Sample records for program ed hecker

  1. Canadian EdGEO National Workshop Program (United States)

    Clinton, L. A.; Haidl, F. M.; Hymers, L. A.; van der Flier-Keller, E.


    Established in the early 1970s, EdGEO supports locally driven geosciences workshops for Canadian teachers. Workshops are organized by geoscientists and teachers, and typically have field, laboratory and classroom components. Grants of up to $3000 per workshop are available from the National EdGEO Program. By providing educational opportunities for today's teachers and, through them, their students, EdGEO seeks to cultivate a heightened awareness of our planet. EdGEO workshops provide teachers with potential fieldtrip sites for their students and the knowledge, enthusiasm and materials to inspire their students to engage in geoscience. Networking opportunities with local experts promote the importance of the geoscience profession. The expected result is an improved capacity on the part of Canadians to understand the Earth and to make informed decisions, especially with regard to the use of mineral and energy resources, the maintenance and remediation of the environment, and response to geological hazards. There exists a critical need to provide teachers with training and resources to tackle their Earth science curricula. In 2008, EdGEO supported fourteen workshops, with an unprecedented 521 teachers attending. These teachers then used our resources to reach an estimated 14,000 students during that single academic year. EdGEO workshops are locally driven and are therefore very diverse. Workshops are strongly tied to the provincial curriculum, focus on a specific geoscience topic, or may be largely field-based to demonstrate and practice how field activities could be incorporated into Earth science teaching. Many strive to include all of these important components. Geoscientists and teachers work collaboratively to develop and deliver EdGEO workshops to ensure that the activities can be effectively used in the classroom. The length of these professional development opportunities range from two-hour sessions to several days, and can generally accommodate up to twenty

  2. Creating a Minnesota Statewide SNAP-Ed Program Evaluation (United States)

    Gold, Abby; Barno, Trina Adler; Sherman, Shelley; Lovett, Kathleen; Hurtado, G. Ali


    Systematic evaluation is an essential tool for understanding program effectiveness. This article describes the pilot test of a statewide evaluation tool for the Supplemental Nutrition Assistance Program-Education (SNAP-Ed). A computer algorithm helped Community Nutrition Educators (CNEs) build surveys specific to their varied educational settings…

  3. Translation of Hecker's 1922 "the occipital-atlanto-axial ligament system": A study in comparative anatomy. (United States)

    Oakes, Peter C; Sardi, Juan Pablo; Iwanaga, Joe; Topale, Nitsa; Oskouian, Rod J; Tubbs, R Shane


    In 1922, Paul Hecker, a French physician and Head of Anatomy at the Medical College of Strasbourg, published a sentinel thesis on the ligaments of the craniocervical junction based on a study of comparative anatomy. Unfortunately, this dissertation has been lost to history and until now, was unavailable in the English language. Herein, we present a translation of Hecker's work with an update in its nomenclature, which with modern imaging capabilities of the craniocervical junction is germane and timely. Clin. Anat. 30:322-329, 2017. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

  4. Teachers are students in ZPG program called 'Pop Ed.'. (United States)

    Schline, S


    Zero Population Growth's Population Education (Pop Ed) program began in 1975 as an ongoing effort to bring the "real world" into the classroom by demonstrating the relationships among population trends, food and energy resources, and environmental and economic problems. The training workshops which last for a day or 2 have the following goals: 1) to offer a brief demographic overview for teachers, 2) to provide lesson plans and techniques readily usable in the classroom, 3) to alert teachers to the best written and audiovisual materials available, 4) to identify local resources for teaching Pop Ed, and 5) to provide sample materials. In the 1st year of program operation 10 workshops were held. These workshops are credited, at least partly, with the subsequent population instruction that reached over 10,400 students and 1600 teachers. Another 15 workshops were held in the 2nd year of operation. Obstacles to the program are the assumption on the part of some teachers that Pop Ed belongs in disciplines other than their own and the belief on the part of many teachers that they will require extensive training.

  5. Action Research in EdD Programs in Educational Leadership (United States)

    Osterman, Karen; Furman, Gail; Sernak, Kathleen


    This exploratory study gathered information about the use of action research within doctor of education programs in educational leadership and explored faculty understanding of and perspectives on action research. Survey data established that action research is used infrequently to meet dissertation requirements. Contributing factors include lack…

  6. Unique program aims to connect frequent ED utilizers with medical homes, resources to meet complex needs. (United States)


    Sinai Hospital of Baltimore in Baltimore, MD, is partnering with HealthCare Access Maryland, a non-profit organization in the state, to link patients who frequent the ED for care with medical homes and other resources that can better meet their medical and social needs. Under the Access Health Program, ED-based care coordinators intervene with patients who meet program criteria, linking them with medical homes and other resources that address their complex needs. The hospital has devised a flag to notify the ED when a frequent-utilizing patient presents in the department for care. Care coordinators then meet with these patients and get their consent to participate in the program. Within a week of the ED visit, care coordinators schedule a home visit with the patient to establish a care plan containing specific goals and a time frame to carry out these goals. Patients remain in the program for 90 days as care coordinators work to hand them off to longer-term resources. Many of the patients enrolled in the program have substance abuse and mental health problems. Patients are also often uninsured and/or homeless. Within two months of launching the program, care coordinators enrolled 74 patients, with the goal of eventually bringing that number to 200.

  7. APA Reporting Standards in Quantitative Research Dissertations from an Online EdD Program (United States)

    Salgado, Griselle


    This study was an investigation of the reporting practices in dissertations with quantitative research designs produced by students enrolled in an online Doctor of Education (EdD) program, one that follows the American Psychological Association (APA) standards for reporting research. Limited, empirical information exists about the competencies in…

  8. Connecting Teachers and Ed-Tech Developers: Lessons from NYC's "Gap App" Program. Technical Appendices (United States)

    Villavicencio, Adriana; Siman, Nina; Lafayette, Camille; Kang, David


    In 2011, with support from a federal Investing in Innovation grant, the NYC Department of Education launched Innovate NYC Schools. The initiative was designed to address two, related challenges to effectively integrating education technology (ed-tech) into classrooms: First, procurement of ed-tech tools is often hampered by a disconnect between…

  9. Connecting Teachers and Ed-Tech Developers: Lessons from NYC's "Gap App" Program. Report (United States)

    Villavicencio, Adriana; Siman, Nina; Lafayette, Camille; Kang, David


    In 2011, with support from a federal Investing in Innovation grant, the NYC Department of Education launched Innovate NYC Schools. The initiative was designed to address two, related challenges to effectively integrating education technology (ed-tech) into classrooms: First, procurement of ed-tech tools is often hampered by a disconnect between…

  10. Student Support and Advising in a New Online Ed.D. of Instructional Systems Technology Program: A Design Case (United States)

    Exter, Marisa; Korkmaz, Nilufer; Boling, Elizabeth


    This design case describes an online Ed.D. in Instructional Systems Technology (IST) launched in 2012. We will focus on a key aspect of the design: program advising and students' relationship with their advisors. While the design was responsive in its earliest stages to organizational constraints, legislative requirements and the known…

  11. The development of a TED-Ed online resident research training program

    Directory of Open Access Journals (Sweden)

    Katherine A. Moreau


    Full Text Available Background: Pediatric health research is important for improving the health and well-being of children and their families. To foster the development of physicians’ research competencies, it is vital to integrate practical and context-specific research training into residency programs. Purpose: To describe the development of a resident research training program at one tertiary care pediatric academic health sciences center in Ontario, Canada. Methods: We surveyed residents and pediatricians/research staff to establish the need and content for a resident research training program. Results: Residents and resident research supervisors agreed or strongly agreed that research training is important for residents. However, few residents and supervisors believed that their academic health sciences center provided adequate training and resources to support resident research. As such, an online resident research training program was established. Residents and supervisors agreed that the program should focus on the following topics: 1 critically evaluating research literature, 2 writing a research proposal, 3 submitting an application for research funding, and 4 writing a manuscript. Discussion: This highly accessible, context-specific, and inexpensive online program model may be of interest and benefit to other residency programs as a means to enhance residents’ scholarly roles. A formal evaluation of the research training program is now underway.

  12. Differences Between Emergency Nurse Perception and Patient Reported Experience With an ED HIV and Hepatitis C Virus Screening Program. (United States)

    White, Douglas A E; Anderson, Erik S; Pfeil, Sarah K; Graffman, Sarah E; Trivedi, Tarak K


    Nontargeted human immunodeficiency virus (HIV) screening and targeted hepatitis C virus (HCV) screening for selected high-risk patients (those born between 1945 and 1965 and those who report injection drug use) was integrated into our ED triage process and carried out by nurses. Determining whether emergency nurses accurately perceive what patients experience is important to know because staff misperceptions may pose a barrier to program adherence and sustainability. We performed a cross-sectional survey study of emergency nurses and patients to assess the accuracy of emergency nurses' perception of patient experience with the HIV/HCV screening program. Respondents evaluated their level of agreement using a 5-item Likert scale for 9 statements across 4 domains related to the patient experience with the screening process (satisfaction, sense of autonomy, sense of privacy, and comfort level). Surveys were completed by 65 of the 153 eligible emergency nurses (42%). Of the 1040 patients approached, 610 (59%) were eligible, and 491 of the 610 eligible patients (80%) completed surveys. Across all domains, statistically significant differences were found between emergency nurse perception and patient report, P < .001. Emergency nurses perceived patients to be less satisfied with the screening program, more uncomfortable with being asked screening questions, more concerned about privacy issues, and less likely to feel that the decision to decline screening was autonomous than were patients. Emergency nurses not only frequently misperceive how patients experience ED-based HIV/HCV screening, but these misperceptions are skewed toward the negative, representing a type of staff bias. Further research is recommended to determine if such misperceptions adversely affect implementation of screening. Copyright © 2016 Emergency Nurses Association. Published by Elsevier Inc. All rights reserved.

  13. Online learning tools in an M.Ed. in Earth Sciences program (United States)

    Richardson, E.


    Penn State's Master of Education in Earth Sciences program is a fully online 30-credit degree program serving mid-career secondary science teachers. Teachers in the program have a diverse background in science and math, are usually many years removed from their most recent degree, and are often deficient in the same geoscience skills as are beginning undergraduates. For example, they habitually assign incorrect causal relationships to concepts that are taught at the same time (such as sea-floor spreading and magnetic field reversals), and they have trouble with both object and spatial visualization. Program faculty also observe anecdotally that many teachers enter the program lacking the ability to describe their mental model of a given Earth science process, making it difficult to identify teachers' knowledge gaps. We have implemented many technical strategies to enhance program content delivery while trying to minimize the inherent barriers to completing quantitative assignments online and at a distance. These barriers include competence with and access to sophisticated data analysis and plotting programs commonly used by scientists. Here, I demonstrate two technical tools I use frequently to strengthen online content delivery and assessment. The first, Jing, is commercially-available, free, and platform-independent. Jing allows the user to make screencasts with narration and embed them into a web page as a flash movie or as an external link. The second is a set of simple sketching tools I have created using the programming language Processing, which is a free, open source, platform-independent language built on Java. The integration of easy-to-use drawing tools into problem sets and other assessments has enabled faculty to appraise a learner's grasp of the material without the steep technical learning curve and expense inherent in most computer graphics packages. A serendipitous benefit of teaching with these tools is that they are easy to learn and freely

  14. Feasibility, acceptability, and initial efficacy of an online sexual health promotion program for LGBT youth: the Queer Sex Ed intervention. (United States)

    Mustanski, Brian; Greene, George J; Ryan, Daniel; Whitton, Sarah W


    Lesbian, gay, bisexual, and transgender (LGBT) youth experience multiple sexual health inequities driven, in part, by deficits in parental and peer support, school-based sex education programs, and community services. Research suggests that the Internet may be an important resource in the development of sexual health among LGBT youth. We examined the feasibility of recruiting youth in same-sex relationships into an online sexual health intervention, evaluated intervention acceptability, and obtained initial estimates of intervention efficacy. LGBT youth (16 to 20 years old) completed Queer Sex Ed (QSE), an online, multimedia sexual health intervention consisting of five modules. The final sample (N = 202) completed the pretest, intervention, and posttest assessments. The primary study outcomes were sexual orientation identity and self-acceptance (e.g., coming-out self-efficacy), sexual health knowledge (e.g., sexual functioning), relationship variables (e.g., communication skills), and safer sex (e.g., sexual assertiveness). Analyses indicated that 15 of the 17 outcomes were found to be significant (p acceptability, and initial efficacy of QSE, an innovative online comprehensive sexual health program for LGBT youth.

  15. Validation of a Collaboration Readiness Assessment Tool for Use by Supplemental Nutrition Assistance Program-Education (SNAP-Ed) Agencies and Partners. (United States)

    Butel, Jean A; Banna, Jinan C; Novotny, Rachel; Franck, Karen L; Parker, Stephany P; Stephenson, Laura


    To evaluate content and face validity of a collaboration readiness assessment tool developed to facilitate collaborative efforts to implement policy, systems, and environment changes in Supplemental Nutrition Assistance Program-Education (SNAP-Ed). Evaluation of the validity of the tool involved 2 steps. Step 1 was conducted with 4 subject matter experts to evaluate content validity. Step 2 used an iterative cognitive testing process with 4 rounds and 16 SNAP-Ed staff and community partners to evaluate face validity. Subject matter experts found that survey items appropriately matched the content area indicated and adequately covered collective efficacy, change efficacy, and readiness. Cognitive testing with SNAP-Ed staff and partners informed modifications and resulted in adequate face validity. The ability to measure collaboration readiness will allow agencies and community partners that implement SNAP-Ed to target areas that facilitate collaboration efforts needed for policy, systems, and environment change and collective efficacy. Further cognitive testing of the tool with other populations is needed to ensure its applicability and usefulness. Evaluation of the reliability of the tool with a broad range of SNAP-Ed programs and community agencies is also recommended. Copyright © 2017 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

  16. Age Difference in Research Course Satisfaction in a Blended Ed.D. Program: A Moderated Mediation Model of the Effects of Internet Self-Efficacy and Statistics Anxiety (United States)

    Liu, Lu; Haque, M. D.


    This study identified the moderated mediation relationship among age, Internet self-efficacy, and statistics anxiety on student satisfaction after controlling for demographics and technology experiences in research methods courses in a blended professional doctoral program. One hundred and thirty-one students in a three-year Ed.D. Program…

  17. SNAP-Ed (Supplemental Nutrition Assistance Program-Education) Increases Long-Term Food Security among Indiana Households with Children in a Randomized Controlled Study. (United States)

    Rivera, Rebecca L; Maulding, Melissa K; Abbott, Angela R; Craig, Bruce A; Eicher-Miller, Heather A


    Food insecurity is negatively associated with US children's dietary intake and health. The Supplemental Nutrition Assistance Program-Education (SNAP-Ed) aims to alleviate food insecurity by offering nutrition, budgeting, and healthy lifestyle education to low-income individuals and families. The objective of this study was to evaluate the long-term impact of the Indiana SNAP-Ed on food security among households with children. A randomized, controlled, parallel study design with SNAP-Ed as an intervention was carried out during a 4- to 10-wk intervention period. Intervention group participants received the first 4 Indiana SNAP-Ed curriculum lessons. Study participants (n = 575) were adults aged ≥18 y from low-income Indiana households with ≥1 child living in the household. Both treatment groups completed an assessment before and after the intervention period and 1 y after recruitment. The 18-item US Household Food Security Survey Module was used to classify the primary outcomes of food security for the household and adults and children in the household. A linear mixed model was used to compare intervention with control group effects over time on food security. Mean ± SEM changes in household food security score and food security score among household adults from baseline to 1-y follow-up were 1.2 ± 0.4 and 0.9 ± 0.3 units lower, respectively, in the intervention group than in the control group (P food security score from baseline to 1-y follow-up among household children was not significantly different in the intervention group compared with the control group. SNAP-Ed improved food security over a longitudinal time frame among low-income Indiana households with children in this study. SNAP-Ed may be a successful intervention to improve food security. © 2016 American Society for Nutrition.

  18. 78 FR 71591 - Privacy Act of 1974; Computer Matching Program between the U.S. Department of Education (ED) and... (United States)


    ...) (recipient agency) and the U.S. Department of Veterans Affairs (VA) (source agency). After the ED and VA Data..., the Computer Matching and Privacy Protection Act of 1988, 54 FR 25818 (June 19, 1989), and OMB... published in the Federal Register, in text or Adobe Portable Document Format (PDF). To use PDF you must have...

  19. Higher Ed Meets Public Ed. (United States)

    Olenick, Mary Jo


    The University of Connecticut is revitalizing the Avery Point campus with two new buildings. A Marine Sciences and Technology Center will serve graduate and undergraduate students. A separate Marine Sciences Field Station/Hostel will house Project Oceanology: a science program for students in grades 5-12. (MLF)

  20. Application of IMPLAN to Extension Programs: Economic Impacts of the University of Arizona Cooperative Extension SNAP-Ed Spending (United States)

    Kerna, Ashley; Frisvold, George; Jacobs, Laurel; Farrell, Vanessa A.; Houtkooper, Linda; Misner, Scottie


    Many Extension programs are turning to the input-output software IMPLAN to demonstrate economic impacts. IMPLAN is a powerful tool that can be used to estimate the total economic activity associated with an industry, event, or policy. One possible application, therefore, is to use program spending data to estimate the economic effects of…

  1. Practice characteristics of Emergency Department extracorporeal cardiopulmonary resuscitation (eCPR) programs in the United States: The current state of the art of Emergency Department extracorporeal membrane oxygenation (ED ECMO). (United States)

    Tonna, Joseph E; Johnson, Nicholas J; Greenwood, John; Gaieski, David F; Shinar, Zachary; Bellezo, Joseph M; Becker, Lance; Shah, Atman P; Youngquist, Scott T; Mallin, Michael P; Fair, James Franklin; Gunnerson, Kyle J; Weng, Cindy; McKellar, Stephen


    To characterize the current scope and practices of centers performing extracorporeal cardiopulmonary resuscitation (eCPR) on the undifferentiated patient with cardiac arrest in the emergency department. We contacted all US centers in January 2016 that had submitted adult eCPR cases to the Extracorporeal Life Support Organization (ELSO) registry and surveyed them, querying for programs that had performed eCPR in the Emergency Department (ED ECMO). Our objective was to characterize the following domains of ED ECMO practice: program characteristics, patient selection, devices and techniques, and personnel. Among 99 centers queried, 70 responded. Among these, 36 centers performed ED ECMO. Nearly 93% of programs are based at academic/teaching hospitals. 65% of programs are less than 5 years old, and 60% of programs perform ≤3 cases per year. Most programs (90%) had inpatient eCPR or salvage ECMO programs prior to starting ED ECMO programs. The majority of programs do not have formal inclusion and exclusion criteria. Most programs preferentially obtain vascular access via the percutaneous route (70%) and many (40%) use mechanical CPR during cannulation. The most commonly used console is the Maquet Rotaflow(®). Cannulation is most often performed by cardiothoracic (CT) surgery, and nearly all programs (>85%) involve CT surgeons, perfusionists, and pharmacists. Over a third of centers that submitted adult eCPR cases to ELSO have performed ED ECMO. These programs are largely based at academic hospitals, new, and have low volumes. They do not have many formal inclusion or exclusion criteria, and devices and techniques are variable. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  2. Inform@ed space

    DEFF Research Database (Denmark)

    Bjerrum, Peter; Olsen, Kasper Nefer


    Inform@ed space Sensorial Perception And Computer Enchancement - bidrag til Nordisk Arkitekturforskningsforenings IT-konference, AAA april 2001.......Inform@ed space Sensorial Perception And Computer Enchancement - bidrag til Nordisk Arkitekturforskningsforenings IT-konference, AAA april 2001....

  3. A Mixed-Methods Evaluation of a SNAP-Ed Farmers' Market-Based Nutrition Education Program. (United States)

    Dannefer, Rachel; Abrami, Alyson; Rapoport, Rebecca; Sriphanlop, Pathu; Sacks, Rachel; Johns, Michael


    Evaluate the effectiveness of the Stellar Farmers' Market program. Mixed methods including focus groups and a quasi-experiment comparing a control group of market shoppers who had never attended a class, participants attending 1 class, and participants attending ≥ 2 classes. Eighteen farmers' markets in New York City. A total of 2,063 survey respondents; 47 focus group participants. Farmers' market-based nutrition education and cooking classes paired with vouchers for fresh produce. Attitudes, self-efficacy, and behaviors regarding fruit and vegetable (FV) preparation and consumption. Bivariate and regression analysis examined differences in outcomes as a function of number of classes attended. Qualitative analysis based on a grounded theory approach. Attending ≥ 1 classes was associated with more positive attitudes toward consuming FV; attending ≥ 2 classes was associated with greater FV consumption and higher self-efficacy to prepare and consume produce. Respondents attending ≥ 2 classes consumed almost one-half cup more FV daily than others. These associations remained after controlling for age, race/ethnicity, education, and gender. Offering nutrition education and cooking classes at farmers' markets may contribute to improving attitudes, self-efficacy, and behaviors regarding produce preparation and consumption in low-income populations. Copyright © 2015 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

  4. Face validity of VIS-Ed: a visualization program for teaching medical students and residents the biomechanics of cervical spine trauma. (United States)

    Courteille, Olivier; Ho, Johnson; Fahlstedt, Madelen; Fors, Uno; Felländer-Tsai, Li; Hedman, Leif; Möller, Hans


    This RCT study aimed to investigate if VIS-Ed (Visualization through Imaging and Simulation - Education) had the potential to improve medical student education and specialist training in clinical diagnosis and treatment of trauma patients. The participants' general opinion was reported as high in both groups (lecture vs. virtual patient (VP)). Face validity of the VIS-Ed for cervical spine trauma was demonstrated and the VP group reported higher stimulation and engagement compared to the lecture group. No significant difference in the knowledge test between both groups could be observed, confirming our null hypothesis that VIS-Ed was on par with a lecture.

  5. Exploring the association of urban or rural county status and environmental, nutrition- and lifestyle-related resources with the efficacy of SNAP-Ed (Supplemental Nutrition Assistance Program-Education) to improve food security. (United States)

    Rivera, Rebecca L; Dunne, Jennifer; Maulding, Melissa K; Wang, Qi; Savaiano, Dennis A; Nickols-Richardson, Sharon M; Eicher-Miller, Heather A


    To investigate the association of policy, systems and environmental factors with improvement in household food security among low-income Indiana households with children after a Supplemental Nutrition Assistance Program-Education (SNAP-Ed) direct nutrition education intervention. Household food security scores measured by the eighteen-item US Household Food Security Survey Module in a longitudinal randomized and controlled SNAP-Ed intervention study conducted from August 2013 to April 2015 were the response variable. Metrics to quantify environmental factors including classification of urban or rural county status; the number of SNAP-authorized stores, food pantries and recreational facilities; average fair market housing rental price; and natural amenity rank were collected from government websites and data sets covering the years 2012-2016 and used as covariates in mixed multiple linear regression modelling. Thirty-seven Indiana counties, USA, 2012-2016. SNAP-Ed eligible adults from households with children (n 328). None of the environmental factors investigated were significantly associated with changes in household food security in this exploratory study. SNAP-Ed improves food security regardless of urban or rural location or the environmental factors investigated. Expansion of SNAP-Ed in rural areas may support food access among the low-income population and reduce the prevalence of food insecurity in rural compared with urban areas. Further investigation into policy, systems and environmental factors of the Social Ecological Model are warranted to better understand their relationship with direct SNAP-Ed and their impact on diet-related behaviours and food security.

  6. PREFACE: EDS2010 Preface (United States)

    Heggie, Malcolm I.


    The biennial international conference on Extended Defects in Semiconductors started in 1978 with a meeting in Hünfeld, Germany. Subsequent meetings rotated between Poland, France, Great Britain, Germany, Russia and Italy, culminating in EDS2004 in Chernogolovka, EDS2006 in Halle and EDS2008 in Poitiers. EDS2010 was held at the University of Sussex at Brighton, UK from September 19th to 24th. An extension of the tabulation of this history, which first appeared on the EDS2006 website, is given in the attached PDF. It is with sadness that we note one of the founders of the series, Prof. Dr Helmut Alexander, passed away on 3 December 2009 and we were proud to dedicate EDS2010 to his memory. It has become a tradition to make an award in his name, and this year it was made to Ivan Isacov for his poster "Electrical levels of dislocation networks in p- and n-type silicon". A short and warm celebration of Prof. Dr Alexander's life by his friends and colleagues, Prof. Drs Helmut Gottschalk, Eicke Weber and Wolfgang Schröter, is included in this volume. The conference was a forum for the state-of-the-art of investigation and modelling of extended defects in semiconductors. Scientists from universities, research institutes and industry made contributions to a deeper understanding of extended defects, their interaction with point defects and their role in the development of semiconductor technology. The remit of the conference included extended defects, nanostructures, nanoparticles, quantum dots and interfaces within semiconducting materials ranging from narrow to wide band gaps, including graphene-derived materials and diamond. Scientific interests range from defect geometry, electronic structure, dynamics, spectroscopy, microscopy, reactions and chemistry to introduction mechanisms, such as implantation and strained layers and the operation of devices such as integrated circuits, heterostructures, and solar cells. The organisers were confronted with a long period between

  7. Completing EdTPA: TSOL Candidate Performance and Reflection (United States)

    Micek, Timothy A.


    edTPA is a pre-service assessment process designed to determine if a new teacher is ready for the job. edTPA is part of a national movement towards the use of performance assessments in teacher education. As of 2014, 41 states (a) require a state-approved performance assessment like edTPA for program completion or for state licensure and/or state…

  8. Using Kentucky State Standards as Benchmarks: Quantifying Incoming Ed.S. Students' Knowledge as They Journey toward Principalship (United States)

    Hearn, Jessica E.


    Principal preparation programs in Kentucky can use the items in the Dispositions, Dimensions, and Functions for School Leaders (EPSB, 2008) as mastery benchmarks to quantify incoming Educational Specialist (Ed.S) students' perceived level of mastery. This can serve both internal and external purposes by providing diagnostic feedback to students…

  9. Patient-Centered Care Transition for Patients Admitted through the ED: Improving Patient and Employee Experience


    Andrea Algauer BSN, RN; Stephanie Rivera BSN, RN; Robert Faurote BSN, RN


    With increasing wait times in emergency departments (ED) across America, there is a need to streamline the inpatient admission process in order to decrease wait times and more important, to increase patient and employee satisfaction. One inpatient unit at New York-Presbyterian Weill Cornell Medical Center initiated a program to help expedite the inpatient admission process from the ED. The goal of the ED Bridge program is to ease the patient's transition from the ED to an inpatient unit by vi...

  10. EDS becomes CERN Openlab contributor

    CERN Multimedia


    "EDS today announced that it has become an official contributor to CERN openlab. The purpose of the joint project between CERN and EDS is to carry out research and development in the field of monitoring, management and operaiton of grid services." (2/3 page)

  11. Rebooting the EdD (United States)

    Wergin, Jon F.


    In this essay, Jon Wergin reminds readers of the philosophical and historical foundations of the doctor of education (EdD) degree. He argues that the EdD should be based, in large part, on John Dewey's progressive ideals of democratization and Paulo Freire's concepts of emancipatory education. Drawing on theories of reflective practice,…

  12. EDS becoms CERN Openlab contributor

    CERN Multimedia


    "EDS announced that it has become an official contributor to CERN openlab. The purpose of the joint project beteween CERN and EDS is to carry out research and development in the field of monitoring, management and operation of grid services." (1 page)

  13. Voc-Ed Update. (United States)

    Hawaii Univ., Honolulu. Office of the State Director for Vocational Education.

    An overview is presented of vocational education in Hawaii. The first two sections define vocational education and contrast it to employment training, emphasizing the need for coordination between secondary and postsecondary programs. Noting the impact of federal funding laws, the next section describes the composition and responsibilities of the…

  14. TechEdSat Project (United States)

    National Aeronautics and Space Administration — The overall goal of the Technical Education Satellite (TechEdSat) is to employ a small spacecraft to evaluate, demonstrate, and validate two new technologies for...

  15. Democrazia ed élites

    Directory of Open Access Journals (Sweden)



    Full Text Available L’articolo si propone di mostrare che la teoria della classe politica, formulata ed elaborata da scrittori conservatori con precisi intenti di polemica antidemocratica, è stata utilizzata anche da scrittori decoratici; in secondo luogo di confermare la tesi cara a Pareto, secondo cui altro è il valore scientifico di una teoria politica, altro il suo uso ideologico

  16. Mitigating Higher Ed Cyber Attacks (United States)

    Rogers, Gary; Ashford, Tina


    In this presentation we will discuss the many and varied cyber attacks that have recently occurred in the higher ed community. We will discuss the perpetrators, the victims, the impact and how these institutions have evolved to meet this threat. Mitigation techniques and defense strategies will be covered as will a discussion of effective security…

  17. 35 years of EDS software. (United States)

    Schamber, Frederick H


    The computerized multichannel analyzer running software specifically designed for X-ray analysis appeared very early in the commercialization of the energy dispersive X-ray spectrometer (EDS) and, like the solid-state X-ray detector itself, was built on a technology foundation originally developed for nuclear spectroscopy. However, software techniques employed for gamma-ray spectra could not accommodate the continuum component of EDS spectra, and a new approach was required. Least-squares fitting with "top-hat" filtered spectra proved to be an effective solution that is still widely used today. Though modern computer technology has subsequently contributed greatly to the speed and convenience of present-day EDS software, it seems that the achievable accuracy and precision of spectrum analysis has not fundamentally improved, and most of the early challenges are still quite relevant, although they may appear in new guises. The availability of the high speed silicon drift detector, however, may provide both the incentive and the data precision to drive future advances. This article traces the formative years of EDS software from the personalized perspective of a participant. Factors that shaped the development of the industry are identified, and future directions are speculated.

  18. Structure of catalase determined by MicroED (United States)

    Nannenga, Brent L; Shi, Dan; Hattne, Johan; Reyes, Francis E; Gonen, Tamir


    MicroED is a recently developed method that uses electron diffraction for structure determination from very small three-dimensional crystals of biological material. Previously we used a series of still diffraction patterns to determine the structure of lysozyme at 2.9 Å resolution with MicroED (Shi et al., 2013). Here we present the structure of bovine liver catalase determined from a single crystal at 3.2 Å resolution by MicroED. The data were collected by continuous rotation of the sample under constant exposure and were processed and refined using standard programs for X-ray crystallography. The ability of MicroED to determine the structure of bovine liver catalase, a protein that has long resisted atomic analysis by traditional electron crystallography, demonstrates the potential of this method for structure determination. DOI: PMID:25303172

  19. Patient-Centered Care Transition for Patients Admitted through the ED: Improving Patient and Employee Experience

    Directory of Open Access Journals (Sweden)

    Andrea Algauer BSN, RN


    Full Text Available With increasing wait times in emergency departments (ED across America, there is a need to streamline the inpatient admission process in order to decrease wait times and more important, to increase patient and employee satisfaction. One inpatient unit at New York-Presbyterian Weill Cornell Medical Center initiated a program to help expedite the inpatient admission process from the ED. The goal of the ED Bridge program is to ease the patient's transition from the ED to an inpatient unit by visiting the patient in the ED and introducing and setting expectations for the inpatient environment (i.e. telemetry alarms, roommates, hourly comfort rounds. Along with improving the patient experience, this program intends to improve the collaboration between ED nurses and inpatient nurses. With the continued support of our nurse management, hospital administrators and most important, our staff, this concept is aimed to increase patient satisfaction scores and subsequently employee satisfaction.

  20. Patient-Centered Care Transition for Patients Admitted through the ED: Improving Patient and Employee Experience. (United States)

    Algauer, Andrea; Rivera, Stephanie; Faurote, Robert


    With increasing wait times in emergency departments (ED) across America, there is a need to streamline the inpatient admission process in order to decrease wait times and more important, to increase patient and employee satisfaction. One inpatient unit at New York-Presbyterian Weill Cornell Medical Center initiated a program to help expedite the inpatient admission process from the ED. The goal of the ED Bridge program is to ease the patient's transition from the ED to an inpatient unit by visiting the patient in the ED and introducing and setting expectations for the inpatient environment (i.e. telemetry alarms, roommates, hourly comfort rounds). Along with improving the patient experience, this program intends to improve the collaboration between ED nurses and inpatient nurses. With the continued support of our nurse management, hospital administrators and most important, our staff, this concept is aimed to increase patient satisfaction scores and subsequently employee satisfaction.

  1. Ed Watson 1940-2006

    CERN Document Server


    Ed Watson arrived at CERN in March 1973 to work on digital electronics and CAMAC systems under Bob Dobinson, after many years at Rolls Royce in Scotland. He joined the European Muon Collaboration in 1976, where he played a major role in the design, deployment and running of its data acquisition system (DAQ) with David Botterill, Bob Dobinson, and Vicky White. The CAMAC-ROMULUS system was by far the largest and most advanced of its time, and it became a defining standard for DAQ systems for years to come. Ed was deeply involved in the detailed planning of the control rooms and the experiment cabling, as well as sharing the responsibility for the CAMAC readout system. He had a real talent for trouble shooting and played a vital part in supporting the experiment throughout its lifetime. He offered great moral support to the younger members of the collaboration and helped them a great deal with their work. The EMC had a wonderful social life to which Ed was a major contributor - who can forget its barbecues?  In...

  2. Ed Watson - 1940-2006

    CERN Multimedia


    Ed Watson passed away suddenly on 1 August in Geneva, he was 66. He leaves his wife and two children. Ed Watson arrived at CERN in March 1973 to work on digital electronics and CAMAC systems under Bob Dobinson, after many years at Rolls Royce in Scotland. He joined the European Muon Collaboration in 1976, where he played a major role in the design, deployment and running of its data acquisition system (DAQ) with David Botterill, Bob Dobinson, and Vicky White. The CAMAC-ROMULUS system was by far the largest and most advanced of its time, and it became a defining standard for DAQ systems for years to come. Ed was deeply involved in the detailed planning of the control rooms and the experiment cabling, as well as sharing the responsibility for the CAMAC readout system. He had a real talent for trouble shooting and played a vital part in supporting the experiment throughout its lifetime. He offered great moral support to the younger members of the collaboration and helped them a great deal with their work. The...

  3. Perceptions of empowerment among ED nurses. (United States)

    DeVivo, Diane; Quinn Griffin, Mary T; Donahue, Moreen; Fitzpatrick, Joyce J


    Nurses' perceptions of empowerment have been linked to a number of variables in the hospital workplace, including job satisfaction, autonomy, and work effectiveness. Yet there have been no previous studies of perceptions of empowerment specifically among emergency department (ED) nurses. Registered nurses (RNs) employed in the EDs of 6 hospitals in a major health care system in the eastern United States were surveyed regarding their perceptions of empowerment. Of the 240 RNs eligible to participate, there were 167 usable surveys. There was a moderate level of empowerment among the RNs who participated, consistent with the level of empowerment reported in several other studies of staff nurses and nurses in other positions. The moderate level of empowerment in this sample may be attributed to the many opportunities for RN involvement in the hospitals within this health care system. Nurse leaders can initiate programs focused on enhancing RN perceptions of empowerment. In addition, there is a need for further research among RNs with different specialty preparation. Copyright © 2013. Published by Mosby, Inc.

  4. 78 FR 55684 - ConnectED Workshop (United States)


    ... National Telecommunications and Information Administration ConnectED Workshop AGENCY: National... in the United States to next- generation broadband. This Notice announces that the ConnectED Workshop... ConnectED Workshop will discuss the growing bandwidth needs of K-12 schools as more schools use mobile...

  5. AdvancED Flex 4

    CERN Document Server

    Tiwari, Shashank; Schulze, Charlie


    AdvancED Flex 4 makes advanced Flex 4 concepts and techniques easy. Ajax, RIA, Web 2.0, mashups, mobile applications, the most sophisticated web tools, and the coolest interactive web applications are all covered with practical, visually oriented recipes. * Completely updated for the new tools in Flex 4* Demonstrates how to use Flex 4 to create robust and scalable enterprise-grade Rich Internet Applications.* Teaches you to build high-performance web applications with interactivity that really engages your users.* What you'll learn Practiced beginners and intermediate users of Flex, especially

  6. Phys Ed Facility Invites Participation (United States)

    American School and University, 1975


    The visibility and central location of the Robert Crown Center at Hampshire College in Amherst, Massachusetts, bring the students in contact with the physical recreation and sports program. (Author/MLF)

  7. Protecting the Voc Ed Consumer. (United States)

    Wilms, Wellford W.

    To test the differences in effect of postsecondary vocational training offered by public schools and by proprietary schools, a study based on a sample of 4,8000 students and graduates in the accounting, programing, electronic technician training, dental assisting, secretarial, and cosmetology occupations was designed. Even though vocational…

  8. Does routine symptom screening with ESAS decrease ED visits in breast cancer patients undergoing adjuvant chemotherapy? (United States)

    Barbera, L; Sutradhar, R; Howell, D; Sussman, J; Seow, H; Dudgeon, D; Atzema, C; Earle, C; Husain, A; Liu, Y; Krzyzanowska, M K


    In 2007, the provincial cancer agency in Ontario, Canada initiated a wide-scale program to screen for symptoms in the cancer population using the Edmonton Symptom Assessment Scale (ESAS). The purpose of this study is to evaluate the impact of screening with ESAS on emergency department (ED) visit rates in women with breast cancer receiving adjuvant chemotherapy. This retrospective cohort study used linked administrative health care data from across the province of Ontario, Canada. The cohort included all women aged ≥18 who were diagnosed with stage I-III breast cancer between January 2007 and December 2009 and received adjuvant chemotherapy within 6 months of diagnosis. Using an adjusted recurrent event model, we examined the association of screening with ESAS at a clinic visit on the ED visit rate. The relative rate of ED visits was 0.57 when prior ESAS screening occurred compared to when it did not. The relative rate of ED visits was 0.83 when the prior number of ESAS screens was modeled as a continuous variable. Alternatively stated, the rate of ED visits was 43 % lower among patients previously screened with ESAS compared to those not previously screened. For each additional prior ESAS assessment, there was a 17 % decreased rate of ED visits. Our results demonstrate that screening with ESAS is associated with decreased ED visits. To our knowledge, this is the first report on the effectiveness of routinely documenting a patient reported outcome on ED visits, in a real-world setting.

  9. New EdF's three challenges; Les trois defis du nouvel EdF

    Energy Technology Data Exchange (ETDEWEB)

    Lepetit, V


    The opening of 15% of Electricite de France (EdF) capital to the private sector will allow the first world electric utility to raise 7 billions of euros of cash flow. EdF will have also to face the new European situation: a strained market, several consolidations to come and many competitors to deal with. EdF has to re-launch its production tool and to reinforce its interconnection capacities if it wants to stay the number one of power exports in Europe. The integration of Edison company (Italy) by EdF gives access to new gas capacities but other resources have to be found if EdF wants to enlarge its gas offer. A new concentration era is foreseen in Europe and EdF will have to seize the economic growth opportunities in particular in Europe and China. (J.S.)

  10. TED-Ed lessons & TED-Ed clubs: Educational activities to amplify students' voices (United States)

    Villias, Georgios


    TED-Ed lessons and TED-Ed clubs are two powerful educational tools that can be used in today's school classrooms in order to create an educational environment that is engaging for the students and favors their active participation, created and fostered by TED-Ed. TED-Ed is TED's educational initiative, committed to create lessons worth sharing and amplify the voices and ideas of teachers and students around the world. TED-Ed animated lessons are fully organized lessons structured around an animated video that introduces new topics to learners in an exciting, thought-provoking way. These lessons have been created as a result of the cooperation between expert educators and animators and have been uploaded at the TED-Ed platform ( On the other hand, TED-Ed Clubs are also an interesting way to offer students the chance, the voice and the opportunity to express their thoughts, engage actively on these matters and connect with each other, both at a local, as well as at an international level ( By developing new TED-Ed lessons or by customizing appropriately existing animated TED-Ed lessons (translating, modifying the questions asked, introducing new discussion topics), I have created and implemented in my student-centered, didactic approach, a series of TED-ED animated lessons directly connected with the Greek national science syllabus that were used to spark students curiosity and initiate a further analytical discussion or introduce other relevant educational activities ( Furthermore, at my school, we established Varvakeio TED-Ed Club, an environment that supports and empowers our students to research, develop and disseminate their own personal ideas that worth spreading. During the year, our members were inspired by watching TED talks presented by experts on their field on various different areas, including social, economical, environmental and technological-scientific issues. Our aim

  11. Ed Lorenz: Father of the 'Butterfly Effect'

    Indian Academy of Sciences (India)

    IAS Admin

    Ed Lorenz, rightfully acclaimed as the father of the 'Butterfly Effect', was an American math- ematician and meteorologist whose early work on weather prediction convinced the world at large about the unpredictability of weather. His seminal work on a simplified model for convec- tions in the atmosphere led to the modern ...

  12. (ED) by men in Edo state, Nigeria

    African Journals Online (AJOL)

    E. (Eshiobo) Irekpita


    May 3, 2017 ... of men in Edo state with regards to ED. The secondary objective .... Variables with sta- tistically significant correlation with IIEF score were respondents' location (P = 0.000), respondents' educational level (P = 0.000), number of wives (P ... between this variable and the level of education of the respondents.

  13. Clinical outcomes of ED patients with bandemia. (United States)

    Shi, Eileen; Vilke, Gary M; Coyne, Christopher J; Oyama, Leslie C; Castillo, Edward M


    Although an elevated white blood cell count is a widely utilized measure for evidence of infection and an important criterion for evaluation of systemic inflammatory response syndrome, its component band count occupies a more contested position within clinical emergency medicine. Recent studies indicate that bandemia is highly predictive of a serious infection, suggesting that clinicians who do not appreciate the value of band counts may delay diagnosis or overlook severe infections. Whereas previous studies focused on determining the quantitative value of the band count (ie, determining sensitivity, threshold for bandemia, etc.), this study directs attention to patient-centered outcomes, hypothesizing that the degree of bandemia predisposes patients to subsequent negative clinical outcomes associated with underappreciated severe infections. This retrospective study of electronic medical records includes patients who initially presented to the emergency department (ED) with bandemia and were subsequently discharged from the ED. These patients were screened for repeat ED visits within 7 days and death within 30 days. In patients with severe bandemia who were discharged from the ED, there was a 20.9% revisit rate at 7 days and a 4.9% mortality rate at 30 days, placing severely bandemic patients at 5 times significantly greater mortality compared to nonbandemic patients (P = .032). Our review of patient outcomes suggests that the degree of bandemia, especially in the setting of concurrent tachycardia or fever, is associated with greater likelihood of negative clinical outcomes. Copyright © 2015 Elsevier Inc. All rights reserved.

  14. Sustainable Mechanism to Reduce Emergency Department (ED) Length of Stay: The Use of ED Holding (ED Transition) Orders to Reduce ED Length of Stay. (United States)

    Haydar, Samir A; Strout, Tania D; Baumann, Michael R


    The objective was to evaluate the effect of an emergency clinician-initiated "ED admission holding order set" on emergency department (ED) treatment times and length of stay (LOS). We further describe the impact of a performance improvement strategy with sequential plan-do-study-act (PDSA) cycles used to influence the primary outcome measures, ED LOS, and disposition decision to patient gone (DDTPG) time, for admitted patients. We developed and implemented an expedited, emergency physician-facilitated admission protocol that bypassed typical inpatient workflows requiring inpatient evaluations prior to the placement of admission orders. During the 48-month study period, ED flow metrics generated during the care of 27,580 admissions from the 24-month period prior to the intervention were compared to the 29,978 admissions that occurred during the 24-month period following the intervention. The intervention was the result of an in-depth, five-phase PDSA cycle quality improvement intervention evaluating ED flow, which identified the requirement of bedside inpatient evaluations prior admission order placement as being a "non-value-added" activity. ED output flow metrics evaluating the admission process were tracked for 24 months following the intervention and were compared to the 24 months prior. The use of an emergency physician-initiated admission holding order protocol resulted in sustainable reductions in ED LOS when comparing the 2 years prior to the intervention, with median LOS of 410 (interquartile range [IQR] = 295 to 543) and 395 (IQR = 283 to 527) minutes, to the 2 calendar years following the intervention, with the median LOS of 313 (IQR = 21 to 431) and 316 (IQR = 224 to 438) minutes, respectively. This overall reduction in ED LOS of nearly 90 minutes was found to be primarily the result of a decrease in the time from the emergency physician's admitting DDTPG times with median times of 219 (IQR = 150 to 306) and 200 (IQR = 136 to 286) minutes for the 2 years

  15. Risk factors for ED use among homeless veterans. (United States)

    Tsai, Jack; Rosenheck, Robert A


    Despite national concern about homeless veterans, there has been little examination of their use of emergency department (ED) services. This study examines factors related to the use of ED services in the Veterans Affairs (VA) healthcare system, where insurance is not a barrier to ambulatory healthcare. National VA administrative data from fiscal year 2010 are used to describe the proportions of ED users among homeless and domiciled VA patients. A case-control design is then used to compare homeless ED and non-ED users on sociodemographic and clinical correlates, as well as use of ambulatory care and psychotropic medications. Sixteen percent of domiciled VA patients used EDs at least once during the year and 1% were frequent ED users (>4 ED visits) compared to 45% of homeless VA patients, 10% who were frequent ED users. Among homeless VA patients, those who used EDs were more likely to have a range of psychiatric and medical conditions, and had more service visits and psychotropic medication prescriptions than non-ED users. Multivariate analyses suggest their risk for psychiatric and medical conditions increase their likelihood of using ED services. The high rate of ED use among homeless veterans is associated with significant morbidity, but also greater use of ambulatory care and psychotropics suggesting their ED use may reflect unmet psychosocial needs. Published by Elsevier Inc.

  16. edX e-learning course development

    CERN Document Server

    Gilbert, Matthew A


    If you are an educator creating a course for edX or a corporate trainer using Open edX for large-scale learning and development initiatives, then edX E-Learning Course Development is the ideal book for you.

  17. La Costituzione Islandese: storia ed evoluzione

    Directory of Open Access Journals (Sweden)

    Fabio Quartino


    Full Text Available "La Costituzione Islandese: storia ed evoluzione" is a degree thesis defended on 15th July 2009 by Fabio Quartino under the supervision of Prof. Andrea Canepa of the University of Genoa, Italy. It offers an extensive overview of Icelandic history aimed at finding out the roots of the nation's constitutional order, which is currently in the process of being revised by the first ever elected constitutional assembly in the life of the country. Fabio Quartino's work wishes to be a source of useful information for Italian-speaking scholars who have an interest in Iceland's constitutional history and may not have access to comprehensive overviews in their native tongue.

  18. Bike Ed '77: A Conference Report (Washington, D.C., May 4-6, 1977). (United States)

    Johnson (Lawrence) and Associates, Inc., Washington, DC.

    As a result of intensified need for sound safety education programs for both young and mature bicyclists due to the dramatic increase in bicycling as a form of transportation and recreation, the first national conference on bicyclist safety education was held--Bike Ed '77. Major purposes of the conference were to stimulate communication among…

  19. WORK-ED. (World of Related Knowledge and Educational Development). A Manual for Trainers. (United States)

    Fraleigh, Virginia A.

    This manual is designed to assist personnel responsible for training teachers in the implementation of the World of Related Knowledge and Educational Development (WORK-ED). (The program is a career education course for ninth graders developed to enable students who have not chosen the traditional college-prep high school course to make career…

  20. Work-Ed. A Guide to the Changing World of Work. (United States)

    Fraleigh, Virginia A.

    A description of the project, its development process, evaluation results, and exportability are included in this overview of WORK-ED (World of Related Knowledge and Educational Development), a program to provide ninth grade students both basic skills in communication and exposure to twelve career clusters. Introductory sections describe the…

  1. An Analysis of Professional Practice Ed.D. Dissertations in Educational Technology (United States)

    Dawson, Kara; Kumar, Swapna


    The University of Florida offers an online professional practice Ed.D. focused on Educational Technology. Twenty-three students have completed professional practice dissertations and graduated since the program's inception in 2008. The purpose of this article is to share what these dissertations have looked like and to begin a dialogue about…

  2. Stanislaw Widlak (ed.), Italianità ed Italianistica nell'Europa Centrale ...

    African Journals Online (AJOL)


    nel futuro ad intensi scambi e collaborazioni tra italianisti che sono necessari allo sviluppo ed alla crescita di ogni disciplina. I partecipanti al congresso sono stati circa una cinquantina, tra studiosi e studenti, provenienti da una ventina di università e da una dozzina di paesi. Gli argomenti trattati nei loro interventi sono stati ...

  3. Hardiness Mediates Stress and Impact Level in ED Nurses Who Experienced a Violent Event. (United States)

    Park, Jin Hee; Lee, Eun Nam; Kong, Kyung Ran; Jang, Moon Jung


    This secondary analysis examined the mediating effect of hardiness between stress and impact level in ED nurses who experienced a violent event. This correlational study was conducted from June to August 2014. We used the visual analog scale to measure stress level, the Impact of Event Scale-Revised to measure impact level after the violent event, and the Dispositional Resilience Scale to measure hardiness. We then analyzed mediating effects with the Sobel test. Data were collected in 31 emergency medical centers located in B city in Korea. Data from 321 ED nurses who experienced a violent event were analyzed. Most nurses (91.9%) were women, with a mean age of 28.73 years. The main outcome measure was the mediating effect of hardiness between stress and impact level after ED nurses experienced violence. We found that both violence-related stress (B = 0.22, P level from a violent event. Based on results of a Sobel test, hardiness partially mediated the relationship between violence-related stress and impact level from a violent event (Z = 2.03, P = .044). Hardiness had an effect on reducing the impact level of ED nurses who had experienced a violent event and had a mediating role in mitigating their stress. Therefore, we recommend the development of an intervention program that emphasizes the improvement of hardiness in ED nurses. Copyright © 2017 Emergency Nurses Association. Published by Elsevier Inc. All rights reserved.

  4. Citar e referenciar : APA 6ª ed.


    Marcos, Isabel Marques


    A elaboração correta dos trabalhos científicos pressupõe o respeito por um conjunto de princípios normativos de citação e referenciação bibliográfica que salvaguardam os autores das criações intelectuais do uso indevido das mesmas. Partindo de três conceitos: citação, referência bibliográfica e lista de referências apresentam-se as normas da APA 6ª ed. nos seus elementos essenciais. Estas normas, da área da informação e documentação, definem regras para a normalização das referências bibliogr...

  5. Giocare, tra violenza ed ecologia della mente.

    Directory of Open Access Journals (Sweden)

    Enrico Euli


    Full Text Available L'articolo riflette sulle relazioni tra comunicazione, violenza e gioco, nel tentativo di rintracciare tra loro convergenze, affinità e contrasti. Le nostre relazioni, infatti, ci immettono inerzialmente in dilemmi e paradossi di così alta complessità da rendere spesso inadeguati gli strumenti 'logici' ed 'analitici': dal che può derivare un senso di impotenza, rabbia, paralisi, ma anche un desiderio potente di controllo e di soluzione degli eventi. Entrambe queste strade ci conducono dentro le false alternative della violenza. La cultura del gioco, invece, ci propone (attraverso le sue pratiche, ma anche negli scritti teorici di Freud, Winnicott, Bateson, qui riassunti e rivisitati una modalità più creativa e nonviolenta, più prossima ad un' ecologia della mente e ad un'estetica delle emozioni.

  6. Emergency Doses (ED) - Revision 3: A calculator code for environmental dose computations

    Energy Technology Data Exchange (ETDEWEB)

    Rittmann, P.D.


    The calculator program ED (Emergency Doses) was developed from several HP-41CV calculator programs documented in the report Seven Health Physics Calculator Programs for the HP-41CV, RHO-HS-ST-5P (Rittman 1984). The program was developed to enable estimates of offsite impacts more rapidly and reliably than was possible with the software available for emergency response at that time. The ED - Revision 3, documented in this report, revises the inhalation dose model to match that of ICRP 30, and adds the simple estimates for air concentration downwind from a chemical release. In addition, the method for calculating the Pasquill dispersion parameters was revised to match the GENII code within the limitations of a hand-held calculator (e.g., plume rise and building wake effects are not included). The summary report generator for printed output, which had been present in the code from the original version, was eliminated in Revision 3 to make room for the dispersion model, the chemical release portion, and the methods of looping back to an input menu until there is no further no change. This program runs on the Hewlett-Packard programmable calculators known as the HP-41CV and the HP-41CX. The documentation for ED - Revision 3 includes a guide for users, sample problems, detailed verification tests and results, model descriptions, code description (with program listing), and independent peer review. This software is intended to be used by individuals with some training in the use of air transport models. There are some user inputs that require intelligent application of the model to the actual conditions of the accident. The results calculated using ED - Revision 3 are only correct to the extent allowed by the mathematical models. 9 refs., 36 tabs.

  7. 'Psych ed' helps speed throughput time by 9%. (United States)


    Adequate staffing, proper location, and design of psychiatric ED services area are critical to successful implementation. One ED cut average throughput time by 9%. Have mental health workers available to determine the level of care each patient needs. Have your psych area set apart from the main ED to avoid excessive noise and confusion. Have a minimal amount of equipment in the rooms so that patients cannot harm themselves.

  8. An association between snowfall and ED presentation of cardiac arrest. (United States)

    Spitalnic, S J; Jagminas, L; Cox, J


    Studies from several cities have reported increased cardiovascular mortality associated with snowfall; whether this weather also results in increased emergency department (ED) presentation of cardiac arrests is not known. A retrospective review was conducted of cardiac arrest patients presenting to a New England ED during the months of October through May, from 1991 to 1994. Comparing daily frequency of cardiac arrest patients with climactic data, a 27% increase was observed in the frequency of cardiac arrest presentation to the ED on days with snowfall (P = .0004). ED physicians and staff should anticipate an increased frequency of cardiac arrest patients on days with snowfall.

  9. Minor injury attendance times to the ED.

    LENUS (Irish Health Repository)

    Conlon, Ciaran


    The Health Service Executive (HSE) highlights the need for effective patient throughput and management, whilst providing appropriate staffing and therapeutic interventions. It acknowledges that patient need is integral to the development of a nurse led service and advocates planning staffing levels to reflect arrival times of patients. An observational study of all patients who presented to the emergency department in July 2005 and February 2006 was undertaken (n=7768). The study identified 1577 patients suitable for treatment by the Advanced Nurse Practitioner (ANP) in these two months, which represents 20% of all patient attendances to the ED in this time period. A data collection tool was devised collectively by the ANPs to identify appropriate patients. The findings of the study revealed that 73% of patients suitable for the ANP service presented between the hours of 0800 and 2000, of which 54% attended between 0800 and 1600 h. Sunday emerged as the busiest day in July 2005 whereas Monday was found to be the busiest day in February 2006. Friday was found to be consistently busy for both months.

  10. Bilingual Voc Ed. Information Series No. 269. (United States)

    Friedenberg, Joan; Bradley, Curtis

    This paper presents a historical overview of the field of bilingual education and vocational education. The extent of the need for bilingual vocational education is described along with the status of current programming. The description of the state of the art includes program design, assessment practices, instructional materials, personnel, and…

  11. Teaching Elementary School Social Studies Methods under edTPA (United States)

    An, Sohyun


    This article reports a self-study that analyzes my experience as a teacher educator navigating a turbulent educational landscape with the advent of edTPA. The data consist of my journal entries, the syllabi, handouts, work submitted by my students, and course evaluations. Data were analyzed by using an inductive process to describe how the edTPA…

  12. TechEdSat Nano-Satellite Series Fact Sheet (United States)

    Murbach, Marcus; Martinez, Andres; Guarneros Luna, Ali


    TechEdSat-3p is the second generation in the TechEdSat-X series. The TechEdSat Series uses the CubeSat standards established by the California Polytechnic State University Cal Poly), San Luis Obispo. With typical blocks being constructed from 1-unit (1U 10x10x10 cm) increments, the TechEdSat-3p has a 3U volume with a 30 cm length. The project uniquely pairs advanced university students with NASA researchers in a rapid design-to-flight experience lasting 1-2 semesters.The TechEdSat Nano-Satellite Series provides a rapid platform for testing technologies for future NASA Earth and planetary missions, as well as providing students with an early exposure to flight hardware development and management.

  13. ED leadership competency matrix: an administrative management tool. (United States)

    Propp, Douglas A; Glickman, Seth; Uehara, Dennis T


    A successful ED relies on its leaders to master and demonstrate core competencies to be effective in the many arenas in which they interact and are responsible. A unique matrix model for the assessment of an ED leadership's key administrative skill sets is presented. The model incorporates capabilities related to the individual's cognitive aptitude, experience, acquired technical skills, behavioral characteristics, as well as the ability to manage relationships effectively. Based on the personnel inventory using the matrix, focused evaluation, development, and recruitment of ED key leaders occurs. This dynamic tool has provided a unique perspective for the evaluation and enhancement of overall ED leadership performance. It is hoped that incorporation of such a model will similarly improve the accomplishments of EDs at other institutions.



    Wahyudi Wahyudi; M. Hasim As’ari


    The development of technology demands efficient and work speed, so it needs a system which can handleseveral things.This problem can be covered with PLC (Programmable Logic Control) that can integrateseveral self standing component to be an integrated control system and can be changed the configurationwithout change all instrument. Modify the ladder program can alter system of PLC. This paper showsHoist Hanger system in PTC/ED (Pre Treatment Chemical/Electrocoat Dispotition) process that cont...

  15. Home modification to prevent falls by older ED patients. (United States)

    Gerson, Lowell W; Camargo, Carlos A; Wilber, Scott T


    This trial was conducted at 11 EDs to test the effectiveness of distributing fall prevention information to patients 65 years or older. Intervention patients were given 2 brochures and received a reminder call 2 weeks later. All patients were called at 1 month and asked if they made home safety modifications. Three hundred ninety-seven patients were enrolled (118 control, 279 intervention). Seventy-six percent had complete follow up interviews. Nine percent of control and 8% of intervention patients reported a home modification (95% confidence interval on difference, -8.1% to 5.5%). Patients who fell in the prior year had a 2.0 increased odds (95% confidence interval, 0.8-4.6) of making a home modification. The similar home modification rates in the 2 study groups suggest that even minimum discussion (eg, the informed consent procedure) may increase patients' fall prevention activities. The stronger association in patients who fell suggests that a targeted program may have added benefit.

  16. Building a Re-ED Culture (United States)

    Mills, Connie


    Youth Villages is a private nonprofit organization, headquartered in Memphis, Tennessee. Originally providing residential services, it now also offers a full continuum including intensive in-home services, foster care, adoption, and transitional living services for young people who age out of foster care. Each of the programs has its own…

  17. ED Strengthens Credit Management and Debt Collection. (United States)

    Olmo, Ralph J.


    This interview with the comptroller for the U.S. Department of Education focuses on efforts to improve credit management and debt collection. Topics discussed are the credit management initiative, the extent of the problem, improvements, the Housing and Facilities Loan Program, and the significance of the Debt Collection Act of 1982. (JOW)

  18. A Comparative SEM-EDS Elemental ...

    African Journals Online (AJOL)

    Michael Horsfall

    X25) and microscopic. (X5000) pictures of the mud exhibited a wide range of shapes and surface texture for individual particle. Elemental criteria: EDS analysis showed the clear distribution criteria of ten elements, Carbon,. Phosphorous,. Sulfur ...

  19. Erectile Dysfunction Herbs: A Natural Treatment for ED? (United States)

    ... erectile dysfunction: A natural treatment for ED? Some herbs claim to help erectile dysfunction. Find out the ... You've likely seen advertisements for erectile dysfunction herbs or supplements to "increase your sexual performance." Could ...

  20. Review: Gravers, Mikael (ed. (2007, Exploring Ethnic Diversity in Burma

    Directory of Open Access Journals (Sweden)

    Roland Mischung


    Full Text Available Review of the edited volume: Gravers, Mikael (ed., Exploring Ethnic Diversity in Burma, Copenhagen: NIAS Press (= NIAS Studies in Asian Topics Series, 39, 2007, ISBN 9788791114960, 283 pages

  1. Elementi ed esercizi di geometria analitica e proiettiva

    CERN Document Server

    Francia, Giovanni


    La retta : preliminario ; coordinate cartesiane nel piano, equazioni della retta, distanze ed angoli ; cambiamento delle coordinate, coordinate polari ; il cerchio ; le coniche come luoghi geometrici : l'ellisse, l'iperbole, parabola.

  2. Nuclear Medicine Physics: The Basics. 7th ed. (United States)

    Mihailidis, Dimitris


    Nuclear Medicine Physics: The Basics. 7th ed. Ramesh Chandra, Lippincott Williams and Wilkins, a Wolters Kluwer Business. Philadelphia, 2012. Softbound, 224 pp. Price: $69.99. ISBN: 9781451109412. © 2012 American Association of Physicists in Medicine.

  3. Ambienti Circumstellari ed Interstellari di Supernovae di vario Tipo ed Applicazioni Astrofisiche (United States)

    Boffi, Francesca R.

    Nella presente tesi vengono studiati gli ambienti circumstellari ed interstellari di supernovae (anche SNe; singolare SN) di vario tipo. In particolare si descrivono alcune applicazioni astrofisiche, relative a questi ambienti, che permettono di desumere informazioni sui sistemi stellari progenitori delle supernovae o di determinare le distanze a tali oggetti. L' emissione radio da supernovae, prodotta nell' ambiente circumstellare ad opera dell'interazione idrodinamica del gas di SN con l' ambiente circostante, puo' essere impiegata come mezzo di indagine del sistema di pre-supernova. In particolare si e' introdotta l'idea che tale emissione possa essere impiegata nel caso delle SNe di tipo Ia come test dei sistemi progenitori di tipo simbiotico. Il test e' stato effettuato sulla SN 1986G, per la quale avevamo ottenuto limiti superiori a lunghezze d'onda radio. Nel caso che un sistema simbiotico sia responsabile di una SN Ia, l'interazione tra l' ejecta e una shell circumstellare origina, in un'epoca molto prossima al massimo di luce, un'emissione radio rivelabile con strumenti tipo Very Large Array. Inoltre l'emissione radio fornisce informazioni circa gli stadi di pre-supernova nel caso di altri tipi di supernova. In questo lavoro di tesi vengono presentati i risultati ottenuti nel caso delle SNe di tipo II 1984E e 1986E. Queste due SNe non mostrano emissione radio: la prima, in prossimita del massimo ottico, stava interagendo con una shell circumstellare prodotta da un episodio di perdita di massa di breve durata in fase di pre-supernova; la seconda, invece e' la prima SN ``vecchia'' ad essere rivelata nell' ottico ma non nel radio (l' oggetto non ha ancora iniziato la fase di supernova remnant ed emette radiazione ottica prodotta ancora per interazione circumstellare). In ambiente circum-interstellare, gli echi di luce, prodotti dallo scattering della luce della supernova ad opera della polvere presente, possono essere utilizzati per determinare le distanze

  4. Patient anxiety may influence the efficacy of ED pain management. (United States)

    Craven, Philip; Cinar, Orhan; Madsen, Troy


    The aim of this study was to evaluate the incidence of anxiety and rates of anxiety treatment in emergency department (ED) patients presenting with pain-related complaints. We prospectively evaluated patients in an urban academic tertiary care hospital ED from 2000 through 2010. We enrolled a convenience sample of adult patients presenting with pain and recorded patient complaint, medication administration, satisfaction, and pain and anxiety scores throughout their stay. We stratified patients into 4 different groups according to anxiety score at presentation (0, none; 1-4, mild; 5-7, moderate; 8-10, severe). We enrolled 10 664 ED patients presenting with pain-related complaints. Patients reporting anxiety were as follows: 25.7%, none; 26.1%, mild; 23.7%, moderate; and 24.5%, severe. Although 48% of patients described moderate to severe anxiety at ED presentation and 60% were willing to take a medication for anxiety, only 1% received anxiety treatment. Thirty-five percent of patients still reported moderate/severe anxiety at discharge. Severe anxiety at ED presentation was associated with increased demand for pain medication (odds ratio [OR], 1.40; 95% confidence interval [CI], 1.10-1.79) and anxiety medication (OR, 4.34; 95% CI, 3.68-5.11) during the ED stay and decreased satisfaction with the treatment of pain (β coefficient = -0.328; P < .001). After adjusting for age, sex, and presentation pain scores, patients who reported severe anxiety were more likely to receive an analgesic (OR, 1.33; 95% CI, 1.19-1.50) and an opioid (OR, 1.25; 95% CI, 1.11-1.41) during the ED stay. Anxiety may be underrecognized and undertreated in patients presenting with pain-related complaints. Patients reporting severe anxiety were less likely to report satisfaction with the treatment of their pain, despite higher rates of analgesic administration. Copyright © 2013 Elsevier Inc. All rights reserved.


    Directory of Open Access Journals (Sweden)

    Tan HM


    Full Text Available This paper aimed to identify and explore the understanding and perception of erectile dysfunction (ED using exploratory qualitative approaches. This study was conducted in Klang Valley, Malaysia. Purposive sampling was used to recruit 17 urban men aged 40-75 years. A semi-structural interview guide was used to explore men’s understanding of ED, impacts on their well-being and experiences with treatments. The focus groups revealed that ED was perceived to be an important loss in men’s lives as sexual performance was closely related to manhood. The men associated ED with a loss of masculinity and self-esteem. Men’s understanding of ED treatments was restricted to phophodiesterase type 5 inhibitors (PDE-5 inhibitors and traditional therapies. Although PDE-5 inhibitors were perceived to be effective, they were concerned about their safety and costs. Some of the men have learned to cope with ED rather than to seek help, particularly among older men, who attributed their decreased sexual capacities and erection difficulties to aging, and therefore conditioned themselves to accepting it. In contrast, younger men who have erectile difficulties are considered as ‘abnormal’, and are more likely to seek help and receive treatment for their sexual problem. Men’s knowledge of and experience with modern treatments of ED were mainly associated with PDE-5 inhibitors. Their perception towards PDE-5 inhibitors was largely influenced by personal experience, information from mass media and friends. The high cost and fear of side effects were two main deterrents in the use of PDE-5 inhibitors. Many men had conceded their use of PDE-5 inhibitors without their partners’ knowledge. They worried that their partners would view the matter with suspicion and mistrust.

  6. Chasing Extreme Polymer Morphologies with Ed (United States)

    Fredrickson, Glenn

    I was privileged to have a seventeen year friendship and scientific collaboration with Edward J. Kramer that produced 55 papers and countless student and postdoc co-advisements. This talk will discuss our last project together; an ongoing research program to achieve thermoplastic polymer materials that are uniquely hard, tough, and elastic, with moduli greater than 100 MPa and elastic recovery greater than 0.9 at strains of 1 or more. The targeted materials are based on an A(BA')n mikto-arm block copolymer architecture, and alloys of these molecules with A homopolymer. The molecular design of the miktopolymer was optimized using self-consistent field theory and the materials realized in a polystyrene (A)-polyisoprene (B) system. TEM, SAXS, and tensile mechanical tests were used to validate the designs and probe microstructure/mechanics relationships. An unexpected discovery was the emergence of a new structured disordered phase - the bricks and mortar phase -in which the A domains remain discrete at up to a volume fraction of 0.7. Field-theoretic simulations have been used to understand the origins of this new fluctuation-stabilized equilibrium phase, which has no precedent in the polymer physics literature.

  7. Automated SEM-EDS GSR Analysis for Turkish Ammunitions (United States)

    Cakir, Ismail; Uner, H. Bulent


    In this work, Automated Scanning Electron Microscopy with Energy Dispersive X-ray Spectrometry (SEM-EDS) was used to characterize 7.65 and 9mm cartridges Turkish ammunition. All samples were analyzed in a SEM Jeol JSM-5600LV equipped BSE detector and a Link ISIS 300 (EDS). A working distance of 20mm, an accelerating voltage of 20 keV and gunshot residue software was used in all analysis. Automated search resulted in a high number of particles analyzed containing gunshot residues (GSR) unique elements (PbBaSb). The obtained data about the definition of characteristic GSR particles was concordant with other studies on this topic.

  8. New psych unit eases patient burden in ED. (United States)


    Creating a special unit for psychiatric patients frees up beds in your ED, ensures better care for that patient population, and improves the atmosphere in the main department for the rest of your patients. Consider these suggestions: The creation of a psych unit can be extremely costly. Be prepared to demonstrate projected savings when pitching the idea to administration. Make sure an ED physician has overall responsibility for each patient at all times. Keep a regular group of nurses in rotation. This setup will help ensure smooth handoffs.

  9. Structural requirements for the interaction between peptide antigens and I-Ed molecules

    DEFF Research Database (Denmark)

    Sette, A; Adorini, L; Appella, E


    amino acid substitution analogues of one good I-Ed binder, hen egg lysozyme 107-116, were analyzed for their capacity to bind to I-Ed molecules and to activate two different I-Ed-restricted T cell hybridomas. The results illustrate the great permissiveness of I-Ed-peptide interaction and the great......We have analyzed the structural characteristics of the interaction between I-Ed molecules and their peptide ligands. It was found that unrelated good I-Ed binders share structurally similar "core" regions that were experimentally demonstrated to be crucial for binding to I-Ed molecules. Single...

  10. Inside the Sex Ed Studio: An Interview with Peggy Brick (United States)

    Taverner, William J.


    "Inside the Sex Ed Studio" profiles leaders in the field of sexuality education. Peggy Brick, former director of Planned Parenthood of Greater Northern New Jersey's Center for Family Life Education (CFLE) and author of numerous sexuality education resources used worldwide, is the subject of this interview. Ms. Brick was interviewed by…

  11. Psychological and psychopathological variables associated with eating disorders (ED

    Directory of Open Access Journals (Sweden)

    Antonio Fernández-Delgado


    Full Text Available Objective: The aim of this study was to compare some psychological and psychopathological variables usually associated with different types of patients with eating disorders (ED. A total of 22 variables (psychological, psychopathological and specifically related to TCA were analyzed in three groups of patients with anorexia nervosa (AN, bulimia nervosa (BN and eating disorders not otherwise specified (EDNOS. Method: The sample consisted of 76 patients diagnosed with ED (mean age 20.13 ± 6.28 years; 69 women and 7 men. The following questionnaires were administered: Rosenberg's Self-Esteem Scale (SES, Symptom Checklist-90-Revised (SCL-90-R, Beck's Depression Inventory (BDI, State-Trait Anxiety Inventory (STAI, Body Shape Questionnaire (BSQ, Body Appreciation Scale (BAS, Eating Disorder Inventory-2 (EDI-2 and Body Image Quality of Life Inventory (BIQLI-SP. Results: Generally no significant differences between groups, except for the variables related to the BSQ and EDI-2 questionnaires, were found. The study of the correlations among the different variables specifically related to eating disorders and others, showed differences between groups. Conclusions: The present study shows few differences with respect to psychopathological symptoms among the different types of ED. Bearing in mind future studies, it would be interesting to use a bigger sample size, to include more men, and to distinguish between restricted/purging types of ED.

  12. Diagnostic utility of the genital Gram stain in ED patients. (United States)

    Stefanski, Peter; Hafner, John W; Riley, Shanda L; Sunga, Kharmene L Y; Schaefer, Timothy J


    The study aimed to determine the diagnostic usefulness of the genital Gram stain in an emergency department (ED) population. A linked-query of an urban, tertiary-care, university- affiliated hospital laboratory database was conducted for all completed Chlamydia trachomatis and Neisseria gonorrhoeae DNA probes, Trichomonas vaginalis wet preps, and genital Gram stains performed on ED patient visits between January and December 2004. Positive criteria for a Gram stain included greater than 10 white blood cells per high-power field, gram-negative intracellular/extracellular diplococci (suggesting N gonorrhoeae), clue cells (suggesting T vaginalis), or direct visualization of T vaginalis organisms. DNA probes were used as the gold standard definition for N gonorrhoeae and C trachomatis infection. Of 1511 initially eligible ED visits, 941 were analyzed (genital Gram stain and DNA probe results both present), with a prevalence of either C trachomatis or N gonorrhoeae of 11.4%. A positive genital Gram stain was 75.7% sensitive and 43.3% specific in diagnosing either C trachomatis and/or N gonorrhoeae infection, and 80.4% sensitive and 32.2% specific when the positive cutoff was lowered to more than 5 white blood cells/high-power field. No Gram stains were positive for T vaginalis (with 47 positive wet mounts), and clue cells were noted on 117 Gram stains (11.6%). Gram stains in isolation lack sufficient diagnostic ability to detect either C trachomatis or N gonorrhoeae infection in the ED.

  13. I>Lo specchio frammentato ed il pagliaccio piangente : alienation ...

    African Journals Online (AJOL)

    Quest'articolo esamina il modo in cui il cinema di Nanni Moretti usa uno sguardo autoriflessivamente critico per parlare della condizione frammentata ed alienata di un soggetto maschile, italiano e di sinistra, nella tarda età capitalista. L'articolo mette a fuoco come l'uso morettiano dell' umorismo, con palesi tratti ...

  14. Mai alguses linastub dokfilm "Sinimäed" / Andris Feldmanis

    Index Scriptorium Estoniae

    Feldmanis, Andris, 1982-


    Valminud on 6-osalise ajaloodokumentaalide sarja "Kuum külm sõda" teine film "Sinimäed" : stsenaristid Kiur Aarma, Mart Laar, Eerik-Niiles Kross, Raimo Jõerand : režissöör Raimo Jõerand : Ruut Pictures

  15. Murray Pittock, ed., The Edinburgh Companion to Scottish Romanticism.

    Directory of Open Access Journals (Sweden)

    Manfred Malzahn


    Full Text Available Murray Pittock, ed., The Edinburgh Companion to Scottish Romanticism. Edinburgh: Edinburgh University Press, 2011. Pp. 251. ISBN 978-0-7486-3845-1 (hardback. £ 65.00. ISBN 978-0-7486-3846-8 (paperback. £ 21.99.

  16. Impact of Physician Navigators on productivity indicators in the ED. (United States)

    Leung, Alexander K; Puri, Gaurav; Chen, Bingshu E; Gong, Zhenxian; Chan, Eddie; Feng, Edward; Duic, Marko


    We created Physician Navigators in our ED to help improve emergency physician (EP) productivity. We aimed to quantify the effect of Physician Navigators on measures of EP productivity: patient seen per hour (Pt/hr), and turn-around time (TAT) to discharge. Secondary objectives included examining their impact on measures of ED throughput for non-resuscitative patients: ED length of stay (LOS), door-to-physician time and left-without-being-seen rates (LWBS). In this retrospective study, 6845 clinical shifts worked by 20 EPs at a community ED in Newmarket, Canada from 1 January 2012 to 31 March 2015 were evaluated. Using a clustered design, we compared productivity measures between shifts with and without Physician Navigators, by physician. We used a linear mixed model to examine mean changes in Pt/hr and TAT to discharge for EPs who employed Physician Navigators. For secondary objectives, autoregressive modelling was performed to compare ED throughput metrics before and after the implementation of Physician Navigators for non-resuscitative patients. Patient volumes increased by 20 patients per day (p<0.001). Mean Pt/hr increased by 1.07 patients per hour (0.98 to 1.16, p<0.001). The mean TAT to discharge decreased by 10.6 min (-13.2 to -8.0, p<0.001). After implementation of the Physician Navigator programme, overall mean LOS for non-resuscitative patients decreased by 2.6 min (p=0.007), and mean door-to-physician time decreased by 7.4 min (p<0.001). LBWS rates decreased from 1.13% to 0.63% of daily patient volume (p<0.001). Despite an ED volume increase, the use of a Physician Navigator was associated with significant improvements in EP productivity, and significant reductions in ED throughput times. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  17. Rozvoj motorických schopností u předškolních dětí s mentálním a vývojovým handicapem – rozdíly po ročním komplexním výukovém programu Motor skill development in preschool children with mental and developmental disorders – the difference after a one year comprehensive education program

    Directory of Open Access Journals (Sweden)

    Hana Válková


    Full Text Available Cílem této studie bylo přehodnocení motorických schopností u předškolních dětí s mentálním a vývojovým handicapem. Studie navazuje na první část, která byla dokončena v roce 2006 (Samouilidou, 2006. V roce 2006 byly u těchto dětí zaznamenány významné deficity v motorických schopnostech. Studie se zúčastnilo 5 dětí – 4 chlapci a 1 dívka. Loňského hodnocení se jeden z chlapců nezúčastnil, protože během roku odešel ze zvláštní školky. V únoru 2007 účastníci dokončili jeden rok komplexního programu ve zvláštní školce, který se řídil doporučeními MABC (Movement Assessment Battery for Children, Henderson & Sudgen, 1992. Uvedené výsledky prokázaly, že se dle hodnocení MABC projevilo významné zlepšení v různých oblastech rozvoje motorických schopností. Toto lze částečně přisuzovat školnímu programu. Kromě motorických schopností se zlepšilo i sociální cítění a chování dětí, což bylo zaznamenáno zejména během kvalitativních pozorování. Výsledkem tohoto včasného zásahu byl pozitivní vývoj. Aby tento vývoj mohl i nadále pokračovat, byly předány příslušné pokyny. The aim of this study was to reassess the motor skill performance of preschool children with mental and developmental disorders. The study follows the first part of the study which was completed in 2006 (Samoulidu, 2006. In 2006, significant deficits in motor skills performance were found to exist in these children. There were 5 participants in this study – 4 boys and 1 girl. One participant from the last year's assessment did not participate as he left the special kindergarten during the year. As of February 2007, the participants had completed a one year comprehensive program at the special kindergarten. This program was guided by recommendations made by MABC (Movement Assessment Battery for Children results, Henderson & Sudgen, 1992. Scores presented therein showed that

  18. TrED: the Trichophyton rubrum Expression Database

    Directory of Open Access Journals (Sweden)

    Liu Tao


    Full Text Available Abstract Background Trichophyton rubrum is the most common dermatophyte species and the most frequent cause of fungal skin infections in humans worldwide. It's a major concern because feet and nail infections caused by this organism is extremely difficult to cure. A large set of expression data including expressed sequence tags (ESTs and transcriptional profiles of this important fungal pathogen are now available. Careful analysis of these data can give valuable information about potential virulence factors, antigens and novel metabolic pathways. We intend to create an integrated database TrED to facilitate the study of dermatophytes, and enhance the development of effective diagnostic and treatment strategies. Description All publicly available ESTs and expression profiles of T. rubrum during conidial germination in time-course experiments and challenged with antifungal agents are deposited in the database. In addition, comparative genomics hybridization results of 22 dermatophytic fungi strains from three genera, Trichophyton, Microsporum and Epidermophyton, are also included. ESTs are clustered and assembled to elongate the sequence length and abate redundancy. TrED provides functional analysis based on GenBank, Pfam, and KOG databases, along with KEGG pathway and GO vocabulary. It is integrated with a suite of custom web-based tools that facilitate querying and retrieving various EST properties, visualization and comparison of transcriptional profiles, and sequence-similarity searching by BLAST. Conclusion TrED is built upon a relational database, with a web interface offering analytic functions, to provide integrated access to various expression data of T. rubrum and comparative results of dermatophytes. It is devoted to be a comprehensive resource and platform to assist functional genomic studies in dermatophytes. TrED is available from URL:

  19. An innovative data collection method for investigating unresolved pain after ED discharge: a pilot study. (United States)

    Stapleton, Stephen J; Degitz, R Joseph


    Research focused on improving the outcome of patients with pain is an important aspect of emergency care, yet little information has been published to quantify pain severity, patient improvement, and return to independent function after ED discharge. Because of the paucity of available clinical data, this pilot study was designed to determine the acceptability and feasibility of using electronic data collection procedures. Specifically, we examined the willingness of discharged ED patients to use portable touch-screen computers as an alternative to traditional "paper and pencil" or telephone data collection methods to report postdischarge pain. Participants in this prospective pilot study all reported acute pain that was unresolved at the time of ED discharge. Descriptive data were self-entered on touch-screen computers at ED discharge and 7 days later in subjects' homes. Participants completed 4 Patient-Reported Outcomes Measurement Information System (PROMIS Network, Silver Spring, MD), questionnaires and the computer acceptability scale (CAS), using the Assessment Center platform program (National Institute of Health, Bethesda, MD) for instrument administration, data storage, and information retrieval. Determinants of study success were willingness of the participants to use touch-screen computers, questionnaire completion time, and completeness of the data. Participants (N = 25) used touch-screen computers to complete 18 questions at the time of ED discharge. The mean completion time was 3.54 (± 1.13) minutes. Participants averaged 5.83 (± 2.00) minutes to complete the follow-up questionnaires. Ninety-two percent of subjects reported that the touch-screen computer was easy to use. We encountered no issues with data management using the Assessment Center platform. Touch-screen computers are a feasible and acceptable approach to collecting information about how patients self-manage unresolved pain after discharge from an emergency department. This methodology

  20. Do Adherence Variables Predict Outcome in an Online Program for the Prevention of Eating Disorders? (United States)

    Manwaring, Jamie L.; Bryson, Susan W.; Goldschmidt, Andrea B.; Winzelberg, Andrew J.; Luce, Kristine H.; Cunning, Darby; Wilfley, Denise E.; Taylor, C. Barr


    Unlike traditional interventions, Internet interventions allow for objective tracking and examination of the usage of program components. Student Bodies (SB), an online eating disorder (ED) prevention program, significantly reduced ED attitudes/behaviors in college-aged women with high body image concerns, and reduced the development of EDs in…


    Directory of Open Access Journals (Sweden)

    Wahyudi Wahyudi


    Full Text Available The development of technology demands efficient and work speed, so it needs a system which can handleseveral things.This problem can be covered with PLC (Programmable Logic Control that can integrateseveral self standing component to be an integrated control system and can be changed the configurationwithout change all instrument. Modify the ladder program can alter system of PLC. This paper showsHoist Hanger system in PTC/ED (Pre Treatment Chemical/Electrocoat Dispotition process that controlledby PLC. Above input from limit switch, sensor, or the other input, PLC system drives the motorrelay Hoist Hanger machine. That cause the motor relay Hoist Hanger change its condition, so the movingof Hoist Hanger machine will be suitable with PLC program.

  2. Mount Sinai leverages smartphone technology, aiming to boost care, coordination of ED patients while also trimming costs. (United States)


    Mount Sinai Hospital in New York, NY, is using smartphone technology to enhance follow-up calls to senior patients who have visited the ED, and to help provide acute-level care to select patients in their own homes. Investigators are hoping to show that these approaches can improve care and coordination while trimming costs, and they expect that patients will approve of these new approaches as well. While senior patients are still in the ED, nurse coordinators will work with them to load a HIPAA-compliant application to their smartphones so they can conduct face-to-face follow-up calls that meet HIPAA standards. Nurses say the face-to-face communications enhance their ability to assess how patients are doing following their ED visit. The hospital is also testing a program that enables some ED patients who meet inpatient criteria to receive this care in the home setting through the use of a mobile acute care team (MACT). In the case of emergencies, the MACT team relies on community paramedics who will visit the patients' homes and provide care under the direction of MACT physicians who are linked in to these visits via smartphone technology.

  3. Microbiologic methods utilized in the MAL-ED cohort study. (United States)

    Houpt, Eric; Gratz, Jean; Kosek, Margaret; Zaidi, Anita K M; Qureshi, Shahida; Kang, Gagandeep; Babji, Sudhir; Mason, Carl; Bodhidatta, Ladaporn; Samie, Amidou; Bessong, Pascal; Barrett, Leah; Lima, Aldo; Havt, Alexandre; Haque, Rashidul; Mondal, Dinesh; Taniuchi, Mami; Stroup, Suzanne; McGrath, Monica; Lang, Dennis


    A central hypothesis of The Etiology, Risk Factors and Interactions of Enteric Infections and Malnutrition and the Consequences for Child Health and Development (MAL-ED) study is that enteropathogens contribute to growth faltering. To examine this question, the MAL-ED network of investigators set out to achieve 3 goals: (1) develop harmonized protocols to test for a diverse range of enteropathogens, (2) provide quality-assured and comparable results from 8 global sites, and (3) achieve maximum laboratory throughput and minimum cost. This paper describes the rationale for the microbiologic assays chosen and methodologies used to accomplish the 3 goals. © The Author 2014. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail:

  4. Safe Handling of Snakes in an ED Setting. (United States)

    Cockrell, Melanie; Swanson, Kristofer; Sanders, April; Prater, Samuel; von Wenckstern, Toni; Mick, JoAnn


    Efforts to improve consistency in management of snakes and venomous snake bites in the emergency department (ED) can improve patient and staff safety and outcomes, as well as improve surveillance data accuracy. The emergency department at a large academic medical center identified an opportunity to implement a standardized process for snake disposal and identification to reduce staff risk exposure to snake venom from snakes patients brought with them to the ED. A local snake consultation vendor and zoo Herpetologist assisted with development of a process for snake identification and disposal. All snakes have been identified and securely disposed of using the newly implemented process and no safety incidents have been reported. Other emergency department settings may consider developing a standardized process for snake disposal using listed specialized consultants combined with local resources and suppliers to promote employee and patient safety. Copyright © 2017 Emergency Nurses Association. Published by Elsevier Inc. All rights reserved.

  5. Prepared for the unthinkable: EDs respond to terrorist attacks. (United States)


    The response to the terrorist attacks at the World Trade Center and the Pentagon provided many key lessons for disaster preparedness. Volunteer physicians were not used in most cases, but EDs recognized the need for a system to check credentials. Communication from disater sites was problem. Injured patients went to the nearest hospital, even if it was not the most appropriate hospital. Experts recommend using existing disaster plans as templates to design or update your own.

  6. MobilED: a step backwards to look ahead

    CSIR Research Space (South Africa)

    Van Den Berg, M


    Full Text Available of technology development and the widespread integration of the device in social and cultural practices (Kress & Pachler, 2007), has created unique opportunities for educators, researchers and practitioners. Mobile learning has developed from a few small scale... only ever reach a small fraction of them, while the network of invisible computers continues its exponential penetration into those same regions, below the radar(Selanikio, 2008). MobilED (Mobile Education) (2005) started as an international...

  7. Interact-ed interwinning nature of virtual reality


    Özenç, Kürşat Fatih; Ozenc, Kursat Fatih


    In our highly computerized world, we live in an environment which resembles an intertwining mobius of 'real' and 'virtual'. In interact-ed's visual context, the virtual and the real have been quettioned with respect to this interrelation. The investigation is moreover done with the concept of dreams. Dreams, like virtual environments, affect our life 'apperently'; not 'really'. As affective experiences, virtual (environments) and dreams are tightly related to each other. In somne conditions t...

  8. Active Intervention Can Decrease Burnout In Ed Nurses. (United States)

    Wei, Rong; Ji, Hong; Li, Jianxin; Zhang, Liyao


    The aim of this study was to evaluate whether active intervention can decrease job burnout and improve performance among ED nurses. This study was carried out in the emergency departments of 3 hospitals randomly selected from 8 comprehensive high-level hospitals in Jinan, China. A total of 102 nurses were enrolled and randomly divided into control and intervention groups. For 6 months, nurses in intervention groups were treated with ordinary treatment plus comprehensive management, whereas nurses in the control group were treated with ordinary management, respectively. Questionnaires were sent and collected at baseline and at the end of the study. The Student t test was used to evaluate the effect of comprehensive management in decreasing burnout. All ED nurses showed symptoms of job burnout at different levels. Our data indicated that comprehensive management significantly decreased emotional exhaustion and depersonalization (P burnout in ED nurses and contribute to relieving work-related stress and may further protect against potential mental health problems. Copyright © 2016 Emergency Nurses Association. Published by Elsevier Inc. All rights reserved.

  9. States leverage telepsychiatry solutions to ease ED crowding, accelerate care. (United States)


    Many states are having success turning to telepsychiatry-based solutions to connect mental health patients with needed care while also decompressing crowded EDs. Just one year into a statewide telepsychiatry initiative in North Carolina (NC-STeP), administrators say the approach has saved as much as $7 million, and hospital demand for the service is higher than anticipated. In Texas, mental health emergency centers (MHEC) that use telepsychiatry to connect patients in rural areas with needed psychiatric care are freeing up EDs to focus on medical care. In just 11 months, 91 North Carolina hospitals have at least started the process to engage in NC-STeP. Much of the savings from NC-STeP come from involuntary commitment orders being overturned as a result of the telepsychiatry consults, reducing the need for expensive inpatient care. Implementing NC-STeP has involved multiple hurdles including credentialing difficulties and technical/firewall challenges. The Texas model provides 24/7 availability of psychiatrists via telemedicine through a network of MHECs. In-person staff at the MHECs perform basic screening tests and blood draws so that medical clearance can be achieved without the need for an ED visit in most cases. Funding for the MHECs comes from the state, hospitals in the region, and local governmental authorities that reap savings or benefits from the initiative.

  10. Analysis of microtraces in invasive traumas using SEM/EDS. (United States)

    Vermeij, E J; Zoon, P D; Chang, S B C G; Keereweer, I; Pieterman, R; Gerretsen, R R R


    Scanning electron microscopy in combination with energy-dispersive X-ray spectrometry (SEM/EDS) is a proven forensic tool and has been used to analyze several kinds of trace evidence. A forensic application of SEM/EDS is the examination of morphological characteristics of tool marks that tools and instruments leave on bone. The microtraces that are left behind by these tools and instruments on the bone are, however, often ignored or not noticed at all. In this paper we will describe the use of SEM/EDS for the analysis of microtraces in invasive sharp-force, blunt-force and bone-hacking traumas in bone. This research is part of a larger multi-disciplinary approach in which pathologists, forensic anthropologists, toolmark and microtrace experts work together to link observed injuries to a suspected weapon or, in case of an unknown weapon, to indicate a group of objects that could have been used as a weapon. Although there are a few difficulties one have to consider, the method itself is rather simple and straightforward to apply. A sample of dry and clean bone is placed into the SEM sample chamber and brightness and contrast are set such that bone appears grey, metal appears white and organic material appears black. The sample is then searched manually to find relevant features. Once features are found their elemental composition is measured by an energy dispersive X-ray spectrometer (EDS). This method is illustrated using several cases. It is shown that SEM/EDS analysis of microtraces in bone is a valuable tool to get clues about an unknown weapon and can associate a specific weapon with injuries on the basis of appearance and elemental composition. In particular the separate results from the various disciplines are complementary and may be combined to reach a conclusion with a stronger probative value. This is not only useful in the courtroom but above all in criminal investigations when one have to know for what weapon or object to look for. Copyright © 2011

  11. Health care utilization before and after an outpatient ED visit in older people. (United States)

    Horney, Carolyn; Schmader, Kenneth; Sanders, Linda L; Heflin, Mitchell; Ragsdale, Luna; McConnell, Eleanor; Hocker, Michael; Hastings, S Nicole


    Older adults in the United States receive a significant amount of care in the emergency department (ED), yet the associations between ED and other types of health care utilization have not been adequately studied in this population. The goals of this study were to examine the relationships between health care use before and after an ED visit among older adults. This retrospective cohort study examined health care use among 308 patients 65 years or older discharged from a university-affiliated ED. Proportional-hazards models were used to assess the relationship between pre-ED health care use (primary care physician [PCP], specialist, ED, and hospital) and risk of return ED visits. Older ED patients in this study had visited other types of providers frequently in the previous year (median number of PCP and specialist visits, 4). Patients who used the ED on 2 or more occasions in the previous year were found to have visited their PCP more often than those without frequent ED use (median number of visits, 7.0 vs 4.0; P < .001). Despite more PCP use in this population, frequent ED use was associated with increased risk of a repeat ED visit (hazard ratio, 2.20; 95% confidence interval, 1.15-4.21), in models adjusted for demographics and health status. Older adults who use the ED are also receiving significant amounts of care from other sources; simply providing additional access to care may not improve outcomes for these vulnerable individuals. Published by Elsevier Inc.

  12. EDS coal liquefaction process development. Phase V. EDS commercial plant study design update. Illinois coal. Volume 1. Main report

    Energy Technology Data Exchange (ETDEWEB)

    Epperly, W. R.


    The objectives of the Study Design Update (SDU) were to identify the technical issues facing a potential commercial-size EDS plant design; to provide a reliable basis for estimating the cost of EDS products; and to furnish research guidance to the EDS Project. The SDU consists of two distinct studies in which different processing schemes are used to produce the hydrogen and fuel gas required by the plant. These studies are referred to as the Base Case and the Market Flexibility Sensitivity Case. In the Base Case, hydrogen is generated by steam reforming of the light hydrocarbon gases produced in the plant. Fuel gas is generated by feeding the bottoms stream from the liquefaction section vacuum pipestill to a FLEXICOKING unit. In the FLEXICOKING unit reactor, the bottoms stream is converted to coke; additional liquid product is also recovered. The coke is converted to low-Btu fuel gas in the FLEXICOKING unit gasifier. In the Market Flexibility Sensitivity (MFS) Case, the bottoms stream from the vacuum pipestill is split, and about half is sent to the FLEXICOKING unit for recovery of additional liquid product and production of fuel gas. The remainder of the bottoms stream is converted to hydrogen in a Partial Oxidation Unit. Hence the MFS Case does not consume light hydrocarbon gases produced and they are available for sale. The study of these two cases has demonstrated the importance of bottoms process selection to the economics and thermal efficiency of an EDS plant. Volume 1 - Main Report has been developed to be a stand-alone document. Both the Base Case and Market Flexibility Sensitivity (MFS) Case are covered. This volume includes an overview and detailed case summaries. It also covers economics, product recovery factors, material and energy balances, cost estimates and enviromental considerations.

  13. Prevalence and correlates of erectile dysfunction (ED) and treatment seeking for ED in Asian Men: the Asian Men's Attitudes to Life Events and Sexuality (MALES) study. (United States)

    Tan, Hui-Meng; Low, Wah Yun; Ng, Chirk Jenn; Chen, Kuang-Kuo; Sugita, Minoru; Ishii, Nobuhisa; Marumo, Ken; Lee, Sung Won; Fisher, William; Sand, Michael


    There have been limited multiregional studies in Asia examining the parameters of men's general and sexual health and quality of life in the general population vs. those in clinical cohorts of patients with erectile dysfunction (ED). The aims of the Asian Men's Attitudes to Life Events and Sexuality (Asian MALES) study were to investigate the prevalence of ED, associated health conditions, and ED treatment-seeking patterns in the general male population in five regions of Asia (China, Japan, Korea, Malaysia, and Taiwan). Standardized questionnaire previously used in a similar multiregional study and modified to ensure culturally appropriate content for Asia. Phase I of the study involved 10,934 adult men, aged 20-75 years, who were interviewed using the standardized questionnaire. Phase II of the study involved men with self-reported ED recruited from Phase I and via physician referral, invitations in general practitioner offices, and street interception (total Phase II sample, N = 1,209). The overall prevalence of self-reported ED in the Phase I study population was 6.4%. ED prevalence varied by region and significantly increased with age (P quality of life (P = 0.0001), compared with men without ED. Phase II of the study revealed that fewer than half of men with self-reported ED had sought treatment for their problem. Men were more likely to seek help for erection difficulties from Western doctors than from traditional medicine practitioners (P = 0.0001). A man's partner/spouse was the most common influencer of treatment seeking in all regions except Malaysia. The findings confirm those of existing research on ED in both Asian and non-Asian males: ED is a prevalent condition; the prevalence of ED increases with age and is strongly associated with comorbid conditions; and the majority of men have never sought treatment for their condition. This study highlights a substantial need for the evaluation and treatment of ED in Asian men.

  14. Treatment of Nausea and Vomiting in Pregnancy: Factors Associated with ED Revisits

    Directory of Open Access Journals (Sweden)

    Brian R. Sharp


    Full Text Available Introduction: Nausea and vomiting in pregnancy (NVP is a condition that commonly affects women in the first trimester of pregnancy. Despite frequently leading to emergency department (ED visits, little evidence exists to characterize the nature of ED visits or to guide its treatment in the ED. Our objectives were to evaluate the treatment of NVP in the ED and to identify factors that predict return visits to the ED for NVP. Methods: We conducted a retrospective database analysis using the electronic medical record from a single, large academic hospital. Demographic and treatment variables were collected using a chart review of 113 ED patient visits with a billing diagnosis of “nausea and vomiting in pregnancy” or “hyperemesis gravidarum.” Logistic regression analysis was used with a primary outcome of return visit to the ED for the same diagnoses. Results: There was wide treatment variability of nausea and vomiting in pregnancy patients in the ED. Of the 113 patient visits, 38 (33.6% had a return ED visit for NVP. High gravidity (OR 1.31, 95% CI [1.06-1.61], high parity (OR 1.50 95% CI [1.12-2.00], and early gestational age (OR 0.74 95% CI [0.60-0.90] were associated with an increase in return ED visits in univariate logistic regression models, while only early gestational age (OR 0.74 95% CI [0.59-0.91] was associated with increased return ED visits in a multiple regression model. Admission to the hospital was found to decrease the likelihood of return ED visits (p=0.002. Conclusion: NVP can be difficult to manage and has a high ED return visit rate. Optimizing care with aggressive, standardized treatment in the ED and upon discharge, particularly if factors predictive of return ED visits are present, may improve quality of care and reduce ED utilization for this condition.

  15. Self-Esteem and Emotional Intelligence among B.Ed Trainees of Tsunami Affected Coastal Belt (United States)

    Babu M, Sameer


    Through this study the author investigates the relationship between self-esteem and emotional intelligence among B.Ed trainees of Tsunami affected coastal belt of Alappey district of Kerala, India. Stream of study, marital status and age based comparisons were made among the B.Ed trainees. 92 B.Ed trainees were the participants in the study. It…

  16. EDS V26 Containment Vessel Explosive Qualification Test Report

    Energy Technology Data Exchange (ETDEWEB)

    Crocker, Robert W. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Haroldsen, Brent L. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Stofleth, Jerome H. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States)


    The objective of the test was to qualify the vessel for its intended use by subjecting it to a 1.25 times overtest. The criteria for success are that the measured strains do not exceed the calculated strains from the vessel analysis, there is no significant additional plastic strain on subsequent tests at the rated design load (shakedown), and there is no significant damage to the vessel and attached hardware that affect form, fit, or function. Testing of the V25 Vessel in 2011 established a precedent for testing V26 [2]. As with V25, two tests were performed to satisfy this objective. The first test used 9 pounds of Composition C-4 (11.25 lbs. TNT-equivalent), which is 125 percent of the design basis load. The second test used 7.2 pounds of Composition C-4 (9 lbs. TNT-equivalent) which is 100 percent of the design basis load. The first test provided the required overtest while the second test served to demonstrate shakedown and the absence of additional plastic deformation. Unlike the V25 vessel, which was mounted in a shipping cradle during testing, the V26 vessel was mounted on the EDS P2U3 trailer prior to testing. Visual inspections of the EDS vessel, surroundings, and diagnostics were completed before and after each test event. This visual inspection included analyzing the seals, fittings, and interior surfaces of the EDS vessel and documenting any abnormalities or damages. Photographs were used to visually document vessel conditions and findings before and after each test event.

  17. Research Becomes You: Cultivating EdD Students' Identities as Educational Leaders and Researchers and a "Learning by Doing" Meta-Study (United States)

    Buss, Ray R.; Avery, Andrea


    We examined how end-of-first-year students in a Carnegie Project on the Education Doctorate (CPED)-affiliated EdD program were developing professional identities as educational leaders and researchers. Quantitative and qualitative data revealed substantial development of leadership skills, but even greater growth in perceptions of research skills.…

  18. Book review: Psychology in a work context (2nd Ed.

    Directory of Open Access Journals (Sweden)

    Nanette Tredoux


    Full Text Available Bergh, Z. & Theron, A.L. (Eds (2003 Psychology in a work context (2nd Ed.. Cape Town: Oxford University Press. This book is an overview and introduction to Industrial and Organisational Psychology. It is a work of ambitious scope, and it is clear that the contributors have invested a great deal of thought and effort in the planning and execution of the book. The current version is the second edition, and it looks set to become one of those standard textbooks that are revised every few years to keep up with changing times. It is a handsome volume, produced to a high standard of editorial care, pleasingly laid out and organised well enough to be useful as an occasional reference source. An English-Afrikaans glossary, tables of contents for every chapter as well as for the entire book, a comprehensive index and extensive bibliography make it easy to retrieve the information relating to a particular topic. Every chapter ends with a conclusion summarising the gist of the material covered. Quality illustrations lighten the tone and help to bring some of the concepts to life. Learning outcomes and self-assessment exercises and questions for every chapter will be useful to the lecturer using the book as a source for a tutored course, and for the student studying by distance learning. If sold at the suggested retail price, the book represents good value compared to imported textbooks that cover similar ground.


    Directory of Open Access Journals (Sweden)

    RJ Salway


    Full Text Available Overcrowding in emergency departments is a problem in many countries around the world, including the United States and Chile. Emergency department (ED overcrowding causes problems for patients and staff, including increased waiting times, increased ambulance diversion, increased length of stay, increased medical errors, increased patient mortality, and increased harm to hospitals due to financial losses. This article aims to describe the etiology of ED overcrowding and potential solutions through an examination of the evidence. Ultimately, ED overcrowding originates from hospital overcrowding and thus the solutions to this complex problem lie in the ED itself as well as outside of the ED.

  20. Improving ED specimen TAT using Lean Six Sigma. (United States)

    Sanders, Janet H; Karr, Tedd


    Lean and Six Sigma are continuous improvement methodologies that have garnered international fame for improving manufacturing and service processes. Increasingly these methodologies are demonstrating their power to also improve healthcare processes. The purpose of this paper is to discuss a case study for the application of Lean and Six Sigma tools in the reduction of turnaround time (TAT) for Emergency Department (ED) specimens. This application of the scientific methodologies uncovered opportunities to improve the entire ED to lab system for the specimens. This case study provides details on the completion of a Lean Six Sigma project in a 1,000 bed tertiary care teaching hospital. Six Sigma's Define, Measure, Analyze, Improve, and Control methodology is very similar to good medical practice: first, relevant information is obtained and assembled; second, a careful and thorough diagnosis is completed; third, a treatment is proposed and implemented; and fourth, checks are made to determine if the treatment was effective. Lean's primary goal is to do more with less work and waste. The Lean methodology was used to identify and eliminate waste through rapid implementation of change. The initial focus of this project was the reduction of turn-around-times for ED specimens. However, the results led to better processes for both the internal and external customers of this and other processes. The project results included: a 50 percent decrease in vials used for testing, a 50 percent decrease in unused or extra specimens, a 90 percent decrease in ED specimens without orders, a 30 percent decrease in complete blood count analysis (CBCA) Median TAT, a 50 percent decrease in CBCA TAT Variation, a 10 percent decrease in Troponin TAT Variation, a 18.2 percent decrease in URPN TAT Variation, and a 2-5 minute decrease in ED registered nurses rainbow draw time. This case study demonstrated how the quantitative power of Six Sigma and the speed of Lean worked in harmony to improve

  1. Volunteers and Voc Ed. Information Series No. 271. (United States)

    Katz, Douglas S.

    This report describes the benefits to vocational educators of involving volunteers in vocational programs and presents a model for planning and implementing a volunteer program. Outlined first are programmatic and nonprogrammatic approaches to designing volunteer programs. Next, in a discussion of the benefits of vocational volunteer programs, the…

  2. 76 FR 11435 - Privacy Act of 1974; Computer Matching Program (United States)


    ... Federal student financial assistance, and the ED personal information number (PIN) Registration System of Records (18-11-12), which contains the applicant's information to receive an ED PIN, will be matched... Dates of the Matching Program This matching program must be approved by the Data Integrity Board of each...

  3. Fisica e fumetti: Paperone ed il deposito sotterraneo

    CERN Document Server

    Bagnoli, Franco


    I fumetti, come i film, spesso utilizzano idee scientifiche "fantasiose". Non ci riferiamo qui alla violazione implicita delle leggi della fisica, cosa permessa in un mondo di fantasia, quanto piuttosto all'uso di spiegazioni fisiche errate che vengono usate in buona fede perch\\'e a riflettono convinzioni molto diffuse, ma sbagliate, sull'interpretazione di fenomeni a partire dai principi fisici. D'altra parte questi errori possono servire a illustrare la corretta applicazione della fisica in una maniera molto pi\\`u accattivante rispetto alla modalit\\'a tradizionale di presentazione. Analizziamo qui l'avventura Paperone ed il deposito sotterraneo di Pezzin e Cavezzano. ----- Comics and cartoon movies sometimes exploit fictitious scientific ideas. It is often the case that these ideas, althought wrong, actually reflect the popular vision of some natural phenomenon. We do not refer here to the implicit violation of physical laws in fictions, a practice allowed by the underlining "poetic licence" of comics. Howe...

  4. Proteste ed emancipazione alla frontiera europea. Il caso di Lampedusa

    Directory of Open Access Journals (Sweden)

    Annalisa Lendaro

    Full Text Available Riassunto Questo articolo si propone di approfondire a livello teorico i legami tra proteste ed emancipazione dei migranti senza status legale, che si trovano in situazione di detenzione amministrativa sull’isola italiana di Lampedusa. Il presente contributo mette in evidenza il fatto che l’agency dei migranti, seppur privi di libertà e di uno status legale, è determinante per sbloccare una situazione di crisi in un contesto simile allo stato di eccezione descritto da Agamben. Più precisamente, la protesta dei migranti di Lampedusa mostra in che modo la sospensione dello stato di diritto apra degli spiragli per, non solo denunciare l’ingiustizia di alcune norme, ma anche per agire.

  5. EDS'09: 13th International Conference on Elastic & Diffractive Scattering

    CERN Multimedia

    CERN. Geneva


    The series of International Conferences on Elastic and Diffractive Scattering was founded in 1985 in the picturesque old French town of Blois, famous for its XIV - XVIIth century château, inside of which the first meeting took place. Since then, meetings have been organised every two years in different places of the world: New York (1987), Evanston (1989), Isola d'Elba (1991), Providence (1993), Blois (1995), Seoul (1997), Protvino (1999), Prague (2001), Helsinki (2003), Blois (2005) and Hamburg (2007). The conference will focus on the most recent experimental and theoretical results in particle physics with an emphasis on Quantum Chromodynamics (QCD). The conference agenda is now full. No further contributions can be accepted.

  6. Pivot Nursing: An Alternative to Traditional ED Triage. (United States)

    Christensen, Maria; Rosenberg, Mark; Mahon, Eileen; Pineda, Sharon; Rojas, Eva; Soque, Victoria; Johansen, Mary L


    A 7.2% increase in patient volume from 130,700 to 140,800 in 2012 prompted St Joseph's Regional Medical Center Emergency Department to review existing triage processes to decrease turnaround time. "Pivot triage" is a new, efficient intake process that entails use of 4 rather than 8 determinants to identify acuity levels. The purpose of this performance improvement project was to create alternatives to traditional triage to decrease ED length of stay and door-to-physician time. After education, the pivot process was implemented using 4 determinants established by a multidisciplinary team. The pivot process was slowly implemented for 6 hours over a 1-week period to work out processing issues. Arrival time, door-to-physician time, and departure time from the emergency department were elements used to calculate the patient's turnaround time. Length of ED stay was collected monthly beginning in the fourth quarter of 2011. Comparisons were made after Pivot implementation in the fourth quarter of 2012. Despite the increasing volume, the mean door-to-physician time decreased from 71 to 40 minutes, a 43.7% reduction. The overall turnaround time decreased from 220 to 181 minutes, representing approximately a 17.7% reduction. The percentage of patients who left without being seen decreased from 2.5% to 1.0%. The pivot process improved patient flow in the emergency department, reducing time spent by the patient in the department. The pivot process is a viable alternative to traditional triage. Nurses are able to accurately pivot patients with a reduced amount of information. Copyright © 2016 Emergency Nurses Association. Published by Elsevier Inc. All rights reserved.

  7. ED services: the impact of caring behaviors on patient loyalty. (United States)

    Liu, Sandra S; Franz, David; Allen, Monette; Chang, En-Chung; Janowiak, Dana; Mayne, Patricia; White, Ruth


    This article describes an observational study of caring behaviors in the emergency departments of 4 Ascension Health hospitals and the impact of these behaviors on patient loyalty to the associated hospital. These hospitals were diverse in size and geography, representing 3 large urban community hospitals in metropolitan areas and 1 in a midsized city. Research assistants from Purdue University (West Lafayette, IN) conducted observations at the first study site and validated survey instruments. The Purdue research assistants trained contracted observers at the subsequent study sites. The research assistants conducted observational studies of caregivers in the emergency departments at 4 study sites using convenience sampling of patients. Caring behaviors were rated from 0 (did not occur) to 5 (high intensity). The observation included additional information, for example, caregiver roles, timing, and type of visit. Observed and unobserved patients completed exit surveys that recorded patient responses to the likelihood-to-recommend (loyalty) questions, patient perceptions of care, and demographic information. Common themes across all study sites emerged, including (1) the area that patients considered most important to an ED experience (prompt attention to their needs upon arrival to the emergency department); (2) the area that patients rated as least positive in their actual ED experience (prompt attention to their needs upon arrival to the emergency department); (3) caring behaviors that significantly affected patient loyalty (eg, making sure that the patient is aware of care-related details, working with a caring touch, and making the treatment procedure clearly understood by the patient); and (4) the impact of wait time to see a caregiver on patient loyalty. A number of correlations between caring behaviors and patient loyalty were statistically significant (P caring behaviors that are most closely linked to patient loyalty but that occurred least frequently. The

  8. Lack of information underlies women's perceptions of erectile dysfunction (ED) drugs in Japan. (United States)

    Mita, Koji; Kakehashi, Masayuki; Hasegawa, Yasuhisa; Inoue, Yoji; Shigeta, Masanobu; Matsubara, Akio; Usui, Tsuguru


    Some Japanese women are known to have negative attitudes toward erectile dysfunction (ED) drugs, but the environment underlying these perceptions is unclear. To reveal the underlying environment that shapes women's perceptions of ED drugs in Japan. A web-based questionnaire was conducted through an Internet-based market research company. A total of 2,593 women in five age groups (20s, 30s, 40s, 50s, and 60s or older) were randomly invited to participate in this study, with an almost equal number in each age group. The questionnaire contained 30 items related to individual background and sexual information, concerns about the image of ED drugs, ED drug-related perceptions, and attitude toward sexual information media. The women's attitude and the independent predictors that affect their partner's use of ED drugs were clarified. Answers were obtained from 1,077 women, of whom 35.4% (n=381) had a negative image of ED drugs. Although 69.5% (n=749) agreed that a sexual relationship with a male partner was important, only 26.7% (n=288) agreed that this remained important if ED drugs were used. However, 56.7% (n=611) and 57.7% (n=621) of respondents, respectively, answered that they would allow their partner's use of ED drugs if they imagined that they understood the safety and effectiveness of ED drugs and that their quality of life was improved by their partner's use of the drugs. Lack of information about ED drugs was a significant predictor for acceptance of a partner's use of ED drugs among women with a negative image of ED drugs, since they were more likely to accept the use of these drugs if they were convinced about their safety and effectiveness or positive effect on quality of life. Lack of information about ED drugs may influence the perception of women in Japan regarding these drugs.

  9. ER vs. ED: a comparison of televised and real-life emergency medicine. (United States)

    Primack, Brian A; Roberts, Traci; Fine, Michael J; Dillman Carpentier, Francesca R; Rice, Kristen R; Barnato, Amber E


    Although accurate health-related representations of medical situations on television can be valuable, inaccurate portrayals can engender misinformation. The purpose of this study was to compare sociodemographic and medical characteristics of patients depicted on television vs. actual United States (US) Emergency Department (ED) patients. Two independently working coders analyzed all 22 programs in one complete year of the popular "emergency room" drama ER. Inter-rater reliability was excellent, and all initial coding differences were easily adjudicated. Actual health data were obtained from the National Heath and Ambulatory Medical Care Survey from the same year. Chi-squared goodness-of-fit tests were used to compare televised vs. real distribution across key sociodemographic and medical variables. Ages at the extremes of age (i.e., ≤ 4 and ≥ 45 years) were less commonly represented on television compared with reality. Characters on television vs. reality were less commonly women (31.2% vs. 52.9%, respectively), African-American (12.7% vs. 20.3%), or Hispanic (7.1% vs. 12.5%). The two most common acuity categories for television were the extreme categories "non-urgent" and "emergent," whereas the two most common categories for reality were the middle categories "semi-urgent" and "urgent." Televised visits compared with reality were most commonly due to injury (63.5% vs. 37.0%, respectively), and televised injuries were less commonly work-related (4.2% vs. 14.8%, respectively). Comparison of represented and actual characteristics of ED patients may be valuable in helping us determine what types of patient misperceptions may exist, as well as what types of interventions may be beneficial in correcting that potential misinformation. Copyright © 2012 Elsevier Inc. All rights reserved.

  10. Bhaktapur, Nepal: the MAL-ED birth cohort study in Nepal. (United States)

    Shrestha, Prakash Sunder; Shrestha, Sanjaya Kumar; Bodhidatta, Ladaporn; Strand, Tor; Shrestha, Binob; Shrestha, Rita; Chandyo, Ram Krishna; Ulak, Manjeswori; Mason, Carl J


    The Etiology, Risk Factors and Interactions of Enteric Infections and Malnutrition and the Consequences for Child Health and Development (MAL-ED) cohort study site in Nepal is located in the Bhaktapur municipality, 15 km east of Kathmandu, the capital city of Nepal. Bhaktapur, an ancient city famous for its traditional temples and buildings, is included on UNESCO's World Heritage List and is a major tourist attraction in Nepal. Nepal is a land-locked country located in South Asia between China and India with an area of 147 181 km(2), ranging from sea-level plains to Mount Everest, the world's highest peak. The total population as of the 2011 census was 26.6 million, with an average annual population growth rate of 1.4. Nepal is one of the world's least developed countries and is ranked 157 of 186 in the 2013 Human Development Report; one-third of the Nepali population lives below the poverty line. The current under-5 mortality rate is 54 per 1000 live births, the infant mortality rate is 46 per 1000 live births, and the neonatal mortality rate is 33 per 1000 live births. Vaccine coverage for all Expanded Program on Immunization vaccines is >80%. Among children, the most common diseases contributing to significant morbidity and mortality are acute respiratory infection and dehydration from severe diarrhea. In this article, we report on the geographic, demographic, and socioeconomic features of the Bhaktapur MAL-ED site and describe the data that informed our cohort recruitment strategy. © The Author 2014. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail:

  11. MetEd Training Resources from COMET: Assisting User Readiness for JPSS Era (United States)

    Stevermer, A.; Jeffries, R. A.


    With all the new advancements, finding time to learn and stay current regarding new satellite instruments, capabilities, applications, and products can be daunting. COMET's self-paced online training resources available via the globally-renowned MetEd Website are available 24/7/365 to help meet this challenge.. UCAR's COMET® Program ( has been funded for years by NOAA NESDIS as well as EUMETSAT and the Meteorological Service of Canada to support education and training in satellite meteorology. Experts from NOAA-NESDIS its Cooperative Institutes, the Meteorological Service of Canada, EUMETSAT, the Naval Research Laboratory and others work with COMET staff to create self-paced training lessons that encourage greater use of current and future satellite observations and products. As of fall 2016, nearly 90 satellite-focused, interactive materials are freely available in English via the MetEd Web site at Many of these lessons are also available in Spanish and French making training more easily accessible to an international audience. This presentation will focus on COMET's satellite training offerings that are directly applicable to helping users learn more about the capabilities of the S-NPP and JPSS satellite series just in time to prepare for JPSS-1 launch! Our educational offerings include lessons on the VIIRS imager and its applications including the exciting nighttime visible observation with the VIIRS Day-Night Band. We'll show how the lessons introduce users to the advances these systems bring to forecasting, numerical weather prediction, and environmental monitoring. We'll also highlight the recently published lesson, " JPSS River Ice and Flood Products" and discuss current and future work.

  12. ER vs. ED: A Comparison of Televised and Real-Life Emergency Medicine (United States)

    Primack, Brian A.; Roberts, Traci; Fine, Michael J.; Dillman Carpentier, Francesca R.; Rice, Kristen R.; Barnato, Amber E.


    Background Although accurate health-related representations of medical situations on television can be valuable, inaccurate portrayals can engender misinformation. Objective The purpose of this study was to compare socio-demographic and medical characteristics of patients depicted on television vs. actual U.S. Emergency Department (ED) patients. Methods Two independently working coders analyzed all 22 programs in one complete year of the popular emergency room drama ER. Inter-rater reliability was excellent, and all initial coding differences were easily adjudicated. Actual health data were obtained from the National Heath and Ambulatory Medical Care Survey data from the same year. We used Pearson’s chi-squared test to compare televised vs. real distribution across key socio-demographic and medical variables. Results Ages at the extremes (e.g., ≤4 and ≥45) were less commonly represented on television compared with reality. Compared with reality, characters on television were less commonly women (31.2% vs. 52.9%), African American (12.7% vs. 20.3%) or Hispanic (7.1% vs. 12.5%). The two most common acuity categories for television were the extreme categories “non-urgent” and “emergent,” whereas the two most common categories for reality were the middle categories “semi-urgent” and “urgent.” Compared with reality, televised visits were most commonly due to injury (63.5% vs. 37.0%), and televised injuries were less commonly work-related (4.2% vs. 14.8%). Conclusions Comparison of represented and actual characteristics of ED patients may be valuable in helping us determine what types of patient misperceptions may exist as well as what types of interventions may be beneficial in correcting that potential misinformation. PMID:22766407

  13. RT-PCR Analysis of ED-A,ED-B, and IIICS Fibronectin Domains: A New Screening Marker For Bladder Cancer

    Directory of Open Access Journals (Sweden)

    M Ahmadi Javid


    Full Text Available Background: Fibronectin seems to play a very important role in the progression and invasion of bladder cancer. EDA, EDB, and IIICS domains of fibronectin are not expressed in the adult persons but they’re expressed in different cancers. The aim of this study is to investigate the mRNA of fibronectin in transitional carcinoma cells (TCC of bladder to study these domains. Methods: A total of 20 patients with known bladder cancer were studied. Two of them excluded since their excised tissues were not enough for both the pathological examination and RNA study. Another 20 (control group were normal volunteers who needed bladder operations. The excised tissue was immediately transferred to RNAlater (Ambion,TX. RNA was extracted via RNAWIZ (Ambion, TX. cDNA was made via RevertAid First Strand cDNA Synthesis Kit (Fermentas. PCR of the cDNAs was performed using primers for EDA, EDB, and IIICS (Eurogentec,Belgium. Results: For the first time, we present the expression of the oncofetal fibronectin mRNA in the transitional cell carcinoma of bladder. The high grade muscle invasive (G3T2 tumor, expressed ED-A, ED-B, and IIICS. Expression of ED-A, ED-B, and IIICS was confirmed in the two patients with G3T1 TCC. The four patients with G2Ta and G3Ta expressed both ED-A and ED-B. The four patients with G1T1 tumor expressed ED-A only, similar to the nine patients with G1Ta tumor. None of the normal volunteers expressed the oncofetal extra domains. The sensitivity of ED-A positive fibronectin RNA for detecting TCC of any kind is 100%, and of ED-B was only 35%. The specificity of ED-B positive fibronectin RNA for the high grade TCC is 100%. Conclusion: ED-A, ED-B, and IIICS could be used as useful markers for the diagnosis and following up of bladder carcinoma. Keywords: Transitional Cell Carcinoma, bladder cancer, fibronectin, RT-PCR, oncofetal.

  14. SED-ED, a workflow editor for computational biology experiments written in SED-ML. (United States)

    Adams, Richard R


    The simulation experiment description markup language (SED-ML) is a new community data standard to encode computational biology experiments in a computer-readable XML format. Its widespread adoption will require the development of software support to work with SED-ML files. Here, we describe a software tool, SED-ED, to view, edit, validate and annotate SED-ML documents while shielding end-users from the underlying XML representation. SED-ED supports modellers who wish to create, understand and further develop a simulation description provided in SED-ML format. SED-ED is available as a standalone Java application, as an Eclipse plug-in and as an SBSI ( plug-in, all under an MIT open-source license. Source code is at The application itself is available from

  15. A graphic approach to the analysis of a large X-ray microanalysis dataset obtained via SEM-EDS. (United States)

    Parkhimovich, N Yu; Salikhov, A R; Imayev, M F


    A graphical method for phase analysis of advanced materials by EDS-SEM was developed and demonstrated on deformed superconducting Bi(Pb)2223 ceramics. Through visual representation, this method allows for the rapid and efficient analysis of large X-ray microanalysis datasets and to identify phase composition of fine particles of secondary phases against a background of other phases. The graphical method can be applied using existing software and therefore does not require the development of new programs or complex computations. © 2017 Wiley Periodicals, Inc.

  16. X-linked anhidrotic ectodermal dysplasia (ED1 in men, mice, and cattle

    Directory of Open Access Journals (Sweden)

    Drögemüller Cord


    Full Text Available Abstract Ectodermal dysplasias are a large group of rare genetic disorders characterized by impaired development of hair, teeth, and eccrine glands in humans, mice, and cattle. Here, we review the cloning, mutation analyses, and functional studies of the known causative genes for the X-chromosomal anhidrotic ectodermal dysplasia (ED1 in these species. Mutations in the ectodysplasin 1 (ED1 gene are responsible for X-linked anhidrotic ectodermal dysplasia. The ED1 gene encodes a signaling molecule of the tumor necrosis factor family that is involved in development of ectodermal appendages. The bovine disorder may serve as an animal model for human ED1.

  17. A Preliminary Examination of Loss of Control Eating Disorder (LOC-ED) in Middle Childhood (United States)

    Matherne, Camden E.; Tanofsky-Kraff, Marian; Altschul, Anne M.; Shank, Lisa M.; Schvey, Natasha A.; Brady, Sheila M.; Galescu, Ovidiu; Demidowich, Andrew P.; Yanovski, Susan Z.; Yanovski, Jack A.


    Loss of Control Eating Disorder (LOC-ED) has been proposed as a diagnostic category for children 6–12y with binge-type eating. However, characteristics of youth with LOC-ED have not been examined. We tested the hypothesis that the proposed criteria for LOC-ED would identify children with greater adiposity, more disordered eating attitudes, and greater mood disturbance than those without LOC-ED. Participants were 251 youth (10.29y ± 1.54, 53.8% female, 57.8 % White, 35.5% Black, 2.0% Asian, 4.8% Hispanic, 53.0% overweight). Youth were interviewed regarding eating attitudes and behaviors, completed questionnaires to assess general psychopathology, and underwent measurements of body fat mass. Using previously proposed criteria for LOC-ED, children were classified as LOC-ED (n = 19), LOC in the absence of the full disorder (subLOC, n = 33), and youth not reporting LOC (noLOC, n = 199). LOC-ED youth had higher BMIz (p = 0.001) and adiposity (p = 0.003) and reported greater disordered eating concerns (p disordered eating attitudes (p = 0.02). SubLOC youth had greater disordered eating concerns (p disordered eating cognitions and anthropometric measures compared to youth without LOC-ED. Longitudinal studies are needed to determine if those with LOC-ED are at particularly increased risk for progression of disordered eating and excess weight gain. PMID:25913008

  18. 8 Different approaches needed to manage ED demand among different age-groups. (United States)

    Rimmer, Melanie; Ablard, Suzanne; O'Keeffe, Colin; Mason, Suzanne


    A variety of interventions have been proposed to manage rising demand for Emergency and Urgent Care, described by an NHS England review as unsustainable in the long term. However it is unlikely that any suggested approach will be equally suitable for the diverse population of ED users.We aimed to understand the patterns of demand amongst different types of patients attending ED. We also sought to understand the intended and unintended effects of demand management initiatives. Our study combined insights from routine data, a survey of ED patients, and qualitative interviews with ED staff. This paper describes the results of our analysis of the interviews. We conducted semi-structured interviews with 25 ED and Urgent Care Centre staff across 7 hospital sites in Yorkshire and Humber between 25 April and 11 July 2016. The interview topic guide asked about 4 broad areas; job role, description of patients and their impact on demand, description of inappropriate attendance, and current/future initiatives to deal with rising demand. Interviews were transcribed verbatim and analysed using framework analysis. We analysed the results to identify groups of patients with different patterns of use of ED services. We also explored ED staff experiences of demand management initiatives, and their suggestions for future initiatives. Although we did not ask specifically about patients' age, our analysis revealed that ED staff categorised attenders as children and young people, working age people, and older people. These groups had different reasons for attendance, different routes to the ED, different rate of non-urgent attendance, and different issues driving demand. Staff also described variation in the time taken to treat patients of different ages, with the oldest and youngest patients described as requiring the most time.There was no consensus amongst staff about the effectiveness of initiatives for managing demand. A strikingly wide variety of initiatives were mentioned

  19. The emerging Doctor of Education (EdD) in instructional leadership for nurse educators. (United States)

    Graves, Barbara A; Tomlinson, Stephen; Handley, Marilyn; Oliver, JoAnn S; Carter-Templeton, Heather; Gaskins, Susan; Adams, Marsha H; Wood, Felecia


    The nursing faculty shortage is directly related to the ongoing shortage of nurses. As a result of many nursing faculty retiring, the discipline of nursing is losing its most experienced educators. The need is great for programs that will increase access and prepare nurse educators. Doctorate degrees for nurses have evolved in myriad ways. Discussions over the nature of doctoral education for the preparation of nurse educators are at the forefront of debates in nursing education. In response to National League for Nursing (2007; Core competencies of nurse educators, and Institute of Medicine (2010; The future of nursing: Leading change, advancing health. Washington, DC: National Academies Press, calls to increase the number of nursing faculty, the colleges of nursing and education at a major university have combined to establish a collaborative doctoral program. This article describes the historical evolution of the nursing doctorate degrees and the development and implementation of the EdD in Instructional Leadership for Nurse Educators.

  20. The MAL-ED cohort study in Mirpur, Bangladesh. (United States)

    Ahmed, Tahmeed; Mahfuz, Mustafa; Islam, Md Munirul; Mondal, Dinesh; Hossain, Md Iqbal; Ahmed, Am Shamsir; Tofail, Fahmida; Gaffar, Sm Abdul; Haque, Rashidul; Guerrant, Richard L; Petri, William A


    The Etiology, Risk Factors and Interactions of Enteric Infections and Malnutrition and the Consequences for Child Health and Development (MAL-ED) study site in Bangladesh is located in the capital city of Dhaka in an urban slum that has one of the highest population densities in the world. The site is in the Bauniabadh area of Mirpur, Dhaka. A typical squatter settlement, the average family size of households in Mirpur Bauniabadh is 4.5, with 48% females. About 20% of households have a monthly income of only US$62. About 30% of mothers never attended school, and only 3% obtained secondary school education. The majority of the people are day laborers, garment workers, and transport workers. About 72% of caregivers always wash their hands after helping the child defecate and 6.6% never wash their hands. The diarrheal attack rate for Mirpur is 4.69 episodes per child per year. The study site is representative of a typical urban slum of Dhaka city in terms of demographics, socioeconomic status, and general health indicators. © The Author 2014. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail:


    Energy Technology Data Exchange (ETDEWEB)

    Noyes, H. Pierre


    By taking seriously the limits on observability which come from combining relativistic quantum mechanics with general relativity, Ed Jones has shown that the current measurements of the cosmological constant density {Omega}{sub {Lambda}} {approx} 0.7 imply that the temperature scale at which it becomes possible to discuss cosmological models is {approx} 5 Tev (5.8 x 10{sup 16} K). This is self-consistent with the assumption that the number of Planck masses which make some sort of ''phase transition'' to this state is N{sub Pk} {approx} 4 x 10{sup 61}. We review Jones' argument and the bit-string physics calculation which gives the baryon-photon ratio at nucleosynthesis as {approx} 2/256{sup 4}, the dark matter-baryon ratio as {approx} 12.7, and hence {Omega}{sub m} {approx} 0.3, in agreement with current observations. Accepting these values for the two energy densities {Omega}{sub {Lambda}} + {Omega}{sub m} {approx} 1 in accord with recent analyses of fluctuations in the CMB showing that space is flat to about 6%. We conclude that experiments with particle accelerators in the 5-10 Tev range must either show that current theory can adequately describe the currently observed structure of our universe or force us to revise our ideas about physics at a very fundamental level.

  2. Spazio, movimento, prospettiva ed empatia: un prototipo di videogame didattico

    Directory of Open Access Journals (Sweden)

    Pio Alfredo Di Tore


    Full Text Available Questo lavoro presenta la cornice teorica che sta alla base della progettazione di un videogame didattico pensato per valutare le abilità di perspective taking (capacità di adottare la prospettiva altrui e di mental rotation (rotazione mentale dei giocatori. Lo studio mira a rilevare come tali abilità siano coinvolte nella relazione empatica e a verificarne le implicazioni in campo educativo. Il lavoro adotta la definizione di empatia riconducibile ad Alain Berthoz ed alla teoria spaziale dell’empatia qui presentata con i relativi sistemi di riferimento spaziale. È inoltre fornita una rapida revisione della letteratura sulla rappresentazione dello spazio nel bambino e sulla rappresentazione dello spazio nel gioco (su base visiva. Infine, il lavoro descrive il prototipo di gioco – realizzato presso l’Università di Salerno – in cui il giocatore si trova alle prese con tre differenti compiti di cui due progettati per misurare le abilità di perspective taking mentre il terzo è calibrato sulle abilità di mental rotation.

  3. Spirometrie v prostředí LabVIEW


    Pernicová, Lenka


    Tato bakalářská práce se zabývá funkčním vyšetřením plic – spirometrií. Skládá se ze dvou základních částí. V první části je důležité seznámit se s jednotlivými metodami funkčního vyšetření plic. Na základě důkladného prostudování parametrů popisujících funkci plic a zaměření se na spirometrickou křivkou, bylo možné přejít k druhé části této práce, tzn. k realizaci spirometru v grafickém prostředí LabVIEW. Vytvořený virtuální přístroj nám umožňuje zobrazení spirometrické křivky, následnou ana...

  4. Alprostadil plus Vacuum (VITARUM in severe erectile dysfunction (ED

    Directory of Open Access Journals (Sweden)

    Franco Mantovani


    Full Text Available Objectives: Severe erectile dysfunction (ED is not uncommon, as can be seen from the epidemiological literature, and there are several possible causes, which are not always known, or leastways evident. Having ascertained the ineffectiveness, intolerance to or rejection of pharmacological aids, the option of prosthetic surgery remains, but before this, it may be wise when feasible to use Alprostadil cream in association with Vacuum device. Material and methods: 12 patients, aged between 55 and 65 years, with severe erectile dysfunction without palpable cavernous fibrosis, were instructed to self-insert into the urethral meatus, 3 mg of Alprostadil cream, sufficient to make it easy to place the Vacuum device over the penis. Results: In the cases observed, the preliminary use of Alprostadil cream fast produced an erection with enough rigidity to place the Vacuum. A sufficient erection was maintained, obviously using an elastic ring at the base of the penis, to achieve penetration. The reproducibility of the use of Alprostadil cream with Vacuum device was then confirmed at home, to the satisfaction of the patients.

  5. Ready-JET-Go: Split Flow Accelerates ED Throughput. (United States)

    Bish, Peter A; McCormick, Mary A; Otegbeye, Mojisola


    Struggling to keep up with The Centers for Medicare and Medicaid Services out-patient throughput metrics, an adult emergency department serving Burlington and Camden Counties, New Jersey, sought to redefine its care delivery model by adopting the patient segmentation initiatives of the split-flow process of patient care. A multidisciplinary team of ED clinicians collaboratively defined the patient segmentation criteria. A joint assessment team approach to patient care was instituted. A 3-pronged approach was adopted to prepare staff for the patient care changes in line with an existing framework specified by the Institute of Medicine. Simulation and queuing analyses were used to estimate the accompanying resource needs. Since implementing split flow, the emergency department has witnessed significant improvements in patient throughput and patient satisfaction, despite a sustained 10% increase in patient volumes after split-flow implementation. The median length of stay for discharged patients and the door-to-diagnostic evaluation time are now down to 112 minutes and 30 minutes, respectively, compared with pre-split-flow values of 192 minutes and 72 minutes, respectively. Working collaboratively with all stakeholders to define the right patient care delivery model, combined with an understanding of the right resource assignments to optimally support that care delivery model, an emergency department can institute cost-effective changes to realize and sustain significant patient throughput improvements. Copyright © 2016 Emergency Nurses Association. Published by Elsevier Inc. All rights reserved.

  6. Book Review: Digital Forensic Evidence Examination (2nd ed.

    Directory of Open Access Journals (Sweden)

    Gary Kessler


    Full Text Available Cohen, F. (2010. Digital Forensic Evidence Examination (2nd ed.. Livermore, CA: ASP Press. 452 pages, ISBN: 978-1-878109-45-3, US$79.Reviewed by Gary C. Kessler, Gary Kessler Associates & Edith Cowan University (gck@garykessler.netOn the day that I sat down to start to write this review, the following e-mailcame across on one of my lists:Person A and Person B write back and forth and create an email thread. Person A then forwards the email to Person C, but changes some wording in the email exchange between A & B. What is the easiest way (and is it even possible to find out when that earlier email message was altered before sent to Person C?Before you try to answer these questions, read Fred Cohen's Digital Forensic Evidence Examination. His book won't actually tell you how to answer these questions but it will help you understand the difficulty in even trying to answer them with any level of certainty.(see PDF for full review

  7. Verbo come elemento della frase in friulano ed in frances

    Directory of Open Access Journals (Sweden)

    David Bizjak


    Full Text Available Il presente lavoro e dedicato a una parte della sfera del verbo nel friulano  lettera­ rio della seconda meta del ventesimo secolo, alla perifrasi verbale e alla locuzione verbale. Nella definizione della perifrasi verbale (PV ho seguito il modello dei lin­ guisti spagnoli Javier Garcia Gonzales, Fernandez de Castro e Leonard Gomez Torrego, essendo ilpunto di partenza ilmio postulato che la PV rappresenti in friu­ lano una categoria grammaticale a parte o, almeno, una categoria in via di gramma­ ticalizzazione. Parallelamente alla situazione in friulano osservo quella nel francese scritto contemporaneo, con lo scopo di constatare delle eventuali somiglianze e diffe­ renze. Tenendo in considerazione la realta linguistica nella regione Friuli-Venezia Giulia, dove le interferenze fra l'italiano, il friulano ed il veneto sono tali che un non-friulanofono non riesce facilmente a distinguere quando si tratta di un sintag­ ma di origine friulana e quando di un calco sintattico sull'italiano, sembra oppor­ tuno, in numerosi casi, confrontare ilsintagma friulano e quello francese anche con la variante corrispondente in italiano letterario moderno; inoltre, nel capitolo in cui sono trattati i cosiddetti tempi bicomposti, vengono citati alcuni esempi nelle diver­ se varieta venete.

  8. Etica ed evoluzionismo: la proposta di Marc Hauser

    Directory of Open Access Journals (Sweden)

    Irene Pilloni


    Full Text Available Le recenti scoperte nell’ambito della psicologia evoluzionistica potrebbero offrire una risposta al dibattito sull’origine evoluzionistica della facoltà morale dell’Homo sapiens. In passato, il tentativo di spiegare il comportamento morale a partire dalla teoria dell’evoluzione è stato intrapreso dal padre fondatore dell’evoluzionismo Charles Darwin, successivamente da T.H. Huxley e da H. Spencer e infine dal sociobiologo E. Wilson a metà degli anni ‘70 del Novecento. Oggi questa impresa è stata ereditata dallo psicologo evoluzionista Marc Hauser, le cui indagini prendono avvio da un’analogia tra facoltà morale e facoltà linguistica. Questa analogia gli consente di affermare che la pluralità di codici morali adottati dagli uomini nelle differenti culture dipende da un numero limitato di principi morali, nello stesso modo in cui la varietà di lingue con cui gli uomini si esprimono, dipende da un numero limitato di principi linguistici universali. Dunque, sembrerebbe che l’evoluzione biologica abbia plasmato dei principi morali universali e uniformi che si presentano costanti in tutti gli uomini a prescindere dalla loro appartenenza culturale. Come vadano intesi i principi morali universali e quale rapporto intercorre tra di essi e i vari codici morali sarà l’argomento di questo saggio, il quale tenterà di analizzare la proposta di Marc Hauser all’interno della cornice dei rapporti tra etica ed evoluzionismo.

  9. Sappiamo davvero come far apprendere? Credenza ed evidenza empirica.

    Directory of Open Access Journals (Sweden)

    Roberto Trinchero


    Full Text Available “I ragazzi con più stimoli apprendono di più e meglio di quelli sottoposti a meno stimoli!”, “In questa scuola non possiamo fare didattica attiva perché non abbiamo i laboratori!”, “I ragazzi imparano meglio se li si lascia sperimentare e costruire i concetti da soli!”, “La lezione frontale? Ormai è una strategia didattica superata!”, “Se hai capito il concetto una volta, poi lo saprai applicare sempre!”, “I ragazzi imparano meglio quando fanno lavori di gruppo!”. Quante volte avete sentito insegnanti ed educatori pronunciare queste frasi? Ma cosa dice la ricerca in proposito? Queste sono solo credenze o hanno davvero un fondamento empirico? Il presente articolo intende fornire alcune evidenze per supportare, confutare, chiarire le condizioni di validità degli asserti suddetti. Le evidenze sono tratte dalla ricerca sul funzionamento della mente e dalle meta-analisi che si sono occupate di sintetizzare i principali studi empirici riguardanti l’impatto di varie strategie didattiche sull’apprendimento dei soggetti in formazione.

  10. An Evidence-Based Alcohol Screening, Brief Intervention and Referral to Treatment (SBIRT) Curriculum for Emergency Department (ED) Providers Improves Skills and Utilization (United States)

    Bernstein, Edward; Bernstein, Judith; Feldman, James; Fernandez, William; Hagan, Melissa; Mitchell, Patricia; Safi, Clara; Woolard, Robert; Mello, Mike; Baird, Janette; Lee, Cristina; Bazargan-Hejazi, Shahrzad; Broderick, Kerry; LaPerrier, Kathryn A.; Kellermann, Arthur; Wald, Marlena M.; Taylor, Robert E.; Walton, Kim; Grant-Ervin, Michelle; Rollinson, Denise; Edwards, David; Chan, Theodore; Davis, Dan; Marshall, Jean Buchanan; Aseltine, Robert; James, Amy; Abu-Hasaballah, Khamis; Schilling, Elizabeth; Baumann, Brigitte M.; Boudreaux, Edwin D.; Maio, Ronald; Cunningham, Rebecca; Murrell, Teresa; Doezema, David; Bauer, Michael J.; Anglin, Deirdre; Eliassen, Adriana; Martin, Marcus; Pines, Jesse; Buchanan, Leslie; Turner, James; D'Onofrio, Gail; Degutis, Linda C.; Owens, Patricia


    SUMMARY Objective Emergency Departments (EDs) offer an opportunity to improve the care of patients with at-risk and dependent drinking by teaching staff to screen, perform brief intervention and refer to treatment (SBIRT). We describe here the implementation at 14 Academic EDs of a structured SBIRT curriculum to determine if this learning experience improves provider beliefs and practices. Methods ED faculty, residents, nurses, physician extenders, social workers, and Emergency Medical Technicians (EMTs) were surveyed prior to participating in either a two hour interactive workshops with case simulations, or a web-based program ( A pre-post repeated measures design assessed changes in provider beliefs and practices at three and 12 months post-exposure. Results Among 402 ED providers, 74% reported < 10 hours of prior professional alcohol-related education and 78% had < 2 hours exposure in the previous year. At 3-month follow-up, scores for self-reported confidence in ability, responsibility to intervene, and actual utilization of SBIRT skills all improved significantly over baseline. Gains decreased somewhat at 12 months, but remained above baseline. Length of time in practice was positively associated with SBIRT utilization, controlling for gender, race and type of profession. Persistent barriers included time limitations and lack of referral resources. Conclusions ED providers respond favorably to SBIRT. Changes in utilization were substantial at three months post-exposure to a standardized curriculum, but less apparent after 12 months. Booster sessions, trained assistants and infrastructure supports may be needed to sustain changes over the longer term. PMID:18077305

  11. Hearing of Mr. Francois Roussely, President of EdF; Audition de M. Francois Roussely, President d'EdF

    Energy Technology Data Exchange (ETDEWEB)

    Roussely, F. [Electricite de France (EDF), 75 - Paris (France)


    This document is the proceedings of the hearing of F. Roussely, President of Electricite de France (EdF), at the commission of economic affairs of the French house of commons, about the advisability of the construction of the EPR (European pressurized reactor) demonstration plant and about its possible financing by EdF. In a first part, F. Roussely recalls the European context of deregulation of energy markets and its impact of the French electric power industry (opening of the French market, industrial and social actions of EdF, need of a new generation of nuclear reactor, preservation of EdF's energy mix, warranty of public utility, un-bundling between energy trade and distribution, EdF's turnover and profitability, EdF's foreign daughter companies). In a second part, F. Roussely answers a series of questions asked by the different members of the commission concerning the different points presented in the first part. (J.S.)

  12. A Disability Studies in Education Analysis of the edTPA through Teacher Candidate Perspectives (United States)

    Bacon, Jessica; Blachman, Sheila


    This analysis of the Special Education edTPA is written by two professors who co-taught a student teaching seminar at one institution and supported the first groups of teacher candidates required to submit the edTPA for certification in New York State. Data were gathered over three semesters and included open-ended student surveys, student…

  13. Multiple Intelligence and Digital Learning Awareness of Prospective B.Ed Teachers (United States)

    Gracious, F. L. Antony; Shyla, F. L. Jasmine Anne


    The present study Multiple Intelligence and Digital Learning Awareness of prospective B.Ed teachers was probed to find the relationship between Multiple Intelligence and Digital Learning Awareness of Prospective B.Ed Teachers. Data for the study were collected using self made Multiple Intelligence Inventory and Digital Learning Awareness Scale.…

  14. A Review of "Older, Wiser, Sexually Smarter: 30 Sex Ed Lessons for Adults Only" (United States)

    Garrity, Joan Mogul


    While virtually all sex ed curricula are designed to be used with children, teens and young adults, "Older, Wiser, Sexually Smarter: 30 Sex Ed Lessons for Adults Only" ([C] 2009, Planned Parenthood of Greater Northern New Jersey) offers lessons to help participants fully embrace the possibility of sexual pleasure and intimacy from mid-life through…

  15. Is There a Future for Teacher Ed Curriculum? An Answer from History and Moral Philosophy (United States)

    Null, J. Wesley


    Is there a future for teacher ed "curriculum"? The author contends that he is not sure if there is a future for teacher ed curriculum, but if such a future is to exist, the answer will come only from history and moral philosophy. In this article, the author opines that individuals cannot make good decisions about the future of teacher ed…

  16. Book Review: John M. Hobson and Leonard Seabrooke (2007) (eds) Everyday Politics of the World Economy

    DEFF Research Database (Denmark)

    Strange, Michael Stewart


    Book Review: John M. Hobson and Leonard Seabrooke (2007) (eds) Everyday Politics of the World Economy (Cambridge: Cambridge University Press), 254pp. Udgivelsesdato: 2009......Book Review: John M. Hobson and Leonard Seabrooke (2007) (eds) Everyday Politics of the World Economy (Cambridge: Cambridge University Press), 254pp. Udgivelsesdato: 2009...

  17. Mental Health and Academic Achievement among M.Ed. Students in Kerala (United States)

    Moradi Sheykhjan, Tohid; K., Rajeswari; Jabari, Kamran


    The present research endeavor was aimed to assess relationship between Mental Health and Academic Achievement among M.Ed. students in Kerala. The sample of the study consisted of 314 M.Ed. students in Kerala. The method used for the present study was survey method. Mental Health Status Scale (M.H.S. Scale) was used and the study used the total…

  18. Agro obacter pop rium m pular In mediate ndica r ed gen rice Ra ...

    African Journals Online (AJOL)


    ed equally. e and Skoog, 2 remain perma e mediate ndica r. ¥, Swadesh. Plant Patholog unge Circular ge, 1/1, Suren hutosh Colleg ceived 27 Januar ansformation ing a binary ed. Various p. , bacterial co nd the conce equence an requency we ormation tech m tumefacien ry food crop population, h and proteom two third of t.

  19. A mechanistic nitrogen limitation model for CLM(ED) (United States)

    Ali, A. A.; Xu, C.; McDowell, N. G.; Rogers, A.; Wullschleger, S. D.; Fisher, R.; Vrugt, J. A.


    Photosynthetic capacity is a key plant trait that determines the rate of photosynthesis; however, in Earth System Models it is either a fixed value or derived from a linear function of leaf nitrogen content. A mechanistic leaf nitrogen allocation model have been developed for a DOE-sponsored Community Land Model coupled to the Ecosystem Demography model (CLM-ED) to predict the photosynthetic capacity [Vc,max25 (μmol CO2 m-2 s-1)] under different environmental conditions at the global scale. We collected more than 800 data points of photosynthetic capacity (Vc,max25) for 124 species from 57 studies with the corresponding leaf nitrogen content and environmental conditions (temperature, radiation, humidity and day length) from literature and the NGEE arctic site (Barrow). Based on the data, we found that environmental control of Vc,max25 is about 4 times stronger than the leaf nitrogen content. Using the Markov-Chain Monte Carlo simulation approach, we fitted the collected data to our newly developed nitrogen allocation model, which predict the leaf nitrogen investment in different components including structure, storage, respiration, light capture, carboxylation and electron transport at different environmental conditions. Our results showed that our nitrogen allocation model explained 52% of variance in observed Vc,max25 and 65% variance in observed Jmax25 using a single set of fitted model parameters for all species. Across the growing season, we found that the modeled Vc,max25 explained 49% of the variability in measured Vc,max25. In the context of future global warming, our model predicts that a temperature increase by 5oC and the doubling of atmospheric carbon dioxide reduced the Vc,max25 by 5%, 11%, respectively.

  20. Francesco Fiorentino (ed., Figure e forme della memoria culturale

    Directory of Open Access Journals (Sweden)

    Paola Di Gennaro


    Full Text Available Lavorare la memoria, obliare, ricordare, riscrivere il passato con gli strumenti del presente, è questo il soggetto e l’oggetto dei saggi riuniti in questo volume da Francesco Fiorentino, che li introduce attraverso l’operazione artistica di Robert Rauschenberg, il quale, dopo aver chiesto un disegno a de Kooning, maestro dell’Espressionismo astratto, lo espone cancellato. Questa «sottile meditazione iconologica sul tempo edipico dell’arte moderna» (7-8 annuncia uno dei leitmotiv del volume, verità ovvia ma necessaria: se la novità ha valore estetico, come è vero dal Settecento, allora il passato diventa fondamentale come sistema interno dell’arte. È su questo necessario filtro di selezione che agiscono le memorie citate nei saggi seguenti: intersezioni di tracce e cancellazioni, di cui si indagano autenticità, costruzione, ricostruzione, senza che i confini siano tra l’altro mai definiti – ed è questo, forse, che crea l’arte, per suo mezzo e scopo, tramite l’inaffidabilità della memoria: arte che è, come il quadro di Rauschenberg, «rappresentazione della permanenza e, insieme, dell’inattingibilità di ciò che è cancellato» (11. È insomma la «dimensione performativa dell’agire culturale» che viene messa in evidenza in questo volume, memoria che è culturale, appunto, umana e storica, e che, come il Wunderblock di Freud, si cancella ma mai completamente, e mai innocuamente. L’irriconoscibilità finale del ricordo rappresenta quindi il risultato della dimenticanza, e il suo prodotto più creativo. È proprio l’infedeltà della memoria a renderla oggetto sostanziale dell’arte, così come di questo lavoro, oggetto autoriflessivo della memoria collettiva.

  1. Ridgefield Complex - Invasive Plant ED/RR Search 2015 (United States)

    US Fish and Wildlife Service, Department of the Interior — The proposed project is a part of the Gorge NWRs’ invasives management program and will help achieve goals and improve targeted habitats identified in the Refuges’...

  2. VocEd Goes Underground in West Virginia. (United States)

    Helgager, David B.


    Describes development of a coal mining training curriculum in West Virginia for adults and high school students, as well as programs to retrain people in new equipment repair and in the emergency medical services required by state law. (MF)

  3. Ridgefield - Invasive Plant Targeted Control and ED/RR (United States)

    US Fish and Wildlife Service, Department of the Interior — The proposed project is a part of the Refuge invasive species management program and will help achieve goals and priority habitats identified in the Refuge CCP. The...

  4. Ridgefield Complex - Invasive Plant ED/RR Search 2015 (United States)

    Department of the Interior — The proposed project is a part of the Gorge NWRs’ invasives management program and will help achieve goals and improve targeted habitats identified in the Refuges’...

  5. Accuracy of ED Bedside Ultrasound for Identification of Gallstones: Retrospective Analysis of 575 Studies

    Directory of Open Access Journals (Sweden)

    Scruggs, William


    Full Text Available Study Objective: To determine the ability of emergency department (ED physicians to diagnose cholelithiasis with bedside ultrasound. Methods: ED gallbladder ultrasounds recorded over 37 months were compared to radiology ultrasound interpretation. Results: Of 1,690 ED gallbladder ultrasound scans performed during this period, radiology ultrasound was performed in 575/1690 (34% cases. ED physician bedside interpretation was 88% sensitive [95% CI, 84-91] and 87% specific [95% CI, 82-91], while positive predictive value (PPV was 91% [88- 94%] and negative predictive value (NPV was 83% [78-87%], using radiology interpretation as the criterion reference. Conclusion: ED physician ultrasound of the gallbladder for cholelithiasis is both sensitive and specific.

  6. High-Resolution Macromolecular Structure Determination by MicroED, a cryo-EM Method (United States)

    Rodriguez, J.A.; Gonen, T.


    Microelectron diffraction (MicroED) is a new cryo-electron microscopy (cryo-EM) method capable of determining macromolecular structures at atomic resolution from vanishingly small 3D crystals. MicroED promises to solve atomic resolution structures from even the tiniest of crystals, less than a few hundred nanometers thick. MicroED complements frontier advances in crystallography and represents part of the rebirth of cryo-EM that is making macromolecular structure determination more accessible for all. Here we review the concept and practice of MicroED, for both the electron microscopist and crystallographer. Where other reviews have addressed specific details of the technique (Hattne et al., 2015; Shi et al., 2016; Shi, Nannenga, Iadanza, & Gonen, 2013), we aim to provide context and highlight important features that should be considered when performing a MicroED experiment. PMID:27572734

  7. The influence of sonority on the production of words ending in -ed by Brazilian EFL learners

    Directory of Open Access Journals (Sweden)

    Fernanda Delatorre


    Full Text Available This study investigated the influence of sonority on the production of vowel epenthesis in verbs ending in -ed by Brazilian learners of English. Participants were twenty-six upper-intermediate Brazilian EFL learners who read and audio-recorded ten paragraphs containing 91 verbs ending in ed. The results demonstrated that sonority influenced mispronunciations since the least sonorous obstruents preceding -ed induced more vowel epenthesis than the more sonorous sonorants, which in turn induced more epenthesis than vowels in the same position. The results also demonstrated that within the class of obstruents, affricates preceding -ed induced more epenthesis than stops, which induced more epenthesis than fricatives, and that, within the class of sonorants, nasals induced more epenthesis than liquids. These results suggest that markedness in terms of sonority affects the production of vowel epenthesis in words ending in -ed.

  8. The influence of sonority on the production of words ending in -ed by Brazilian EFL learners

    Directory of Open Access Journals (Sweden)

    Fernanda Delatorre


    Full Text Available This study investigated the influence of sonority on the production of vowel epenthesis in verbs ending in -ed by Brazilian learners of English. Participants were twenty-six upper-intermediate Brazilian EFL learners who read and audio-recorded ten paragraphs containing 91 verbs ending in ed. The results demonstrated that sonority influenced mispronunciations since the least sonorous obstruents preceding -ed induced more vowel epenthesis than the more sonorous sonorants, which in turn induced more epenthesis than vowels in the same position. The results also demonstrated that within the class of obstruents, affricates preceding -ed induced more epenthesis than stops, which induced more epenthesis than fricatives, and that, within the class of sonorants, nasals induced more epenthesis than liquids. These results suggest that markedness in terms of sonority affects the production of vowel epenthesis in words ending in -ed.

  9. MetEd Resources for Embracing Advances with S-NPP and JPSS (United States)

    Abshire, W. E.; Dills, P. N.; Weingroff, M.


    The COMET® Program (, a part of the UCAR Community Programs (UCP) at UCAR, receives funding from NOAA NESDIS as well as EUMETSAT and the Meteorological Service of Canada to support education and training in satellite meteorology. For many years COMET's satellite education programs have focused on developing self-paced online educational materials that highlight the capabilities and applications of current and next-generation operational geostationary and polar-orbiting satellites and their relevance to operational forecasters and other user communities. By partnering with experts from the Naval Research Laboratory, NOAA-NESDIS and its Cooperative Institutes, Meteorological Service of Canada, EUMETSAT, and other user communities, COMET stimulates greater use of current and future satellite observations and products. This presentation provides a tour of COMET's satellite training and education offerings that are directly applicable to data and products from the S-NPP and JPSS satellite series. A recommended set of lessons for users who wish to learn more will be highlighted, including excerpts from the newest materials on the Suomi NPP VIIRS imager and its applications, as well as advances in nighttime visible observation with the VIIRS Day-Night Band. We'll show how the lessons introduce users to the advances these systems bring to forecasting, numerical weather prediction, and environmental monitoring. Over 90 satellite-focused, self-paced, online materials are freely available on the of the MetEd Web site ( via the "Education & Training", "Satellite" topic area. Quite a few polar-orbiting-related lessons are available in both English, Spanish, and French. Additionally, S-NPP and JPSS relevant information can also be found on the the Environmental Satellite Resource Center (ESRC) Web site ( that is maintained by COMET. The ESRC is a searchable, database-driven Web site that provides access to

  10. Examining Internet Access and Social Media Application Use for Online Nutrition Education in SNAP-Ed Participants in Rural Illinois. (United States)

    Loehmer, Emily; Smith, Sylvia; McCaffrey, Jennifer; Davis, Jeremy


    To examine Internet access and interest in receiving nutrition education via social media applications among low-income adults participating in the Supplemental Nutrition Assistance Program Education (SNAP-Ed). A cross-sectional survey was distributed during 25 SNAP-Ed classes throughout the 16 southernmost counties of Illinois. From 188 responses, the majority of participants had Internet access (76%). Among participants aged 18-32 years (n = 51), 92% owned a smartphone with Internet access and 57% indicated that they would use online nutrition education, with most interest in e-mail (41%), Facebook (40%), and text messaging (35%). There was little interest in using blogs, Vine, Twitter, Tumblr, and Pinterest. Overall, 49% of middle-aged adults aged 33-64 years and 87% of seniors aged ≥65 years reported they would not use online nutrition education. Results indicated similar Internet accessibility in southern Illinois among low-income populations compared with national rural rates. Interest in using online nutrition education varied among SNAP-Ed participants according to age. Young adults appeared to be the most captive audience regarding online nutrition education. Results may be useful to agencies implementing SNAP-Ed to supplement current curriculum with online nutrition education for audiences aged ≤32 years. Copyright © 2017 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

  11. Partial Evaluation and Automatic Program Generation (C. A. R. Hoare (Ed.))

    DEFF Research Database (Denmark)

    Jones, Neil D.; Gomard, Carsten Krogh; Sestoft, Peter

    This book provides a broad coverage of basic and advanced topics in partial evaluation. A wide spectrum of languagesa are treated including imperative, functional (first-order, higher-order), and ......This book provides a broad coverage of basic and advanced topics in partial evaluation. A wide spectrum of languagesa are treated including imperative, functional (first-order, higher-order), and ...

  12. (Eds.). Resource-bounded problem solving (Dagstuhl Seminar 14341)

    NARCIS (Netherlands)

    Haxhimusa, Y.; Rooij, I.J.E.I. van; Varma, S.; Wareham, H.T.


    This report documents the program and the outcomes of Dagstuhl Seminar 14341 'Resource-bounded Problem Solving'. This seminar is a successor to Dagstuhl Seminar 11351: 'Computer Science & Problem Solving: New Foundations', held in August 2011, which was the first Dagstuhl event to bring together

  13. The World Wide Web of Ed.D.s (United States)

    Cooper, Kenneth J.


    This article reports that the flexibility and convenience of online degree programs have attracted minorities in droves, especially Black K-12 educators. Universities that deliver most or all of their courses online have become the leading producers of Blacks earning graduate degrees in education. The online trend is most pronounced among Black…

  14. Q & A with Ed Tech Leaders: Interview with Punya Mishra (United States)

    Fulgham, Susan M.; Shaughnessy, Michael F.


    Punya Mishra is Professor of Educational Psychology and Educational Technology at Michigan State University, where he directs the Master of Arts in Educational Technology program. He currently chairs the Creativity Special Interest Group at the Society for Information Technology in Teacher Education. He is nationally and internationally recognized…

  15. Aerospace Technology Curriculum Guide. Invest in Success. Vo. Ed. #260. (United States)

    Idaho State Dept. of Education, Boise. Div. of Vocational Education.

    This document contains standards for an articulated secondary and postsecondary curriculum in aerospace technology. The curriculum standards can be used to ensure that vocational programs meet the needs of local business and industry. The first part of the document contains a task list and student performance standards for the aerospace technology…

  16. Educational Technology in Voc Ed. Information Series No. 268. (United States)

    Lipson, Joseph I.

    This monograph provides a vision of the future for vocational educators in a position to improve programs, such as teachers and administrators of local educational agencies and state leaders who set priorities in educational agencies. The monograph addresses nationwide technological concerns of the computer, image storage and creation, and…

  17. Undocumented Students Ask Jesuit Higher Ed: "Just Us" or Justice? (United States)

    Ryscavage, Richard; Canaris, Michael M.


    More than three-quarters of administrators, faculty and staff at Jesuit colleges agree or strongly agree that "admitting, enrolling, and supporting undocumented students fits with the mission of the institution." And yet 40% recently said there were no known programs or outreach to undocumented students of which they were aware. There is…

  18. AB006. Erectile dysfunction (ED) as a marker for cardiovascular diseases (CVD) (United States)

    Torres, Luiz Otavio


    In 1973 V. Michal, a vascular surgeon said “Erectile dysfunction (ED) is related to diseases of the vascular bed”. And this makes sense since ED and cardiovascular diseases (CVD) share many risk factors like aging, obesity, inactivity, smoking, depression, dyslipidemia, hypertension, diabetes/insuline resistance. These conditions may lead to an oxidative stress which ultimately can promote vasoconstriction, thrombosis, atherosclerosis and finally ED and CVD. One of the most accepted Idea is that small vessels plug earlier, it means, small arteries when have for example 50% of obstruction will probably have a clinical manifestation before bigger arteries!

  19. [Efficacy of low-dose tadalafil on ED assessed by Self-Esteem and Relationship Questionnaire]. (United States)

    Li, Jing-Ping; Li, Fei; Guo, Wen-Bin; Zhou, Qi-Zhao; Liu, Cun-Dong; Mao, Xiang-Ming; Tan, Wan-Long; Zheng, Shao-Bin


    To explore the effects of low-dose oral tadalafil on self-esteem, confidence and sexual relationship in ED patients. We treated 17 ED patients with oral tadalafil at the low dose of 5 mg once daily for 12 weeks, and used the paired t test to compare their scores on The Self-Esteem and Relationship Questionnaire (SEAR) and IIEF-5 and the results of nocturnal penile tumescence (NPT) obtained by nocturnal electrobioimpedance volumetric assessment (NEVA) before and after the medication. The scores on SEAR and IIEF-5 were significantly increased (P self-esteem, confidence, sexual relationship satisfaction and NPT of ED patients.

  20. Materiel Testing in the Tropics (6th Ed) (United States)


    PROGRAM ELEMENT. PROJECT. TASK US trnlyTropc Te Cete AREA 6 WORK UNIT NUMBERS ATTN: STETC-TD APO Miami 34004 It. CONTROLLING OFFICE NAME AND ADDRESS 12...Strands . ........ IV-2 IV-2 Effects of Changing Relative Humidity on Conductance of Hyphae of Rhizopus arrhizus ..... ............... IV-2 IV-3 Percent of...Canal Company, was limited to investigations of corrosion and methods of corrosion control . At the onset of World War II, high equipment failure

  1. A Model Program for Teenage Youth: First Year Evaluation of Knowledge Development. (United States)

    Pooley, Richard C.

    Progress in the second 6 months of a program development model for learning disabled (LD) and emotionally disturbed (ED) adolescents is reported. The program is designed to teach ED and LD children necessary work skills so that they can become productive members of society. Three methods are under investigation: (1) use of audio/visual resources…

  2. Review: Funston, John (ed. (2009, Divided Over Thaksin: Thailand’s Coup and Problematic Transition

    Directory of Open Access Journals (Sweden)

    Paul Chambers


    Full Text Available Review of the edited volume: Funston, John (ed. (2009, Divided Over Thaksin: Thailand’s Coup and Problematic Transition, Chiangmai: Silkworm Books, Singapore: ISEAS. ISBN 978-981-230-961-7, 203 pages.

  3. Patient-Centered Care Transition for Patients Admitted through the ED: Improving Patient and Employee Experience

    National Research Council Canada - National Science Library

    Algauer, Andrea; Rivera, Stephanie; Faurote, Robert


    With increasing wait times in emergency departments (ED) across America, there is a need to streamline the inpatient admission process in order to decrease wait times and more important, to increase patient and employee satisfaction...

  4. Hispaania võib oma väed Iraagist ära tuua / Erkki Bahovski

    Index Scriptorium Estoniae

    Bahovski, Erkki, 1970-


    Hispaania parlamendivalimised võitnud sotsialistliku partei liider, arvatav uus peaminister Jose Luis Rodriguez Zapatero lubas Hispaania väed Iraagist ära tuua. Diagrammid: Hispaania valimistulemused

  5. Jean Libis, Fabio Ferreira, Catherine Gublin, Sarah Mezaguer (eds., Les Lectures de Gaston Bachelard. Index bibliographique

    Directory of Open Access Journals (Sweden)

    Aurosa Alison


    Full Text Available Jean Libis, Fabio Ferreira, Catherine Gublin, Sarah Mezaguer (eds., Les Lectures de Gaston Bachelard. Index bibliographique (Paris, Presse Universitaire de Franche-Comté, 2011 ISBN: 978-2-84867-392 di     Aurosa Alison

  6. G. L. Castelli, principe di Torremuzza, numismatico ed antichista ad Halaesa Archonidea

    National Research Council Canada - National Science Library

    Antonino Crisà


    ... dell’antiquaria siciliana del XVIII secolo. Questo contributo esamina l’attività di ricerca di Castelli, interessato alla monetazione ed alle evidenze archeologiche di Halaesa Archonidea, oggi identificata nei pressi di Tusa (ME). È proposta...

  7. In a dynamic health care environment, take steps to fully leverage case managers in the ED. (United States)


    In an effort to create more capacity while also improving the patient experience, the University of Virginia Medical Center (UVAMC) in Charlottesville, VA, has taken steps to better leverage case managers in the ED. Under the new approach, case managers work alongside clinicians on the floor. They step in when added resources are needed or services need to be arranged before discharge. Administrators say the new ED case manager role has helped UVAMC reduce medically unnecessary length-of-stay by 34 minutes, enabling the hospital to see up to 4,000 additional patients per year. The ED-based case managers learn of patients who may benefit from their involvement by regularly participating in flow rounds with clinicians on the floor. Administrators are eyeing future improvements from the approach, including a concentrated effort to reduce visits to the ED by frequent utilizers.

  8. Drying Time and Quality of EDS-Treated Compared to Untreated Beech Wood (Fagus japonica

    Directory of Open Access Journals (Sweden)

    Mihaela CAMPEAN


    Full Text Available The paper presents the results of an experimental study performed with Japanese beech timber heattreated by the EDS method (Japanese patent and then dried in order to evaluate the effects of this treatment upon the drying rate and the drying uniformity. The obtained results demonstrate benefitting effects of the EDS treatment both upon the drying time and the drying quality. The drying rate of EDS-treated beech wood is by 29% higher in the case of wood without red heart and by 11% higher in the case of wood with red heart. As far as the drying uniformity is concerned, the minimum moisture content gradient across the 50mm thickness of the timber boards was recorded for the EDS-treated beech wood with red heart (∆MC=1.66, by 21.7% lower than in the case of untreated beech wood with red heart.

  9. 2003 annual results of EdF group; Resultats annuels 2003 du groupe EDF

    Energy Technology Data Exchange (ETDEWEB)



    The Electricite de France (EdF) group Board of Directors, meeting on March 11, 2004, under the Chairmanship of Francois Roussely, reviewed the audited consolidated financial statements for the year ended 12/31/2003. This document presents the consolidated results of EdF group for 2003: consolidated financial statements, highlights of the year, focus on 2003 events, commercial results, EDF in Europe and worldwide, EDF France highlights, key figures. (J.S.)

  10. Bedside point of care toxicology screens in the ED: Utility and pitfalls


    Bhalla, Ashish


    Exposure to drugs and toxins is a major cause for patients’ visits to the emergency department (ED). For most drugs-of-abuse intoxication, ED physicians are skeptical to rely on results of urine drug testing for emergent management decisions. This is partially because immunoassays, although rapid, have limitations in sensitivity and specificity and chromatographic assays, which are more definitive, are more labor intensive. Testing for toxic alcohols is needed, but rapid commercial assays are...

  11. Test Review: Gilliam, J. E. (2015), "Attention-Deficit/Hyperactivity Disorder Test" (2nd Ed) [Assessment Instrument]. Austin, TX: Pro-Ed. (United States)

    Perdue, Elizabeth A.


    The "Attention-Deficit/Hyperactivity Disorder Test-Second Edition" (ADHDT-2) is published through Pro-Ed in Austin, Texas. It was formally published in 2014, following critical revisions of the ADHDT, the reportedly popular initial version of this test that was published in 1995. The ADHDT-2 purports to act as a screener for individuals…

  12. EdF-Gaz de France. No merger without dismembering; EdF-Gaz de France. Pas de fusion sans depecage

    Energy Technology Data Exchange (ETDEWEB)

    Lepetit, V


    Gathering together the two historical French energy monopolies, Electricite de France (EdF) and Gaz de France (GdF), and warranting low electricity and gas prices is still an attractive idea for some political and syndicate representatives. However, such a merger would create a dominating position which is forbidden with respect to Brussels criteria. (J.S.)

  13. Impact of revised triage to improve throughput in an ED with limited traditional fast track population. (United States)

    Gardner, Ryan M; Friedman, Nathan A; Carlson, Michael; Bradham, Tamala S; Barrett, Tyler W


    Emergency department (ED) crowding is associated with patient safety concerns, increased patients left without being seen (LWBS), low patient satisfaction, and lost ED revenue. The objective was to measure the impact of a revised triage process on ED throughput. This study took place at an urban, university-affiliated, adult ED with an annual census of 70,000 and admission rate of 34%. The revised triage approach included: identifying eligible patients at triage based on complaint, comorbidities, and illness acuity; and reallocating a nurse practitioner (NP) into our triage area. We trialed the intervention from 1100-2300 on weekdays from January 13-26, 2016. Adult patients who were not likely to require intensive evaluations were eligible. Primary outcomes were throughput measures including: time to provider, ED length of stay (LOS), and LWBS. Pre- and post-intervention metrics were compared using the Mann-Whitney U test, given the non-normal distribution of the metrics. The NP evaluated 120 patients of which 101 (84%) were discharged, 3 (2.5%) admitted, and 16 (13%) required more intense evaluation. Time to provider decreased from a median (IQR) of 42 (16, 114) to 27 (12.4, 81.5) minutes (ptriage intervention was associated with improvements in several ED throughput metrics and a reduction in LWBS. Copyright © 2017 Elsevier Inc. All rights reserved.

  14. Registered nurse scope of practice and ED complaint-specific protocols. (United States)

    Castner, Jessica; Grinslade, Susan; Guay, Jennifer; Hettinger, A Zach; Seo, Jin Young; Boris, Lenore


    The use of complaint-specific protocols (CSPs) by emergency registered nurses (RNs) can improve ED efficiency. However, RN practice is influenced by regulatory environments that may facilitate or inhibit the use of protocols. The purpose of this policy analysis was to explore the language of state boards of nursing scope-of-practice documents related to the use of RN-initiated CSPs in the ED setting. A qualitative descriptive design was used to investigate how the RN's scope of practice relates to the use of CSPs in ED settings across states. Data were collected from state boards of nursing Web site documents. Three major themes emerged: cautiously within scope, intentionally vague/silent, and outside scope. Seven states (Connecticut, Illinois, Kansas, Louisiana, New Jersey, New York, and Oklahoma) were identified where RN-initiated CSPs appear to be currently outside the RN's scope of practice. Therefore 18% of the US population, or 55,973,900 people, resides in states where CSPs are not allowed. State-to-state inconsistencies in the RN's scope of practice may interfere with the implementation of practices that enhance ED efficiency. RNs in all states must ensure that they have the requisite knowledge, skill, and documented competency to implement CSPs, if supported by their employing facility. Efforts to standardize ED RN education and policy are warranted. Continued research is needed assess the impact of RN-initiated CSPs on the efficiency of ED care. Copyright © 2013 Emergency Nurses Association. Published by Mosby, Inc. All rights reserved.

  15. Chemical analysis and biological testing of materials from the EDS coal liquefaction process: a status report

    Energy Technology Data Exchange (ETDEWEB)

    Later, D.W.; Pelroy, R.A.; Wilson, B.W.


    Representative process materials were obtained from the EDS pilot plant for chemical and biological analyses. These materials were characterized for biological activity and chemical composition using a microbial mutagenicity assay and chromatographic and mass spectrometric analytical techniques. The two highest boiling distillation cuts, as well as process solvent (PS) obtained from the bottoms recycle mode operation, were tested for initiation of mouse skin tumorigenicity. All three materials were active; the crude 800/sup 0 +/F cut was substantially more potent than the crude bottoms recycle PS or 750 to 800/sup 0/F distillate cut. Results from chemical analyses showed the EDS materials, in general, to be more highly alkylated and have higher hydroaromatic content than analogous SRC II process materials (no in-line process hydrogenation) used for comparison. In the microbial mutagenicity assays the N-PAC fractions showed greater activity than did the aliphatic hydrocarbon, hydroxy-PAH, or PAH fractions, although mutagenicity was detected in certain PAH fractions by a modified version of the standard microbial mutagenicity assay. Mutagenic activities for the EDS materials were lower, overall, than those for the corresponding materials from the SRC II process. The EDS materials produced under different operational modes had distinguishable differences in both their chemical constituency and biological activity. The primary differences between the EDS materials studied here and their SRC II counterparts used for comparison are most likely attributable to the incorporation of catalytic hydrogenation in the EDS process. 27 references, 28 figures, 27 tables.

  16. Effect of Job Specialization on the Hospital Stay and Job Satisfaction of ED Nurses. (United States)

    Shamsi, Vahid; Mahmoudi, Hosein; Sirati Nir, Masoud; Babatabar Darzi, Hosein


    In recent decades, the increasing crowdedness of the emergency departments has posed various problems for patients and healthcare systems worldwide. These problems include prolonged hospital stay, patient dissatisfaction and nurse burnout or job dissatisfaction. The aim of this study was to investigate the effect of emergency department (ED) nurses' job specialization on their job satisfaction and the length of patient stay in the ED. This before-after quasi-experimental study was conducted from April to May 2014 at the Baqiyatallah Hospital, Tehran, Iran. Initially, 35 patients were recruited as controls and the length of their stay in the ED was measured in minutes via a chronometer; Moreover, nurses' job satisfaction was evaluated using the Mohrman-Cooke-Mohrman job satisfaction scale. Then, a job specialization intervention was developed based on the stabilization model. After that, 35 new patients were recruited to the treatment group and received specialized care services. Accordingly, the length of their stay in the ED was measured. Moreover, the same nurses' job satisfaction was re-evaluated after the study. The study intervention lasted one month. Data were analyzed using the SPSS software version 20 and statistical tests such as the Kolmogrov-Smirnov, the paired and the independent t, and chi-square tests. There was a significant difference between the two groups of patients concerning the length of their stay in the ED (P nurses had greater job satisfaction after the study (P nurses' satisfaction and relieve the crowdedness of the EDs.

  17. The use of SEM/EDS method in mineralogical analysis of ordinary chondritic meteorite

    Directory of Open Access Journals (Sweden)

    Breda Mirtič


    Full Text Available The aim of this study was to evaluate the potential of scanning electron microscopy coupled with energy dispersiveX-ray spectroscopy (SEM/EDS for determination of mineral phases according to their stoichiometry and assessment of mineral composition of ordinary chondritic meteorite. For the purposes of this study, H3 type ordinary chondritic meteorite Abbott was selected. SEM/EDS allows identification and characterisation of mineralphases, whose size is below the resolution of an optical microscope. Mineral phases in chondrules and interstitial matrix were located in backscattered electron (BSE mode and were assessed from atomic proportions of constituent elements, obtained by the EDS analysis. SEM/EDS analyses of mineral phases showed that Abbott meteorite is characterised by Fe-rich (Fe, Ni-alloy kamacite, Fe-sulphide troilite or pyrrhotite, chromite, Mg-rich olivine, orthopyroxene bronzite or hypersthene, clinopyroxene Al-diopside, acid plagioclase oligoclase, accessory mineral chlorapatite and secondary minerals Fe-hydroxides (goethite or lepidocrocite. Results of semi-quantitative analyses confirmed that most of analysed mineralphases conform well to stoichiometric minerals with minor deviations of oxygen from stoichiometric proportions. Comparison between mineral phases in chondrules and interstitial matrix was also performed, however it showed no significant differences in elemental composition.Differences in chemical composition between minerals in interstitial matrix and chondrules are sometimes too small to be discernedby the SEM/EDS, therefore knowledge of SEM/EDS capabilities is important for correct interpretation of chondrite formation.

  18. [Survey on the barriers in providing the mental health services to the suicide attempters in ED]. (United States)

    Zhao, Xiaohui; Li, Tao; Hong, Xia; Jiang, Yinan; Xiong, Nana; Cao, Jinya; Wei, Jing


    The purpose of this study was to explore the barriers existing in medical settings behind the phenomenon that few suicide attempters were provided by mental health services when they got treatment in the general hospital ED. An anonymous and voluntary survey was administered among two groups: ED physicians and psychiatrists. Two tertiary general hospitals and one psychiatric hospital were chosen through convenience sampling. Suicide Behavior Attitude Questionnaire and a self-made questionnaire to evaluate barriers were used. The response rate was 68.7% for ED physicians, and 87.0% for psychiatrists. ED physicians generally scored unfavorably than psychiatrists on many items in SBAQ (P suicide attempters should have access to mental health services, the median of the scores = 10 for both group (P = 0.059), meaning highly agree. Some consistent barriers could be summarized from the self-made questionnaire. The majority of ED physicians in general hospitals still hold some misunderstanding about the suicide attempters, but they fully agree that the suicide attempters should have access to mental health services. The barriers for psychiatrists are clear.The barriers for ED physicians are complicated but workable.

  19. Extensive FE-SEM/EDS, HR-TEM/EDS and ToF-SIMS studies of micron- to nano-particles in anthracite fly ash. (United States)

    Ribeiro, Joana; DaBoit, Kátia; Flores, Deolinda; Kronbauer, Marcio A; Silva, Luis F O


    The generation of anthropogenic carbonaceous matter and mixed crystalline/amorphous mineral ultrafine/nano-particles in the 1 to 100 nm size range by worldwide coal power plants represents serious environmental problems due to their potential hazards. Coal fly ash (CFA) that resulted from anthracite combustion in a Portuguese thermal power plant was studied in this work. The physico-chemical characterization of ultrafine/nano-particles present in the CFA samples and their interaction with environment are the aim of this study. The methodologies applied for this work were field emission scanning electron microscopy (FE-SEM) with energy dispersive X-ray spectroscopy (EDS), high-resolution transmission electron microscopy with energy dispersive X-ray spectroscopy (HR-TEM/EDS) and time of flight secondary ion mass spectrometry (ToF-SIMS). Some hazardous volatile elements, C, N, S and Hg contents were also determined in the studied samples. Generally, the CFA samples comprise carbonaceous, glassy and metallic solid spheres with some containing mixed amorphous/crystalline phases. The EDS analysis coupled with the FE-SEM and HR-TEM observations of the fly ash particles with 100 to 0.1 nm demonstrates that these materials contain a small but significant proportion of encapsulated HVEs. In addition, the presence of abundant multi-walled carbon nanotubes (MWCNTs) and amorphous carbon particles, both containing hazardous volatile elements (HVEs), was also evidenced by the FE-SEM/EDS and HR-TEM/EDS analysis. A wide range of organic and inorganic compounds was determined by chemical maps obtained in ToF-SIMS analysis. Copyright © 2013 Elsevier B.V. All rights reserved.

  20. Extensive FE-SEM/EDS, HR-TEM/EDS and ToF-SIMS studies of micron- to nano-particles in anthracite fly ash

    Energy Technology Data Exchange (ETDEWEB)

    Ribeiro, Joana [Centro de Geologia, Universidade do Porto, Rua do Campo Alegre, 687, 4169-007 Porto (Portugal); DaBoit, Kátia [Institute of Environmental Research and Human Development, IPADHC, Capivari de Baixo, Santa Catarina (Brazil); Flores, Deolinda [Centro de Geologia, Universidade do Porto, Rua do Campo Alegre, 687, 4169-007 Porto (Portugal); Departamento de Geociências, Ambiente e Ordenamento do Território, Faculdade de Ciências, Universidade do Porto, Rua do Campo Alegre, 687, 4169-007 Porto (Portugal); Kronbauer, Marcio A. [Laboratory of Environmental Researches and Nanotechnology Development, Centro Universitário La Salle, Victor Barreto, 2288 Centro 92010-000, Canoas, RS (Brazil); Silva, Luis F.O., E-mail: [Laboratory of Environmental Researches and Nanotechnology Development, Centro Universitário La Salle, Victor Barreto, 2288 Centro 92010-000, Canoas, RS (Brazil); Environmental Science and Nanotechnology Department, Catarinense Institute of Environmental Research and Human Development, IPADHC, Capivari de Baixo, Santa Catarina (Brazil)


    The generation of anthropogenic carbonaceous matter and mixed crystalline/amorphous mineral ultrafine/nano-particles in the 1 to 100 nm size range by worldwide coal power plants represents serious environmental problems due to their potential hazards. Coal fly ash (CFA) that resulted from anthracite combustion in a Portuguese thermal power plant was studied in this work. The physico-chemical characterization of ultrafine/nano-particles present in the CFA samples and their interaction with environment are the aim of this study. The methodologies applied for this work were field emission scanning electron microscopy (FE-SEM) with energy dispersive X-ray spectroscopy (EDS), high-resolution transmission electron microscopy with energy dispersive X-ray spectroscopy (HR-TEM/EDS) and time of flight secondary ion mass spectrometry (ToF-SIMS). Some hazardous volatile elements, C, N, S and Hg contents were also determined in the studied samples. Generally, the CFA samples comprise carbonaceous, glassy and metallic solid spheres with some containing mixed amorphous/crystalline phases. The EDS analysis coupled with the FE-SEM and HR-TEM observations of the fly ash particles with 100 to 0.1 nm demonstrates that these materials contain a small but significant proportion of encapsulated HVEs. In addition, the presence of abundant multi-walled carbon nanotubes (MWCNTs) and amorphous carbon particles, both containing hazardous volatile elements (HVEs), was also evidenced by the FE-SEM/EDS and HR-TEM/EDS analysis. A wide range of organic and inorganic compounds was determined by chemical maps obtained in ToF-SIMS analysis. - Highlights: ► We examine changes in the level of ultrafine and nanoparticles of coal mining. ► Increasing geochemical information will increase human health information in this area. ► Electron bean and Tof-SIMS increase area information.

  1. Guide: Photovoltaic plants. 3. rev. ed.; Leitfaden Photovoltaische Anlagen

    Energy Technology Data Exchange (ETDEWEB)

    Haselhuhn, Ralf; Hemmerle, Claudia


    The guide under consideration contains comprehensive information on all aspects of photovoltaic systems. The up-to-date knowledge of the photovoltaics is presented practically oriented and founded in order to make progress with the innovative, sustainable and environmentally careful power supply on the basis of local sources of energy. Contents: (a) Fundamentals; (b) Components of photovoltaic systems; (c) In situ analysis, site analysis and shading analysis; (d) Planning and dimensioning of grid-connected photovoltaic plants; (e) Planning and dimensioning of autonomous systems; (f) Computer programs and simulation; (g) Assembly systems and building integration; (h) Installation, start-up and operation of photovoltaic systems; (i) Market, economic efficiency and ecology; (i) Marketing; (j) Presentation of companies.

  2. Guide: Photovoltaic plants.. 4. compl. rev. ed.; Leitfaden Photovoltaische Anlagen

    Energy Technology Data Exchange (ETDEWEB)

    Haselhuhn, Ralf


    The guide under consideration contains comprehensive information on all aspects of photovoltaic systems. The up-to-date knowledge of the photovoltaics is presented practically oriented and founded in order to make progress with the innovative, sustainable and environmentally careful power supply on the basis of local sources of energy. Contents: (a) Fundamentals; (b) Components of photovoltaic systems; (c) In situ analysis, site analysis and shading analysis; (d) Planning and dimensioning of grid-connected photovoltaic plants; (e) Planning and dimensioning of autonomous systems; (f) Computer programs and simulation; (g) Assembly systems and building integration; (h) Installation, start-up and operation of photovoltaic systems; (i) Market, economic efficiency and ecology; (i) Marketing; (j) Presentation of companies.

  3. Neurobiological mechanisms of exercise and psychotherapy in depression: The SPeED study-Rationale, design, and methodological issues. (United States)

    Heinzel, Stephan; Rapp, Michael A; Fydrich, Thomas; Ströhle, Andreas; Terán, Christina; Kallies, Gunnar; Schwefel, Melanie; Heissel, Andreas


    Even though cognitive behavioral therapy has become a relatively effective treatment for major depressive disorder and cognitive behavioral therapy-related changes of dysfunctional neural activations were shown in recent studies, remission rates still remain at an insufficient level. Therefore, the implementation of effective augmentation strategies is needed. In recent meta-analyses, exercise therapy (especially endurance exercise) was reported to be an effective intervention in major depressive disorder. Despite these findings, underlying mechanisms of the antidepressant effect of exercise especially in combination with cognitive behavioral therapy have rarely been studied to date and an investigation of its neural underpinnings is lacking. A better understanding of the psychological and neural mechanisms of exercise and cognitive behavioral therapy would be important for developing optimal treatment strategies in depression. The SPeED study (Sport/Exercise Therapy and Psychotherapy-evaluating treatment Effects in Depressive patients) is a randomized controlled trial to investigate underlying physiological, neurobiological, and psychological mechanisms of the augmentation of cognitive behavioral therapy with endurance exercise. It is investigated if a preceding endurance exercise program will enhance the effect of a subsequent cognitive behavioral therapy. This study will include 105 patients diagnosed with a mild or moderate depressive episode according to the Diagnostic and Statistical Manual of Mental Disorders (4th ed.). The participants are randomized into one of three groups: a high-intensive or a low-intensive endurance exercise group or a waiting list control group. After the exercise program/waiting period, all patients receive an outpatient cognitive behavioral therapy treatment according to a standardized therapy manual. At four measurement points, major depressive disorder symptoms (Beck Depression Inventory, Hamilton Rating Scale for Depression

  4. Program on Resorbable Radio Devices (United States)


    transfer, interconnect islands i s l a n d s Wafer Layout Transient Interconnects for Si Micro-Die Transient Dual-Sided PCB – Design & Fabrication 1. Mg...Behaviors in the transistors and circuits were verifi ed by SPICE (Simulation Program with Inte- grated Circuit Emphasis) simulation. Here, the

  5. training program in Jimma University

    African Journals Online (AJOL)

    Assessment on problems of the new pre-service teachers training program in Jimma University. Tadesse Walelign* Meaza Fantahun**. ABSTRACT. Education is the key to development; however, it is impossible to think the quality of education With out having academically qualified and professionally responsible teachers.

  6. Availability of Insurance Linkage Programs in U.S. Emergency Departments

    Directory of Open Access Journals (Sweden)

    Mia Kanak


    Full Text Available Introduction: As millions of uninsured citizens who use emergency department (ED services are now eligible for health insurance under the Affordable Care Act, the ED is ideally situated to facilitate linkage to insurance. Forty percent of U.S. EDs report having an insurance linkage program. This is the first national study to examine the characteristics of EDs that offer or do not offer these programs. Methods: This was a secondary analysis of data from the National Survey for Preventive Health Services in U.S. EDs conducted in 2008-09. We compared EDs with and without insurance programs across demographic and operational factors using univariate analysis. We then tested our hypotheses using multivariable logistic regression. We also further examined program capacity and priority among the sub-group of EDs with no insurance linkage program. Results: After adjustment, ED-insurance linkage programs were more likely to be located in the West (RR= 2.06, 95% CI = 1.33 – 2.72. The proportion of uninsured patients in an ED, teaching hospital status, and public ownership status were not associated with insurance linkage availability. EDs with linkage programs also offer more preventive services (RR = 1.87, 95% CI = 1.37–2.35 and have greater social worker availability (RR = 1.71, 95% CI = 1.12–2.33 than those who do not. Four of five EDs with a patient mix of ≥25% uninsured and no insurance linkage program reported that they could not offer a program with existing staff and funding. Conclusion: Availability of insurance linkage programs in the ED is not associated with the proportion of uninsured patients served by an ED. Policy or hospital-based interventions to increase insurance linkage should first target the 27% of EDs with high rates of uninsured patients that lack adequate program capacity. Further research on barriers to implementation and cost effectiveness may help to facilitate increased adoption of insurance linkage programs. [West J

  7. Improved Early Detection of Sepsis in the ED With a Novel Monocyte Distribution Width Biomarker. (United States)

    Crouser, Elliott D; Parrillo, Joseph E; Seymour, Christopher; Angus, Derek C; Bicking, Keri; Tejidor, Liliana; Magari, Robert; Careaga, Diana; Williams, JoAnna; Closser, Douglas R; Samoszuk, Michael; Herren, Luke; Robart, Emily; Chaves, Fernando


    Sepsis most often presents to the ED, and delayed detection is harmful. WBC count is often used to detect sepsis, but changes in WBC count size also correspond to sepsis. We sought to determine if volume increases of circulating immune cells add value to the WBC count for early sepsis detection in the ED. A blinded, prospective cohort study was conducted in two different ED populations within a large academic hospital. Neutrophil and monocyte volume parameters were measured in conjunction with routine CBC testing on a UniCel DxH 800 analyzer at the time of ED admission and were evaluated for the detection of sepsis. There were 1,320 subjects in the ED consecutively enrolled and categorized as control subjects (n = 879) and those with systemic inflammatory response syndrome (SIRS) (n = 203), infection (n = 140), or sepsis (n = 98). Compared with other parameters, monocyte distribution width (MDW) best discriminated sepsis from all other conditions (area under the curve [AUC], 0.79; 95% CI, 0.73-0.84; sensitivity, 0.77; specificity, 0.73; MDW threshold, 20.50), sepsis from SIRS (AUC, 0.74; 95% CI, 0.67-0.84), and severe sepsis from noninfected patients in the ED (AUC, 0.88; 95% CI, 0.75-0.99; negative predictive value, 99%). The added value of MDW to WBC count was statistically significant (AUC, 0.89 for MDW + WBC vs 0.81 for WBC alone; P sepsis compared with WBC count alone at the time of admission in the ED.; No.: NCT02232750; URL: Copyright © 2017 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

  8. Trends in Hospital Admission and Surgical Procedures Following ED visits for Diverticulitis. (United States)

    Greenwood-Ericksen, Margaret B; Havens, Joaquim M; Ma, Jiemin; Weissman, Joel S; Schuur, Jeremiah D


    Diverticulitis is a common diagnosis in the emergency department (ED). Outpatient management of diverticulitis is safe in selected patients, yet the rates of admission and surgical procedures following ED visits for diverticulitis are unknown, as are the predictive patient characteristics. Our goal is to describe trends in admission and surgical procedures following ED visits for diverticulitis, and to determine which patient characteristics predict admission. : We performed a cross-sectional descriptive analysis using data on ED visits from 2006-2011 to determine change in admission and surgical patterns over time. The Nationwide Emergency Department Sample database, a nationally representative administrative claims dataset, was used to analyze ED visits for diverticulitis. We included patients with a principal diagnosis of diverticulitis (ICD-9 codes 562.11, 562.13). We analyzed the rate of admission and surgery in all admitted patients and in low-risk patients, defined as age diverticulitis. Fryom 2006 to 2011 ED visits for diverticulitis increased by 21.3% from 238,248 to 302,612, while the admission rate decreased from 55.7% to 48.5% (-7.2%, 95% CI [-7.78 to -6.62]; pdiverticulitis was independently associated with male gender, comorbid illnesses, higher income and commercial health insurance. The surgical rate decreased from 6.5% in 2006 to 4.7% in 2011 (-1.8%, 95% CI [-2.1 to -1.5]; pdiverticulitis increased, while ED admission rates and surgical rates declined, with comorbidity, sociodemographic factors predicting hospitalization. Future work should focus on determining if these differences reflect increased disease prevalence, increased diagnosis, or changes in management.

  9. Prevalence of Diabetes Mellitus (DM) in a population of men affected by Erectile Dysfunction (ED). (United States)

    Mazzilli, R; Elia, J; Delfino, M; Benedetti, F; Scordovillo, G; Mazzilli, F


    A) to evaluate the prevalence of patients affected by Diabetes Mellitus (DM) in a population of men with Erectile Dysfunction (ED); B) to define the epidemiological, biochemical and therapeutic aspects. N.934 subjects referred at our Andrology Unit for ED were studied. The diagnosis of ED was evaluated using the IIEF-5 questionnaire (Total score ≤21). The prevalence of subjects affected by DM in a population of men with ED was 19.5% (182/934). The age ranges were: ≥55 years (108/182; 59.3%); ≥40diabetic treatment. In n.125/182 cases (68.7%) the ED onset followed the diagnosis of DM; in n.34/182 cases (18.7%) it appeared at the same time; and in n.23/182 cases (12.6%) appeared before DM diagnosis. in n.18/182 subjects (9.9%) there was a concomitant hypotestosteronemia; these patients were treated only with testosterone replacement; this treatment was efficacious (IIEF-5 total score ≥22) in 8/18 subjects (44.4%). In n.146/182 subjects (80.2%) a treatment with PDE5-i was given. Of these 146 subjects, the therapy was given "on demand" to 108 subjects (efficacy in 50.9%; 55/108) and "once a day" to the remaining 38 subjects (efficacy 63.1%, 24/38) (p=0.428, n.s.). N.15/182 subjects (8.2%) were treated with intracavernous injections of Alprostadil (efficacy in 8/15, 53.3%). In n.3/182 subjects (1.6%) a penile prosthesis was implanted. DM is one of the most frequent organic causes of ED; there were many strategies to treat this symptom without interfering with the antidiabetic treatment. Finally, ED can be predictive of DM.

  10. Suicide Prevention in an Emergency Department Population: The ED-SAFE Study. (United States)

    Miller, Ivan W; Camargo, Carlos A; Arias, Sarah A; Sullivan, Ashley F; Allen, Michael H; Goldstein, Amy B; Manton, Anne P; Espinola, Janice A; Jones, Richard; Hasegawa, Kohei; Boudreaux, Edwin D


    Suicide is a leading cause of deaths in the United States. Although the emergency department (ED) is an opportune setting for initiating suicide prevention efforts, ED-initiated suicide prevention interventions remain underdeveloped. To determine whether an ED-initiated intervention reduces subsequent suicidal behavior. This multicenter study of 8 EDs in the United States enrolled adults with a recent suicide attempt or ideation and was composed of 3 sequential phases: (1) a treatment as usual (TAU) phase from August 2010 to December 2011, (2) a universal screening (screening) phase from September 2011 to December 2012, and (3) a universal screening plus intervention (intervention) phase from July 2012 to November 2013. Screening consisted of universal suicide risk screening. The intervention phase consisted of universal screening plus an intervention, which included secondary suicide risk screening by the ED physician, discharge resources, and post-ED telephone calls focused on reducing suicide risk. The primary outcome was suicide attempts (nonfatal and fatal) over the 52-week follow-up period. The proportion and total number of attempts were analyzed. A total of 1376 participants were recruited, including 769 females (55.9%) with a median (interquartile range) age of 37 (26-47) years. A total of 288 participants (20.9%) made at least 1 suicide attempt, and there were 548 total suicide attempts among participants. There were no significant differences in risk reduction between the TAU and screening phases (23% vs 22%, respectively). However, compared with the TAU phase, patients in the intervention phase showed a 5% absolute reduction in suicide attempt risk (23% vs 18%), with a relative risk reduction of 20%. Participants in the intervention phase had 30% fewer total suicide attempts than participants in the TAU phase. Negative binomial regression analysis indicated that the participants in the intervention phase had significantly fewer total suicide attempts

  11. Triage quality control is missing tools-a new observation technique for ED quality improvement. (United States)

    Malmström, Tomi; Harjola, Veli-Pekka; Torkki, Paulus; Kumpulainen, Salla; Malmström, Raija


    Correct assessment of patient urgency is critical to ensuring patient safety in emergency departments (EDs). Although significant time and effort have been devoted to developing triage systems, less attention has been paid to the development of quality control. The aim of this study is to introduce and test observation technique, which enables identifying of patient groups at risk of erroneous assessment in triage. The introduced technique is aimed to be less laborious to use than existing triage quality control methods. The study developed an observation technique for identifying patients with possible erroneous assessments in triage. Data sample for the observation technique is carried out with survey form filled in by nurse. Hospital ED with ~74 000 patient visits annually. Consecutive adult patients in an ED for baseline study period of 14 days (1774 patients) in 2010 and control study period of 4 days (541 patients) in 2012. Triage observation technique for continuous improvement of triage performance. Primary measures of triage improvement were triage accuracy and nurses' ability to predict patient admissions. With the observation technique the ED staff was able to identify patient groups at risk for erroneous triage. Under-triage related mostly to patients with chest pain, shortness of breath, collapse, stomach pain and infections. Instead injures and muscular skeletal symptoms were seldom undertriaged even though they are common. EDs can control triage quality with simple observation technique. The usability of observation technique and triage quality improvement process were good.

  12. The Relationship Between the Use of a Worksite Medical Home and ED Visits or Hospitalizations

    Directory of Open Access Journals (Sweden)

    Marissa Stroo BS


    Full Text Available Worksite medical homes may be a good model for improving employee health. The aim of this study was to compare the likelihood of being seen in the emergency department (ED or being hospitalized by level of use (no use, occasional use, or primary care of a worksite medical home, overall and by type of user (employee, adult dependent, or pediatric dependent. This was a retrospective analysis of claims data, using covariate-adjusted logistic regression models for ED visits and inpatient hospitalizations. Secondary data for the years 2006 to 2008 from a company that offers an on-site health care center (HCC were used. Analyses were based on a data set that combines health plan claims and human resources demographic data. Overall, people who did not use the HCC were more likely to be seen in the ED (adjusted odds ratio [OR] = 1.20, 95% confidence interval or CI [1.06, 1.37], P = .005 or to be hospitalized (adjusted OR = 1.58; 95% CI [1.34, 1.86]; P < .0001 compared with those who used the HCC for primary care. Both ED visits and hospitalizations for employees and dependents in this study were lower among those who used the worksite medical home for primary care. Worksite medical homes can improve chronic disease management and thus reduce ED visits and hospitalizations. These findings contribute to growing evidence that worksite medical homes are potentially cost-effective.

  13. Factors affecting stress in emergency medicine residents while working in the ED. (United States)

    Wrenn, Keith; Lorenzen, Brent; Jones, Ian; Zhou, Chuan; Aronsky, Dominik


    The aim of this study was to identify factors other than work hours in the emergency department (ED) work environment contributing to resident stress. This study involved a prospective cohort evaluation of emergency medicine residents in the ED. Twelve surveys were collected from 18 subjects, 4 each from the day, evening, and night shifts. The Perceived Stress Questionnaire and a visual analog stress scale were administered. Data collected included the shift number of a given consecutive sequence of shifts, number of procedures performed, number of adverse events, average age of the patients seen by the resident, triage nurse-assigned acuities of the patients seen by the resident during the shift, the number of patients seen during a shift, the number of patients admitted by the resident during the shift, anticipated overtime after a shift, and shift-specific metrics related to overcrowding, including average waiting room time both for the individual residents and for all patients, average waiting room count for all patients, and average occupancy of the ED for all patients. Among the 216 studied shifts, there was considerable variability in stress both within and between residents. In the multivariate mixed-effect regression analysis, only anticipated overtime and process failures were correlated with stress. Factors related to ED overcrowding had no significant effect on resident stress. Resident stress was most impacted by anticipation of overtime and adverse events. Overcrowding in the ED and traditional measures of workload did not seem to affect stress as much. Copyright © 2010 Elsevier Inc. All rights reserved.

  14. Patient-centered transfer process for patients admitted through the ED boosts satisfaction, improves safety. (United States)


    To improve safety and patient flow, administrators at Hallmark Health System, based in Melrose, MA, implemented a new patient-centered transfer process for patients admitted through the ED at the health system's two hospitals. Under the new approach, inpatient nurses come down to the ED to take reports on new patients in a process that includes the ED care team as well as family members. The inpatient nurses then accompany the patients up to their designated floors. Since the new patient-transfer process was implemented in June 2012, patient satisfaction has increased by at least one point on patient satisfaction surveys. Administrators anticipate that medical errors or omissions related to the handoff process will show a drop of at least 50%, when data is tabulated.

  15. "Etica ed Estetica sono tutt’uno" Riflessioni su TLP 6.421

    Directory of Open Access Journals (Sweden)

    Gabriele Tomasi


    Full Text Available Per il primo Wittgenstein etica ed estetica erano tutt’uno. Scopo del saggio è fornire un’interpretazione di questa concezione. Esaminando il modo in cui è proposta nel Tractatus e considerando alcune annotazioni dei Quaderni 1914-1916 si evidenzia che l’unità di etica ed estetica è in un modo di vedere il mondo per cui esso non appare come fonte di limitazione. L’etica è un’estensione al mondo - alla vita - della capacità di conferire significato che nell’arte si realizza nei riguardi di oggetti particolari. Affermando l’unità di etica ed estetica Wittgenstein attira l’attenzione sul fatto che la radice dell’etica è in un certo modo di vedere le cose, in un atteggiamento verso la vita. Si tratta della prospettiva di un valore non connesso a come il mondo è e che è evocato dalla meraviglia per l’esistenza del mondo.

  16. Impact of 40 years of technology advances on EDS system performance. (United States)

    McCarthy, Jon; Friel, John; Camus, Patrick


    The rapid advance and falling costs of computing power and data storage during the last 40 years have greatly enhanced the data reduction speed and analytical capacity of energy dispersive spectroscopy (EDS) systems. At the same time, the solid state X-ray detector [until recently, the Si(Li) diode] has seen performance increases due to the use of advanced materials and processing techniques. In addition, the performance of the electronic components (field effect transistor, preamp, and pulse processor) of an EDS system has been constantly improved. These technology advances have resulted in improved spectral quality, excellent light element detection, and increased count rate performance. The results have been truly remarkable and driven by the needs of the analyst. This article will summarize the progress made in these areas in the last 40 years and make a brief reference to prospects for future development in EDS system performance.

  17. Benzodiazepine-opioid co-prescribing in a national probability sample of ED encounters. (United States)

    Kim, Howard S; McCarthy, Danielle M; Mark Courtney, D; Lank, Patrick M; Lambert, Bruce L


    Benzodiazepine-opioid combination therapy is potentially harmful due to the risk of synergistic respiratory depression, and the rate of death due to benzodiazepine-opioid overdose is increasing. Little is known about the prevalence and characteristics of benzodiazepine-opioid co-prescribing from the ED setting. Secondary analysis of data from the National Hospital Ambulatory Medical Care Survey, using sample weights to generate population estimates. The primary objective was to describe the annual prevalence of benzodiazepine-opioid co-prescribing from 2006 to 2012, using 95% confidence intervals (95% CI) to compare adjacent years. The secondary objective was to compare characteristics of ED encounters receiving a benzodiazepine-opioid co-prescription versus those receiving an opioid prescription alone, using a multivariable logistic regression. The prevalence of benzodiazepine-opioid co-prescribing did not significantly change from 2006 to 2012. During this period, 2.7% (95% CI: 2.5-2.8%) of ED encounters prescribed an opioid were also prescribed a benzodiazepine. Relative to encounters receiving an opioid prescription alone, encounters receiving a co-prescription were more likely to represent a follow-up rather than initial visit (Odds Ratio [OR] 1.52), receive more medications (OR 1.41) and fewer procedures (OR 0.48) while in the ED, and more likely to have a diagnosis related to mental disorder (OR 20.60) or musculoskeletal problem (OR 3.71). From 2006 to 2012, almost 3% of all ED encounters receiving an opioid prescription also received a benzodiazepine co-prescription. The odds of benzodiazepine-opioid co-prescribing were significantly higher in ED encounters representing a follow-up visit and in diagnoses relating to a mental disorder or musculoskeletal problem. Copyright © 2016 Elsevier Inc. All rights reserved.

  18. Multidisciplinary intervention decreases the use of opioid medication discharge packs from 2 urban EDs. (United States)

    Gugelmann, Hallam; Shofer, Frances S; Meisel, Zachary F; Perrone, Jeanmarie


    Prescription opioid overdoses and deaths constitute a public health epidemic, and recent studies show that emergency department (ED) prescribers may contribute to this crisis. We hypothesized that a multidisciplinary educational intervention would decrease ED opioid packs dispensed at discharge. This prospective study implemented a "bundle" of interdisciplinary educational modalities: lectures, journal clubs, case discussions, and an electronic medical record decision support tool. Implementation occurred in 2 urban EDs in the same health system at different times ("affiliate," September 2011; "primary," January 2012) to better distinguish its effects. The primary outcome was preintervention/postintervention change in opioid discharge packs dispensed to all patients treated and discharged through August 2012 and was assessed by 2-way analysis of variance. The secondary outcome was bivariate analysis (using Fisher exact test) of change in opioid dispensing among patients with known risk factors for prescription opioid dependence: age less than 65 years, history of substance abuse, chronic pain, or psychiatric disorders. A total of 71,512 and 45,746 patients were evaluated and discharged from primary and affiliate EDs, respectively. Orders for opioid discharge packs decreased from 13.9% to 8.4% and 4.7% to 1.9% at the primary and affiliate hospitals (P opioid dependence at the primary ED decreased from 21.8% to 13.9%. A staged, multidisciplinary intervention targeting nurses, residents, nurse practitioners, and attending physicians was associated with decreased orders for opioid discharge packs in 2 urban EDs. Opioid discharge pack orders decreased slightly more among patients with risk factors for prescription opioid dependence. © 2013.

  19. PopED lite: An optimal design software for preclinical pharmacokinetic and pharmacodynamic studies. (United States)

    Aoki, Yasunori; Sundqvist, Monika; Hooker, Andrew C; Gennemark, Peter


    Optimal experimental design approaches are seldom used in preclinical drug discovery. The objective is to develop an optimal design software tool specifically designed for preclinical applications in order to increase the efficiency of drug discovery in vivo studies. Several realistic experimental design case studies were collected and many preclinical experimental teams were consulted to determine the design goal of the software tool. The tool obtains an optimized experimental design by solving a constrained optimization problem, where each experimental design is evaluated using some function of the Fisher Information Matrix. The software was implemented in C++ using the Qt framework to assure a responsive user-software interaction through a rich graphical user interface, and at the same time, achieving the desired computational speed. In addition, a discrete global optimization algorithm was developed and implemented. The software design goals were simplicity, speed and intuition. Based on these design goals, we have developed the publicly available software PopED lite ( Optimization computation was on average, over 14 test problems, 30 times faster in PopED lite compared to an already existing optimal design software tool. PopED lite is now used in real drug discovery projects and a few of these case studies are presented in this paper. PopED lite is designed to be simple, fast and intuitive. Simple, to give many users access to basic optimal design calculations. Fast, to fit a short design-execution cycle and allow interactive experimental design (test one design, discuss proposed design, test another design, etc). Intuitive, so that the input to and output from the software tool can easily be understood by users without knowledge of the theory of optimal design. In this way, PopED lite is highly useful in practice and complements existing tools. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  20. Macrofauna edáfica asociada con sistemas agroforestales en la Amazonía Colombiana


    Juan Carlos Suárez Salazar; Ervin Humprey Duran Bautista; Gelber Rosas Patiño


    La densidad, riqueza y diversidad de la macrofauna edáfica son afectadas, entre otros factores, por la configuración de los agroecosistemas y la estacionalidad de la precipitación. Con el fin de evaluar estos efectos en mayo y noviembre de 2011, correspondientes a épocas de máxima y mínima precipitación, respectivamente, se realizaron estudios sobre la composición de la macrofauna edáfica asociada con los arreglos agroforestales ubicados en el Centro de Investigaciones Macagual Cesar Augusto ...

  1. Warning: are you prepared to lose your ED after a natural disaster? (United States)


    Natural catastrophes that can lead to loss of the ED itself are often overlooked in disaster plans and drills. Plans should address evacuation of patients, including transportation and equipment to take, and drills should include these scenarios. You should have alternatives to cope with loss of power and communications, such as oxygen-powered backup generators. To prepare for a deluge of individuals coming to the ED after a disaster, decide how to utilize volunteers, and limit access by using disaster identification vests. New Environment of Care standards from the Joint Commission on Accreditation of Healthcare Organizations require you to perform a hazard and vulnerability analysis.

  2. Planning a brand new ED? Study up on acoustics, air quality, and patient wish-lists. (United States)


    Hospitals planning to construct new EDs have a golden opportunity to integrate designs and materials that can please both patients and providers. Experts say attention to acoustics, privacy, and air quality can lower stress levels and boost satisfaction. Further, designs that prioritize efficient work flows get high marks from providers. Experts advise hospital leaders to get considerable input from patients before designing a new ED facility. Privacy, quiet, and a connection to nature are top priorities for patients. Use design to enhance patient flow.

  3. G. L. Castelli, principe di Torremuzza, numismatico ed antichista ad Halaesa Archonidea

    Directory of Open Access Journals (Sweden)

    Antonino Crisà


    Full Text Available G. L. Castelli (1727-1792, principe di Torremuzza, fu uno dei massimi esponenti dell’antiquaria siciliana del XVIII secolo. Questo contributo esamina l’attività di ricerca di Castelli, interessato alla monetazione ed alle evidenze archeologiche di Halaesa Archonidea, oggi identificata nei pressi di Tusa (ME. È proposta un’analisi degli scritti di Castelli inerenti queste tematiche, valutandone criticamente l’importanza secondo le istanze della ricerca antiquaria. Certamente è emerso il profilo di un antichista dai poliedrici interessi, da considerarsi il fondatore degli studi numismatici ed archeologici moderni dell’antica Halaesa.

  4. Is your ED a medical department or a business? Survey says...both. (United States)


    Taking a solid business-like approach to the management of your ED involves--but is certainly not limited to--getting a handle on revenues and expenses. Here are a few strategies some ED managers say help them run a tighter, and better, ship: Have a clinical audit specialist review charts, and have a clerical person "check the checker." Use a "cultural fit" interview with prospective staff members to ensure you're on the same page when it comes to service. Develop a charge structure with numerical values for clinical activities and services, to help ensure optimal reimbursement.

  5. SEM, EDS, PL and absorbance study of CdTe thin films grown by CSS method

    Energy Technology Data Exchange (ETDEWEB)

    Hernandez-Torres, M.E.; Silva-Gonzalez, R.; Gracia-Jimenez, J.M. [Instituto de Fisica, BUAP, Apdo. Postal J-48, San Manuel, 72570 Puebla, Pue. (Mexico); Casarrubias-Segura, G. [CIE- UNAM, 62580 Temixco, Morelos (Mexico)


    Oxygen-doped CdTe films were grown on conducting glass substrates by the close spaced sublimation (CSS) method and characterized using SEM, EDS, photoluminescence (PL) and absorbance. A significant change in the polycrystalline morphology is observed when the oxygen proportion is increased in the deposition atmosphere. The EDS analysis showed that all samples are nonstoichiometric with excess Te. The PL spectra show emission bands associated with Te vacancies (V{sub Te}), whose intensities decrease as the oxygen proportion in the CSS chamber is increased. The oxygen impurities occupy Te vacancies and modify the surfaces states, improving the nonradiative process. (author)

  6. New Zealand's emergency department target - did it reduce ED length of stay, and if so, how and when? (United States)

    Tenbensel, Tim; Chalmers, Linda; Jones, Peter; Appleton-Dyer, Sarah; Walton, Lisa; Ameratunga, Shanthi


    In 2009, the New Zealand government introduced a hospital emergency department (ED) target - 95% of patients seen, treated or discharged within 6 h - in order to alleviate crowding in public hospital EDs. While these targets were largely met by 2012, research suggests that such targets can be met without corresponding overall reductions in ED length-of-stay (LOS). Our research explores whether the NZ ED time target actually reduced ED LOS, and if so, how and when. We adopted a mixed-methods approach with integration of data sources. After selecting four hospitals as case study sites, we collected all ED utilisation data for the period 2006 to 2012. ED LOS data was derived in two forms-reported ED LOS, and total ED LOS - which included time spent in short-stay units. This data was used to identify changes in the length of ED stay, and describe the timing of these changes to these indicators. Sixty-eight semi-structured interviews and two surveys of hospital clinicians and managers were conducted between 2011 and 2013. This data was then explored to identify factors that could account for ED LOS changes and their timing. Reported ED LOS reduced in all sites after the introduction of the target, and continued to reduce in 2011 and 2012. However, total ED LOS only decreased from 2008 to 2010, and did not reduce further in any hospital. Increased use of short-stay units largely accounted for these differences. Interview and survey data showed changes to improve patient flow were introduced in the early implementation period, whereas increased ED resources, better information systems to monitor target performance, and leadership and social marketing strategies mainly took throughout 2011 and 2012 when total ED LOS was not reducing. While the ED target clearly stimulated improvements in patient flow, our analysis also questions the value of ED targets as a long term approach. Increased use of short-stay units suggests that the target became less effective in 'standing

  7. AB162. Is it feasible to apply a new concept of erectile dysfunction syndrome (EDS) in clinical practice?


    Chen, Jun; Zhang, Bin; Wen, Jiaming


    How to understand the erectile function? How to define erectile dysfunction? In general, erectile function is evaluated by the quality of penile erection. If penis shows good erection, we think erectile function is normal. Otherwise, erectile dysfunction occurs. This concept is reflected in the definition of erectile dysfunction (ED). ED is defined as the persistent inability to attain and maintain an erection sufficient to permit satisfactory sexual performance. From the definition of ED, it...

  8. A Patient with Splenic Artery Aneurysm Rupture and the Importance of Rapid Sonography in the ED

    Directory of Open Access Journals (Sweden)

    Masayuki Iyanaga


    Full Text Available We report a case of a splenic artery aneurysm rupture presenting with shock which required timely embolization therapy. This case demonstrates how the rapid use of bedside ultrasound by emergency department (ED physicians can help identify the cause of shock and, therefore, initiate appropriate treatment quickly even if the cause is rare, as in this case.

  9. Energy dispersive X-ray fluorescent (ED XRF) analyzer X-Art for investigation of artworks (United States)

    Serebryakov, A. S.; Demchenko, E. L.; Koudryashov, V. I.; Sokolov, A. D.


    A novel compact ED XRF analyzer based on Si(Li) detector is developed for the attribution of artworks. Approbation of the instrument in two leading museums in Moscow and St. Petersburg showed that the chemical elements in the range from Mg to Pb can be determined in the artworks simultaneosely in the open air.

  10. Massively Open Online Course for Educators (MOOC-Ed) Network Dataset (United States)

    Kellogg, Shaun; Edelmann, Achim


    This paper presents the Massively Open Online Course for Educators (MOOC-Ed) network dataset. It entails information on two online communication networks resulting from two consecutive offerings of the MOOC called "The Digital Learning Transition in K-12 Schools" in spring and fall 2013. The courses were offered to educators from the USA…

  11. ReEDS-Mexico: A Capacity Expansion Model of the Mexican Power System

    Energy Technology Data Exchange (ETDEWEB)

    Ho, Jonathan L [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Cole, Wesley J [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Spyrou, Evangelia [National Renewable Energy Laboratory (NREL), Golden, CO (United States)


    This report documents the ReEDS-Mexico capacity expansion model, which is an extension of the ReEDS model to the Mexican power system. In recent years Mexico’s power sector has undergone considerable reform that has significant potential to impact the future electricity mix (Alpizar–Castro and Rodríguez–Monroy 2016). Day-ahead and real-time trading in Mexico’s power markets opened in early 2016. In addition to this reform, Mexico is striving to ensure that 35% of its electricity is generated from clean energy sources by 2024, 40% by 2035, and 50% by 2050 (Presidencia de la República 2016). These rapid changes in both the market and the generation mix create a need for robust tools that can help electricity sector stakeholders make informed decisions. The purpose of this report is to document the extension of the National Renewable Energy Laboratory’s (NREL’s) Regional Energy Deployment System (ReEDS) model (Eurek et al. 2016) to cover the Mexico power system. This extension, which we will refer to throughout this paper as ReEDS-Mexico, provides a model of the Mexico power sector using a system-wide, least-cost optimization framework.

  12. From fruit flies to fallout: Ed Lewis and his science1

    Indian Academy of Sciences (India)


    during the Depression, his father somehow managed to come up with funds to buy Ed a silver flute. He played in the High School Orchestra and the Wilkes-. Barre Symphony, beginning his tertiary education at. Bucknell College on a music scholarship. Howard D. Lipshitz. Journal of Genetics, Vol. 83, No. 2, August 2004 ...

  13. Developing a Culture of Learning around the edTPA: One University's Journey (United States)

    Miller, Matthew; Carroll, David; Jancic, Mitchell; Markworth, Kimberly


    In this article, we discuss how an interdisciplinary faculty team at a midsized public university created supports for the Teacher Performance Assessment (edTPA), a high-stakes performance assessment for preservice candidates being adopted by many states. We provide a general description of our work in contending with the challenge of developing a…

  14. Global variables and identified hadrons in the PHENIX experiment

    Indian Academy of Sciences (India)

    PHENIX measurements related to global variables and identified hadrons are discussed. These include two-pion correlations, elliptic flow, and dN=dη. Measurements of event-by-event fluctuations in mean transverse momentum, mean transverse energy, and net charge are presented for particles within the PHENIX ...

  15. Problemi di fisica meccanica e termologia, ottica ed elettricità

    CERN Document Server

    Foglia, C


    Equazioni dimensionali ed unità di misura ; elementi di calcolo vettoriale ; cinematica ; dinamica ; fenomeni ondulatori ; meccanica dei fluidi ; termologia ; elettrostatica ; la corrente elettrica nei conduttori ohmici e non ohmici ; elettromagnetismo e correnti alternate ; equazioni di Maxwell e onde elettromagntiche ; ottica geometrica ; interferenza e diffrazione della luce ; polarizzazione della luce ; applicazioni elementari della teoria degli errori.

  16. (M.Ed.) students' experiences of part-time study: A South African

    African Journals Online (AJOL)

    This article reports on a study of how a group of first year M.Ed. students in the Faculty of Education of the University of KwaZulu-Natal experienced part-time study. Literature suggests that each year, South Africa suffers significant student departures from universities without completing their studies. Apart from the cost and ...

  17. J. Crush and D.A. McDonald. (eds). 2002. Transnationalism and ...

    African Journals Online (AJOL)

    J. Crush and D.A. McDonald. (eds). 2002. Transnationalism and New African Immigration to South Africa. Cape Town. Southern African Migration Project and the Canadian Association of African Studies. IV + 188 pp. ISBN 0-88911-926-0.

  18. A Comparative SEM-EDS Elemental Composition of Mud in Coastal ...

    African Journals Online (AJOL)

    The present study was aimed to understand the comparative abundance and source of elemental constituents in mud of four coastal shrimp farming areas, Vunh Tau (VT), Nha Trang (NT), Da Nang (DN) and Hue (HU) in Viet Nam using SEM-EDS analysis. Mud samples were collected from shrimp farming coastal zones ...

  19. 09 | 26 | organic.html 3 | chemistry | resources | sci ed | initiat | Indian ...

    Indian Academy of Sciences (India)

    Home; initiat; sci ed; resources; chemistry; organic.html 3; 26; 09. 404! error. The page your are looking for can not be found! Please check the link or use the navigation bar at the top. YouTube · Twitter · Facebook · Blog. Academy News. IAS Logo. Good Governance: Contribution of Vigilance · Vigilance Awareness Talk

  20. Impact of Curricular Reforms on Educational Philosophy Courses in M.Ed Programmes (United States)

    Gafoor, K. Abdul; Remia, K. R.


    In the context of Vision of Teacher Education envisaged in National Curriculum Framework for Teacher Education, this study probes "Do M.Ed programmes provide for the prerequisites of educational philosophy for teacher educators?" and "whether the syllabi following credit and non credit pattern vary in their coverage of content of…

  1. A bimodal tomographic reconstruction technique combining EDS-STEM and HAADF-STEM

    NARCIS (Netherlands)

    Z. Zhong (Zhichao); B. Goris (Bart); Schoenmakers, R. (Remco); S. Bals (Sara); K.J. Batenburg (Joost)


    textabstractA three-dimensional (3D) chemical characterization of nanomaterials can be obtained using tomography based on high angle annular dark field (HAADF) scanning transmission electron microscopy (STEM) or energy dispersive X-ray spectroscopy (EDS) STEM. These two complementary techniques have

  2. EFNEP and SNAP-Ed Initial Paraprofessional Training Materials and Methods (United States)

    Byington, Charlene; Baker, Susan


    Western Region EFNEP coordinators were frustrated by the apparent lack of materials available for training newly hired paraprofessional nutrition educators. An on-line survey was distributed to all EFNEP and SNAP-Ed state coordinators seeking details about initial training and available materials and requesting copies of materials for review.…

  3. Syncope prevalence in the ED compared to general practice and population: a strong selection process

    NARCIS (Netherlands)

    Olde Nordkamp, Louise R. A.; van Dijk, Nynke; Ganzeboom, Karin S.; Reitsma, Johannes B.; Luitse, Jan S. K.; Dekker, Lukas R. C.; Shen, Win-Kuang; Wieling, Wouter


    Objective: We assessed the prevalence and distribution of the different causes of transient loss of consciousness (TLOC) in the emergency department (ED) and chest pain unit (CPU) and estimated the proportion of persons with syncope in the general population who seek medical attention from either

  4. Communicative Learning Outcomes and World Language edTPA: Characteristics of High-Scoring Portfolios (United States)

    Swanson, Pete; Hildebrandt, Susan A.


    Teacher accountability continues to be at the forefront of educational policy in the United States, with the current focus on the Outcomes of K-12 teaching and teacher education (Cochran-Smith 2000). edTPA, a high-stakes assessment used in many states to make licensure or certification decisions, purports to measure those content-specific…

  5. Introducing the Collaborative E-Learning Design Method (CoED)

    DEFF Research Database (Denmark)

    Ryberg, Thomas; Buus, Lillian; Nyvang, Tom


    In this chapter, a specific learning design method is introduced and explained, namely the Collaborative E-learning Design method (CoED), which has been developed through various projects in “e-Learning Lab – Centre for User Driven Innovation, Learning and Design” (Nyvang & Georgsen, 2007). We br...

  6. Book review: Robert Leckey (ed. After Legal Equality: Family, Sex, Kinship

    Directory of Open Access Journals (Sweden)

    Pawel Drągowski


    Full Text Available Book review: Robert Leckey (ed. After Legal Equality: Family, Sex, Kinship. Abingdon: Oxon; New York, NY: Routledge, 2015, pp. 224, ISBN 978-0-415-72161-5 £85DOWNLOAD THIS PAPER FROM SSRN:

  7. Children's Productions of the Affix -"ed" in Past Tense and Past Participle Contexts (United States)

    Redmond, Sean M.


    Children's productions of the affix -"ed" in past tense and past participle contexts (e.g., "the boy kicked the ball" vs. "the ball was kicked") were examined in spontaneous conversations and elicited productions. The performances of 7 children with specific language impairment (SLI) were compared with those of 2 control groups of typically…

  8. Identified hadron production in $\\sqrt {s}= 130$ GeV Au–Au ...

    Indian Academy of Sciences (India)

    ... Pramana – Journal of Physics; Volume 60; Issue 5. Identified hadron production in s = 130 GeV Au–Au collisions at relativistic heavy-ion collider. Julia Velkovska. Volume 60 Issue 5 May 2003 pp 1011-1015 ... Author Affiliations. Julia Velkovska1. Brookhaven National Laboratory, Bldg. 510C, Upton, NY 11973, USA ...

  9. Modified Berlekamp—Massey algorithm 243 of examples illustrate ...

    Indian Academy of Sciences (India)

    white noise' sequence. 2. Modified recursive form of the Berlekamp-Massey algorithm. We are here interested in modelling data as the impulse response of a discrete linear. filter, the objective being to obtain a minimal representation by such a ...

  10. Viirastuslikud Sinimäed. Mõtteid Raimo Jõeranna filmi ainetel / Rein Ruutsoo

    Index Scriptorium Estoniae

    Ruutsoo, Rein, 1947-


    6-osalise ajaloodokumentaalide sarja "Kuum külm sõda" teist filmi "Sinimäed" : stsenaristid Kiur Aarma, Mart Laar, Eerik-Niiles Kross, Raimo Jõerand : režissöör Raimo Jõerand : Ruut Pictures 2006

  11. MobilED: a mobile tools and services platform for formal and informal learning

    CSIR Research Space (South Africa)

    Ford, M


    Full Text Available MobilED is a South African initiative aimed at designing teaching and learning environments that are meaningfully enhanced with mobile technologies and services. The deliverables are the development of a set of scenarios and guidelines on how mobile...

  12. Cross-sectional analysis of fouled SWRO membranes by STEM-EDS

    KAUST Repository

    Aubry, Cyril


    The intact cross-section of two fouled reverse osmosis membranes was characterized using a scanning transmission electron microscope (STEM) equipped with an electron energy dispersive spectroscope (EDS). Focused ion beam (FIB) was used to prepare a thin lamella of each membrane. These lamellas were then attached to a TEM grid for further STEM/EDS analysis. The foulant in sample A was mainly inorganic in nature and predominantly composed of alumino-silicate particles. These particles were surrounded by carbon at high concentrations, indicating the presence of organic materials. Iron was diffusely present in the cake layer and this could have enhanced the fouling process. The cake layer of membrane B was mainly consisted of organic matter (C, O, and N representing 95% of the total elemental composition) and organized in thin parallel layers. Small concentrations of Si, F, Na, Mg, and Cl were detected inside the active layer and support layer of the membrane. Due to the high sensitivity of the cake layer of membrane A to the electron beam, STEM/EDS line analyses might have been performed on large areas. On the other hand, the cake layer of sample B was resistant to the electron beam and the resolution of STEM/EDS was gradually improved until obtaining a resolution of 25. nm. © 2013 Elsevier B.V.

  13. The use of open source electronic medical records in an urban ED in Kumasi-Ghana

    Directory of Open Access Journals (Sweden)

    P.K. Forson*


    Conclusion: Open source medical records may be the most appropriate and cost-effective software to adapt for keeping patient records electronically in a low resource setting. Further studies need to be conducted to demonstrate how EMR may affect the pace of work in the ED.

  14. Inside the Sex Ed Studio: An Interview with Susan N. Wilson (United States)

    Taverner, William J.


    "Inside the Sex Ed Studio" profiles leaders in the field of sexuality education. Susan N. Wilson, former Executive Coordinator of the Network for Family Life Education, long-time advocate for sexuality education, and the driving force behind New Jersey's K-12 mandate for comprehensive sexuality education was the first such leader to be…

  15. The role of plain radiographs in patients with acute abdominal pain at the ED

    NARCIS (Netherlands)

    Randen, A. van; Lameris, W.; Luitse, J.S.; Gorzeman, M.; Hesselink, E.J.; Dolmans, D.E.; Peringa, J.; Geloven, A.A. van; Bossuyt, P.M.; Stoker, J.; Boermeester, M.A.; Gooszen, H.G.


    OBJECTIVE: The purpose of this study was to evaluate the added value of plain radiographs on top of clinical assessment in unselected patients presenting with acute abdominal pain at the emergency department (ED). METHODS: In a multicenter prospective trial, patients with abdominal pain more than 2

  16. The role of plain radiographs in patients with acute abdominal pain at the ED

    NARCIS (Netherlands)

    van Randen, Adrienne; Lameris, Wytze; Luitse, Jan S. K.; Gorzeman, Michiel; Hesselink, Erik J.; Dolmans, Dennis E. J. G. J.; Peringa, Jan; van Geloven, Anna A. W.; Bossuyt, Patrick M.; Stoker, Jaap; Boermeester, Marja A.

    Objective: The purpose of this study was to evaluate the added value of plain radiographs on top of clinical assessment in unselected patients presenting with acute abdominal pain at the emergency department (ED). Methods: In a multicenter prospective trial, patients with abdominal pain more than 2

  17. Systematic Review of ED-based Intimate Partner Violence Intervention Research

    Directory of Open Access Journals (Sweden)

    Esther K. Choo,


    Full Text Available Introduction: Assessment reactivity may be a factor in the modest results of brief interventions for substance use in the emergency department (ED. The presence of assessment reactivity in studies of interventions for intimate partner violence (IPV has not been studied. Our objectives were to identify ED IPV intervention studies and evaluate the presence of a consistently positive effect on the control groups. Methods: We performed a systematic search of electronic databases for English=language intervention studies addressing IPV in the ED published since 1990. Study selection and assessment of methodologic quality were performed by two independent reviewers. Data extraction was performed by one reviewer and then independently checked for completeness and accuracy by a second reviewer. Results: Of 3,620 unique manuscripts identified by database search, 667 underwent abstract review and 12 underwent full-text review. Only three met full eligibility criteria; data on the control arm were available for two studies. In these two studies, IPV-related outcomes improved for both the experimental and control condition. Conclusion: The paucity of controlled trials of IPV precluded a robust evaluation for assessment reactivity. This study highlighted a critical gap in ED research on IPV.

  18. Next Generation Science Standards and edTPA: Evidence of Science and Engineering Practices (United States)

    Brownstein, Erica M.; Horvath, Larry


    Science teacher educators in the United States are currently preparing future science teachers to effectively implement the "Next Generation Science Standards" (NGSS) and, in thirteen states, to successfully pass a content-specific high stakes teacher performance assessment, the edTPA. Science education and teacher performance assessment…

  19. Using Ontological Engineering to Overcome AI-ED Problems: Contribution, Impact and Perspectives (United States)

    Mizoguchi, Riichiro; Bourdeau, Jacqueline


    This article reflects on the ontology engineering methodology discussed by the paper entitled "Using Ontological Engineering to Overcome AI-ED Problems" published in this journal in 2000. We discuss the achievements obtained in the last 10 years, the impact of our work as well as recent trends and perspectives in ontology engineering for…

  20. Fertilizing ROSES through the STEM: Interdisciplinary Modules as Pre-service Research Experiences for Secondary STEM Educators (IMPRESS-Ed) (United States)

    Magee, N. B.; Kavic, M.; Benoit, M. H.; Wiita, P.


    IMPRESS-Ed is a program designed to provide authentic summer research experiences in the space, earth, and atmospheric sciences for pre-service K-12 educators at The College of New Jersey (TCNJ). In 2011, the program involved five students and took place over eight weeks with recruitment occurring during the preceding academic year. The program was divided into two modules: A common core module and an individual mentored research experience. The common module consisted of three units focusing on data-driven pedagogical approaches in astrophysics, tectonophysics, and atmospheric science, respectively. The common module also featured training sessions in observational astronomy, and use of a 3D geowall and state of the art planetarium. Participants in the program are also offered the opportunity to utilize the available TCNJ facilities with their future students. Given that a large number of graduates from the TCNJ take positions in local New Jersey schools, the opportunity to make use of these facilities at a future time would be of great significance to them and their future students. The individual mentored research module matched student interests with potential projects. Research led by M.H. Benoit analyzed gravity data from the NASA-GRACE mission to find lithospheric density contrasts beneath the eastern US. A student working with N.B. Magee used data from NASA satellites CALIPSO, CloudSat, and AQUA-MODIS to study the dynamics of convective cloud tops. Research projects led by M. Kavic performed simulations to investigate the possibility of detecting superconducting cosmic strings using radio observations and also designed and constructed a radio interferometer based on the NASA's Radio-Jove program. P. Wiita supervised a research project studying star-forming regions of active galaxies through analysis of images from NASA's Hubble Space Telescope and GALEX. The research program was also incorporated into the framework of the TCNJ Mentored Undergraduate Summer

  1. Exploring personality clusters among parents of ED subjects. Relationship with parents' psychopathology, attachment, and family dynamics. (United States)

    Amianto, Federico; Daga, Giovanni Abbate; Bertorello, Antonella; Fassino, Secondo


    Eating disorders are some of the most difficult mental disorders to treat and manage. Family interacts with genetic dispositions and other pathogenic factors, and may influence the outburst, development and outcome of EDs. The present study explores with a cluster analysis the personality traits of parents of ED subjects. One-hundred-eight mothers and 104 fathers were tested with Temperament Character Inventory (TCI), Eating Disorder Inventory-2 (EDI-2), State-Trait Anger Expression Inventory (STAX), Family Assessment Device (FAD), Attachment Style Questionnaire (ASQ), Symptom Questionnaire (SQ), Psychological Well-Being scales (PWB). The cluster distribution of parents based on personality traits was explored. Parents' clusters TCI scores were compared as regards personality, psychopathology, attachment and family features. Cross distribution of temperament and character clusters in mothers and fathers, among couples and ED diagnoses of the daughters was explored. Two clusters of mothers and fathers were identified with temperament clustering. Character traits led to two mothers and three fathers clusters. Mothers temperament cluster 1 (MTC1) correspond to a explosive/adventurous profile, MTC2 to a cautious/passive-dependent profile. Fathers temperament cluster 1 (FTC1) was explosive/methodic, FTC2 was independent/methodic. Character clustering distinguished very immature mothers (MCC1) and majority (65%) of character mature mothers with low self-transcendence (MCC2). A third of fathers was severely immature (FCC1), a third impaired as regards relationships (poor cooperativeness and self-transcendence; FCC2), and one third character mature fathers with low self-transcendence (FCC3). Each cluster evidences specific psychopathology and attachment characteristics. FTC1 was more frequently associated with character immaturity. No significant clusters' cross correlation was found in parental couples. Parents' clusters analyze in depth the univocal picture of

  2. Tackling causes and costs of ED presentation for American football injuries: a population-level study. (United States)

    Smart, Blair J; Haring, R Sterling; Asemota, Anthony O; Scott, John W; Canner, Joseph K; Nejim, Besma J; George, Benjamin P; Alsulaim, Hatim; Kirsch, Thomas D; Schneider, Eric B


    American tackle football is the most popular high-energy impact sport in the United States, with approximately 9 million participants competing annually. Previous epidemiologic studies of football-related injuries have generally focused on specific geographic areas or pediatric age groups. Our study sought to examine patient characteristics and outcomes, including hospital charges, among athletes presenting for emergency department (ED) treatment of football-related injury across all age groups in a large nationally representative data set. Patients presenting for ED treatment of injuries sustained playing American tackle football (identified using International Classification of Diseases, Ninth Revision, Clinical Modification code E007.0) from 2010 to 2011 were studied in the Nationwide Emergency Department Sample. Patient-specific injuries were identified using the primary International Classification of Diseases, Ninth Revision, Clinical Modification diagnosis code and categorized by type and anatomical region. Standard descriptive methods examined patient demographics, diagnosis categories, and ED and inpatient outcomes and charges. During the study period 397363 football players presented for ED treatment, 95.8% of whom were male. Sprains/strains (25.6%), limb fractures (20.7%), and head injuries (including traumatic brain injury; 17.5%) represented the most presenting injuries. Overall, 97.9% of patients underwent routine ED discharge with 1.1% admitted directly and fewer than 11 patients in the 2-year study period dying prior to discharge. The proportion of admitted patients who required surgical interventions was 15.7%, of which 89.9% were orthopedic, 4.7% neurologic, and 2.6% abdominal. Among individuals admitted to inpatient care, mean hospital length of stay was 2.4days (95% confidence interval, 2.2-2.6) and 95.6% underwent routine discharge home. The mean total charge for all patients was $1941 (95% confidence interval, $1890-$1992) with substantial

  3. Final Report: Software Support for Programming in the Large (United States)


    34 Science of Computer Programming 17 (1991). 139-215. [4] Yang, W., "Identifying syntactic differences between two programs," Software - Practice...Science, Vol. 432, N. Jones (ed.), Springer-Vedag, New York, NY. 1990, pp. 326-340. Invited for a special issue of Science of Computer Programming (see

  4. Progress of the BT-EdF-CEA project. The lithium polymer battery; Avancees du projet BT-EdF-CEA. Batterie lithium polymere

    Energy Technology Data Exchange (ETDEWEB)

    Marginedes, D.; Majastre, H. [Bollore Technologies, 29 - Quimper (France); Baudry, P.; Lascaud, S. [Electricite de France, 77 - Moret sur Loing (France). Direction des Etudes et Recherches; Bloch, D.; Lebrun, N. [CEA Grenoble, CEREM, 38 (France)


    The lithium-polymer energy storage technology requires the production of thin films of huge surface. The BT-EdF-CEA consortium has studied the various manufacturing techniques of these films and their assembly. The process was chosen according to its productivity, low expensiveness, ecological impact and energy performances with capacities reaching 40 Ah. This paper explains: the objectives and specifications of the project, the advantage of the consortium and the role of the different partners, the results (coating, dry extrusion and battery element manufacturing techniques), and the electrochemical performances of the elements. (J.S.)

  5. Torrefied Biomass Pellets—Comparing Grindability in Different Laboratory Mills

    Directory of Open Access Journals (Sweden)

    Jan Hari Arti Khalsa


    Full Text Available The firing and co-firing of biomass in pulverized coal fired power plants around the world is expected to increase in the coming years. Torrefaction may prove to be a suitable way of upgrading biomass for such an application. For transport and storage purposes, the torrefied biomass will tend to be in pellet form. Whilst standard methods for the assessment of the milling characteristics of coal exist, this is not the case for torrefied materials—whether in pellet form or not. The grindability of the fuel directly impacts the overall efficiency of the combustion process and as such it is an important parameter. In the present study, the grindability of different torrefied biomass pellets was tested in three different laboratory mill types; cutting mill (CM, hammer mill (HM and impact mill (IM. The specific grinding energy (SGE required for a defined mass throughput of pellets in each mill was measured and results were compared to other pellet characterization methods (e.g., durability, and hardness as well as the modified Hardgrove Index. Seven different torrefied biomass pellets including willow, pine, beech, poplar, spruce, forest residue and straw were used as feedstock. On average, the particle-size distribution width (across all feedstock was narrowest for the IM (0.41 mm, followed by the HM (0.51 mm and widest for the CM (0.62 mm. Regarding the SGE, the IM consumed on average 8.23 Wh/kg while CM and HM consumed 5.15 and 5.24 Wh/kg, respectively. From the three mills compared in this study, the IM seems better fit for being used in a standardized method that could be developed in the future, e.g., as an ISO standard.

  6. Is scanning electron microscopy/energy dispersive X-ray spectrometry (SEM/EDS) quantitative? (United States)

    Newbury, Dale E; Ritchie, Nicholas W M


    Scanning electron microscopy/energy dispersive X-ray spectrometry (SEM/EDS) is a widely applied elemental microanalysis method capable of identifying and quantifying all elements in the periodic table except H, He, and Li. By following the "k-ratio" (unknown/standard) measurement protocol development for electron-excited wavelength dispersive spectrometry (WDS), SEM/EDS can achieve accuracy and precision equivalent to WDS and at substantially lower electron dose, even when severe X-ray peak overlaps occur, provided sufficient counts are recorded. Achieving this level of performance is now much more practical with the advent of the high-throughput silicon drift detector energy dispersive X-ray spectrometer (SDD-EDS). However, three measurement issues continue to diminish the impact of SEM/EDS: (1) In the qualitative analysis (i.e., element identification) that must precede quantitative analysis, at least some current and many legacy software systems are vulnerable to occasional misidentification of major constituent peaks, with the frequency of misidentifications rising significantly for minor and trace constituents. (2) The use of standardless analysis, which is subject to much broader systematic errors, leads to quantitative results that, while useful, do not have sufficient accuracy to solve critical problems, e.g. determining the formula of a compound. (3) EDS spectrometers have such a large volume of acceptance that apparently credible spectra can be obtained from specimens with complex topography that introduce uncontrolled geometric factors that modify X-ray generation and propagation, resulting in very large systematic errors, often a factor of ten or more. © Wiley Periodicals, Inc.

  7. The Phosphodiesterase 5-Inhibitors (PDE-5i) for ERECTILE DYSFUNCTION (ED): A Therapeutic Challenge For Psychiatrists. (United States)

    Koon, Chong Siew; Sidi, Hatta; Kumar, Jaya; Das, Srijit; Xi, Ong Wan; Hatta, Muhammad Hizri; Alfonso, Cesar


    Erectile function (EF) is a prerequisite for satisfactory sexual intercourse (SI) and central to male sexual functioning. Satisfactory SI eventually leads to orgasm - a biopsychophysiological state of euphoria - leading to a sense of bliss, enjoyment and positive mental well being. For a psychiatrist, treating ED is self-propelled to harmonize these pleasurable experiences alongside with encouragement of physical wellness and sensuality. Hence, the role of PDE-5i is pivotal in the context of treating ED constitutes a therapeutic challenge. PDE-5i work via the dopaminergic-oxytocin-nitric oxide pathway by increasing the availability of endothelial's guanosine monophosphate (GMP), immediately causing relaxation of the penile smooth muscle and an erection. The PDE-5i, like sildenafil, vardenafil and tadalafil, are effective in the treatment of ED with some benefits and disadvantages compared to other treatment modalities. Prescribed PDE-5i exclusively improve EF, fostering male's self-confidence and self-esteem. Treatment failures are associated with factors such as absent (or insufficient) sexual stimulation, psychosexual conflicts and the co-existence of medical disorders. Managing ED requires dealing with underlying medical diseases, addressing other co-morbid sexual dysfunctions like premature ejaculation (PE), and educating the patient on healthy life-styles beside being cautious with the potential side-effects and drug-drug interactions. Furthermore, by dealing with interpersonal dynamics within the couple and embracing adequate lifestyles (managing stress and revising one's sexual scripts), PDE-5i treatment benefits may be enhanced. In this review, we propose a holistic conceptual framework approach for psychiatric management of patients with ED. Copyright© Bentham Science Publishers; For any queries, please email at

  8. Ed Couzens

    African Journals Online (AJOL)

    MJM Venter

    users – human beings, for a daily needs component, and the environment itself – became the only "priority ... Stewart and Horsten argue that "South Africa is one of the few jurisdictions in the world that provides for an ... ruling on payment for water services in Mazibuko, questions related to access to water will continue to ...

  9. 48 CFR 3432.770 - Prohibition against the use of ED funds to influence legislation or appropriations. (United States)


    ... use of ED funds to influence legislation or appropriations. 3432.770 Section 3432.770 Federal... legislation or appropriations. The contracting officer shall insert the clause at 3452.232-70, Prohibition Against the Use of ED Funds to Influence Legislation or Appropriations, in contracts with educational...

  10. 48 CFR 3452.232-70 - Prohibition against the use of ED funds to influence legislation or appropriations. (United States)


    ... use of ED funds to influence legislation or appropriations. 3452.232-70 Section 3452.232-70 Federal... funds to influence legislation or appropriations. The following clause is to be used in accordance with 3432.770: Prohibition Against the Use of ED Funds To Influence Legislation or Appropriations (APR 1987...

  11. Disruption of the Arabidopsis Defense Regulator Genes SAG101, EDS1, and PAD4 Confers Enhanced Freezing Tolerance. (United States)

    Chen, Qin-Fang; Xu, Le; Tan, Wei-Juan; Chen, Liang; Qi, Hua; Xie, Li-Juan; Chen, Mo-Xian; Liu, Bin-Yi; Yu, Lu-Jun; Yao, Nan; Zhang, Jian-Hua; Shu, Wensheng; Xiao, Shi


    In Arabidopsis, three lipase-like regulators, SAG101, EDS1, and PAD4, act downstream of resistance protein-associated defense signaling. Although the roles of SAG101, EDS1, and PAD4 in biotic stress have been extensively studied, little is known about their functions in plant responses to abiotic stresses. Here, we show that SAG101, EDS1, and PAD4 are involved in the regulation of freezing tolerance in Arabidopsis. With or without cold acclimation, the sag101, eds1, and pad4 single mutants, as well as their double mutants, exhibited similarly enhanced tolerance to freezing temperatures. Upon cold exposure, the sag101, eds1, and pad4 mutants showed increased transcript levels of C-REPEAT/DRE BINDING FACTORs and their regulons compared with the wild type. Moreover, freezing-induced cell death and accumulation of hydrogen peroxide were ameliorated in sag101, eds1, and pad4 mutants. The sag101, eds1, and pad4 mutants had much lower salicylic acid (SA) and diacylglycerol (DAG) contents than the wild type, and exogenous application of SA and DAG compromised the freezing tolerance of the mutants. Furthermore, SA suppressed the cold-induced expression of DGATs and DGKs in the wild-type leaves. These findings indicate that SAG101, EDS1, and PAD4 are involved in the freezing response in Arabidopsis, at least in part, by modulating the homeostasis of SA and DAG. Copyright © 2015 The Author. Published by Elsevier Inc. All rights reserved.

  12. Effectiveness of Mutual Learning Approach in the Academic Achievement of B.Ed Students in Learning Optional II English (United States)

    Arulselvi, Evangelin


    The present study aims at finding out the effectiveness of Mutual learning approach over the conventional method in learning English optional II among B.Ed students. The randomized pre-test, post test, control group and experimental group design was employed. The B.Ed students of the same college formed the control and experimental groups. Each…

  13. Communication and Influencing for ED Professionals: A training programme developed in the emergency department for the emergency department. (United States)

    Rixon, Andrew; Rixon, Sascha; Addae-Bosomprah, Hansel; Ding, Mingshuang; Bell, Anthony


    The objective of the present study is to develop and pilot a communication and influencing skills training programme that meets ED health professionals' needs at an urban district hospital. Qualitative methods within a participatory action research framework were utilised. An interdisciplinary team guided the programme's design and development. A training needs analysis saw team meetings, interviews, focus groups and observations conducted across the ED. Thematic analysis of the data identified health professionals' communication and influencing challenges. The training needs analysis informed the training programme curriculum's development. The pilot programme involved an interdisciplinary group of seven health professionals across 5 × 2 h sessions over 3 months, followed by a post-training survey. Five themes of communication and influencing challenges were identified: participating in effective handovers, involving patients in bedside handovers, effectively communicating with interdepartmental colleagues, asking ED colleagues to do tasks and understanding ED colleagues' roles, expectations and assumptions. Based on these challenges, the formulated RESPECT model (which stands for Relationships, Expectations, Styles, Partnerships, Enquiry, Coaching and Teamwork) informed the training curriculum. The peer coaching model used in the training programme was highly regarded by participants. Communication and Influencing for ED Professionals™ (Babel Fish Group Pty Ltd, Melbourne, Victoria, Australia) addresses a gap for communication programmes developed in the ED for the ED. Future research will evaluate the programme's impact in this ED. © 2016 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

  14. Using Google Flu Trends data in forecasting influenza-like-illness related ED visits in Omaha, Nebraska. (United States)

    Araz, Ozgur M; Bentley, Dan; Muelleman, Robert L


    Emergency department (ED) visits increase during the influenza seasons. It is essential to identify statistically significant correlates in order to develop an accurate forecasting model for ED visits. Forecasting influenza-like-illness (ILI)-related ED visits can significantly help in developing robust resource management strategies at the EDs. We first performed correlation analyses to understand temporal correlations between several predictors of ILI-related ED visits. We used the data available for Douglas County, the biggest county in Nebraska, for Omaha, the biggest city in the state, and for a major hospital in Omaha. The data set included total and positive influenza test results from the hospital (ie, Antigen rapid (Ag) and Respiratory Syncytial Virus Infection (RSV) tests); an Internet-based influenza surveillance system data, that is, Google Flu Trends, for both Nebraska and Omaha; total ED visits in Douglas County attributable to ILI; and ILI surveillance network data for Douglas County and Nebraska as the predictors and data for the hospital's ILI-related ED visits as the dependent variable. We used Seasonal Autoregressive Integrated Moving Average and Holt Winters methods with3 linear regression models to forecast ILI-related ED visits at the hospital and evaluated model performances by comparing the root means square errors (RMSEs). Because of strong positive correlations with ILI-related ED visits between 2008 and 2012, we validated the use of Google Flu Trends data as a predictor in an ED influenza surveillance tool. Of the 5 forecasting models we have tested, linear regression models performed significantly better when Google Flu Trends data were included as a predictor. Regression models including Google Flu Trends data as a predictor variable have lower RMSE, and the lowest is achieved when all other variables are also included in the model in our forecasting experiments for the first 5 weeks of 2013 (with RMSE = 57.61). Google Flu Trends data

  15. Experiences of patients with acute abdominal pain in the ED or acute surgical ward --a qualitative comparative study

    DEFF Research Database (Denmark)

    Schultz, Helen; Qvist, Niels; Backer Mogensen, Christian


    The Danish health care system is currently establishing emergency departments (EDs) with an observation unit nationwide. The aim of the study was to investigate patients with acute abdominal pain and their experiences upon arrival and stay in an acute surgical ward (ASW) versus an ED with an obse......The Danish health care system is currently establishing emergency departments (EDs) with an observation unit nationwide. The aim of the study was to investigate patients with acute abdominal pain and their experiences upon arrival and stay in an acute surgical ward (ASW) versus an ED...... was that the ED included a multidisciplinary team with nurses, who mainly had interactions with the patients before surgical assessment. In all, it resulted in fragmentation of care and a patient experience of repetition. In ASW, focus was on assessment by a senior physician, only, and the nurses' interaction...

  16. The NOURISHED randomised controlled trial comparing mentalisation-based treatment for eating disorders (MBT-ED) with specialist supportive clinical management (SSCM-ED) for patients with eating disorders and symptoms of borderline personality disorder. (United States)

    Robinson, Paul; Hellier, Jennifer; Barrett, Barbara; Barzdaitiene, Daiva; Bateman, Anthony; Bogaardt, Alexandra; Clare, Ajay; Somers, Nadia; O'Callaghan, Aine; Goldsmith, Kimberley; Kern, Nikola; Schmidt, Ulrike; Morando, Sara; Ouellet-Courtois, Catherine; Roberts, Alice; Skårderud, Finn; Fonagy, Peter


    In this multi-centre randomized controlled trial (RCT) we compared modified mentalisation-based treatment (MBT-ED) to specialist supportive clinical management (SSCM-ED) in patients with eating disorders (EDs) and borderline personality disorder symptoms (BPD). This group of patients presents complex challenges to clinical services, and a treatment which addresses their multiple problems has the potential to improve outcome. MBT has been shown to be effective in improving outcome in patients with BPD, but its use has not been reported in ED. Sixty-eight eligible participants were randomised to MBT-ED or SSCM-ED. The primary outcome measure was the global score on the Eating Disorder Examination. Secondary outcomes included measures of BPD symptoms (the Zanarini Rating Scale for Borderline Personality Disorder), general psychiatric state, quality of life and service utilisation. Participants were assessed at baseline and at 6, 12 and 18 months after randomisation. Analysis was performed using linear mixed models. Only 15 participants (22 %) completed the 18 month follow-up. Early drop-out occurred significantly more in the SSCM-ED group. Drop-out did not vary with treatment model later in therapy and was sometimes attributed to participants moving away. There was higher drop--out amongst smokers and those with higher neuroticism scores. 47.1 % of participants in the MBT-ED arm and 37.1 % in the SSCM-ED arm attended at least 50 % of therapy sessions offered. Amongst those remaining in the trial, at 12 and 18 months MBT-ED was associated with a greater reduction in Shape Concern and Weight Concern in the Eating Disorder Examination compared to SSCM-ED. At 6, 12 and 18 months there was a decline of ED and BPD symptoms in both groups combined. Ten participants were reported as having had adverse events during the trial, mostly self-harm, and there was one death, attributed as 'unexplained' by the coroner. The high drop-out rate made interpretation of the results

  17. Investigation of Detectability of Elementary Composition of Rainbow trout muscle with EDS (Energy Dispersive Spectroscopy Method

    Directory of Open Access Journals (Sweden)

    Saltuk Buğrahan CEYHUN


    Full Text Available In present study, it is investigated that detectability of elementary composition of rainbow trout muscle using Energy Dispersive Spectroscopy (EDS. EDS system which has worked with attached to scanning electron microscope can do qualitative and semi-quantitative elementary analyses on selected region of sample using characteristic X-rays. For this purpose, it was performed four point and two mapping analyses from four samples. According to results, it was detected 13 elements which are consist of C, N and O in 87.70 percentage. As a result, although the method is sensitive and reliable, it is concluded that not adequate for elemental analysis alone but can be used as a support for analyzes with systems such as especially atomic absorption and ICP-MS.

  18. "Head käed" tõid Berlinalelt auhinna / Tiit Tuumalu

    Index Scriptorium Estoniae

    Tuumalu, Tiit, 1971-


    Berliini 52. filmifestivali tulemustest. Festivali "Panorama Special" kavas olnud Peeter Simmi "Head käed" saavutas hea publikuedu ning jagas sloveenlase Maja Weiss'i filmiga "Piirivalvur" Manfred Salzgeberi auhinda, mis on mõeldud subtiitrite tegemiseks filmi levitamisel euroopa ekraanidele. Kuldkaru jagasid briti Paul Greengrassi "Verine pühapäev" ja jaapanlase Hayao Miyazaki animafilm "Vaimudest viidud". Parima režissööri Hõbekaru sai Otar Ioseliani

  19. HigherEd 2.0: Using social media in engineering education


    Berger, Edward


    Social media (blogs, wikis, video, and a digital authoring culture) has emerged in the last decade as a dominant feature of the technology landscape, especially for our current generation of digital-native students. Leveraging these tools for higher education in general, and engineering education in particular, should be of immediate and pressing concern for engineering educators. This discussion summarizes the HigherEd 2.0 project, the creative convergence of higher education and “web 2.0” t...

  20. Dym, J. y K. Offen (eds.: 2011, Mapping Latin America. A Cartographic Reader

    Directory of Open Access Journals (Sweden)

    Ricardo A. Fagoaga Hernández


    Full Text Available Dym, J. y K. Offen (eds.: 2011, Mapping Latin America. A Cartographic Reader, The University of Chicago Press, Chicago/London, xix+338 p., 131 illustrations, ISBN-13: 978-0-226-61821-0; ISBN-10: 0-226-61821-8 (hard cover; ISBN-13: 978-0-226-61822-7, ISBN-10: 0-226-61822-6 (paperback

  1. TEM EDS analysis of epitaxially-grown self-assembled indium islands

    Directory of Open Access Journals (Sweden)

    Jasmine Sears


    Full Text Available Epitaxially-grown self-assembled indium nanostructures, or islands, show promise as nanoantennas. The elemental composition and internal structure of indium islands grown on gallium arsenide are explored using Transmission Electron Microscopy (TEM Energy Dispersive Spectroscopy (EDS. Several sizes of islands are examined, with larger islands exhibiting high (>94% average indium purity and smaller islands containing inhomogeneous gallium and arsenic contamination. These results enable more accurate predictions of indium nanoantenna behavior as a function of growth parameters.

  2. Validating the ABCD(2) Score for predicting stroke risk after transient ischemic attack in the ED. (United States)

    Ong, Marcus Eng Hock; Chan, Yiong Huak; Lin, Wan Ping; Chung, Wan Ling


    The aim of the study was to validate the use of the ABCD(2) score for the prediction of stroke after transient ischemic attack (TIA) in patients presenting to the emergency department (ED). The ABCD(2) scoring is based on 5 factors as follows: age of at least 60 years; blood pressure of at least 140/90 mm Hg; clinical features such as unilateral weakness and speech impairment alone; duration of at least 60 minutes or 10 to 59 minutes; and diabetes. The authors conducted a retrospective observational study of all patients presented to the ED for TIA, as diagnosed by the attending emergency physicians, for a 2-year period. Sensitivity, specificity, and negative predictive value (NPV) were calculated for risk of stroke at 2, 7, 30, and 90 days after presentation. From January 1, 2005, to December 31, 2006, there were 470 patients diagnosed with TIA at the ED. Mean age was 61.0 years (SD, 13.2), with 63.3% males. Age of at least 60 years, unilateral weakness, and duration of at least 60 minutes were found to be significant predictors of stroke at 2 days. An admission rule based on an ABCD(2) score of at least 4 showed sensitivity of 86.4% and NPV of 91.7% for stroke at 7 days. Admission based on a score of at least 3 showed sensitivity of 96.6% and NPV of 96.1%. Admission rate was 69.1% and. 83.6%, respectively. The ABCD(2) rule showed good sensitivity and NPV for stroke at 7 days. However, NPV was not 100%, and there would still be patients being discharged from the ED and returning with a stroke if this cutoff was implemented in our setting.

  3. Representation of Solar Capacity Value in the ReEDS Capacity Expansion Model

    Energy Technology Data Exchange (ETDEWEB)

    Sigrin, B. [National Renewable Energy Lab. (NREL), Golden, CO (United States); Sullivan, P. [National Renewable Energy Lab. (NREL), Golden, CO (United States); Ibanez, E. [National Renewable Energy Lab. (NREL), Golden, CO (United States); Margolis, R. [National Renewable Energy Lab. (NREL), Golden, CO (United States)


    An important issue for electricity system operators is the estimation of renewables' capacity contributions to reliably meeting system demand, or their capacity value. While the capacity value of thermal generation can be estimated easily, assessment of wind and solar requires a more nuanced approach due to the resource variability. Reliability-based methods, particularly assessment of the Effective Load-Carrying Capacity, are considered to be the most robust and widely-accepted techniques for addressing this resource variability. This report compares estimates of solar PV capacity value by the Regional Energy Deployment System (ReEDS) capacity expansion model against two sources. The first comparison is against values published by utilities or other entities for known electrical systems at existing solar penetration levels. The second comparison is against a time-series ELCC simulation tool for high renewable penetration scenarios in the Western Interconnection. Results from the ReEDS model are found to compare well with both comparisons, despite being resolved at a super-hourly temporal resolution. Two results are relevant for other capacity-based models that use a super-hourly resolution to model solar capacity value. First, solar capacity value should not be parameterized as a static value, but must decay with increasing penetration. This is because -- for an afternoon-peaking system -- as solar penetration increases, the system's peak net load shifts to later in the day -- when solar output is lower. Second, long-term planning models should determine system adequacy requirements in each time period in order to approximate LOLP calculations. Within the ReEDS model we resolve these issues by using a capacity value estimate that varies by time-slice. Within each time period the net load and shadow price on ReEDS's planning reserve constraint signals the relative importance of additional firm capacity.

  4. Treating primary headaches in the ED: can droperidol regain its role? (United States)

    Faine, Brett; Hogrefe, Christopher; Van Heukelom, Jon; Smelser, Jamie


    The aim of this study was to describe the use and efficacy of low-dose (≤2 mg) droperidol for the treatment of primary headaches (ie, migraine, cluster, tension-type headache and trigeminal autonomic cephalalgias, and other primary headaches) in the emergency department (ED). A report was generated from a pharmacy database to identify all adult patients who received low-dose droperidol in the ED over a 7-month period; a subsequent retrospective chart review was conducted. Low-dose droperidol was defined as a cumulative dose of ≤2 mg. Patients who received droperidol for any other reason than the treatment of a headache were excluded. Data were analyzed descriptively. Seventy-three cases in which droperidol was administered for the treatment of a headache were identified over the 7-month period. Most doses (92%) administered were 1.25 mg or less. Fifty-three patients (73%) had complete resolution or significant improvement of headache symptoms as subjectively or objectively (eg, numerical pain scale) documented by the treating physician. Eight patients (11%) had minimal improvement in their headaches symptoms; 12 patients (16%) received no relief after the administration of droperidol. The average time to discharge from the ED was 94.8 ± 67.2 minutes. No cardiac arrhythmias were noted. Other adverse events included 2 cases of extrapyramidal side effects; one patient reported restlessness/anxiousness and the other patient had dystonia. The administration of low-dose (≤2 mg) droperidol may be safe and effective for the treatment of primary headaches in the ED. Published by Elsevier Inc.

  5. The accuracy of point-of-care ultrasound to diagnose long bone fractures in the ED. (United States)

    Waterbrook, Anna L; Adhikari, Srikar; Stolz, Uwe; Adrion, Carrie


    To determine the diagnostic accuracy of emergency physician performed point-of care ultrasound (POCUS) for detecting long bone fractures compared to standard radiography. This was a single-blinded, prospective observational study of patients presenting to two emergency departments (ED) with trauma to long bones. The study used a convenience sample of patients seen during the study investigators' scheduled clinical shifts. Patients presenting to the ED with complaints of long bone trauma were included in the study when a study investigator was available in the ED. POCUS examinations of injured long bones were performed using a standard protocol. The investigators documented their interpretation prior to radiographs being performed. After standard radiographs were performed, the final radiology reading by a radiology attending physician was obtained from the medical record. One-hundred six patients were enrolled into the study, and 147 long bone POCUS examinations were performed. Forty-two fractures were present by radiographs and the prevalence of fractures was 29%. The sensitivity was 90.2% (4/41, 95% CI: 76.9-97.3) and specificity was 96.1% (4/102, 95% CI: 90.3-98.9). The positive likelihood ratio was 23.0 (95% CI: 8.8-60.5), and the negative likelihood ratio was 0.102 (95% CI: 0.040, 0.258). The positive predictive value was 90.2% (4/41, 95% CI: 76.9-97.3) and the negative predictive value was 96.1% (4/102, 95% CI: 90.3-98.9). Emergency physicians can accurately evaluate long bone fractures in the ED using POCUS. In particular, long bone fractures can be excluded with a high degree of confidence. © 2013.

  6. DisturbED: A Generalized Framework for Modeling Forest Insects and Pathogens in the Earth System (United States)

    Matthes, J. H.


    Forest insects and pathogens (FIPs) are ubiquitous agents of disturbance that cause major alterations to ecosystem function and billions of dollars in damage annually. Future feedbacks between FIPs, forests, and climate change are not well understood at continental scales, due in part to the absence of the processes modulated by FIPs within Earth System Models (ESMs). To address this challenge, we developed a generalized, globally-scalable framework — DisturbED — in which mechanistic impacts of FIPs on plant physiology are scaled up to ecosystem-level processes so they can be integrated into ESMs. This framework can be used to test a suite of hypotheses concerning the effects of FIPs on forest biogeochemistry, demography, and structure in response to FIPs that vary in their host specificity, timescale and intensity of attack, and sensitivity to climatic change. Both native and invasive FIPs initiate a vast range of ecophysiological responses within individual trees, from slight stress and recovery to rapid mortality. Rather than modeling FIPs as direct agents of mortality, DisturbED couples FIP functional types with changes in individual host plant physiology to simulate resulting changes in ecosystem processes within the Ecosystem Demography (ED) model. This bottom-up modeling framework will allow for investigation of interactions among tree and FIPs physiology; demography and ecosystem dynamics; and their contingency on climatic change.

  7. A new e-learning platform for radiology education (RadEd). (United States)

    Xiberta, Pau; Boada, Imma


    One of the key elements of e-learning platforms is the content provided to the students. Content creation is a time demanding task that requires teachers to prepare material taking into account that it will be accessed on-line. Moreover, the teacher is restricted by the functionalities provided by the e-learning platforms. In contexts such as radiology where images have a key role, the required functionalities are still more specific and difficult to be provided by these platforms. Our purpose is to create a framework to make teacher's tasks easier, specially when he has to deal with contents where images have a main role. In this paper, we present RadEd, a new web-based teaching framework that integrates a smart editor to create case-based exercises that support image interaction such as changing the window width and the grey scale used to render the image, taking measurements on the image, attaching labels to images and selecting parts of the images, amongst others. It also provides functionalities to prepare courses with different topics, exercises and theory material, and also functionalities to control students' work. Different experts have used RadEd and all of them have considered it a very useful and valuable tool to prepare courses where radiological images are the main component. RadEd provides teachers functionalities to prepare more realistic cases and students the ability to make a more specific diagnosis. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.


    Directory of Open Access Journals (Sweden)

    Sutapa BOSE


    Full Text Available Indira Gandhi National Open University (IGNOU of India uses multiple media and modes for reaching out to its distant learners. For most of the programmes offered to these learners, print is the master medium and other media supplement it. Instructions for the Bachelor in Education (B.Ed., one of the popular programmes of IGNOU, are also delivered similarly. A survey was undertaken to determine the extent of utilization of instructions provided through various media by the students of B.Ed of two Indian metropolises –Delhi and Kolkata, having high penetration of advanced communication technologies. As the students of B.Ed. happen to be teachers who are supposed to be using ICT for teaching in their schools, the survey aimed to determine whether they were also using ICT for learning. The survey was carried out with a questionnaire with closed and open ended questions. It was found that only print medium was used for learning while the other media of the multimedia package remained mostly unused. The reason for this trend was found to be mainly the perception that the print medium is sufficient for assessment purposes. Suggestions have been made that to utilize the multiple media instructional system, interesting programmes that can hook learners be developed for delivery by electronic media and that gradually ICT may be integrated into the programmes from the present supplementary mode so that complacence in using it is reduced among learners.

  9. Synthesis and characterization of Ce and La modified bismuth titanate

    Directory of Open Access Journals (Sweden)

    Nikolina Pavlović


    Full Text Available Bismuth titanate based nanopowders with the different content of La or Ce were synthesized by the modified sol-gel method. After calcination at 600°C, in addition to Aurivillius layered structure, a small quantity of cubic pyrochlore phase was detected in the La modified powders, while this second phase was much more pronounced in the Ce substituted powders. In fact, as the powder with the highest amount of Ce (Bi3CeTi3O12 has the pure pyrochlore phase it seems that the presence of Ce stabilizes the formation of this phase. This different infl uence of cerium and lanthanum could be explained by the incorporation of their ions on the different sites in the titanate structure. Bismuth titanate based ceramics, sintered at 1050°C/2h, had densities above 93% of theoretical density and characteristic plate-like grain morphology. Small quantity of cubic pyrochlore phase was detected only in the Ce modifi ed bismuth titanate ceramics. On the other hand, lanthanum addition caused formation of smaller grain size with pronounced plate-like morphology.

  10. SEM/EDS and optical microscopy analyses of microplastics in ocean trawl and fish guts. (United States)

    Wang, Zhong-Min; Wagner, Jeff; Ghosal, Sutapa; Bedi, Gagandeep; Wall, Stephen


    Microplastic particles from Atlantic and Pacific Ocean trawls, lab-fed fish guts and ocean fish guts have been characterized using optical microscopy and SEM/EDS in terms of size, morphology, and chemistry. We assessed whether these measurements could serve as a rapid screening process for subsequent identification of the likely microplastic candidates by micro-spectroscopy. Optical microscopy enabled morphological classification of the types of particles or fibers present in the sample, as well as the quantification of particle size ranges and fiber lengths. SEM/EDS analysis was used to rule out non-plastic particles and screen the prepared samples for potential microplastic, based on their element signatures and surface characteristics. Chlorinated plastics such as polyvinyl chloride (PVC) could be easily identified with SEM/EDS due to their unique elemental signatures including chlorine, as could mineral species that are falsely identified as plastics by optical microscopy. Particle morphology determined by optical microscopy and SEM suggests the fish ingested particles contained both degradation fragments from larger plastic pieces and also manufactured microplastics. SEM images of microplastic particle surfaces revealed characteristic cracks consistent with environmental exposure, as well as pigment particles consistent with manufactured materials. Most of the microplastic surfaces in the fish guts and ocean trawls were covered with biofilms, radiolarians, and crustaceans. Many of the fish stomachs contained micro-shell pieces which visually resembled microplastics. Copyright © 2017 Elsevier B.V. All rights reserved.

  11. PAs in the ED: do physicians think they increase the malpractice risk? (United States)

    Gifford, Alisa; Hyde, Mark; Stoehr, James D


    This study evaluates emergency physicians' perceptions of the malpractice risk posed by utilization of physician assistants (PAs) in emergency departments (EDs) in 2004 and again in 2009. A 16-question survey was mailed to a random sample of 1,000 active members of the American College of Emergency Physicians in 2004 and again in 2009. In both 2004 and 2009, 70% of the emergency physicians did not believe that PAs, when properly supervised, are more likely to commit malpractice than any other clinician. In both surveys, 80% of the respondents did not believe PAs were more likely to be sued for malpractice. A significant negative correlation was found between perceived risk of malpractice by PAs and the number of years physicians had worked with PAs or had worked in emergency medicine. From 2004 to 2009, the number of respondents practicing with PAs increased by 26%, the number directly supervising a PA in the ED increased by 19%, the number who thought PAs decreased patient wait times increased by 13%, and the number who reported that PAs increased patient satisfaction increased by 10%. As physicians gain clinical experience with PAs, their perceived risk of malpractice tends to decrease. These results may have implications for the utilization of PAs, particularly as EDs become more utilized for noncritical situations.

  12. Application of the TIMI risk score in ED patients with cocaine-associated chest pain. (United States)

    Chase, Maureen; Brown, Aaron M; Robey, Jennifer L; Zogby, Kara E; Shofer, Frances S; Chmielewski, Lauren; Hollander, Judd E


    The TIMI risk score has been validated as a risk stratification tool in emergency department (ED) patients with potential acute coronary syndrome. The goal of this study was to assess its ability to predict adverse cardiovascular outcomes in cocaine-associated chest pain. This was a prospective cohort study of ED patients with chest pain with cocaine use. Data included demographics, medical history, and TIMI risk score. The main outcomes were acute myocardial infarction, revascularization, or death within 30 days of ED presentation. There were 261 patient visits. Patients were 43.2+8 years old, 73% male, 92% black, and 75% smokers. There were 33 patients with the composite outcome. The incidence of 30-day outcomes according to TIMI score is as follows: TIMI 0, 3.7% (95% CI, 0.1-8.3); TIMI 1, 13.2% (5.7-20.7); TIMI 2, 17.1% (4.3-29.8); TIMI 3, 21.4% (4.4-38.4); TIMI 4, 20.0% (0.1-43.6); TIMI 5/6, 50.0% (0.1-100). The TIMI risk score has no clinically useful predictive value in patients with cocaine-associated chest pain.

  13. Mid-term NEAT review: analysing the improvements in hospital ED performance. (United States)

    Khanna, Sankalp; Boyle, Justin; Good, Norm; Lind, James


    Introduced with a promise to reduce overcrowding in the Emergency Department (ED) and the associated morbidity and mortality linked to bed access difficulties, the National Emergency Access Target (NEAT) is now over halfway through transitionary arrangements towards a target of 90% of patients that visit a hospital ED being admitted or discharged within 4 hours. Facilitation and reward funding has ensured hospitals around the country are remodelling workflows to ensure compliance. Recent reports however show that the majority of hospitals are still far from being able to meet this target. We investigate the NEAT journey of 30 Queensland hospitals over the past two years and compare this performance to a previous study that investigated the 4 hour ED discharge performance of these hospitals at various times of day and under varying occupancy conditions. Our findings reveal that, while most hospitals have made significant improvements to their 4 hour discharge performance in 2013, the underlying flow patterns and periods of poor NEAT compliance remain largely unchanged. The work identifies areas for targeted improvement to inform system redesign and workflow planning.

  14. The epidemiology of assault-related hospital in-patient admissions and ED attendances.

    LENUS (Irish Health Repository)

    O'Farrell, A


    The aim of this study was to describe the epidemiology and impact of serious assault warranting in-patient care over six years and its impact on ED attendances in a large teaching hospital in Dublin over 2 years. There were 16,079 emergency assault-related inpatient hospital discharges reducing from 60.1 per 100,000 population in 2005 to 50.6 per 100,000 population in 2010. The median length of stay was 1 day (1-466) representing 49,870 bed days. The majority were young males (13,921, 86.6%; median age 26 years). Overall crime figures showed a similar reduction. However, knife crimes did not reduce over this period. Data on ED attendances confirmed the age and gender profile and also showed an increase at weekends. Alcohol misuse was recorded in 2,292\\/16079 (14%) of in-patient cases and 242\\/2484 (10%) in ED attendances. An inter-sectoral preventative approach specifically targeting knife crime is required to reduce this burden on health services.

  15. Representation of the Solar Capacity Value in the ReEDS Capacity Expansion Model: Preprint

    Energy Technology Data Exchange (ETDEWEB)

    Sigrin, B.; Sullivan, P.; Ibanez, E.; Margolis, R.


    An important emerging issue is the estimation of renewables' contributions to reliably meeting system demand, or their capacity value. While the capacity value of thermal generation can be estimated easily, assessment of wind and solar requires a more nuanced approach due to resource variability. Reliability-based methods, particularly, effective load-carrying capacity (ELCC), are considered to be the most robust techniques for addressing this resource variability. The Regional Energy Deployment System (ReEDS) capacity expansion model and other long-term electricity capacity planning models require an approach to estimating CV for generalized PV and system configurations with low computational and data requirements. In this paper we validate treatment of solar photovoltaic (PV) capacity value by ReEDS capacity expansion model by comparing model results to literature for a range of energy penetration levels. Results from the ReEDS model are found to compare well with both comparisons--despite not being resolved at an hourly scale.

  16. Determination of ED50 and ED95 of 0.5% Ropivacaine in Adductor Canal Block to Produce Quadriceps Weakness: A Dose-Finding Study. (United States)

    Johnston, David F; Sondekoppam, Rakesh V; Giffin, Robert; Litchfield, Robert; Ganapathy, Sugantha

    Adductor canal block (ACB) is popular for knee analgesia because of its favorable effect on quadriceps strength. The aim of this study was to find the minimum volume of local anesthetic, which can be injected into the ACB that would result in quadriceps weakness. This nonrandomized study used an up-and-down sequential allocation design. Twenty-six patients scheduled to undergo arthroscopic knee surgery received an ultrasound-guided ACB preoperatively. The initial volume of ropivacaine 0.5% injected was 30 mL, which was subsequently increased or decreased by 2 mL, depending on whether the previous subject had a 30% reduction in quadriceps function. The minimum effective volume in 50% of patients was determined using Dixon-Massey up-and-down method. The effective volume in 95% of patients was then calculated using probit transformation. The ED50 (minimum effective anesthetic volume in 50% of the subjects) needed for a 30% decrease in quadriceps power was 46.5 mL (95% confidence interval, 45.01-50.43 mL), and estimated ED95 (minimum effective anesthetic volume in 95% of the subjects) was 50.32 mL (95% confidence interval, 48.66-67.26 mL). The local anesthetic volume injected correlated with degree of quadriceps weakness at 20 minutes postblock (P unit (P = 0.032). Significant quadriceps weakness is unlikely when clinically representative volumes of 0.5% ropivacaine is used for ACB performed using sonographic landmarks. This study was registered at, identifier NCT02541552.

  17. INSIST-ED: Italian Society of Andrology registry on penile prosthesis surgery. First data analysis

    Directory of Open Access Journals (Sweden)

    Edoardo Pescatori


    Full Text Available Objectives: The Italian Society of Andrology, i.e. “Società Italiana di Andrologia” (S.I.A., launched on December 2014 a prospective, multicenter, monitored and internal review board approved Registry for penile implants, the “INSIST-ED” (Italian Nationwide Systematic Inventarisation of Surgical Treatment for ED Registry. Purpose of this first report is to present a baseline data analysis of the characteristics of penile implant surgery in Italy. Material and methods: The INSIST-ED Registry is open to all surgeons implanting penile prostheses (all brands, all models in Italy, providing anonymous patient, device, surgical procedure, outcome, follow-up data, for both first and revision surgeries. A Registry project Board overviews all the steps of the project, and a Registry Monitor interacts with the Registry implanting surgeons. Results: As by April 8, 2016, 31 implanting surgeons actively joined the Registry, entering 367 surgical procedures in its database, that comprise: 310 first implants, 43 prosthesis substitutions, 14 device explants without substitution. Implanted devices account for: 288 three-component devices (81,3%, 20 two-component devices (5,4%, 45 non-hydraulic devices (12,3%. Leading primary ED etiologies in first implant surgeries resulted: former radical pelvic surgery in 111 cases (35,8%, Peyronie’s disease in 66 cases (21,3%, diabetes in 39 cases (12,6%. Two intraoperative complications have been recorded. Main reasons for 57 revision surgeries were: device failure (52,6%, erosion (19,3%, infection (12,3%, patient dissatisfaction (10,5%. Surgical settings for patients undergoing a first penile implant were: public hospitals in 251 cases (81%, private environments in 59 cases (19%. Conclusions: The INSIST-ED Registry represents the first European experience of penile prosthesis Registry. This baseline data analysis shows that: three-pieces inflatable prosthesis is the most implanted device, leading etiology of

  18. Factors associated with self-reported pain scores among ED patients. (United States)

    Marco, Catherine A; Nagel, Jacqueline; Klink, Ellen; Baehren, David


    Pain is a common presenting complaint among emergency department (ED) patients. The verbal numeric pain scale is commonly used in the ED to assess self-reported pain. This study was undertaken to describe and compare pain scores in a variety of painful conditions and identify factors associated with self-reported pain scores. The study was a prospective, observational, descriptive survey study conducted at an urban university hospital ED. Eligible participants included consenting adults 18 years and older, with an acute painful condition, who spoke English, and were not in severe distress. Through a structured interview, collected data included pain score; diagnosis; medical history; previous painful experiences; and demographic information including age, insurance status, and highest level of education completed. Among 268 eligible participants, 263 (98%) consented and completed the study protocol. Seventy-one percent of participants were 50 years old or younger; 55%, women; and 68%, white. Fifty-four percent had private insurance, and 81%, high school education or higher. The most common chief complaints were soft tissue injury (33%), abdominal pain (18%), and chest pain (13%). The median self-reported pain score was 7/10 (mean, 6.7; interquartile range, 6-9; range, 0-10). The most common previous painful experiences were childbirth (21%), major trauma (18%), and surgery (14%). Participants cited reasons for self-reported pain scores, including current feeling of pain (62%), comparison to previous pain (31%), and comparison to hypothetical pain (12%). The number of previous ED visits was positively correlated with current pain score (Spearman correlation R = 0.28; P associated with the highest pain scores included dental pain (mean pain score, 8.5) and back pain (mean pain score, 7.6). Chief complaints associated with the lowest pain scores included chest pain (mean pain score, 5.2) and other medical conditions (mean pain score, 5.3). Factors associated with

  19. Early Lessons Learned from Extramural School Programs That Offer HPV Vaccine (United States)

    Hayes, Kim A.; Entzel, Pamela; Berger, Wendy; Caskey, Rachel N.; Shlay, Judith C.; Stubbs, Brenda W.; Smith, Jennifer S.; Brewer, Noel T.


    Background: There has been little evaluation of school-located vaccination programs that offer human papillomavirus (HPV) vaccine in US schools without health centers (ie, extramural programs). This article summarizes lessons learned from such programs. Methods: In July to August 2010, 5 programs were identi?ed. Semistructured, in-depth telephone…

  20. Emergency department tobacco cessation program: staff participation and intervention success among patients. (United States)

    Greenberg, Marna Rayl; Weinstock, Michael; Fenimore, Deborah Gaston; Sierzega, Gina M


    The emergency department (ED) is often the primary source of healthcare for uninsured and underinsured patients. To evaluate ED staff attitudes toward and participation in referring patients to a tobacco cessation program, and to assess the program's effectiveness. A nonvalidated survey on smoking cessation and preventative services for ED patients was mailed to ED staff at a suburban hospital. After survey completion, ED staff was encouraged to refer smokers with diagnoses substantially worsened by tobacco use to a brief intervention delivered in the ED. An incentive was provided to staff beginning in the second month of the 3-month period. Referred patients were briefly counseled by a hospital social worker or an ED physician or nurse. Follow-up telephone interviews with patients occurred 1 to 3 months postintervention. Of the 70 ED staff contacted, 63 (90%) responded to the survey. Most staff members (81%) agreed that they should facilitate clinical prevention. Fewer staff (60%) were comfortable advising patients to quit tobacco use (Pstaff should assist patients in tobacco cessation (PStaff referrals increased with program incentives (P=.008), with a total of 150 interventions occurring in the 3-month span. Of the 36 patients (24%) reached for follow-up, 13 (36%) attempted to quit and 6 (17%) succeeded. Overall, 45% of the patients reached for follow-up either cut down or quit tobacco use. Staff members' attitudes toward tobacco cessation are not a firm barrier to the successful implementation of an ED tobacco cessation program. In addition, the ED provides an important opportunity to encourage patients to quit or cut down tobacco use.

  1. #ClimateEdCommunity : Field Workshops Bring Together Teachers and Researchers to Make Meaning of Science and Classroom Integration (United States)

    Bartholow, S.; Warburton, J.; Wood, J. H.; Steiner, S. M.


    Seeing Understanding and Teaching: Climate Change in Denali is a four-day immersive teacher professional development course held in Denali National Park. Developed through three partner organizations, the course aims to develop teachers' skills for integrating climate change content into their classrooms. This presentation aims to share tangible best practices for linking researchers and teachers in the field, through four years of experience in program delivery and reported through a published external evaluation. This presentation will examine the key aspects of a successful connection between teachers, researchers, science, and classrooms: (1) Inclusion of teacher leaders, (2) dedicated program staff, (3) workshop community culture, and will expose barriers to this type of collaboration including (1) differences in learning style, (2) prior teaching experience, (3) existing/scaffolding understanding of climate change science, and (4) accessibility of enrollment and accommodations for the extended learning experience. Presentation Content Examples:Participants overwhelmingly value the deep commitment this course has to linking their field experience to the classroom attributing to the role of a teacher-leader; an expert science teacher with first-hand field research experience in the polar regions. The goal of including a teacher-leader is to enhance translatability between fieldwork and the classroom. Additionally, qualitative aspects of the report touches on the intangible successes of the workshop such as: (1) the creation of a non-judgmental learning atmosphere, (2) addressing accessibility to science learning tools in rural and under-served communities, (3) defining successful collaboration as making meaning together through exploratory questioning while in the field (4) discussed the social and cultural implications of climate change, and the difficulty of navigating these topics in educational and/or multicultural spaces. Next Steps? Create a #ClimateEd

  2. Evaluating the Impact of Six Supplemental Nutrition Assistance Program Education Interventions on Children's At-Home Diets (United States)

    Williams, Pamela A.; Cates, Sheryl C.; Blitstein, Jonathan L.; Hersey, James C.; Kosa, Katherine M.; Long, Valerie A.; Singh, Anita; Berman, Danielle


    Background: Nutrition education in the Supplemental Nutrition Assistance Program Education (SNAP-Ed) is designed to promote healthy eating behaviors in a low-income target population. Purpose: To evaluate the effectiveness of six SNAP-Ed interventions delivered in child care centers or elementary school settings in increasing participating…

  3. Dimensionality and scale properties of the Edinburgh Depression Scale (EDS) in patients with type 2 diabetes mellitus

    DEFF Research Database (Denmark)

    de Cock, Evi S A; Emons, Wilco H M; Nefs, Giesje


    Scale (EDS) is a widely used method for screening depression. However, there is still debate about the dimensionality of the test. Furthermore, the EDS was originally developed to screen for depression in postpartum women. Empirical evidence that the EDS has comparable measurement properties in both......BACKGROUND: Depression is a common complication in type 2 diabetes (DM2), affecting 10-30% of patients. Since depression is underrecognized and undertreated, it is important that reliable and validated depression screening tools are available for use in patients with DM2. The Edinburgh Depression...... to laugh or enjoy) and sleeping problems were the most informative indicators for being able to differentiate between the diagnostic groups of mild and severe depression. CONCLUSIONS: The EDS constitutes a sound scale for measuring an attribute of general depression. Persons can be reliably measured using...

  4. Berliini filmifestivalil näeb ka Peeter Simmi filmi "Head käed" / Triin Tael

    Index Scriptorium Estoniae

    Tael, Triin


    Berliini 52. filmifestival algas eile sakslase Tom Tykweri mängufilmiga "Taevas". Esmakordselt on festivali "Panorama" kavas eesti mängufilm, milleks on Peeter Simmi "Head käed". Eesti filmid on esil ka festivali suurel filmiturul

  5. Review: Iwanaga, Kazuki (ed. (2008, Women’s Political Participation and Representation in Asia. Obstacles and Challenges

    Directory of Open Access Journals (Sweden)

    Dagmar Hellmann-Rajanayagam


    Full Text Available Review of the edited volume: Iwanaga, Kazuki (ed. (2008, Women’s Political Participation and Representation in Asia. Obstacles and Challenges, Copenhagen: NIAS Press, = Women and Politics in Asia No. 2, ISBN 9788776940164, XVII and 314 pages.

  6. Thomas Crombez, Luk van den Dries (eds., Mass Theatre in Interwar Europe: Flanders and the Netherlands in an International Perspective

    Directory of Open Access Journals (Sweden)

    Maartje Abbenhuis


    Full Text Available Thomas Crombez, Luk van den Dries (eds., Mass Theatre in Interwar Europe: Flanders and the Netherlands in an International Perspective (Leuven: Universitaire pers Leuven, 2014, 164 pp., ISBN 978 90 5867 992 5.

  7. Screening and detection of delirium in older ED patients: performance of the modified Confusion Assessment Method for the Emergency Department (mCAM-ED). A two-step tool. (United States)

    Hasemann, Wolfgang; Grossmann, Florian F; Stadler, Rahel; Bingisser, Roland; Breil, Dieter; Hafner, Martina; Kressig, Reto W; Nickel, Christian H


    Delirium is frequent in older Emergency Department (ED) patients, but detection rates for delirium in the ED are low. To aid in identifying delirium, we developed and implemented a two-step systematic delirium screening and assessment tool in our ED: the modified Confusion Assessment Method for the Emergency Department (mCAM-ED). Components of the mCAM-ED include: (1) screening for inattention, the main feature of delirium, which was performed with the Months Backwards Test (MBT); (2) delirium assessment based on a structured interview with questions from the Mental Status Questionnaire by Kahn et al. and the Comprehension Test by Hart et al. The aims of our study are (1) to investigate the performance criteria of the mCAM-ED tool in a consecutive sample of older ED patients, (2) to evaluate the performance of the mCAM-ED in patients with and without dementia and (3) to test whether this tool is efficient in keeping evaluation time to a minimum and reducing screening and assessment burden on the patient. For this prospective validation study, we recruited a consecutive sample of ED patients aged 65 and older during an 11-day period in November 2015. Trained nurses assessed patients with the mCAM-ED. Results were compared to the reference standard [i.e. the geriatricians' delirium diagnosis based on the criteria of the Text Revision of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR)]. Performance criteria were computed. We included 286 consecutive ED patients aged 65 and older. The median age was 80.02 (Q1 = 72.15; Q3 = 86.76), 58.7% of included patients were female, 14.3% had dementia. We found a delirium prevalence of 7.0%. In patients with dementia, specificity and positive likelihood ratio were lower. When compared to the reference standard, delirium assessment with the mCAM-ED has a 0.98 specificity and a 39.9 positive likelihood ratio. In 80.0% of all cases, the first step of the mCAM-ED, i.e. screening for inattention with the MBT

  8. Risk factors associated with difficult venous access in adult ED patients. (United States)

    Fields, J Matthew; Piela, Nicole E; Au, Arthur K; Ku, Bon S


    The objective was to determine risk factors associated with difficult venous access (DVA) in the emergency department (ED). This was a prospective, observational study conducted in the ED of an urban tertiary care hospital. Adult patients undergoing intravenous (IV) placement were consecutively enrolled during periods of block enrollment. The primary outcome was DVA, defined as 3 or more IV attempts or use of a method of rescue vascular access to establish IV access. Univariate and multivariate analyses for factors predicting DVA were performed using logistic regression. A total of 743 patients were enrolled, of which 88 (11.8%) met the criteria for DVA. In the adjusted analysis, only 3 medical conditions were significantly associated with DVA: diabetes (odds ratio [OR] 1.72, 95% confidence interval [CI] 1.1-2.8), sickle cell disease (OR 3.8, 95% CI 1.5-9.5), and history of IV drug abuse (OR 2.5, 95% CI 1.1-5.7). Notably, age, body mass index, and dialysis were not. Of patients who reported a history of requiring multiple IV attempts in the past for IV access, 14% met criteria for DVA on this visit (OR 7.7 95% CI 3-18). Of the patients who reported a history of IV insertion into the external jugular, ultrasound-guided IV placement, or a central venous catheter for IV access, 26% had DVA on this visit (OR 16.7, 95% CI 6.8-41). Nearly 1 of every 9 to 10 adults in an urban ED had DVA. Diabetes, IV drug abuse, and sickle cell disease were found to be significantly associated with DVA. Copyright © 2014 Elsevier Inc. All rights reserved.

  9. Qualitative analysis of adhesive interface nanoleakage using FE-SEM/EDS. (United States)

    Yuan, Yang; Shimada, Yasushi; Ichinose, Shizuko; Tagami, Junji


    The purpose of this study was to evaluate the quality of short term sealing of current adhesives. Five adhesive systems were used and evaluated in this study; two kinds of two-step adhesives (Single Bond and Clearfil SE Bond) and three one-step adhesives (Clearfil S3 Bond, G Bond and One-Up Bond F-plus). Flat occlusal superficial dentin surfaces from extracted human third molars were finished with wet 600-grit silicon-carbide paper and bonded with one of the adhesives. After 24h storage at 37 degrees C in water, the bonded assemblies were sectioned into approximately 1mm thick slabs. Two central slabs from each tooth were chosen and immersed into 50% (w/v) solution of silver ammoniacal nitrate for 18 h and exposed to photodeveloping solution for 6h. The specimens were then slightly polished, argon ion-etched. In order to examine the nanoleakage within the resin/dentin interface, penetration of silver was observed in a field emission (FE)-SEM using yttrium-aluminium-garnet (YAG) backscattered electron mode. EDS analysis was also carried out in parallel to identify the existence of metallic silver particles. The penetration pattern of silver depended on the adhesive used, indicating different nanoleakage in different adhesive systems. Single Bond, One-Up Bond F-plus and G Bond showed clear silver uptake in both the adhesive and hybrid layer. Clearfil SE Bond showed less silver penetration and slight silver peak on the elemental energy spectroscopy of EDS. Clearfil S3 Bond did not display clear silver penetration under 2000x magnification by FE-SEM, and no existence of metallic silver of the Clearfil S3 Bond group by EDS, could be detected. The nanoleakage, as well as its location depends on the adhesives. Different nanoleakage expressions were revealed between two-step and one-step adhesives and also among one-step adhesives themselves.

  10. Metabolic vs structural coma in the ED--an observational study. (United States)

    Forsberg, Sune; Höjer, Jonas; Ludwigs, Ulf; Nyström, Harriet


    Patients presenting unconscious may reasonably be categorized as suffering from a metabolic or structural condition. The objective was to investigate if some routinely recorded clinical features may help to distinguish between these 2 main forms of coma in the emergency department (ED). Adults admitted to an ED in Stockholm between February 2003 and May 2005 with a Glasgow Coma Scale (GCS) score less than 11 were enrolled prospectively. The GCS score was entered into a protocol that was complemented with available data within 1 month. The study population of 875 patients was classified into 2 main groups: one with a metabolic (n = 633; 72%) and one with a structural disorder (n = 242; 28%). Among the clinical features recorded in the ED, 3 were found to be strongly associated with a metabolic disorder, namely, young age, low or normal blood pressure, and absence of focal signs in the neurological examination. Patients younger than 51 years with a systolic blood pressure less than 151 mm Hg who did not display signs of focal pathology had a probability of 96% for having a metabolic coma. The mean GCS score on admission was identical in the groups. Hospital mortality was 14% in the metabolic and 56% in the structural group. These findings indicate that unconscious young adults who present without a traumatic incident with a low or normal blood pressure and without signs of focal pathology most probably suffer from a metabolic disorder, wherefore computed tomography of the brain may be postponed and often avoided. Copyright © 2012 Elsevier Inc. All rights reserved.

  11. La narrazione orale tra bambini ed adulti: da flusso continuo a vena carsica?

    Directory of Open Access Journals (Sweden)

    Milena Bernardi


    Full Text Available Con il segmento di ricerca che viene presentato nella sua prima fase si prende in esame l’ipotesi di un processo, in atto da tempo, di trasformazione e/o di declino della narrazione orale nel rapporto quotidiano tra adulti e bambini, inteso, in questo specifico contesto, come “spia” dei mutamenti degli stili educativi e degli interscambi tra famiglie ed operatori dei servizi in relazione all’alleanza educativa. La complessità dei filoni di studio che rimandano alla voce “narrazione” negli ambiti delle scienze umane esige la precisazione della curvatura “narrativa” scelta per la ricerca in corso: curvatura che appartiene all’epistemologia della letteratura per l’infanzia e della pedagogia della narrazione in quanto permette di imboccare la strada della ricerca pedagogica rivolta innanzi tutto ai significati che il narrare assume nella relazione educativa e poi ai modi ed alle forme della narrazione che coinvolgono l’infanzia. In un’epoca di grande vitalità e visibilità delle narrazioni, tra cui abbondano le produzioni scritte, illustrate, filmate per l’infanzia, sembra esserci una zona marginale e quasi sommersa della comunicazione narrante che rischia di sfumare in una sorta di oblio. E’ la zona della narrazione orale esperita in praesentia da bambini ed adulti insieme, tessuta con fili di parole che restituiscono senso all’intero arco delle esperienze, tentando di riordinare il disordine che spesso connota la realtà, interpretando, stabilendo connessioni, impregnando di quel senso i vissuti, i fatti, le relazioni, le cose e le parole stesse, ancora, nelle voci. Del rischio e delle conseguenze che possono derivare dalla sua mancanza si occupa questo contributo di ricerca che, dal punto di vista metodologico, si è avvalso e si avvale sia di analisi condotte sul corpus dei testi sia della raccolta di dati e informazioni tramite incontri condotti con la modalità del focus group, con educatrici e genitori.

  12. Rates and Correlates of Violent Behaviors among Adolescents Treated in an Urban ED (United States)

    Walton, Maureen A.; Cunningham, Rebecca M.; Goldstein, Abby L.; Chermack, Stephen T.; Zimmerman, Marc; Bingham, C. Raymond; Shope, Jean T.; Stanley, Rachel; Blow, Frederic C.


    Purpose Violence is a leading cause of death for adolescents in inner-city settings. This paper describes violent behaviors in relation to other risk behaviors (e.g., substance use) among adolescents screened in an urban ED. Methods Patients ages 14–18 were approached to self-administer a computerized survey assessing violent behaviors (i.e., physical aggression), substance use (cigarettes, alcohol, marijuana), and weapon carriage. Results 1128 adolescents (83.8% participation rate; 45.9% male; 58.0% African-American) were surveyed. In the past year, 75.3% of adolescents reported peer violence, 27.6% reported dating violence, and 23.5% carried a weapon. In the past year, 28.0% drank alcohol, 14.4% binge drank, 5.7% reported alcohol-related fighting, and 36.9% smoked marijuana. Logistic regression analyses predicting violent behaviors were significant. Teens reporting peer violence were more likely to be younger, African-American, on public assistance, carry a weapon, binge drink, and smoke marijuana. Teens reporting dating violence were more likely to be female, African-American, carry a weapon, binge drink, screen positive for alcohol problems, and smoke marijuana. Teens reporting alcohol-related fighting were more likely to carry a weapon, binge drink, screen positive for alcohol problems, and smoke marijuana. Conclusions Adolescents presenting to an urban ED have elevated rates of violent behaviors. Substance use (i.e., binge drinking and smoking marijuana) is an important risk factor for violent behaviors among urban adolescents. Universal screening and intervention protocols to address multiple risk behaviors, including violent behaviors and substance use, may be useful to prevent injury among adolescents presenting to the urban ED. PMID:19541253

  13. Composition and microstructure of MTA and Aureoseal Plus: XRF, EDS, XRD and FESEM evaluation. (United States)

    Cianconi, L; Palopoli, P; Campanella, V; Mancini, M


    The aim of this study was to determine the chemical composition and the phases' microstructure of Aureoseal Plus (OGNA, Italy) and ProRoot MTA (Dentsply Tulsa Dental, USA) and to compare their characteristics. Study Design: Comparing Aureoseal Plus and ProRoot MTA microstructure by means of several analyses type. The chemical analysis of the two cements was assessed following the UNI EN ISO 196-2 norm. X-Ray fluorescence (XRF) was used to determine the element composition. The crystalline structure was analysed quantitatively using x-ray diffraction (XRD). Powders morphology was evaluated using a scanning electron microscope (SEM) with backscattering detectors, and a field emission scanning electron microscope (FESEM). Elemental analysis was performed by energy dispersive x-ray analysis (EDS). The semi-quantitative XRF analysis showed the presence of heavy metal oxides in both cements. The XRD spectra of the two cements reported the presence of dicalcium silicate, tricalcium silicate, tricalcium aluminate, tetracalcium aluminoferrite, bismuth oxide and gypsum. SEM analysis showed that ProRoot MTA powder is less coarse and more homogeneous than Aureoseal. Both powders are formed by particles of different shapes: round, prismatic and oblong. The EDS analysis showed that some ProRoot MTA particles, differently from Aureoseal, contain Ca, Si, Al and Fe. Oblong particles in ProRoot and Aureoseal are rich of bismuth. The strong interest in developing new Portland cement-based endodontic sealers will create materials with increased handling characteristics and physicochemical properties. A thorough investigation on two cement powders was carried out by using XRF, XRD, SEM and EDS analysis. To date there was a lack of studies on Aureoseal Plus. This cement is similar in composition to ProRoot MTA. Despite that it has distinctive elements that could improve its characteristics, resulting in a good alternative to MTA.

  14. Self-reported quality of life, anxiety and depression in individuals with Ehlers-Danlos syndrome (EDS): a questionnaire study. (United States)

    Berglund, Britta; Pettersson, Carina; Pigg, Maritta; Kristiansson, Per


    Many individuals with Ehlers-Danlos Syndrome (EDS) are hypermobile, suffer from long term pain, and have complex health problems. Since these sometimes have no objective physical signs, individuals with EDS sometimes are referred for psychiatric evaluation. The aim was therefore to identify the level of anxiety and quality of life in a Swedish group of individuals with EDS. A postal survey in 2008 was distributed to 365 members over 18 years of the Swedish National EDS Association and 250 with EDS diagnosis responded. Two questionnaires, the Hospital Anxiety and Depression Scale (HADS) and SF-36, were used. A Swedish population study was used to compare results from SF-36. Independent Student's t-test was used to compare differences between groups, possible relationships were tested using Spearman's correlation coefficient and the General Linear Model was used for regression analyses. Higher scores on HADS represent higher levels of anxiety and depression and higher scores on SF-36 represent higher quality of health. Of the respondents 74.8% scored high on anxiety and 22.4% scored high on depression on the HADS. Age, tiredness and back pain was independently associated with the HAD anxiety score in a multiple regression analysis, When comparing the SF-36 scores from the EDS group and a Swedish population group, the EDS group scored significantly lower, indicating lower health-related quality of health than the general population (p depression were detected in individuals with EDS. The importance to explore the factors behind these results and what initiatives can be taken to alleviate the situation for this group is emphasized.

  15. A Novel Method to Establish a Rat ED Model Using Internal Iliac Artery Ligation Combined with Hyperlipidemia


    Hu, Chao; Wang, Feixiang; Dong, Yehao; Dai, Jican


    OBJECTIVE: To investigate a novel method, namely using bilateral internal iliac artery ligation combined with a high-fat diet (BCH), for establishing a rat model of erectile dysfunction (ED) that, compared to classical approaches, more closely mimics the chronic pathophysiology of human ED after acute ischemic insult. MATERIALS AND METHODS: Forty 4-month-old male Sprague Dawley rats were randomly placed into five groups (n = 8 per group): normal control (NC), bilateral internal iliac artery l...

  16. Review: Michael Crandall & Karen E. Fisher (Eds) Digital Inclusion: Measuring the Impact of Information and Community Technology

    DEFF Research Database (Denmark)

    Pors, Niels Ole


    Review: Michael Crandall & Karen E. Fisher (Eds) Digital Inclusion: Measuring the Impact of Information and Community Technology. Medford. Information Today. ASIS&T Monographs, 2009. 185 pages. $ 59.50. ISBN 978-1-57387-373-4......Review: Michael Crandall & Karen E. Fisher (Eds) Digital Inclusion: Measuring the Impact of Information and Community Technology. Medford. Information Today. ASIS&T Monographs, 2009. 185 pages. $ 59.50. ISBN 978-1-57387-373-4...

  17. Evidence of salicylic acid pathway with EDS1 and PAD4 proteins by molecular dynamics simulation for grape improvement. (United States)

    Tandon, Gitanjali; Jaiswal, Sarika; Iquebal, M A; Kumar, Sunil; Kaur, Sukhdeep; Rai, Anil; Kumar, Dinesh


    Biotic stress is a major cause of heavy loss in grape productivity. In order to develop biotic stress-resistant grape varieties, the key defense genes along with its pathway have to be deciphered. In angiosperm plants, lipase-like protein phytoalexin deficient 4 (PAD4) is well known to be essential for systemic resistance against biotic stress. PAD4 functions together with its interacting partner protein enhanced disease susceptibility 1 (EDS1) to promote salicylic acid (SA)-dependent and SA-independent defense pathway. Existence and structure of key protein of systemic resistance EDS1 and PAD4 are not known in grapes. Before SA pathway studies are taken in grape, molecular evidence of EDS1: PAD4 complex is to be established. To establish this, EDS1 protein sequence was retrieved from NCBI and homologous PAD4 protein was generated using Arabidopsis thaliana as template and conserved domains were confirmed. In this study, computational methods were used to model EDS1 and PAD4 and simulated the interactions of EDS1 and PAD4. Since no structural details of the proteins were available, homology modeling was employed to construct three-dimensional structures. Further, molecular dynamic simulations were performed to study the dynamic behavior of the EDS1 and PAD4. The modeled proteins were validated and subjected to molecular docking analysis. Molecular evidence of stable complex of EDS1:PAD4 in grape supporting SA defense pathway in response to biotic stress is reported in this study. If SA defense pathway genes are explored, then markers of genes involved can play pivotal role in grape variety development especially against biotic stress leading to higher productivity.

  18. Period Determination for (23621) 1996 PA, (29564) 1998 ED6 and (31775) 1999 JN122 (United States)

    Marchini, Alessandro; Papini, Riccardo; Salvaggio, Fabio


    Photometric observations of three asteroids were conducted from the Astronomical Observatory of the University of Siena (Italy) in order to determine their synodic rotation periods. For (23621) 1996 PA, a Marscrosser asteroid, we found a period of 2.666 ± 0.001 h with an amplitude of 0.10 mag. For the two main-belt asteroids (29564) 1998 ED6 and (31775) 1999 JN122, we found, respectively, a period of 8.434 ± 0.002 h with an amplitude of 0.57 mag and a period of 4.319 ± 0.01 h with an amplitude of 0.12 mag.

  19. MobilED – a mobile tools and services platform for formal and informal learning

    CSIR Research Space (South Africa)

    Ford, M


    Full Text Available and the audio played. The teacher could add an audio/video annotation to add his/her ideas to the lesson plan. 2. Making existing educational video/animation “bytes” available to teachers and learners via MMS and data services. Interest in the project has... will discuss the vision of MobilED, cover the role of mobile phones in young people’s everyday knowledge acquisition and problem-solving situations, the applicability of this in an educational environment with a specific focus on the differences...

  20. Application of SEM/EDS to environmental geochemistry of heavy metals

    Directory of Open Access Journals (Sweden)

    Mateja Gosar


    Full Text Available Heavy metals represent a ubiquitous constituent of the near-surface environment, present in widely varyingconcentrations that typically have little impact on human behaviour and health. However, the mining of metals anduse of these metals in industrial processes has produced significant anthropogenic inputs of metals to both localand global environments. As such, a rigorous overview of the current accumulation of heavy metals and knowledgeof mineralogy of heavy metal-bearing phases is important for understanding their stability, solubility, mobility,bioavailability and toxicity. These data are of fundamental importance for environmental risk assessment and evaluationof future scenarios. Since conventional geochemical analyses provide limited information, other analyticalmethods have to be utilized for the characterisation of heavy metal-bearing phases. Significant analytical methodfor identification and characterisation of heavy metals in environmental media is a scanning electron microscopecoupled with energy dispersive X-ray spectrometer (SEM/EDS, an apparatus for qualitative and semi-quantitative chemical analysis at microne level, newly introduced to Geological Survey of Slovenia. Use of SEM/EDS was already introduced to environmental studies world-wide. In Slovenia, SEM/EDS analyses of environmental media werefirstly carried out on the Meža River stream sediments and snow deposits from Ljubljana urban area.Heavy metal-bearing phases in the Meža River stream sediments were apportioned to three source areas: Mežica mining/smelting area (geogenic-technogenic origin, Ravne ironworks area (technogenic origin and the Meža River catchment area (geogenic origin, which corresponds to data obtained by conventional geochemical and multivariate statistical methods. Airborne particles, identified in urban snow deposits, were interpreted as geogenic particles, represented by fragments of heavy metal-bearing minerals, and technogenic particles that

  1. Vlivy jaderné energetiky na životní prostředí


    Malkova, Kristina


    Title: Environmental impacts of nuclear energy Author: Malkova Kristina Supervisor: Ing. Luboš Matějíček, Dr., Ústav pro životní prostředí Přírodovědecké fakulty Univerzity Karlovy v Praze, Benátská 2, 128 01 Praha 2 Supervisor's e-mail adress: Abstract: The thesis is focused on study the impact of nuclear energy on the environment regard to non - renewable and renewable energy sources. The work includes evaluation of the entire fuel cycle of the use of various technolo...

  2. ESSEA On-Line Courses and the WestEd Eisenhower Regional Consortium (WERC) (United States)

    Rognier, E.


    The WestEd Eisenhower Regional Consortium (WERC) is in its second year of offering two Earth Systems Science On-line Graduate courses from IGES - one for High School teachers, and one for Middle School teachers. These high-quality courses support WERC's commitment to "supporting increased scientific and mathematical literacy among our nation's youth through services and other support aimed at enhancing the efforts of those who provide K-12 science and mathematics education." WERC has been able to use its EdGateway online community network to offer these courses to environmental education and science teachers nationwide. Through partnerships with the North American Association for Environmental Education (NAAEE), the National Environmental Education Advancement Project (NEEAP), and other regional, state and local science and environmental education organizations, WERC has a broad reach in connecting with science educators nationwide. WERC manages several state and national listservs, which enable us to reach thousands of educators with information about the courses. EdGateway also provides a private online community in which we offer the courses. WERC partners with two Master Teachers from Utah, who facilitate the courses, and with the Center for Science and Mathematics Education at Weber State University, who provides low-cost graduate credit for the courses. Our students have included classroom teachers from upper elementary through high school, community college science teachers, and environmental science center staff who provide inservice for teachers. Educators from Hawaii to New Jersey have provided diverse personal experiences of Earth Systems Science events, and add richness to the online discussions. Two Earth Science Experts, Dr. Rick Ford from Weber State University, and Dr. Art Sussman from WestEd also contribute to the high caliber of learning the students experience in the courses. (Dr. Sussman's book, Dr. Art's Guide to Planet Earth, is used as one of

  3. Experts: to crack down on violence in the ED, establish a robust system of reporting, educating staff. (United States)


    Researchers say that most ED personnel will experience some form of physical or verbal violence at some point in their careers. However, when such incidents are regularly reported, the patients involved can be flagged in a hospital's computer system, making future events involving the same patients much less likely. Further, when ED personnel are alert to the clues that a patient or family member is becoming agitated, early intervention can usually prevent the situation from escalating to violence. About one-half of all ED personnel will experience a physical assault, and 97%-100% will experience verbal abuse during their careers, according to research. A first step in developing a strategy for dealing with violence is to educate ED personnel about what constitutes workplace violence so that all such incidents can be reported. Experts say many ED workers fail to recognize some instances of violence, based on the intent of the person involved. However, intent should not be a factor, they say. In many cases, empathy and good customer service skills can prevent tense situations from escalating to violence, but experts say that it is important to intervene at the first sign of agitation. ED administrators should gather input from frontline staff on how to most effectively derail instances of violence.

  4. Do teachers and students get the Ed-Tech products they need: The challenges of Ed-Tech procurement in a rapidly growing market

    Directory of Open Access Journals (Sweden)

    Jennifer Morrison


    Full Text Available Ed-tech courseware products to support teaching and learning are being developed and made available for acquisition by school districts at a rapid rate. In this growing market, developers and providers face challenges with making their products visible to customers, while school district stakeholders must grapple with “discovering” which products of the many available best address their instructional needs. The present study presents the experiences with and perceptions about the procurement process from 47 superintendents representing diverse school districts in the U. S. Results indicate that, while improvements are desired in many aspects of the procurement process, the superintendents, overall, believe that, once desired products are identified, they are generally able to acquire them. Difficulties lie in tighter budgets, discovering products that are potentially the best choices, and evaluating the effectiveness of the products selected as options. These findings are presented and interpreted in relation to five major “Action Points” in the procurement process, and also with regard to implications for evaluating how educational technology impacts K-12 instruction.


    Directory of Open Access Journals (Sweden)

    Marco Greggi


    Full Text Available Nel lavoro gli autori esaminano il sistema della risoluzione alternativa delle controversie (ADR - Alternative Dispute Resolution nelle questioni fi scali in un’ottica comparatistica, ovvero alla luce delle legislazioni e delle dottrine italiana e croata. Nella prima parte del lavoro l’attenzione è rivolta all’esperienza italiana di attuazione del sistema ADR; mentre la seconda parte del lavoro è dedicata all’evoluzione del quadro normativo croato nei tentativi di costruzione di meccanismi di ADR. Il lavoro in entrambe le sue parti contiene una rassegna degli orientamenti dottrinali e attraverso i vari capitoli si sottolinea l’aspetto storico e teorico della questione esaminata. Gli autori dibattono ed espongono sul piano comparatistico anche le implicazioni dell’attuazione del sistema in esame; mentre l’infl uenza della dottrina di diritto pubblico sulla comparsa e lo sviluppo del sistema ADR viene evidenziata mediante l’esposizione della recente prassi italiana e croata del sistema di risoluzione dei contenziosi tributari.

  6. Quality assurance in transnational higher education: a case study of the tropEd network. (United States)

    Zwanikken, Prisca A C; Peterhans, Bernadette; Dardis, Lorraine; Scherpbier, Albert


    Transnational or cross-border higher education has rapidly expanded since the 1980s. Together with that expansion issues on quality assurance came to the forefront. This article aims to identify key issues regarding quality assurance of transnational higher education and discusses the quality assurance of the tropEd Network for International Health in Higher Education in relation to these key issues. Literature review and review of documents. From the literature the following key issues regarding transnational quality assurance were identified and explored: comparability of quality assurance frameworks, true collaboration versus erosion of national education sovereignty, accreditation agencies and transparency. The tropEd network developed a transnational quality assurance framework for the network. The network accredits modules through a rigorous process which has been accepted by major stakeholders. This process was a participatory learning process and at the same time the process worked positive for the relations between the institutions. The development of the quality assurance framework and the process provides a potential example for others.

  7. Improving utilization of antimicrobial drugs among physician assistants in the ED. (United States)

    Kiyatkin, Dmitry E; Wright, Scott; Zenilman, Jonathan; Kisuule, Flora


    This study examines the effectiveness of an educational intervention that used audit and feedback to influence physician assistant (PA) antimicrobial utilization in an emergency department (ED). Twelve ED PAs participated in this pre- and postintervention study. Their prescribing patterns were retrospectively reviewed and classified as appropriate, effective but inappropriate, or inappropriate using a previously developed methodology. A hospitalist physician conducted a 1-hour academic detailing intervention session with each PA that reviewed inappropriate prescribing practices and provided feedback for improvement based on current guidelines. After the meetings, the prescribing patterns of the providers were followed prospectively and comparisons were made between the proportions of antimicrobials prescribed appropriately and inappropriately before and after the intervention. The percentage of appropriate prescriptions increased from 64% (95% CI, 58-72) to 81% (95% CI, 75-86), whereas the proportion of inappropriate prescriptions decreased from 36% (95% CI, 31-43) to 19% (95% CI, 14-23) across the study periods (both P < .001). PA antimicrobial utilization was responsive to an academic detailing initiative that relied heavily on audit and feedback of past performance. Targeting PAs in quality improvement initiatives may be a highly effective way to influence change in health care utilization.

  8. Phosphate Reduction in Emulsifi ed Meat Products: Impact of Phosphate Type and Dosage on Quality Characteristics

    Directory of Open Access Journals (Sweden)

    Seline Glorieux


    Full Text Available Phosphate reduction is of important industrial relevance in the manufacturing of emulsifi ed meat products because it may give rise to a healthier product. The eff ect of seven diff erent phosphate types was tested on the physicochemical and quality characteristics to select the most promising phosphate type for further cooked sausage manufacturing. Next, phosphate mass fraction was gradually reduced. Tetrasodium di- or pyrophosphate (TSPP and sodium tripolyphosphate (STPP increased pH, reduced structural properties, resulted in the highest emulsion stability, lowest cooking loss and had litt le eff ect on hardness. Based on the viscoelastic properties, a minimum mass fraction of 0.06 % TSPP was suffi cient to obtain an acceptable quality product. Rheology proved to be a very useful tool to evaluate the quality of meat products, as it gives insight in the structure of the meat product and especially the functional properties of meat proteins. Based on the obtained results, it can be concluded that the current amount of phosphate added to emulsifi ed meat products can be signifi cantly reduced with minimal loss of product quality.

  9. Quality assurance in transnational higher education: a case study of the tropEd network (United States)


    Introduction Transnational or cross-border higher education has rapidly expanded since the 1980s. Together with that expansion issues on quality assurance came to the forefront. This article aims to identify key issues regarding quality assurance of transnational higher education and discusses the quality assurance of the tropEd Network for International Health in Higher Education in relation to these key issues. Methods Literature review and review of documents. Results From the literature the following key issues regarding transnational quality assurance were identified and explored: comparability of quality assurance frameworks, true collaboration versus erosion of national education sovereignty, accreditation agencies and transparency. The tropEd network developed a transnational quality assurance framework for the network. The network accredits modules through a rigorous process which has been accepted by major stakeholders. This process was a participatory learning process and at the same time the process worked positive for the relations between the institutions. Discussion The development of the quality assurance framework and the process provides a potential example for others. PMID:23537108

  10. Assessment of environmental enteropathy in the MAL-ED cohort study: theoretical and analytic framework. (United States)

    Kosek, Margaret; Guerrant, Richard L; Kang, Gagandeep; Bhutta, Zulfiqar; Yori, Pablo Peñataro; Gratz, Jean; Gottlieb, Michael; Lang, Dennis; Lee, Gwenyth; Haque, Rashidul; Mason, Carl J; Ahmed, Tahmeed; Lima, Aldo; Petri, William A; Houpt, Eric; Olortegui, Maribel Paredes; Seidman, Jessica C; Mduma, Estomih; Samie, Amidou; Babji, Sudhir


    Individuals in the developing world live in conditions of intense exposure to enteric pathogens due to suboptimal water and sanitation. These environmental conditions lead to alterations in intestinal structure, function, and local and systemic immune activation that are collectively referred to as environmental enteropathy (EE). This condition, although poorly defined, is likely to be exacerbated by undernutrition as well as being responsible for permanent growth deficits acquired in early childhood, vaccine failure, and loss of human potential. This article addresses the underlying theoretical and analytical frameworks informing the methodology proposed by the Etiology, Risk Factors and Interactions of Enteric Infections and Malnutrition and the Consequences for Child Health and Development (MAL-ED) cohort study to define and quantify the burden of disease caused by EE within a multisite cohort. Additionally, we will discuss efforts to improve, standardize, and harmonize laboratory practices within the MAL-ED Network. These efforts will address current limitations in the understanding of EE and its burden on children in the developing world. © The Author 2014. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail:

  11. Voluntary Medication Error Reporting by ED Nurses: Examining the Association With Work Environment and Social Capital. (United States)

    Farag, Amany; Blegen, Mary; Gedney-Lose, Amalia; Lose, Daniel; Perkhounkova, Yelena


    Medication errors are one of the most frequently occurring errors in health care settings. The complexity of the ED work environment places patients at risk for medication errors. Most hospitals rely on nurses' voluntary medication error reporting, but these errors are under-reported. The purpose of this study was to examine the relationship among work environment (nurse manager leadership style and safety climate), social capital (warmth and belonging relationships and organizational trust), and nurses' willingness to report medication errors. A cross-sectional descriptive design using a questionnaire with a convenience sample of emergency nurses was used. Data were analyzed using descriptive, correlation, Mann-Whitney U, and Kruskal-Wallis statistics. A total of 71 emergency nurses were included in the study. Emergency nurses' willingness to report errors decreased as the nurses' years of experience increased (r = -0.25, P = .03). Their willingness to report errors increased when they received more feedback about errors (r = 0.25, P = .03) and when their managers used a transactional leadership style (r = 0.28, P = .01). ED nurse managers can modify their leadership style to encourage error reporting. Timely feedback after an error report is particularly important. Engaging experienced nurses to understand error root causes could increase voluntary error reporting. Published by Elsevier Inc.

  12. Modeling environmental influences on child growth in the MAL-ED cohort study: opportunities and challenges. (United States)

    Richard, Stephanie A; McCormick, Benjamin J J; Miller, Mark A; Caulfield, Laura E; Checkley, William


    Although genetics, maternal undernutrition and low birth weight status certainly play a role in child growth, dietary insufficiency and infectious diseases are key risk factors for linear growth faltering during early childhood. A primary goal of the Etiology, Risk Factors and Interactions of Enteric Infections and Malnutrition and the Consequences for Child Health and Development (MAL-ED) study is to identify specific risk factors associated with growth faltering during the first 2 years of life; however, growth in early childhood is challenging to characterize because growth may be inherently nonlinear with age. In this manuscript, we describe some methods for analyzing longitudinal growth to evaluate both short- and long-term associations between risk factors and growth trajectories over the first 2 years of life across 8 resource-limited settings using harmonized protocols. We expect there will be enough variability within and between sites in the prevalence of risk factors and burden of linear growth faltering to allow us to distinguish some of the key pathways to linear growth faltering in the MAL-ED study. Published by Oxford University Press on behalf of the Infectious Diseases Society of America 2014. This work is written by (a) US Government employee(s) and is in the public domain in the US.

  13. Laboratory sample turnaround times: do they cause delays in the ED? (United States)

    Gill, Dipender; Galvin, Sean; Ponsford, Mark; Bruce, David; Reicher, John; Preston, Laura; Bernard, Stephani; Lafferty, Jessica; Robertson, Andrew; Rose-Morris, Anna; Stoneham, Simon; Rieu, Romelie; Pooley, Sophie; Weetch, Alison; McCann, Lloyd


    Blood tests are requested for approximately 50% of patients attending the emergency department (ED). The time taken to obtain the results is perceived as a common reason for delay. The objective of this study was therefore to investigate the turnaround time (TAT) for blood results and whether this affects patient length of stay (LOS) and to identify potential areas for improvement. A time-in-motion study was performed at the ED of the John Radcliffe Hospital (JRH), Oxford, UK. The duration of each of the stages leading up to receipt of 101 biochemistry and haematology results was recorded, along with the corresponding patient's LOS. The findings reveal that the mean time for haematology results to become available was 1 hour 6 minutes (95% CI: 29 minutes to 2 hours 13 minutes), while biochemistry samples took 1 hour 42 minutes (95% CI: 1 hour 1 minute to 4 hours 21 minutes), with some positive correlation noted with the patient LOS, but no significant variation between different days or shifts. With the fastest 10% of samples being reported within 35 minutes (haematology) and 1 hour 5 minutes (biochemistry) of request, our study showed that delays can be attributable to laboratory TAT. Given the limited ability to further improve laboratory processes, the solutions to improving TAT need to come from a collaborative and integrated approach that includes strategies before samples reach the laboratory and downstream review of results. © 2010 Blackwell Publishing Ltd.

  14. Mesofauna edáfica: indicador biológico de la calidad del suelo

    Directory of Open Access Journals (Sweden)

    Ana Socarrás

    Full Text Available La búsqueda, el uso y la aplicación de los indicadores de la calidad del suelo se han intensificado en las últimas décadas, debido a la necesidad de preservar este recurso no renovable e indispensable para la vida humana, ante el deterioro creciente. La selección de los indicadores se ha dirigido, fundamentalmente, a conocer el efecto de los usos aplicados y el curso de la rehabilitación de los suelos degradados o contaminados. Los grupos que integran la mesofauna edáfica son sensibles a las perturbaciones naturales y antrópicas del medio, las que provocan cambios en su composición específica y su abundancia, y ocasionan la pérdida de especies y de su diversidad, con la consiguiente disminución de la estabilidad y la fertilidad del suelo. Por ello la mesofauna edáfica es considerada como un buen indicador biológico de su estado de conservación. El número, la densidad y el balance de sus grupos permiten predecir y evaluar las transformaciones ocasionadas por la aplicación de diferentes métodos de producción agrícola en condiciones edafoclimáticas específicas, así como considerar integralmente el funcionamiento del ecosistema.

  15. Optical Klystron Enhancement to Self Amplified Spontaneous Emission at FERMI

    Directory of Open Access Journals (Sweden)

    Giuseppe Penco


    Full Text Available The optical klystron enhancement to a self-amplified spontaneous emission free electron laser has been studied in theory and in simulations and has been experimentally demonstrated on a single-pass high-gain free electron laser, the FERMI FEL-1, in 2014. The main concept consists of two undulators separated by a dispersive section that converts the energy modulation induced in the first undulator in density modulation, enhancing the coherent harmonic generation in the first part of the second undulator. This scheme could be replicated in a multi-stage: the bunching is enhanced after each dispersive section, consistently reducing the saturation length. We have applied the multi-stage optical klystron (OK scheme on the FEL-2 line at FERMI, whose layout includes three dispersive sections. Optimizing the strength of the dispersions allowed a significant increase of the self-amplified spontaneous emission (SASE intensity in comparison to a single-stage OK and extending to the soft-X rays the OK enhanced SASE previously demonstrated on FEL-1.

  16. Evaluating the Value of High Spatial Resolution in National Capacity Expansion Models using ReEDS

    Energy Technology Data Exchange (ETDEWEB)

    Krishnan, Venkat; Cole, Wesley


    This poster is based on the paper of the same name, presented at the IEEE Power & Energy Society General Meeting, July18, 2016. Power sector capacity expansion models (CEMs) have a broad range of spatial resolutions. This paper uses the Regional Energy Deployment System (ReEDS) model, a long-term national scale electric sector CEM, to evaluate the value of high spatial resolution for CEMs. ReEDS models the United States with 134 load balancing areas (BAs) and captures the variability in existing generation parameters, future technology costs, performance, and resource availability using very high spatial resolution data, especially for wind and solar modeled at 356 resource regions. In this paper we perform planning studies at three different spatial resolutions - native resolution (134 BAs), state-level, and NERC region level - and evaluate how results change under different levels of spatial aggregation in terms of renewable capacity deployment and location, associated transmission builds, and system costs. The results are used to ascertain the value of high geographically resolved models in terms of their impact on relative competitiveness among renewable energy resources.

  17. Evaluation and development of an ED management model: an effort to optimize patient-centered care. (United States)

    McDonough, Kelly S; Pemberton, Meg


    In 2008, the emergency department at Mary Washington Hospital was in the midst of a crisis marked by increasing volumes, increasing numbers of left without being seen (LWBS) patients, falling patient satisfaction numbers and a staff dissatisfied with ED leadership. The existing ED model of charge nurses, a nurse manager, and an administrative director was not working. The single nurse manager could not effectively manage the over 200 staff members he/she was assigned. Based upon the findings from the employee satisfaction survey the inability of the nurse managers to properly manage such large numbers of employees was at the core of the issue. Through benchmarking with a similar healthcare system, an evidence based leadership model was identified, developed, and implemented. The model included the addition of six patient care managers with 24-hour coverage in the department, led to a reduced number of direct reports per manager, and an increased connection with employees. The goal was to engage employees in the effort to provide patient centered, quality care. Residual benefits of our change effort improved the patient satisfaction scores as evidenced by meeting organizational goals within 12 months; goal was exceeded in the following year. Additionally, the walk out rate was reduced 75% over 18 months. The correlation between satisfied employees, patient satisfaction, and reduced walk-outs cannot be ignored. Engaged employees positively impact service and quality. Copyright © 2013 Emergency Nurses Association. Published by Mosby, Inc. All rights reserved.

  18. Evaluation of acid-base status in patients admitted to ED-physicochemical vs traditional approaches. (United States)

    Antonogiannaki, Elvira-Markela; Mitrouska, Ioanna; Amargianitakis, Vassilis; Georgopoulos, Dimitris


    The aim of this study is to evaluate the value of physicochemical, base excess (BE), and plasma bicarbonate concentration ([HCO3(-)]) approaches on the assessment of acid-base status in patients presented to the emergency department (ED). Upon presentation at ED, patients whose arterial blood was deemed in need of analysis were studied. Arterial blood gases, serum electrolytes, and proteins were measured and used to derive [HCO3(-)], BE, anion gap (AG), AG adjusted for albumin (AGadj), strong ion difference, strong ion gap (SIG) and SIG corrected for water excess/deficit (SIGcor). In each patient the acid-base status was evaluated using the BE, [HCO3(-)], and physicochemical approaches. A total of 365 patients were studied. Compared with BE (n = 202) and [HCO3(-)] (n = 151), physicochemical approach (n = 279) identified significantly more patients with metabolic acid-base disturbances (P physicochemical approach. The corresponding values with [HCO3(-)] approach were 108 and 95 (88%) patients. When patients with high AGadj were excluded, 44 patients with BE and 67 with [HCO3(-)] approach had normal acid-base status, and most of them exhibited at least 1 acid-base disturbance with the physicochemical approach, whereas 12 and 21 patients, respectively, had high SIGcor. Compared with the BE and [HCO3(-)] methods, the physicochemical approach has a better diagnostic accuracy to identify metabolic acid-base disturbances. Copyright © 2014 Elsevier Inc. All rights reserved.

  19. Carrying out a program for the support of photoelectric compact systems; 3. ed.; Durchfuehrung eines Programmes zur Foerderung photovoltaischer Kompaktsysteme

    Energy Technology Data Exchange (ETDEWEB)

    Bendel, C.


    The work target of the project consists of solving scientific/technical problems in the field of system technique of photoelectric compact systems of small output: - Reducing the manufacturing costs - Improving the efficiency - Improving the transfer of know-how from Research Institutions to industry - Supporting small and medium sized firms - Supporting the trade by improved transfer of know-how. (HW) [Deutsch] Das Arbeitsziel des Vorhabens bestand in der Loesung wissenschaftlich-technischer Probleme im Bereich der Systemtechnik photovoltaischer Kompaktsysteme kleiner Leistung: - Reduzierung der Herstellungskosten - Wirkungsgradverbesserung - Verbesserung des Know-How-Transfers vom Forschungsinstitut zur Industrie - Foerderung von Klein- u. mittelstaendischen Unternehmen - Unterstuetzung des Handwerks durch verbesserten Know-How Transfer. (HW)

  20. Vaccine coverage and adherence to EPI schedules in eight resource poor settings in the MAL-ED cohort study. (United States)

    Hoest, Christel; Seidman, Jessica C; Lee, Gwenyth; Platts-Mills, James A; Ali, Asad; Olortegui, Maribel Paredes; Bessong, Pascal; Chandyo, Ram; Babji, Sudhir; Mohan, Venkata Raghava; Mondal, Dinesh; Mahfuz, Mustafa; Mduma, Estomih R; Nyathi, Emanuel; Abreu, Claudia; Miller, Mark A; Pan, William; Mason, Carl J; Knobler, Stacey L


    Launched in 1974, the Expanded Program on Immunization (EPI) is estimated to prevent two-three million deaths annually from polio, diphtheria, tuberculosis, pertussis, measles, and tetanus. Additional lives could be saved through better understanding what influences adherence to the EPI schedule in specific settings. The Etiology, Risk Factors and Interactions of Enteric Infections and Malnutrition and the Consequences for Child Health and Development (MAL-ED) study followed cohorts in eight sites in South Asia, Africa, and South America and monitored vaccine receipt over the first two years of life for the children enrolled in the study. Vaccination histories were obtained monthly from vaccination cards, local clinic records and/or caregiver reports. Vaccination histories were compared against the prescribed EPI schedules for each country, and coverage rates were examined in relation to the timing of vaccination. The influence of socioeconomic factors on vaccine timing and coverage was also considered. Coverage rates for EPI vaccines varied between sites and by type of vaccine; overall, coverage was highest in the Nepal and Bangladesh sites and lowest in the Tanzania and Brazil sites. Bacillus Calmette-Guérin coverage was high across all sites, 87-100%, whereas measles vaccination rates ranged widely, 73-100%. Significant delays between the scheduled administration age and actual vaccination date were present in all sites, especially for measles vaccine where less than 40% were administered on schedule. A range of socioeconomic factors were significantly associated with vaccination status in study children but these results were largely site-specific. Our findings highlight the need to improve measles vaccination rates and reduce delayed vaccination to achieve EPI targets related to the establishment of herd immunity and reduction in disease transmission. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

  1. Impact of a bronchiolitis guideline on ED resource use and cost: a segmented time-series analysis. (United States)

    Akenroye, Ayobami T; Baskin, Marc N; Samnaliev, Mihail; Stack, Anne M


    Bronchiolitis is a major cause of infant morbidity and contributes to millions of dollars in health care costs. Care guidelines may cut costs by reducing unnecessary resource utilization. Through the implementation of a guideline, we sought to reduce unnecessary resource utilization and improve the value of care provided to infants with bronchiolitis in a pediatric emergency department (ED). We conducted an interrupted time series that examined ED visits of 2929 patients with bronchiolitis, aged 1 to 12 months old, seen between November 2007 and April 2013. Outcomes were proportion having a chest radiograph (CXR), respiratory syncytial virus (RSV) testing, albuterol or antibiotic administration, and the total cost of care. Balancing measures included admission rate, returns to the ED resulting in admission within 72 hours of discharge, and ED length of stay (LOS). There were no significant preexisting trends in the outcomes. After guideline implementation, there was an absolute reduction of 23% in CXR (95% confidence interval [CI]: 11% to 34%), 11% in RSV testing (95% CI: 6% to 17%), 7% in albuterol use (95% CI: 0.2% to 13%), and 41 minutes in ED LOS (95% CI: 16 to 65 minutes). Mean cost per patient was reduced by $197 (95% CI: $136 to $259). Total cost savings was $196,409 (95% CI: $135,592 to $258,223) over the 2 bronchiolitis seasons after guideline implementation. There were no significant differences in antibiotic use, admission rates, or returns resulting in admission within 72 hours of discharge. A bronchiolitis guideline was associated with reductions in CXR, RSV testing, albuterol use, ED LOS, and total costs in a pediatric ED.

  2. Use of a midstream clean catch mobile application did not lower urine contamination rates in an ED. (United States)

    Jacob, Mary S; Kulie, Paige; Benedict, Cameron; Ordoobadi, Alexander J; Sikka, Neal; Steinmetz, Erika; McCarthy, Melissa L


    Urine microscopy is a common test performed in emergency departments (EDs). Urine specimens can easily become contaminated by different factors, including the collection method. The midstream clean-catch (MSCC) collection technique is commonly used to reduce urine contamination. The urine culture contamination rate from specimens collected in our ED is 30%. We developed an instructional application (app) to show ED patients how to provide a MSCC urine sample. We hypothesized that ED patients who viewed our instructional app would have significantly lower urine contamination rates compared to patients who did not. We prospectively enrolled 257 subjects with a urinalysis and/or urine culture test ordered in the ED and asked them to watch our MSCC instructional app. After prospective enrollment was complete, we retrospectively matched each enrolled subject to an ED patient who did not watch the instructional app. Controls were matched to cases based on gender, type of urine specimen provided, ED visit date and shift. Urinalysis and urine culture contamination results were compared between the matched pairs using McNemar's test. The overall urine culture contamination rate of the 514 subjects was 38%. The majority of the matched pairs had a urinalysis (63%) or urinalysis plus urine culture (35%) test done. There were no significant differences in our urine contamination rates between the matched pairs overall or when stratified by gender, by prior knowledge of the clean catch process or by type of urine specimen. We did not see a lower contamination rate for patients who viewed our instructional app compared to patients who did not. It is possible that MSCC is not effective for decreasing urine specimen contamination. Copyright © 2017 Elsevier Inc. All rights reserved.

  3. Should we fear "flu fear" itself? Effects of H1N1 influenza fear on ED use. (United States)

    McDonnell, William M; Nelson, Douglas S; Schunk, Jeff E


    Surges in patient volumes compromise emergency departments' (EDs') ability to deliver care, as shown by the recent H1N1 influenza (flu) epidemic. Media reports are important in informing the public about health threats, but the effects of media-induced anxiety on ED volumes are unclear. The aim of this study is to examine the effect of widespread public concern about flu on ED use. We reviewed ED data from an integrated health system operating 18 hospital EDs. We compared ED visits during three 1-week periods: (a) a period of heightened public concern regarding flu before the disease was present ("Fear Week"), (b) a subsequent period of active disease ("Flu Week"), and (c) a week before widespread concern ("Control Week"). Fear Week was identified from an analysis of statewide Google electronic searches for "swine flu" and from media announcements about flu. Flu Week was identified from statewide epidemiological data. Data were reviewed from 22 608 visits during the study periods. Fear Week (n = 7712) and Flu Week (n = 7687) were compared to Control Week (n = 7209). Fear Week showed a 7.0% increase in visits (95% confidence interval, 6-8). Pediatric visits increased by 19.7%, whereas adult visits increased by 1%. Flu Week showed an increase over Control Week of 6.6% (95% confidence interval, 6-7). Pediatric visits increased by 10.6%, whereas adult visits increased by 4.8%. At a time of heightened public concern regarding flu but little disease prevalence, EDs experienced substantial increases in patient volumes. These increases were significant and comparable to the increases experienced during the subsequent epidemic of actual disease. Copyright © 2012 Elsevier Inc. All rights reserved.

  4. Feasibility of a computer-assisted alcohol SBIRT program in an urban emergency department: patient and research staff perspectives

    National Research Council Canada - National Science Library

    Murphy, Mary K; Bijur, Polly E; Rosenbloom, David; Bernstein, Steven L; Gallagher, E John


    ...) program to identify at-risk alcohol users among adult emergency department (ED) patients. The study aimed to evaluate the feasibility of implementing a computerized screening, brief intervention, and referral to treatment...

  5. Improving predictions of carbon fluxes in the tropics undre climatic changes using ED2 (United States)

    Feng, X.; Uriarte, M.


    Tropical forests play a critical role in the exchange of carbon between land and atmosphere, highlighting the urgency of understanding the effects of climate change on these ecosystems. The most optimistic predictions of climate models indicate that global mean temperatures will increase by up to 2 0C with some tropical regions experiencing extreme heat. Drought and heat-induced tree mortality will accelerate the release of carbon to the atmosphere creating a positive feedback that greatly exacerbates global warming. Thus, under a warmer and drier climate, tropical forests may become net sources, rather than sinks, of carbon. Earth system models have not reached a consensus on the magnitude and direction of climate change impacts on tropical forests, calling into question the reliability of their predictions. Thus, there is an immediate need to improve the representation of tropical forests in earth system models to make robust predictions. The goal of our study is to quantify the responses of tropical forests to climate variability and improve the predictive capacity of terrestrial ecosystem models. We have collected species-specific physiological and functional trait data from 144 tree species in a Puerto Rican rainforest to parameterize the Ecosystem Demography model (ED2). The large amount of data generated by this research will lead to better validation and lowering the uncertainty in future model predictions. To best represent the forest landscape in ED2, all the trees have been assigned to three plant functional types (PFTs): early, mid, and late successional species. Trait data for each PFT were synthesized in a Bayesian meta-analytical model and posterior distributions of traits were used to parameterize the ED2 model. Model predictions show that biomass production of late successional PFT (118.89 ton/ha) was consistently higher than mid (71.33 ton/ha) and early (13.21 ton/ha) PFTs. However, mid successional PFT had the highest contributions to NPP for the

  6. Early primary care follow-up after ED and hospital discharge - does it affect readmissions? (United States)

    Sinha, Sanjai; Seirup, Joanna; Carmel, Amanda


    After hospitalization, timely discharge follow-up has been linked to reduced readmissions in the heart failure population, but data from general inpatients has been mixed. The objective of this study was to determine if there was an association between completed follow-up appointments within 14 days of hospital discharge and 30-day readmission amongst primary care patients at an urban academic medical center. Index discharges included both inpatient and emergency room settings. A secondary objective was to identify patient factors associated with completed follow-up appointments within 14 days. We conducted a retrospective review of primary care patients at an urban academic medical center who were discharged from either the emergency department (ED) or inpatient services at the Weill Cornell Medical Center/New York Presbyterian Hospital from 1 January 2014-31 December 2014. Cox proportional hazard models were used to identify the relationship between follow-up in primary care within 14 days and readmission within 30 days. Logistic regression was used to evaluate the association of patient factors with 14-day follow-up. Among 9,662 inpatient and ED discharges, multivariable analysis (adjusting for age, gender, race/ethnicity, insurance, number of diagnoses on problem list, length of stay, and discharge service) showed that follow-up with primary care within 14 days was not associated with a lower hazard of readmission within 30 days (HR = 0.78; 95% CI 0.56-1.09). A higher number of diagnoses on the problem list was associated with greater odds of follow-up for both inpatient and emergency department discharges (inpatient: HR = 1.03, 95% CI 1.02-1.04; ED: HR = 1.02, 95% CI 1.00-1.04). For inpatient discharges, each additional day in length of stay was associated with 3% lower odds of follow-up (HR = 0.97, 95% CI 0.96-0.99). Early follow-up within 14 days after discharge from general inpatient services was associated with a trend toward lower hazard of

  7. Dynamic evapotranspiration in tree-resolving LES - The ED2RAFLES model (United States)

    Bohrer, G.; Medvigy, D.


    How evapotranspiration scales from individual plants to a landscape is a critical problem in hydrology. To investigate this problem, we developed a version of the RAMS-Based Forest Large Eddy Simulations (RAFLES) which includes a dynamic, multi-layered evapotranspiration and CO2 uptake. RAFLES resolves vegetation as a heterogeneous 3D field. It can run at resolutions down to 1 m^3 and can incorporate explicit canopy representations derived from lidar. The canopy influences dynamics through a drag term, proportional to the leaf density at each numerical cell, and as a solid volume, which blocks some of the volume and apertures inside the canopy space. To calculate the exchange of scalar fluxes between the canopy and the air, the Ecosystem Demography version 2 (ED2) was coupled with RAFLES. ED2RAFLES dynamically resolves sensible heat fluxes, evapotranspiration, radiative transfer, and carbon fluxes. The surface energy budget is solved at vertical levels inside the canopy to find the skin temperature of the leaves and soil surface, and evapotranspiration rates. Evapotranspiration is also driven by frictional velocity near the leaves and is further restricted by stomatal conductance, parameterized using a Ball-Berry scheme, and by soil water availability. We tested the sensitivity of modeled evapotranspiration to the dynamic representation for a virtual canopy domain, based on the spatial structure of the forest around the Ameriflux eddy-flux tower, at the University of Michigan Biological Station (UMBS). A “test” simulation used the dynamic ED2-driven evaporation. A “control” simulation prescribed sensible and latent heat fluxes as a function of LAI and light attenuation at a rate equal to the mean heat flux from the test simulation. The simulation differed in the degree of spatial heterogeneity of fluxes across the domains and in the coherency between canopy structure and evaporation. Quantifying this coherency is important to our understanding of the

  8. Management of ED under the "severe distress" criteria in the NHS: a real-life study. (United States)

    Mohee, Amar; Bretsztajn, Laure; Storey, Anne; Eardley, Ian


    The United Kingdom is unusual in that a significant proportion of patients with erectile dysfunction (ED) have their treatment fully reimbursed by the National Health Service (NHS). This may have consequences for the choice of treatment and for compliance with treatment. The aim of this study was to evaluate the use and cost implications of phosphodiesterase type 5 inhibitor in an NHS setting. Basic demographics and data on ED management for patients treated from January 2000 to April 2011 were obtained from a prospectively accrued database. We reviewed drug usage and costs as well as switching between drugs. Patients were given the choice of all available therapies and were followed up annually. Switching, compliance, and costs of treating ED under the "severe distress" criteria in the NHS were reviewed for this study. Two thousand one hundred fifty-nine patients qualified for reimbursed therapy. Two hundred twenty-six patients were excluded from further analysis owing to missing data. Patients were followed up on an annual basis. The mean patient age was 60.2 years (min 23, max 90), and the mean follow-up was 50.8 months (min 1, max 127). Six hundred ninety-six were started on sildenafil, 990 on tadalafil, 163 on vardenafil, and 84 on intracavernosal alprostadil. Eighteen percent of patients initially started on the scheme and stopped medication unilaterally. Of the patients, 12.3% changed their medication during follow-up. The cost of drugs increased year by year from £257,100 in 2007 to £352,519 in 2011. Our real-life observational study shows that in our institution, dropout of therapy is unusual. We hypothesize that this reflects, in part, the reimbursement issue. We also found that switching between drugs was unusual, although there are several possible explanations for that. Although this is a successful system for the patients, the hospital, which bears the costs of medication, is finding this an increasing economic drain. © 2014 International Society

  9. WDS versus silicon drift detector EDS: a case report for the comparison of quantitative chemical analyses of natural silicate minerals. (United States)

    Cubukçu, H Evren; Ersoy, Orkun; Aydar, Erkan; Cakir, Uner


    Electron probe microanalysis (EPMA) is an essential analytical approach to determine elemental concentrations of various solid specimens quantitatively in mineralogical, petrological and materials research. Either wavelength dispersive X-ray (WDS) or energy dispersive X-ray (EDS) spectrometric techniques can collect the characteristic X-rays generated from each element in the specimen by an incident electron beam in order to define chemical constituents. Although WDS has been the preferred technique because of its higher spectral resolution and ability to detect trace elements, new generation EDS systems with silicon drift detectors (SDD), equipped with thin windows and integrated digital processing electronics, are claimed to approach the WDS throughput. In this study, we compared the analytical capability of a SDD EDS system with respect to WDS equipped systems on natural silicate minerals. For this purpose, natural rock samples, in which the silicate minerals present had already been analysed by various WDS systems, were chosen to compare these results with the ones acquired with a SDD EDS system. SDD EDS yielded satisfactory results for major elements (Na, Mg, Al, Si, K, Ca, Ti, Mn and Fe) compared with the results of the same minerals obtained by various WDS systems.

  10. Reliability and validity of the Conditional Goal Setting in Eating Disorders Scale (CGS-EDS) among adults with eating disorders. (United States)

    Watson, Hunna J; Street, Helen; Raykos, Bronwyn C; Byrne, Susan M; Fursland, Anthea; Nathan, Paula R


    The aim of this study was to develop and validate a self-report measure of Conditional Goal Setting (CGS) for use among individuals with eating disorders, the Conditional Goal Setting in Eating Disorders Scale (CGS-EDS). The CGS-EDS assesses the degree to which an individual believes that the achievement of happiness is contingent upon the attainment of body shape and weight goals. Women with a DSM-IV diagnosed eating disorder consecutively referred to a specialist outpatient clinic (N=238) completed the CGS-EDS and self-report measures of theoretically related constructs. Exploratory factor analysis indicated a one-factor solution, which accounted for 65% of the variance. The CGS-EDS correlated positively with theoretically related measures of overvaluation of shape and weight, concern with shape and weight, dichotomous thinking, and depression. The alpha reliability of the scale was .92. The CGS-EDS is a valid and reliable measure of CGS in eating disorders and is relevant to cognitive and behavioral models of maintenance and intervention. Copyright 2009 Elsevier Ltd. All rights reserved.


    Directory of Open Access Journals (Sweden)

    O. M. Bondarev


    Full Text Available Purpose. The purpose of article is to develop the measures of hardness indices improvement of the supporting structures of motor cars of the electric trains ED9M. Methodology. In order to achieve the above stated aims the following measures had to be done: to develop a finite element model of the supporting structures of the motor bogie of the electric train ED9M, determine parameters of the developed model; perform the calculations to determine the stress-strain state during loads corresponding to different operating conditions with the search of geometric parameters reducing the highest stress levels. Findings. The obtained results of calculations (fields of stress distribution and strains in the elements of the motor bogie frame from the viewpoint of the strength and stiffness discovered the best geometric parameters of the bearings in the central suspension beams of the electric trains ED9M in the places of load transmission from the car body to the bogie frame. Originality. Based on the developed finite element models and the theoretical and experimental researches the scientifically grounded modernization measures of the construction elements of the central suspension beams for motor bogies of the electric trains ED9M were developed. Practical value. It was developed an engineering solution concerning the measures to improve the strength and stiffness characteristics of the central suspension beams for the motor cars of the electric trains ED9M. It was given to the Ukrzaliznytsya’s professionals to implement them during repairs.

  12. The HEADS-ED: a rapid mental health screening tool for pediatric patients in the emergency department. (United States)

    Cappelli, Mario; Gray, Clare; Zemek, Roger; Cloutier, Paula; Kennedy, Allison; Glennie, Elizabeth; Doucet, Guy; Lyons, John S


    The American Academy of Pediatrics called for action for improved screening of mental health issues in the emergency department (ED). We developed the rapid screening tool home, education, activities/peers, drugs/alcohol, suicidality, emotions/behavior, discharge resources (HEADS-ED), which is a modification of "HEADS," a mnemonic widely used to obtain a psychosocial history in adolescents. The reliability and validity of the tool and its potential for use as a screening measure are presented. ED patients presenting with mental health concerns from March 1 to May 30, 2011 were included. Crisis intervention workers completed the HEADS-ED and the Child and Adolescent Needs and Strengths-Mental Health tool (CANS MH) and patients completed the Children's Depression Inventory (CDI). Interrater reliability was assessed by using a second HEADS-ED rater for 20% of the sample. A total of 313 patients were included, mean age was 14.3 (SD 2.63), and there were 182 females (58.1%). Interrater reliability was 0.785 (P mental health concerns.

  13. Origine ed evoluzione dell'universo dal big-bang alle galassie

    CERN Document Server

    Gratton, Livio


    Il volume, destinato a un vasto pubblico di lettori anche non particolarmente versati in materie scientifiche, offre un panorama aggiornato e completo degli sviluppi più recenti della cosmologia, la scienza che studia l'Universo nel suo complesso. Abbandonate ormai completamente visioni mitiche e geocentriche, la moderna cosmologia ripresenta come un ambizioso e affascinante tentativo di creare un modello unitario dell'Universo e della sua evoluzione attraverso gli strumenti della fisica e dell'astronomia. In questo quadro, nato da una profonda riflessione sui concetti di spazio e di tempo sviluppatasi nei primi decenni del secolo soprattutto da parte di Einstein, e sostenuto dal prodigioso progresso della tecnologia che ha aperto nuove e rivoluzionarie possibilità di osservazione, un succedersi sempre più incalzante ed emozionante di scoperte sta rivelando un panorama inaspettatamente vario, complesso, e allo stesso tempo semplice e unitario, la cui interpretazione richiede al cosmologo rigore, fantasia e...

  14. Temperature dependence of direct current conductivity in Ag-ED20 nanocomposite films (United States)

    Novikov, G. F.; Rabenok, E. V.; Bogdanova, L. M.; Irzhak, V. I.


    The effect of silver nanoparticles (NPs) in the concentration range of ≤0.8 wt % have on direct current conductivity σdc of Ag-ED20 nanocomposite is studied by method of broadband dielectric spectroscopy (10-2-105 Hz) method of broadband dielectric spectroscopy. It is found that temperature dependence σdc consists of two sections: above the glass transition temperature ( T g), the dependence corresponds to the empirical Vogel-Fulcher-Tammann law (Vogel temperature T 0 does not depend on the NP concentration); below T g, the dependence is Arrhenius with activation energy E a ≈ 1.2 eV. In the region where T > T g, the σdc value grows along with NP concentration. It is concluded that the observed broken form of the temperature dependence is apparently due to a change in the conduction mechanism after the freezing of ion mobility at temperatures below T g.

  15. Enrico Biasin - Giovanna Maina - Federico Zecca (Eds., Porn After Porn. Contemporary Alternative Pornographies

    Directory of Open Access Journals (Sweden)

    Mirko Lino


    Full Text Available Dopo Il Porno Espanso, recensito a suo tempo su Between, il nuovo libro a cura di Enrico Biasin, Giovanna Maina e Federico Zecca, Porn After Porn, è il primo tassello di un'interessante collana, “Mapping Pornographies: Histories, Geographies, Cultures”, che ha l'obiettivo di fornire materiali e strumenti metodologici al dibattito scientifico sulla pornografia contemporanea.I contributi che compongono il volume, dai saggi prettamente accademici alle testimonianze di artisti, produttori e registi del porno, creano tra loro fitte geometrie tematiche che illustrano i corpi, gli usi dei new media, gli sguardi e i consumi delle pornografie alternative, dalla loro proliferazione in Rete alla democratizzazione dell'accesso ai piaceri visivi inscritti nella fruizione di contenuti hard-core a pubblici non esclusivamente maschili ed eterosessuali.

  16. Microstructure evolution of directionally solidifi ed Sn-16%Sb hyperperitectic alloy

    Directory of Open Access Journals (Sweden)

    Li Shuangming


    Full Text Available The directionally solidifi ed microstructure of Sn-16%Sb hyperperitectic alloy has been investigated at various solidifi cation rates using a high-thermal gradient directional solidifi cation apparatus. The results indicate that the solidifi cation microstructure consists of hard primary intermetallic SnSb phase embedded in a matrix of soft peritectic β-Sn phase. The primary SnSb phase exhibits faceted growth with tetragonal or trigonal shapes. At the same time, the primary SnSb phase is refi ned with an increase in the solidifi cation rate and dispersed more uniformly in the matrix of β-Sn phase. The volume fraction of the SnSb phase fi rstly decreases and then increases when the solidifi cation rate increases in directional solidifi cation of Sn-16%Sb hyperperitectic alloy.

  17. Book Review: The Communicating Leader: The key to strategic alignment (2nd Ed

    Directory of Open Access Journals (Sweden)

    X. C. Birkenbach


    Full Text Available Title: The Communicating Leader: The key to strategic alignment (2nd Ed Author: Gustav Puth Publisher: Van Schaik Publishers Reviewer: XC Birkenbach The aim of the book according to the author, is "meant to be a usable tool, an instrument in the toolbox of the real leader and leadership student". The book is written in conversational style (as intended by the author and the 219 pages of the 10 chapters are logically packaged into three parts. While the main emphasis is naturally on leadership and communication, the coverage includes topics typically encountered in Organisational Behaviour or Management texts, e.g., organizational culture, managing change, motivation, conflict management and strategic management.

  18. The FAST-ED App: A Smartphone Platform for the Field Triage of Patients With Stroke. (United States)

    Nogueira, Raul G; Silva, Gisele S; Lima, Fabricio O; Yeh, Yu-Chih; Fleming, Carol; Branco, Daniel; Yancey, Arthur H; Ratcliff, Jonathan J; Wages, Robert Keith; Doss, Earnest; Bouslama, Mehdi; Grossberg, Jonathan A; Haussen, Diogo C; Sakano, Teppei; Frankel, Michael R


    The Emergency Medical Services field triage to stroke centers has gained considerable complexity with the recent demonstration of clinical benefit of endovascular treatment for acute ischemic stroke. We sought to describe a new smartphone freeware application designed to assist Emergency Medical Services professionals with the field assessment and destination triage of patients with acute ischemic stroke. Review of the application's platform and its development as well as the different variables, assessments, algorithms, and assumptions involved. The FAST-ED (Field Assessment Stroke Triage for Emergency Destination) application is based on a built-in automated decision-making algorithm that relies on (1) a brief series of questions assessing patient's age, anticoagulant usage, time last known normal, motor weakness, gaze deviation, aphasia, and hemineglect; (2) a database of all regional stroke centers according to their capability to provide endovascular treatment; and (3) Global Positioning System technology with real-time traffic information to compute the patient's eligibility for intravenous tissue-type plasminogen activator or endovascular treatment as well as the distances/transportation times to the different neighboring stroke centers in order to assist Emergency Medical Services professionals with the decision about the most suitable destination for any given patient with acute ischemic stroke. The FAST-ED smartphone application has great potential to improve the triage of patients with acute ischemic stroke, as it seems capable to optimize resources, reduce hospital arrivals times, and maximize the use of both intravenous tissue-type plasminogen activator and endovascular treatment ultimately leading to better clinical outcomes. Future field studies are needed to properly evaluate the impact of this tool in stroke outcomes and resource utilization. © 2017 American Heart Association, Inc.

  19. Microwave oven-related injuries treated in hospital EDs in the United States, 1990 to 2010. (United States)

    Thambiraj, Dana F; Chounthirath, Thiphalak; Smith, Gary A


    The widespread availability of microwave ovens has sparked interest in injuries resulting from their use. Using a retrospective cohort design, the objective of this study is to investigate the epidemiology of microwave oven-related injuries treated in United States emergency departments (EDs) from 1990 through 2010 by analyzing data from the National Electronic Injury Surveillance System. An estimated 155959 (95% confidence interval [CI], 133515-178402) individuals with microwave oven-related injuries were treated in US hospital EDs from 1990 through 2010, which equals an average of 21 individuals per day; 60.7% were female; 63.3% were adults (≥18 years); 98.1% of injury events occurred at home; and 3.9% of patients were hospitalized. During the 21-year study period, the number and rate of microwave oven-related injuries increased significantly by 93.3% and 50.0%, respectively. The most common mechanism of injury was a spill (31.3%), and the most common body region injured was the hand and fingers (32.4%). Patients younger than 18 years were more likely to sustain an injury to their head and neck (relative risk: 1.65; 95% CI, 1.39-1.96) than adults. To our knowledge, this is the first study to investigate microwave oven-related injuries on a national scale. Microwave ovens are an important source of injury in the home in the United States. The large increases in the number and rate of these injuries underscore the need for increased prevention efforts, especially among young children. Copyright © 2013 Elsevier Inc. All rights reserved.


    Directory of Open Access Journals (Sweden)

    N. V. Zhelninskaya


    Full Text Available Statistical methods play an important role in the objective evaluation of quantitative and qualitative characteristics of the process and are one of the most important elements of the quality assurance system production and total quality management process. To produce a quality product, one must know the real accuracy of existing equipment, to determine compliance with the accuracy of a selected technological process specified accuracy products, assess process stability. Most of the random events in life, particularly in manufacturing and scientific research, are characterized by the presence of a large number of random factors, is described by a normal distribution, which is the main in many practical studies. Modern statistical methods is quite difficult to grasp and wide practical use without in-depth mathematical training of all participants in the process. When we know the distribution of a random variable, you can get all the features of this batch of products, to determine the mean value and the variance. Using statistical control methods and quality control in the analysis of accuracy and stability of the technological process of production of epoxy resin ED20. Estimated numerical characteristics of the law of distribution of controlled parameters and determined the percentage of defects of the investigated object products. For sustainability assessment of manufacturing process of epoxy resin ED-20 selected Shewhart control charts, using quantitative data, maps of individual values of X and sliding scale R. Using Pareto charts identify the causes that affect low dynamic viscosity in the largest extent. For the analysis of low values of dynamic viscosity were the causes of defects using Ishikawa diagrams, which shows the most typical factors of the variability of the results of the process. To resolve the problem, it is recommended to modify the polymer composition of carbon fullerenes and to use the developed method for the production of

  1. Acute neck pain in the ED: Consider longus colli calcific tendinitis vs meningitis. (United States)

    Patel, Tyag K; Weis, James C


    Presented here is a rare cause of severe neck pain - acute longus colli calcific tendinitis - in a 54year old man who presented to the emergency department. The neck pain is due to inflammation caused by calcium hydroxyapatite crystal deposition in the tendons on the longus colli muscles. This is non-infectious. The gold standard for diagnosis is a CT neck which best shows the calcifications in the anterior vertebral column of C1-C4, where the tendons of these muscles insert bilaterally. Longus colli calcific tendinitis is not life-threatening and patients will make a full recovery after treatment with NSAIDs. However, this condition is often confused with life-threatening conditions such as infection (meningitis or retropharyngeal abscess), intracranial hemorrhage, trauma, herniation of cervical discs, or malignancy (Estimable et al. (2015) [1]). Symptoms associated with calcific tendinitis of the longus colli muscle are non-specific and include mild fever, moderate-severe headache, neck pain, and drastically reduced range of motion of the neck. More specific symptoms are the presence of dysphagia and odynophagia. Lab findings usually are significant for mild leukocytosis, and elevated ESR and CRP. Awareness of this condition by E.D. physicians can avoid unnecessary invasive interventions, increased costs, and delays that result from incorrect diagnosis and treatment. This is a unique case in which a patient who was afebrile with a normal ESR was worked up for meningitis and an intracranial process, and also empirically treated for meningitis before finally being diagnosed with acute calcific tendinitis of the longus colli muscle in the E.D. Copyright © 2017 Elsevier Inc. All rights reserved.

  2. Analysis of closed malpractice medical claims against Taiwanese EDs: 2003 to 2012. (United States)

    Wu, Kuan-Han; Wu, Chien-Hung; Cheng, Shih-Yu; Lee, Wen-Huei; Kung, Chia-Te


    The objective of the study is to examine the epidemiologic data of closed malpractice medical claims against emergency departments (EDs) in Taiwanese civil courts and to identify high-risk diseases. We conducted a retrospective study and reviewed the verdicts from the national database of the Taiwan judicial system that pertained to EDs. Between 2003 and 2012, a total of 63 closed medical claims were included. Seven cases (11.1%) resulted in an indemnity payment, 55.6% of the cases were closed in the district court, but appeals were made to the supreme court in 12 cases (19.1%). The mean incident-to-litigation closure time was 57.7 ± 26.8 months. Of the cases with indemnity paid, 5 cases (71.4%) were deceased, and 2 cases (28.6%) were gravely injured. All cases with indemnity paid were determined to be negligent by a medical appraisal. The gravely injured patients had more indemnity paid than deceased patients ($299800 ± 37000 vs $68700 ± 29300). The most common medical conditions involved were infectious diseases (27.0%), central nervous system bleeding (15.9%), and trauma cases (12.7%). It was also found that 71.4% of the allegations forming the basis of the lawsuit were diagnosis related. Emergency physicians (EPs) in Taiwan have similar medico-legal risk as American EPs, with an annual risk of being sued of 0.63%. Almost 90% of EPs win their cases but spend 58 months in litigation, and the mean indemnity payment was $134738. Cases with indemnity paid were mostly categorized as having diagnosis errors, with the leading cause of error as failure to order an appropriate diagnostic test. Copyright © 2014 Elsevier Inc. All rights reserved.

  3. Diseases associated with electrolyte imbalance in the ED: age-related differences. (United States)

    Giordano, Mauro; Ciarambino, Tiziana; Castellino, Pietro; Malatino, Lorenzo; Di Somma, Salvatore; Biolo, Gianni; Paolisso, Giuseppe; Adinolfi, Luigi Elio


    The objective of the study is to investigate the prevalence of electrolyte imbalance (EI) in the emergency department (ED) with systemic diseases in different decades of life. We enrolled patients admitted to the ED. The population study included 7941 patients, subdivided in 3 groups: young group (Y), middle-aged group (MA), and elderly group (E). We observed EI in 13.7% of the whole population. Hyponatremia (hNa(+)) is the most frequent EI (44%) followed by hypokalemia (hK(+)) (39%), hyperkalemia (HK(+)) (13%), and hypernatremia (HNa(+)) (4.4%). In the Y group, the EI occurred in 7.1% of all patients (P< .05 vs MA and E), whereas in the MA group, they were shown in 11.5% of patients and in the E group in 22% of all patients group (P< .05 vs MA and Y). In the Y group, gastrointestinal diseases are the most frequently associated disease (24.6%; P< .05 vs MA and E). In the MA group, the most frequently associated disease was a current cardiovascular disease (29.7%; P< .05 vs Y and E). In the E group, the frequently associated diseases are cardiovascular (22.8%; P< .05 vs Y) and lung diseases (16.7%; P< .05 vs MA and Y). In our study, 13.7% of all patients showed an EI, and only 2% of cases were alone without any associated systemic disease. Most EIs are associated to other systemic diseases. The present data also depict different age-related and disease-associated prevalence patterns of EI, thus highlighting a complex clinical scenario. Copyright © 2016. Published by Elsevier Inc.

  4. Electromagnetic field effect simulation over a realistic pixel ed phantom human's brain

    Energy Technology Data Exchange (ETDEWEB)

    Rojas, R.; Calderon, J. A.; Rivera, T. [IPN, Centro de Investigacion en Ciencia Aplicada y Tecnologia Avanzada, Calz. Legaria No. 694, Col. Irrigacion, 11500 Mexico D. F. (Mexico); Azorin, J., E-mail: [Universidad Autonoma Metropolitana, Unidad Iztapalapa, Av. San Rafael Atlixco 186, Col. Vicentina, 09340 Mexico D. F. (Mexico)


    The exposition to different types of electromagnetic radiations can produce damages and injures on the people's tissues. The scientist, spend time and resources studying the effects of electromagnetic fields over the organs. Particularly in medical areas, the specialist in imaging methodologies and radiological treatment, are very worried about no injure there patient. Determination of matter radiation interaction, can be experimental or theoretical is not an easy task anyway. At first case, is not possible make measures inside the patient, then the experimental procedure consist in make measures in human's dummy, however, is not possible see deformations of electromagnetic fields due the organs presence. In the second case, is necessary solve, the Maxwell's equations with the electromagnetic field, crossing a lot of organs and tissues with different electric and magnetic properties each one. One alternative for theoretical solution, is make a computational simulation, however, this option, require an enormous quantity of memory and large computational times. Then, the most simulations are making in 2 dimensional or in 3 dimensional although using human models approximations, build ed with basic geometrical figures, like spheres, cylinders, ellipsoids, etc. Obviously this models just lets obtain a coarse solution of the actually situation. In this work, we propose a novel methodology to build a realistic pixel ed phantom of human's organs, and solve the Maxwell's equations over this models, evidently, the solutions are more approximated to the real behaviour. Additionally, there models results optimized when they are discretized and the finite element method is used to calculate the electromagnetic field and the induced currents. (Author)

  5. Motivations and barriers to implementing electronic health records and ED information systems in Japan. (United States)

    Inokuchi, Ryota; Sato, Hajime; Nakamura, Kensuke; Aoki, Yuta; Shinohara, Kazuaki; Gunshin, Masataka; Matsubara, Takehiro; Kitsuta, Yoichi; Yahagi, Naoki; Nakajima, Susumu


    Although electronic health record systems (EHRs) and emergency department information systems (EDISs) enable safe, efficient, and high-quality care, these systems have not yet been studied well. Here, we assessed (1) the prevalence of EHRs and EDISs, (2) changes in efficiency in emergency medical practices after introducing EHR and EDIS, and (3) barriers to and expectations from the EHR-EDIS transition in EDs of medical facilities with EHRs in Japan. A survey regarding EHR (basic or comprehensive) and EDIS implementation was mailed to 466 hospitals. We examined the efficiency after EHR implementation and perceived barriers and expectations regarding the use of EDIS with existing EHRs. The survey was completed anonymously. Totally, 215 hospitals completed the survey (response rate, 46.1%), of which, 76.3% had basic EHRs, 4.2% had comprehensive EHRs, and 1.9% had EDISs. After introducing EHRs and EDISs, a reduction in the time required to access previous patient information and share patient information was noted, but no change was observed in the time required to produce medical records and the overall time for each medical care. For hospitals with EHRs, the most commonly cited barriers to EDIS implementation were inadequate funding for adoption and maintenance and potential adverse effects on workflow. The most desired function in the EHR-EDIS transition was establishing appropriate clinical guidelines for residents within their system. To attract EDs to EDIS from EHR, systems focusing on decreasing the time required to produce medical records and establishing appropriate clinical guidelines for residents are required. Copyright © 2014 Elsevier Inc. All rights reserved.

  6. GeoEd - Teaching teachers for a better GeoEducation in Germany (United States)

    Bergner, Andreas; Bookhagen, Britta; Ellger, Christoff; Schneider, Simon


    In Germany, diverse activities have been developed over the last couple of years to make Geosciences more visible and support teachers for interdisciplinary teaching Geosciences in class room. This is important, because Geosciences are not an obligatory classroom topic in Germany and geo-related topics are taught primarily under a social science perspective. To overcome this situation, diverse attempts from educational organizations, industry and administration have been developed to provide adequate hands-on materials for teachers and students in in elementary and secondary school. Parallel, research departments fostered their efforts to provide school materials in the course of newly designed outreach activities. In 2013, a new Germany-wide initiative GeoEd was set up as a platform to (1) link existing teaching materials and (2) provide access to these materials through teacher-focused workshops. For the workshops, GeoEd partners with natural science museums in order to profit from the experience of the museum's teaching professionals. Also, natural science museums provide own materials, which are an additional source of information for the presented geo-scientific topics. After the kickoff in fall 2013, first workshops on Rare Earth Elements have been established and an online searchable database of existing teaching materials was established. Simultaneously, further requirements for classroom teaching material will be contented (e.g. prepared lesson plans in combination with hands-on material) and professional teacher's training will be organized. Ultimately, we hope to enlighten teachers and students for the highly interdisciplinary variety of geosciences and provide links to everyday life.

  7. Correlation between capillary and arterial blood gas parameters in an ED. (United States)

    Heidari, Kamran; Hatamabadi, Hamidreza; Ansarian, Nader; Alavi-Moghaddam, Mostafa; Amini, Afshin; Safari, Saeed; Darbandsar Mazandarani, Parvin; Vafaee, Alireza


    Sampling from arteries for the analysis of blood gases is a common procedure in emergency departments (ED). The procedure is painful for the patients and causes concern for the medical personnel due to possible complications, such as hematoma, infection, ischemia, and formation of fistula or aneurism. The present study compared the results of capillary and arterial blood gases analyses (CBG and ABG) to emphasizing a less aggressive technique with the fewest complications for this procedure. In the comparative/analytical study, the results of ABG and CBG for 187 patients referring to the ED of a teaching hospital were compared using SPSS 18 statistical software (SPSS, Chicago, IL) in relation to the mean partial pressure of oxygen (Po(2)), partial pressure of carbon dioxide (Pco(2)), base excess (BE), bicarbonate (HCO(3)), serum acidity (pH), and saturation of hemoglobin oxygen (SaO(2)). Saturation of hemoglobin oxygen, HCO(3), pH, Pco(2), Po(2), and BE exhibited significant statistical correlation between ABG and CBG (P = .001). The average correlations between capillary and arterial samples were 0.78 for pH, 0.73 for Pco(2), 0.71 for BE, 0.90 for HCO(3), 0.77 for Po(2), and 0.52 for SaO(2). Comparison of the parameters means did not exhibit significant differences between arterial and capillary samples except for Po(2) and SaO(2) (P > .05). There appear to be strong correlation between samples collected from the finger tip capillaries with the arterial blood samples in relation to the analysis of blood gas. Copyright © 2013 Elsevier Inc. All rights reserved.

  8. Macrofauna edáfica asociada con sistemas agroforestales en la Amazonía Colombiana

    Directory of Open Access Journals (Sweden)

    Juan Carlos Suárez Salazar


    Full Text Available La densidad, riqueza y diversidad de la macrofauna edáfica son afectadas, entre otros factores, por la configuración de los agroecosistemas y la estacionalidad de la precipitación. Con el fin de evaluar estos efectos en mayo y noviembre de 2011, correspondientes a épocas de máxima y mínima precipitación, respectivamente, se realizaron estudios sobre la composición de la macrofauna edáfica asociada con los arreglos agroforestales ubicados en el Centro de Investigaciones Macagual Cesar Augusto Estrada González, Amazonia, Caquetá, Colombia. El experimento se dispuso en un diseño completo al azar bifactorial con cuatro tratamientos (arreglos agroforestales: AB = abarco - Cariniana pyriformis Miers; CH = caucho Hevea brasiliensis (Willd. ex A. Juss. Müll. Arg. ; CP = caucho-parica Schizolobium amazonicum Huber; UV = uvito Genipa Americana L. y dos épocas (máxima y mínima precipitación, y cuatro repeticiones en parcelas divididas. Para explorar las relaciones entre los órdenes de macrofauna, se realizó un análisis de componentes principales y se evalúo el efecto de los arreglos agroforestales con una prueba de Monte Carlo. Los resultados mostraron que la densidad de la macrofauna fue mayor en el periodo de máxima precipitación (1129 individuos en comparación con el de mínima (598 individuos. Los arreglos agroforestales influyen sobre la presencia o ausencia de algunos grupos taxonómicos (P < 0.05 como Homoptera (Insecta y Raphidioptera (Insecta; además los UV y AB pueden favorecer a la macrofauna del estrés por sequía

  9. Direct relationship between aging and overcrowding in the ED, and a calculation formula for demand projection: a cross-sectional study. (United States)

    Kawano, Takahisa; Nishiyama, Kei; Anan, Hideaki; Tujimura, Yuka


    Although it has been suggested that the increase in older population contributes to overcrowding in emergency departments (EDs), there are limited data defining this relationship. This study examines whether patients' mean age per day affects length of ED stay. This cross-sectional analysis evaluated how patient age affects length of ED stay. The study was conducted at an ED attached to Fujisawa City Hospital, Japan, between 1 November 2009 and 31 October 2010. Patients scheduled to visit for childbirth and patients under age 15 were excluded. The primary outcome measure was the relationship between length of ED stay and patient age. The secondary outcome was the relationship between patient age and patient dispositions indicated by column chart and 100% staked column chart. Over the study period, there were 17 744 patient visits to the ED. The study included 15 840 (89.3%) patients. The mean (SD) age of these patients was 56.9 (21.5) years. In single and multiple linear regression analyses, mean patient age per day was an important factor in length of ED stay for the total number of patients visiting the ED (single linear regression analysis: regression coefficient=1.59 min/year, r(2)=0.005, page. The increase in older patients visiting the ED has a direct significant negative effect on overcrowding in the ED.

  10. Autonomic symptom burden in the hypermobility type of Ehlers-Danlos syndrome: a comparative study with two other EDS types, fibromyalgia, and healthy controls. (United States)

    De Wandele, Inge; Calders, Patrick; Peersman, Wim; Rimbaut, Steven; De Backer, Tine; Malfait, Fransiska; De Paepe, Anne; Rombaut, Lies


    This study provides insight into the profile and importance of autonomic symptoms in the hypermobility type (HT) of Ehlers-Danlos syndrome (EDS). The impact of these symptoms is put into perspective by comparing with fibromyalgia (FM) and two other EDS types. Overall, 80 patients with EDS-HT participated, as well as 11 with classical EDS (cEDS), seven with vascular EDS (vEDS), 38 with FM, and 43 healthy controls. All participants filled out the autonomic symptom profile (ASP). Furthermore, they were inquired about quality of life (QOL, SF-36) and factors contributing to the EDS disease burden, e.g., hypermobility (5-point questionnaire, GHQ), fatigue (checklist individual strength, CIS), pain (pain detect questionnaire, PDQ), affective distress (hospital anxiety and depression scale, HADS), and physical activity (Baecke). The total autonomic symptom burden was higher in EDS-HT (57.9 ± 21.57) than in controls (11.3 ± 19.22), cEDS (32.3 ± 19.47), and vEDS (29.1 ± 19.18), but comparable to FM (53.8 ± 19.85). Especially orthostatic and gastrointestinal complaints were prevalent. The importance of autonomic symptoms in EDS-HT was emphasized by the correlation with lowered QOL (r = -0.402), fatigue (r = 0.304), and pain severity (r = 0.370). Although affective distress and decreased physical activity are often suggested as possible causes for dysautonomia, the ASP did not correlate with the HADS and Baecke score. By contrast, the correlation of the GHQ (r = 0.298) and PDQ (r = 0.413) with the ASP supports the hypothesis that joint hypermobility and neuropathy may play a role in the development of autonomic symptoms. Autonomic symptoms, especially orthostatic and gastrointestinal complaints, are frequent extraarticular manifestations of EDS-HT and contribute to the disease burden. Copyright © 2014 Elsevier Inc. All rights reserved.

  11. Disease management program for chronic obstructive pulmonary disease: a randomized controlled trial. (United States)

    Rice, Kathryn L; Dewan, Naresh; Bloomfield, Hanna E; Grill, Joseph; Schult, Tamara M; Nelson, David B; Kumari, Sarita; Thomas, Mel; Geist, Lois J; Beaner, Caroline; Caldwell, Michael; Niewoehner, Dennis E


    The effect of disease management for chronic obstructive pulmonary disease (COPD) is not well established. To determine whether a simplified disease management program reduces hospital admissions and emergency department (ED) visits due to COPD. We performed a randomized, adjudicator-blinded, controlled, 1-year trial at five Veterans Affairs medical centers of 743 patients with severe COPD and one or more of the following during the previous year: hospital admission or ED visit for COPD, chronic home oxygen use, or course of systemic corticosteroids for COPD. Control group patients received usual care. Intervention group patients received a single 1- to 1.5-hour education session, an action plan for self-treatment of exacerbations, and monthly follow-up calls from a case manager. We determined the combined number of COPD-related hospitalizations and ED visits per patient. Secondary outcomes included hospitalizations and ED visits for all causes, respiratory medication use, mortality, and change in Saint George's Respiratory Questionnaire. After 1 year, the mean cumulative frequency of COPD-related hospitalizations and ED visits was 0.82 per patient in usual care and 0.48 per patient in disease management (difference, 0.34; 95% confidence interval, 0.15-0.52; P management reduced hospitalizations for cardiac or pulmonary conditions other than COPD by 49%, hospitalizations for all causes by 28%, and ED visits for all causes by 27% (P management program reduced hospitalizations and ED visits for COPD. Clinical trial registered with (NCT00126776).

  12. Psychological distress in medical patients seeking ED care for somatic reasons: results of a systematic literature review. (United States)

    Faessler, Lukas; Perrig-Chiello, Pasqualina; Mueller, Beat; Schuetz, Philipp


    The aim of this systematic literature review is to investigate (A) currently used instruments for assessing psychological distress, (B) the prevalence of psychological distress in medical emergency department (ED) patients with acute somatic conditions and (C) empirical evidence on how predictors are associated with psychological distress. We conducted an electronic literature search using three databases to identify studies that used validated instruments for detection of psychological distress in adult patients presented to the ED with somatic (non-psychiatric) complaints. From a total of 1688 potential articles, 18 studies were selected for in-depth review. A total of 13 instruments have been applied for assessment of distress including screening questionnaires and briefly structured clinical interviews. Using these instruments, the prevalence of psychological distress detected in medical ED patients was between 4% and 47%. Psychological distress in general and particularly depression and anxiety have been found to be associated with demographic factors (eg, female gender, middle age) and illness-related variables (eg, urgency of triage category). Some studies reported that coexisting psychological distress of medical patients identified in the ED was associated with physical and psychological health status after ED discharge. Importantly, during routine clinical care, only few patients with psychological distress were diagnosed by their treating physicians. There is strong evidence that psychological distress is an important and prevalent cofactor in medically ill patients presenting to the ED with harmful associations with (subjective) health outcomes. To prove causality, future research should investigate whether screening and lowering psychological distress with specific interventions would result in better patient outcomes. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to

  13. Performance of the modified Richmond Agitation Sedation Scale in identifying delirium  in older ED patients. (United States)

    Grossmann, Florian F; Hasemann, Wolfgang; Kressig, Reto W; Bingisser, Roland; Nickel, Christian H


    Delirium in older emergency department (ED) patients is associated with severe negative patient outcomes and its detection is challenging for ED clinicians. ED clinicians need easy tools for delirium detection. We aimed to test the performance criteria of the modified Richmond Agitation Sedation Scale (mRASS) in identifying delirium in older ED patients. The mRASS was applied to a sample of consecutive ED patients aged 65 or older by specially trained nurses during an 11-day period in November 2015. Reference standard delirium diagnosis was based on Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR) criteria, and was established by geriatricians. Performance criteria were computed. Analyses were repeated in the subsamples of patients with and without dementia. Of 285 patients, 20 (7.0%) had delirium and 41 (14.4%) had dementia. The sensitivity of an mRASS other than 0 to detect delirium was 0.70 (95% confidence interval, CI, 0.48; 0.85), specificity 0.93 (95% CI 0.90; 0.96), positive likelihood ratio 10.31 (95% CI 6.06; 17.51), negative likelihood ratio 0.32 (95% CI 0.16; 0.63). In the sub-sample of patients with dementia, sensitivity was 0.55 (95% CI 0.28; 0.79), specificity 0.83 (95% CI 0.66; 0.93), positive likelihood ratio 3.27 (95% CI 1.25; 8.59), negative likelihood ratio 0.55 (95% CI 0.28; 1.06). The sensitivity of the mRASS to detect delirium in older ED patients was low, especially in patients with dementia. Therefore its usefulness as a stand-alone screening tool is limited. Copyright © 2017 Elsevier Inc. All rights reserved.

  14. The impact of age and gender on resource utilization and profitability in ED patients seen and released. (United States)

    Henneman, Philip L; Nathanson, Brian H; Ribeiro, Kara; Balasubramanian, Hari


    To determine how age and gender impact resource utilization and profitability in patients seen and released from an Emergency Department (ED). Billing data for patients seen and released from an Emergency Department (ED) with >100,000 annual visits between 2003 and 2009 were collected. Resource utilization was measured by length of stay (placement in ED bed to leaving the bed) and direct clinical costs (e.g., ED nursing salary and benefits, pharmacy and supply costs, etc.) estimated using relative value unit cost accounting. The primary outcome of profitability was defined as contribution margin per hour. A patient's contribution margin by insurance type (excluding self-pay) was determined by subtracting direct clinical costs from facility contractual revenue. Results are expressed as medians and US dollars. In 523 882 outpatient ED encounters, as patients' aged, length of stay and direct clinical cost increased while the contribution margin and contribution margin by hour decreased. Women of childbearing age (15-44) had higher median length of stay (2.1 hours), direct clinical cost ($149), and contribution margin per hour ($103/hour) than men of same age (1.7, $131, $85/hour, respectively). Resource utilization and profitability by gender were similar in children and adults over 45. Resource utilization increased and profitability decreased with increasing age in patients seen and released from an ED. The care of women of childbearing age resulted in higher resource utilization and higher profitability than men of the same age. No differences in resource utilization or profitability by gender were observed in children and adults over 45. Copyright © 2014 Elsevier Inc. All rights reserved.

  15. EscapED: A Framework for Creating Educational Escape Rooms and Interactive Games to For Higher/Further Education.

    Directory of Open Access Journals (Sweden)

    Samantha Jane Clarke


    Full Text Available Game-based learning (GBL is often found to be technologically driven and more often than not, serious games for instance, are conceptualised and designed solely for digital platforms and state of the art technologies. To encourage a greater discussion on the potential benefits and challenges of a more holistic approach to developing GBL that promote human centered interactions and play for learning, the authors present the escapED programme. The escapED programme was conceived following the recent entertainment trend of escape rooms and is used for developing non-digital GBL approaches within education. escapED aids the design and creation of educational Escape Rooms and Interactive Gaming Experiences for staff and students in further/higher education settings. The paper first presents a pilot study that was used to assess the feasibility and acceptance of University teaching staff of embedding interactive GBL into a higher education environment. The authors then present the escapED theoretical framework that was used to create the prototype game for the pilot study as a tool to aid future design and development of on-site interactive experiences. The paper also presents an external developer report of using the escapED framework to develop a prototype game for teaching research methods to Southampton University students. Finally, the authors present a discussion on the use of the escapED framework so far and plans for future work and evaluation in order to provide engaging alternatives for learning and soft skills development amongst higher education staff andstudents.

  16. Effect of Concentration on Median Effective Dose (ED50) for Motor Block of Intrathecal Plain Bupivacaine in Elderly Patients. (United States)

    Chen, Ming-quan; Xia, Zhong-yuan


    The aim of the study was to determine the median effective dose (ED50) for motor block of various concentrations of intrathecally administered plain bupivacaine. Between 2011 and 2013, 64 patients aged ≥70 years, undergoing transurethral, or lower limb surgery with combined spinal and epidural anesthesia in a single hospital were enrolled. The patients were randomized into 3 groups to receive intrathecal 0.75% bupivacaine (Group 1), 0.375% bupivacaine (Group 2) or 0.25% bupivacaine (Group 3). Spinal anesthesia was achieved using injections of up-and-down doses of 0.75%, 0.375%, or 0.25% plain bupivacaine. The first patient in each group received 7.5 mg bupivacaine, and the testing interval was set at 0.75 mg. The efficacy of motor block in both legs was determined using a modified Bromage and a hip motor function scale. The ED50 for motor block was estimated according to the Dixon's up-and-down method. The ED50 for motor block of bupivacaine was 6.10 (95% CI 5.58-6.66) mg in Group 1, 6.04 (95% CI 5.82-6.28) mg in Group 2, and 5.43 (95% CI 5.19-5.67) mg in Group 3. There were significant differences in the ED50 for motor block among the groups (P=0.008). The ED50 doses for motor block with 3 bupivacaine concentrations were significantly different in elderly patients; the ED50 dose of 0.75% bupivacaine being significantly higher than that of 0.25% bupivacaine.

  17. Comparison of management and outcomes of ED patients with acute decompensated heart failure between the Canadian and United States' settings. (United States)

    Lai, Anita; Tenpenny, Elliott; Nestler, David; Hess, Erik; Stiell, Ian G


    Introduction The objective of this study was to compare the emergency department (ED) management and rate of admission of acute decompensated heart failure (ADHF) between two hospitals in Canada and the United States and to compare the outcomes of these patients. This was a health records review of adults presenting with ADHF to two EDs in Canada and the United States between January 1 and April 30, 2010. Outcome measures were admission to the hospital, myocardial infarction (MI), and death or relapse rates to the ED. Data were analysed using descriptive, univariate and multivariate analyses. In total, 394 cases were reviewed and 73 were excluded. Comparing 156 Canadian to 165 U.S. patients, respectively, mean age was 76.0 and 75.8 years; male sex was 54.5% and 52.1%. Canadian and U.S. ED treatments were noninvasive ventilation 7.7% v. 12.8% (p=0.13); IV diuretics 77.6% v. 36.0% (p3.0 hours, p<0.001). Proportion of Canadian and U.S. patients who died within 30 days of the ED visit was 5.1% v. 9.7% (p=0.12); relapsed to the ED within 30 days was 20.8% v. 17.5% (p=0.5); and had MI within 30 days was 2.0% v. 1.9% (p=1.0). The U.S. and Canadian centres saw ADHF patients with similar characteristics. Although the U.S. site had almost double the admission rate, the outcomes were similar between the sites, which question the necessity of routine admission for patients with ADHF.

  18. Environmental Education and Development Program

    Energy Technology Data Exchange (ETDEWEB)


    The Environmental Education and Development Program is a component on the effort to accomplish the Office of Environmental Restoration and Waste Management`s (EM) goal of environmental compliance and cleanup of the 1989 inventory of inactive DOE sites and facilities by the year 2019. Education and Development programs were designed specifically to stimulate the knowledge and workforce capability necessary to achieve EM goals while contributing to DOE`s overall goal of increasing scientific and technical literacy and competency. The primary implementation criterion for E&D activities involved a focus on programs and projects that had both immediate and long-range leveraging effects on infrastructure. This focus included programs that yielded short term results (one to five years), as well as long-term results, to ensure a steady supply of appropriately trained and educated human resources, including women and minorities, to meet EM`s demands.

  19. Novel methods for Solving Economic Dispatch of Security-Constrained Unit Commitment Based on Linear Programming (United States)

    Guo, Sangang


    There are two stages in solving security-constrained unit commitment problems (SCUC) within Lagrangian framework: one is to obtain feasible units’ states (UC), the other is power economic dispatch (ED) for each unit. The accurate solution of ED is more important for enhancing the efficiency of the solution to SCUC for the fixed feasible units’ statues. Two novel methods named after Convex Combinatorial Coefficient Method and Power Increment Method respectively based on linear programming problem for solving ED are proposed by the piecewise linear approximation to the nonlinear convex fuel cost functions. Numerical testing results show that the methods are effective and efficient.

  20. The influence of surface chemistry on GSR particles: using XPS to complement SEM/EDS analytical techniques (United States)

    Schwoeble, A. J.; Strohmeier, Brian R.; Piasecki, John D.


    Gunshot residue particles (GSR) were examined using scanning electron microscopy/energy dispersive X-ray spectroscopy (SEM/EDS) to illustrate the size, shape, morphology, and elemental composition normally observed in particulate resulting from a discharged firearm. Determining the presence of lead (Pb), antimony (Sb), and barium (Ba), barring other elemental tags, fused together in a single particle with the correct morphology, is all that is required for the positive identification of GSR. X-ray photoelectron spectroscopy (XPS), however, can reveal more detailed information on surface chemistry than SEM/EDS. XPS is a highly surface-sensitive (analysis.

  1. What does it take to create an effective and interactive learning environment with 700 students in a college Gen. Ed. Astro Course? (United States)

    Prather, Edward E.; Brissenden, G.; Cormier, S.; Eckenrode, J.; Collaboration of Astronomy Teaching Scholars CATS


    College-level general education (gen ed.) curricula in the US have many goals: exposing students to the breadth of human ideas; elevating their reading comprehension, writing abilities, critical reasoning skills; and providing an understanding of, and appreciation for, subjects outside of their chosen field of study. Unfortunately the majority of the teaching and learning for gen ed. courses takes place in large enrollment courses. In the wake of the recent US financial crisis, many institutions of higher learning face extreme budget cuts, leading many faculty to teach in substantially larger classes with increasingly fewer resources. At the University of Arizona this issue manifests itself in mega-classes with enrollments from 700-1400. We discuss key programmatic and pedagogical changes involved in successfully implementing proven collaborative learning strategies into an Astro 101 mega-class. From devising new ways to hand out and collect papers, to altering course seating, to outlawing cell phones and laptops, to implementing new ways of administering tests. We take a "what ever it takes” approach to engineering this mega-course environment so it can succeed as a learner-centered classroom. Paramount to the success of this course has been the creation of the new CAE Ambassadors program which advances the leadership role of prior non-science majors along the continuum from student, to teaching assistant, to science education researcher, to STEM minor. This material is based in part upon work supported by the National Science Foundation under Grant No. 0715517, a CCLI Phase III Grant for the Collaboration of Astronomy Teaching Scholars (CATS). Any opinions, findings, and conclusions or recommendations expressed in this material are those of the authors and do not necessarily reflect the views of the National Science Foundation.

  2. Development and Evaluation of a Web-Based Training Program for Oral Health Care Providers on Secondary Prevention of Eating Disorders (United States)

    DeBate, Rita D.; Severson, Herbert; Zwald, Marissa L.; Shaw, Tracy; Christiansen, Steve; Koerber, Anne; Tomar, Scott; Brown, Kelli McCormack; Tedesco, Lisa A.


    Although oral health care providers (OHP) are key in the secondary prevention of eating disorders (ED), the majority are not engaged in assessment, referral, and case management. This innovative pilot project developed and evaluated a web-based training program for dental and dental hygiene students and providers on the secondary prevention of ED. The intervention combined didactic and skill-based objectives to train OHP on ED and its oral health effects, OHP roles, skills in identifying the oral signs of ED, communication, treatment, and referral. Using a convenience sample of OHP (n=66), a pre-/post-test evaluated short-term outcomes and user satisfaction. Results revealed statistically significant improvements in self-efficacy (p<.001); knowledge of oral manifestations from restrictive behaviors (p<.001) and purging behaviors (p<.001); knowledge of oral treatment options (p<.001); and attitudes towards the secondary prevention of ED (p<.001). Most participants strongly agreed or agreed that the program provided more information (89 percent) and resources (89 percent) about the secondary prevention of ED than were currently available; 91 percent strongly agreed or agreed that they would access this program for information regarding the secondary prevention of ED. This pilot project provides unique training in the clinical evaluation, patient approach, referral, and oral treatment that takes a multidisciplinary approach to address ED. PMID:19491349

  3. Critical Care in the Emergency Department: An assessment of the length of stay and invasive procedures performed on critically ill ED patients

    Directory of Open Access Journals (Sweden)

    Green Robert S


    Full Text Available Abstract Introduction Critically ill patients commonly present to the ED and require aggressive resuscitation. Patient transfer to an ICU environment in an expedient manner is considered optimal care. However, this patient population may remain in the ED for prolonged periods of time. The goal of this study is to describe the ED length of stay, and the invasive procedures performed in critically ill ED patients. Methods This is a retrospective medical record review of all patients who presented to the study center over a 1 year period. Patient demographic data, in addition to the times of ED presentation and ICU admission were recorded. Invasive procedures performed in the pre-hospital, ED and the initial 24 hours of ICU care were also recorded. Results Overall, 178 patients' required direct admission to an ICU from the ED, with a mortality rate of 21.9%. The median LOS in the ED for critically ill patients requiring ICU admission was 4.9 h (mean 6.5 h, range 1.4-28.2 h. Seventy percent of patients (125,178, 70.2% required endotracheal intubation with the majority (118/125, 94.4% being performed in the ED (80/125, 64.0% or the prehospital setting (38/125, 30.4%. Central venous access was obtained in 56/178 patients (31.5%, with 17.9% (10/56 completed in the ED. Similarly, arterial catheters were inserted in 99/178 patients (55.6% with 14.1% (14/99 inserted in the ED. Conclusion Critically ill patients are managed in the emergency department for a significant length of time. Although the majority of airway intervention occurs in the prehospital setting and ED, relatively few patients undergo invasive procedures while in the emergency department.

  4. EdGCM: Research Tools for Training the Climate Change Generation (United States)

    Chandler, M. A.; Sohl, L. E.; Zhou, J.; Sieber, R.


    Climate scientists employ complex computer simulations of the Earth's physical systems to prepare climate change forecasts, study the physical mechanisms of climate, and to test scientific hypotheses and computer parameterizations. The Intergovernmental Panel on Climate Change 4th Assessment Report (2007) demonstrates unequivocally that policy makers rely heavily on such Global Climate Models (GCMs) to assess the impacts of potential economic and emissions scenarios. However, true climate modeling capabilities are not disseminated to the majority of world governments or U.S. researchers - let alone to the educators who will be training the students who are about to be presented with a world full of climate change stakeholders. The goal is not entirely quixotic; in fact, by the mid-1990's prominent climate scientists were predicting with certainty that schools and politicians would "soon" be running GCMs on laptops [Randall, 1996]. For a variety of reasons this goal was never achieved (nor even really attempted). However, around the same time NASA and the National Science Foundation supported a small pilot project at Columbia University to show the potential of putting sophisticated computer climate models - not just "demos" or "toy models" - into the hands of non-specialists. The Educational Global Climate Modeling Project (EdGCM) gave users access to a real global climate model and provided them with the opportunity to experience the details of climate model setup, model operation, post-processing and scientific visualization. EdGCM was designed for use in both research and education - it is a full-blown research GCM, but the ultimate goal is to develop a capability to embed these crucial technologies across disciplines, networks, platforms, and even across academia and industry. With this capability in place we can begin training the skilled workforce that is necessary to deal with the multitude of climate impacts that will occur over the coming decades. To

  5. Diversidade da macrofauna edáfica em diferentes usos da terra em Pinheiral, RJ

    Directory of Open Access Journals (Sweden)

    André Barbosa Vargas


    Full Text Available O uso da terra, na maioria das vezes, altera consideravelmente a composição e riqueza da fauna edáfica, alterando a cobertura florestal existente. Deste modo, funções ecológicas e biológicas desenvolvidas por estes organismos são afetadas e/ou perdidas. Portanto, os objetivos foram avaliar a biodiversidade de artrópodes em quatro ambientes distintos, no campus do IFRJ, em Pinheral, RJ. Foram instaladas 12 armadilhas no solo do tipo “pitfall” em cada ambiente, espaçadas 10m uma da outra. Foram amostrados 19 grupos de artópodes, sendo 18 ordens e uma família (Formicidae, a qual apresentou 100% de ocorrência em todos os ambientes e períodos de coleta. No período chuvoso foram coletadas 16 ordens e no período seco 14. No período chuvoso o Plantio de eucalipto apresentou maior número de ordens (14, seguido de Pasto (9, Cultivo de goiaba (8 e Reflorestamento com (6. No período seco se observou um resultado contrário com o ambiente de Reflorestamento apresentando 13 ordens, seguido de Cultivo de goiaba (11, Plantio de eucalipto (8 e Pasto com (6. Entretanto, estas variações não foram significativas entre os ambientes e entre os períodos de coleta. Os índices de diversidade não apresentaram diferenças significativas entre os ambientes, mas sim para os períodos de coleta. A ordenação mostrou agrupamentos dos blocos, separando os ambientes. Portanto, a biodiversidade de artrópodes apresenta diversidade distinta para os ambientes, demonstrando a importância da heterogeneidade ambiental na manutenção da biodiversidade e das funções ecológicas prestadas pelos organismos. Os resultados também reforçam a utilização da macrofauna edáfica em avaliações e estudos ambientais como indicadora de biodiversidade e da qualidade ambiental. 

  6. Identification of tobacco smoke components in indoor breathable particles by SEM-EDS (United States)

    Slezakova, K.; Pires, J. C. M.; Martins, F. G.; Pereira, M. C.; Alvim-Ferraz, M. C.


    Tobacco smoke is one of the greatest sources of indoor particles, which has been linked with serious health effects. Consequently, there has been a widespread interest in analysing tobacco related indoor particulate matter (PM). Nevertheless, the majority of performed studies focused on bulk chemical composition of tobacco related PM, but the knowledge of individual tobacco smoke particles is still limited. Therefore, more information on PM should be provided, namely concerning morphological and chemical characterisation of individual particles. Aiming to further understand the impact of tobacco smoke on human health, this work studied the influence of tobacco smoke on chemical and morphological characteristics of PM 10 and PM 2.5, collected at one site influenced by smoking and at one reference (non-smoking) site. Chemical and morphological characteristics of 4000 individual particles were determined by Scanning Electron Microscopy (SEM) combined with X-ray microanalysis (by Energy Dispersive Spectrometer - EDS). Cluster analysis (CA) was used to classify different particle groups that occurred in PM, aiming the identification of the respective emission sources. The results showed that tobacco smoke influenced the characteristics of both fine and coarse particles, this influence being stronger for fine fraction. The abundance of particles associated with tobacco smoke was 27% and 5% for PM 2.5 and PM 2.5-10, respectively; as expected, those particles were not identified in PM 2.5 and PM 2.5-10 of the reference (non-smoking) site. The results showed that at both sites PM was also influenced by outdoor sources. For PM 2.5-10, outdoor particles essentially originated from natural sources accounting for 35% and 15% at the smoking and reference sites, respectively. For PM 2.5, outdoor particles account for 38% and 29% at the smoking and reference sites, respectively; these particles showed considerable contribution (13% and 17%) from anthropogenic sources (mainly from

  7. Crystal structure, configurational and DFT-NEDA analysis of nickel(II) complexes with pentadentate ed3a-type ligands

    NARCIS (Netherlands)

    Belosevic, Svetlana; Cendic, Marina; Meetsma, Auke; Matovic, Zoran D.


    The O-O-N-N-O-type pentadentate ligands H(3)ed3a, H(3)1,2-pd3a, H(3)eda2p and H(3)ed3p (H(3)ed3a stands for ethylenediamine-N,N,N'-triacetic acid; H(3)1,2-pd3a stands for 1,2-propanediamine-N,N,N'-triacetic acid; H(3)eda2p stands for ethylenediamine-N-acetato-N,N'-di-3-propionic acid and H(3)ed3p

  8. Bán, Zsófia and Turai, Hedvig, eds.: "Exposed Memories: Family Pictures in Private and Collective Memory"

    Directory of Open Access Journals (Sweden)

    Katalin Kádár Lynn


    Full Text Available Zsófia Bán and Hedvig Turai, eds. Exposed Memories: Family Pictures in Private and Collective Memory. AICA: International Association of Art Critics: Hungarian Section: Distributed by Central European University Press, 2010, 193 pp. Reviewed by Katalin Kádár Lynn, Senior Researcher, ELTE.

  9. More and Better Learning: Year Three Report on the National Demonstration of ExpandED Schools. A TASC Report (United States)

    Traill, Saskia; Brohawn, Katie


    In the 2013-14 school year, TASC entered the third year of its national demonstration of ExpandED Schools. Ten elementary and middle schools in New York City, Baltimore and New Orleans continued their partnerships with youth-serving community organizations, such as settlement houses or community development corporations. Together, principals,…

  10. Vasyl' Danylenko, ed. Ukrains'ka intelihentsiia i vlada: Zvedennia sekretnoho viddilu DPU USRR 1927–1929 rr.

    Directory of Open Access Journals (Sweden)

    Olena Palko


    Full Text Available Vasyl' Danylenko, ed. Ukrains'ka intelihentsiia i vlada: Zvedennia sekretnoho viddilu DPU USRR 1927–1929 rr. [The Ukrainian Intelligentsia and State Power. Summaries of the Secret Department of State Political Administration of the Ukrainian SSR for 1927–1929]. Kyiv: Tempora, 2012. 756 pp. Illustrations. Appendix. Indexes. 70 UAH, cloth.

  11. Exploratory Content Analysis of Candidates' Perspectives on Multicultural Education as Evidenced in Their edTPA Portfolios (United States)

    Cannon, Sarah


    This exploratory qualitative content analysis examined the edTPA portfolios of 36 randomly selected teacher candidates to address a national trend towards standardization and accountability in teacher education in relationship to the critical need for multicultural educators. Using multicultural education as a theoretical framework, this study…

  12. Relevance of Item Analysis in Standardizing an Achievement Test in Teaching of Physical Science in B.Ed Syllabus (United States)

    Marie, S. Maria Josephine Arokia; Edannur, Sreekala


    This paper focused on the analysis of test items constructed in the paper of teaching Physical Science for B.Ed. class. It involved the analysis of difficulty level and discrimination power of each test item. Item analysis allows selecting or omitting items from the test, but more importantly item analysis is a tool to help the item writer improve…

  13. A Study on Attitude and Opinion towards Using Computer Technology in Teaching among B.Ed. Trainees in Tiruchirappalli District (United States)

    Kumar, C. Ashok


    The main aim of the study was to find out whether there was a significant difference in the attitude and opinion towards using Computer Technology in teaching among B.Ed., trainees in terms of select independent variables. Normative survey was the technique employed. Opinion towards Computer Usage and Attitude towards Computer Technology inventory…

  14. Simmi "Head käed" tuli, nägi ja võitis / Triin Tael

    Index Scriptorium Estoniae

    Tael, Triin


    Berliini 52. filmifestivali "Panorama Special" kavas olnud Peeter Simmi Eesti-Läti ühisfilm "Head käed" saavutas hea publikuedu ning jagas sloveenlase Maja Weiss'i filmiga "Piirivalvur" Manfred Salzgeberi auhinda, mis on mõeldud subtiitrite tegemiseks filmi levitamisel euroopa ekraanidele. P. Simm on rahul ja plaanib uut filmi

  15. Book Review: Shrestha, Omkar Lal, and Aekapol Chongvilaivan (eds, Greater Mekong Subregion: From Geographical to Socio-economic Integration

    Directory of Open Access Journals (Sweden)

    Timotheus J. Krahl


    Full Text Available Book Review of the edited volume: Omkar Lal Shrestha and Aekapol Chongvilaivan (eds (2013, Greater Mekong Subregion: From Geographical to Socio-economic Integration. Singapore: Institute of Southeast Asian Studies (ISEAS, ISBN: 978-981-4379-68-7, 270 pages

  16. CrashEd – A live immersive, learning experience embedding STEM subjects in a realistic, interactive crime scene

    Directory of Open Access Journals (Sweden)

    Marie L. Bassford


    Full Text Available Interactive experiences are rapidly becoming popular via the surge of ‘escape rooms’; part game and part theatre, the ‘escape’ experience is exploding globally, having gone from zero offered at the outset of 2010 to at least 2800 different experiences available worldwide today. CrashEd is an interactive learning experience that parallels many of the attractions of an escape room – it incorporates a staged, realistic ‘crime scene’ and invites participants to work together to gather forensic evidence and question a witness in order to solve a crime, all whilst competing against a ticking clock. An animation can enhance reality and engage with cognitive processes to help learning; in CrashEd, it is the last piece of the jigsaw that consolidates the students’ incremental acquisition of knowledge to tie together the pieces of evidence, identify a suspect and ultimately solve the crime. This article presents the background to CrashEd and an overview of how a timely placed animation at the end of an educational experience can enhance learning. The lessons learned, from delivering bespoke versions of the experience to different demographic groups, are discussed. The article will consider the successes and challenges raised by the collaborative project, future developments and potential wider implications of the development of CrashEd.

  17. The regulation of the proliferation and differentiation of rat Leydig cell precursor cells after EDS administration or daily HCG treatment

    NARCIS (Netherlands)

    Teerds, K. J.; de rooij, D. G.; Rommerts, F. F.; Wensing, C. J.


    The proliferation and differentiation of possible Leydig cell precursors in adult rats were studied after destruction of the existing Leydig cells with EDS or after daily treatment with hCG. After 2 days with either treatment, a 12- to 16-fold increase in the number of [3H]thymidine-incorporating

  18. Integrated Canada-U.S. Power Sector Modeling with the Regional Energy Deployment System (ReEDS)

    Energy Technology Data Exchange (ETDEWEB)

    Martinez, A.; Eurek, K.; Mai, T.; Perry, A.


    The electric power system in North America is linked between the United States and Canada. Canada has historically been a net exporter of electricity to the United States. The extent to which this remains true will depend on the future evolution of power markets, technology deployment, and policies. To evaluate these and related questions, we modify the Regional Energy Deployment System (ReEDS) model to include an explicit representation of the grid-connected power system in Canada to the continental United States. ReEDS is unique among long-term capacity expansion models for its high spatial resolution and statistical treatment of the impact of variable renewable generation on capacity planning and dispatch. These unique traits are extended to new Canadian regions. We present example scenario results using the fully integrated Canada-U.S. version of ReEDS to demonstrate model capabilities. The newly developed, integrated Canada-U.S. ReEDS model can be used to analyze the dynamics of electricity transfers and other grid services between the two countries under different scenarios.

  19. Types of Language Disorders in Students Classified as ED: Prevalence and Association with Learning Disabilities and Psychopathology (United States)

    Benner, Gregory J.; Mattison, Richard E.; Nelson, J. Ron; Ralston, Nicole C.


    The purpose of this study was to determine the prevalence of four types of language disorders among public school students (N = 152) classified as Emotional Disturbance (ED). We also examined the association of the types of language disorders experienced by these students with specific learning disabilities and clinical levels of specific types of…

  20. The EdUReP approach plus manual therapy for the management of insertional Achilles tendinopathy: a case report. (United States)

    Sartorio, Francesco; Zanetta, Anna; Ferriero, Giorgio; Bravini, Elisabetta; Vercelli, Stefano


    Insertional Achilles tendinopathy (IAT) is a challenging overuse disorder. The aim of this case report was to study the feasibility of a comprehensive rehabilitative approach according to the Education, Unloading, Reloading, and Prevention (EdUReP) framework combined with Instrument-Augmented Soft Tissue Mobilization (I-ASTM). An active 51-year-old man patient with chronic IAT was studied. Clinical assessment battery was composed by visual analogue scale for pain during the Achilles tendon palpation test, passive straight leg raise test, single leg hop test, Patient-Specific Functional Scale, and Foot and Ankle Ability Measure. The patient was treated over a 8 weeks period using the EdUReP guidelines plus 8 sessions of I-ASTM, applied with a solid instrument to the Achilles tendon and to the muscle fibrotic areas previously identified during evaluation. Clinically significant improvements were observed in all outcome measures, and a resume of patient's usual sports activities without pain or limitations was possible after treatment. Results lasted over a 6-month follow-up. To the best of our knowledge, this is the first study applying a comprehensive approach based on accurate physical assessment, and using the EdUReP theoretical model. The combination of the EdUReP model and manual therapy was effective in resolving the patient's symptoms and restore his usual sport activities. While these results cannot be generalized, the present findings could provide a valuable foundation for future researches.

  1. ed, puud, rohukõrred : [luuletused] / Domokos Szil{u00E1gyi ; tlk. Tiiu Kokla

    Index Scriptorium Estoniae

    Szil{u00E1gyi, Domokos


    Sisu: Mäed, puud, rohukõrred ; Väiksed armuhümnid ; Nõid ; Katke kinni vanaisa ; Pööripäev ; Avaldus ; Kelles iseoma südametunnistusele koputad ; Süüdistus ; Tee nii, et armastaksin ; Circumdederunt ; Hädamaandumine. Eluloolisi andmeid autori kohta lk. 297-298

  2. A SEM-EDS Study of Cultural Heritage Objects with Interpretation of Constituents and Their Distribution Using PARC Data Analysis

    NARCIS (Netherlands)

    Hoek, van C.J.G.; Roo, M.; Veer, van der G.; Laan, der S.R.


    Two cultural heritage objects studied with scanning electron microscopy-energy dispersive spectroscopy (EDS) are presented in this article: (1) archeological iron present in a soil sample and (2) a chip from a purple-colored area of an undisclosed 17th century painting. Novel PARC software was used

  3. Test Reviews: Reynolds, C., & Voress, J. K. (2007). "Test of Memory and Learning: Second Edition." Austin, TX: PRO-ED (United States)

    Schmitt, Ara J.; Decker, Scott L.


    This article reviews the Test of Memory and Learning: Second Edition (TOMAL-2), published by PRO-ED, which constitutes a recent revision of the Test of Memory and Learning (TOMAL; Reynolds & Bigler, 1994). Advertised as the "single most comprehensive memory battery available for the entire age range of 5 years through 59 years of age", the TOMAL-2…

  4. Thomas DaCosta Kaufmann and Michael North (eds., Mediating Netherlandish Art and Material Culture in Asia

    Directory of Open Access Journals (Sweden)

    Claartje Rasterhoff


    Full Text Available Book notice of: Thomas DaCosta Kaufmann and Michael North (eds., Mediating Netherlandish Art and Material Culture in Asia (Amsterdam Studies in the Dutch Golden Age Amsterdam, Amsterdam University Press, 2014. 348 pp. ISBN 978-90-8964-569-2. € 99,00.

  5. The Common Core State Standards and the Role of Instructional Materials: A Case Study on (United States)

    Watt, Michael G.


    The purpose of this study was to review research studies investigating the role of instructional materials in relation to the Common Core State Standards and to evaluate whether a new organisation,, founded to evaluate the alignment of instructional materials to the Common Core State Standards, has achieved its objectives. Content…

  6. CrashEd--A Live Immersive, Learning Experience Embedding STEM Subjects in a Realistic, Interactive Crime Scene (United States)

    Bassford, Marie L.; Crisp, Annette; O'Sullivan, Angela; Bacon, Joanne; Fowler, Mark


    Interactive experiences are rapidly becoming popular via the surge of "escape rooms"; part game and part theatre, the "escape" experience is exploding globally, having gone from zero offered at the outset of 2010 to at least 2800 different experiences available worldwide today. CrashEd is an interactive learning experience that…

  7. Questioning expertise. (book review of Evan Selinger & Robert Crease (eds), 'The philosophy of expertise, and Roger Pielke, 'The honest broker'.)

    NARCIS (Netherlands)

    Briggle, A.R.


    The Philosophy of Expertise / Evan Selinger & Robert P. Crease, (eds). - New York : Columbia University Press, 2006. - ISBN 0-231-13644-7 [and] The Honest Broker: Making Sense of Science in Policy and Politics / Roger A. Pielke. - New York : Cambridge University Press, 2007. - ISBN 05-218-7320-7

  8. Impact of a logistics management program on admitted patient boarders within an emergency department. (United States)

    Healy-Rodriguez, Mary Anne; Freer, Chris; Pontiggia, Laura; Wilson, Rula; Metraux, Steve; Lord, Lyndsey


    ED crowding is a public health issue, and hospitals across the country must pursue aggressive strategies to improve patient flow to help solve this growing problem. The logistics management program (LMP) is an expansion of the bed management process to include a systematic approach to patient flow management throughout the facility and a clinical liaison or field agent to drive throughput at all points of care. The purpose of this study was to examine the effects of an LMP on ED length of stay (ED evaluation times and ED placement times), as well as inpatient length of stay (IPLOS). This is a quasi-experimental study of 28,684 ED admissions in a suburban, tertiary medical center before and after implementing an LMP (2008 vs 2009). The median ED evaluation time was 219 minutes (interquartile range [IQR], 178 minutes) in 2008 versus 207 minutes (IQR, 171 minutes) in 2009 (P < .001). The median ED placement time was 219 minutes (IQR, 259 minutes) in 2008 versus 193 minutes (IQR, 158 minutes) in 2009 (P < .001). The median IPLOS was 3.93 days (IQR, 4.9 days) in 2008 versus 3.83 days (IQR, 4.7 days) in 2009 (P < .001), which represents a reduction of 1,483 inpatient days in 2009. The results provide strong evidence to support the impact of an LMP on decreasing ED evaluation times, ED placement times, and IPLOS. Further exploration is needed to examine the program as a best practice, as well as its applicability for other facilities. Copyright © 2014 Emergency Nurses Association. Published by Mosby, Inc. All rights reserved.

  9. Impact of a Community Dental Access Program on Emergency Dental Admissions in Rural Maryland. (United States)

    Rowland, Sandi; Leider, Jonathon P; Davidson, Clare; Brady, Joanne; Knudson, Alana


    To characterize the expansion of a community dental access program (CDP) in rural Maryland providing urgent dental care to low-income individuals, as well as the CDP's impact on dental-related visits to a regional emergency department (ED). We used de-identified CDP and ED claims data to construct a data set of weekly counts of CDP visits and dental-related ED visits among Maryland adults. A time series model examined the association over time between visits to the CDP and ED visits for fiscal years (FYs) 2011 through 2015. The CDP served approximately 1600 unique clients across 2700 visits during FYs 2011 through 2015. The model suggested that if the CDP had not provided services during that time period, about 670 more dental-related visits to the ED would have occurred, resulting in $215 000 more in charges. Effective ED dental diversion programs can result in substantial cost savings to taxpayers, and more appropriate and cost-effective care for the patient. Community dental access programs may be a viable way to patch the dental safety net in rural communities while holistic solutions are developed.

  10. Comparing CLM and CLM-ED as a basis for representing carbon cycling dynamics in a Central Amazonian forest (United States)

    Knox, R. G.; Holm, J. A.; Koven, C. D.; Riley, W. J.; Chambers, J. Q.; Fisher, R.; Muszala, S.; Higuchi, N.


    Old-growth tropical forests are responsible for a potentially large portion of the terrestrial carbon sink, although the underlying control mechanisms of that sink, has large uncertainties. The quantification of the tropical forest carbon sink is a grand challenge of measurement scale. Therefore, there is a strong emphasis on incorporating improved vegetation structure and compositional representativeness in land-surface modeling. Vegetation demography, plant competition, mechanistic mortality, disturbance cycling, and plant functional traits strongly control carbon dynamics and energy budgets of the Earth's surface. Size and age structured scaling processes have not been represented in the widely used Community Land Model (CLM) until the recent inclusion of the Ecosystem Demography (ED) model into CLM 4.5, i.e., CLM-ED. The goal of this study was to compare how CLM-ED captured tropical carbon cycling dynamics compared to CLM and 16 years of field measurements from a central Amazonian forest. We evaluated critical carbon flux processes (Mg C ha-1 yr-1) such as net ecosystem exchange (NEE), net primary production (NPP), and autotrophic respiration (AR), and additional representations of growth and maintenance in CLM and CLM-ED. For a central Amazonian forest CLM estimated GPP from 2000-2012, with transient CO2 concentrations, to be 31.5 Mg C ha-1 yr-1 and was similar to field measurements, while initial evaluation of the newly developed CLM-ED estimated GPP to be substantially higher. The introduction of the size and age structure of ED to the CLM framework enables a finer granularity of state information in the canopy and new ways to represent canopy physics. Therefore alternative physics processes were compared, including those that are highly resolved at the cohort scale (i.e. plant groups) to those at the highly parameterized community scale (i.e. the plant canopy as a whole). CLM serves as the land-model component for nearly 40% of the Earth System Models

  11. In memoriam: Cristiana Patta, DVM, 1958-2012, Virologa ed esperta di peste suina africana e malattie esotiche

    Directory of Open Access Journals (Sweden)



    Full Text Available Il mondo della veterinaria è profondamente costernato per la scomparsa prematura di Cristiana Patta, Dirigente dell’Istituto Zooprofilattico Sperimentale della Sardegna.Valente virologa di rilevanza nazionale ed internazionale, si è sempre distinta, nel corso della sua intensa seppure troppo breve esistenza, per competenza e professionalità. Ha iniziato la sua attività come ricercatrice presso l’Istituto di Sassari nel settore delle malattie virali degli animali. Ha conseguito la Specializzazionein microbiologia e virologia con indirizzo in tecniche microbiologiche e virologiche presso la Facoltà di Medicina e Chirurgia dell’Università di Sassari. L’approfondimento delle sue competenze ha poi riguardato i principali aspetti delle malattie esotiche, dalla diagnosi al loro controllo, e la pianificazione e gestione dei piani di eradicazione delle principali malattie infettive sottoposte a controllo a livello comunitario (pesti suine, brucellosi, tubercolosi, blue tongue.Le conoscenze che ha avuto modo di acquisire nella lotta alle pesti suine ed in particolare alla peste suina africana, hanno fatto si che diventasse una esperta a livello nazionale ed internazionale nel settore del controllo di questa malattia. È in tale veste che ha ricoperto il ruolo di un membro del roster degli esperti del Ministero della Salute e della Commissione Europea. Ha contribuito a numerosi progetti di ricerca europei ed è stata invitata, in qualità di relatore, in numerosi consessi scientifici promossi dalle Istituzioni internazionali quali OIE, FAO ed UE.Cristiana Patta ha collaborato in varie circostanze, con la sua autorevole presenza, anche alle iniziative formative che l’Istituto Zooprofilattico Sperimentale dell’Abruzzo e del Molise “G. Caporale” di Teramo ha promosso in qualità di Centro di Collaborazione OIE per la Formazione Veterinaria, l’Epidemiologia, la Sicurezza Alimentare e il Benessere Animale, offrendo il suo contributo in


    Directory of Open Access Journals (Sweden)

    Domenico Enrico Massimo


    Full Text Available Pollution, environmental disruption, oversized urban development and infrastructure new construction jeopardize landscape integrity and people’s quality of life. Research deals with the landscape protection and enhancement providing governments and decision makers with a comprehensive Decision Support System to assess the quality of natural and cultural heritage and address planning measures and policy actions for landscape treasuring. Research set-up a methodology relying upon GIS tools, to spatially discover, detect and define landscape units, so called “Landscape Elements” (“Elementi di Paesaggio”, EdP, along with their endowment such as natural, ecological, historic, cultural, and urban resources. Then evaluate them through a Multi Criteria Analysis (MCA tool set-up by the research team and integrated with a GIS. Research developed a Case Study in the European Mediterranean Basin, validating the whole census system and the performance and support of valuation tools. Results achieved open the possibility to generalize the prototype application at the regional, country and federation levels and therefore support the planning implementation for landscape enhancement.

  13. Book Review: Guide to computer forensics and investigations (3rd ed.

    Directory of Open Access Journals (Sweden)

    Keyu Jiang


    Full Text Available Nelson, B., Phillips, A., Enfinger, F., & Steuart, C. (2008. Guide to computer forensics and investigations (3rd ed.. New Jersey: Pearson Education, Inc. 693 pages, ISBN: 1-4180-6733-4 (paper.Reviewed by Keyu Jiang ( and Ruifeng Xuan (, Department of Information Networking and Telecommunications, Fort Hays State University, Hays, KS 67601Nelson, Phillips, Enfinger, and Steuart’s book is about the science of computer forensics and its implications in crime investigations. This book is not intended to provide comprehensive training in computer forensics, but introduce the science the science of computer forensics and its implications in crime investigations.  It focused on establishing a solid foundation for those who are new to this field.  Nelson, Philips, Enfiger, and Steuart are experienced experts in different areas of computer forensics.  Different expertise makes this book could benefit many groups of people at different educational level and industrial background.(see PDF for full review

  14. Nine years of DentEd--a global perspective on dental education. (United States)

    Reynolds, P A; Eaton, K A; Paganelli, C; Shanley, D


    This paper describes the three successive and successful DentEd projects, funded by the European Union, that established a productive thematic network which identified common content within the dental curriculum. It then developed an agreed professional profile, with a defined set of competences and a modular curriculum for all new dental graduates based on the European Credit Transfer System and trends in learning and assessment. The three phases took nine years to complete. Phase one investigated all aspects of dental undergraduate education and included over 30 visits to different dental schools by teams of dental educators. Phase two built on this work and included further visits to dental schools. Phase three refined the competency framework that had been developed in phase two and culminated in a global dental conference which finalised position papers on all aspects of dental education. The work and recommendations of the ICT in dental education group are considered in detail in the paper. The projects provided the stimulus for a number of European and international collaborations, including the web-based International Federation of Dental Education and Associations (IFDEA) Knowledge Centre and the International Virtual Dental School (IVIDENT), both of which aim to make increasingly sophisticated ICT-based educational material available worldwide and to promote international understanding.

  15. LinkED: A Novel Methodology for Publishing Linked Enterprise Data

    Directory of Open Access Journals (Sweden)

    Shreyas Suresh Rao


    Full Text Available Semantic Web technologies have redefined and strengthened the Enterprise-Web interoperability over the last decade. Linked Open Data (LOD refers to a set of best practices that empower enterprises to publish and interlink their data using existing ontologies on the World Wide Web. Current research in LOD focuses on expert search, the creation of unified information space and augmentation of core data from an enterprise context. However, existing approaches for publication of enterprise data as LOD are domain-specific, ad-hoc and suffer from lack of uniform representation across domains. The paper proposes a novel methodology called LinkED that contributes towards LOD literature in two ways: (a streamlines the publishing process through five stages of cleaning, triplification, interlinking, storage and visualization; (b addresses the latest challenges in LOD publication, namely: inadequate links, inconsistencies in the quality of the dataset and replicability of the LOD publication process. Further, the methodology is demonstrated via the publication of digital repository data as LOD in a university setting, which is evaluated based on two semantic standards: Five-Star model and data quality metrics. Overall, the paper provides a generic LOD publication process that is applicable across various domains such as healthcare, e-governance, banking, and tourism, to name a few.

  16. Microstructural characterization of autogenous laser welds on 316L stainless steel using EBSD and EDS. (United States)

    Kell, J; Tyrer, J R; Higginson, R L; Thomson, R C


    This research is concerned with autogenous welding of 316L stainless steel and the microstructure generated by such a process. Autogenous welding does not require a filler material and in this case relies on an initial shallow melt phase to maintain a conduction limited weld. Essentially, a high power laser beam traverses the substrate, with the beam shaped by conventional optics, which produces a Gaussian irradiance distribution; or with a diffractive optical element, used to produce a uniform irradiance distribution. Initial results have shown that due to the nature of the heating cycle, complex microstructures are developed. These fine, complicated microstructures cannot be satisfactorily resolved and quantified using standard optical microscopy techniques. Electron backscatter diffraction (EBSD) and energy dispersive spectroscopy (EDS) have been carried out on a number of different microstructures prepared using a range of welding parameters. It is demonstrated that the simultaneous determination of the chemistry and crystallography is a very useful tool for rapid identification of the different phases formed on solidification as a consequence of varying welding procedures.

  17. EDs credit drills, community engagement with helping them manage casualties from tornado crises. (United States)


    Emergency department leaders at DCH Regional Medical Center in Tuscaloosa, AL, and Cullman Regional Medical Center in Cullman, AL, credit their regular practice drills with helping them deal with unprecedented demand when deadly tornadoes swept through the South this past April. Both facilities used the hospital instant command structure (HICS) to mobilize the resources needed to care for the surge in patients, and say the approach worked well in helping them meet the needs of their communities. However, the crises also showcased opportunities for improvement. The ED at DCH Regional Medical Center saw more than 600 patients on the day of the storm, a three-fold increase in the hospital's typical volume. CRMC treated 99 patients in the seven hours immediately following the storm when it usually treats 114 patients per day. In addition to a big surge in patients, both hospitals dealt with power outages that limited access to some services such as radiology. Triage proved particularly challenging at DCH Regional Medical Center, as patients flowed into the hospital from numerous access points. The hospital plans to assign coordinators to each area of the hospital to better manage the influx in the future. When reviewing emergency operations plans, Joint Commission reviewers often find deficiencies in hazard vulnerability analyses as well as the processes used to determine the emergency credentials of licensed independent practitioners.

  18. La crisi energetica nel mondo e in Italia da Enrico Fermi ed Edoardo Amaldi a oggi

    CERN Document Server

    Salvini, Giorgio


    Enrico Fermi e il suo allievo Edoardo Amaldi, grandi padri della Scuola di fisica nucleare italiana, hanno promosso l'impiego pacifico dell'energia nucleare: Fermi con il primo reattore a Chicago nel 1942, Arnaldi con i suoi contributi a tutti gli usi pacifici, dalla medicina alla produzione di energia. L'Italia, però, ha fatto eccessivo ricorso al petrolio, di cui non è produttrice. La ricerca è rimasta molto indietro rispetto a quella degli altri paesi e la politica sta dedicando pochissimi sforzi a questa gravissima situazione. Ragioni economiche, nonché ambientali, esigono ora una revisione e una ricontestualizzazione del problema. Durante un importante Convegno, tenutosi a Roma il 15 e 16 maggio 2007, alcuni tra i più noti ed esperti fisici italiani e stranieri hanno discusso proprio di questo problema. L'intento del volume, che raccoglie gli interventi del Convegno romano, è quello di fornire dati e informazioni che mettano il lettore in condizione di farsi un'idea propria, libera da pregiudizi, s...

  19. Evaluation of the subacute and subchronic toxicity of inhaled EDS hydrotreated naphtha in the rat. (United States)

    McKee, R H; Hinz, J P


    Inhalation studies were conducted to assess the subacute and subchronic toxicity of EDS hydrotreated naphtha (HN). In the subacute toxicity study, male and female Sprague-Dawley rats were exposed to various concentrations of HN vapor (0.2, 1.0, and 5.0 g/m3) 6 hr/day for 5 consecutive days. Following 2 recovery days, the animals were exposed for 4 additional days and then sacrificed on the 12th study day. In the subchronic toxicity study, a similar protocol was utilized; however, the animals were exposed 5 days/week for 13 weeks. Following a 2-week recovery period, the animals were sacrificed. Parameters examined in both studies included survival, growth, clinical observations, urinalysis, blood chemistry at necropsy, and microscopic examination of selected tissues. There was some evidence of systemic effects associated with repeated inhalation exposure to HN, although these effects were mild and were primarily confined to the high-exposure groups. The major systemic effect appeared to be renal toxicity in male rats as evidenced by increased urinary excretion of renal epithelial cells, creatinine, glucose, and protein and decreased urine osmolality. However, the absence of consistent pathologic changes in the kidneys of these animals suggested that the lesions were either slight or reversible during the 2-week recovery period.

  20. The hydrogen resource. Productive, technical and economic analysis; La risorsa idrogeno: analisi produttiva tecnica ed economica

    Energy Technology Data Exchange (ETDEWEB)

    De Fronzo, G. [Lecce Univ., Lecce (Italy). Dipt. di Scienze Economiche, Matematico-Statistiche, Economici-Aziendali


    Diffusion of hydrogen as an energetic vector meets with a lot of obstacles that don't depend on available raw material, but on hydrogen combination with other elements. It is necessary, therefore, to separate hydrogen picking out the available different technologies to have different pure hydrogen of variable quantities. Besides, its diffusion as fuel is limited because of the great production cost compared to fuels sprung from petroleum. Hydrogen used on a large scale could have advantages on the environment and occupation, but there are economic and politic obstacles to limit its diffusion. Future of economic system, based on hydrogen as the main energetic vector, will depend on the programme that national and international qualified governing bodies will be able to do. [Italian] L'articolo analizza l'uso dell'idrogeno come risorsa dal punto di vista tecnico ed economico. Si discute la relazione con i programmi che governi nazionali sapranno mettere in campo per il suo sfruttamento.

  1. SEM/EDS characterisation of dusty deposits in precipitation and assessment of their origin

    Directory of Open Access Journals (Sweden)

    Miloš Miler


    Full Text Available Detailed scanning electron microscopy/energy dispersive spectroscopy (SEM/EDS analysis of dusty material in rainfall residue, deposited and collected on February 19th 2014 in Ljubljana, was carried out with the intention to characterise it according to its chemical and mineral composition and to assess its origin. The material consists of poorly sorted and sharp-edged particles of mostly very fine-grained silt and clay fractions, which is consistent with long-range aerial transport. Particles are represented by illite, chlorite and kaolinite group clay minerals, quartz, feldspars, carbonates, accessory minerals and secondary Fe-oxy-hydroxide minerals. Quantities of minerals and illite/ kaolinite ratio (4.5 correspond to dusts in rainfall residues originating from Moroccan Atlas, while chlorite/kaolinite ratio (2.8 agrees better with dust from central Libya. The element ratios Al/Si, Ca/Al, K/Ca, Mg/Al, Fe/Al and (Ca+Mg/Fe in the studied dusty deposit are in good agreement with ratios in dusts from rainfall residues originating from Morocco and northern Mauritania. This was also confirmed by the trajectories of cloud movement that caused precipitation with dusty deposit, although the back trajectory HYSPLIT simulation of air masses indicated northern Mauritania, central Niger, southern Algeria, southwestern and central Libya as the most possible source regions.

  2. Esistenza del modo O in piastre tridimensionali con fori circolari ed ellittici soggette a modo II

    Directory of Open Access Journals (Sweden)

    Christian Marangon


    Full Text Available Il problema di una piastra criccata tridimensionale soggetta a modo II è stato affrontato in letteratura dimostrando che l’effetto del coefficiente di Poisson provoca l’insorgere di una nuova singolarità accoppiata al carico esterno applicato e non contemplata dalla soluzione piana di Williams. Recenti analisi teoriche e numeriche hanno evidenziato come questo effetto tridimensionale sia presente anche in piastre intagliate a spigolo vivo. Il nuovo modo (denominato modo O rimane singolare anche per angoli di apertura dell’intaglio maggiori di 102.6° e cioè quando il modo II risulta essere non singolare. Tutte le analisi fino ad ora effettuate hanno riguardato piastre indebolite da cricche o intagli a spigolo vivo non considerando l’effetto di un raggio di raccordo diverso da zero all’apice dell’intaglio.L’obiettivo del presente contributo è quello di dimostrare che il modo O è presente anche in piastre tridimensionali indebolite da intagli raccordati e soggette a modo II. Si sono quindi analizzate piastre con fori circolari ed ellittici variando sia la geometria dell’intaglio sia il valore del coefficiente di Poisson.

  3. The impact of ED nurse manager leadership style on staff nurse turnover and patient satisfaction in academic health center hospitals. (United States)

    Raup, Glenn H


    Nurse managers with effective leadership skills are an essential component to the solution for ending the nursing shortage. Empirical studies of existing ED nurse manager leadership styles and their impact on key nurse management outcomes such as staff nurse turnover and patient satisfaction have not been performed. The specific aims of this study were to determine what types of leadership styles were used by ED nurse managers in academic health center hospitals and examine their influence on staff nurse turnover and patient satisfaction. ED nurse managers were asked to complete the Multifactor Leadership Questionnaire and a 10-item researcher defined nurse manager role and practice demographics survey. Completed surveys (15 managers and 30 staff nurses) representing 15 out of 98 possible U.S. academic health centers were obtained. Fisher's exact test with 95% confidence intervals were used to analyze the data. The sample percentage of managers who exhibited Transformational leadership styles and demographic findings of nurse manager age, total years experience and length of time in current position matched current reports in the literature. A trend of lower staff nurse turnover with Transformational leadership style compared to non-Trasformational leadership styles was identified. However, the type of leadership style did not appear to have an effect on patient satisfaction. The ED is an ever-changing, highly regulated, critical-care environment. Effective ED nurse manager leadership strategies are vital to maintaining the standards of professional emergency nursing practice to create an environment that can produce management outcomes of decreased staff nurse turnover, thereby enhancing staff nurse retention and potentially impacting patient satisfaction.

  4. Testing the effects of educational toilet posters: a novel way of reducing haemolysis of blood samples within ED. (United States)

    Corkill, David


    Haemolysed blood samples are an unnecessary burden on Emergency Departments (ED) as they increase workloads and drive down efficiencies. Little empirical data exists that demonstrates the effectiveness of educational posters displayed in staff toilet cubicles. This study explored the impact educational toilet posters have on reducing haemolysis rates within the ED. A time series study of the clinical effect of educational toilet posters on reducing haemolysis rates throughout a 12 month period at the Gold Coast Hospital ED was undertaken. The GCH ED is a tertiary emergency service that has approximately 66,000 patient presentations per year. Data was collected prospectively. Analysis was undertaken to investigate the effects on total number of haemolysed samples and those clinically significant samples with a haemolytic index >3. Further investigation explored the specific effects on medical and nursing staff. Analysis undertaken using an independent t-test found that the pre-intervention data demonstrates a medium haemolysis rate of 4.92% (SD=1.04). This is a statistically significantly different (t=3.56, df=50, p=0.001) from the median post intervention data of 3.95% (SD=0.84). The difference of 0.97% (95%CI=0.42, 1.52) represents a 19.72% reduction in clinically significant haemolysed samples over the study period. This study reveals that the use of educational toilet posters had a positive impact on reducing the rates of haemolysed samples collected within the ED. This simple and cost effective educational initiative changed the behaviour of clinical staff. Further investigation is warranted to examine the impact of educational toilet posters on additional clinical scenarios. Crown Copyright © 2011. Published by Elsevier Ltd. All rights reserved.

  5. Lindenmayer DB and Likens GE (eds): Effective ecological monitoring [book review (United States)

    Charles T. Scott


    Long-term ecological monitoring is becoming increasingly important but more challenging to fund. Lindenmayer and Likens describe the common characteristics of successful monitoring programs and of those that fail. They draw upon their monitoring experiences together, independently, and from a variety of other long-term monitoring programs around the world. They then...

  6. Progress Report for the Joint Services Electronics Program (United States)


    design of algorithmi- cally specified systolic arrays," in Computer Architecture: Concepts and Systems. V . M. Milu - tinovic, Ed. Elsevier, 1988. (NSF) [13... V COORDINATED SCIENCE LABORATORY c0 00 PROGRESS REPORT FOR THE JOINT SERVICES ELECTRONICS PROGRAM FOR THE PERIOD APRIL 1, 1987, THROUGH MARCH 31...Heterostructure Electronic Devices by Metalorganic Chemical V apor Deposition (M OCV D

  7. Log-normal based mutation evolutionary programming technique for ...

    African Journals Online (AJOL)

    Economic dispatch requires a reliable optimization technique so loss is minimal. This paper presents Log-Normal Evolutionary Programming (LNEP) technique for solving Economic Dispatch (ED) problem considering loss minimization. Validations on the IEEE 6-bus and IEEE 26-bus test systems demonstrated that LNEP is ...

  8. "Mental deprogramming and programming": An ethical and cultural ...

    African Journals Online (AJOL)

    "Mental deprogramming and programming": An ethical and cultural outlook. T Naisiko. Abstract. No Abstract. Mtafiti Mwafrika Vol. Spec Ed. 2004: pp. 62-75. Full Text: EMAIL FULL TEXT EMAIL FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT. Article Metrics. No metrics found. Metrics powered by PLOS ALM

  9. A Research Program in Computer Technology. 1987 Annual Technical Report (United States)


    mathematical approach to computational network design," in E. E. Swartzlander (ed.), Systolic Signal Processing Systems, chapter 1, Marcel Dekker, 1987...Intention-Based Diagnosis of Novice Programming Errors, Morgan Kaufmann, Los Altos, California, 1986. 32. Johnson, W. L., and E. Soloway, " PROUST

  10. Eagle Adventure: School-Based Type 2 Diabetes Prevention Program Results in Improved Outcomes Related to Food and Physical Activity (United States)

    Stovall-Amos, Angelina; Parker, Stephany; Mata, Sara; Fox, Jill; Jackson, Teresa; Miracle, Sarah; Hermann, Janice


    The Eagle Adventure program was designed as a semester-long, SNAP-Ed program to address food and physical activity choices important for prevention of type 2 diabetes, obesity, and other chronic diseases. The program was developed for implementation in Grades 1-3. This article presents findings from two participating grade centers inclusive of…

  11. Breen, M (Ed. (2001. Learner contributions to language learning: New directions in research Breen, M (Ed. (2001. Learner contributions to language learning: New directions in research.

    Directory of Open Access Journals (Sweden)

    Heliana Mello


    Full Text Available The advances in the field of second (L2 and foreign (FL language teaching and learning in the past two decades have been manifold, among these: acquisition theories that have emerged as a consequence of refinements in experimental and methodological tools; the shift of focus to approaches rather than methods in L2 and FL teaching; socio- interactionist studies’ emphasis on the ecology of the classroom, geared towards community building; and the questioning of teacher training paradigms by teacher development and education programs. The advances in the field of second (L2 and foreign (FL language teaching and learning in the past two decades have been manifold, among these: acquisition theories that have emerged as a consequence of refinements in experimental and methodological tools; the shift of focus to approaches rather than methods in L2 and FL teaching; socio- interactionist studies’ emphasis on the ecology of the classroom, geared towards community building; and the questioning of teacher training paradigms by teacher development and education programs.

  12. A avaliação do Burnout em professores. Comparação de instrumentos: CBP-R e MBI-ED Evaluation of Burnout in teachers. Comparison tools: CBP-R and MBI-ED

    Directory of Open Access Journals (Sweden)

    Bernardo Moreno-Jimenez


    Full Text Available A categoria de professores vem sendo apontada como uma das mais propensas ao estresse e burnout. O instrumento mais utilizado para a avaliação do burnout em docentes tem sido o MBI-Ed. No entanto, pelas especificidades da própria profissão, tem-se verificado a necessidade da elaboração de um questionário que contemple aspectos característicos da organização escolar e das atividades de ensino, inclusive avaliando os elementos antecedentes e conseqüentes da síndrome. Assim sendo foi desenvolvido o CBP. Neste trabalho apresentam-se os estudos efetuados com o CBP-R (Revisado, sua fiabilidade assim como validades interna e de convergência com o MBI-Ed. Pode-se concluir que o CBP-R e o MBI-Ed medem o mesmo fenômeno e que o primeiro destes, além do mais, permite analisar as diferentes fases do processo e explica melhor a sintomatologia dos profissionais acometidos pelo burnout, confirmando suas qualidades como instrumento.Teachers are being appointed as the ones more prone to stress and burnout. Up to now the most used tool for burnout evaluation on teachers are the MBI-Ed. However, due to the complexity of the profession there is a need of a specific questionnaire that involves school organization and learning activities, evaluating also the preceding and the consequential elements of the syndrome. For that, a CBP was developed. This work presents the studies done with CBP-R (revised, its reliabilities, internal validity and convergence with MBI-Ed. It was possible to conclude that CBP-R and MBI-Ed measure the same phenomenon and that the first allows the analysis of different phases of the emotional wear process and better explains the symptoms of professionals assaulted by burnout, confirming the qualities of alternative tools for the evaluation of professional wear on teachers.

  13. Pediatric Critical Care Telemedicine Program: A Single Institution Review. (United States)

    Hernandez, Maria; Hojman, Nayla; Sadorra, Candace; Dharmar, Madan; Nesbitt, Thomas S; Litman, Rebecca; Marcin, James P


    Rural and community emergency departments (EDs) often receive and treat critically ill children despite limited access to pediatric expertise. Increasingly, pediatric critical care programs at children's hospitals are using telemedicine to provide consultations to these EDs with the goal of increasing the quality of care. We conducted a retrospective review of a pediatric critical care telemedicine program at a single university children's hospital. Between the years 2000 and 2014, we reviewed all telemedicine consultations provided to children in rural and community EDs, classified the visits using a comprehensive evidence-based set of chief complaints, and reported the consultations' impact on patient disposition. We also reviewed the total number of pediatric ED visits to calculate the relative frequency with which telemedicine consultations were provided. During the study period, there were 308 consultations provided to acutely ill and/or injured children for a variety of chief complaints, most commonly for respiratory illnesses, acute injury, and neurological conditions. Since inception, the number of consultations has been increasing, as has the number of participating EDs (n = 18). Telemedicine consultations were conducted on 8.6% of seriously ill children, the majority of which resulted in admission to the receiving hospital (n = 150, 49%), with a minority of patients requiring transport to the university children's hospital (n = 103, 33%). This single institutional, university children's hospital-based review demonstrates that a pediatric critical care telemedicine program used to provide consultations to seriously ill children in rural and community EDs is feasible, sustainable, and used relatively infrequently, most typically for the sickest pediatric patients.

  14. The impact of the TelEmergency program on rural emergency care: An implementation study. (United States)

    Sterling, Sarah A; Seals, Samantha R; Jones, Alan E; King, Melissa H; Galli, Robert L; Isom, Kristen C; Summers, Richard L; Henderson, Kristi A


    Introduction Timely, appropriate intervention is key to improving outcomes in many emergent conditions. In rural areas, it is particularly challenging to assure quality, timely emergency care. The TelEmergency (TE) program, which utilizes a dual nurse practitioner and emergency medicine-trained, board-certified physician model, has the potential to improve access to quality emergency care in rural areas. The objective of this study was to examine how the implementation of the TE program impacts rural hospital Emergency Department (ED) operations. Methods Methods included a before and after study of the effect of the TE program on participating rural hospitals between January 2007 and December 2008. Data on ED and hospital operations were collected one year prior to and one year following the implementation of TE. Data from participating hospitals were combined and compared for the two time periods. Results Nine hospitals met criteria for inclusion and participated in the study. Total ED volumes did not significantly change with TE implementation, but ED admissions to the same rural hospital significantly increased following TE implementation (6.7% to 8.1%, p-value = 0.02). Likewise, discharge rates from the ED declined post-initiation (87.1% to 80.0%, p-value = 0.003). ED deaths and transfer rates showed no significant change, while the rate of patient discharge against medical advice significantly increased with TE use. Discussion In this analysis, we found a significant increase in the rate of ED admissions to rural hospitals with TE use. These findings may have important implications for the quality of emergency care in rural areas and the sustainability of rural hospitals' EDs.

  15. Confirmatory analysis of field-presumptive GSR test sample using SEM/EDS (United States)

    Toal, Sarah J.; Niemeyer, Wayne D.; Conte, Sean; Montgomery, Daniel D.; Erikson, Gregory S.


    RedXDefense has developed an automated red-light/green-light field presumptive lead test using a sampling pad which can be subsequently processed in a Scanning Electron Microscope for GSR confirmation. The XCAT's sampling card is used to acquire a sample from a suspect's hands on the scene and give investigators an immediate presumptive as to the presence of lead possibly from primer residue. Positive results can be obtained after firing as little as one shot. The same sampling card can then be sent to a crime lab and processed on the SEM for GSR following ASTM E-1588-10 Standard Guide for Gunshot Residue Analysis by Scanning Electron Microscopy/Energy Dispersive X-Ray Spectrometry, in the same manner as the existing tape lifts currently used in the field. Detection of GSR-characteristic particles (fused lead, barium, and antimony) as small as 0.8 microns (0.5 micron resolution) has been achieved using a JEOL JSM-6480LV SEM equipped with an Oxford Instruments INCA EDS system with a 50mm2 SDD detector, 350X magnification, in low-vacuum mode and in high vacuum mode after coating with carbon in a sputter coater. GSR particles remain stable on the sampling pad for a minimum of two months after chemical exposure (long term stability tests are in progress). The presumptive result provided by the XCAT yields immediate actionable intelligence to law enforcement to facilitate their investigation, without compromising the confirmatory test necessary to further support the investigation and legal case.

  16. ED Triage Decision-Making With Mental Health Presentations: A "Think Aloud" Study. (United States)

    Clarke, Diana E; Boyce-Gaudreau, Krystal; Sanderson, Ana; Baker, John A


    Triage is the process whereby persons presenting to the emergency department are quickly assessed by a nurse and their need for care and service is prioritized. Research examining the care of persons presenting to emergency departments with psychiatric and mental health problems has shown that triage has often been cited as the most problematic aspect of the encounter. Three questions guided this investigation: Where do the decisions that triage nurses make fall on the intuitive versus analytic dimensions of decision making for mental health presentations in the emergency department, and does this differ according to comfort or familiarity with the type of mental health/illness presentation? How do "decision aids" (i.e., structured triage scales) help in the decision-making process? To what extent do other factors, such as attitudes, influence triage nurses' decision making? Eleven triage nurses participating in this study were asked to talk out loud about the reasoning process they would engage in while triaging patients in 5 scenarios based on mental health presentations to the emergency department. Themes emerging from the data were tweaking the results (including the use of intuition and early judgments) to arrive at the desired triage score; consideration of the current ED environment; managing uncertainty and risk (including the consideration of physical reasons for presentation); and confidence in communicating with patients in distress and managing their own emotive reactions to the scenario. Findings support the preference for using the intuitive mode of decision making with only tacit reliance on the decision aid. Copyright © 2015 Emergency Nurses Association. Published by Elsevier Inc. All rights reserved.

  17. Usability Evaluation of a Clinical Decision Support System for Geriatric ED Pain Treatment. (United States)

    Genes, Nicholas; Kim, Min Soon; Thum, Frederick L; Rivera, Laura; Beato, Rosemary; Song, Carolyn; Soriano, Jared; Kannry, Joseph; Baumlin, Kevin; Hwang, Ula


    Older adults are at risk for inadequate emergency department (ED) pain care. Unrelieved acute pain is associated with poor outcomes. Clinical decision support systems (CDSS) hold promise to improve patient care, but CDSS quality varies widely, particularly when usability evaluation is not employed. To conduct an iterative usability and redesign process of a novel geriatric abdominal pain care CDSS. We hypothesized this process would result in the creation of more usable and favorable pain care interventions. Thirteen emergency physicians familiar with the Electronic Health Record (EHR) in use at the study site were recruited. Over a 10-week period, 17 1-hour usability test sessions were conducted across 3 rounds of testing. Participants were given 3 patient scenarios and provided simulated clinical care using the EHR, while interacting with the CDSS interventions. Quantitative System Usability Scores (SUS), favorability scores and qualitative narrative feedback were collected for each session. Using a multi-step review process by an interdisciplinary team, positive and negative usability issues in effectiveness, efficiency, and satisfaction were considered, prioritized and incorporated in the iterative redesign process of the CDSS. Video analysis was used to determine the appropriateness of the CDS appearances during simulated clinical care. Over the 3 rounds of usability evaluations and subsequent redesign processes, mean SUS progressively improved from 74.8 to 81.2 to 88.9; mean favorability scores improved from 3.23 to 4.29 (1 worst, 5 best). Video analysis revealed that, in the course of the iterative redesign processes, rates of physicians' acknowledgment of CDS interventions increased, however most rates of desired actions by physicians (such as more frequent pain score updates) decreased. The iterative usability redesign process was instrumental in improving the usability of the CDSS; if implemented in practice, it could improve geriatric pain care. The


    Directory of Open Access Journals (Sweden)

    Rosaria Solarino


    Full Text Available Si può oggi affrontare il tema degli errori di italiano da una prospettiva che possa giovare contemporaneamente a docenti di italiano L1 ed L2? Noi pensiamo di sì: la ricerca glottodidattica sembra aver ormai apprestato un terreno comune alle due situazioni di apprendimento, sgombrando il campo da vecchi pregiudizi e distinzioni che appaiono ormai superate. Attraverso la contrapposizione di concetti quali “lingua parlata/lingua scritta”,  “errori di lingua / errori di linguaggio”, “apprendimento spontaneo/apprendimento guidato”, “italiano L1/italiano L2”, “errori di apprendimento/errori di interferenza, si indicano diversi criteri per la interpretazione degli errori e la loro valutazione in relazione alle cause, alle situazioni comunicative, ai contesti o allo stadio di evoluzione dell’apprendimento della lingua.     Errors in italian L1 and L2: interference and learning   Can errors in Italian be approached in a way that benefits both L1 and L2 Italian teachers? We believe so: glottodidactic research seems to have prepared a common terrain for these two learning situations, clearing the field of old prejudices and obsolete distinctions.  Through the juxtaposition of concepts like “spoken language/written language”, “language errors/speech errors”, “spontaneous learning/guided learning”, “L1 Italian/L2 Italian”, “learning errors/interference errors”, different criteria for interpreting errors and evaluating them in relation to their causes, to communicative situations, to contexts and the developmental state in learning a language are singled out.

  19. Evaluation of the MIND Research Institute's Spatial-Temporal Math (ST Math) Program in California (United States)

    Wendt, Staci; Rice, John; Nakamoto, Jonathan


    The MIND Research Institute contracted with the Evaluation Research Program at WestEd to conduct an independent assessment of mathematics outcomes in elementary school grades across California that were provided with the ST Math program. Spatial-Temporal (ST) Math is a game-based instructional software designed to boost K-5 and secondary-level…

  20. The Impact Factor: Measuring Student Professional Growth in an Online Doctoral Program (United States)

    Kumar, Swapna; Dawson, Kara


    This article describes the impact of an online Ed.D. in educational technology based on data collected from students at regular intervals during the program. It documents how students who were working professionals applied learning from the program within their practice, enculturated into the educational technology community, and grew…

  1. Evaluation of Supplemental Nutrition Assistance Program Education: Application of Behavioral Theory and Survey Validation (United States)

    Wyker, Brett A.; Jordan, Patricia; Quigley, Danielle L.


    Objective: Application of the Transtheoretical Model (TTM) to Supplemental Nutrition Assistance Program Education (SNAP-Ed) evaluation and development and validation of an evaluation tool used to measure TTM constructs is described. Methods: Surveys were collected from parents of children receiving food at Summer Food Service Program sites prior…

  2. Report from the commission about the industrial and financial project of EdF; Rapport de la commission sur le projet industriel et financier d'EDF

    Energy Technology Data Exchange (ETDEWEB)



    This report takes stock of the work carried out by the commission appointed by the French ministry of economy, finances and industry about the industrial and financial project of Electricite de France (EdF) in the framework of the liberalization of European energy markets. The report presents the conclusions of the commission about EdF's position in the new competition context, about the financial position of the group and about the foreseeable strategic options and their consequences in terms of equity fund needs. 5 appendixes present: the evolution of electricity prices, EdF and the energy policy, the electricity market and the competition in Europe, the EdF group: presentation and main adaptation stakes, the financial situation of EdF group. (J.S.)

  3. Evaluating the Value of High Spatial Resolution in National Capacity Expansion Models using ReEDS: Preprint

    Energy Technology Data Exchange (ETDEWEB)

    Krishnan, Venkat; Cole, Wesley


    Power sector capacity expansion models (CEMs) have a broad range of spatial resolutions. This paper uses the Regional Energy Deployment System (ReEDS) model, a long-term national scale electric sector CEM, to evaluate the value of high spatial resolution for CEMs. ReEDS models the United States with 134 load balancing areas (BAs) and captures the variability in existing generation parameters, future technology costs, performance, and resource availability using very high spatial resolution data, especially for wind and solar modeled at 356 resource regions. In this paper we perform planning studies at three different spatial resolutions--native resolution (134 BAs), state-level, and NERC region level--and evaluate how results change under different levels of spatial aggregation in terms of renewable capacity deployment and location, associated transmission builds, and system costs. The results are used to ascertain the value of high geographically resolved models in terms of their impact on relative competitiveness among renewable energy resources.

  4. Comparative Analgesic Efficacy of Oxycodone/Acetaminophen vs Codeine/Acetaminophen for Short-Term Pain Management Following ED Discharge. (United States)

    Chang, Andrew K; Bijur, Polly E; Lupow, Jason B; Gallagher, E John


    To test the hypothesis that oxycodone/acetaminophen provides analgesia superior to codeine/acetaminophen following emergency department (ED) discharge. Prospective, randomized, double-blind, trial. Adult inner city ED. ED patients with acute extremity pain who were discharged home. Patients randomized to oxycodone/acetaminophen (5 mg/325 mg) or codeine/acetaminophen (30 mg/300 mg). The primary outcome, obtained via telephone one day after ED discharge, was the between-group difference in improvement in numerical rating scale (NRS) pain scores over a 2-hour period following the most recent ingestion of study drug. Secondary outcomes included proportion of patients with >50% pain reduction, side-effect profile, and patient satisfaction. Two hundred and forty patients were enrolled. Mean baseline NRS scores were 7.9 in both groups. Mean decrease over 2 hours was 4.5 NRS units in the oxycodone/acetaminophen group vs 4.2 NRS units in the codeine/acetaminophen group, for a clinically and statistically nonsignificant difference of 0.2 NRS units (95% CI -0.4-0.9 NRS units). Similarly, 66% vs 61% achieved >50% pain relief for a nonsignificant difference of 5% (95% CI -8% to 17%). Side-effect profile and patient satisfaction were similar. Our hypothesis that oxycodone/acetaminophen provides analgesia superior to codeine/acetaminophen was rejected. Although pain within each group was reduced by more than half, the between-group difference was not significant. Pending independent validation, these unexpected findings suggest that codeine/acetaminophen, a Schedule III agent, may be a clinically reasonable outpatient opioid alternative to oxycodone/acetaminophen, a more tightly restricted Schedule II agent thought to be more prone to misuse. Wiley Periodicals, Inc.

  5. Feasibility of Non-Mydriatic Ocular Fundus Photography in the Emergency Department: Phase I of the FOTO-ED Study (United States)

    Bruce, Beau B.; Lamirel, Cédric; Biousse, Valérie; Ward, Antionette; Heilpern, Katherine L.; Newman, Nancy J.; Wright, David W.


    Objectives Examination of the ocular fundus is imperative in many acute medical and neurologic conditions, but direct ophthalmoscopy by non-ophthalmologists is underutilized, poorly performed, and difficult without pharmacologic pupillary dilation. The objective was to examine the feasibility of non-mydriatic fundus photography as a clinical alternative to direct ophthalmoscopy by emergency physicians (EPs). Methods Adult patients presenting to the emergency department (ED) with headache, acute focal neurologic deficit, diastolic blood pressure ≥ 120 mmHg, or acute visual change had ocular fundus photographs taken by nurse practitioners using a non-mydriatic fundus camera. Photographs were reviewed by a neuro-ophthalmologist within 24 hours for findings relevant to acute ED patient care. Nurse practitioners and patients rated ease, comfort, and speed of non-mydriatic fundus photography on a 10-point Likert scale (10 best). Timing of visit and photography were recorded by automated electronic systems. Results Three hundred fifty patients were enrolled. There were 1,734 photographs taken during 230 nurse practitioner shifts. Eighty-three percent of the 350 patients had at least one eye with a high quality photograph, while only 3% of patients had no photographs of diagnostic value. Mean ratings were ≥ 8.7 (standard deviation [SD] ≤ 1.9) for all measures. The median photography session lasted 1.9 minutes (interquartile range [IQR] 1.3 to 2.9 minutes), typically accounting for less that 0.5% of the patient’s total ED visit. Conclusions Non-mydriatic fundus photography taken by nurse practitioners is a feasible alternative to direct ophthalmoscopy in the ED. It is performed well by non-physician staff, is well-received by staff and patients, and requires a trivial amount of time to perform. PMID:21906202

  6. A novel method to establish a rat ED model using internal iliac artery ligation combined with hyperlipidemia. (United States)

    Hu, Chao; Wang, Feixiang; Dong, Yehao; Dai, Jican


    To investigate a novel method, namely using bilateral internal iliac artery ligation combined with a high-fat diet (BCH), for establishing a rat model of erectile dysfunction (ED) that, compared to classical approaches, more closely mimics the chronic pathophysiology of human ED after acute ischemic insult. Forty 4-month-old male Sprague Dawley rats were randomly placed into five groups (n = 8 per group): normal control (NC), bilateral internal iliac artery ligation (BIIAL), high-fat diet (HFD), BCH, and mock surgery (MS). All rats were induced for 12 weeks. Copulatory behavior, intracavernosal pressure (ICP), ICP/mean arterial pressure, hematoxylin-eosin staining, Masson's trichrome staining, serum lipid levels, and endothelial and neuronal nitric oxide synthase immunohistochemical staining of the cavernous smooth muscle and endothelium were assessed. Data were analyzed by SAS 8.0 for Windows. Serum total cholesterol and triglyceride levels were significantly higher in the HFD and BCH groups than the NC and MS groups. High density lipoprotein levels were significantly lower in the HFD and BCH groups than the NC and MS groups. The ICP values and mount and intromission numbers were significantly lower in the BIIAL, HFD, and BCH groups than in the NC and MS groups. ICP was significantly lower in the BCH group than in the BIIAL and HFD groups. Cavernous smooth muscle and endothelial damage increased in the HFD and BCH groups. Cavernous smooth muscle to collagen ratio, nNOS and eNOS staining decreased significantly in the BIIAL, HFD, and BCH groups compared to the NC and MS groups. The novel BCH model mimics the chronic pathophysiology of ED in humans and avoids the drawbacks of traditional ED models.

  7. A novel method to establish a rat ED model using internal iliac artery ligation combined with hyperlipidemia.

    Directory of Open Access Journals (Sweden)

    Chao Hu

    Full Text Available OBJECTIVE: To investigate a novel method, namely using bilateral internal iliac artery ligation combined with a high-fat diet (BCH, for establishing a rat model of erectile dysfunction (ED that, compared to classical approaches, more closely mimics the chronic pathophysiology of human ED after acute ischemic insult. MATERIALS AND METHODS: Forty 4-month-old male Sprague Dawley rats were randomly placed into five groups (n = 8 per group: normal control (NC, bilateral internal iliac artery ligation (BIIAL, high-fat diet (HFD, BCH, and mock surgery (MS. All rats were induced for 12 weeks. Copulatory behavior, intracavernosal pressure (ICP, ICP/mean arterial pressure, hematoxylin-eosin staining, Masson's trichrome staining, serum lipid levels, and endothelial and neuronal nitric oxide synthase immunohistochemical staining of the cavernous smooth muscle and endothelium were assessed. Data were analyzed by SAS 8.0 for Windows. RESULTS: Serum total cholesterol and triglyceride levels were significantly higher in the HFD and BCH groups than the NC and MS groups. High density lipoprotein levels were significantly lower in the HFD and BCH groups than the NC and MS groups. The ICP values and mount and intromission numbers were significantly lower in the BIIAL, HFD, and BCH groups than in the NC and MS groups. ICP was significantly lower in the BCH group than in the BIIAL and HFD groups. Cavernous smooth muscle and endothelial damage increased in the HFD and BCH groups. Cavernous smooth muscle to collagen ratio, nNOS and eNOS staining decreased significantly in the BIIAL, HFD, and BCH groups compared to the NC and MS groups. CONCLUSIONS: The novel BCH model mimics the chronic pathophysiology of ED in humans and avoids the drawbacks of traditional ED models.

  8. Seventy-two-hour antibiotic retrieval from the ED: a randomized controlled trial of discharge instructional modality. (United States)

    Olives, Travis D; Patel, Roma G; Thompson, Hannah M; Joing, Scott; Miner, James R


    Limited health literacy is a risk factor for poor outcomes in numerous health care settings. Little is known about the impact of instructional modality and health literacy on adherence to emergency department (ED) discharge instructions. To examine the impact of instructional modality on 72-hour antibiotic retrieval among ED patients prescribed outpatient antibiotics for infections. English-speaking ED patients diagnosed as having acute infections and prescribed outpatient antibiotics were randomized to standard discharge instructions, standard instructions plus text-messaged instructions, or standard instructions plus voicemailed instructions targeting ED prescriptions. Health literacy was determined by validated instrument. Seventy-two-hour antibiotic retrieval, 30-day report of prescription completion, and discharge instructional modality preference were assessed. Nearly one-quarter of the 2521 participants demonstrated low health literacy. Low health literacy predicted decreased 72-hour antibiotic retrieval (χ(2) = 9.56, P=.008). No significant association with antibiotic retrieval was noted across the 3 treatment groups (χ(2) = 5.112, P=.078). However, patients randomized to the text message group retrieved antibiotic prescriptions within 72 hours more frequently than did those randomized to the voicemail treatment group (χ(2) = 4.345, P=.037), and patients with low health literacy randomized to voicemailed instructions retrieved their antibiotic prescriptions less frequently than did those randomized to standard of care instructions (χ(2) = 5.526, P=.019). Reported instructional modality preferences were inconsistent with the primary findings of the study. Discharge instructional modality impacts antibiotic retrieval in patients with low health literacy. Preference for discharge instructional modality varies by degree of health literacy, but does not predict which modality will optimize 72-hour antibiotic retrieval. Copyright © 2016 Elsevier Inc. All

  9. Prognostic value of early warning scores in the emergency department (ED) and acute medical unit (AMU): A narrative review. (United States)

    Nannan Panday, R S; Minderhoud, T C; Alam, N; Nanayakkara, P W B


    A wide array of early warning scores (EWS) have been developed and are used in different settings to detect which patients are at risk of deterioration. The aim of this review is to provide an overview of studies conducted on the value of EWS on predicting intensive care (ICU) admission and mortality in the emergency department (ED) and acute medical unit (AMU). A literature search was conducted in the bibliographic databases PubMed and EMBASE, from inception to April 2017. Two reviewers independently screened all potentially relevant titles and abstracts for eligibility. 42 studies were included. 36 studies reported on mortality as an endpoint, 13 reported ICU admission and 9 reported the composite outcome of mortality and ICU admission. For mortality prediction National Early Warning Score (NEWS) was the most accurate score in the general ED population and in those with respiratory distress, Mortality in Emergency Department Sepsis score (MEDS) had the best accuracy in patients with an infection or sepsis. ICU admission was best predicted with NEWS, however in patients with an infection or sepsis Modified Early Warning Score (MEWS) yielded better results for this outcome. MEWS and NEWS generally had favourable results in the ED and AMU for all endpoints. Many studies have been performed on ED and AMU populations using heterogeneous prognostic scores. However, future studies should concentrate on a simple and easy to use prognostic score such as NEWS with the aim of introducing this throughout the (pre-hospital and hospital) acute care chain. Copyright © 2017 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.

  10. PathEdEx - Uncovering High-explanatory Visual Diagnostics Heuristics Using Digital Pathology and Multiscale Gaze Data. (United States)

    Shin, Dmitriy; Kovalenko, Mikhail; Ersoy, Ilker; Li, Yu; Doll, Donald; Shyu, Chi-Ren; Hammer, Richard


    Visual heuristics of pathology diagnosis is a largely unexplored area where reported studies only provided a qualitative insight into the subject. Uncovering and quantifying pathology visual and nonvisual diagnostic patterns have great potential to improve clinical outcomes and avoid diagnostic pitfalls. Here, we present PathEdEx, an informatics computational framework that incorporates whole-slide digital pathology imaging with multiscale gaze-tracking technology to create web-based interactive pathology educational atlases and to datamine visual and nonvisual diagnostic heuristics. We demonstrate the capabilities of PathEdEx for mining visual and nonvisual diagnostic heuristics using the first PathEdEx volume of a hematopathology atlas. We conducted a quantitative study on the time dynamics of zooming and panning operations utilized by experts and novices to come to the correct diagnosis. We then performed association rule mining to determine sets of diagnostic factors that consistently result in a correct diagnosis, and studied differences in diagnostic strategies across different levels of pathology expertise using Markov chain (MC) modeling and MC Monte Carlo simulations. To perform these studies, we translated raw gaze points to high-explanatory semantic labels that represent pathology diagnostic clues. Therefore, the outcome of these studies is readily transformed into narrative descriptors for direct use in pathology education and practice. PathEdEx framework can be used to capture best practices of pathology visual and nonvisual diagnostic heuristics that can be passed over to the next generation of pathologists and have potential to streamline implementation of precision diagnostics in precision medicine settings.

  11. Dal carnalis concubitus all’heretica pravitate. Sesso, matrimonio ed eresia nel tribunale di Jacques Fournier (1318-1325

    Directory of Open Access Journals (Sweden)

    Irene Bueno


    Full Text Available Amore, sessualità e matrimonio sono tematiche ricorrenti nei documenti inquisitoriali due-trecenteschi ed entrano con forza nel registro di Jacques Fournier, vescovo-inquisitore di Pamiers (1318-1325. Il significato di questi racconti non si può comprendere senza chiarire quale interesse essi rivestissero agli occhi dell’autorità ecclesiastica: i rapporti adulterini, incestuosi, omosessuali di imputati e imputate sono in effetti mediati dalla figura di Fournier nell’ambito di una corte che sovrappone competenze vescovili e inquisitoriali. Collegando condotte ed affermazioni licenziose alle posizioni antimatrimoniali dei catari, il vescovo stabilisce in sede processuale un nesso fra carnalis concubitus extraconiugale ed heretica pravitate. Ogni trasgressione allo spazio sacro del matrimonio diventa indizio di eresia e contribuisce a disegnare un ritratto dissoluto e vizioso di eretici ed eretiche, funzionale al successo e alla popolarità della repressione.Love, sex, and marriage are recurring themes in inquisition records of the thirteenth and fourteenth centuries, and especially in the register of Jacques Fournier, bishop-inquisitor of Pamiers from 1318 to 1325. The significance of these confessions cannot be  understood without indicating the ecclesiastical authority’s interest: adultery, incest and homosexual relations of the accused are in fact mediated by Fournier within a court that superimposes episcopal and inquisitorial competences. Linking licentious conducts and libertine statements to the anti-matrimonial tenets of the Cathars, the bishop establishes, during the trial, a connection between sexual sin and heretical crime. Any transgression of the sacred space of marriage is understood to be an indication sign of heresy and contributes to depict a dissolute and vicious portrait of the heretical believers, which is ultimately functional to the success and popularity of repression.

  12. Combined use of SEM-EDS, OM and XRD for the characterization of corrosion products grown on silver roman coins (United States)

    Ingo, G. M.; Balbi, S.; de Caro, T.; Fragalà, I.; Angelini, E.; Bultrini, G.


    In the framework of the PROMET project (European Commission contract No. 509126) aimed to develop new analytical techniques and materials for monitoring and protecting metal artefacts and monuments from the Mediterranean region, the corrosion products grown on silver Roman coins during archaeological burial is studied by means of scanning electron microscopy combined with energy dispersive spectrometry (SEM-EDS), X-ray diffraction (XRD) and optical microscopy (OM) techniques.

  13. An Attempt to Develop the Methodology of Examining the Boron Content in Construction Materials with the Use of Eds Method

    Directory of Open Access Journals (Sweden)

    Popławski M.


    Full Text Available Borided layers are mainly produced during the process of heat-chemical treatment as a result of reactive diffusion of boron inside the material. The borided layers are particularly useful in difficult exploitation conditions. Generally, the borided layers are characterized by the increased hardness, heat resistance and good corrosion resistance. It is commonly known that the major disadvantage of X-ray microanalysis with EDS method is the difficulty in light elements analysis such as boron.

  14. Hepatitis C virus infection in the 1945-1965 birth cohort (baby boomers) in a large urban ED. (United States)

    Allison, Waridibo E; Chiang, William; Rubin, Ada; O'Donnell, Lauren; Saldivar, Miguel A; Maurantonio, Michael; Dela Cruz, Jeffrey; Duvidovich, Svetlana; Carmody, Ellie


    The US Preventive Services Task Force recommends one-time screening of the 1945-1965 birth cohort (baby boomers) for hepatitis C (HCV) infection. New York State legislation mandates screening of baby boomers for HCV in most patient care settings except the emergency department (ED). This cross-sectional study explores baby boomer knowledge of HCV, prevalence of HCV infection, and linkage to care from a large urban ED. Patients participated in a researcher-administered structured interview and were offered an HCV screening test. If HCV antibody reactive, a follow-up clinic appointment was made within 6 weeks. Reminder telephone calls were made a week before the appointment. Attendance at the follow-up appointment was considered successful linkage to care. A total of 915 eligible patients were approached between October 21, 2014, and July 13, 2015. A total of 427 patients participated in the structured interview; 383 agreed to an HCV rapid test. Prevalence of HCV antibody reactivity was 7.3%. Four patients were successfully linked to care. General knowledge about HCV was fair. Misconceptions about transmission were apparent. Beliefs that "if someone is infected with HCV they will most likely carry the virus all their lives unless treated" and that "someone with hepatitis can look and feel fine" were significantly associated with agreement to testing. Better linkage to care is needed to justify HCV screening in the 1945-1965 birth cohort in this particular ED setting. Linkage to care from the ED is challenging but can potentially be improved with specific measures including simplified screening algorithms and supportive resources. Copyright © 2015 Elsevier Inc. All rights reserved.

  15. Sindrome dell'ovaio policistico: ruolo dell'obesità ed impatto sulla qualità di vita




    La Sindrome dell’Ovaio Policistico (Pcos) è disordine non esclusivamente riproduttivo ma sistemico, con importanti implicazioni metaboliche. Nelle adolescenti affette da Pcos sono molto frequenti oligomenorrea, irsutismo ed obesità; in età riproduttiva, infertilità e, in fase climiterica, obesità, dislipidemia, intolleranza ai carboidrati e franco diabete mellito. Le donne con Pcos possono presentare gradi diversi di Insulino-resistenza (IR), che contribuiscono all’aumentato rischio di Sindro...

  16. Effect of fillers in epoxy coatings based on the ED-20 resin on the mechanical properties determined by instrumented microindentation (United States)

    Smirnov, S. V.; Veretennikova, I. A.; Smirnova, E. O.; Pestov, A. V.


    Epoxy lacquer coatings based on the ED-20 epoxy-diane resin, filled with nanosized TiO2, SiO2 and ZnO oxides and applied on an aluminum-magnesium alloy base, are studied by instrumented indentation. The effect of the duration of loading and the duration of holding under a constant load of 1 N on Martens hardness and the normal elastic modulus, depending on the material of the epoxy lacquer filler, has been established.

  17. Comparison of bedside ultrasound and panorex radiography in the diagnosis of a dental abscess in the ED. (United States)

    Adhikari, Srikar; Blaivas, Michael; Lander, Lina


    The purpose of the study was to compare bedside ultrasound (US) and panorex radiography in the diagnosis of a dental abscess in emergency department (ED). A retrospective review of ED records of adult patients with atraumatic facial pain, swelling, and toothache who received a panorex x-ray and bedside US was performed. Medical records were reviewed for ED evaluation and disposition. Sensitivity and specificity of US and panorex x-ray were calculated to determine the clinical utility of the 2 tests. A total of 19 patients were identified. No periapical abscess was reported on panorex x-rays in 7 (37%) of 19 patients. Ultrasound agreed with panorex x-rays in 6 (86%) of 7 cases. One case where US disagreed with x-rays was evaluated by dentistry consultants; and incision and drainage were performed, confirming the presence of an abscess. An x-ray diagnosis of periapical abscess was made in 12 (63%) of 19 patients. Ultrasound agreed with panorex x-ray in 10 (83%) of 12 cases. In 1 of the 2 cases where US disagreed with panorex x-rays, x-ray abnormalities were reported on the nonsymptomatic side. The other patient was given antibiotics and recommended outpatient follow-up. Follow-up information was not available to further confirm the presence of an abscess. Assuming that the patient who was lost to follow-up had dental abscess, the sensitivity and specificity of US in diagnosing a dental abscess were 92% and 100%, respectively. Bedside US is nonionizing, is readily available, and can provide an alternative to panorex x-rays in the evaluation of a dental abscess in ED. Copyright © 2011 Elsevier Inc. All rights reserved.

  18. Reevaluation of the effect of mandatory interpreter legislation on use of professional interpreters for ED patients with language barriers. (United States)

    Ginde, Adit A; Sullivan, Ashley F; Corel, Blanka; Caceres, J Alfredo; Camargo, Carlos A


    We sought to compare emergency department (ED) use of professional interpreters in 2008 to previously reported 2002 data. We surveyed consecutive adult patients for two 24-h periods at 4 Boston EDs in 2008. We used identical questions as in our 2002 study to assess English language barriers and to measure use and type of interpreter for those with language barriers. We enrolled 498 patients (66% of eligible). Of these, 8% had a significant English language barrier, but any interpreter was used for only 69% of these patients; the corresponding data for 2002 were 11% and 89%, respectively. In 2008, compared to 2002, professional interpreter use was similar (18% vs. 15%; p = 0.70), but a friend or family member interpreted more often (59% vs. 24%; pinterpreters by Boston ED patients with language barriers remained low, despite publicity of the state mandatory interpreter law. However, a majority were comfortable with a friend or family member serving as the interpreter for the clinical encounter, a finding that may contribute to the limited usage of professional interpreters. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

  19. Serious conditions for ED elderly fall patients: a secondary analysis of the Basel Non-Specific Complaints study. (United States)

    Liu, Shan W; Sri-On, Jiraporn; Tirrell, Gregory Philip; Nickel, Christian; Bingisser, Roland


    Falls among older adults are a public health problem and are multifactorial. We sought to determine whether falls predict more serious conditions in older adult patients presenting to the emergency department (ED) with a "nonspecific complaint" (NSC). A secondary objective was to examine what factors predicted serious conditions among older adult patients with a fall. This study was a secondary analysis of a prospective delayed-type cross-sectional diagnostic study that included a 30-day follow-up. We included patients 65 years and older who presented to the ED from May 2007 and July 2011 with a NSC and had an Emergency Severity Index score of 2 or 3. We then compared the serious conditions among older adults who presented to the ED with a fall with those who did not fall in a cohort of patients with NSC. We had 1111 patients enrolled in our study; 518 (47%) of them had fallen. We found that 310 (60%) of elderly fall patients vs 349 (59%) of nonfall patients had a 30-day serious condition (P=.74). In multiple logistic regression analysis, falls did not predict serious conditions or 30-day mortality among all NSC patients. Among fall patients, male sex, diuretic use, and generalized weakness predicted serious conditions. Fall patients share many features with nonfall NSC patient. However, falls did not increase the risk of serious conditions. Falls in the elderly could be considered under the broader entity of NSC. Copyright © 2016 Elsevier Inc. All rights reserved.

  20. L’identificazione di virus citopatogeni isolati dall’ambiente:ricerca ed applicazione di protocolli analitici

    Directory of Open Access Journals (Sweden)

    A. Carducci


    conferma molto complessa e richiede l’utilizzo e l’integrazione di più tecniche con specificità e sensibilità
    diverse; le tecniche biomolecolari, ed in particolare la PCR, appaiono di grande utilità a patto di utilizzare primer il più possibile rappresentativi dei virus di derivazione umana. È infatti necessario individuare specificamente i virus patogeni
    per l’uomo per una corretta valutazione del rischio sanitario.

  1. Aktueller Stand und Ausblick der ED-Therapie mit Apomorphin SL

    Directory of Open Access Journals (Sweden)

    Rauchenwald M


    Full Text Available Apomorphin ist ein Dopamin-Agonist mit hoher Affinität zu den D2-Rezeptoren. Es wird als zentraler Initiator beschrieben, obwohl es im engeren Sinn ein zentraler Verstärker des Erektionsreizes ist. Nach derzeitigem Wissensstand bilden die Medial Preoptic Area (MPOA und der paraventrikuläre Nucleus (PVN im Bereich des Zwischenhirns ein supraspinales Integrationszentrum, in welchem erektogene Stimuli wie Phantasiebilder, Gerüche, visuelle und taktile Reize verarbeitet werden. Dopaminerge Neurone, welche mit oxytocinergen im PVN in Verbindung stehen, führen zum sakralen parasympathischen Nukleus und beeinflussen die erektile Balance. Im Bereich des Hirnstamms wird die Erregung moduliert, indem vom Nucleus paragigantocellularis - durch Vorstellungen, Angst, Depression und neurale Afferenzen ausgelöst – inhibitorische Stimuli ausgehen. Dopamin und Oxytocin spielen bei diesen Prozessen als Neurotransmitter eine zentrale Rolle, wobei Oxytocin wahrscheinlich einen Mediator der dopaminergen Erregung darstellt. Sowohl im zentralen Nervensystem als auch am Erfolgsorgan im Schwellkörper wird die Erregung aber letztendlich durch Stickoxyd (NO übertragen. Oxytocin ist derzeit Gegenstand intensiver Forschung und könnte ein weiteres Ziel für eine neue Gruppe von Pharmaka in der Behandlung der erektilen Dysfunktion darstellen. Die in vivo-Aktivität von Apomorphin konnte im funktionellen MRI durch Aktivierung kortikaler und subkortikaler Gehirnstrukturen bei 8 Patienten mit psychogener ED unter visueller sexueller Stimulation nachgewiesen werden. Der jeweilige Funktionszustand der Schwellkörper wird durch die Balance von sympathischen Stimuli aus dem unteren Thorakalmark und parasympathischen Stimuli aus dem Sakralmark bestimmt. Eine zentral ausgelöste Sakralnerven-Stimulation über die Nervi cavernosi führt daher zu einem Überwiegen der parasympathischen Erregung und zu einer vermehrten NO-Freisetzung an den parasympathischen Nervenendigungen und

  2. Carnivore rabies: ecological and evolutionary aspects / La rabbia nei Carnivori: aspetti ecologici ed evolutivi

    Directory of Open Access Journals (Sweden)

    Alexander Wandeler


    monoclonali. I diversi ceppi di virus della rabbia ed i rispettivi ospiti si sono coadattati, al fine di consentire la loro prolungata coesistenza. I caratteri che hanno subito un coadattamento (o una coevoluzione? sono la patogenità, la specificità cellulare (compresa la specificità specifica, la durata del periodo di incubazione, la durata e l'intensità della escrezione virale, la durata e i sintomi delle manifestazioni cliniche, il tasso di crescita pro capite dell'ospite, il suo utilizzo delle risorse (uso dell'habitat, l'organizzazione sociale e il comportamento, e i fattori di mortalità diversi da quelli riconducibili alla rabbia. Tutte queste proprietà dei virus e dell'ospite determinano l'andamento dei contatti infettanti e di tutti gli altri parametri epidemiologici quali l'incidenza, la prevalenza, la morbosità e la mortalità.

  3. An Analysis of the Relationship Between the Professionalism of Defense Acquisition Program Managers and Program Outcomes (United States)


    manager’s job: Folklore and fact . Harvard Business Review, 53(4), 49–61. Mohr, L. (1995). Impact analysis for social evaluation (2nd ed.). Thousand...and Mintzberg (1975) documented the attributes and competencies of effective managers. B. Fox’s Studies J. Ronald Fox’s two books (1974, 1988...significantly better than those of other components. In almost no cases, however, was this relationship evident. In fact , outcomes of Army programs

  4. Analisi tipologiche e morfologiche a supporto della manutenzione programmata con l’ausilio di rilievi catastali ed analisi Istat in operazioni di esproprio

    Directory of Open Access Journals (Sweden)

    Agata Lo Tauro


    Full Text Available A seguito di uno studio iniziato nel 1993 presso la Manchester University, su city centres italiani ed inglesi, è stata avviata una indagine sulle trasformazioni diacroniche e sincroniche delle principali tipologie edilizie utilizzando analisi archivistiche, storiche e strumenti normativi, in primis coniugate con la computer graphics e nella mid-term phase con la geomatica in genere. La fase finale della ricerca ha evidenziato la necessità di implementare strategie di “manutenzione programmata” capaci di “prevenire piuttosto che curare”, utilizzando varie tipologie di Open Data implementando approcci pluridisciplinari. Come case-study è stato scelto il centro storico di Acireale. Typological and morphological analysis to support the mainte-nance program with the help of cadastral surveys Following a study that began in 1993 at Manchester Univer-sity, city centers in Italy and UK started an investigation on the diachronic transformations and synchronic analysis of the main building using archival, historical and regulatory instruments, primarily conjugated with computer graphics and in the mid-term phase with the geomatics in general. The final phase of the  research  highlighted  the  need  to  implement  strategies for "scheduled maintenance" capable of  "prevention rather than cure", using various types of Open Date implementing multidisciplinary approaches. As a case study was chosen the historical center of Acireale.

  5. The effect of age on the median effective dose (ED50) of intrathecally administered plain bupivacaine for motor block. (United States)

    Chen, Mingquan; Chen, Chun; Ke, Qibin


    In this study, we sought to determine the median effective dose (ED50) for motor block of intrathecally administered plain bupivacaine in adults (20-80 years) and to assess the effect of age on ED50 required for motor block. This study was performed in 129 adult patients undergoing transurethral, urological, or lower limb surgery under combined spinal and epidural anesthesia. Patients were stratified according to age as follows: 20 to 30, 31 to 40, 41 to 50, 51 to 60, 61 to 70, and 71 to 80 years. The spinal component of the anesthetic was established by bolus administration of up-and-down doses of 0.75% plain bupivacaine, determined by Dixon's method. The degree of motor block after intrathecal administration of each dose was evaluated by the modified Bromage and hip motor function score. The ED50 values were estimated from the up-and-down sequences using the method of Dixon and Massey and logistic regression. Other end points were included on the basis of sensory block level, duration of motor blockade, hypotension, and vasopressor requirements. ED50 for motor block using intrathecal bupivacaine was 10.22 mg (95% confidence interval [CI], 9.96-10.49 mg) in 20- to 30-, 9.52 mg (95% CI, 9.02-10.07 mg) in 31- to 40-, 8.37 mg (95% CI, 7.56-9.26 mg) in 41- to 50-, 7.30 mg (95% CI, 6.84-7.79 mg) in 51 to 60, 6.55 mg (95% CI, 6.01-7.13 mg) in 61- to 70-, and 5.78 mg (95% CI, 5.01-6.67 mg) in 71- to 80-year-old patients. The maximum cephalic analgesic level was L1-L2 level at 5 minutes and T10-L1 at 10 minutes after administration of intrathecal plain bupivacaine in the 6 age groups. There was a significant difference in the duration of motor blockade among groups. The ED50 for motor block of intrathecally administered plain bupivacaine decreased steeply with advancing age.

  6. Teach for America and Teacher Ed: Heads They Win, Tails We Lose (United States)

    Labaree, David


    Teach for America (TFA) is a marvel at marketing, offering elite college students a win-win option: by becoming corps members, they can do good and do well at the same time. Teacher education (TE) programs are in a hopeless position in trying to compete with TFA for prospective students. They cannot provide students with the opportunity to do…

  7. The evaluation of tertiary institution service quality using HiEdQUAL ...

    African Journals Online (AJOL)

    ... were implemented using Java programming language. This study was able to present the importance of each service quality factor, quantitatively reveal each institution's weak and strong points, and rank the institutions according to the multiple criteria service quality measure. Keywords: Institutions, Fuzzy MCDM, Quality ...

  8. Preservice Teacher Education Benchmarking a Standalone Ed Tech Course in Preparation for Change (United States)

    Foulger, Teresa S.; Buss, Ray R.; Wetzel, Keith; Lindsey, LeeAnn


    In an effort to reform a teacher education program by strengthening content-area preparation and adding opportunities to practice by extending the time for student teaching, Arizona State University's Mary Lou Fulton Teachers College eliminated a group of teacher education courses, including the standalone educational technology course.…

  9. edTPA and Physical Education: Tips for Success for All Stakeholders (United States)

    Treadwell, Sheri M.; Cameron, Jay L.; Manson, Mara


    Many teacher candidates, cooperating teachers, school administrators, and physical education teacher education (PETE) programs have increased responsibilities and needs related to teacher performance assessments (TPA). One TPA in particular is increasing in usage across all content subject areas in the United States: the Education Teacher…

  10. Sex Ed...And the Reds? Reconsidering the Anaheim Battle over Sex Education, 1962-1969 (United States)

    Mehlman, Natalia


    By December 1968, the Anaheim Family Life and Sex Education (FLSE) program, celebrated since its formal introduction in 1965 as one of the most progressive in the nation, was being smeared as communistic and perverse. Local activists in this Orange County city had been congregating in hotel rooms and homes, screening cautionary films for the…

  11. "They Shouldn't Be Coming to the ED, Should They?": A Descriptive Service Evaluation of Why Patients With Palliative Care Needs Present to the Emergency Department. (United States)

    Green, Emilie; Ward, Sarah; Brierley, Will; Riley, Ben; Sattar, Henna; Harris, Tim


    Patients with palliative care needs frequently attend the emergency department (ED). There is no international agreement on which patients are best cared for in the ED, compared to the primary care setting or direct admission to the hospital. This article presents the quantitative phase of a mixed-methods service evaluation, exploring the reasons why patients with palliative care needs present to the ED. This is a single-center, observational study including all patients under the care of a specialist palliative care team who presented to the ED over a 10-week period. Demographic and clinical data were collected from electronic health records. A total of 105 patients made 112 presentations to the ED. The 2 most common presenting complaints were shortness of breath (35%) and pain (28%). Eighty-three percent of presentations required care in the ED according to a priori defined criteria. They either underwent urgent investigation or received immediate interventions that could not be delivered in another setting, were referred by a health-care professional, or were admitted. Findings challenge the misconception that patients known to a palliative care team should be cared for outside the ED. The importance and necessity of the ED for patients in their last years of life has been highlighted, specifically in terms of managing acute, unpredictable crises. Future service provision should not be based solely on a patient's presenting complaint. Further qualitative research exploring patient perspective is required in order to explore the decision-making process that leads patients with palliative care needs to the ED.

  12. Results from an explorative screening program for elbow dysplasia in some breeds of dogs in Italy

    Directory of Open Access Journals (Sweden)

    Luigi Gallo


    Full Text Available This paper aimed to present the first results of an explorative screening program currently running in Italy and focussing  on the prevalence of a specific orthopaedic disorder, elbow dysplasia (ED, in some breeds of dogs commonly reared in  Italy. Data consisted of radiographic findings taken on 1370 dogs (758 females and 612 males of 6 breeds (Bernese  Mountain dog, Cane Corso, German Shepherd , Golden Retriever, Labrador Retriever and Rottweiler screened at an age  of 20.6 ± 11.6 months. Radiographs were graded for both ED and hip dysplasia (HD according to a four- (0 to 3 or a  five-grade (A to E linear system, respectively. Logistic regression analysis was used for studying the relationships  between breed, sex, age of dogs at screening and HD diagnosis with the outcome of the diagnosis for ED. Prevalence of  ED (ED score ≥ 1 for the pool of breeds involved was 25%, and Labrador Retriever (17% and Rottweiler (40% showed,  respectively, the lowest and the highest prevalence of ED among breeds in the study. Prevalence of HD (grades C or high-  er approached 15%. When compared to other breeds, Rottweiler and Bernese Mountain dogs showed significantly high-  er risk to be affected by ED (odds ratio 3.2 and 3.0, respectively. Conversely, sex did not significantly affect the onset  of ED. When compared to the youngest group of dogs at screening (average: 14 months, the oldest group of screened  dogs (average: 40 months exhibited a significantly higher risk of being diagnosed as affected by ED (odds ratio: 1.9.  A negative status of hip joints appeared positively associated with a negative status of elbow joints, and dogs diagnosed  as affected by HD had a 40% increased risk of being diagnosed as affected by ED. In conclusion, results from this study  demonstrated that ED has a noticeable prevalence in some Italian dog populations, particularly in heavy breeds.  Screening of dogs for ED appeared feasible and should be performed

  13. What makes community engagement effective?: Lessons from the Eliminate Dengue Program in Queensland Australia.

    Directory of Open Access Journals (Sweden)

    Pamela A Kolopack


    Full Text Available Worldwide, more than 40% of the population is at risk from dengue and recent estimates suggest that up to 390 million dengue infections are acquired every year. The Eliminate Dengue (ED Program is investigating the use of Wolbachia-infected, transmission-compromised, mosquitoes to reduce dengue transmission. Previous introductions of genetically-modified strategies for dengue vector control have generated controversy internationally by inadequately engaging host communities. Community Engagement (CE was a key component of the ED Program's initial open release trials in Queensland Australia. Their approach to CE was perceived as effective by the ED team's senior leadership, members of its CE team, and by its funders, but if and why this was the case was unclear. We conducted a qualitative case study of the ED Program's approach to CE to identify and critically examine its components, and to explain whether and how these efforts contributed to the support received by stakeholders.In-depth semi-structured interviews were conducted with 24 participants with a range of experiences and perspectives related to the ED Program's CE activities. Our analytic approach combined techniques of grounded theory and qualitative description. The ED Program's approach to CE reflected four foundational features: 1 enabling conditions; 2 leadership; 3 core commitments and guiding values; and 4 formative social science research. These foundations informed five key operational practices: 1 building the CE team; 2 integrating CE into management practices; 3 discerning the community of stakeholders; 4 establishing and maintaining a presence in the community; and 5 socializing the technology and research strategy. We also demonstrate how these practices contributed to stakeholders' willingness to support the trials.Our case study has identified, and explained the functional relationships among, the critical features of the ED Program's approach to CE. It has also

  14. Vardenafil improves sexual function and treatment satisfaction in couples affected by erectile dysfunction (ED): a randomized, double-blind, placebo-controlled trial in PDE5 inhibitor-naïve men with ED and their partners. (United States)

    Edwards, David; Hackett, Geoff; Collins, Owen; Curram, John


    Erectile dysfunction (ED) is a common condition with diverse sequelae affecting men and their women partners. The FINDER study aimed to evaluate the efficacy and tolerability of the phosphodiesterase type-5 (PDE5) inhibitor, vardenafil, in a broad population of PDE5-naïve men with ED of different etiologies and severity and included their partners' assessments of treatment with vardenafil. Men with ED (N = 260) were randomized to receive either vardenafil or placebo in a multicenter, flexible-dose study. Primary efficacy variables were patients' responses to the Global Assessment Question (GAQ), and Sexual Encounter Profile questions 2 and 3 (SEP2 and SEP3). Compared with placebo, vardenafil significantly improved rates of successful "Yes" responses to SEP3 ("Did your erection last long enough for you to have successful intercourse?") (49% placebo vs. 78% vardenafil at last period carried forward [LPCF]; P < 0.0001), SEP2 ("Were you able to insert your penis into your partner's vagina?") (65% placebo vs. 85% vardenafil at LPCF; P < 0.0001), and GAQ (36% placebo vs. 83% vardenafil at last observation carried forward; P < 0.0001). In addition, patients' and their partners' Treatment Satisfaction Scale (TSS) scores were statistically significantly improved across each of the TSS domains (satisfaction with orgasm, ease with erection, confidence, pleasure, erectile function satisfaction, and satisfaction with medication) in the vardenafil group compared with the placebo group. Vardenafil improved sexual function to the extent that both patients and their partners expressed a considerable and agreed level of satisfaction with treatment.

  15. Expanding The INSPIRED COPD Outreach ProgramTM to the emergency department: a feasibility assessment

    Directory of Open Access Journals (Sweden)

    Gillis D


    Full Text Available Darcy Gillis,1 Jillian Demmons,1 Graeme Rocker1,2 1Division of Respirology, Department of Medicine, Queen Elizabeth II Health Sciences Centre, Nova Scotia Health Authority, Halifax, NS, Canada; 2Division of Respirology, Nova Scotia Health Authority, Dalhousie University, Halifax, NS, Canada Background: The Halifax-based INSPIRED COPD Outreach Program™ is a facility-to-community home-based novel clinical initiative that through improved care transitions, self-management, and engagement in advance care planning has demonstrated a significant (60%–80% reduction in health care utilization with substantial cost aversion. By assessing the feasibility of expanding INSPIRED into the emergency department (ED we anticipated extending reach and potential for positive impact of INSPIRED to those with acute exacerbation of chronic obstructive pulmonary disease (AECOPD who avoid hospital admission.Methods: Patients were eligible for the INSPIRED-ED study if >40 years of age, diagnosed with AECOPD and discharged from the ED, willing to be referred, community dwelling with at least one of: previous use of the ED services, admission to Intermediate Care Unit/Intensive Care Unit, or admission to hospital with AECOPD in the past year. We set feasibility objectives for referral rates, completion of action plans, advance care planning participation, and reduction in ED visit frequency.Results: Referral rates were 0.5/week. Among eligible patients (n=174 33 (19% were referred of whom 15 (M=4, F=11 enrolled in INSPIRED-ED. Mean (SD age was 68 (7 years, post-bronchdilator FEV1 44.2 (15.5 % predicted, and Medical Research Council (MRC dyspnea score 3.8 (0.41. We met feasibility objectives for action plan and advance care planning completion. Frequency of subsequent ED visits fell by 54%. Mean (SD Care Transition Measure (CTM-3 improved from 8.6 (2.0 to 11.3 (1.3, P=0.0004, and of 14 patients responding 12 (86% found the program very helpful. An additional 34

  16. Eoin Devereux, Aileen Dillane and Martin J. Power (eds., David Bowie: Critical Perspectives (New York and London, Routledge, 2015, 323 pp. ISBN 978-0-415-74572-7

    Directory of Open Access Journals (Sweden)

    Pietro Deandrea


    Full Text Available Eoin Devereux, Aileen Dillane and Martin J. Power (eds., David Bowie: Critical Perspectives (New York and London, Routledge, 2015, 323 pp. ISBN 978-0-415-74572-7 by Pietro Deandrea

  17. Review: Martine Guichard, Tilo Grätz, and Youssouf Diallo (eds, Friendship, Descent and Alliance in Africa: Anthropological Perspectives (2014

    Directory of Open Access Journals (Sweden)

    Astrid Bochow


    Full Text Available Review of the edited volume: Martine Guichard, Tilo Grätz, and Youssouf Diallo (eds, Friendship, Descent and Alliance in Africa: Anthropological Perspectives, Oxford: Berghahn, 2014, ISBN 9781782382867, 220 pages

  18. Depth contours for NOS Chart 11013, 39th Ed., 1992-04-25 for South Florida, Cuba, and the Bahamas in GIS vector form (NODC Accession 0000459) (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — GIS line coverage of depth contours (bathymetry) for the area shown in National Ocean Service (NOS) chart 11013, 39th Ed., 25 Apr 1992. Area covers South Florida,...

  19. Hannele Niemi, Auli Toom and Arto Kallioniemi (eds., Miracle of Education. The Principles and Practices of Teaching and Learning in Finnish Schools (Rotterdam: Sense Publishers, 2012

    Directory of Open Access Journals (Sweden)

    Guðmundur Heiðar Frímannsson


    Full Text Available Review of the book: Hannele Niemi, Auli Toom and Arto Kallioniemi (eds., Miracle of Education. The Principles and Practices of Teaching and Learning in Finnish Schools (Rotterdam: Sense Publishers, 2012

  20. Reseña de: Joaquín Roses (ed.. El Universo Góngora: Orígenes, textos y representaciones

    Directory of Open Access Journals (Sweden)

    Margherita Mulas


    Full Text Available Joaquín Roses (ed.. El Universo Góngora: Orígenes, textos y representaciones // Review of: Joaquín Roses (ed.. El Universo Góngora: Orígenes, textos y representaciones. Córdoba: Diputación de Córdoba, 2014. 556 pp. ISBN 978-84-8154-387-2. // Joaquín Roses (ed.. El Universo Góngora: Orígenes, textos y representaciones // Reseña de: Joaquín Roses (ed.. El Universo Góngora: Orígenes, textos y representaciones. Córdoba: Diputación de Córdoba, 2014. 556 pp. ISBN 978-84-8154-387-2.

  1. Book review: Working with academic literacies: case studies towards transformative practice. Lillis, T., Harrington, K., Lea, M.R. & Mitchell, S. eds.

    Directory of Open Access Journals (Sweden)

    Mastin Prinsloo


    Full Text Available This is a review of Lillis, T., Harrington, K., Lea, M.R. & Mitchell, S. (eds. 2015. Working with academic literacies: case studies towards transformative practice. Fort Collins, Colorado: WAC Clearinghouse.

  2. Roy Ellen, Stephen J. Lycett, Sarah E. Johns, eds., 2013, Understanding Cultural Transmission in Anthropology: A Critical Synthesis New York and Oxford: Berghahn Books

    Directory of Open Access Journals (Sweden)

    Clelia Viecelli


    Full Text Available recensione: Roy Ellen, Stephen J. Lycett, Sarah E. Johns, eds., 2013, Understanding Cultural Transmission in Anthropology: A Critical Synthesis New York and Oxford: Berghahn Books di Clelia Viecelli

  3. Maurizio Isabella & Konstantina Zanou (eds., Mediterranean Diasporas: Politics and Ideas in the Long 19th Century (London, New Delhi, New York, Sydney: Bloomsbury Academic, 2016

    Directory of Open Access Journals (Sweden)

    Páll Björnsson


    Full Text Available A review of: Maurizio Isabella and Konstantina Zanou (eds., Mediterranean Diasporas: Politics and Ideas in the Long 19th Century (London, New Delhi, New York, Sydney: Bloomsbury Academic, 2016

  4. Bárbara Mujica, ed., Shakespeare and the Spanish «Comedia». Translation, Interpretation, Performance. Essays in Honor of Susan L. Fischer

    Directory of Open Access Journals (Sweden)

    Alejandro García-Reidy


    Full Text Available Reseña de Bárbara Mujica, ed., Shakespeare and the Spanish «Comedia». Translation, Interpretation, Performance. Essays in Honor of Susan L. Fischer, Bucknell University Press, Lewisburg, 2013, 298 pp. ISBN 9781611485172.

  5. Michele Renee Salzman, Marvina A. Sweeney & William Adler (eds., The Cambridge History of Religions in the Ancient World (2 vols. (New York: Cambridge University Press, 2013

    Directory of Open Access Journals (Sweden)

    Giorgio Baruchello


    Full Text Available Review of: Michele Renee Salzman, Marvina A. Sweeney & William Adler (eds., The Cambridge History of Religions in the Ancient World (2 vols. (New York: Cambridge University Press, 2013

  6. Matte Svart Kristiansen & Kate Giles (eds., Dwellings, Identities and Homes. European Housing Culture from the Viking Age to the Renaissance (Hojbjerg: Jutland Archeological Society, 2014

    Directory of Open Access Journals (Sweden)

    Thomas Hoeren


    Full Text Available Book review of: Matte Svart Kristiansen & Kate Giles (eds., Dwellings, Identities and Homes. European Housing Culture from the Viking Age to the Renaissance (Hojbjerg: Jutland Archeological Society, 2014

  7. Florian Mussgnug – Matthew Reza (eds., The Good Place. Comparative Perspectives on Utopia. Proceedings of Synapsis: European School of Comparative Studies XI

    Directory of Open Access Journals (Sweden)

    Irina Marchesini


    Full Text Available Review of the book The Good Place. Comparative Perspectives on Utopia. Proceedings of Synapsis: European School of Comparative Studies XI by Florian Mussgnug – Matthew Reza (eds.

  8. Emanuele KANCEFF, "L’immagine della Sicilia nei resoconti di viaggio del Settecento. Tra classicità ed emozione romantica", 2015

    Directory of Open Access Journals (Sweden)

    Pino Menzio


    Full Text Available Emanuele KANCEFF, "L’immagine della Sicilia nei resoconti di viaggio del Settecento. Tra classicità ed emozione romantica", Scicli, Edizioni di storia e studi sociali, 2015 [Book Review

  9. PIGRAU SOLÉ, Antoni (ed.), Pueblos indígenas, diversidad cultural y justicia ambiental. Un estudio de las nuevas constituciones de Ecuador y Bolivia


    Picó Reig, Laura; Lopes Ricarte, Thays


    PIGRAU SOLÉ, Antoni (ed.), Pueblos indígenas, diversidad cultural y justicia ambiental. Un estudio de las nuevas constituciones de Ecuador y Bolivia, Tirant Lo Blanch, Estudios Latinoamericanos, Valencia, 2013, 76

  10. Phenotypic variability of the kyphoscoliotic type of Ehlers-Danlos syndrome (EDS VIA): clinical, molecular and biochemical delineation (United States)


    Background The kyphoscoliotic type of Ehlers-Danlos syndrome (EDS VIA) (OMIM 225400) is a rare inheritable connective tissue disorder characterized by a deficiency of collagen lysyl hydroxylase 1 (LH1; EC due to mutations in PLOD1. Biochemically this results in underhydroxylation of collagen lysyl residues and, hence, an abnormal pattern of lysyl pyridinoline (LP) and hydroxylysyl pyridinoline (HP) crosslinks excreted in the urine. Clinically the disorder is characterized by hypotonia and kyphoscoliosis at birth, joint hypermobility, and skin hyperelasticity and fragility. Severe hypotonia usually leads to delay in gross motor development, whereas cognitive development is reported to be normal. Methods We describe the clinical, biochemical and molecular characterisation, as well as electron microscopy findings of skin, in 15 patients newly diagnosed with this rare type of Ehlers-Danlos syndrome. Results Age at diagnosis ranged from 5 months to 27 years, with only 1/3 of the patients been diagnosed correctly in the first year of life. A similar disease frequency was found in females and males, however a broad disease severity spectrum (intra- and interfamilial), independent of molecular background or biochemical phenotype, was observed. Kyphoscoliosis, one of the main clinical features was not present at birth in 4 patients. Importantly we also noted the occurrence of vascular rupture antenatally and postnatally, as well as developmental delay in 5 patients. Conclusion In view of these findings we propose that EDS VIA is a highly variable clinical entity, presenting with a broad clinical spectrum, which may also be associated with cognitive delay and an increased risk for vascular events. Genotype/phenotype association studies and additional molecular investigations in more extended EDS VIA populations will be necessary to further elucidate the cause of the variability of the disease severity. PMID:21699693

  11. Phenotypic variability of the kyphoscoliotic type of Ehlers-Danlos syndrome (EDS VIA: clinical, molecular and biochemical delineation

    Directory of Open Access Journals (Sweden)

    Kariminejad Ariana


    Full Text Available Abstract Background The kyphoscoliotic type of Ehlers-Danlos syndrome (EDS VIA (OMIM 225400 is a rare inheritable connective tissue disorder characterized by a deficiency of collagen lysyl hydroxylase 1 (LH1; EC due to mutations in PLOD1. Biochemically this results in underhydroxylation of collagen lysyl residues and, hence, an abnormal pattern of lysyl pyridinoline (LP and hydroxylysyl pyridinoline (HP crosslinks excreted in the urine. Clinically the disorder is characterized by hypotonia and kyphoscoliosis at birth, joint hypermobility, and skin hyperelasticity and fragility. Severe hypotonia usually leads to delay in gross motor development, whereas cognitive development is reported to be normal. Methods We describe the clinical, biochemical and molecular characterisation, as well as electron microscopy findings of skin, in 15 patients newly diagnosed with this rare type of Ehlers-Danlos syndrome. Results Age at diagnosis ranged from 5 months to 27 years, with only 1/3 of the patients been diagnosed correctly in the first year of life. A similar disease frequency was found in females and males, however a broad disease severity spectrum (intra- and interfamilial, independent of molecular background or biochemical phenotype, was observed. Kyphoscoliosis, one of the main clinical features was not present at birth in 4 patients. Importantly we also noted the occurrence of vascular rupture antenatally and postnatally, as well as developmental delay in 5 patients. Conclusion In view of these findings we propose that EDS VIA is a highly variable clinical entity, presenting with a broad clinical spectrum, which may also be associated with cognitive delay and an increased risk for vascular events. Genotype/phenotype association studies and additional molecular investigations in more extended EDS VIA populations will be necessary to further elucidate the cause of the variability of the disease severity.

  12. FlexED8: the first member of a fast and flexible sample-changer family for macromolecular crystallography. (United States)

    Papp, Gergely; Felisaz, Franck; Sorez, Clement; Lopez-Marrero, Marcos; Janocha, Robert; Manjasetty, Babu; Gobbo, Alexandre; Belrhali, Hassan; Bowler, Matthew W; Cipriani, Florent


    Automated sample changers are now standard equipment for modern macromolecular crystallography synchrotron beamlines. Nevertheless, most are only compatible with a single type of sample holder and puck. Recent work aimed at reducing sample-handling efforts and crystal-alignment times at beamlines has resulted in a new generation of compact and precise sample holders for cryocrystallography: miniSPINE and NewPin [see the companion paper by Papp et al. (2017, Acta Cryst., D73, 829-840)]. With full data collection now possible within seconds at most advanced beamlines, and future fourth-generation synchrotron sources promising to extract data in a few tens of milliseconds, the time taken to mount and centre a sample is rate-limiting. In this context, a versatile and fast sample changer, FlexED8, has been developed that is compatible with the highly successful SPINE sample holder and with the miniSPINE and NewPin sample holders. Based on a six-axis industrial robot, FlexED8 is equipped with a tool changer and includes a novel open sample-storage dewar with a built-in ice-filtering system. With seven versatile puck slots, it can hold up to 112 SPINE sample holders in uni-pucks, or 252 miniSPINE or NewPin sample holders, with 36 samples per puck. Additionally, a double gripper, compatible with the SPINE sample holders and uni-pucks, allows a reduction in the sample-exchange time from 40 s, the typical time with a standard single gripper, to less than 5 s. Computer vision-based sample-transfer monitoring, sophisticated error handling and automatic error-recovery procedures ensure high reliability. The FlexED8 sample changer has been successfully tested under real conditions on a beamline.

  13. SmEdA vibro-acoustic modelling in the mid-frequency range including the effect of dissipative treatments (United States)

    Hwang, H. D.; Maxit, L.; Ege, K.; Gerges, Y.; Guyader, J.-L.


    Vibro-acoustic simulation in the mid-frequency range is of interest for automotive and truck constructors. The dissipative treatments used for noise and vibration control such as viscoelastic patches and acoustic absorbing materials must be taken into account in the problem. The Statistical modal Energy distribution Analysis (SmEdA) model consists in extending Statistical Energy Analysis (SEA) to the mid-frequency range by establishing power balance equations between the modes of the different subsystems. The modal basis of uncoupled-subsystems that can be estimated by the finite element method in the mid-frequency range is used as input data. SmEdA was originally developed by considering constant modal damping factors for each subsystem. However, this means that it cannot describe the local distribution of dissipative materials. To overcome this issue, a methodology is proposed here to take into account the effect of these materials. This methodology is based on the finite element models of the subsystems that include well-known homogenized material models of dissipative treatments. The Galerkin method with subsystem normal modes is used to estimate the modal damping loss factors. Cross-modal coupling terms which appear in the formulation due to the dissipative materials are assumed to be negligible. An approximation of the energy sharing between the subsystems damped by dissipative materials is then described by SmEdA. The different steps of the method are validated experimentally by applying it to a laboratory test case composed of a plate-cavity system with different configurations of dissipative treatments. The comparison between the experimental and the simulation results shows good agreement in the mid-frequency range.

  14. Identifying patients with mild traumatic intracranial hemorrhage at low risk of decompensation who are safe for ED observation. (United States)

    Pruitt, Peter; Penn, Joshua; Peak, David; Borczuk, Pierre


    Patients with traumatic intracranial hemorrhage and mild traumatic brain injury (mTIH) receive broadly variable care which often includes transfer to a trauma center, neurosurgery consultation and ICU admission. However, there may be a low risk cohort of patients who can be managed without utilizing such significant resources. Describe mTIH patients who are at low risk of clinical or radiographic decompensation and can be safely managed in an ED observation unit (EDOU). Retrospective evaluation of patients age≥16, GCS≥13 with ICH on CT. Primary outcomes included clinical/neurologic deterioration, CT worsening or need for neurosurgery. 1185 consecutive patients were studied. 814 were admitted and 371 observed patients (OP) were monitored in the EDOU or discharged from the ED after a period of observation. None of the OP deteriorated clinically. 299 OP (81%) had a single lesion on CT; 72 had mixed lesions. 120 patients had isolated subarachnoid hemorrhage (iSAH) and they did uniformly well. Of the 119 OP who had subdural hematoma (SDH), 6 had worsening CT scans and 3 underwent burr hole drainage procedures as inpatients due to persistent SDH without new deficit. Of the 39 OP who had cerebral contusions, 3 had worsening CT scans and one required NSG admission. No patient returned to the ED with a complication. Follow-up was obtained on 81% of OP. 2 patients with SDH required burr hole procedure >2weeks after discharge. Patients with mTIH, particularly those with iSAH, have very low rates of clinical or radiographic deterioration and may be safe for monitoring in an emergency department observation unit. Copyright © 2016 Elsevier Inc. All rights reserved.

  15. Comparison of secure messaging application (WhatsApp) and standard telephone usage for consultations on Length of Stay in the ED. A prospective randomized controlled study. (United States)

    Gulacti, Umut; Lok, Ugur


    Consultation, the process of an Emergency Physician seeking an opinion from other specialties, occurs frequently in the Emergency Department (ED). The aim of this study was to determine the effect of secure messaging application (WhatsApp) usage for medical consultations on Emergency Department Length of Stay (ED LOS) and consult time. We conducted a prospective, randomized controlled trial in the ED using allocation concealment over three months. Consultations requested in the ED were allocated into two groups: consultations requested via the secure messaging application and consultations requested by telephone as verbal. A total of 439 consultations requested in the ED were assessed for eligibility and 345 were included in the final analysis: 173 consultations were conducted using secure messaging application and 172 consultations were conducted using standard telephone communications. The median ED LOS was 240 minutes (IQR:230-270, 95% CI:240 to 255.2) for patients in the secure messaging application group and 277 minutes (IQR:270-287.8, 95% CI:277 to 279) for patients in the telephone group. The median total ED LOS was significantly lower among consults conducted using Secure messaging application relative to consults conducted by telephone (median dif: -30, 95%CI:-37to-25, p<0.0001). The median consult time was 158 minutes (IQR:133 to 177.25, 95% CI:150 to 169) for patients in the Secure messaging application group and 170 minutes (IQR:165 to 188.5, 95% CI:170-171) for patients in the Telephone group (median dif: -12, 95%CI:-19 to-7,p<0.0001). Consultations completed without ED arrival was 61.8% in the secure messaging group and 33.1% in the Telephone group (dif: 28.7, 95% CI:48.3 to 66, p<0.001). Use of secure messaging application for consultations in the ED reduces the total ED LOS and consultation time. Consultation with secure messaging application eliminated more than half of in-person ED consultation visits.

  16. Theory in the Service of Practice: Theories in Action Research Dissertations Written by Students in Education Doctorate Programs (United States)

    Zambo, Debby


    Educational leaders are enrolling in second-generation education doctorate (EdD) programs because these are allowing them to remain in the field as they pursue their degree and perform action research within their workplace. As part of degree requirements, students in these programs are challenged to cross the theory-to-practice divide. However,…

  17. Copper(II) complexes with unsymmetrical pentadentate ed3a-type diamino-tricarboxylate ligands. Crystal structures, configurational analysis and DFT study of complexes

    NARCIS (Netherlands)

    Matovic, Zoran D.; Meetsma, Auke; Miletic, Vesna D.; van Koningsbruggen, Petra J.; Matović, Zoran D.; Miletić, Vesna D.; D. Matović, Z.; D. Miletić, V.


    The O-O-N-N-O-type pentadentate ligands H(3)ed3a, H(3)pd3a and H(3)pd3p (H(3)ed3a stands ethylenediamine-N,N,N'-triacetic acid; H3pd3a stands 1,3-propanediamine-N,N,N'-triacetic acid and H3pd3p stands 1,3-propanediamine-N,N,N'-tri-3-propionic acid) and the corresponding novel octahedral or

  18. The vitamin D analogue ED71 but Not 1,25(OH2D3 targets HIF1α protein in osteoclasts.

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    Yuiko Sato

    Full Text Available Although both an active form of the vitamin D metabolite, 1,25(OH2D3, and the vitamin D analogue, ED71 have been used to treat osteoporosis, anti-bone resorbing activity is reportedly seen only in ED71- but not in 1,25(OH2D3 -treated patients. In addition, how ED71 inhibits osteoclast activity in patients has not been fully characterized. Recently, HIF1α expression in osteoclasts was demonstrated to be required for development of post-menopausal osteoporosis. Here we show that ED71 but not 1,25(OH2D3, suppress HIF1α protein expression in osteoclasts in vitro. We found that 1,25(OH2D3 or ED71 function in osteoclasts requires the vitamin D receptor (VDR. ED71 was significantly less effective in inhibiting M-CSF and RANKL-stimulated osteoclastogenesis than was 1,25(OH2D3 in vitro. Downregulation of c-Fos protein and induction of Ifnβ mRNA in osteoclasts, both of which reportedly block osteoclastogenesis induced by 1,25(OH2D3 in vitro, were both significantly higher following treatment with 1,25(OH2D3 than with ED71. Thus, suppression of HIF1α protein activity in osteoclasts in vitro, which is more efficiently achieved by ED71 rather than by 1,25(OH2D3, could be a reliable read-out in either developing or screening reagents targeting osteoporosis.

  19. Use of SEM and EDS analysis in the investigation of Al-Si-Cu piston alloy cast porosity

    Directory of Open Access Journals (Sweden)

    D. Kakaš


    Full Text Available Porosity formation was detected in the casting thinnest section in the proximity of the as cast surface and near the wall centerline. In order to investigate the cause of the porosity formation light microscopy was used to define as cast structure. After initial findings SEM and EDS analyses were performed. Based on the results it is possible to define cause of the observed porosity. A number of pores originates from the mould filling stage and entrainment of the oxide films, while others appear due to insufficient feeding during solidification.

  20. Histoplasmosis epidémica II. Hallazgos en la Cueva del Edén (Cunday, Tolima)


    Elizabeth Castañeda; Alberto Cadena; Alvaro Aguilera; Luz Helena Sanín; Liberto Ajello; Robert Weeks; Vladimir Corredor; Mauricio Restrepo


    Se informa el estudio realizado en la Cueva del Edén (Cunday, Tolima) para aislar, de las tierras de la cueva y de murciélagos allí capturados, al Histoplasma capsulatum, como agente causal de una anterior epidemia de histoplasmosis ocurrida entre visitantes de la cueva. El agente se aisló en 8 de las 27 muestras de tierra y guano de murciélago. Se capturaron 233 ejemplares pertenecientes a 4 géneros de murciélagos y en los cultivos, practicados en hígado, pulmón y bazo de cien de ellos, no f...