cases of accidental profound hypothermia occur most frequently in cold, northern climates. We describe an atypical case, occurring in a temperate climate, where a hypothermic cardiac-arrested patient was successfully resuscitated using extracorporeal circulation (ECC).

  10. Impact of ART on TB case fatality stratified by CD4 count for HIV-positive TB patients in Cape Town, South Africa (2009-2011).

    Science.gov (United States)

    Kaplan, Richard; Caldwell, Judy; Middelkoop, Keren; Bekker, Linda-Gail; Wood, Robin

    2014-08-15

    To identify determinants of tuberculosis (TB) case fatality including the impact of antiretroviral therapy (ART) at different CD4 thresholds for HIV-positive adult and adolescent TB patients. Through a retrospective analysis of the electronic TB database, we identified the HIV status of newly registered patients aged ≥15 years. Multivariable Cox proportional hazard models were used to determine the risk factors for TB case fatality in these patients. In 2009, 2010, and 2011, 25,841, 26,104, and 25,554 newly registered adult TB patients were treated in primary health care clinics in Cape Town, of whom 49.7%, 50.4%, and 50.9% were HIV positive. ART uptake increased over 3 years from 43% to 64.9%, and case fatality of the HIV-positive patients decreased from 7.0% to 5.8% (P ART had a substantial decrease in case fatality. The difference in case fatality between patients on ART and not on ART was most pronounced at low CD4 counts with the positive influence of ART noted up to a CD4 count threshold of 350 cells per cubic millimeter (P ART uptake, in 2011, 21% of the patients with CD4 counts ART during TB treatment. This study showed a relatively poor uptake of ART among severely immune-compromised TB patients. Patients with CD4 counts ART during TB treatment, and ART initiation should be prioritized for this category of patients.

  11. Pairing images of unhealthy and healthy foods with images of negative and positive health consequences: Impact on attitudes and food choice.

    Science.gov (United States)

    Hollands, Gareth J; Marteau, Theresa M

    2016-08-01

    To examine the impact of presenting images of foods paired with images of positive and negative health consequences of their consumption on food choice and attitudes. Participants (N = 711) were randomly allocated in a 2 × 3 factorial design (Food Type × Affective Valence) to 1 of 6 conditioning procedures that paired images of either energy-dense snack foods or fruit, with (a) images of negative health outcomes, (b) images of positive health outcomes, or (c) a no image control. The primary outcome was food choice assessed postintervention with a behavioral choice task. Secondary outcomes were implicit attitudes (assessed pre- and postintervention) and explicit attitudes (assessed postintervention). Presenting images of negative health outcomes led to more healthy food choices relative to control and positive image conditions, irrespective of whether they were paired with images of energy-dense snack foods or fruit. This relationship was partially mediated by changes in implicit and explicit attitudes. Images of positive health outcomes did not alter food choices. This study replicates and extends previous research showing that presenting images of negative health consequences increases healthy food choices. Because effects were elicited by manipulating affective valence irrespective of paired food type, these results appear more consistent with an explanation based on priming than on evaluative conditioning. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  12. Psychological resilience: the impact of affectivity and coping on state anxiety and positive emotions during and after the Washington, DC sniper killings.

    Science.gov (United States)

    Moore, Philip J; Chrabaszcz, Jeffrey S; Peterson, Rolf A; Rohrbeck, Cynthia A; Roemer, Enid C; Mercurio, Andrea E

    2014-01-01

    This research examined the impact of affectivity and coping on state anxiety and positive emotions among young adults living in the Washington, DC metro area both during and after the Washington, DC sniper killings. Participants completed questionnaires during three waves of data collection: (1) during the sniper attacks (n=92); (2) within two weeks after the snipers were captured (n=45); and (3) six months later (n=43). Affectivity (measured by neuroticism) was significantly associated with state anxiety and positive emotions during all three time periods. Coping (measured by constructive thinking) predicted state anxiety and positive emotions during the shootings, but was unrelated to either outcome immediately after the attacks, and marginally related to them six months later. Consistent with the Dynamic Model of Affect, state anxiety and positive emotions were more strongly (and negatively) correlated with each other during the killings than they were after the snipers were apprehended. Taken together, these results support transactional models of stress that emphasize the interaction between dispositional and situational influences, and they suggest that affectivity reflects a fundamental set of reactions to one's environment, while coping dispositions result in more stress-specific responses. Additional theoretical and practical implications of these findings are also discussed.

  13. Nitrogen Availability Dampens the Positive Impacts of CO2 Fertilization on Terrestrial Ecosystem Carbon and Water Cycles

    Science.gov (United States)

    He, Liming; Chen, Jing M.; Croft, Holly; Gonsamo, Alemu; Luo, Xiangzhong; Liu, Jane; Zheng, Ting; Liu, Ronggao; Liu, Yang

    2017-11-01

    The magnitude and variability of the terrestrial CO2 sink remain uncertain, partly due to limited global information on ecosystem nitrogen (N) and its cycle. Without N constraint in ecosystem models, the simulated benefits from CO2 fertilization and CO2-induced increases in water use efficiency (WUE) may be overestimated. In this study, satellite observations of a relative measure of chlorophyll content are used as a proxy for leaf photosynthetic N content globally for 2003-2011. Global gross primary productivity (GPP) and evapotranspiration are estimated under elevated CO2 and N-constrained model scenarios. Results suggest that the rate of global GPP increase is overestimated by 85% during 2000-2015 without N limitation. This limitation is found to occur in many tropical and boreal forests, where a negative leaf N trend indicates a reduction in photosynthetic capacity, thereby suppressing the positive vegetation response to enhanced CO2 fertilization. Based on our carbon-water coupled simulations, enhanced CO2 concentration decreased stomatal conductance and hence increased WUE by 10% globally over the 1982 to 2015 time frame. Due to increased anthropogenic N application, GPP in croplands continues to grow and offset the weak negative trend in forests due to N limitation. Our results also show that the improved WUE is unlikely to ease regional droughts in croplands because of increases in evapotranspiration, which are associated with the enhanced GPP. Although the N limitation on GPP increase is large, its associated confidence interval is still wide, suggesting an urgent need for better understanding and quantification of N limitation from satellite observations.

  14. Flow cytometric evaluation of physico-chemical impact on Gram-positive and Gram-negative bacteria

    Science.gov (United States)

    Fröhling, Antje; Schlüter, Oliver

    2015-01-01

    Since heat sensitivity of fruits and vegetables limits the application of thermal inactivation processes, new emerging inactivation technologies have to be established to fulfill the requirements of food safety without affecting the produce quality. The efficiency of inactivation treatments has to be ensured and monitored. Monitoring of inactivation effects is commonly performed using traditional cultivation methods which have the disadvantage of the time span needed to obtain results. The aim of this study was to compare the inactivation effects of peracetic acid (PAA), ozonated water (O3), and cold atmospheric pressure plasma (CAPP) on Gram-positive and Gram-negative bacteria using flow cytometric methods. E. coli cells were completely depolarized after treatment (15 s) with 0.25% PAA at 10°C, and after treatment (10 s) with 3.8 mg l−1 O3 at 12°C. The membrane potential of CAPP treated cells remained almost constant at an operating power of 20 W over a time period of 3 min, and subsequently decreased within 30 s of further treatment. Complete membrane permeabilization was observed after 10 s O3 treatment, but treatment with PAA and CAPP did not completely permeabilize the cells within 2 and 4 min, respectively. Similar results were obtained for esterase activity. O3 inactivates cellular esterase but esterase activity was detected after 4 min CAPP treatment and 2 min PAA treatment. L. innocua cells and P. carotovorum cells were also permeabilized instantaneously by O3 treatment at concentrations of 3.8 ± 1 mg l−1. However, higher membrane permeabilization of L. innocua and P. carotovorum than of E. coli was observed at CAPP treatment of 20 W. The degree of bacterial damage due to the inactivation processes is highly dependent on treatment parameters as well as on treated bacteria. Important information regarding the inactivation mechanisms can be obtained by flow cytometric measurements and this enables the definition of critical process parameters. PMID

  15. Flow cytometric evaluation of physico-chemical impact on Gram-positive and Gram-negative bacteria

    Directory of Open Access Journals (Sweden)

    Antje eFröhling

    2015-09-01

    Full Text Available Since heat sensitivity of fruits and vegetables limits the application of thermal inactivation processes, new emerging inactivation technologies have to be established to fulfil the requirements of food safety without affecting the produce quality. The efficiency of inactivation treatments has to be ensured and monitored. Monitoring of inactivation effects is commonly performed using traditional cultivation methods which have the disadvantage of the time span needed to obtain results.The aim of this study was to compare the inactivation effects of peracetic acid (PAA, ozonated water (O3 and cold atmospheric pressure plasma (CAPP on Gram-positive and Gram-negative bacteria using flow cytometric methods. E. coli cells were completely depolarized after treatment (15 s with 0.25 % PAA at 10 °C, and after treatment (10 s with 3.8 mg l-1 O3 at 12°C. The membrane potential of CAPP treated cells remained almost constant at an operating power of 20 W over a time period of 3 min, and subsequently decreased within 30 s of further treatment. Complete membrane permeabilization was observed after 10 s O3 treatment, but treatment with PAA and CAPP did not completely permeabilize the cells within 2 min and 4 min, respectively. Similar results were obtained for esterase activity. O3 inactivates cellular esterase but esterase activity was detected after 4 min CAPP treatment and 2 min PAA treatment. L. innocua cells and P. carotovorum cells were also permeabilized instantaneously by O3 treatment at concentrations of 3.8 ± 1 mg l-1. However, higher membrane permeabilization of L. innocua and P. carotovorum than of E. coli was observed at CAPP treatment of 20 W. The degree of bacterial damage due to the inactivation processes is highly dependent on treatment parameters as well as on treated bacteria. Important information regarding the inactivation mechanisms can be obtained by flow cytometric measurements and this enables the definition of critical process

  16. Use of Anthropogenic Sea Floor Structures by Australian Fur Seals: Potential Positive Ecological Impacts of Marine Industrial Development?

    Directory of Open Access Journals (Sweden)

    John P Y Arnould

    Full Text Available Human-induced changes to habitats can have deleterious effects on many species that occupy them. However, some species can adapt and even benefit from such modifications. Artificial reefs have long been used to provide habitat for invertebrate communities and promote local fish populations. With the increasing demand for energy resources within ocean systems, there has been an expansion of infrastructure in near-shore benthic environments which function as de facto artificial reefs. Little is known of their use by marine mammals. In this study, the influence of anthropogenic sea floor structures (pipelines, cable routes, wells and shipwrecks on the foraging locations of 36 adult female Australian fur seals (Arctocephalus pusillus doriferus was investigated. For 9 (25% of the individuals, distance to anthropogenic sea floor structures was the most important factor in determining the location of intensive foraging activity. Whereas the influence of anthropogenic sea floor structures on foraging locations was not related to age and mass, it was positively related to flipper length/standard length (a factor which can affect manoeuvrability. A total of 26 (72% individuals tracked with GPS were recorded spending time in the vicinity of structures (from 75% of the foraging trip duration with pipelines and cable routes being the most frequented. No relationships were found between the amount of time spent frequenting anthropogenic structures and individual characteristics. More than a third (35% of animals foraging near anthropogenic sea floor structures visited more than one type of structure. These results further highlight potentially beneficial ecological outcomes of marine industrial development.

  17. The impact of arm position and pulse pressure on the validation of a wrist-cuff blood pressure measurement device in a high risk population

    Directory of Open Access Journals (Sweden)

    Ali Reza Khoshdel

    2010-03-01

    Full Text Available Ali Reza Khoshdel1,2, Shane Carney2, Alastair Gillies21Faculty of Medicine, Aja University of Medical Science, Tehran, Iran; 2John Hunter Hospital, Faculty of Health, The University of Newcastle, Newcastle, NS W, AustraliaAbstract: Despite the increasing popularity of blood pressure (BP wrist monitors for self-BP measurement at home, device validation and the effect of arm position remains an issue. This study focused on the validation of the Omron HEM-609 wrist BP device, including an evaluation of the impact of arm position and pulse pressure on BP measurement validation. Fifty patients at high risk for cardiovascular disease were selected (age 65 ± 10 years. Each patient had two measurements with a mercury sphygmomanometer and three measurements with the wrist BP device (wrist at the heart level while the horizontal arm supported [HORIZONTAL], hand supported on the opposite shoulder [SHOULDER], and elbow placed on a desk [DESK], in random order. The achieved systolic BP (SBP and diastolic BP (DBP wrist-cuff readings were compared to the mercury device and the frequencies of the readings within 5, 10, and 15 mmHg of the gold standard were computed and compared with the British Hypertension Society (BHS and Association for the Advancement of Medical Instrumentation (AAMI protocols. The results showed while SBP readings with HORIZONTAL and SHOULDER positions were significantly different from the mercury device (mean difference = 7.1 and 13.3 mmHg, respectively; P < 0.05, the DESK position created the closest reading to mercury (mean difference = 3.8, P > 0.1. Approximately 71% of SBP readings with the DESK position were within ±10 mmHg, whereas it was 62.5% and 34% for HORIZONTAL and SHOULDER positions, respectively. Wrist DBP attained category D with BHS criteria with all three arm positions. Bland–Altman plots illustrated that the wrist monitor systematically underestimated SBP and DBP values. However a reading adjustment of 5 and 10 mm

  18. Positive impacts on rural and regional workforce from the first seven cohorts of James Cook University medical graduates.

    Science.gov (United States)

    Sen Gupta, T; Woolley, T; Murray, R; Hays, R; McCloskey, T

    2014-01-01

    location, as compared to 'intent to practice'. The geographic profile by RA of JCU graduates' hometown and patterns of postgraduate practice is different to that of other Australian medical students and doctors. This early evidence supports the JCU model of distributed non-metropolitan medical education, and suggests more regionally-located internship and specialty training places would further increase the medical workforce in northern and/or rural Australia. The workforce impact of the seven cohorts of graduates in this study is starting to be felt in rural and regional Australia, and, if these trends continue, will result in significant workforce improvements over the next decade. These results support further investment in regional and rural medical education.

  19. The positive impact of interprofessional education: a controlled trial to evaluate a programme for health professional students.

    Science.gov (United States)

    Darlow, Ben; Coleman, Karen; McKinlay, Eileen; Donovan, Sarah; Beckingsale, Louise; Gray, Ben; Neser, Hazel; Perry, Meredith; Stanley, James; Pullon, Sue

    2015-06-04

    -reported ability to function within an interprofessional team, and self-reported confidence, knowledge, and ability to manage people with long-term conditions. These findings indicate that a brief intervention such as this can have immediate positive effects and contribute to the development of health professionals who are ready to collaborate with others to improve patient outcomes.

  20. Profound hypoglycemia-ınduced by vaccinium corymbosum juice and laurocerasus fruit.

    Science.gov (United States)

    Aktan, Ahmet Hamdi; Ozcelik, Abdullah; Cure, Erkan; Cure, Medine Cumhur; Yuce, Suleyman

    2014-01-01

    An emergency intervention was performed in a 75-year-old male patient with hypoglycemic attack and blackout. Although he was diagnosed with prediabetes before 2 years, he did not take any anti-diabetic drug or follow dietary advice. He drank Vaccinium corymbosum L (VC) juice daily with a belief that it increases sexual potency. Before the development of hypoglycemia, the patient had consumed about 500 ml VC juice in addition to eating 200-300 gram of Laurocerasus officinalis (LO) fruit. The measured plasma glucose (PG) level during loss of consciousness was 30 mg/dl. The profound hypoglycemia may be an unexpected side effect of an interaction between the chemical compositions of the two plants, occurred as a result of LO fruit intake that may have a strong PG-lowering effect or related to excessive intake of VC juice. Both plants may be considered in the alternative treatment of diabetes.

  1. Hypothalamic obesity in patients with craniopharyngioma: Profound changes of several weight regulatory circuits

    Directory of Open Access Journals (Sweden)

    Christian eRoth

    2011-10-01

    Full Text Available One of the most striking examples of dysfunctional hypothalamic signaling of energy homeostasis is observed in patients with hypothalamic lesions leading to hypothalamic obesity (HO. This drastic condition is frequently seen in patients with craniopharyngioma (CP, an embryological tumor located in the hypothalamic and/or pituitary region, frequently causing not only hypopituitarism, but also leading to damage of medial hypothalamic nuclei due to the tumor and its treatment. HO syndrome in CP patients is characterized by fatigue, decreased physical activity, uncontrolled appetite, and morbid obesity, and is associated with insulin and leptin resistance. Mechanisms leading to the profoundly disturbed energy homeostasis are complex. This review summarizes different aspects of important clinical studies as well as data obtained in rodent studies. In addition a model is provided describing how medial hypothalamic lesion can interact simultaneously with several weight regulating circuitries.

  2. Profound Endothelial Damage Predicts Impending Organ Failure and Death in Sepsis

    DEFF Research Database (Denmark)

    Johansen, Maria E; Johansson, Pär I.; Ostrowski, Sisse R

    2015-01-01

    levels at enrollment predicted risk of multiple organ failure during follow-up (HR [> 14 ng/mL vs. organ failure and death in septic......Endothelial damage contributes to organ failure and mortality in sepsis, but the extent of the contribution remains poorly quantified. Here, we examine the association between biomarkers of superficial and profound endothelial damage (syndecan-1 and soluble thrombomodulin [sTM], respectively......), organ failure, and death in sepsis. The data from a clinical trial, including critically ill patients predominantly suffering sepsis (Clinicaltrials.gov: NCT00271752) were studied. Syndecan-1 and sTM levels at the time of study enrollment were determined. The predictive ability of biomarker levels...

  3. Accentuate the positive: nursing's challenge for 2017.

    Science.gov (United States)

    Scott, Graham

    2016-12-14

    Few of us will forget the momentous events of 2016 - a remarkable year on so many fronts. Brexit, a new prime minister and the election of Donald Trump as US president stand out as defining events, but there have also been less dramatic developments that will have a profound impact on the future of nursing.

  4. Outcomes of laryngohyoid suspension techniques in an ovine model of profound oropharyngeal dysphagia.

    Science.gov (United States)

    Johnson, Christopher M; Venkatesan, Naren N; Siddiqui, M Tausif; Cates, Daniel J; Kuhn, Maggie A; Postma, Gregory M; Belafsky, Peter C

    2017-12-01

    To evaluate the efficacy of various techniques of laryngohyoid suspension in the elimination of aspiration utilizing a cadaveric ovine model of profound oropharyngeal dysphagia. Animal study. The head and neck of a Dorper cross ewe was placed in the lateral fluoroscopic view. Five conditions were tested: baseline, thyroid cartilage to hyoid approximation (THA), thyroid cartilage to hyoid to mandible (laryngohyoid) suspension (LHS), LHS with cricopharyngeus muscle myotomy (LHS-CPM), and cricopharyngeus muscle myotomy (CPM) alone. Five 20-mL trials of barium sulfate were delivered into the oropharynx under fluoroscopy for each condition. Outcome measures included the penetration aspiration scale (PAS) and the National Institutes of Health (NIH) Swallow Safety Scale (NIH-SSS). Median baseline PAS and NIH-SSS scores were 8 and 6, respectively, indicating severe impairment. THA scores were not improved from baseline. LHS alone reduced the PAS to 1 (P = .025) and NIH-SSS to 2 (P = .025) from baseline. LHS-CPM reduced the PAS to 1 (P = .025) and NIH-SSS to 0 (P = .025) from baseline. CPM alone did not improve scores. LHS-CPM displayed improved NIH-SSS over LHS alone (P = .003). This cadaveric model represents end-stage profound oropharyngeal dysphagia such as what could result from severe neurological insult. CPM alone failed to improve fluoroscopic outcomes in this model. Thyrohyoid approximation also failed to improve outcomes. LHS significantly improved both PAS and NIH-SSS. The addition of CPM to LHS resulted in improvement over suspension alone. NA. Laryngoscope, 127:E422-E427, 2017. © 2017 The American Laryngological, Rhinological and Otological Society, Inc.

  5. SU-E-P-21: Impact of MLC Position Errors On Simultaneous Integrated Boost Intensity-Modulated Radiotherapy for Nasopharyngeal Carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Chengqiang, L; Yin, Y; Chen, L [Shandong Cancer Hospital and Institute, 440 Jiyan Road, Jinan, 250117 (China)

    2015-06-15

    Purpose: To investigate the impact of MLC position errors on simultaneous integrated boost intensity-modulated radiotherapy (SIB-IMRT) for patients with nasopharyngeal carcinoma. Methods: To compare the dosimetric differences between the simulated plans and the clinical plans, ten patients with locally advanced NPC treated with SIB-IMRT were enrolled in this study. All plans were calculated with an inverse planning system (Pinnacle3, Philips Medical System{sub )}. Random errors −2mm to 2mm{sub )},shift errors{sub (} 2mm,1mm and 0.5mm) and systematic extension/ contraction errors (±2mm, ±1mm and ±0.5mm) of the MLC leaf position were introduced respectively into the original plans to create the simulated plans. Dosimetry factors were compared between the original and the simulated plans. Results: The dosimetric impact of the random and system shift errors of MLC position was insignificant within 2mm, the maximum changes in D95% of PGTV,PTV1,PTV2 were-0.92±0.51%,1.00±0.24% and 0.62±0.17%, the maximum changes in the D0.1cc of spinal cord and brainstem were 1.90±2.80% and −1.78±1.42%, the maximum changes in the Dmean of parotids were1.36±1.23% and −2.25±2.04%.However,the impact of MLC extension or contraction errors was found significant. For 2mm leaf extension errors, the average changes in D95% of PGTV,PTV1,PTV2 were 4.31±0.67%,4.29±0.65% and 4.79±0.82%, the averaged value of the D0.1cc to spinal cord and brainstem were increased by 7.39±5.25% and 6.32±2.28%,the averaged value of the mean dose to left and right parotid were increased by 12.75±2.02%,13.39±2.17% respectively. Conclusion: The dosimetric effect was insignificant for random MLC leaf position errors up to 2mm. There was a high sensitivity to dose distribution for MLC extension or contraction errors.We should pay attention to the anatomic changes in target organs and anatomical structures during the course,individual radiotherapy was recommended to ensure adaptive doses.

  6. Absence of bone sialoprotein (BSP) alters profoundly hematopoiesis and upregulates osteopontin.

    Science.gov (United States)

    Granito, Renata Neves; Bouleftour, Wafa; Sabido, Odile; Lescale, Chloé; Thomas, Mireille; Aubin, Jane E; Goodhardt, Michèle; Vico, Laurence; Malaval, Luc

    2015-06-01

    Matrix proteins of the SIBLING family interact with bone cells, extracellular matrix and mineral and are thus in a key position to regulate the microenvironment of the bone tissue, including its hematopoietic component. In this respect, osteopontin (OPN) has been implicated in the hematopoietic stem cell (HSC) niche as negative regulator of the HSC function. We investigated the impact on hematopoietic regulation of the absence of the cognate bone sialoprotein (BSP). BSP knockout (-/-) mice display increased bone marrow cellularity, and an altered commitment of hematopoietic precursors to myeloid lineages, leading in particular to an increased frequency of monocyte/macrophage cells. The B cell pool is increased in -/- bone marrow, and its composition is shifted toward more mature lymphocyte stages. BSP-null mice display a decreased HSC fraction among LSK cells and a higher percentage of more committed progenitors as compared to +/+. The fraction of proliferating LSK progenitors is higher in -/- mice, and after PTH treatment the mutant HSC pool is lower than in +/+. Strikingly, circulating levels of OPN as well as its expression in the bone tissue are much higher in the -/-. Thus, a BSP-null bone microenvironment affects the hematopoietic system both quantitatively and qualitatively, in a manner in part opposite to the OPN knockout, suggesting that the effects might in part reflect the higher OPN expression in the absence of BSP. © 2014 Wiley Periodicals, Inc.

  7. What Factors Are Associated with Positive Effects of Dog Ownership in Families with Children with Autism Spectrum Disorder? The Development of the Lincoln Autism Pet Dog Impact Scale.

    Directory of Open Access Journals (Sweden)

    Sophie Susannah Hall

    Full Text Available Scientific literature exploring the value of assistance dogs to children with autism spectrum disorder (ASD is rapidly emerging. However, there is comparably less literature reporting the effects of pet (as opposed to assistance dogs to these children. In particular, there are no known validated scales which assess how children may alter their behaviours in the presence of the dog, to evaluate the efficacy of pet dogs to these families. Additionally, given the highly individualised nature of ASD it is likely that some children and families gain more benefits from dog ownership than others, yet no research has reported the effect of individual differences. This pilot study reports the development of a 28-item scale based on the perceived impact of a pet dog on a child with autism by parents (Lincoln Autism Pet Dog Impact Scale--LAPDIS. The scale is comprised of three mathematically derived factors: Adaptability, Social Skills and Conflict Management. We assessed how individual differences (aspects may be associated with scores on these three factors. Family Aspects and Dog Aspects were not significantly associated with ratings on the three factors, but Child Aspects (including: contact with horses, child age, disability level and language abilities were related to impact of the dog on all factors. Training Aspects were related to scores on Social Skills (formal training with children with ASD and dogs and attendance at PAWS workshops run by Dogs for Good. These results suggest that individual differences associated with the child and the training approach may be important considerations for a positive impact from dog ownership on families with children with ASD. Differences in family features and the dog may not be so important, but may be worthy of further investigations given the early stage of development in this field.

  8. What Factors Are Associated with Positive Effects of Dog Ownership in Families with Children with Autism Spectrum Disorder? The Development of the Lincoln Autism Pet Dog Impact Scale.

    Science.gov (United States)

    Hall, Sophie Susannah; Wright, Hannah F; Mills, Daniel Simon

    2016-01-01

    Scientific literature exploring the value of assistance dogs to children with autism spectrum disorder (ASD) is rapidly emerging. However, there is comparably less literature reporting the effects of pet (as opposed to assistance) dogs to these children. In particular, there are no known validated scales which assess how children may alter their behaviours in the presence of the dog, to evaluate the efficacy of pet dogs to these families. Additionally, given the highly individualised nature of ASD it is likely that some children and families gain more benefits from dog ownership than others, yet no research has reported the effect of individual differences. This pilot study reports the development of a 28-item scale based on the perceived impact of a pet dog on a child with autism by parents (Lincoln Autism Pet Dog Impact Scale--LAPDIS). The scale is comprised of three mathematically derived factors: Adaptability, Social Skills and Conflict Management. We assessed how individual differences (aspects) may be associated with scores on these three factors. Family Aspects and Dog Aspects were not significantly associated with ratings on the three factors, but Child Aspects (including: contact with horses, child age, disability level and language abilities) were related to impact of the dog on all factors. Training Aspects were related to scores on Social Skills (formal training with children with ASD and dogs and attendance at PAWS workshops run by Dogs for Good). These results suggest that individual differences associated with the child and the training approach may be important considerations for a positive impact from dog ownership on families with children with ASD. Differences in family features and the dog may not be so important, but may be worthy of further investigations given the early stage of development in this field.

  9. Non-nematode-derived double-stranded RNAs induce profound phenotypic changes in Meloidogyne incognita and Globodera pallida infective juveniles.

    Science.gov (United States)

    Dalzell, Johnathan J; McMaster, Steven; Johnston, Michael J; Kerr, Rachel; Fleming, Colin C; Maule, Aaron G

    2009-11-01

    Nine non-nematode-derived double-stranded RNAs (dsRNAs), designed for use as controls in RNA interference (RNAi) screens of neuropeptide targets, were found to induce aberrant phenotypes and an unexpected inhibitory effect on motility of root knot nematode Meloidogyne incognita J2s following 24h soaks in 0.1 mg/ml dsRNA; a simple soaking procedure which we have found to elicit profound knockdown of neuronal targets in Globodera pallida J2s. We have established that this inhibitory phenomenon is both time- and concentration-dependent, as shorter 4h soaks in 0.1 mg/ml dsRNA had no negative impact on M. incognita J2 stage worms, yet a 10-fold increase in concentration to 1 mg/ml for the same 4h time period had an even greater qualitative and quantitative impact on worm phenotype and motility. Further, a 10-fold increase of J2s soaked in 0.1 mg/ml dsRNA did not significantly alter the observed phenotypic aberration, which suggests that dsRNA uptake of the soaked J2s is not saturated under these conditions. This phenomenon was not initially observed in potato cyst nematode G. pallida J2s, which displayed no aberrant phenotype, or diminution of migratory activity in response to the same 0.1 mg/ml dsRNA 24h soaks. However, a 10-fold increase in dsRNA to 1mg/ml was found to elicit comparable irregularity of phenotype and inhibition of motility in G. pallida, to that initially observed in M. incognita following a 24h soak in 0.1 mg/ml dsRNA. Again, a 10-fold increase in the number of G. pallida J2s soaked in the same volume of 1 mg/ml dsRNA preparation did not significantly affect the observed phenotypic deviation. We do not observe any global impact on transcript abundance in either M. incognita or G. pallida J2s following 0.1 mg/ml dsRNA soaks, as revealed by reverse transcriptase-PCR and quantitative PCR data. This study aims to raise awareness of a phenomenon which we observe consistently and which we believe signifies a more expansive deficiency in our knowledge and

  10. Simultaneous versus Sequential Intratympanic Steroid Treatment for Severe-to-Profound Sudden Sensorineural Hearing Loss.

    Science.gov (United States)

    Yoo, Myung Hoon; Lim, Won Sub; Park, Joo Hyun; Kwon, Joong Keun; Lee, Tae-Hoon; An, Yong-Hwi; Kim, Young-Jin; Kim, Jong Yang; Lim, Hyun Woo; Park, Hong Ju

    2016-01-01

    Severe-to-profound sudden sensorineural hearing loss (SSNHL) has a poor prognosis. We aimed to compare the efficacy of simultaneous and sequential oral and intratympanic steroids for this condition. Fifty patients with severe-to-profound SSNHL (>70 dB HL) were included from 7 centers. The simultaneous group (27 patients) received oral and intratympanic steroid injections for 2 weeks. The sequential group (23 patients) was treated with oral steroids for 2 weeks and intratympanic steroids for the subsequent 2 weeks. Pure-tone averages (PTA) and word discrimination scores (WDS) were compared before treatment and 2 weeks and 1 and 2 months after treatment. Treatment outcomes according to the modified American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS) criteria were also analyzed. The improvement in PTA and WDS at the 2-week follow-up was 23 ± 21 dB HL and 20 ± 39% in the simultaneous group and 31 ± 29 dB HL and 37 ± 42% in the sequential group; this was not statistically significant. Complete or partial recovery at the 2-week follow-up was observed in 26% of the simultaneous group and 30% of the sequential group; this was also not significant. The improvement in PTA and WDS at the 2-month follow-up was 40 ± 20 dB HL and 37 ± 35% in the simultaneous group and 41 ± 25 dB HL and 48 ± 41% in the sequential group; this was not statistically significant. Complete or partial recovery at the 2-month follow-up was observed in 33% of the simultaneous group and 35% of the sequential group; this was also not significant. Seven patients in the sequential group did not need intratympanic steroid injections for sufficient improvement after oral steroids alone. Simultaneous oral/intratympanic steroid treatment yielded a recovery similar to that produced by sequential treatment. Because the addition of intratympanic steroids can be decided upon based on the improvement after an oral steroid, the sequential regimen can be recommended to avoid unnecessary

  11. The onset of the progression of acute phase response mechanisms induced by extreme impacts can be followed by the decrease in blood levels of positive acute phase proteins.

    Science.gov (United States)

    Larina, Olga; Bekker, Anna

    Studies performed at space flights and earth-based simulation models detected the plasma indices of acute phase reaction (APR), i.e. the increase of APR cytokine mediators and alterations in the production of blood acute phase proteins (APP) at the initial stages of adaptation to altered gravity conditions. Acute phase response is the principal constituent of the functional activity of innate immunity system. Changes in plasma APPs contents are considered to serve the restoration of homeostasis state. According to trends of their concentration shifts at the evolving of acute phase reaction APPs are denoted as positive, neutral, or negative. Plasma concentrations of positive acute phase proteins α1-acid glycoprotein (α1-AGP), α1-antitrypsin (α1-AT), and neutral α2-macroglobulin (α2-M) were measured in human study at 12-hour antiorthostatic position (AOP) with 15° head down tilt and hypoxia experiments at 14% oxygen in pressure chamber. Both of these impacts were shown to produce alterations in the APP levels indicative for acute phase response. Nevertheless, in AOP experiment noticeable decrease in α1-AGP concentration occurred by hour 12, and even more pronounced decline of α1-AGP and α1-AT were found on hypoxia hours 12 and 36. Acute phase proteins α1-AGP and α2-M possess the features of proteinase inhibitors. This function is implemented by the formation of complexes with the molecules of proteolytic enzymes which subsequently are removed from the blood flow. Transient decrease in plasma concentrations of protease inhibitors on early phases of APR development was reported to result from the growth of plasma protease activity due to cathepsin release from activated leukocytes, which had not yet been compensated by enhanced APP synthesis. Being a carrier protein for positively charged and neutral substances, α1-AGP shows pronounced elevation in its blood content during APR development. As assumed, it is required for the transportation of the increased

  12. Impact of subject related factors and position of flight control stick on acquisition of simulated flying skills using a flight simulator

    Science.gov (United States)

    Cho, Bo-Keun

    Increasing demand on aviation industry calls for more pilots. Thus, pilot training systems and pilot-candidate screening systems are essential for civil and military flying training institutes. Before actual flight training, it is not easy to determine whether a flight trainee will be successful in the training. Due to the high cost of actual flight training, it would be better if there were low cost methods for screening and training candidates prior to the actual flight training. This study intended to determine if subject related factors and flight control stick position have an impact on acquisition of simulated flying skills using a PC-based flight simulator. The experimental model was a factorial design with repeated measures. Sixty-four subjects participated in the experiment and were divided into 8 groups. Experiment consisted of 8 sessions in which performance data, such as heading, altitude and airspeed were collected every 15 seconds. Collected data were analyzed using SAS statistical program. Result of multivariate analysis of variance indicated that the three independent variables: nationality, computer game experience, and flight stick position have significant impact on acquiring simulated flying skill. For nationality, Americans recorded higher scores in general (mean: 81.7) than Koreans (mean: 78.9). The difference in mean scores between Americans and Koreans was 2.8 percent. Regarding computer game experience, the difference between high experience group (82.3) and low experience group (78.3) is significant. For high experience group, American side-stick group recorded the highest (mean: 85.6), and Korean side-stick group (mean: 77.2) scored the lowest. For the low experience group, American center-stick group scored the highest (80.6), and the Korean side-stick group (74.2) scored the lowest points. Therefore, there is a significant difference between high experience group and low experience group. The results also reveal that the center

  13. SU-E-T-132: Dosimetric Impact of Positioning Errors in Hypo-Fractionated Cranial Radiation Therapy Using Frameless Stereotactic BrainLAB System

    International Nuclear Information System (INIS)

    Keeling, V; Jin, H; Ali, I; Ahmad, S

    2014-01-01

    Purpose: To determine dosimetric impact of positioning errors in the stereotactic hypo-fractionated treatment of intracranial lesions using 3Dtransaltional and 3D-rotational corrections (6D) frameless BrainLAB ExacTrac X-Ray system. Methods: 20 cranial lesions, treated in 3 or 5 fractions, were selected. An infrared (IR) optical positioning system was employed for initial patient setup followed by stereoscopic kV X-ray radiographs for position verification. 6D-translational and rotational shifts were determined to correct patient position. If these shifts were above tolerance (0.7 mm translational and 1° rotational), corrections were applied and another set of X-rays was taken to verify patient position. Dosimetric impact (D95, Dmin, Dmax, and Dmean of planning target volume (PTV) compared to original plans) of positioning errors for initial IR setup (XC: Xray Correction) and post-correction (XV: X-ray Verification) was determined in a treatment planning system using a method proposed by Yue et al. (Med. Phys. 33, 21-31 (2006)) with 3D-translational errors only and 6D-translational and rotational errors. Results: Absolute mean translational errors (±standard deviation) for total 92 fractions (XC/XV) were 0.79±0.88/0.19±0.15 mm (lateral), 1.66±1.71/0.18 ±0.16 mm (longitudinal), 1.95±1.18/0.15±0.14 mm (vertical) and rotational errors were 0.61±0.47/0.17±0.15° (pitch), 0.55±0.49/0.16±0.24° (roll), and 0.68±0.73/0.16±0.15° (yaw). The average changes (loss of coverage) in D95, Dmin, Dmax, and Dmean were 4.5±7.3/0.1±0.2%, 17.8±22.5/1.1±2.5%, 0.4±1.4/0.1±0.3%, and 0.9±1.7/0.0±0.1% using 6Dshifts and 3.1±5.5/0.0±0.1%, 14.2±20.3/0.8±1.7%, 0.0±1.2/0.1±0.3%, and 0.7±1.4/0.0±0.1% using 3D-translational shifts only. The setup corrections (XC-XV) improved the PTV coverage by 4.4±7.3% (D95) and 16.7±23.5% (Dmin) using 6D adjustment. Strong correlations were observed between translation errors and deviations in dose coverage for XC. Conclusion

  14. The Effect of Organizational Culture, Leadership Style, and Functional Position on Organizational Commitment and Their Impact on the Performance of Internal Auditors in Aceh, Indonesia

    Directory of Open Access Journals (Sweden)

    M. Shabri Abd. Majid

    2016-06-01

    Full Text Available This study aims at empirically examining the influence of the organizational culture, leadership style, and functional position of an auditor on organizational commitment and their impact on the performance of government internal auditors in Aceh, Indonesia. All 183 of the governmental internal auditors at the district level within the Province of Aceh, Indonesia, were investigated. Data, which are gathered by distributing questionnaires to the entire population, are then analysed by the Structural Equation Modelling (SEM technique.The study found that organizational culture, leadership style, and functional auditor have affected the performance of the governmental internal auditor either directly or indirectly through organizational commitment.Keywords: Organizational Culture, Leadership Style, Functional Auditor, Organizational Commitment, Internal Auditor Performance.

  15. Impact of HIV on and the constructions of masculinities among HIV-positive men in South Africa: implications for secondary prevention programs.

    Science.gov (United States)

    Sikweyiya, Yandisa M; Jewkes, Rachel; Dunkle, Kristin

    2014-01-01

    To date, whilst there have been many published studies exploring the links between masculinity and HIV, not much work has been done to explore how an HIV-positive diagnosis impacts men's sense of masculinity and contextualizing the masculinities as fluid and changing. To explore how human immunodeficiency virus (HIV) impacts the lives of men and their constructions of masculinity through interviews with 18 men living with HIV. Qualitative study involving conveniently and purposively selected black South African adult men who lived with HIV. In-depth interviews were conducted with 18 men who resided in Johannesburg and Mthatha, South Africa. Our analysis suggests that the performance of risky masculinity may influence the acquisition of HIV. Yet, it also reveals that HIV can have a significant effect on men and their masculinities. Men's constructions of harmful notions of hegemonic masculinity pre-HIV diagnosis negatively affected their help-seeking behavior and coping and adjustment to living with HIV, post-diagnosis. The dominant discourse that men are strong and healthy visibly presented challenges for men when faced with an HIV-positive status. They interpreted HIV diagnosis as a loss, a sign of failure as a man, and evidence of an inability to retain control. Being sick undermined their ability to perform roles expected of them, and this led to feelings of powerlessness, worthlessness, and distress. Interventions with men living with HIV need to provide safe spaces for men to critically explore gender and constructions of social identities and the pressures these place on men and implications for their health. With this approach, harmful constructions of masculinities may be challenged and mitigated, and this process may render men amenable to change.

  16. Impact of HIV on and the constructions of masculinities among HIV-positive men in South Africa: implications for secondary prevention programs

    Directory of Open Access Journals (Sweden)

    Yandisa M. Sikweyiya

    2014-10-01

    Full Text Available Background: To date, whilst there have been many published studies exploring the links between masculinity and HIV, not much work has been done to explore how an HIV-positive diagnosis impacts men's sense of masculinity and contextualizing the masculinities as fluid and changing. Objective: To explore how human immunodeficiency virus (HIV impacts the lives of men and their constructions of masculinity through interviews with 18 men living with HIV. Design: Qualitative study involving conveniently and purposively selected black South African adult men who lived with HIV. In-depth interviews were conducted with 18 men who resided in Johannesburg and Mthatha, South Africa. Results: Our analysis suggests that the performance of risky masculinity may influence the acquisition of HIV. Yet, it also reveals that HIV can have a significant effect on men and their masculinities. Men's constructions of harmful notions of hegemonic masculinity pre-HIV diagnosis negatively affected their help-seeking behavior and coping and adjustment to living with HIV, post-diagnosis. The dominant discourse that men are strong and healthy visibly presented challenges for men when faced with an HIV-positive status. They interpreted HIV diagnosis as a loss, a sign of failure as a man, and evidence of an inability to retain control. Being sick undermined their ability to perform roles expected of them, and this led to feelings of powerlessness, worthlessness, and distress. Conclusions: Interventions with men living with HIV need to provide safe spaces for men to critically explore gender and constructions of social identities and the pressures these place on men and implications for their health. With this approach, harmful constructions of masculinities may be challenged and mitigated, and this process may render men amenable to change.

  17. Budget impact analysis of everolimus for the treatment of hormone receptor positive, human epidermal growth factor receptor-2 negative (HER2-) advanced breast cancer in the United States.

    Science.gov (United States)

    Xie, Jipan; Diener, Melissa; De, Gourab; Yang, Hongbo; Wu, Eric Q; Namjoshi, Madhav

    2013-01-01

    To estimate the budget impact of everolimus as the first and second treatment option after letrozole or anastrozole (L/A) failure for post-menopausal women with hormone receptor positive (HR+), human epidermal growth factor receptor-2 negative (HER2-) advanced breast cancer (ABC). Pharmacy and medical budget impacts (2011 USD) were estimated over the first year of everolimus use in HR+, HER2- ABC from a US payer perspective. Epidemiology data were used to estimate target population size. Pre-everolimus entry treatment options included exemestane, fulvestrant, and tamoxifen. Pre- and post-everolimus entry market shares were estimated based on market research and assumptions. Drug costs were based on wholesale acquisition cost. Patients were assumed to be on treatment until progression or death. Annual medical costs were calculated as the average of pre- and post-progression medical costs weighted by the time in each period, adjusted for survival. One-way and two-way sensitivity analyses were conducted to assess the model robustness. In a hypothetical 1,000,000 member plan, 72 and 159 patients were expected to be candidates for everolimus treatment as first and second treatment option, respectively, after L/A failure. The total budget impact for the first year post-everolimus entry was $0.044 per member per month [PMPM] (pharmacy budget: $0.058 PMPM; medical budget: -$0.014 PMPM), assuming 10% of the target population would receive everolimus. The total budget impacts for the first and second treatment options after L/A failure were $0.014 PMPM (pharmacy budget: $0.018; medical budget: -$0.004) and $0.030 PMPM (pharmacy budget: $0.040; medical budget: -$0.010), respectively. Results remained robust in sensitivity analyses. Assumptions about some model input parameters were necessary and may impact results. Increased pharmacy costs for HR+, HER2- ABC following everolimus entry are expected to be partially offset by reduced medical service costs. Pharmacy and total

  18. Targeting superoxide dismutase to endothelial caveolae profoundly alleviates inflammation caused by endotoxin.

    Science.gov (United States)

    Shuvaev, Vladimir V; Kiseleva, Raisa Yu; Arguiri, Evguenia; Villa, Carlos H; Muro, Silvia; Christofidou-Solomidou, Melpo; Stan, Radu V; Muzykantov, Vladimir R

    2018-02-28

    Inflammatory mediators binding to Toll-Like receptors (TLR) induce an influx of superoxide anion in the ensuing endosomes. In endothelial cells, endosomal surplus of superoxide causes pro-inflammatory activation and TLR4 agonists act preferentially via caveolae-derived endosomes. To test the hypothesis that SOD delivery to caveolae may specifically inhibit this pathological pathway, we conjugated SOD with antibodies (Ab/SOD, size ~10nm) to plasmalemmal vesicle-associated protein (Plvap) that is specifically localized to endothelial caveolae in vivo and compared its effects to non-caveolar target CD31/PECAM-1. Plvap Ab/SOD bound to endothelial cells in culture with much lower efficacy than CD31 Ab/SOD, yet blocked the effects of LPS signaling with higher efficiency than CD31 Ab/SOD. Disruption of cholesterol-rich membrane domains by filipin inhibits Plvap Ab/SOD endocytosis and LPS signaling, implicating the caveolae-dependent pathway(s) in both processes. Both Ab/SOD conjugates targeted to Plvap and CD31 accumulated in the lungs after IV injection in mice, but the former more profoundly inhibited LPS-induced pulmonary inflammation and elevation of plasma level of interferon-beta and -gamma and interleukin-27. Taken together, these results indicate that targeted delivery of SOD to specific cellular compartments may offer effective, mechanistically precise interception of pro-inflammatory signaling mediated by reactive oxygen species. Copyright © 2018 Elsevier B.V. All rights reserved.

  19. Smoking cessation induces profound changes in the composition of the intestinal microbiota in humans.

    Directory of Open Access Journals (Sweden)

    Luc Biedermann

    Full Text Available BACKGROUND: The human intestinal microbiota is a crucial factor in the pathogenesis of various diseases, such as metabolic syndrome or inflammatory bowel disease (IBD. Yet, knowledge about the role of environmental factors such as smoking (which is known to influence theses aforementioned disease states on the complex microbial composition is sparse. We aimed to investigate the role of smoking cessation on intestinal microbial composition in 10 healthy smoking subjects undergoing controlled smoking cessation. METHODS: During the observational period of 9 weeks repetitive stool samples were collected. Based on abundance of 16S rRNA genes bacterial composition was analysed and compared to 10 control subjects (5 continuing smokers and 5 non-smokers by means of Terminal Restriction Fragment Length Polymorphism analysis and high-throughput sequencing. RESULTS: Profound shifts in the microbial composition after smoking cessation were observed with an increase of Firmicutes and Actinobacteria and a lower proportion of Bacteroidetes and Proteobacteria on the phylum level. In addition, after smoking cessation there was an increase in microbial diversity. CONCLUSIONS: These results indicate that smoking is an environmental factor modulating the composition of human gut microbiota. The observed changes after smoking cessation revealed to be similar to the previously reported differences in obese compared to lean humans and mice respectively, suggesting a potential pathogenetic link between weight gain and smoking cessation. In addition they give rise to a potential association of smoking status and the course of IBD.

  20. Attentional processes in interactions between people with profound intellectual and multiple disabilities and direct support staff.

    Science.gov (United States)

    Hostyn, Ine; Ine, Hostyn; Neerinckx, Heleen; Heleen, Neerinckx; Maes, Bea; Bea, Maes

    2011-01-01

    Few studies have examined joint attention in interactions with persons with profound intellectual and multiple disabilities (PIMD), despite its important role in high-quality interaction. The purpose of this study is to describe the attention-directing behaviours of persons with PIMD and their direct support staff and the attention episodes resulting from their interactions, and to understand how these variables relate to each other. Video observations of 17 staff-client dyads were coded using partial interval recording. The results showed considerable variation across individuals and dyads. In general, persons with PIMD directed the attention of staff members infrequently. The staff members frequently directed their clients' attention towards a topic of interest but did not often use the tactile modality. Within the staff-client dyad, there was not much joint attention; however, shared attention episodes occurred frequently. Shared attention and joint attention are strongly correlated. A negative correlation was found between clients not using attention-directing behaviours and staff members using tactile methods to direct the attention, and joint attention episodes. This study presents both directions for future research and practical implications. Copyright © 2010 Elsevier Ltd. All rights reserved.

  1. The current status of audiologic rehabilitation for profound unilateral sensorineural hearing loss.

    Science.gov (United States)

    Bishop, Charles E; Eby, Thomas L

    2010-03-01

    Audiologic rehabilitation of individuals with profound unilateral sensorineural hearing loss (USNHL) has traditionally been limited to the use of air-conduction contralateral routing of sound (CROS) hearing aids. Treatment for these individuals has expanded with new applications of the bone-anchored hearing aid (BAHA), transcranial hearing aid (t-CROS), and the cochlear implant. In this article, the authors review the literature that addresses these various treatment options. Contemporary review Historical information is available that describes the limited efficacy of air-conduction CROS hearing aids in lifting hearing handicap associated with USNHL. Current investigations on providing cross hearing are generally focused on use of the BAHA. Little is known at present whether new developments in hearing aid technology can improve on conventional air-conduction CROS or t-CROS approaches. Interestingly, the cochlear implant seems to be a viable option for individuals with USNHL and tinnitus who also have intact auditory nerve pathways. There is indication in the literature that BAHA provides greater relief of hearing handicap associated with USNHL than CROS hearing aids; however, both have been found to provide limited patient satisfaction and seemingly fall short of restoring true sound localization. Adequate trials have not been performed comparing BAHA with the best CROS hearing aid technology. Transcranial hearing aids and cochlear implants are experimental methods to treat USNHL and hold promise, although there remains a lack of studies available to fully support this.

  2. Differentiating characteristics of deafblindness and autism in people with congenital deafblindness and profound intellectual disability.

    Science.gov (United States)

    Hoevenaars-van den Boom, M A A; Antonissen, A C F M; Knoors, H; Vervloed, M P J

    2009-06-01

    In persons with deafblindness, it is hard to distinguish autism spectrum disorders from several deafblind specific behaviours caused by the dual sensory impairments, especially when these persons are also intellectually disabled. As a result, there is an over-diagnosis of autism in persons who are deafblind leading to unsuitable interventions. Autism as specified by the DSM-IV was studied in 10 persons with congenital deafblindness with profound intellectual disabilities. Behaviours of people with deafblindness and autism (n = 5) and of people with deafblindness without autism (n = 5) were observed in a semi-standardised assessment. All people with deafblindness showed impairments in social interaction, communication and language. In contrast to persons without autism, people with deafblindness and autism showed significantly more impairments in reciprocity of social interaction, quality of initiatives to contact and the use of adequate communicative signals and functions. No differences between the groups were found for quantity and persistence of stereotyped behaviour, quality of play and exploration and adequate problem-solving strategies. This study indicates that there are some possibilities to differentiate autism from behaviours specific for deafblindness. It also confirms the large overlap in overt behaviours between people with deafblindness and persons with autism.

  3. Driving to learn in a powered wheelchair: the process of learning joystick use in people with profound cognitive disabilities.

    Science.gov (United States)

    Nilsson, Lisbeth; Eklund, Mona; Nyberg, Per; Thulesius, Hans

    2011-01-01

    The Driving to Learn project explored ways to help people with profound cognitive disabilities practice operating a joystick-operated powered wheelchair. The project used a grounded theory approach with constant comparative analysis and was carried out over 12 yr. The participants were 45 children and adults with profound cognitive disabilities. Reference groups included 17 typically developing infants and 64 participants with lesser degrees of cognitive disability. The data sources included video recordings, field notes, open interviews, and a rich mixture of literature. The findings that emerged yielded strategies for facilitating achievements, an 8-phase learning process, an assessment tool, and a grounded theory of deplateauing explaining the properties necessary for participants to exceed expected limitations and plateaus. Eight participants with profound cognitive disabilities reached goal-directed driving or higher. Participants were empowered by attaining increased control over tool use, improving their autonomy and quality of life.

  4. Impact of the type of mask on the effectiveness of and adherence to continuous positive airway pressure treatment for obstructive sleep apnea*

    Science.gov (United States)

    de Andrade, Rafaela Garcia Santos; Piccin, Vivien Schmeling; Nascimento, Juliana Araújo; Viana, Fernanda Madeiro Leite; Genta, Pedro Rodrigues; Lorenzi-Filho, Geraldo

    2014-01-01

    Continuous positive airway pressure (CPAP) is the gold standard for the treatment of obstructive sleep apnea (OSA). Although CPAP was originally applied with a nasal mask, various interfaces are currently available. This study reviews theoretical concepts and questions the premise that all types of interfaces produce similar results. We revised the evidence in the literature about the impact that the type of CPAP interface has on the effectiveness of and adherence to OSA treatment. We searched the PubMed database using the search terms "CPAP", "mask", and "obstructive sleep apnea". Although we identified 91 studies, only 12 described the impact of the type of CPAP interface on treatment effectiveness (n = 6) or adherence (n = 6). Despite conflicting results, we found no consistent evidence that nasal pillows and oral masks alter OSA treatment effectiveness or adherence. In contrast, most studies showed that oronasal masks are less effective and are more often associated with lower adherence and higher CPAP abandonment than are nasal masks. We concluded that oronasal masks can compromise CPAP OSA treatment adherence and effectiveness. Further studies are needed in order to understand the exact mechanisms involved in this effect. PMID:25610507

  5. Impact of the type of mask on the effectiveness of and adherence to continuous positive airway pressure treatment for obstructive sleep apnea.

    Science.gov (United States)

    Andrade, Rafaela Garcia Santos de; Piccin, Vivien Schmeling; Nascimento, Juliana Araújo; Viana, Fernanda Madeiro Leite; Genta, Pedro Rodrigues; Lorenzi-Filho, Geraldo

    2014-01-01

    Continuous positive airway pressure (CPAP) is the gold standard for the treatment of obstructive sleep apnea (OSA). Although CPAP was originally applied with a nasal mask, various interfaces are currently available. This study reviews theoretical concepts and questions the premise that all types of interfaces produce similar results. We revised the evidence in the literature about the impact that the type of CPAP interface has on the effectiveness of and adherence to OSA treatment. We searched the PubMed database using the search terms "CPAP", "mask", and "obstructive sleep apnea". Although we identified 91 studies, only 12 described the impact of the type of CPAP interface on treatment effectiveness (n = 6) or adherence (n = 6). Despite conflicting results, we found no consistent evidence that nasal pillows and oral masks alter OSA treatment effectiveness or adherence. In contrast, most studies showed that oronasal masks are less effective and are more often associated with lower adherence and higher CPAP abandonment than are nasal masks. We concluded that oronasal masks can compromise CPAP OSA treatment adherence and effectiveness. Further studies are needed in order to understand the exact mechanisms involved in this effect.

  6. Mass spectrometric study of the negative and positive secondary ions emitted from ethanol microdroplets by MeV-energy heavy ion impact

    Science.gov (United States)

    Kitajima, Kensei; Majima, Takuya; Nishio, Tatsuya; Oonishi, Yoshiki; Mizutani, Shiori; Kohno, Jun-ya; Saito, Manabu; Tsuchida, Hidetsugu

    2018-06-01

    We have investigated the negative and positive secondary ions emitted from ethanol droplets by 4.0-MeV C3+ impact to reveal the characteristic features of the reaction processes induced by fast heavy ions at the liquid ethanol surface. Analysis of the secondary ions was performed by time-of-flight mass spectrometry for microdroplet targets in a high vacuum environment. Fragment ions, deprotonated cluster ions, and trace amounts of the reaction product ions are observed in the negative secondary ions. The main fragment anions are C2HmO- (m = 1, 3, and 5) and C2H- generated by loss of hydrogen and oxygen atoms. The reaction product anions include deprotonated glycols, larger alcohols, and their dehydrated and dehydrogenated forms generated by secondary reactions between fragments and radicals. Furthermore, C3Hm- (m = 0-2) and C4Hm- (m = 0 and 1) are observed, which could be produced through a plasma state generated in the heavy ion track. Deprotonated ethanol cluster ions, [(EtOH)n - H]-, are observed up to about n = 25. [(EtOH)n - H]- have smaller kinetic energies than the protonated cluster ions (EtOH)nH+. This probably represents the effect of the positive Coulomb potential transiently formed in the ion track. We also discuss the size distributions and structures of the water- and CH2OH-radical-attached ethanol cluster ions.

  7. An audit to investigate the impact of false positive breast screening results and diagnostic work-up on re-engagement with subsequent routine screening

    International Nuclear Information System (INIS)

    Nightingale, Julie M.; Borgen, Rita; Porter-Bennett, Lisa; Szczepura, Katy

    2015-01-01

    Introduction: Women attending breast screening may have suspicious mammographic findings that are subsequently found at assessment clinic to be normal (false positive, FP). A false positive diagnosis is not harmless, with short and long term negative psychosocial consequences reported. Women are at increased relative risk of breast cancer therefore their attendance at subsequent screening is essential. Aims: To assess the impact of FP breast screening diagnosis and diagnostic work-up on re-attendance rates across four consecutive screening rounds at a typical breast screening centre. Method: Diagnostic interventions and screening re-attendance rates at one prior and two consecutive rounds were analysed for women receiving an FP diagnosis between 2004 and 2006. Results: 397 women (5.57%) were referred for further assessment, including 228 (57.43%) false positives. 34 eligible women failed to re-attend routine screening (+3 years), with 17 failing to re-attend subsequently (+6 years). 70.6% (24/34) of non-attenders had attended at least two screening rounds prior to FP assessment. 75% of FP women had an imaging-only assessment with 17.5% (30/171) failing to re-attend, and 25% received a biopsy, with 7% (4/57) failing to re-attend subsequently. Conclusion: This study is unique as it follows FP women through four consecutive screening rounds. FP non-attendance rates were considerably lower compared to the general screening population, with diagnostic work-up having limited influence. FP non-attendance may appear insignificant in comparison to total screened population, but these women are at greater risk of subsequent cancer so should be actively encouraged to re-engage with the screening programme

  8. The impact of tamoxifen on breast recurrence, cosmesis, complications, and survival in estrogen receptor-positive early-stage breast cancer

    International Nuclear Information System (INIS)

    Fowble, Barbara; Fein, Douglas A.; Hanlon, Alexandra L.; Eisenberg, Burton L.; Hoffman, John P.; Sigurdson, Elin R.; Daly, Mary B.; Goldstein, Lori J.

    1996-01-01

    Purpose: To evaluate the impact of tamoxifen on breast recurrence, cosmesis, complications, overall and cause-specific survival in women with Stage I-II breast cancer and estrogen receptor positive tumors undergoing conservative surgery and radiation. Methods and Materials: From 1982 to 1991, 491 women with estrogen receptor positive Stage I-II breast cancer underwent excisional biopsy, axillary dissection, and radiation. The median age of the patient population was 60 years with 21% < 50 years of age. The median follow-up was 5.3 years (range 0.1 to 12.8). Sixty-nine percent had T1 tumors and 83% had histologically negative axillary nodes. Reexcision was performed in 49% and the final margin of resection was negative in 64%. One hundred fifty-four patients received tamoxifen and 337 patients received no adjuvant therapy. None of the patients received adjuvant chemotherapy. Results: There were no significant differences between the two groups for age, race, clinical tumor size, histology, the use of reexcision, or median total dose to the primary. Patients who received tamoxifen were more often axillary node positive (44% tamoxifen vs. 5% no tamoxifen), and, therefore, a greater percentage received treatment to the breast and regional nodes. The tamoxifen patients less often had unknown margins of resection (9% tamoxifen vs. 22% no tamoxifen). The 5-year actuarial breast recurrence rate was 4% for the tamoxifen patients compared to 7% for patients not receiving tamoxifen (p 0.21). Tamoxifen resulted in a modest decrease in the 5-year actuarial risk of a breast recurrence in axillary node-negative patients, in those with unknown or close margins of resection, and in those who underwent a single excision. Axillary node-positive patients had a clinically significant decrease in the 5-year actuarial breast recurrence rate (21 vs. 4%; p 0.08). The 5-year actuarial rate of distant metastasis was not significantly decreased by the addition of adjuvant tamoxifen in all

  9. A Glance on Diagnosis and Ttreatment of Profound Fatigue in Multiple Sclerosis

    Directory of Open Access Journals (Sweden)

    Mojtaba Azimian

    2007-09-01

    Full Text Available Multiple Sclerosis (M.S is one of the prevalent diseases of the central nervous system which cause disability in young adults. This appears as neural signs in different parts and various times. The main defect is local deterioration or destruction of myelin tissue in the brain and spinal cord. Profound fatigue is one the most common symptoms of this disease. Because MS is prevalent in middle ages, so the presence of this symptom affects the life and activity of the patient In these ages people have high amount of activities and this functional disorder creates many difficulties for daily works in patient. For this reason, fatigue problem in patients, always, have caught the attention of researchers. Despite numerous studies, still the exact reason for producing fatigue have not been mentioned But several mechanisms have been discussed, such as: autoimmune mechanism of the disease, Involvement and disorder of endocrine system, involvement of central nervous system and de-synchronization of autonom system. Among these, autoimmune mechanism is considered as a main role in producing fatigue. Lack of proper knowledge regarding exact fatigue mechanism several problems in its treatment. Evaluation is the first step for controlling fatigue, which is done through various tests. Clear and proper evaluation can be obtained by these tests. After evaluation, non-drug and finally drug procedures are helpful. In non-drug treatment the focus is on: sport exercises, suitable diet program, identification and improvement of the patient psychotic disorders, energy conservation methods. Finally, the use of drugs such as Amantadine, Pemoline and Modafini is recommended for fatigue treatment.

  10. Cochlear implantation: is hearing preservation necessary in severe to profound hearing loss?

    Science.gov (United States)

    Derinsu, Ufuk; Serin, Gediz Murat; Akdaş, Ferda; Batman, Çağlar

    2011-03-01

    The goal of the cochlear implant surgery is to place the electrode array with minimal damage to preserve the residual hearing. Round-window insertion can be performed in a manner that is potentially less traumatic than the standard cochleostomy. The purpose of the study was to investigate audiological results of the round-window approach using standard electrode. A retrospective study was performed to evaluate our experience in patients with implanted through round window between January 2007 and March 2009. Sixty patients had undergone cochlear implant surgery through the round window with full insertion of a standard electrode array. Preoperative and postoperative pure-tone thresholds were measured for implanted ears in the range of 250 to 4000 Hz. Within these 60 cases, 31 patients had been evaluated. The population comprised 16 women and 15 men. The mean age was 15.96 years (range, 4-64 years). Follow-up times ranged from 6 to 26 months. Preservation of low-frequency hearing (250 and 500 Hz) was achieved in 27 (87%) of 31 patients. Complete hearing preservation (all frequencies) was accomplished in 11 patients (35.48%). No hearing could be determined postoperatively in 4 patients (12.9%), having preoperative thresholds of 120 dB at 250, 500, and 1000 Hz. Round-window approach has been widely used for preservation of residual hearing. In our patients with severe to profound hearing loss, we preserved residual hearing. Although the residual hearing cannot be sufficient for using additional acoustic stimulation, the preserved residual hearing means minimal damage and a more convenient cochlea, so this is promising for future development.

  11. The notochord in Atlantic salmon (Salmo salar L.) undergoes profound morphological and mechanical changes during development.

    Science.gov (United States)

    Kryvi, Harald; Rusten, Iselin; Fjelldal, Per Gunnar; Nordvik, Kari; Totland, Geir K; Karlsen, Tine; Wiig, Helge; Long, John H

    2017-11-01

    We present the development of the notochord of the Atlantic salmon (Salmo salar L.), from early embryo to sexually mature fish. Over the salmon's lifespan, profound morphological changes occur. Cells and gross structures of the notochord reorganize twice. In the embryo, the volume of the notochord is dominated by large, vacuolated chordocytes; each cell can be modeled as a hydrostat organized into a larger cellular-hydrostat network, structurally bound together with desmosomes. After the embryo hatches and grows into a fry, vacuolated chordocytes disappear, replaced by extracellular lacunae. The formation of mineralized, segmental chordacentra stiffens the notochord and creates intervertebral joints, where tissue strain during lateral bending is now focused. As development proceeds towards the parr stage, a process of devacuolization and intracellular filament accumulation occur, forming highly dense, non-vacuolated chordocytes. As extracellular lacunae enlarge, they are enclosed by dense filamentous chordocytes that form transverse intervertebral septa, which are connected to the intervertebral ligaments, and a longitudinal notochordal strand. In the vertebral column of pelagic adults, large vacuolated chordocytes reappear; cells of this secondary population have a volume up to 19 000 times larger than the primary vacuolated chordocytes of the early notochord. In adults the lacunae have diminished in relative size. Hydrostatic pressure within the notochord increases significantly during growth, from 525 Pa in the alevins to 11 500 Pa in adults, at a rate of increase with total body length greater than that expected by static stress similarity. Pressure and morphometric measurements were combined to estimate the stress in the extracellular material of the notochordal sheath and intervertebral ligaments and the flexural stiffness of the axial skeleton. The functional significance of the morphological changes in the axial skeleton is discussed in relation to the

  12. Classic Bartter syndrome complicated with profound growth hormone deficiency: a case report.

    Science.gov (United States)

    Adachi, Masanori; Tajima, Toshihiro; Muroya, Koji; Asakura, Yumi

    2013-12-30

    Classic Bartter syndrome is a salt-wasting tubulopathy caused by mutations in the CLCNKB (chloride channel Kb) gene. Although growth hormone deficiency has been suggested as a cause for persistent growth failure in patients with classic Bartter syndrome, in our opinion the diagnoses of growth hormone deficiency has been unconvincing in some reports. Moreover, Gitelman syndrome seems to have been confused with Bartter syndrome in some cases in the literature. In the present work, we describe a new case with CLCNKB gene mutations and review the reported cases of classic Bartter syndrome associated with growth hormone deficiency. Our patient was a Japanese boy diagnosed as having classic Bartter syndrome at eight months of age. The diagnosis of Bartter syndrome was confirmed by CLCNKB gene analysis, which revealed compound heterozygous mutations with deletion of exons 1 to 3 (derived from his mother) and ΔL130 (derived from his father). His medical therapy consisted of potassium (K), sodium chloride, spironolactone, and anti-inflammatory agents; this regime was started at eight months of age. Our patient was very short (131.1cm, -4.9 standard deviation) at 14.3 years and showed profoundly impaired growth hormone responses to pharmacological stimulants: 0.15μg/L to insulin-induced hypoglycemia and 0.39μg/L to arginine. His growth response to growth hormone therapy was excellent. The present case strengthens the association between classic Bartter syndrome and growth hormone deficiency. We propose that growth hormone status should be considered while treating children with classic Bartter syndrome.

  13. Achieving and sustaining profound institutional change in healthcare: case study using neo-institutional theory.

    Science.gov (United States)

    Macfarlane, Fraser; Barton-Sweeney, Cathy; Woodard, Fran; Greenhalgh, Trisha

    2013-03-01

    Change efforts in healthcare sometimes have an ambitious, whole-system remit and seek to achieve fundamental changes in norms and organisational culture rather than (or as well as) restructuring the service. Long-term evaluation of such initiatives is rarely undertaken. We report a secondary analysis of data from an evaluation of a profound institutional change effort in London, England, using a mixed-method longitudinal case study design. The service had received £15 million modernisation funding in 2004, covering multiple organisations and sectors and overseen by a bespoke management and governance infrastructure that was dismantled in 2008. In 2010-11, we gathered data (activity statistics, documents, interviews, questionnaires, site visits) and compared these with data from 2003 to 2008. Data analysis was informed by neo-institutional theory, which considers organisational change as resulting from the material-resource environment and three 'institutional pillars' (regulative, normative and cultural-cognitive), enacted and reproduced via the identities, values and activities of human actors. Explaining the long-term fortunes of the different components of the original programme and their continuing adaptation to a changing context required attention to all three of Scott's pillars and to the interplay between macro institutional structures and embedded human agency. The paper illustrates how neo-institutional theory (which is typically used by academics to theorise macro-level changes in institutional structures over time) can also be applied at a more meso level to inform an empirical analysis of how healthcare organisations achieve change and what helps or hinders efforts to sustain those changes. Copyright © 2013 Elsevier Ltd. All rights reserved.

  14. What parents find important in the support of a child with profound intellectual and multiple disabilities.

    Science.gov (United States)

    Jansen, S L G; van der Putten, A A J; Vlaskamp, C

    2013-05-01

    The importance of a partnership between parents and professionals in the support of children with disabilities is widely acknowledged and is one of the key elements of 'family-centred care'. To what extent family-centred principles are also applied to the support of persons with profound intellectual and multiple disabilities (PIMD) is not yet known. The purpose of this exploratory study was to examine what parents with a child with PIMD find important in the support of their child. In addition, we examined which child or parent characteristics influence these parental opinions. In total, 100 parents completed an adapted version of the Measure of Processes of Care. Mean unweighted and weighted scale scores were computed. Non-parametric tests were used to examine differences in ratings due to child (gender, age, type and number of additional disabilities, type of services used and duration of service use) and parent characteristics (gender, involvement with support and educational level). Parents rated situations related to 'Respectful and Supportive Care' and 'Enabling and Partnership' with averages of 7.07 and 6.87 respectively on a scale from 1 to 10. They were generally satisfied with the services provided, expressed in a mean score of 6.88 overall. The age of the child significantly affected the scores for 'Providing Specific Information about the Child'. Parents of children in the '6-12 years' age group gave significantly higher scores on this scale than did parents of children in the '≥17 years' age group (U = 288, r = -0.34). This study shows that parents with children with PIMD find family-centred principles in the professional support of their children important. Although the majority of parents are satisfied with the support provided for their children, a substantial minority of the parents indicated that they did not receive the support they find important. © 2012 Blackwell Publishing Ltd.

  15. Time use of parents raising children with severe or profound intellectual and multiple disabilities.

    Science.gov (United States)

    Luijkx, J; van der Putten, A A J; Vlaskamp, C

    2017-07-01

    Raising children with severe or profound intellectual and multiple disabilities (PIMD) is expected to put extreme pressure on parental time use patterns. The aim of this study was to examine the total time use of mothers and fathers raising children with PIMD and compare it with the time use of parents of typically developing children. Twenty-seven fathers and 30 mothers raising children with PIMD completed a time use diary on a mobile phone or tablet app, as did 66 fathers and 109 mothers of typically developing children. Independent t-tests and Mann-Whitney tests were performed to compare mean time use. There are no differences in the time use of parents of children with PIMD on contracted time (paid work and educational activities) and necessary time (personal care, eating and drinking and sleeping) when compared with parents of typically developing children. There are significant differences between the parents of children with PIMD and the parents of typically developing children in terms of committed time (time for domestic work and the care and supervision of their children) and free time. The mothers of children with PIMD spend significantly less time on domestic work and more time on care and supervision than mothers of typically developing children. This study shows that the parents of children with PIMD have to spend a significant amount of time on care tasks and have on average 1.5 h less free time per day than parents of typically developing children. This is a striking difference, because leisure time can substantially contribute to well-being. Therefore, it is important not only to consider a child with PIMD's support needs but also to identify what parents need to continue their children's daily care and supervision. © 2017 John Wiley & Sons Ltd.

  16. Improving Social Skills in Adolescents and Adults with Autism and Severe to Profound Intellectual Disability: A Review of the Literature

    Science.gov (United States)

    Walton, Katherine M.; Ingersoll, Brooke R.

    2013-01-01

    Social skills are important treatment targets for individuals with autism spectrum disorders (ASD) across the lifespan. However, few treatments are available for adolescents and adults with ASD who also have severe to profound intellectual disability (S/PID). Several social skill interventions have been described that may improve social skills in…

  17. The Hands with Eyes and Nose in the Palm: As Effective Communication Alternatives for Profoundly Deaf People in Zimbabwe

    Science.gov (United States)

    Mutswanga, Phillipa

    2017-01-01

    Drawing from the experiences and testimonies of people with profound deafness, the study qualitatively explored the use of the hands with eyes and nose in the palm as communication alternatives in the field of deafness. The study was prompted by the 27 year old lady, Leah Katz-Hernandez who is deaf who got engaged in March 2015 as the 2016…

  18. How to Facilitate Transition to Adulthood? Innovative Solutions from Parents of Young Adults with Profound Intellectual Disability

    Science.gov (United States)

    Gauthier-Boudreault, Camille; Couture, Mélanie; Gallagher, Frances

    2018-01-01

    Background: At age 21, access to specialised services for youth with profound intellectual disability is reduced. Few studies have focused on parents' views concerning potential solutions to ease the transition to adulthood, and most existing solutions target young adults with less severe intellectual disability. The aim of this study is to…

  19. Reliability of assessing the sensory perception of children with profound intellectual and multiple disabilities : a case study

    NARCIS (Netherlands)

    Vlaskamp, C.; Cuppen-Fonteine, H.

    Background This study describes preliminary stages of developing a checklist to enable practitioners to determine the behavioural responses of children with profound intellectual and multiple disabilities to sensory stimuli. Reliability of currently used checklists is low, with a focus on the

  20. Motor activation in people with profound intellectual and multiple disabilities: research in daily practice in residential facilities

    NARCIS (Netherlands)

    Bossink, Leontien; van der Putten, Annette; Vlaskamp, Carla

    2014-01-01

    Aim: The total study aims at generating knowledge about the best way to motor activate persons with profound intellectual and multiple disabilities (PIMD) in residential facilities. The purpose of the current poster presentation is to present the results of the first step executed in this project

  1. Parental Adaptation to Out-of-Home Placement of a Child with Severe or Profound Developmental Disabilities

    Science.gov (United States)

    Jackson, Jeffrey B.; Roper, Susanne Olsen

    2014-01-01

    Utilizing grounded theory qualitative research methods, a model was developed for describing parental adaptation after voluntary placement of a child with severe or profound developmental disabilities in out-of-home care. Interviews of parents from 20 families were analyzed. Parents' cognitive appraisals of placement outcomes were classified…

  2. The documentation of health problems in relation to prescribed medication in people with profound intellectual and multiple disabilities

    NARCIS (Netherlands)

    van der Heide, D. C.; van der Putten, A. A. J.; van den Berg, P. B.; Taxis, K.; Vlaskamp, C.

    Persons with profound intellectual and multiple disabilities (PIMD) suffer from a wide range of health problems and use a wide range of different drugs. This study investigated for frequently used medication whether there was a health problem documented in the medical notes for the drug prescribed.

  3. You Should be Dancin:! The Role of Performing Arts in the Lives of the Severely and Profoundly Handicapped.

    Science.gov (United States)

    Barringer, Mary Dean

    The manual presents a program planning framework and teaching units for teaching dance and movement to severely and profoundly handicapped individuals. The planning framework contains four components: (1) aesthetic perception/multisensory integration; (2) creative expression; (3) dance heritage/historical and cultural; and (4) aesthetic…

  4. Domains of quality of life of people with profound multiple disabilities : The perspective of parents and direct support staff

    NARCIS (Netherlands)

    Petry, K; Maes, B; Vlaskamp, C

    Background This study considered the general validity of the basic domains of quality of life that appear in theoretical models, in relation to people with profound multiple disabilities. The authors examined how parents and direct support staff operationalized these basic domains for people with

  5. Camera-based microswitch technology to monitor mouth, eyebrow, and eyelid responses of children with profound multiple disabilities

    NARCIS (Netherlands)

    Lancioni, G.E.; Bellini, D.; Oliva, D.; Singh, N.N.; O'Reilly, M.F.; Sigafoos, J.; Lang, R.B.; Didden, H.C.M.

    2011-01-01

    A camera-based microswitch technology was recently used to successfully monitor small eyelid and mouth responses of two adults with profound multiple disabilities (Lancioni et al., Res Dev Disab 31:1509-1514, 2010a). This technology, in contrast with the traditional optic microswitches used