WorldWideScience

Sample records for providing partial support

  1. Wind Turbine Providing Grid Support

    DEFF Research Database (Denmark)

    2011-01-01

    A variable speed wind turbine is arranged to provide additional electrical power to counteract non-periodic disturbances in an electrical grid. A controller monitors events indicating a need to increase the electrical output power from the wind turbine to the electrical grid. The controller...

  2. Support Net for Frontline Providers

    Science.gov (United States)

    2016-03-01

    With a multidisciplinary team that included an external evaluator (Dr. Robert Durham), and an extended research team (Drs. Alan Peterson and Bret...21.7%) indicated being single. The sample of providers included 13 clinical psychologists (21.7%), 17 counselors or psychotherapists (28.3%), three...a sample of service members from Iraq and Afghanistan. Military Medicine, 172, 359–363. Figley, C. R. (2002). Compassion fatigue: Psychotherapists

  3. Implant-supported removable partial dentures in the mandible

    NARCIS (Netherlands)

    Louwerse, Charlotte

    2017-01-01

    Conventional removable partial dentures (RPD) in a free-ending situation in the lower jaw (i.e. only front teeth left) have a poor reputation. Several problems like discomfort and functional problems are frequently encountered, resulting in dissatisfied patients and desperate dentists. By supporting

  4. PROVIDING R-TREE SUPPORT FOR MONGODB

    Directory of Open Access Journals (Sweden)

    L. Xiang

    2016-06-01

    Full Text Available Supporting large amounts of spatial data is a significant characteristic of modern databases. However, unlike some mature relational databases, such as Oracle and PostgreSQL, most of current burgeoning NoSQL databases are not well designed for storing geospatial data, which is becoming increasingly important in various fields. In this paper, we propose a novel method to provide R-tree index, as well as corresponding spatial range query and nearest neighbour query functions, for MongoDB, one of the most prevalent NoSQL databases. First, after in-depth analysis of MongoDB’s features, we devise an efficient tabular document structure which flattens R-tree index into MongoDB collections. Further, relevant mechanisms of R-tree operations are issued, and then we discuss in detail how to integrate R-tree into MongoDB. Finally, we present the experimental results which show that our proposed method out-performs the built-in spatial index of MongoDB. Our research will greatly facilitate big data management issues with MongoDB in a variety of geospatial information applications.

  5. Providing R-Tree Support for Mongodb

    Science.gov (United States)

    Xiang, Longgang; Shao, Xiaotian; Wang, Dehao

    2016-06-01

    Supporting large amounts of spatial data is a significant characteristic of modern databases. However, unlike some mature relational databases, such as Oracle and PostgreSQL, most of current burgeoning NoSQL databases are not well designed for storing geospatial data, which is becoming increasingly important in various fields. In this paper, we propose a novel method to provide R-tree index, as well as corresponding spatial range query and nearest neighbour query functions, for MongoDB, one of the most prevalent NoSQL databases. First, after in-depth analysis of MongoDB's features, we devise an efficient tabular document structure which flattens R-tree index into MongoDB collections. Further, relevant mechanisms of R-tree operations are issued, and then we discuss in detail how to integrate R-tree into MongoDB. Finally, we present the experimental results which show that our proposed method out-performs the built-in spatial index of MongoDB. Our research will greatly facilitate big data management issues with MongoDB in a variety of geospatial information applications.

  6. Air Systems Provide Life Support to Miners

    Science.gov (United States)

    2014-01-01

    Through a Space Act Agreement with Johnson Space Center, Paragon Space Development Corporation, of Tucson, Arizona, developed the Commercial Crew Transport-Air Revitalization System, designed to provide clean air for crewmembers on short-duration space flights. The technology is now being used to help save miners' lives in the event of an underground disaster.

  7. Distal extension mandibular removable partial denture with implant support.

    Science.gov (United States)

    Bural, Canan; Buzbas, Begum; Ozatik, Sebnem; Bayraktar, Gulsen; Emes, Yusuf

    2016-01-01

    This case report describes the fabrication of a distal extension removable partial denture (RPD) of a 65-year-old man with implant support. Loss of fibroelasticity of the peripheral tissues and reduced mandibular vestibular sulcular depth due to a previous surgical resection and radiotherapy at the right side were the main clinical factors that created difficulty for denture retention and stability. The fabrication of a mandibular RPD supported by anterior teeth and two bilaterally placed implants in the molar area to convert from Kennedy Class 1 design to Kennedy Class 3 implant-bounded RPD is reported. Retention and stability of the denture were improved with implant support on the distal extension site of the RPD. The common clinical problems about distally extended RPDs are lack of retention and stability due to the movement around the rotational axis. Dental implant placement to the distal edentulous site minimizes the potential dislodgement of the RPD is popular. Implant-supported RPD can be suggested as an advantageous and cost-effective treatment option for the partially edentulous patients.

  8. Mastication improvement after partial implant-supported prosthesis use.

    Science.gov (United States)

    Gonçalves, T M S V; Campos, C H; Gonçalves, G M; de Moraes, M; Rodrigues Garcia, R C M

    2013-12-01

    Partially edentulous patients may be rehabilitated by the placement of removable dental prostheses, implant-supported removable dental prostheses, or partial implant fixed dental prostheses. However, it is unclear the impact of each prosthesis type over the masticatory aspects, which represents the objective of this paired clinical trial. Twelve patients sequentially received and used each of these 3 prosthesis types for 2 months, after which maximum bite force was assessed by a strain sensor and food comminution index was determined with the sieving method. Masseter and temporal muscle thicknesses during rest and maximal clenching were also evaluated by ultrasonography. Each maxillary arch received a new complete denture that was used throughout the study. Data were analyzed by analysis of variance for repeated measures, followed by the Tukey test (p mastication, and the magnitude of this effect was related to prosthesis type.

  9. 20 CFR 404.1662 - What support we will provide.

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false What support we will provide. 404.1662 Section 404.1662 Employees' Benefits SOCIAL SECURITY ADMINISTRATION FEDERAL OLD-AGE, SURVIVORS AND... support we will provide. Performance support may include, but is not limited to, any or all of the...

  10. 20 CFR 416.1062 - What support we will provide.

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false What support we will provide. 416.1062 Section 416.1062 Employees' Benefits SOCIAL SECURITY ADMINISTRATION SUPPLEMENTAL SECURITY INCOME FOR THE... What support we will provide. Performance support may include, but is not limited to, any or all of the...

  11. Outsourcing customer support : The role of provider customer focus

    NARCIS (Netherlands)

    Wuyts, S.H.K.; Rindfleisch, A.; Citrin, A.

    An increasing number of firms are outsourcing customer support to external service providers. This creates a triadic setting in which an outsourcing provider serves end customers on behalf of its clients. While outsourcing presents an opportunity to serve customers, service providers differ in their

  12. Providing producer mobility support in NDN through proactive data replication

    OpenAIRE

    Lehmann, Matheus; Barcellos, Marinho; Mauthe, Andreas Ulrich

    2016-01-01

    Email Print Request Permissions Named Data Networking (NDN) is a novel architecture expected to overcome limitations of the current Internet. User mobility is one of the most relevant limitations to be addressed. NDN supports consumer mobility by design but fails to offer the same level of support for producer mobility. Existing approaches to extend NDN are host-centric, which conflicts with NDN principles, and provide limited support for producer mobility. This paper proposes a content-centr...

  13. Parent-to-Parent support providers: How recruits are identified.

    Science.gov (United States)

    Dodds, Robin L; Singer, George H S

    2017-10-24

    To examine selection criteria for Parent-to-Parent support parents trained to provide support to other parents of children with disabilities. Ten leaders of Parent-to-Parent programmes participated in telephone interviews to explore attributes associated with parents selected to be trained as support parents. Qualitative analysis reveals parents deemed "ready" to become support parents, build relationships, exhibit positivity, build capacities, have good communication skills and a future orientation and feel the need to give back. An additional set of attributes we have named, "red flags" are associated with parents not suitable to provide support are also presented. Parent-to-Parent support parents are informally identified by a set of characteristics that can be operationalized for screening purposes. Findings provide support for the positive influence of the peer support relationship and identify the need for a measure of parent "readiness" to assist in the recruitment of quality support parents for the Parent-to-Parent organization. © 2017 John Wiley & Sons Ltd.

  14. Providing information communication technology-based support to ...

    African Journals Online (AJOL)

    Student support is a major factor in distance education. This study was concerned with the use of ICT as a medium for providing student support at the University of Zambia. It was necessary to study the factors that would affect the application of ICT, in order to inform policy makers and managers of distance education which ...

  15. Providing Mainstream Parser Generators with Modular Language Definition Support

    OpenAIRE

    Karol, Sven; Zschaler, Steffen

    2012-01-01

    The composition and reuse of existing textual languages is a frequently re-occurring problem. One possibility of composing textual languages lies on the level of parser specifications which are mainly based on context-free grammars and regular expressions. Unfortunately most mainstream parser generators provide proprietary specification languages and usually do not provide strong abstractions for reuse. New forms of parser generators do support modular language development, but they can often...

  16. Lactation Consultants' Perceived Barriers to Providing Professional Breastfeeding Support.

    Science.gov (United States)

    Anstey, Erica H; Coulter, Martha; Jevitt, Cecilia M; Perrin, Kay M; Dabrow, Sharon; Klasko-Foster, Lynne B; Daley, Ellen M

    2018-02-01

    Addressing suboptimal breastfeeding initiation and duration rates is a priority in the United States. To address challenges to improving these rates, the voices of the providers who work with breastfeeding mothers should be heard. Research aim: The purpose of this study was to explore lactation consultants' perceived barriers to managing early breastfeeding problems. This qualitative study was conducted with a grounded theory methodological approach. In-depth interviews were conducted with 30 International Board Certified Lactation Consultants across Florida. Lactation consultants were from a range of practice settings, including hospitals, Special Supplemental Nutrition Program for Women, Infants, and Children clinics, private practice, and pediatric offices. Data were digitally recorded, transcribed, and analyzed in Atlas.ti. A range of barriers was identified and grouped into the following categories/themes: indirect barriers (social norms, knowledge, attitudes); direct occupational barriers (institutional constraints, lack of coordination, poor service delivery); and direct individual barriers (social support, mother's self-efficacy). A model was developed illustrating the factors that influence the role enactment of lactation consultants in managing breastfeeding problems. Inadequate support for addressing early breastfeeding challenges is compounded by a lack of collaboration among various healthcare providers and the family. Findings provide insight into the professional management issues of early breastfeeding problems faced by lactation consultants. Team-based, interprofessional approaches to breastfeeding support for mothers and their families are needed; improving interdisciplinary collaboration could lead to better integration of lactation consultants who are educated and experienced in providing lactation support and management of breastfeeding problems.

  17. Providing Automatic Support for Heuristic Rules of Methods

    NARCIS (Netherlands)

    Tekinerdogan, B.; Aksit, Mehmet; Demeyer, Serge; Bosch, H.G.P.; Bosch, Jan

    In method-based software development, software engineers create artifacts based on the heuristic rules of the adopted method. Most CASE tools, however, do not actively assist software engineers in applying the heuristic rules. To provide an active support, the rules must be formalized, implemented

  18. Depressive Symptoms and Unmitigated Communion in Support Providers

    NARCIS (Netherlands)

    Jin, Lihua; Van Yperen, Nico W.; Sanderman, Robbert; Hagedoorn, Mariet

    In this research, we argue and demonstrate that the association between enacted (un)supportive behaviour and depressive symptoms is a function of the providers' levels of unmitigated communion (UC). UC is characterized by overinvolvement in others' problems, self-neglect and externalized

  19. Partial Support for the Federal Committee for Meteorological Services and Supporting Research

    Energy Technology Data Exchange (ETDEWEB)

    Williamson, Samuel P

    2012-04-30

    DOE E-link Report Number DOE/ER62778 1999-2012 Please see attached Final Technical Report (size too large to post here). Annual Products Provided to DOE: Federal Plan for Meteorological Services and Supporting Research; National Hurricane Operations Plan; Interdepartmental Hurricane Conference Summary Report. All reports and publications can be found on the OFCM website, www.ofcm.noaa.gov.

  20. The Men's Shed: providing biopsychosocial and spiritual support.

    Science.gov (United States)

    Moylan, Matthew M; Carey, Lindsay B; Blackburn, Ric; Hayes, Rick; Robinson, Priscilla

    2015-02-01

    Community Men's Sheds (CMS) have been a unique approach within Australia for addressing and promoting men's health and well-being issues by providing biopsychosocial support. Given the decline of traditional religious influence, and the contemporary understanding of 'spirituality', it can be argued that CMS may also develop and demonstrate characteristics of a communal spirituality. This research aimed to explore the individual and community contribution of CMS in terms of men's health and well-being and subsequently whether CMS programmes satisfied the contemporary and consensus understanding of spirituality. A qualitative case study was undertaken combining both participant observation over a 6-month period and semi-structured in-depth interviews with 21 men of varying ages and occupations attending a Melbourne suburban CMS (Victoria, Australia). Thematic analysis indicated that the CMS provided a number of health and well-being benefits at individual, family, community and public health levels. These included increased self-esteem and empowerment, respite from families, a sense of belonging in the community and the opportunity to exchange ideas relating to personal, family, communal and public health issues. It is concluded that CMS, through the provision of an appropriate spatial context and organizational activities, encourage intra-personal and inter-personal reflection and interaction that subsequently results in men meaningfully, purposefully and significantly connecting with the moment, to self, to others and to their environment-and thus, CMS not only provides biopsychosocial support but can also deliver spiritual support.

  1. Providers' Response to Clinical Decision Support for QT Prolonging Drugs.

    Science.gov (United States)

    Sharma, Sunita; Martijn Bos, J; Tarrell, Robert F; Simon, Gyorgy J; Morlan, Bruce W; Ackerman, Michael J; Caraballo, Pedro J

    2017-09-02

    Commonly used drugs in hospital setting can cause QT prolongation and trigger life-threatening arrhythmias. We evaluate changes in prescribing behavior after the implementation of a clinical decision support system to prevent the use of QT prolonging medications in the hospital setting. We conducted a quasi-experimental study, before and after the implementation of a clinical decision support system integrated in the electronic medical record (QT-alert system). This system detects patients at risk of significant QT prolongation (QTc>500ms) and alerts providers ordering QT prolonging drugs. We reviewed the electronic health record to assess the provider's responses which were classified as "action taken" (QT drug avoided, QT drug changed, other QT drug(s) avoided, ECG monitoring, electrolytes monitoring, QT issue acknowledged, other actions) or "no action taken". Approximately, 15.5% (95/612) of the alerts were followed by a provider's action in the pre-intervention phase compared with 21% (228/1085) in the post-intervention phase (p=0.006). The most common type of actions taken during pre-intervention phase compared to post-intervention phase were ECG monitoring (8% vs. 13%, p=0.002) and QT issue acknowledgment (2.1% vs. 4.1%, p=0.03). Notably, there was no significant difference for other actions including QT drug avoided (p=0.8), QT drug changed (p=0.06) and other QT drug(s) avoided (p=0.3). Our study demonstrated that the QT alert system prompted a higher proportion of providers to take action on patients at risk of complications. However, the overall impact was modest underscoring the need for educating providers and optimizing clinical decision support to further reduce drug-induced QT prolongation.

  2. Women Support Providers Are More Susceptible than Men to Emotional Contagion Following Brief Supportive Interactions

    Science.gov (United States)

    Magen, Eran; Konasewich, Paul A.

    2011-01-01

    People in distress often turn to friends for emotional support. Ironically, although receiving emotional support contributes to emotional and physical health, providing emotional support may be distressing as a result of emotional contagion. Women have been found to be more susceptible than men to emotional contagion in certain contexts, but no…

  3. Meeting Basic Needs: Social Supports and Services Provided by Hospice.

    Science.gov (United States)

    Boucher, Nathan A; Kuchibhatla, Maragatha; Johnson, Kimberly S

    2017-06-01

    Describe social goods and services for which hospices assist patients and families and the resources hospices use to do so. Basic social supports and services not routinely covered by insurers may be needed by terminally ill patients and their families. Little is known about hospices' provision of such social supports and services. A 2014-2015 cross-sectional survey of hospices nationwide. Participating hospices had been in operation for at least 3 years and were located in any of the 50 states or District of Columbia. Hospices were surveyed about availability and sources of internal funds and referral to obtain basic social supports for patients. Descriptive statistics, bivariate analysis, and categorization were used to describe hospice practices. Measures included frequency and nature of goods and services provision in the prior year; and extent to which hospices used internal funds or community referral for goods and services. Over 80% (n = 203) reported internal funds covered services not reimbursed by insurers; 78% used funds in last year. Hospices used internal funds for food (81.7%), shelter (57.8%), utility bills (73.5%), and funeral costs (50%). Hospices referred patients/families to community organizations to obtain a similar range of services, including transportation, clothing, linens/towels, furniture/appliances, home repairs, and caregiver support. Hospices are using internal resources and accessing community resources to provide patients with basic social needs not routinely covered by insurance.

  4. The effect of implant-supported removable partial dentures on oral health quality of life.

    Science.gov (United States)

    Gates, W Day; Cooper, Lyndon F; Sanders, Anne E; Reside, Glenn J; De Kok, Ingeborg J

    2014-02-01

    Removable partial dentures (RPDs) represent standard treatment for partial edentulism despite major shortcomings. To alleviate these shortcomings, endosseous implants provide support and stability as well as contribute to maintenance of alveolar bone. This prospective, within subject, time series study evaluated patient-based outcomes of RPDs compared to implant-supported removable partial dentures (ISRPDs). The study hypothesis was that the ISRPD would substantially improve oral health quality of life for patients. Seventeen patients requesting new mandibular Kennedy I or II RPDs received one 6-mm dental implant in one or both of the posterior edentulous areas. After healing, conventional RPDs were fabricated and delivered. Twelve weeks later, second-stage surgery was performed, and ball abutments with Clix attachments were inserted, thereby converting the prostheses to ISRPDs. Oral health quality of life was evaluated using the 49-item Oral Health Impact Profile (OHIP-49) questionnaire. The OHIP-49 was administered prior to treatment (baseline), at 6 and 12 weeks following RPD delivery and at 6 and 12 weeks following ISRPD conversion. Radiographic evaluation was performed at 6 and 12 weeks following ISRPD conversion. In statistical analysis, a fixed-slope random intercept variance components model took account of the multiple observations per person over time. In 17 subjects, 29 of 30 implants survived. The failed implant was replaced without complications. Abutment complications were limited to one abutment loosening and one attachment replacement. Minor prosthodontic complications were recorded. The OHIP-49 score reduced by 11.8 points, on average, at 12 weeks following ISRPD conversion (P = 0.011). Patients reported improved oral health following conversion to an ISRPD from RPD. The ISRPD involving short implants is one treatment option that should be considered when treatment planning Kennedy Class I and II patients. © 2012 John Wiley & Sons A/S.

  5. Health information support provided by professional associations in Canada.

    Science.gov (United States)

    Chatterley, Trish; Storie, Dale; Chambers, Thane; Buckingham, Jeanette; Shiri, Ali; Dorgan, Marlene

    2012-09-01

    Healthcare practitioners in Alberta and across Canada have varying levels of access to information resources depending on their institutional and professional affiliations, yet access to current health information is critical for all. To determine what information resources and services are provided by Albertan and Canadian professional health associations to their members. Representatives of professional colleges and associations were interviewed regarding information resources and services offered to members and perceptions of their members' information needs. National-level associations are more likely to provide resources than provincial ones. There is a clear distinction between colleges and associations in terms of information offered: colleges provide regulatory information, while associations are responsible for provision of clinical information resources. Only half of the associations interviewed provide members with access to licensed databases, with cost being a major barrier. There is considerable variation in the number of electronic resources and the levels of information support provided by professional health associations in Alberta and Canada. Access and usage vary among the health professions. National licensing of resources or creation of a portal linking to freely available alternatives are potential options for increasing access and awareness. © 2012 The authors. Health Information and Libraries Journal © 2012 Health Libraries Group.

  6. Rapid Deterioration of Basic Life Support Skills in Dentists With Basic Life Support Healthcare Provider.

    Science.gov (United States)

    Nogami, Kentaro; Taniguchi, Shogo; Ichiyama, Tomoko

    2016-01-01

    The aim of this study was to investigate the correlation between basic life support skills in dentists who had completed the American Heart Association's Basic Life Support (BLS) Healthcare Provider qualification and time since course completion. Thirty-six dentists who had completed the 2005 BLS Healthcare Provider course participated in the study. We asked participants to perform 2 cycles of cardiopulmonary resuscitation on a mannequin and evaluated basic life support skills. Dentists who had previously completed the BLS Healthcare Provider course displayed both prolonged reaction times, and the quality of their basic life support skills deteriorated rapidly. There were no correlations between basic life support skills and time since course completion. Our results suggest that basic life support skills deteriorate rapidly for dentists who have completed the BLS Healthcare Provider. Newer guidelines stressing chest compressions over ventilation may help improve performance over time, allowing better cardiopulmonary resuscitation in dental office emergencies. Moreover, it may be effective to provide a more specialized version of the life support course to train the dentists, stressing issues that may be more likely to occur in the dental office.

  7. Examining the Support Peer Supporters Provide Using Structural Equation Modeling: Nondirective and Directive Support in Diabetes Management.

    Science.gov (United States)

    Kowitt, Sarah D; Ayala, Guadalupe X; Cherrington, Andrea L; Horton, Lucy A; Safford, Monika M; Soto, Sandra; Tang, Tricia S; Fisher, Edwin B

    2017-12-01

    Little research has examined the characteristics of peer support. Pertinent to such examination may be characteristics such as the distinction between nondirective support (accepting recipients' feelings and cooperative with their plans) and directive (prescribing "correct" choices and feelings). In a peer support program for individuals with diabetes, this study examined (a) whether the distinction between nondirective and directive support was reflected in participants' ratings of support provided by peer supporters and (b) how nondirective and directive support were related to depressive symptoms, diabetes distress, and Hemoglobin A1c (HbA1c). Three hundred fourteen participants with type 2 diabetes provided data on depressive symptoms, diabetes distress, and HbA1c before and after a diabetes management intervention delivered by peer supporters. At post-intervention, participants reported how the support provided by peer supporters was nondirective or directive. Confirmatory factor analysis (CFA), correlation analyses, and structural equation modeling examined the relationships among reports of nondirective and directive support, depressive symptoms, diabetes distress, and measured HbA1c. CFA confirmed the factor structure distinguishing between nondirective and directive support in participants' reports of support delivered by peer supporters. Controlling for demographic factors, baseline clinical values, and site, structural equation models indicated that at post-intervention, participants' reports of nondirective support were significantly associated with lower, while reports of directive support were significantly associated with greater depressive symptoms, altogether (with control variables) accounting for 51% of the variance in depressive symptoms. Peer supporters' nondirective support was associated with lower, but directive support was associated with greater depressive symptoms.

  8. Removable partial denture supported by implants with prefabricated telescopic abutments - a case report.

    Science.gov (United States)

    Kumar, Lalit; Sehgal, Komal

    2014-06-01

    Implants have been designed to rehabilitate edentulous patients with fixed prosthesis or implant supported overdentures. Implant-supported single crowns and fixed partial dentures have become successful treatment alternatives to removable and fixed partial dentures. However, it is common to have clinical situations which make it impossible to use conventional as well as implant supported fixed partial dentures. The implant supported removable partial dentures can be a treatment modality that offers the multitude of benefits of implant-based therapy-biologic, biomechanical, social, and psychological to such patients. The aim of this article is to present a case report describing the fabrication and advantages of removable partial denture supported by teeth and implants for a patient with long edentulous span. The patient was satisfied with his dentures in terms of function and aesthetics. Regular follow-up visits over a period of three years revealed that the periodontal condition of remaining natural dentition and peri-implant conditions were stable. There was no evidence of excessive residual ridge resorption or mobility of the teeth, nor were any visible changes in the bone levels of the natural teeth or implants noted on radiographs.

  9. Load transfer characteristics of unilateral distal extension removable partial dentures with polyacetal resin supporting components.

    Science.gov (United States)

    Jiao, T; Chang, T; Caputo, A A

    2009-03-01

    To photoelastically examine load transfer by unilateral distal extension removable partial dentures with supporting and retentive components made of the lower stiffness polyacetal resins. A mandibular photoelastic model, with edentulous space distal to the right second premolar and missing the left first molar, was constructed to determine the load transmission characteristics of a unilateral distal extension base removable partial denture. Individual simulants were used for tooth structure, periodontal ligament, and alveolar bone. Three designs were fabricated: a major connector and clasps made from polyacetal resin, a metal framework as the major connector with polyacetal resin clasp and denture base, and a traditional metal framework I-bar removable partial denture. Simulated posterior bilateral and unilateral occlusal loads were applied to the removable partial dentures. Under bilateral and left side unilateral loading, the highest stress was observed adjacent to the left side posterior teeth with the polyacetal removable partial denture. The lowest stress was seen with the traditional metal framework. Unilateral loads on the right edentulous region produced similar distributed stress under the denture base with all three designs but a somewhat higher intensity with the polyacetal framework. The polyacetal resin removable partial denture concentrated the highest stresses to the abutment and the bone. The traditional metal framework I-bar removable partial denture most equitably distributed force. The hybrid design that combined a metal framework and polyacetal clasp and denture base may be a viable alternative when aesthetics are of primary concern.

  10. Effect of implant support on mandibular distal extension removable partial dentures: relationship between denture supporting area and stress distribution.

    Science.gov (United States)

    Sato, Maki; Suzuki, Yasunori; Kurihara, Daisuke; Shimpo, Hidemasa; Ohkubo, Chikahiro

    2013-04-01

    This study explored the relationship between implant support and the denture-supporting area by comparing the stability of an implant-supported distal extension removable partial denture and a conventional distal extension removable partial denture. A model simulating a mandibular bilateral distal extension missing (#34-37 and #44-47) was fabricated using silicone impression material as soft tissue (2 mm thick) on an epoxy resin bone model. The denture base was reduced by 5 mm cutting part of both the retromolar pad and the lingual border. Loads of up to 5 kg were applied, and the pressure and displacement of the RPDs were simultaneously measured and analyzed using the Wilcoxon test (αremovable partial denture (ISRPD) was significantly less than on the conventional RPD (CRPD). As the supporting area of the denture base decreased, the pressure and the denture displacement of the CRPD were greater than for the ISRPD. This study indicated that implant placement at the distal edentulous ridge can prevent denture displacement of the distal extension bases, regardless of the supporting area of the denture base. Copyright © 2013 Japan Prosthodontic Society. Published by Elsevier Ltd. All rights reserved.

  11. Providing over-the-horizon awareness to driver support systems

    NARCIS (Netherlands)

    van Eenennaam, Martijn; Heijenk, Geert

    2008-01-01

    Vehicle-to-vehicle communications is a promising technique for driver support systems to increase traffic safety and efficiency. A proposed system is the Congestion Assistant [1], which aims at supporting drivers when approaching and driving in a traffic jam. Studies have shown great potential for

  12. Cost-effectiveness of implant-supported mandibular removable partial dentures.

    Science.gov (United States)

    Jensen, Charlotte; Ross, Jamila; Feenstra, Talitha L; Raghoebar, Gerry M; Speksnijder, Caroline; Meijer, Henny J A; Cune, Marco S

    2017-05-01

    The aim of this study was to conduct a cost-effectiveness analysis comparing conventional removable partial dentures (RPDs) and implant-supported RPDs (ISRPDs) treatment in patients with an edentulous maxilla and a bilateral free-ending situation in the mandible. Thirty subjects were included. A new RPD was made and implant support was provided 3 months later. Treatment costs (opportunity costs and costs based on tariffs) were calculated. Treatment effect was expressed by means of the Dutch Oral Health Impact Profile questionnaire (OHIP-NL49), a chewing ability test (Mixing Ability Index, MAI) and a short-form health survey measuring perceived general health (SF-36), which was subsequently converted into quality-adjusted-life-years (QALYs). The incremental cost-effectiveness ratio (ICER) was the primary outcome measure of cost-effectiveness, comparing both treatment strategies. The mean total opportunity costs were €981 (95% CI €971-€991) for the RPD treatment and €2.480 (95% CI €2.461-€2.500) for the ISRPD treatment. The total costs derived from the national tariff structure were €850 for the RPD treatment and €2.610 for the ISRPD treatment. The ICER for OHIP-NL49 and MAI using the opportunity costs was €80 and €786, respectively. When using the tariff structure, corresponding ICERs were €94 and €921. The effect of supporting an RPD with implants when expressed in QALYs was negligible; hence an ICER was not determined. It is concluded that depending on the choice of outcome measure and monetary threshold, supporting an RPD with implants is cost-effective when payers are willing to pay more than €80 per OHIP point gained. Per MAI point gained, an additional €786 has to be invested. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  13. Providing Co-Curricular Support: A Multi-Case Study of Engineering Student Support Centers

    Science.gov (United States)

    Lee, Walter C., Jr.

    2015-01-01

    In response to the student retention and diversity issues that have been persistent in undergraduate engineering education, many colleges have developed Engineering Student Support Centers (ESSCs) such as Minority Engineering Programs (MEPs) and Women in Engineering Programs (WEPs). ESSCs provide underrepresented students with co-curricular…

  14. Positive Adult Support and Depression Symptoms in Adolescent Females: The Partially Mediating Role of Eating Disturbances

    Science.gov (United States)

    Linville, Deanna; O'Neil, Maya; Huebner, Angela

    2011-01-01

    This study examined linkages between depression symptoms (DEP) and positive adult support (PAS) in female adolescents and the partially mediating influence of eating disturbances (ED). Structural equation modeling was used to establish measurement models for each of the latent constructs, determine the relationships among the latent constructs,…

  15. Highly Active, Carbon-supported, PdSn Nano-core, Partially ...

    African Journals Online (AJOL)

    Carbon-supported, Pt partially covered, PdSn alloy nanoparticles (Pt-PdSn/C) were synthesized via a metathetical reaction of PdSn alloy nanoparticles, and a platinum precursor. The electrochemical activity was evaluated by methanol oxidation. The Pt-PdSn/C catalysts were characterized by transmission electron ...

  16. Implant-supported removable partial dentures in the mandible : A 3-16 year retrospective study

    NARCIS (Netherlands)

    Jensen, Charlotte; Meijer, Henny J A; Raghoebar, Gerry M; Kerdijk, Wouter; Cune, Marco S

    PURPOSE: The purpose of this retrospective study was to assess performance, together with biological and technical complications, of implant-supported removable partial dentures (ISRPD) in mandibular Kennedy class I situations with implants placed in the anterior or posterior position. METHODS: 23

  17. Implant-supported removable partial dentures in the mandible : A 3-16 year retrospective study

    NARCIS (Netherlands)

    Jensen, Charlotte; Meijer, Henny J. A.; Raghoebar, Gerry M.; Kerdijk, Wouter; Cune, Marco S.

    Purpose: The purpose of this retrospective study was to assess performance, together with biological and technical complications, of implant-supported removable partial dentures (ISRPD) in mandibular Kennedy class I situations with implants placed in the anterior or posterior position. Methods: 23

  18. Partially unzipped carbon nanotubes as a superior catalyst support for PEM fuel cells.

    Science.gov (United States)

    Long, Donghui; Li, Wei; Qiao, Wenming; Miyawaki, Jin; Yoon, Seong-Ho; Mochida, Isao; Ling, Licheng

    2011-09-07

    Partially unzipped carbon nanotubes prepared by strong oxidation and thermal expansion of carbon nanotubes were explored as an advanced catalyst support for PEM fuel cells. The unique hybrid structure of 1D nanotube and 2D double-side graphene resulted in an outstanding electrocatalytic performance. This journal is © The Royal Society of Chemistry 2011

  19. Cost-effectiveness of implant-supported mandibular removable partial dentures

    NARCIS (Netherlands)

    Jensen, Charlotte; Ross, JN; feenstra, Talitha; Raghoebar, G.M.; Speksnijder, CM; Meijer, Henny; Cune, Marco

    Objectives: The aim of this study was to conduct a cost-effectiveness analysis comparing conventional removable partial dentures (RPDs) and implant-supported RPDs (ISRPDs) treatment in patients with an edentulous maxilla and a bilateral free-ending situation in the mandible. Material and methods:

  20. Cost-effectiveness of implant-supported mandibular removable partial dentures

    NARCIS (Netherlands)

    Jensen, Charlotte; Ross, Jamila; Feenstra, Talitha L; Raghoebar, Gerry M; Speksnijder, Caroline; Meijer, Henny J A; Cune, Marco S

    ObjectivesThe aim of this study was to conduct a cost-effectiveness analysis comparing conventional removable partial dentures (RPDs) and implant-supported RPDs (ISRPDs) treatment in patients with an edentulous maxilla and a bilateral free-ending situation in the mandible. Material and methodsThirty

  1. Clinical Evaluation of Implant-Supported Removable Partial Dentures With a Stress-Breaking Attachment.

    Science.gov (United States)

    Suzuki, Yasunori; Kono, Kentaro; Shimpo, Hidemasa; Sato, Yohei; Ohkubo, Chikahiro

    2017-08-01

    The stress-breaking ball (SBB) attachment can distribute the occlusal force equally between the alveolar ridge and the implants. The purpose of this study was to evaluate the implant-supported distal extension removable partial dentures (RPDs) with SBB attachment in 10 patients who were partially edentulous. This randomized crossover study was designed to compare the function of RPDs with and without healing abutments and SBB attachments to support the posterior aspects of the RPDs. Mandibular jaw movements during mastication and the occlusal force and contact area were measured with a commercially available tracking device and pressure-sensitive sheets. Using a visual analog scale, 4 criteria-chewing, retention, stability, and comfort-were evaluated. All of the data obtained were analyzed using a 1-way analysis of variance (α = 0.05). There were no significant differences in either the mean time or the coefficient of variation among the SBB attachments and healing abutments of implant-supported removable partial dentures (ISRPDs) and conventional removable partial dentures (CRPDs). SBB attachments and healing abutments of ISRPDs had greater forces and contact areas than those of CRPDs with significant differences. For all criteria, patients preferred SBB attachments to healing abutments and CRPDs. The implant-supported distal extension RPDs with SBB attachment improved denture stability and patients' satisfaction.

  2. Optimizing stock levels for rental systems with a support warehouse and partial backordering

    NARCIS (Netherlands)

    van der Heide, Gerlach; van Foreest, Nicky; Roodbergen, Kees Jan

    2018-01-01

    Various rental systems, such as public libraries and tool rental companies, have a support warehouse for storing rental products at low cost and carrying out expedited shipments in response to stock-outs at local warehouses. In case of stock-outs, rental systems commonly employ partial backordering,

  3. Providing 'auxiliary' academic writing support to postgraduate students

    African Journals Online (AJOL)

    cultural approach to academic writing support which was part of the inception of a broader orientation programme in a newly established Centre for Postgraduate Studies at a research intensive South African university. The role of writing ...

  4. Providing monitoring and evaluation support for CCAA projects

    International Development Research Centre (IDRC) Digital Library (Canada)

    CCAA

    In February 2010, when CCAA's program leader visited a Malawi-based project team focusing on agricultural innovations, researchers explained how helpful they had found the program's training and mentoring in outcome mapping (OM). This support, organized in 2007 and 2008 by CCAA, helped them and their partners ...

  5. The experiences of nurses in providing psychosocial support to ...

    African Journals Online (AJOL)

    The study was conducted in the surgical ICUs of two private hospitals and one public hospital in the Durban metropolitan area. Findings. Four main themes emerged from the data: cultural awareness, communication challenges, providing assistance, and lack of training. Conclusion. These findings provide implications for ...

  6. Clinical effectiveness of implant-supported removable partial dentures: a review of the literature and retrospective case evaluation.

    Science.gov (United States)

    Grossmann, Yoav; Nissan, Joseph; Levin, Liran

    2009-09-01

    To review the published data on the treatment outcomes of restoring the partially edentulous patient with implant-supported removable partial dentures (ISRPDs) and describe the concept of ISRPDs and the clinical guidelines for placing implants for ISRPDs, and evaluate case series results. For the review, a literature search was performed using the PubMed and Ovid databases. Reports in English from 1969 to 2008 were considered. Also, 35 patients have had their dentition restored with ISRPDs supported by 67 implants. These patients were evaluated in terms of implant and teeth survival. The data from the published reports and the presented case series suggest that the incorporation of dental implants into removable partial dentures could be an optional treatment plan for the partially edentulous patient to improve function and patient satisfaction. ISRPDs provide patients with stable, long-term predictable prostheses. This treatment alternative should be considered whenever fixed restorations are not a valid option. Strict maintenance and a follow-up protocol are recommended to obtain satisfactory results. Longitudinal clinical studies are required for evaluation of ISRPDs.

  7. Private Training Providers: Their Characteristics and Training Activities. Support Document

    Science.gov (United States)

    Harris, Roger; Simons, Michele; McCarthy, Carmel

    2006-01-01

    This document was produced by the authors based on their research for the report, "Private Training Providers: Their Characteristics and Training Activities," [ED495181] and is an added resource for further information. That study examined the nature of the training activity of private registered training organisations (RTOs) offered to…

  8. Comparison of Treatment Outcomes in Partially Edentulous Patients with Implant-Supported Fixed Prostheses and Removable Partial Dentures.

    Science.gov (United States)

    Nogawa, Toshifumi; Takayama, Yoshiyuki; Ishida, Keita; Yokoyama, Atsuro

    The aim of this study was to compare masticatory performance, occlusal force, and oral health-related quality of life (OHRQoL) in patients with mandibular distal-extension edentulism between those with implant-supported fixed prostheses (ISFPs) and those with removable partial dentures (RPDs), and to evaluate relationships among them. Subjects were recruited from patients using ISFPs or RPDs for mandibular distal-extension edentulism. Masticatory performance was evaluated based on the glucose extracted from chewed gummy jelly. Occlusal force was measured with a pressure-sensitive sheet, and data were subjected to computer analysis. The Japanese version of the Oral Health Impact Profile (OHIP-J) was used to evaluate OHRQoL. The masticatory performance, occlusal force, and OHIP-J scores of the ISFP and RPD groups were compared using the Wilcoxon rank-sum test. The relationships among the variables were analyzed using the Spearman rank correlation coefficient test. Multivariate logistic regression analysis was employed with the OHIP-J score as a dependent variable. Nineteen patients with ISFPs and 25 patients with RPDs participated in this study. No significant difference was observed between the two groups with regard to masticatory performance and occlusal force. The OHIP-J score was significantly lower in the ISFP group than in the RPD group. The OHIP-J score had no significant correlation with masticatory performance, but was significantly correlated with occlusal force and the prosthetic method. Multivariate logistic regression analysis showed that younger age, RPDs, and lower occlusal force were significantly associated with a higher OHIP-J summary score. The present results suggest that the difference in masticatory performance and occlusal force between ISFPs and RPDs is small, but ISFPs are superior to RPDs with regard to OHRQoL in patients with mandibular distal-extension edentulism. In addition, there appears to be a slight correlation between the OHIP

  9. Providing of Spatial Wetland Information for Supporting National Development

    Directory of Open Access Journals (Sweden)

    Aris Poniman

    2016-05-01

    Full Text Available The wetland has a strategic role in national development. The potential uses of the wetland are varied such as for agriculture, fisheries, industries, and forestry. The intensive use of the wetland for agricultural development in Sumatera, Kalimantan, Sulawesi, and Papua through transmigration projects has been run since in 1973. Unfortunately, not all the projects were well developed, causing the social, economic, and physical environmental problems. These problems resulted in the negative impact for the life of the transmigration people. For that reason, the community empowerment for the unlucky transmigration people by handling the physical and non physical aspects is very important. This paper will describe the importance of providing spatial data and information biophysical wetland as an initial step in empowering people who live in the wetland resource.

  10. Optimization of a Virtual Power Plant to Provide Frequency Support.

    Energy Technology Data Exchange (ETDEWEB)

    Neely, Jason C. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Johnson, Jay [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Gonzalez, Sigifredo [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Lave, Matthew Samuel [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Delhotal, Jarod James [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States)

    2015-12-01

    Increasing the penetration of distributed renewable sources, including photovoltaic (PV) sources, poses technical challenges for grid management. The grid has been optimized over decades to rely upon large centralized power plants with well-established feedback controls, but now non-dispatchable, renewable sources are displacing these controllable generators. This one-year study was funded by the Department of Energy (DOE) SunShot program and is intended to better utilize those variable resources by providing electric utilities with the tools to implement frequency regulation and primary frequency reserves using aggregated renewable resources, known as a virtual power plant. The goal is to eventually enable the integration of 100s of Gigawatts into US power systems.

  11. Implant retention and support for distal extension partial removable dental prostheses: satisfaction outcomes.

    Science.gov (United States)

    Gonçalves, Thais Marques Simek Vega; Campos, Camila Heitor; Garcia, Renata Cunha Matheus Rodrigues

    2014-08-01

    The rotational movements of the distal extension denture base of partial removable dental prostheses frequently harm the prosthesis stability, leading to discomfort during function. This study evaluated the use of distal implants to retain and support partial removable dental prostheses and assessed the outcomes with respect to specific aspects of patient satisfaction. Twelve participants (mean age, 62.6 ± 7.8 years) received new conventional mandibular partial removable dental prostheses and complete maxillary dentures. After 2 months of conventional prosthesis use, the participants completed a questionnaire assessing their satisfaction. Implants were then inserted bilaterally in the mandibular posterior region and, after 4 months, ball attachments were placed on the implants and on the partial removable dental prosthesis acrylic resin base. The implants and remaining teeth were followed up with clinical and image examinations. After 2 months, satisfaction was reevaluated, and the data were analyzed by the paired Student t test and the Bonferroni correction (α=.05). Clinical evaluation found stable periodontal conditions around the implants, no intrusions or mobility of teeth, and no radiographic changes in bone level. Participants reported significant improvements (Premovable prostheses improve retention and stability, minimize rotational movements, and significantly increase participant satisfaction. Copyright © 2014 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

  12. An ontology-driven, case-based clinical decision support model for removable partial denture design

    Science.gov (United States)

    Chen, Qingxiao; Wu, Ji; Li, Shusen; Lyu, Peijun; Wang, Yong; Li, Miao

    2016-06-01

    We present the initial work toward developing a clinical decision support model for specific design of removable partial dentures (RPDs) in dentistry. We developed an ontological paradigm to represent knowledge of a patient’s oral conditions and denture component parts. During the case-based reasoning process, a cosine similarity algorithm was applied to calculate similarity values between input patients and standard ontology cases. A group of designs from the most similar cases were output as the final results. To evaluate this model, the output designs of RPDs for 104 randomly selected patients were compared with those selected by professionals. An area under the curve of the receiver operating characteristic (AUC-ROC) was created by plotting true-positive rates against the false-positive rate at various threshold settings. The precision at position 5 of the retrieved cases was 0.67 and at the top of the curve it was 0.96, both of which are very high. The mean average of precision (MAP) was 0.61 and the normalized discounted cumulative gain (NDCG) was 0.74 both of which confirmed the efficient performance of our model. All the metrics demonstrated the efficiency of our model. This methodology merits further research development to match clinical applications for designing RPDs. This paper is organized as follows. After the introduction and description of the basis for the paper, the evaluation and results are presented in Section 2. Section 3 provides a discussion of the methodology and results. Section 4 describes the details of the ontology, similarity algorithm, and application.

  13. Effect of implant support on distal-extension removable partial dentures: in vivo assessment.

    Science.gov (United States)

    Ohkubo, Chikahiro; Kobayashi, Mariko; Suzuki, Yasunori; Hosoi, Toshio

    2008-01-01

    The use of a limited number of implants for support of a removable partial denture (RPD) changes a Kennedy Class I or II situation to that of a Class III. This in vivo pilot study evaluated implant-supported distal-extension removable partial dentures (RPD) in 5 partially edentulous patients. Two implants (Brånemark TU MK III, Nobel Biocare) were placed in a mandibular Kennedy Class I arch. To fabricate an implant-supported RPD (ISRPD), a conventional RPD base was fitted to the healing abutment with autopolymerizing acrylic resin (Uni-fast II, GC) to support the posterior aspect of the RPD. By changing the healing abutment to a healing cap, there was no connection between the denture base and implant, and the ISRPD became a conventional RPD (CRPD). Using a crossover study design, the masticatory movements (mandibular movements during mastication) of both dentures were measured using a commercially available tracking device (BioPACK, Bioresearch, Japan). The occlusal force and contact area were also measured using pressure-sensitive sheets and an image scanner (T-scan system). Using a visual analog scale (VAS), the 4 criteria of comfort, chewing, retention, and stability were evaluated. All the data obtained were analyzed using Wilcoxen signed rank tests (alpha = .05). There were no significant differences (P > .05) in masticatory movements between the ISRPD and the CRPD (5 patients: 4 women, 1 man). However, the ISRPD had significantly greater force and greater area than the CRPD (P = .043). The center of occlusal force of the ISRPD tended to move more distally compared to the CRPD. All the patients preferred the ISRPD for comfort, chewing, retention, and stability. One implant per edentulous area and a simple attachment technique yielded a stable distal extension RPD.

  14. Indian community health insurance schemes provide partial protection against catastrophic health expenditure

    Directory of Open Access Journals (Sweden)

    Ranson Kent

    2007-03-01

    Full Text Available Abstract Background More than 72% of health expenditure in India is financed by individual households at the time of illness through out-of-pocket payments. This is a highly regressive way of financing health care and sometimes leads to impoverishment. Health insurance is recommended as a measure to protect households from such catastrophic health expenditure (CHE. We studied two Indian community health insurance (CHI schemes, ACCORD and SEWA, to determine whether insured households are protected from CHE. Methods ACCORD provides health insurance cover for the indigenous population, living in Gudalur, Tamil Nadu. SEWA provides insurance cover for self employed women in the state of Gujarat. Both cover hospitalisation expenses, but only upto a maximum limit of US$23 and US$45, respectively. We reviewed the insurance claims registers in both schemes and identified patients who were hospitalised during the period 01/04/2003 to 31/03/2004. Details of their diagnoses, places and costs of treatment and self-reported annual incomes were obtained. There is no single definition of CHE and none of these have been validated. For this research, we used the following definition; "annual hospital expenditure greater than 10% of annual income," to identify those who experienced CHE. Results There were a total of 683 and 3152 hospital admissions at ACCORD and SEWA, respectively. In the absence of the CHI scheme, all of the patients at ACCORD and SEWA would have had to pay OOP for their hospitalisation. With the CHI scheme, 67% and 34% of patients did not have to make any out-of-pocket (OOP payment for their hospital expenses at ACCORD and SEWA, respectively. Both CHI schemes halved the number of households that would have experienced CHE by covering hospital costs. However, despite this, 4% and 23% of households with admissions still experienced CHE at ACCORD and SEWA, respectively. This was related to the following conditions: low annual income, benefit

  15. An In Vivo Study on Load Distribution in Different Implant Configurations for Supporting Fixed Partial Dentures.

    Science.gov (United States)

    Kobari, Hiromori; Yoda, Nobuhiro; Chen, Junning; Kawata, Tetsuo; Sasaki, Keiichi

    2016-01-01

    The aims of this study were to develop a device for in vivo measurement of three-dimensional (3D) loads on implants and to investigate the effects of implant configuration on the load distribution under a three-unit fixed partial denture (FPD). A 67-year-old female patient with three implants (in the mandibular left second premolar, first molar, and second molar regions) was recruited. Four implant configurations for a three-unit FPD depending on the number and position of the implants were considered in this study. They included a three-implant prosthesis and three types of two-implant prosthesis: a central pontic, posterior cantilever, and anterior cantilever, with the same superstructure (splinted three crowns) for the same occlusal contact. Customized abutments and 3D piezoelectric force transducers were fixed to the implants of the four configurations with the superstructure. The loads on the implants were recorded during maximum voluntary clenching (MVC-test) and when chewing a piece of chewing gum (GUMtest). The occlusal forces on the dental arch during MVC-test with the four implant configurations did not exhibit significant differences. In the three-implant prosthesis, there were no significant differences in the mean maximum resultant load on each implant in both tests. In the central pontic, the load on the second premolar was significantly greater than that on the second molar in the MVC-test but there were no significant differences in the GUM-test. High loads were detected on the first molar in both the posterior cantilever and anterior cantilever. The highest load was detected on the first molar in the posterior cantilever during the GUMtest. The in vivo 3D load-measuring device using the piezoelectric force transducers enabled the measurement of the functional load on implants supporting a FPD. The results suggested, within the limitations of this study, that a three-implant prosthesis and central pontic provide biomechanically beneficial designs

  16. [Influence of attachment type on stress distribution of implant-supported removable partial dentures].

    Science.gov (United States)

    Yang, Xue; Rong, Qi-guo; Yang, Ya-dong

    2015-02-18

    To compare influences of different retention attachments on stress among supporting structures. By 3-dimensional laser scanner and reverse engineering computer aided design (CAD) software, a basic partially edentulous digital model with mandibular premolar and molar missing was established. Implant attachment and removable partial dentures (RPD) were added into the basic model to build three kinds of models: RPD only, RPD + implant + Locator attachment, and RPD + implant + Magfit attachment. Vertical and inclined loads were put on artificial teeth unilaterally. By means of 3-dimensional finite element analysis, the stress distribution and displacement of the main supportive structures were compared. A complete 3-dimensional finite element model was established, which contained tooth structure, and periodontal structures. The displacement of the denture was smaller in Locator (9.38 μm vertically, 45.48 μm obliquely) and Magfit models (9.54 μm vertically, 39.45 μm obliquely) compared with non-implant RPD model (95.27 μm vertically, 155.70 μm obliquely). Compared with the two different attachments, cortical bone stress value was higher in Locator model (Locator model 10.850 MPa vertically, 43.760 MPa obliquely; Magfit model 7.100 MPa vertically, 19.260 MPa obliquely).The stress value of abutment periodontal ligamentin Magfit model (0.420 MPa vertically) was lower than that in Locator model (0.520 MPa vertically). The existence of implant could reduce maximum von Mises value of each supportive structure when Kennedy I partially edentulous mandible was restored. Comparing the structure of Magfit and Locator attachment, the contact of Magfit attachment was rigid, while Locator was resilient. Locator attachment could improve stability of the denture dramatically. Locator had stronger effect on defending horizontal movement of the denture.

  17. Impact of implant support on mandibular free-end base removable partial denture: theoretical study.

    Science.gov (United States)

    Oh, Won-suk; Oh, Tae-Ju; Park, Ju-mi

    2016-02-01

    This study investigated the impact of implant support on the development of shear force and bending moment in mandibular free-end base removable partial dentures (RPDs). Three theoretical test models of unilateral mandibular free-end base RPDs were constructed to represent the base of tooth replacement, as follows: Model 1: first and second molars (M1 and M2); Model 2: second premolar (P2), M1, and M2; and Model 3: first premolar (P1), P2, M1, and M2. The implant support located either at M1 or M2 sites. The occlusal loading was concentrated at each replacement tooth to calculate the stress resultants developed in the RPD models using the free-body diagrams of shear force and bending moment. There was a trend of reduction in the peak shear force and bending moment when the base was supported by implant. However, the degree of reduction varied with the location of implant support. The moment reduced by 76% in Model 1, 58% in Model 2, and 42% in Model 3, when the implant location shifted from M1 to M2 sites. The shear forces and bending moments subjected to mandibular free-end base RPDs were found to decrease with the addition of implant support. However, the impact of implant support varied with the location of implant in this theoretical study. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  18. Alternative complete-arch cement-retained implant-supported fixed partial denture.

    Science.gov (United States)

    Hofstede, T M; Ercoli, C; Hagan, M E

    1999-07-01

    Early implant prostheses designs, which used screw-retained metal and acrylic resin structures, frequently left a space between the prosthesis and the soft tissue. Common deficiencies of this design included phonetic and esthetic problems and screw loosening. Cement-retained implant prostheses are also used in partially and completely edentulous patients, and are thought to have optimal occlusion and esthetics. Moreover, cement-retained prostheses may induce less stress on the implant, thereby maximizing the possibility of a passive fit. Porcelain fused to metal prostheses have been used mostly in partially edentulous situations. Recently, complete-arch porcelain fused to metal prostheses that replace hard and soft tissue have been used and, although this restoration can have excellent esthetics, there are disadvantages such as high cost, potential framework distortion during fabrication, and difficulty in repairing fractures of in-service porcelain. This article describes an alternative technique for the fabrication of a complete-arch, cement-retained, metal-acrylic resin implant-supported fixed partial denture. When compared with porcelain fused to metal complete-arch restorations, this prostheses is esthetic, has excellent retention and stability, yet is relatively inexpensive to fabricate, and requires less laboratory skill.

  19. Mandibular implant-supported removable partial denture with distal extension: a systematic review.

    Science.gov (United States)

    de Freitas, R F C P; de Carvalho Dias, K; da Fonte Porto Carreiro, A; Barbosa, G A S; Ferreira, M A F

    2012-10-01

    The aim of this article is to investigate patient satisfaction, survival rate of implants, and prosthetic complications or maintenance for rehabilitation with removable partial dentures associated with implants in mandibular Kennedy class I and II cases. A systematic literature review was conducted by three independent reviewers including articles published from January 1981 through September 2011. Medline and Cochrane Library electronic databases were used in addition to hand searching to assess clinical outcomes for mandibular implant-supported removable partial denture with distal extension. This review yielded 1751 records that were narrowed down to 5. The studies revealed implant survival rates ranging from 95% to 100% with one failure reported of 98 implants. The removable partial dentures associated with implant in mandibular free-end arches showed some complications and need of repair for relining, pitting of the healing abutment, replacement of resilient component of the attachment, damage in framework, screw loosening and damage in acrylic denture base. Patient satisfaction was evaluated through a five-point questionnaire, and results ranged between 4.12 and 5.0, considering 1 as the least favourable situation. The literature review showed increase in patient satisfaction and high survival rates of implants associated with mandibular removable partial dentures with distal extensions. However, some complications and need of prosthetic repair were reported. Although this treatment approach could represent a low-cost and beneficial rehabilitation for free-end mandibular ridges, the lack of controlled and randomised well-designed clinical trials suggests further studies with more representative samples to validate the outcomes of this treatment modality. © 2012 Blackwell Publishing Ltd.

  20. Implant-supported mandibular removable partial dentures; patient-based outcome measures in relation to implant position.

    Science.gov (United States)

    Jensen, Charlotte; Raghoebar, Gerry M; Kerdijk, Wouter; Meijer, Henny J A; Cune, Marco S

    2016-12-01

    To assess the benefits of implant support to Removable Partial Dentures (RPD) in patients with a bilateral free-ending situation in the mandible and to determine the most favorable implant position: the premolar (PM) or the molar (M) region. Thirty subjects with a bilateral unbounded posterior saddle received 2 PM and 2M implants. A new RPD was placed. Implant support was provided 3 months later. Two PM implants supported the RPD. After 3 months the 2M implants were used or vice versa. Outcome measures included oral health related quality of life (OHIP-NL49), general health status (SF-36), contentment assessed on a Visual Analogue Scale (VAS) and the number of hours that the RPD was worn. Data were collected prior to treatment, 3 months after having functioned with a new RPD and after 3 and 6 months with implant support. Finally, patients expressed their preferred implant position. The general health status (SF-36) was not influenced. OHIP-NL49 values and mean wearing-time were statistical significantly more favorable for ISRPD's, regardless of the implant position. Per day, the ISRPD's were worn 2-3h more than the unsupported new RPD. Patients' expectations were met as the VAS-scores of anticipated and realized contentment did not reach a statistical significant level (p>0.05). VAS scores for ISRPD's with M implant support were higher than for PM implant support. Finally, 56.7% of subjects preferred the M implant support, 13.3% expressed no preference and 30% opted for PM implant support. Mandibular implant support favorably influences oral health related patient-based outcome measures in patients with a bilateral free-ending situation. The majority of patients prefer the implant support to be in the molar region. Patients with a bilateral free-ending situation in the mandible opposed by a maxillary denture benefit from implant support to their mandibular removable partial denture. Most patients prefer this support to be in the molar region. Copyright © 2016

  1. A mixed methods analysis of support for self-management behaviors: Perspectives of people with epilepsy and their support providers

    OpenAIRE

    Walker, Elizabeth Reisinger; Engelhard, George; Barmon, Christina; McGee, Robin E.; Sterk, Claire E.; DiIorio, Colleen; Thompson, Nancy

    2014-01-01

    Social support is associated with improved self-management for people with chronic conditions, such as epilepsy; however, little is known about the perceived ease or difficulty of receiving and providing support for epilepsy self-management. We examined patterns of epilepsy self-management support from the perspectives of both people with epilepsy and their support persons. Fifty-three people with epilepsy and 48 support persons completed a survey on epilepsy self-management support. Of these...

  2. 47 CFR 54.625 - Support for services beyond the maximum supported distance for rural health care providers.

    Science.gov (United States)

    2010-10-01

    ... 47 Telecommunication 3 2010-10-01 2010-10-01 false Support for services beyond the maximum supported distance for rural health care providers. 54.625 Section 54.625 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES (CONTINUED) UNIVERSAL SERVICE Universal Service Support for Health Care Providers § 54.625...

  3. Supportive accountability: a model for providing human support to enhance adherence to eHealth interventions.

    Science.gov (United States)

    Mohr, David C; Cuijpers, Pim; Lehman, Kenneth

    2011-03-10

    The effectiveness of and adherence to eHealth interventions is enhanced by human support. However, human support has largely not been manualized and has usually not been guided by clear models. The objective of this paper is to develop a clear theoretical model, based on relevant empirical literature, that can guide research into human support components of eHealth interventions. A review of the literature revealed little relevant information from clinical sciences. Applicable literature was drawn primarily from organizational psychology, motivation theory, and computer-mediated communication (CMC) research. We have developed a model, referred to as "Supportive Accountability." We argue that human support increases adherence through accountability to a coach who is seen as trustworthy, benevolent, and having expertise. Accountability should involve clear, process-oriented expectations that the patient is involved in determining. Reciprocity in the relationship, through which the patient derives clear benefits, should be explicit. The effect of accountability may be moderated by patient motivation. The more intrinsically motivated patients are, the less support they likely require. The process of support is also mediated by the communications medium (eg, telephone, instant messaging, email). Different communications media each have their own potential benefits and disadvantages. We discuss the specific components of accountability, motivation, and CMC medium in detail. The proposed model is a first step toward understanding how human support enhances adherence to eHealth interventions. Each component of the proposed model is a testable hypothesis. As we develop viable human support models, these should be manualized to facilitate dissemination.

  4. Knee contact forces and lower extremity support moments during running in young individuals post-partial meniscectomy.

    Science.gov (United States)

    Willy, R W; Bigelow, M A; Kolesar, A; Willson, J D; Thomas, J S

    2017-01-01

    While partial meniscectomy results in a compromised tibiofemoral joint, little is known regarding tibiofemoral joint loading during running in individuals who are post-partial meniscectomy. It was hypothesized that individuals post-partial meniscectomy would run with a greater hip support moment, yielding reduced peak knee extension moments and reduced tibiofemoral joint contact forces. 3-D Treadmill running mechanics were evaluated in 23 athletic individuals post-partial meniscectomy (37.5 ± 19.0 months post-partial meniscectomy) and 23 matched controls. Bilateral hip, knee and ankle contributions to the total support moment and the peak knee extension moment were calculated. A musculoskeletal model estimated peak and impulse tibiofemoral joint contact forces. Knee function was quantified with the Knee injury and Osteoarthritis Outcome Score (KOOS). During running, the partial meniscectomy group had a greater hip support moment (p = 0.002) and a reduced knee support moment (p support moment. This movement pattern was associated with a 14.5 % reduction (p = 0.019) in the peak knee extension moment. Despite these differences, there were no significant group differences in peak or impulse tibiofemoral joint contact forces. Lower KOOS Quality of Life scores were associated with greater hip support moment (p = 0.004, r = -0.58), reduced knee support moment (p = 0.006, r = 0.55) and reduced peak knee extension moment (p = 0.01, r = 0.52). Disordered running mechanics are present long term post-partial meniscectomy. A coordination strategy that shifts a proportion of the total support moment away from the knee to the hip reduces the peak knee extension moment, but does not equate to reduced tibiofemoral joint contact forces during running in individuals post-partial meniscectomy. III.

  5. Implant-supported mandibular removable partial dentures: Functional, clinical and radiographical parameters in relation to implant position.

    Science.gov (United States)

    Jensen, Charlotte; Speksnijder, Caroline M; Raghoebar, Gerry M; Kerdijk, Wouter; Meijer, Henny J A; Cune, Marco S

    2017-06-01

    Patients with a Kennedy class I situation often encounter problems with their removable partial denture (RPD). To assess the functional benefits of implant support to RPDs, the clinical performance of the implants and teeth and to determine the most favorable implant position: the premolar (PM) or molar (M) region. Thirty subjects received 2 PM and 2 M implants. A new RPD was made. Implant support was provided 3 months later. In a cross-over model, randomly, 2 implants (PM or M) supported the RPD during 3 months. Masticatory performance was assessed using the mixing ability index (MAI). Clinical and radiographic parameters were assessed. Non-parametric statistical analysis for related samples and post hoc comparisons were performed. Masticatory performance differed significantly between the stages of treatment (P < .001). MAI-scores improved with implant support although the implant position had no significant effect. No complications to the implants or RPD were observed and clinical and radiographical parameters for both implants and teeth were favorable. Higher scores for bleeding on probing were seen for molar implants. Implant support to a Kennedy class I RPD significantly improves masticatory function, regardless of implant position. No major clinical problems were observed. © 2017 Wiley Periodicals, Inc.

  6. Prediction of mitochondrial proteins based on genetic algorithm - partial least squares and support vector machine.

    Science.gov (United States)

    Tan, F; Feng, X; Fang, Z; Li, M; Guo, Y; Jiang, L

    2007-11-01

    Mitochondria are essential cell organelles of eukaryotes. Hence, it is vitally important to develop an automated and reliable method for timely identification of novel mitochondrial proteins. In this study, mitochondrial proteins were encoded by dipeptide composition technology; then, the genetic algorithm-partial least square (GA-PLS) method was used to evaluate the dipeptide composition elements which are more important in recognizing mitochondrial proteins; further, these selected dipeptide composition elements were applied to support vector machine (SVM)-based classifiers to predict the mitochondrial proteins. All the models were trained and validated by the jackknife cross-validation test. The prediction accuracy is 85%, suggesting that it performs reasonably well in predicting the mitochondrial proteins. Our results strongly imply that not all the dipeptide compositions are informative and indispensable for predicting proteins. The source code of MATLAB and the dataset are available on request under liml@scu.edu.cn.

  7. Inhibition effects in the partial oxidation of cyclohexane on polymer supported Co(II catalysts

    Directory of Open Access Journals (Sweden)

    MAJA ODOVIC

    2005-02-01

    Full Text Available Polymer supported catalysts with different contents of metal ions where synthesized by wet impregnation of the degassed support from ethanolic solutions of cobalt(II nitrate. Amacroreticular copolymer of poly-4-vinylpyridine with divinylbenzene was used as the support. The prepared catalysts were tested in the partial oxidation of cyclohexane to cyclohexanol and cyclohexanone. Activity tests were performed in a stainless steel, laboratory scale, stirred autoclave, in the semi batch regime under isothermal and non-isothermal conditions. Isothermal experiments where performed at 170 °C for 120 min. In the non-isothermal conditions. isothermal experiments where performed at 170 °C for 120 min. In the non-isothermal experiments, a constant heating rate of 0.3 degree/min was used in the range between 110 °C and 170 °C. Non-linear, least-squares analysis with the simplex optimization method and numerical simulation of the reaction model in each iterative step was used for the kinetic characterization of the process in a non-stationary, semi-batch regime. Apparent rate constants were obtained as an invariant measure of the catalytic system. Anon-linear effect of the content of metal ions on the reaction rate and on the ratio of the yield of the products was observed, which is attributed to a complex interactions between the reaction medium and the heterogeneous catalyst, including a catalyst-inhibition effect.

  8. Catalytic partial oxidation of methane over porous silica supported VO{sub x} catalysts

    Energy Technology Data Exchange (ETDEWEB)

    Pirovano, C.; Schoenborn, E.; Kalevaru, V.N.; Wohlrab, S.; Luecke, B.; Martin, A. [University Rostock e.V., Rostock (Germany). Leibniz Inst. for Catalysis

    2011-07-01

    High surface area mesoporous siliceous MCM-41 and SBA-15 materials have been used as supports to disperse vanadium oxide species using wet impregnation and incipient wetness impregnation methods. These materials were used as catalysts for the partial oxidation of methane (POM) to formaldehyde. The physico-chemical properties of the solids were studied by means of BET, DR-UV/Vis spectroscopy, Py-FTIR and TEM. The influence of support and the preparation method on the dispersion of VOx is also investigated. The catalytic properties of the catalysts were examined in a fixed bed stainless steel reactor at 923 K. So far a maximum production of formaldehyde can be detected on SBA-15 supported VOx-catalysts prepared by incipient wetness impregnation. On this V/SBA-15 material a covalent attachment of catalytic active molecular vanadium species dominates, which in turn leads to a lower activation temperature and thereby reduced over-oxidation. From the best case, the space time yield of HCHO could be reached close to 775 g{sub HCHO} Kg{sub cat}{sup -1} h{sup -1}. (orig.)

  9. Influence of length of occlusal support on masticatory function of free-end removable partial dentures.

    Science.gov (United States)

    Sanchez-Ayala, Alfonso; Ambrosano, Glaucia Maria Bovi; Rodrigues Garcia, Renata Cunha Matheus

    2012-01-01

    The aim of this study was to determine the influence of occlusal support length (OSL) of free-end removable partial dentures (RPDs) on masticatory function. Twenty-three subjects (mean age: 55.2 ± 8.4 years) who were edentulous in the maxilla and classified as Kennedy Class I in the mandible were selected. Subjects received new maxillary complete dentures and mandibular RPDs. Five OSL conditions were determined by RPD artificial tooth wear: full occlusal support (L1, control), OSL to first molar (L2), OSL to second premolar (L3), OSL to first premolar (L4), and absence of occlusal support (L5). Masticatory performance and efficiency were evaluated using the sieve method. Chewing rate was defined as the number of masticatory cycles per minute. Bolus selection opportunities and bolus breakage function were evaluated using the one-chew method. Qualitative and quantitative measurements of masticatory cycle patterns were recorded kinesiographically. Data were analyzed using repeated-measures analysis of variance and Friedman and Fisher exact tests (α = .05). Masticatory performance and efficiency decreased (P function decreased as OSL was reduced (P masticatory cycle pattern among the OSL conditions (P > .05). Reduction of OSL altered masticatory function, thereby decreasing masticatory performance and efficiency resulting from a lower capacity to select and break down food.

  10. Health organizations providing and seeking social support: a Twitter-based content analysis.

    Science.gov (United States)

    Rui, Jian Raymond; Chen, Yixin; Damiano, Amanda

    2013-09-01

    Providing and seeking social support are important aspects of social exchange. New communication technologies, especially social network sites (SNSs), facilitate the process of support exchange. An increasing number of health organizations are using SNSs. However, how they provide and seek social support via SNSs has yet to garner academic attention. This study examined the types of social support provided and sought by health organizations on Twitter. A content analysis was conducted on 1,500 tweets sent by a random sample of 58 health organizations within 2 months. Findings indicate that providing informational and emotional support, as well as seeking instrumental support, were the main types of social support exchanged by health organizations through Twitter. This study provides a typology for studying social support exchanges by health organizations, and recommends strategies for health organizations regarding the effective use of Twitter.

  11. A mixed methods analysis of support for self-management behaviors: perspectives of people with epilepsy and their support providers.

    Science.gov (United States)

    Walker, Elizabeth Reisinger; Engelhard, George; Barmon, Christina; McGee, Robin E; Sterk, Claire E; Diiorio, Colleen; Thompson, Nancy J

    2014-02-01

    Social support is associated with improved self-management for people with chronic conditions, such as epilepsy; however, little is known about the perceived ease or difficulty of receiving and providing support for epilepsy self-management. We examined patterns of epilepsy self-management support from the perspectives of both people with epilepsy and their support persons. Fifty-three people with epilepsy and 48 support persons completed a survey on epilepsy self-management support. Of these individuals, 22 people with epilepsy and 16 support persons completed an in-depth interview. Rasch measurement models were used to evaluate the degree of difficulty of receiving or providing support often for nine self-management tasks. We analyzed model-data fit, person and item location along the support latent variable and differential person and item functioning. Qualitative methods were used to provide context and insight into the quantitative results. The results demonstrated good model-data fit. Help with seizures was the easiest type of support to receive or provide more often, followed by rides to a doctor's appointments and help avoiding seizure triggers. The most difficult types of support to receive or provide more often were reminders, particularly for taking and refilling medications. While most participants' responses fit the model, responses of several individuals misfit the model. Person misfit generally occurred because the scale items did not adequately capture some individuals' behaviors. These results could be useful in designing interventions that use support as a means of improving self-management. Additionally, the results provide information to improve or expand current measures of support for epilepsy self-management to better assess the experiences of people with epilepsy and their support persons. Copyright © 2013 Elsevier Inc. All rights reserved.

  12. Rationales for Support That African American Grandmothers Provide to Their Children Who Are Parenting Adolescents

    Science.gov (United States)

    Sumo, Jen'nea; Dancy, Barbara; Julion, Wrenetha; Wilbur, JoEllen

    2015-01-01

    African American grandmothers are known to be a major source of support for their children who are parenting adolescents, but little is known about why they provide support. The purpose of this study was to describe the kinds of support provided by African American maternal and paternal grandmothers to their parenting adolescents and the reasons…

  13. 47 CFR 54.613 - Limitations on supported services for rural health care providers.

    Science.gov (United States)

    2010-10-01

    ... 47 Telecommunication 3 2010-10-01 2010-10-01 false Limitations on supported services for rural health care providers. 54.613 Section 54.613 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES (CONTINUED) UNIVERSAL SERVICE Universal Service Support for Health Care Providers § 54.613 Limitations on supported...

  14. A retrospective case series of implants used to restore partially edentulous patients with implant-supported removable partial dentures: 31-month mean follow-up results.

    Science.gov (United States)

    Grossmann, Yoav; Levin, Liran; Sadan, Avishai

    2008-09-01

    The incorporation of dental implants into removable partial dentures is a common clinical practice, but it is poorly documented in the dental literature. The purpose of this retrospective case series study was to evaluate the survival of endosseous dental implants used in restoring partially edentulous patients with implant-supported removable partial dentures (ISRPDs) of different configurations, based on up to 10 years of follow-up. The sample consisted of 23 consecutively treated partially edentulous patients, who, between 1996 and 2005, had a total of 44 implants placed in different arch sites and who were treated with ISRPDs. The mean age was 44.2 +/- 7.5 years at inclusion. Mean follow-up time from implant placement was 31.5 months (range, 9 to 120 months). Smoking status, arch configuration before and after implant placement, follow-up time from implant placement, implant location, implant dimensions, implant and abutment survival, and overall satisfaction (assessed by questionnaire) with the restoration are presented. The overall implant survival rate was 95.5%; 2 implants failed. Kennedy Class I in the maxilla (6 patients) followed by Kennedy Class II in the mandible (4 patients) were the most prevalent arch configurations before implant placement. Arch configuration was modified by implant placement in 6 patients (26.1%). During follow-up, 1 abutment tooth was lost 2 years after prosthesis delivery. All patients were satisfied with their prosthesis. Implant-supported removable partial dentures could serve as a long-term predictable treatment modality. Careful patient selection, with an appropriate maintenance and recall system, is recommended to obtain satisfactory results.

  15. Support provider's appraisal detection bias and the efficacy of received support in medical students preparing for an exam.

    Science.gov (United States)

    Knoll, Nina; Schulz, Ute; Schwarzer, Ralf; Rosemeier, Hans Peter

    2006-09-01

    Matching social support to the recipient's needs requires diagnostic sensitivity on the part of the provider. In particular, support needs to be responsive to the recipient's stress-related appraisals to be maximally effective. To assess the impact of bias in interpersonal stress assessment, medical students in 43 dyads reported on their own and each other's stress appraisals, social support, affect and performance during a 5-day preparation period culminating in a multiple choice examination. Less biased perceptions of loss appraisals by support providers within dyads were followed by support transactions associated with lower negative affect and better exam performance among recipients. More biased perceptions of threat appraisals were followed by increases in the recipients' negative affect. Results therefore suggest that support is more effective when the provider understands the recipient's concerns.

  16. Partial weight support of the arm affects corticomotor selectivity of biceps brachii.

    Science.gov (United States)

    Runnalls, Keith D; Anson, Greg; Byblow, Winston D

    2015-10-26

    Weight support of the arm (WS) can be used in stroke rehabilitation to facilitate upper limb therapy, but the neurophysiological effects of this technique are not well understood. While an overall reduction in muscle activity is expected, the mechanism by which WS may alter the expression of muscle synergies has not been examined until now. We explored the neurophysiological effect of WS on the selectivity of biceps brachii (BB) activation in healthy adults. Thirteen participants completed counterbalanced movement tasks in a repeated measures design. Three levels of WS (0, 45, and 90 % of full support) were provided to the arm using a commercial device (Saebo Mobile Arm Support). At each level of WS, participants maintained a flexed shoulder posture while performing rhythmic isometric elbow flexion (BB agonist) or forearm pronation (BB antagonist). Single-pulse transcranial magnetic stimulation of primary motor cortex was used to elicit motor-evoked potentials (MEPs) in BB 100-300 ms before muscle contraction. Baseline muscle activity and MEP amplitude were the primary dependent measures. Effects of movement TASK and SUPPORT LEVEL were statistically analyzed using linear mixed effects models. As expected, with increased support tonic activity was reduced across all muscles. This effect was greatest in the anti-gravity muscle anterior deltoid, and evident in biceps brachii and pronator teres as well. For BB MEP amplitude, TASK and SUPPORT LEVEL, interacted such that for elbow flexion, MEP amplitudes were smaller with incrementally greater WS whereas, for forearm pronation MEP amplitudes were smaller only at high WS. Weight support of the arm influences corticomotor selectivity of biceps brachii. WS may impact coordination independently of a global reduction in muscle activity. The amount of supportive force applied to the arm influences the neuromechanical control profile for the limb. These findings may inform the application of WS in upper limb stroke

  17. Parents and Peers as Providers of Support in Adolescents' Social Network: A Developmental Perspective

    Science.gov (United States)

    del Valle, Jorge F.; Bravo, Amaia; Lopez, Monica

    2010-01-01

    The authors carried out an assessment of social support networks with a sample of 884 Spanish adolescents aged 12 to 17. The main goal was to analyze the development of the figures of parents and peers as providers of social support in the two basic dimensions of emotional and instrumental support. In peers, they distinguished between the contexts…

  18. State of supported rhodium nanoparticles for methane catalytic partial oxidation (CPO): FT-IR studies.

    Science.gov (United States)

    Finocchio, Elisabetta; Busca, Guido; Forzatti, Pio; Groppi, Gianpiero; Beretta, Alessandra

    2007-09-25

    The effect of pretreatments as well as of rhodium precursor and of the support over the morphology of Rh nanoparticles were investigated by Fourier transform infrared (FT-IR) spectroscopy of adsorbed CO. Over a Rh/alumina catalyst, both metallic Rh particles, characterized by IR bands in the range 2070-2060 cm-1 and 1820-1850 cm-1, and highly dispersed rhodium species, characterized by symmetric and asymmetric stretching bands of RhI(CO)2 gem-dicarbonyl species, are present. Their relative amount changes following pretreatments with gaseous mixtures, representative of the catalytic partial oxidation (CPO) reaction process. The Rh metal particle fraction decreases with respect to the Rh highly dispersed fraction in the order CO approximately CO/H2 > CH4/H2O, CH4/O2 > CH4 > H2. The metal particle dimensions decrease in the order CH4/O2 > H2 > CH4/H2O > CO > CO/H2. Grafting from a carbonyl rhodium complex also increases the amount and the dimensions of Rh0 particles at the catalyst surface. Increasing the ratio (extended rhodium metal particles/highly dispersed Rh species) allows a shorter conditioning process. The surface reconstruction phenomena going on during catalytic activity are related to this effect.

  19. A comparative finite elemental analysis of glass abutment supported and unsupported cantilever fixed partial denture.

    Science.gov (United States)

    Ramakrishaniah, Ravikumar; Al Kheraif, Abdulaziz A; Elsharawy, Mohamed A; Alsaleh, Ayman K; Ismail Mohamed, Karem M; Rehman, Ihtesham Ur

    2015-05-01

    The purpose of this study was to investigate and compare the load distribution and displacement of cantilever prostheses with and without glass abutment by three dimensional finite element analysis. Micro-computed tomography was used to study the relationship between the glass abutment and the ridge. The external surface of the maxilla was scanned, and a simplified finite element model was constructed. The ZX-27 glass abutment and the maxillary first and second premolars were created and modified. The solid model of the three-unit cantilever fixed partial denture was scanned, and the fitting surface was modified with reference to the created abutments using the 3D CAD system. The finite element analysis was completed in ANSYS. The fit and total gap volume between the glass abutment and dental model were determined by Skyscan 1173 high-energy spiral micro-CT scan. The results of the finite element analysis in this study showed that the cantilever prosthesis supported by the glass abutment demonstrated significantly less stress on the terminal abutment and overall deformation of the prosthesis under vertical and oblique load. Micro-computed tomography determined a gap volume of 6.74162 mm(3). By contacting the mucosa, glass abutments transfer some amount of masticatory load to the residual alveolar ridge, thereby preventing damage to the periodontal microstructures of the terminal abutment. The passive contact of the glass abutment with the mucosa not only preserves the health of the mucosa covering the ridge but also permits easy cleaning. It is possible to increase the success rate of cantilever FPDs by supporting the cantilevered pontic with glass abutments. Copyright © 2015 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.

  20. Implant-supported removable partial dentures in the mandible: A 3-16 year retrospective study.

    Science.gov (United States)

    Jensen, Charlotte; Meijer, Henny J A; Raghoebar, Gerry M; Kerdijk, Wouter; Cune, Marco S

    2017-04-01

    The purpose of this retrospective study was to assess performance, together with biological and technical complications, of implant-supported removable partial dentures (ISRPD) in mandibular Kennedy class I situations with implants placed in the anterior or posterior position. 23 subjects with two endosseous implants to support a bilateral-free-ending mandibular removable denture were examined. Eight subjects had implants in the premolar (anterior) region and 15 subjects implants in the molar (posterior) region. Biological and technical complications were recorded from the patients' medical record. Patients filled out a validated questionnaire regarding their appreciation of oral health related quality of life (OHIP-NL49) and a VAS score on overall satisfaction. Over a mean follow-up period of 8 years (median 8 years, range 3-16 years) the cumulative implant survival rate was 91.7% (SE 0.05). Mean peri-implant bone loss was 0.9mm (SD 1.0mm). Scores for bleeding on probing, plaque and mucosal health were generally low, but significantly worse for posteriorly placed implants. Significantly more biological complications occurred in the posterior group (X(2)(1)=3.9; p=0.048). In 65% of the cases no technical complications were registered. Mean overall OHIP score was 16.1 (SD 18.4) and patients were highly satisfied (VAS: 8.4; SD 2.1). Within the limitations of this retrospective study, in case of a Kennedy class I situation in the mandible, an ISRPD is a viable treatment option with a high implant survival rate and satisfied patients after a maximum of 16 years. Technical and biological complications should be anticipated. Anteriorly placed implants performed slightly better. Copyright © 2016 Japan Prosthodontic Society. Published by Elsevier Ltd. All rights reserved.

  1. Virtual reality-enhanced partial body weight-supported treadmill training poststroke: feasibility and effectiveness in 6 subjects.

    Science.gov (United States)

    Walker, Martha L; Ringleb, Stacie I; Maihafer, George C; Walker, Robert; Crouch, Jessica R; Van Lunen, Bonnie; Morrison, Steven

    2010-01-01

    Walker ML, Ringleb SI, Maihafer GC, Walker R, Crouch JR, Van Lunen B, Morrison S. Virtual reality-enhanced partial body weight-supported treadmill training poststroke: feasibility and effectiveness in 6 subjects. To determine whether the use of a low-cost virtual reality (VR) system used in conjunction with partial body weight-supported treadmill training (BWSTT) was feasible and effective in improving the walking and balance abilities of patients poststroke. A before-after comparison of a single group with BWSTT intervention. University research laboratory. A convenience sample of 7 adults who were within 1 year poststroke and who had completed traditional rehabilitation but still exhibited gait deficits. Six participants completed the study. Twelve treatment sessions of BWSTT with VR. The VR system generated a virtual environment that showed on a television screen in front of the treadmill to give participants the sensation of walking down a city street. A head-mounted position sensor provided postural feedback. Functional Gait Assessment (FGA) score, Berg Balance Scale (BBS) score, and overground walking speed. One subject dropped out of the study. All other participants made significant improvements in their ability to walk. FGA scores increased from mean of 13.8 to 18. BBS scores increased from mean of 43.8 to 48.8, although a ceiling effect was seen for this test. Overground walking speed increased from mean of .49m/s to .68m/s. A low-cost VR system combined with BWSTT is feasible for improved gait and balance of patients poststroke. Copyright (c) 2010 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  2. Beliefs about the empirical support of drug abuse treatment interventions: a survey of outpatient treatment providers.

    Science.gov (United States)

    Benishek, Lois A; Kirby, Kimberly C; Dugosh, Karen Leggett; Padovano, Alicia

    2010-03-01

    This study assessed substance abuse treatment providers' beliefs about empirically supported treatments (ESTs) to determine if providing information about empirical support for interventions would change beliefs. Treatment providers (N=136) completed an interview regarding five interventions with varied empirical support: contingency management (CM), motivational interviewing (MI), relapse prevention (RP), 12-step approaches (TSA), and verbal confrontation (VC). Participants then read primers describing empirical support for each intervention prior to completing a repeat interview. Overall, providers reported positive beliefs about ESTs. Baseline beliefs about empirical support for each intervention were inflated relative to that of expert raters except for CM. After reading the primers, beliefs about efficacy changed in the direction of the experts for all interventions except MI, but continued to be inflated except for CM. Willingness to utilize interventions increased for RP, MI, and CM and decreased for TSA and VC, but remained higher than warranted by empirical support. Copyright 2009. Published by Elsevier Ireland Ltd.

  3. Using Variables in School Mathematics: Do School Mathematics Curricula Provide Support for Teachers?

    Science.gov (United States)

    Dogbey, James

    2016-01-01

    This study employed content analysis to examine 3 popular middle-grades mathematics curricula in the USA on the support they provide for teachers to implement concepts associated with variables in school mathematics. The results indicate that each of the 3 curricula provides some type of support for teachers, but in a varied amount and quality.…

  4. (Too) Anxious to help? Social support provider anxiety and cardiovascular function.

    Science.gov (United States)

    Kent de Grey, Robert G; Uchino, Bert N; Smith, Timothy W; Baucom, Brian R W

    2018-01-01

    Provider factors, such as anxiety, may be important in understanding effects of received social support (SS), which are less consistently positive than those of perceived SS. Due to the dyadic nature of support, anxiety on the part of the provider was predicted to influence the effectiveness of received SS. This laboratory study examined effects of SS provider anxiety within unacquainted dyads on cardiovascular reactivity during acute stress. 148 participants were assigned to support roles, and each dyad was randomized to low or high provider anxiety. Results include that SS provider anxiety resulted in greater blood pressure reactivity and less recovery toward baseline diastolic blood pressure within the dyad. Overall, it appears provider anxiety contributes to less effective SS for recipients and that health costs may accompany providing and receiving support under nonoptimal conditions. Copyright © 2017 Elsevier B.V. All rights reserved.

  5. Hydrogen production by partial oxidation of methanol over gold supported on Fe2O3.

    Science.gov (United States)

    Roselin, L Selva; Liao, Li-Mei; Ou, You-Chen; Chang, Feg-Wen

    2014-09-01

    Partial oxidation of methanol (POM) to produce hydrogen was investigated over Au/Fe2O3 catalysts. The catalysts were prepared by inverse co-precipitation method. The influence of catalyst synthesis parameters such as precipitant, gold loading, calcination temperature and reaction parameter such as reaction temperature on POM reaction to produce hydrogen were investigated. The catalysts have been characterized by means of TGA, BET, XRD, TEM, SEM-EDS and XPS analyses. TGA and DTGA profiles clearly indicate that minimum decomposition temperature required to obtain Fe2O3 in Au/Fe2O3 catalysts is 660 K. SEM-EDS analysis confirms that Au and Fe in Au/Fe2O3 are homogeneously distributed over the agglomerate. A detailed microstuctural characterization of Au/Fe2O3 sample by XRD, TEM and XPS analyses has shown that nanometer sized gold particles with oxidized gold species is in predominant amount in the uncalcined catalysts sample. The mean particle size and metallic state of gold particles increase with increasing calcination temperature. A highly active Au/Fe2O3 catalyst is obtained by using Na2CO3 as precipitant with lower gold loading and calcination at 673 K. The catalytic behavior of the Au/Fe2O3 catalyst is related not only to the gold but also to the chemical state of the support. The effect of reaction temperature on the catalytic performance of the Au/Fe2O3 catalysts was studied in the temperature range of 423 to 523 K. Oxygen conversion was complete through out the examined temperature range. Methanol conversion increased with rise in temperature and attains 100% at 503 K; Hydrogen selectivity increased with rise in reaction temperature up to 523 K and then dropped off. The overall reactions involved are methanol combustion, partial oxidation, steam reforming and decomposition. CO produced by methanol decomposition and/or by reverse water gas shift is subsequently transformed into CO2 and H2 by the water gas shift and/or CO oxidation.

  6. [A phd completed 10. Implant-supported removable partial -dentures in a Kennedy Class I-situation in the mandible].

    Science.gov (United States)

    Jensen-Louwerse, C

    2017-06-01

    Implant-supported removable partial dentures in the mandible often cause problems, which means that patients wear their dentures seldom if at all. A solution is to place implants that the dentures can be snapped onto. There is, however, no consensus about the best position of the implants in the mandible yet. In addition, it is worthwhile to balance the cost of treatment with its effectiveness. In a randomised cross-over clinical trial involving 30 patients with a shortened dental arch, the implant-supported removable partial denture in the mandible was evaluated based on the experience of the patient, mean time of wearing, chewing ability and the clinical and radiographic parameters in relation to 2 different implant positions: 2 in the pre-molar region or 2 in the molar region. The cost-effectiveness of both treatments was also evaluated. From the patient's point of view, the implant-supported removable partial dentures are best supported by implants placed in the molar region. The research also revealed, however, that significantly more bleeding occurred around implants placed in the molar region and from a clinical perspective placement in the pre-molar region would have preference. The cost-effectiveness of the treatment with an implant-supported removable partial denture depends on the choice of outcome measurement and monetary threshold.

  7. Providing support to nursing students in the clinical environment: a nursing standard requirement.

    Science.gov (United States)

    Anderson, Carina; Moxham, Lorna; Broadbent, Marc

    2016-10-01

    This discussion paper poses the question 'What enables or deters Registered Nurses to take up their professional responsibility to support undergraduate nursing students through the provision of clinical education?'. Embedded within many nursing standards are expectations that Registered Nurses provide support and professional development to undergraduate nursing students undertaking clinical placements. Expectations within nursing standards that Registered Nurses provide support and professional development to nursing students are important because nursing students depend on Registered Nurses to help them to become competent practitioners. Contributing factors that enable and deter Registered Nurses from fulfilling this expectation to support nursing students in their clinical learning include; workloads, preparedness for the teaching role, confidence in teaching and awareness of the competency requirement to support students. Factors exist which can enable or deter Registered Nurses from carrying out the licence requirement to provide clinical education and support to nursing students.

  8. Pressure distribution of implant-supported removable partial dentures with stress-breaking attachments.

    Science.gov (United States)

    Kono, Kentaro; Kurihara, Daisuke; Suzuki, Yasunori; Ohkubo, Chikahiro

    2014-04-01

    This in vitro study investigated the pressure distribution of the implant-supported removable partial dentures (RPDs) with the stress-breaking attachments under the occlusal force. The experimental model of bilateral missing premolars and molars was modified from a commercial simulation model. Five pressure sensors were embedded near the bilateral first molars, first premolars, and medio-lingual alveolar crest. Two implants were placed near the second molars, and they were connected to the denture base using the following conditions: complete separation between the denture base and implant with cover screws (CRPD), flexible connection with a stress-breaking ball (SBB) attachment, and rigid connection without stress breaking with healing caps (HC). The pressure at five different areas of the soft tissue and the displacement of the RPDs were simultaneously measured, loading up to 50 N. The coefficient of variation (CV) for each connection was calculated from all data of the pressure at five areas to evaluate the pressure distribution. The pressure on medio-lingual alveolar crest and molars of the HC was less than SBB and CRPD. In contrast, the pressure on premolars of SBB was greater than for the HC and CRPD. The CV of SBB was less than that of HC and CRPD. Denture displacement of HC and SBB was less than for CRPD. Within the in vitro limitations, precise denture settlements and pressure distribution under the denture base could be controlled using an SBB attachment. An SBB attachment might be able to protect the implant from harmful force. Crown Copyright © 2014. Published by Elsevier Ltd. All rights reserved.

  9. Assessment of Partially Conductive Cracks from Eddy Current Non-Destructive Testing Signals using Support Vector Machine

    Directory of Open Access Journals (Sweden)

    Ladislav Janousek

    2015-01-01

    Full Text Available This paper deals with a three-dimensional non-destructive evaluation of partially conductive cracks from eddy current testing signals. An SUS316L plate specimen containing a crack is non-destructively inspected by the eddy current method using numerical simulations. An extensive database of eddy current response signals is prepared while dimensional parameters of a crack together with its partial conductivity are varied in wide ranges. A Support Vector Machine classification algorithm is employed to solve the electromagnetic inverse problem. The acquired signals are employed for training the algorithm and for testing its performance. It is demonstrated that the Support Vector Machine algorithm is able to properly classify detected defects into proper classes with very high probability even the partial conductivity of a detected crack together with its width are unknown.

  10. [Specific medico-social supports for drug-resistant partial epilepsies].

    Science.gov (United States)

    Gonnaud, P-M

    2004-06-01

    While employment appears to be among major concerns for epileptic patients, these are confronted with a very high rate of unemployment, especially when epilepsy is pharmacoresistant. However, the persistence of seizures is not the only factor bearing on vocational training or employment; other factors may intervene as well: cognitive dysfunctions, psychological/behavioral disturbances, impact of AEDs, education, vocational training, family members and relatives' attitude, school teams' attitude, employers' attitude, occupational physicians' attitude. Educational level is lower when epilepsy started at school-age; persisting seizures together with other problems may lead the epileptic child or teenager to attend specialized schools. In France, there are few institutions dedicated to children or teenagers with severe epilepsy, and these are very unevenly distributed over the French territory. The main social measures regarding children with epilepsy in France are mentioned. Besides being seizure-free and able to drive, work is one major expectation of patients from epilepsy surgery. The results of epilepsy surgery regarding employment are somewhat controversial; in some studies, temporal lobe surgery may not raise the employment rate; other studies point out that operated-on patients need a long time (up to 6 years) to find a job after surgery. The vocational level or the previous work experiences appear to be as important factors for further employment as being seizure-free, a condition which may not be met in all favourable work outcomes. The medico-social support to patients with pharmacoresistant partial epilepsies has to deal with all the factors mentioned previously; the opportunity for epilepsy surgery may have to be considered early in order to try and prevent the detrimental impact of pharmacoresistant epilepsy on school achievement and vocational training; adult patients with pharmacoresistant epilepsy often cumulate a low qualification level, an absence of

  11. Collaborative learning: A next step in the training of peer support providers.

    Science.gov (United States)

    Cronise, Rita

    2016-09-01

    This column explores how peer support provider training is enhanced through collaborative learning. Collaborative learning is an approach that draws upon the "real life" experiences of individual learners and encompasses opportunities to explore varying perspectives and collectively construct solutions that enrich the practice of all participants. This description draws upon published articles and examples of collaborative learning in training and communities of practice of peer support providers. Similar to person-centered practices that enhance the recovery experience of individuals receiving services, collaborative learning enhances the experience of peer support providers as they explore relevant "real world" issues, offer unique contributions, and work together toward improving practice. Three examples of collaborative learning approaches are provided that have resulted in successful collaborative learning opportunities for peer support providers. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  12. Implant-supported mandibular removable partial dentures; patient-based outcome measures in relation to implant position

    NARCIS (Netherlands)

    Jensen, Charlotte; Raghoebar, Gerry M.; Kerdijk, Wouter; Meijer, Henny J. A.; Cune, Marco S.

    2016-01-01

    Objectives: To assess the benefits of implant support to Removable Partial Dentures (RPD) in patients with a bilateral free-ending situation in the mandible and to determine the most favorable implant position: the premolar (PM) or the molar (M) region. Methods: Thirty subjects with a bilateral

  13. Implant-supported mandibular removable partial dentures : Functional, clinical and radiographical parameters in relation to implant position

    NARCIS (Netherlands)

    Jensen, Charlotte; Speksnijder, Caroline M.; Raghoebar, Gerry M.; Kerdijk, Wouter; Meijer, Henny J. A.; Cune, Marco S.

    Background: Patients with a Kennedy class I situation often encounter problems with their removable partial denture (RPD). Purpose: To assess the functional benefits of implant support to RPDs, the clinical performance of the implants and teeth and to determine the most favorable implant position:

  14. A Novel High-Performance Beam-Supported Membrane Structure with Enhanced Design Flexibility for Partial Discharge Detection

    Directory of Open Access Journals (Sweden)

    Chenzhao Fu

    2017-03-01

    Full Text Available A novel beam-supported membrane (BSM structure for the fiber optic extrinsic Fabry-Perot interferometer (EFPI sensors showing an enhanced performance and an improved resistance to the temperature change was proposed for detecting partial discharges (PDs. The fundamental frequency, sensitivity, linear range, and flatness of the BSM structure were investigated by employing the finite element simulations. Compared with the intact membrane (IM structure commonly used by EFPI sensors, BSM structure provides extra geometrical parameters to define the fundamental frequency when the diameter of the whole membrane and its thickness is determined, resulting in an enhanced design flexibility of the sensor structure. According to the simulation results, it is noted that BSM structure not only shows a much higher sensitivity (increased by almost four times for some cases, and a wider working range of fundamental frequency to choose, but also an improved linear range, making the system development much easier. In addition, BSM structure presents a better flatness than its IM counterpart, providing an increased signal-to-noise ratio (SNR. A further improvement of performance is thought to be possible with a step-forward structural optimization. The BSM structure shows a great potential to design the EFPI sensors, as well as others for detecting the acoustic signals.

  15. Diabetes self-management support for patients with low health literacy: Perceptions of patients and providers

    NARCIS (Netherlands)

    Fransen, Mirjam P.; Beune, Erik J. A. J.; Baim-Lance, Abigail M.; Bruessing, Raynold C.; Essink-Bot, Marie-Louise

    2015-01-01

    The aim of the present study was to explore perceptions and strategies of health care providers regarding diabetes self-management support for patients with low health literacy (LHL), and to compare their self-management support with the needs of patients with LHL and type 2 diabetes. This study

  16. Maintaining Long-Distance Friendships: Communication Practices for Seeking and Providing Social Support across Geographic Divides

    Science.gov (United States)

    Lobburi, Patipan

    2012-01-01

    People seek and provide support through their personal social network, especially when they must cope with stress, deal with an emergency, or need help. Coping with a new culture or new environment is a stressful situation that sojourner students must face. Support through friendship plays an important role in facing such new situations. Focusing…

  17. Children's Support Services: Providing a System of Care for Urban Preschoolers with Significant Behavioral Challenges

    Science.gov (United States)

    Tewhey, Karen

    2006-01-01

    In this article, the author features the Children's Support Services (CSS) project in Lowell, Massachusetts, which is an interagency, multidisciplinary program that provides young children and their families a range of child development, mental health, and family support services. The CSS project, which was begun in September 2000, addresses the…

  18. Biomechanical Outcomes of Tooth-Implant-Supported Fixed Partial Prostheses (FPPs in Periodontally Healthy Patients using Root Shape Dental Implants

    Directory of Open Access Journals (Sweden)

    Harutyunyan Argine

    2017-03-01

    Full Text Available Background: Connecting an osseointegrated implant and a natural tooth is a treatment alternative for partially edentulous patients in some clinical situations. The main issue of a connected tooth-implant system is derived from the dissimilar mobility patterns of the osseointegrated fixtures and natural abutments causing potential biomechanical problems within the entire system. Purpose: The aim of this review was to multilaterally analyze and discuss the main biomechanical factors that may question the reliability of splinted tooth-implant system and the long-term success of fixed partial prostheses (FPPs supported by both teeth and implants with an emphasis on the disparity of mobility of these two different abutments.

  19. Load distribution on abutment tooth, implant and residual ridge with distal-extension implant-supported removable partial denture.

    Science.gov (United States)

    Matsudate, Yoshiki; Yoda, Nobuhiro; Nanba, Masahide; Ogawa, Toru; Sasaki, Keiichi

    2016-10-01

    The aim of this study was to evaluate the effect of implant location on load distribution in the abutment tooth, implant and residual ridge with a distal-extension implant-supported removable partial denture (ISRPD). A mandibular unilateral distal-extension edentulous simulation model was used. Implants were inserted at the second premolar (mesial implant) and second molar (distal implant) positions in the edentulous area. An experimental ISRPD was fabricated of acrylic resin with a cobalt-chromium alloy framework. Loads on the implants and abutment tooth were measured with piezoelectric force transducers. The load on the residual ridge was measured with pressure-sensitive film. A vertical load of 100N was applied at the first molar region. Measurements were made under the following three conditions: with conventional removable partial denture (CRPD), with mesial-implant-supported removable partial denture (MISRPD), and with distal-implant-supported removable partial denture (DISRPD). In each condition, the unused implants were made inactive by eliminating contact with the inner surface of the denture. The load on the abutment tooth was greatest with DISRPD, followed by CRPD and MISRPD (Pdenture design on the load distribution is needed for determining the proper implant location of ISRPD. Copyright © 2016 Japan Prosthodontic Society. Published by Elsevier Ltd. All rights reserved.

  20. What do cancer support groups provide which other supportive relationships do not? The experience of peer support groups for people with cancer.

    Science.gov (United States)

    Ussher, Jane; Kirsten, Laura; Butow, Phyllis; Sandoval, Mirjana

    2006-05-01

    This qualitative study examined the questions of what cancer support groups provide that other supportive relationships do not, and what the self perceived consequences are of support group attendance. Nine representative Australian cancer peer support groups, consisting of a total of 93 interviewees, 75 women, and 18 men, with a mean age of 62, took part in participant observation and focus group interviews, with the data analysed using positioning theory. Support groups were positioned by participants as providing a unique sense of community, unconditional acceptance, and information about cancer and its treatment, in contrast to the isolation, rejection, and lack of knowledge about cancer frequently experienced outside the group. Groups were also positioned as occasionally emotionally challenging, in contrast to the experience of normalising support from family and friends. Increased empowerment and agency were positioned as the most significant consequences of group support, consisting of increased confidence and a sense of control in relation to self, living with cancer, and interactions with others, in particular the medical profession. The support group was also positioned as facilitating positive relationships with family and friends because of relieving their burden of care, by providing a safe space for the expression of emotion. No difference was found between professionally led and peer led support groups, suggesting that it is not the professional background of the leader which is of importance, but whether the group provides a supportive environment, mutuality, and a sense of belonging, and whether it meets the perceived needs of those attending. It is suggested that future research should examine the construction and experience of social support in those who drop out of, or who do not attend, cancer support groups, in order to provide further insight into the contrast between social support within groups and support in other contexts.

  1. Support Needs for Canadian Health Providers Responding to Disaster: New Insights from a Grounded Theory Approach.

    Science.gov (United States)

    Fahim, Christine; O'Sullivan, Tracey L; Lane, Dan

    2015-07-01

    An earlier descriptive study exploring the various supports available to Canadian health and social service providers who deployed to the 2010 earthquake disaster in Haiti, indicated that when systems are compromised, professionals are at physical, emotional and mental risk during overseas deployment. While these risks are generally well-identified, there is little literature that explores the effectiveness of the supports in place to mitigate this risk. This study provides evidence to inform policy development regarding future disaster relief, and the effectiveness of supports available to responders assisting with international disaster response. This study follows Strauss and Corbin's 1990 structured approach to grounded theory to develop a framework for effective disaster support systems. N=21 interviews with Canadian health and social service providers, who deployed to Haiti in response to the 2010 earthquake, were conducted and analyzed. Resulting data were transcribed, coded and analysed for emergent themes. Three themes were identified in the data and were used to develop the evolving theory. The interview data indicate that the experiences of responders are determined based on an interaction between the individual's 'lens' or personal expectations, as well as the supports that an organization is able to provide. Therefore, organizations should consider the following factors: experience, expectations, and supports, to tailor a successful support initiative that caters to the needs of the volunteer workforce.

  2. Identification of risk factors for fracture of veneering materials and screw loosening of implant-supported fixed partial dentures in partially edentulous cases.

    Science.gov (United States)

    Noda, K; Arakawa, H; Maekawa, K; Hara, E S; Yamazaki, S; Kimura-Ono, A; Sonoyama, W; Minakuchi, H; Matsuka, Y; Kuboki, T

    2013-03-01

    This retrospective study identified the risk factors for fracture of veneering materials and screw loosening of implant-supported fixed partial dentures in partially edentulous cases. The study group included a total of 182 patients who were installed 219 suprastructures at the Fixed Prosthodontic Clinic of Okayama University Dental Hospital between February 1990 and March 2005 and were subdivided in two subgroups: 120 patients (149 facing suprastructures) were included in the subgroup to investigate the risk factors of fracture of veneering materials, and 81 patients (92 suprastructures) were included in the subgroup to identify the risk factors of abutment screw loosening. Each patient was followed up from the day of suprastructure installation until March, 2005. A Cox proportional hazards regression model was used to identify the risk factors related to technical complications, and eight factors were regarded as candidate risk factors. Screw retention was the significant risk factor for fracture of veneering materials, whereas connection of suprastructures with natural tooth was the significant risk factor for screw loosening. It was suggested that screw retention was a significant risk factor for the fracture of veneering materials, and connection of suprastructures with natural tooth was a significant risk factor for screw loosening. Future studies, involving dynamic factors (e.g. bruxism) as predictors as well, are more helpful to discuss the risk factor of fracture of veneering materials and screw loosening. © 2013 Blackwell Publishing Ltd.

  3. Highly active, carbon-supported, PdSn nano-core, partially covered ...

    African Journals Online (AJOL)

    NICO

    would be beneficial if core-shell structures could be formed with a shell which is partially covered with Pt atoms. ... This resulted in an architecture, similar to a core-shell structure, which increases the utilization rate of Pt .... radius, cohesive energy and electronegativity of the core and shell metals are the three key factors of ...

  4. Partial Support Ventilation and Mitochondrial-Targeted Antioxidants Protect against Ventilator-Induced Decreases in Diaphragm Muscle Protein Synthesis.

    Directory of Open Access Journals (Sweden)

    Matthew B Hudson

    Full Text Available Mechanical ventilation (MV is a life-saving intervention in patients in respiratory failure. Unfortunately, prolonged MV results in the rapid development of diaphragm atrophy and weakness. MV-induced diaphragmatic weakness is significant because inspiratory muscle dysfunction is a risk factor for problematic weaning from MV. Therefore, developing a clinical intervention to prevent MV-induced diaphragm atrophy is important. In this regard, MV-induced diaphragmatic atrophy occurs due to both increased proteolysis and decreased protein synthesis. While efforts to impede MV-induced increased proteolysis in the diaphragm are well-documented, only one study has investigated methods of preserving diaphragmatic protein synthesis during prolonged MV. Therefore, we evaluated the efficacy of two therapeutic interventions that, conceptually, have the potential to sustain protein synthesis in the rat diaphragm during prolonged MV. Specifically, these experiments were designed to: 1 determine if partial-support MV will protect against the decrease in diaphragmatic protein synthesis that occurs during prolonged full-support MV; and 2 establish if treatment with a mitochondrial-targeted antioxidant will maintain diaphragm protein synthesis during full-support MV. Compared to spontaneously breathing animals, full support MV resulted in a significant decline in diaphragmatic protein synthesis during 12 hours of MV. In contrast, diaphragm protein synthesis rates were maintained during partial support MV at levels comparable to spontaneous breathing animals. Further, treatment of animals with a mitochondrial-targeted antioxidant prevented oxidative stress during full support MV and maintained diaphragm protein synthesis at the level of spontaneous breathing animals. We conclude that treatment with mitochondrial-targeted antioxidants or the use of partial-support MV are potential strategies to preserve diaphragm protein synthesis during prolonged MV.

  5. Support provided by municipalities for families: Experience of families with children with special needs in Latvia

    Directory of Open Access Journals (Sweden)

    Millere J.

    2012-10-01

    Full Text Available For families that are not capable to obtain necessary supplies to meet their needs, State’s social policy guidelines determine support for improving the quality of life for these families. However, it is concluded, that neither the state nor municipality’ provided support for families with children with special needs, does not meet the needs of families, because state social policy is not focused on the assessment of the family needs, as well as often families do not receive the support due to lack of necessary information and disinterest by social service workers, which in turn reflects the problems in social policy delivery mechanisms. The most necessary support that families need is concerned with lodging and financial security, lack of assistants/care at home, as well as – emotional support.

  6. In-vivo job development training among peer providers of homeless veterans supported employment programs.

    Science.gov (United States)

    Gao, Ni; Dolce, Joni; Rio, John; Heitzmann, Carma; Loving, Samantha

    2016-06-01

    This column describes a goal-oriented, time-limited in vivo coaching/training approach for skills building among peer veterans vocational rehabilitation specialists of the Homeless Veteran Supported Employment Program (HVSEP). Planning, implementing, and evaluating the training approach for peer providers was intended, ultimately, to support veterans in their goal of returning to community competitive employment. The description draws from the training experience that aimed to improve the ability of peer providers to increase both rates of employment and wages of the homeless veterans using their services. Training peers using an in vivo training approach provided a unique opportunity for the veterans to improve their job development skills with a focus to support employment outcomes for the service users. Peers who received training also expressed that learning skills through an in vivo training approach was more engaging than typical classroom trainings. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  7. Increasing Positive Outlook Partially Mediates the Effect of Empirically Supported Treatments on Depression Symptoms Among Adolescents

    Science.gov (United States)

    Jacobs, Rachel H.; Becker, Sara J.; Curry, John F.; Silva, Susan G.; Ginsburg, Golda S.; Henry, David B.; Reinecke, Mark A.

    2014-01-01

    Among adolescents there is evidence that cognitive change partially mediates the effect of cognitive behavioral therapy (CBT) on depression outcome. However, prior studies have been limited by small samples, narrow measures of cognition, and failure to compare cognitive change following CBT to cognitive change following antidepressant medication. This study examined whether change in four cognitive constructs (cognitive distortions, cognitive avoidance, positive outlook, and solution-focused thinking) mediated change in depression severity in a sample of 291 adolescents who participated in the Treatment for Adolescents with Depression Study (TADS). TADS assessed the effects of CBT, fluoxetine, and their combination on depression severity. All three treatments were associated with change in the cognitive constructs and combination treatment produced the greatest change. Furthermore, change in the cognitive constructs partially mediated change in depression severity within all three treatments. Results implicated positive outlook as the construct most associated with change in depression severity over 36 weeks. PMID:24944436

  8. Partial sequence analysis of an atypical Turkish isolate provides further information on the evolutionary history of Plum pox virus (PPV).

    Science.gov (United States)

    Glasa, Miroslav; Candresse, Thierry

    2005-03-01

    A variety of techniques, such as typing with subgroup-specific monoclonal antibodies, restriction length polymorphism (RFLP) analysis or subgroup-specific RT-PCR are available for the discrimination of Plum pox virus (PPV) isolates. However, the existence of PPV isolates showing abnormal typing properties has been observed in the past [Candresse, T., Cambra, M., Dallot, S., Lanneau, M., Asensio, M., Gorris, M.T., Revers, F., Macquaire, G., Olmos, A., Boscia, D., Quiot J.B., Dunez, J., 1998. Comparison of monoclonal antibodies and polymerase chain reaction assays for the typing of isolates belonging to the D and M serotypes of Plum pox potyvirus. Phytopathology 88, 198-204.]. In an effort to understand the molecular mechanisms underlying such anomalous serological and molecular typing characteristics, partial 3' (1449 nt) and 5' (3706 nt) sequences have been determined for an atypical Turkish PPV isolate (Abricotier Turquie or Ab-Tk). The results obtained indicate that its unusual typing behaviour is caused by point mutations affecting key restriction sites and epitopes and confirm that this isolate represents a divergent member of the PPV-M subgroup. In addition, analysis of the partial Ab-Tk genomic sequences demonstrated that the 5' region of the genome of this isolate has a mosaic structure resulting from recombination event(s), shedding new light on the evolutionary history of Plum pox virus.

  9. The effectiveness of proactive telephone support provided to breastfeeding mothers of preterm infants: study protocol for a randomized controlled trial.

    Science.gov (United States)

    Ericson, Jenny; Eriksson, Mats; Hellström-Westas, Lena; Hagberg, Lars; Hoddinott, Pat; Flacking, Renée

    2013-05-10

    Although breast milk has numerous benefits for infants' development, with greater effects in those born preterm (at breastfeeding duration than mothers of term infants. One of the explanations proposed is the difficulties in the transition from a Neonatal Intensive Care Unit (NICU) to the home environment. A person-centred proactive telephone support intervention after discharge from NICU is expected to promote mothers' sense of trust in their own capacity and thereby facilitate breastfeeding. A multicentre randomized controlled trial has been designed to evaluate the effectiveness and cost-effectiveness of person-centred proactive telephone support on breastfeeding outcomes for mothers of preterm infants. Participating mothers will be randomized to either an intervention group or control group. In the intervention group person-centred proactive telephone support will be provided, in which the support team phones the mother daily for up to 14 days after hospital discharge. In the control group, mothers are offered a person-centred reactive support where mothers can phone the breastfeeding support team up to day 14 after hospital discharge. The intervention group will also be offered the same reactive telephone support as the control group. A stratified block randomization will be used; group allocation will be by high or low socioeconomic status and by NICU. Recruitment will be performed continuously until 1116 mothers (I: 558 C: 558) have been included. proportion of mothers exclusively breastfeeding at eight weeks after discharge. proportion of breastfeeding (exclusive, partial, none and method of feeding), mothers satisfaction with breastfeeding, attachment, stress and quality of life in mothers/partners at eight weeks after hospital discharge and at six months postnatal age. Data will be collected by researchers blind to group allocation for the primary outcome. A qualitative evaluation of experiences of receiving/providing the intervention will also be

  10. Evidence-based practice implementation: The impact of public versus private sector organization type on organizational support, provider attitudes, and adoption of evidence-based practice

    Directory of Open Access Journals (Sweden)

    Sommerfeld David H

    2009-12-01

    Full Text Available Abstract Background The goal of this study is to extend research on evidence-based practice (EBP implementation by examining the impact of organizational type (public versus private and organizational support for EBP on provider attitudes toward EBP and EBP use. Both organization theory and theory of innovation uptake and individual adoption of EBP guide the approach and analyses in this study. We anticipated that private sector organizations would provide greater levels of organizational support for EBPs leading to more positive provider attitudes towards EBPs and EBP use. We also expected attitudes toward EBPs to mediate the association of organizational support and EBP use. Methods Participants were mental health service providers from 17 communities in 16 states in the United States (n = 170. Path analyses were conducted to compare three theoretical models of the impact of organization type on organizational support for EBP and of organizational support on provider attitudes toward EBP and EBP use. Results Consistent with our predictions, private agencies provided greater support for EBP implementation, and staff working for private agencies reported more positive attitudes toward adopting EBPs. Organizational support for EBP partially mediated the association of organization type on provider attitudes toward EBP. Organizational support was significantly positively associated with attitudes toward EBP and EBP use in practice. Conclusion This study offers further support for the importance of organizational context as an influence on organizational support for EBP and provider attitudes toward adopting EBP. The study demonstrates the role organizational support in provider use of EBP in practice. This study also suggests that organizational support for innovation is a malleable factor in supporting use of EBP. Greater attention should be paid to organizational influences that can facilitate the dissemination and implementation of EBPs in

  11. Macintosh support is provided at the level of the Service Desk

    CERN Multimedia

    2011-01-01

    Since September 2010 the Apple laptops & desktops with Mac OS are recognized and supported at CERN by the IT department. Therefore, the “Macintosh support” procedure now follows the same ITIL*) schema as for all IT services, i.e.: All CERN users must address any request for support on Macintosh PCs to the Service Desk. The Service Desk will move on questions or problems they cannot solve to “IT 2nd level” support people, provided by the “computing support” contract managed by IT department. Mac OS being officially supported by the IT department, a 3rd level support is provided by CERN IT staff; they may give specialized expert assistance, within the scope described at the ITUM-2 presentation, for all incidents or requests which can be neither resolved nor fulfilled by the Service Desk (1st level) and the 2nd level support people. Therefore, users who have problems related to Mac OS should simply fill-in the appropriate form from th...

  12. Patients’ and nurses’ views on providing psychological support within cardiac rehabilitation programmes: a qualitative study

    Science.gov (United States)

    Turner, Katrina M; Winder, Rachel; Campbell, John L; Gandhi, Manish; Dickens, Chris M; Richards, Suzanne

    2017-01-01

    Objective To explore patients’ and nurses’ views on the feasibility and acceptability of providing psychological care within cardiac rehabilitation services. Design In-depth interviews analysed thematically. Participants 18 patients and 7 cardiac nurses taking part in a pilot trial (CADENCE) of an enhanced psychological care intervention delivered within cardiac rehabilitation programmes by nurses to patients with symptoms of depression. Setting Cardiac services based in the South West of England and the East Midlands, UK. Results Patients and nurses viewed psychological support as central to good cardiac rehabilitation. Patients’ accounts highlighted the significant and immediate adverse effect a cardiac event can have on an individual’s mental well-being. They also showed that patients valued nurses attending to both their mental and physical health, and felt this was essential to their overall recovery. Nurses were committed to providing psychological support, believed it benefited patients, and advocated for this support to be delivered within cardiac rehabilitation programmes rather than within a parallel healthcare service. However, nurses were time-constrained and found it challenging to provide psychological care within their existing workloads. Conclusions Both patients and nurses highly value psychological support being delivered within cardiac rehabilitation programmes but resource constraints raise barriers to implementation. Consideration, therefore, should be given to alternative forms of delivery which do not rely solely on nurses to enable patients to receive psychological support during cardiac rehabilitation. Trial registration number ISCTRN34701576. PMID:28864707

  13. Hospice providers' key approaches to support informal caregivers in managing medications for patients in private residences.

    Science.gov (United States)

    Lau, Denys T; Joyce, Brian; Clayman, Marla L; Dy, Sydney; Ehrlich-Jones, Linda; Emanuel, Linda; Hauser, Joshua; Paice, Judith; Shega, Joseph W

    2012-06-01

    Managing and administering medications to relieve pain and symptoms are common, important responsibilities for informal caregivers of patients receiving end-of-life care at home. However, little is known about how hospice providers prepare and support caregivers with medication-related tasks. This qualitative study explores the key approaches that hospice providers use to facilitate medication management for caregivers. Semistructured, open-ended interviews were conducted with 22 providers (14 nurses, four physicians, and four social workers) from four hospice organizations around an urban setting in the midwestern U.S. Based on the interviews, the following five key approaches emerged, constituting how the hospice team collectively helped caregivers manage medications: 1) establishing trust; 2) providing information; 3) promoting self-confidence; 4) offering relief (e.g., provided in-home medication assistance, mobilized supportive resources, and simplified prescriptions); and 5) assessing understanding and performance. Each hospice discipline used multiple approaches. Nurses emphasized tailoring information to individual caregivers and patients, providing in-home assistance to help relieve caregivers, and assessing caregivers' understanding and performance of medication management during home visits. Physicians simplified medication prescriptions to alleviate burden and reassured caregivers using their perceived medical authority. Social workers facilitated medication management by providing emotional support to promote self-confidence and mobilizing resources in caregivers' support networks and the community at large. Hospice nurses, physicians, and social workers identified distinct, yet overlapping, approaches in aiding caregivers with medication management. These findings emphasize the importance of interdisciplinary teamwork among hospice providers. Future research should investigate how common, standardized, effective, and efficient these approaches are in

  14. Providing a Full Circle of Support to Teachers in an Inclusive Elementary School

    Science.gov (United States)

    Waldron, Nancy L.; Redd, Lacy

    2011-01-01

    Providing a full circle of support to teachers in an inclusive elementary school, the Newberry Elementary School (NES) principal and staff have worked for 5 years to ensure the inclusion of students with disabilities in general education classrooms. The authors would like to share their perceptions of how this full circle (the multiple systems) of…

  15. The Implementation of a Behavioural Support Programme: Teachers' Perceptions of the Programme and Themselves as Providers

    Science.gov (United States)

    Ingemarson, Maria; Bodin, Maria; Rubenson, Birgitta; Guldbrandsson, Karin

    2016-01-01

    Purpose: The purpose of this paper is to investigate how teachers received and perceived the school programme Prevention in School (PS), a positive behavioural support programme; how did the teachers perceive the programme characteristics and themselves as providers; and how did this affect programme implementation? Design/methodology/approach:…

  16. Addressing Needs of Military Families during Deployment: Military Service Providers' Perceptions of Integrating Support Services

    Science.gov (United States)

    Hayden, Seth Christian Walter

    2011-01-01

    Service providers are increasingly recognizing the need to develop effective methods for delivering supporting services to military families during deployment. Research suggests that military families experience increased levels of stress during the cycle of deployment. Bronfenbrenner (1979) conceptualized the family operating within the context…

  17. Factors Predicting Oncology Care Providers' Behavioral Intention to Adopt Clinical Decision Support Systems

    Science.gov (United States)

    Wolfenden, Andrew

    2012-01-01

    The purpose of this quantitative correlation study was to examine the predictors of user behavioral intention on the decision of oncology care providers to adopt or reject the clinical decision support system. The Unified Theory of Acceptance and Use of Technology (UTAUT) formed the foundation of the research model and survey instrument. The…

  18. Periodontal ligament influence on the stress distribution in a removable partial denture supported by implant: a finite element analysis

    Directory of Open Access Journals (Sweden)

    Carlos Marcelo Archangelo

    2012-06-01

    Full Text Available OBJECTIVES: The non-homogenous aspect of periodontal ligament (PDL has been examined using finite element analysis (FEA to better simulate PDL behavior. The aim of this study was to assess, by 2-D FEA, the influence of non-homogenous PDL on the stress distribution when the free-end saddle removable partial denture (RPD is partially supported by an osseointegrated implant. MATERIAL AND METHODS: Six finite element (FE models of a partially edentulous mandible were created to represent two types of PDL (non-homogenous and homogenous and two types of RPD (conventional RPD, supported by tooth and fibromucosa; and modified RPD, supported by tooth and implant [10.00x3.75 mm]. Two additional Fe models without RPD were used as control models. The non-homogenous PDL was modeled using beam elements to simulate the crest, horizontal, oblique and apical fibers. The load (50 N was applied in each cusp simultaneously. Regarding boundary conditions the border of alveolar ridge was fixed along the x axis. The FE software (Ansys 10.0 was used to compute the stress fields, and the von Mises stress criterion (svM was applied to analyze the results. RESULTS: The peak of svM in non-homogenous PDL was higher than that for the homogenous condition. The benefits of implants were enhanced for the non-homogenous PDL condition, with drastic svM reduction on the posterior half of the alveolar ridge. The implant did not reduce the stress on the support tooth for both PDL conditions. Conclusion: The PDL modeled in the non-homogeneous form increased the benefits of the osseointegrated implant in comparison with the homogeneous condition. Using the non-homogenous PDL, the presence of osseointegrated implant did not reduce the stress on the supporting tooth.

  19. Family carers providing support to a person dying in the home setting: A narrative literature review.

    Science.gov (United States)

    Morris, Sara M; King, Claire; Turner, Mary; Payne, Sheila

    2015-06-01

    This study is based on people dying at home relying on the care of unpaid family carers. There is growing recognition of the central role that family carers play and the burdens that they bear, but knowledge gaps remain around how to best support them. The aim of this study is to review the literature relating to the perspectives of family carers providing support to a person dying at home. A narrative literature review was chosen to provide an overview and synthesis of findings. The following search terms were used: caregiver, carer, 'terminal care', 'supportive care', 'end of life care', 'palliative care', 'domiciliary care' AND home AND death OR dying. During April-May 2013, Cumulative Index to Nursing and Allied Health Literature (CINAHL), MEDLINE, PsycINFO, Pubmed, Cochrane Reviews and Citation Indexes were searched. Inclusion criteria were as follows: English language, empirical studies and literature reviews, adult carers, perspectives of family carers, articles focusing on family carers providing end-of-life care in the home and those published between 2000 and 2013. A total of 28 studies were included. The overarching themes were family carers' views on the impact of the home as a setting for end-of-life care, support that made a home death possible, family carer's views on deficits and gaps in support and transformations to the social and emotional space of the home. Many studies focus on the support needs of people caring for a dying family member at home, but few studies have considered how the home space is affected. Given the increasing tendency for home deaths, greater understanding of the interplay of factors affecting family carers may help improve community services. © The Author(s) 2015.

  20. What support do nurses need to provide palliative care for people with dementia?

    Science.gov (United States)

    Champion, Elizabeth

    2017-08-31

    The aim of this project was to identify the support required by registered nurses and unregistered healthcare support workers to provide palliative care for people with dementia in an acute hospital in England. A quantitative approach was taken and participants were asked to fill in a questionnaire. Data were collated and analysed to identify support needs and any emerging themes. Respondents were confident in identifying the different stages of dementia. There was less confidence in identifying a patient with dementia for palliative care referral compared with a patient without dementia. Further needs were identified by respondents in supporting the family/carer of the person with dementia and being aware of available support to facilitate palliative care for people with dementia and support for end of life care (EoLC) planning. The findings suggest that further work is required in relation to dementia and EoLC. Practical and educational collaboration with EoLC/palliative care practitioners and dementia leads would be beneficial.

  1. Retrospective comparative ten-year study of cumulative survival rates of remaining teeth in large edentulism treated with implant-supported fixed partial dentures or removable partial dentures.

    Science.gov (United States)

    Yamazaki, Seiya; Arakawa, Hikaru; Maekawa, Kenji; Hara, Emilio Satoshi; Noda, Kinji; Minakuchi, Hajime; Sonoyama, Wataru; Matsuka, Yoshizo; Kuboki, Takuo

    2013-07-01

    This study aimed to compare the survival rates of remaining teeth between implant-supported fixed dentures (IFDs) and removable partial dentures (RPDs) in patients with large edentulous cases. The second goal was to assess the risk factors for remaining tooth loss. The study subjects were selected among those who received prosthodontic treatment at Okayama University Dental Hospital for their edentulous space exceeding at least four continuous missing teeth. Twenty-one patients were included in the IFD group and 82 patients were included in the RPD group. Survival rates of remaining teeth were calculated in three subcategories: (1) whole remaining teeth, (2) adjacent teeth to intended edentulous space, and (3) opposing teeth to intended edentulous space. The ten-year cumulative survival rate of the whole remaining teeth was significantly higher in the IFD group (40.0%) than in the RPD group (24.4%). On the other hand, there was no significant difference between two groups in the survival rate of teeth adjacent or opposing to intended edentulous space. A Cox proportional hazard analysis revealed that RPD restoration and gender (male) were the significant risk factors for remaining tooth loss (whole remaining teeth). These results suggest that IFD treatment can reduce the incidence of remaining tooth loss in large edentulous cases. Copyright © 2013 Japan Prosthodontic Society. Published by Elsevier Ltd. All rights reserved.

  2. [Reconstruction of bilateral occlusal-supporting area with removable partial dentures: a case report].

    Science.gov (United States)

    Hiasa, Kyou

    2005-04-01

    The patient (57-years-old female) suffered from severe chronic periodontitis in the maxillary and mandibular molar regions. After extraction of these teeth, treatment dentures were immediately placed in the maxilla and mandible to restore the occlusal-supporting area. Final denture treatment was done by adjusting the provisional dentures according to the patient's concern. Good prognosis was obtained during 9 years. To restore bilateral occlusal-supporting areas, treatment dentures reduced the loss of remaining teeth. Treatment dentures can stabilize the occlusal relationship immediately after loss of occlusal-supporting area, and may also contribute the patient's acceptance of and satisfaction with the final prostheses.

  3. Partial ventilatory support modalities in acute lung injury and acute respiratory distress syndrome-a systematic review.

    Directory of Open Access Journals (Sweden)

    Sarah M McMullen

    Full Text Available The efficacy of partial ventilatory support modes that allow spontaneous breathing in patients with acute lung injury (ALI and acute respiratory distress syndrome (ARDS is unclear. The objective of this scoping review was to assess the effects of partial ventilatory support on mortality, duration of mechanical ventilation, and both hospital and intensive care unit (ICU lengths of stay (LOS for patients with ALI and ARDS; the secondary objective was to describe physiologic effects on hemodynamics, respiratory system and other organ function.MEDLINE (1966-2009, Cochrane, and EmBase (1980-2009 databases were searched using common ventilator modes as keywords and reference lists from retrieved manuscripts hand searched for additional studies. Two researchers independently reviewed and graded the studies using a modified Oxford Centre for Evidence-Based Medicine grading system. Studies in adult ALI/ARDS patients were included for primary objectives and pre-clinical studies for supporting evidence.Two randomized controlled trials (RCTs were identified, in addition to six prospective cohort studies, one retrospective cohort study, one case control study, 41 clinical physiologic studies and 28 pre-clinical studies. No study was powered to assess mortality, one RCT showed shorter ICU length of stay, and the other demonstrated more ventilator free days. Beneficial effects of preserved spontaneous breathing were mainly physiological effects demonstrated as improvement of gas exchange, hemodynamics and non-pulmonary organ perfusion and function.The use of partial ventilatory support modalities is often feasible in patients with ALI/ARDS, and may be associated with short-term physiological benefits without appreciable impact on clinically important outcomes.

  4. Decision support system of e-book provider selection for library using Simple Additive Weighting

    Science.gov (United States)

    Ciptayani, P. I.; Dewi, K. C.

    2018-01-01

    Each library has its own criteria and differences in the importance of each criterion in choosing an e-book provider for them. The large number of providers and the different importance levels of each criterion make the problem of determining the e-book provider to be complex and take a considerable time in decision making. The aim of this study was to implement Decision support system (DSS) to assist the library in selecting the best e-book provider based on their preferences. The way of DSS works is by comparing the importance of each criterion and the condition of each alternative decision. SAW is one of DSS method that is quite simple, fast and widely used. This study used 9 criteria and 18 provider to demonstrate how SAW work in this study. With the DSS, then the decision-making time can be shortened and the calculation results can be more accurate than manual calculations.

  5. Characteristics of Adults Seeking Health Care Provider Support Facilitated by Mobile Technology: Secondary Data Analysis.

    Science.gov (United States)

    Bosak, Kelly; Park, Shin Hye

    2017-12-21

    Mobile health technology is rapidly evolving with the potential to transform health care. Self-management of health facilitated by mobile technology can maximize long-term health trajectories of adults. Little is known about the characteristics of adults seeking Web-based support from health care providers facilitated by mobile technology. This study aimed to examine the following: (1) the characteristics of adults who seek human support from health care providers for health concerns using mobile technology rather than from family members and friends or others with similar health conditions and (2) the use of mobile health technology among adults with chronic health conditions. Findings of this study were interpreted in the context of the Efficiency Model of Support. We first described characteristics of adults seeking Web-based support from health care providers. Using chi-square tests for categorical variables and t test for the continuous variable of age, we compared adults seeking Web-based and conventional support by demographics. The primary aim was analyzed using multivariate logistic regression to examine whether chronic health conditions and demographic factors (eg, sex, income, employment status, race, ethnicity, education, and age) were associated with seeking Web-based support from health care providers. The sample included adults (N=1453), the majority of whom were female 57.60% (837/1453), white 75.02% (1090/1453), and non-Hispanic 89.13% (1295/1453). The age of the participants ranged from 18 to 92 years (mean 48.6, standard deviation [SD] 16.8). The majority 76.05% (1105/1453) of participants reported college or higher level of education. A disparity was found in access to health care providers via mobile technology based on socioeconomic status. Adults with annual income of US $30,000 to US $100,000 were 1.72 times more likely to use Web-based methods to contact a health care provider, and adults with an annual income above US $100,000 were 2.41 to

  6. Rural health professionals' perspectives on providing grief and loss support in cancer care.

    Science.gov (United States)

    Breen, L J; O'Connor, M

    2013-11-01

    Research demonstrates considerable inequalities in service delivery and health outcomes for people with cancer living outside large metropolitan cities. Semi-structured interviews with 11 professionals providing grief and loss support for people with cancer and their families in rural, regional, and remote areas Western Australia revealed the challenges they faced in delivering such support. The data are presented in four themes - Inequity of regional versus metropolitan services, Strain of the 'Jack of all trades' role, Constraints to accessing professional development, and Challenges in delivering post-bereavement services. These challenges are likely to be of growing concern given that populations are declining in rural areas as Australia becomes increasingly urban. The findings have implications in enhancing the loss and grief support services available in rural, regional, and remote Western Australia, including those grieving the death of a loved one through cancer. © 2013 John Wiley & Sons Ltd.

  7. Patients' and nurses' views on providing psychological support within cardiac rehabilitation programmes: a qualitative study.

    Science.gov (United States)

    Turner, Katrina M; Winder, Rachel; Campbell, John L; Richards, David A; Gandhi, Manish; Dickens, Chris M; Richards, Suzanne

    2017-09-01

    To explore patients' and nurses' views on the feasibility and acceptability of providing psychological care within cardiac rehabilitation services. In-depth interviews analysed thematically. 18 patients and 7 cardiac nurses taking part in a pilot trial (CADENCE) of an enhanced psychological care intervention delivered within cardiac rehabilitation programmes by nurses to patients with symptoms of depression. Cardiac services based in the South West of England and the East Midlands, UK. Patients and nurses viewed psychological support as central to good cardiac rehabilitation. Patients' accounts highlighted the significant and immediate adverse effect a cardiac event can have on an individual's mental well-being. They also showed that patients valued nurses attending to both their mental and physical health, and felt this was essential to their overall recovery. Nurses were committed to providing psychological support, believed it benefited patients, and advocated for this support to be delivered within cardiac rehabilitation programmes rather than within a parallel healthcare service. However, nurses were time-constrained and found it challenging to provide psychological care within their existing workloads. Both patients and nurses highly value psychological support being delivered within cardiac rehabilitation programmes but resource constraints raise barriers to implementation. Consideration, therefore, should be given to alternative forms of delivery which do not rely solely on nurses to enable patients to receive psychological support during cardiac rehabilitation. ISCTRN34701576. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  8. 5 CFR 831.631 - Post-retirement election of fully reduced annuity or partially reduced annuity to provide a...

    Science.gov (United States)

    2010-01-01

    ... divorce terminates the marriage, to continue the reduction to provide for a former spouse annuity; or (ii... court order and § 831.641. (2) If an election under this section causes the total of all current and...

  9. An Intelligent Virtual Human System For Providing Healthcare Information And Support

    Science.gov (United States)

    2011-01-01

    CyberPsychology and Behavior 8, 3 (2005), 187-211. [2] T. Parsons & A.A. Rizzo, Affective Outcomes of Virtual Reality Exposure Therapy for Anxiety...VH System for Providing Healthcare Information and Support508 [4] G. Riva, Virtual Reality in Psychotherapy: Review, CyberPsychology and Behavior 8...3 (2005), 220- 230. [5] F.D. Rose, B.M. Brooks & A.A. Rizzo, Virtual Reality in Brain Damage Rehabilitation: Review, CyberPsychology and Behavior

  10. Top Management Support Partially Optimized Reverse Logistics in The Manufacturing Sector of Pakistan

    Directory of Open Access Journals (Sweden)

    Ms. Sitara Shafiq

    2013-07-01

    Full Text Available Supply chain management urges reverse logistics to be an effective tool for organizational competitive advantage. Reverse chains demand astute resource deployments and strategic focus by the top management. In Pakistan manufacturing industries employing reverse logistics for cost effectiveness reported heavy reliance on top management support. However, literature is yet not benefited by such empirical facts. This study hypothesized that top management support is key for cost effective reverse logistics. Collecting and analyzing reliable data for various elements of its variables of interests, the study confirmed considerable multi linear regression between top management support and cost effectiveness. Substantiating the hypothesis, it contributes that a significant impact of strategic focus and resource commitment by top management leads reverse logistics based manufacturers to success.

  11. A comparison of laser-welded titanium and conventional cast frameworks supported by implants in the partially edentulous jaw: a 3-year prospective multicenter study.

    Science.gov (United States)

    Jemt, T; Henry, P; Lindén, B; Naert, I; Weber, H; Bergström, C

    2000-01-01

    The purpose of this prospective multicenter study was to evaluate and compare the clinical performance of laser-welded titanium fixed partial implant-supported prostheses with conventional cast frameworks. Forty-two partially edentulous patients were provided with Brånemark system implants and arranged into 2 groups. Group A was provided with a conventional cast framework with porcelain veneers in one side of the jaw and a laser-welded titanium framework with low-fusing porcelain on the other side. The patients in group B had an old implant prosthesis replaced by a titanium framework prosthesis. The patients were followed for 3 years after prosthesis placement. Clinical and radiographic data were collected and analyzed. Only one implant was lost, and all prostheses were still in function after 3 years. The 2 framework designs showed similar clinical performance with few clinical complications. Only one abutment screw (1%) and 9 porcelain tooth units (5%) fractured. Four prostheses experienced loose gold screws (6%). In group A, marginal bone loss was similar for both designs of prostheses, with a mean of 1.0 mm and 0.3 mm in the maxilla and mandible, respectively. No bone loss was observed on average in group B. No significant relationship (P > 0.05) was observed between marginal bone loss and placement of prosthesis margin or prosthesis design. The use of laser-welded titanium frameworks seems to present similar clinical performance to conventional cast frameworks in partial implant situations after 3 years.

  12. The "specter" of cancer: exploring secondary trauma for health professionals providing cancer support and counseling.

    Science.gov (United States)

    Breen, Lauren J; O'Connor, Moira; Hewitt, Lauren Y; Lobb, Elizabeth A

    2014-02-01

    Health professionals are vulnerable to occupational stress and tend to report high levels of secondary trauma and burnout; this is especially so for those working in "high-death" contexts such as cancer support and palliative care. In this study, 38 health professionals (psychologists, social workers, pastoral carers/chaplains, nurses, group facilitators, and a medical practitioner) who provide grief support and counseling in cancer and palliative care each participated in a semistructured interview. Qualitatively, a grounded theory analysis revealed four themes: (a) the role of health professionals in supporting people who are experiencing grief and loss issues in the context of cancer, (b) ways of working with patients with cancer and their families, (c) the unique qualities of cancer-related loss and grief experiences, and (d) the emotional demands of the work and associated self-care. The provision of psychological services in the context of cancer is colored by the specter of cancer, an unseen yet real phenomenon that contributes to secondary trauma and burnout. The participants' reported secondary trauma has serious repercussions for their well-being and may compromise the care they provide. The findings have implications for the retention and well-being of personnel who provide psychosocial care in cancer and the quality and delivery of services for people with cancer and their families. PsycINFO Database Record (c) 2014 APA, all rights reserved.

  13. Three-Year Outcome of Fixed Partial Rehabilitations Supported by Implants Inserted with Flap or Flapless Surgical Techniques.

    Science.gov (United States)

    Maló, Paulo; de Araújo Nobre, Miguel; Lopes, Armando

    2016-07-01

    The aim of this prospective clinical study was to evaluate the 3-year outcome of fixed partial prostheses supported by implants with immediate provisionalization without occlusal contacts inserted in predominantly soft bone with flap and flapless protocols. Forty-one patients partially rehabilitated with 72 NobelSpeedy implants (51 maxillary; 21 mandibular) were consecutively included and treated with a flapless surgical protocol (n = 20 patients; 32 implants) and flapped surgical protocol (n = 21 patients; 40 implants). Primary outcome measure was implant survival; secondary outcome measures were marginal bone resorption (comparing the bone levels at 1 and 3 years with baseline) and the incidence of biological, mechanical, and esthetic complications. Survival was computed through life tables; descriptive statistics were applied to the remaining variables of interest. Eight patients with eight implants dropped out of the study. One implant failed in one patient (flapless group) giving an overall cumulative survival rate (CSR) of 98.6%. No failures were noted with the flapped protocol (CSR 100%), while for the implants placed with the flapless surgical technique, a 96.9% CSR was registered. The overall average marginal bone resorption at 3 years was 1.37 mm (SD = 0.94 mm), with 1.14 mm (SD = 0.49 mm) and 1.60 mm (SD = 1.22 mm) for the flap and flapless groups, respectively. Mechanical complications occurred in nine patients (n = 5 patients in the flapless group; n = 4 patients in the flap group). Implant infection was registered in three implants and three patients (flapless group), who exhibited inadequate oral hygiene levels. Partial edentulism rehabilitation through immediate provisionalization fixed prosthesis supported by dental implants inserted through flap or flapless surgical techniques in areas of predominantly soft bone was viable at 3 years of follow-up. The limitations and risks of the "free-hand" method in flapless surgery should be considered when

  14. Influence of length of occlusal support on masticatory function of free-end removable partial dentures: short-term adaptation.

    Science.gov (United States)

    Sánchez-Ayala, Alfonso; Gonçalves, Thaís Marques Simek Vega; Ambrosano, Gláucia Maria Bovi; Garcia, Renata Cunha Matheus Rodrigues

    2013-06-01

    To analyze masticatory function after a short adaptation period relative to occlusal support length reduction in free-end removable partial denture (RPD) wearers. Twenty-three patients (55.2 ± 8.4 years) were rehabilitated with maxillary complete and mandibular free-end RPDs extending to the second molars. Five occlusal support length conditions were determined by removing artificial teeth from the RPDs: full occlusal support (control); occlusal support to the first molars, second premolars, and first premolars; and no occlusal support. To explore a probable short-term adaptation to occlusal support length reduction, participants wore their dentures at each condition for a period of 1 week before starting masticatory function assessment. For this purpose, masticatory performance, masticatory efficiency, chewing rate, selection chance, and breakage function were evaluated at each condition using the sieving method. Data were analyzed using repeated-measures ANOVA and post hoc Dunnett tests (α = 0.05). Masticatory performance and masticatory efficiency for 2 to 4 mm particles under the condition of occlusal support to the first molars and second premolars were similar to control values (p > 0.05). Masticatory efficiency relative to particles smaller than 2 mm was also seen at the condition of support length to the first premolars (p > 0.05). Chewing rates showed adaptation only at the condition of support length to the first molars (p > 0.05). A similar trend was noted for the selection chance of 8-mm particles, and breakage function for 8- and 2.4-mm particles (p > 0.05). After a 1-week adaptation period to free-end RPDs with occlusal support lengths reduced to the premolars, participants were able to achieve adequate masticatory function. © 2013 by the American College of Prosthodontists.

  15. Laser-welded titanium frameworks supported by implants in the partially edentulous mandible: a 10-year comparative follow-up study.

    Science.gov (United States)

    Ortorp, Anders; Jemt, Torsten

    2008-09-01

    Comparative long-term knowledge of different framework materials in the partially edentulous implant patient is not available. To report and compare 10-year data on free-standing implant-supported partial prostheses with laser-welded titanium (test) and conventional gold alloy (control) frameworks. Altogether, 52 partially edentulous patients were consecutively provided with laser-welded prostheses (n = 60) in the partially edentulous lower jaw (test group). A control group of 52 randomly selected patients with gold alloy castings (n = 60) was used for comparison. Clinical and radiographic 10-year data were retrospectively collected and evaluated for both groups. The overall 10-year implant cumulative survival rate (CSR) was 93.0% (loaded implants, 96.4%), with a 10-year implant CSR of 91.5 and 94.7% for test and control implants, respectively (p > .05). Out of a total of 22 lost implants, 17 implants (77.3%) were shorter than 10 mm. The overall 10-year prosthesis CSR was 93.7%, with a corresponding 10-year CSR of 88.4 and 100% for test and control groups, respectively (p implants had >3 mm accumulated bone loss after 10 years. Altogether, 10 of the prostheses in both groups had implant component mechanical problems (8.3%). None of the frameworks or implants fractured, but more fractures of porcelain veneers were observed in the test group (p implant treatment in the partially edentulous jaw functioned well during 10 years, although prosthodontic maintenance was required. However, laser-welded titanium frameworks presented more problems as compared with gold alloy frameworks. More loaded implants were lost (p < .05), and higher incidence of porcelain chipping was noted in the test group (p < .05). However, bone loss was on an average lower for the test group during the 10 years of follow-up (p < .001).

  16. Caregiver and health care provider preferences of nutritional support in a hematopoietic stem cell transplant unit.

    Science.gov (United States)

    Williams-Hooker, Ruth; Adams, Marissa; Havrilla, David A; Leung, Wing; Roach, Robin R; Mosby, Terezie T

    2015-08-01

    Many pediatric oncology patients undergoing hematopoietic stem cell transplantation (HSCT) require nutritional support (NS) because of their inability to consume adequate caloric intake enough calories orally. Although NS can be provided either enteraly (EN) or parenteraly (PN), EN is the preferred method of NS as long as if the gastrointestinal tract is functioning. In this qualitative study, we determined the type of NS preferences and the reservations of caregivers of pediatric HSCT patients undergoing hematopoietic stem cell transplantation (HSCT) as well as those of health care (HC) providers working on the HSCT unit. A survey was developed and completed anonymously by HC providers and caregivers. The hypothesis was that HC providers and caregivers would prefer PN because it is convenient to use in patients who already have a central line in place. Most caregivers preferred PN to EN, while most HC providers preferred EN to PN. The barrier between EN initiation and caregivers' approval was the caregivers' perception that EN was invasive and painful, most common obstacle for initiation of EN among caregivers was that it hurts/is invasive, while the barrier with HC providers was vomiting and/abdominal pain associated with EN. If caregivers were better educated about NS and the advantages/disadvantages of the different forms of NS, their preferences may change. There have been policy changes at St. Jude have been implemented since this study, and an outpatient dietitian now provides education to caregivers about NS during the pre-evaluation for HSCT. © 2015 Wiley Periodicals, Inc.

  17. Asset Management Planning – providing the evidence to support robust and risk-based investment decisions

    Directory of Open Access Journals (Sweden)

    Mitchell Chrissy

    2016-01-01

    Full Text Available Over the last decade the UK’s joint Flood and Coastal Erosion Risk Management Research and Development programme has been developing methods to support a move to a risk-based approach to flood defence asset management. Looking to ensure investment is less ‘find and fix’ and made to those assets where the biggest risk reduction can be made for the money available. In addition, providing the capability to articulate the benefits of investing in these assets quantitatively and transparently. This paper describes how the Asset Performance Tools (APT project [1] is delivering practical methods, prototype tools and supporting guidance which, together with related initiatives such as the Environment Agency’s Creating Asset Management Capacity (CAMC strategic programme [2] and the ‘State of the Nation’ (SoN [3] supportive datasets, will enable a risk-based, ‘predict and protect’ approach to asset management. A key advance is the ability to bring in local knowledge to make national generic datasets locally relevant. The paper also highlights existing outputs that can already be used to support a more proactive approach to asset management. It will summarise the ongoing work which will further develop and fine tune performance assessment and investment decision processes within an integrated conceptual framework aligned with ISO55000, deliverable via CAMC and whose concepts can be used by all risk management authorities.

  18. Training veterans to provide peer support in a weight-management program: MOVE!

    Science.gov (United States)

    Allicock, Marlyn; Haynes-Maslow, Lindsey; Carr, Carol; Orr, Melinda; Kahwati, Leila C; Weiner, Bryan J; Kinsinger, Linda

    2013-11-07

    The Veterans Health Administration (VHA) has implemented MOVE!, a weight-management program for veterans designed to address the increasing proportion of overweight and obese veterans. The objective of our study was to determine whether peer support employing motivational interviewing (MI) could positively influence lifestyle changes, thus expanding the reach of the MOVE! program. We describe the initial evaluation of the peer training program. We developed an MI peer ounselor training program for volunteer veterans, the "Buddies" program, to provide one-on-one telephone support for veterans enrolled in MOVE!. Buddies were recruited at 5 VHA sites and trained to provide peer support for the 6-month MOVE! intervention. We used a DVD to teach MI skills and followed with 2 to 3 booster sessions. We observed training, conducted pre- and posttraining surveys, and debriefed focus groups to assess training feasibility. Fifty-six Buddies were trained. Results indicate positive receipt of the program (89% reported learning about peer counseling and 87% reported learning communication skills). Buddies showed a small improvement in MI self-efficacy on posttraining surveys. We also identified key challenges to learning MI and training implementation. MI training is feasible to implement and acceptable to volunteer Buddies. Trainers must assess how effectively volunteers learn MI skills in order to enhance its effective use in health promotion.

  19. The Oncology Family App: Providing Information and Support for Families Caring for Their Child With Cancer.

    Science.gov (United States)

    Slater, Penelope J; Fielden, Philippa E; Bradford, Natalie K

    2017-11-01

    The Oncology Family App supports families across the vast state of Queensland, Australia, with easy access to vital information, including management plans for a deteriorating child, patient specific information and other resources. This article describes the development and evaluation of this mobile app. The app was developed and tested in collaboration with parents, caregivers, and clinicians and released in November 2015. This first version featured "Statewide Hospital Contacts," including phone numbers, links to Google maps, and 24-hour emergency contacts with click to call functionality; "When to Call" describing symptoms to look out for in a deteriorating child; "Blood Results Table"; and "Information" listing recommended websites, health care team contacts, appointments, and notes. The app was evaluated through interviews with parents, caregivers and patients and download metrics. Six months after the app release, 68% of the 38 parents and caregivers surveyed had downloaded the app. The most used modules were "Blood Results Table," "When to Call," and "Statewide Hospital Contacts," but families reported using all features available. Families were enthusiastic about the support the app provided and gave useful feedback to direct future development. Using mobile health technology to support families is a novel, but rapidly growing concept. Family and caregiver feedback showed that the Oncology Family App was an efficient and convenient way to provide much needed information. A new version of the app is under development and evaluation of outcomes will be ongoing.

  20. A world-wide databridge supported by a commercial cloud provider

    Science.gov (United States)

    Tat Cheung, Kwong; Field, Laurence; Furano, Fabrizio

    2017-10-01

    Volunteer computing has the potential to provide significant additional computing capacity for the LHC experiments. One of the challenges with exploiting volunteer computing is to support a global community of volunteers that provides heterogeneous resources. However, high energy physics applications require more data input and output than the CPU intensive applications that are typically used by other volunteer computing projects. While the so-called databridge has already been successfully proposed as a method to span the untrusted and trusted domains of volunteer computing and Grid computing respective, globally transferring data between potentially poor-performing residential networks and CERN could be unreliable, leading to wasted resources usage. The expectation is that by placing a storage endpoint that is part of a wider, flexible geographical databridge deployment closer to the volunteers, the transfer success rate and the overall performance can be improved. This contribution investigates the provision of a globally distributed databridge implemented upon a commercial cloud provider.

  1. Retaining the next generation of nurses: the Wisconsin nurse residency program provides a continuum of support.

    Science.gov (United States)

    Bratt, Marilyn Meyer

    2009-09-01

    Because of the high costs associated with new graduate nurse turnover, an academic-service partnership developed a nurse residency program that provides a comprehensive support system that spans 15 months. Now in its fourth year, involving more than 50 urban and rural hospitals of varying sizes and geographic locations, the program provides formalized preceptor training, monthly daylong educational sessions, and mentoring by clinical coaches. Key factors contributing to the success of this program are a dedicated, cohesive planning team of individuals who embrace a common agenda, stakeholder buy-in, appropriate allocation of resources, and clear articulation of measures of success, with associated data collection. Successful elements of the monthly educational sessions are the use of interactive teaching methods, inclusion of content tailored to the unique needs of the nurse residents, and storytelling to facilitate learning from practice. Finally, training to advance the skill development of preceptors, coaches, educators, and facilitators has provided organizations with enduring benefits. Copyright 2009, SLACK Incorporated.

  2. Supporting Aboriginal Women to Quit Smoking: Antenatal and Postnatal Care Providers' Confidence, Attitudes, and Practices.

    Science.gov (United States)

    Tzelepis, Flora; Daly, Justine; Dowe, Sarah; Bourke, Alex; Gillham, Karen; Freund, Megan

    2017-05-01

    Tobacco use during pregnancy is substantially higher among Aboriginal women compared to non-Aboriginal women in Australia. However, no studies have investigated the amount or type of smoking cessation care that staff from Aboriginal antenatal and postnatal services provide to clients who smoke or staff confidence to do so. This study examined Aboriginal antenatal and postnatal staff confidence, perceived role and delivery of smoking cessation care to Aboriginal women and characteristics associated with provision of such care. Staff from 11 Aboriginal Maternal and Infant Health Services and eight Aboriginal Child and Family Health services in the Hunter New England Local Health District in Australia completed a cross-sectional self-reported survey (n = 67, response rate = 97.1%). Most staff reported they assessed clients' smoking status most or all of the time (92.2%). However, only a minority reported they offered a quitline referral (42.2%), provided follow-up support (28.6%) or provided nicotine replacement therapy (4.7%) to most or all clients who smoked. Few staff felt confident in motivating clients to quit smoking (19.7%) and advising clients about using nicotine replacement therapy (15.6%). Staff confident with talking to clients about how smoking affected their health had significantly higher odds of offering a quitline referral [OR = 4.9 (1.7-14.5)] and quitting assistance [OR = 3.9 (1.3-11.6)] to clients who smoke. Antenatal and postnatal staff delivery of smoking cessation care to pregnant Aboriginal women or mothers with young Aboriginal children could be improved. Programs that support Aboriginal antenatal and postnatal providers to deliver smoking cessation care to clients are needed. Aboriginal antenatal and postnatal service staff have multiple opportunities to assist Aboriginal women to quit smoking during pregnancy and postpartum. However, staff confidence and practices of offering various forms of smoking cessation support to pregnant Aboriginal

  3. Advanced Life Support Providers Have Poor Knowledge of When to Administer Resuscitation Drugs

    DEFF Research Database (Denmark)

    Johnsen, Josephine; Glerup Lauridsen, Kasper; Løfgren, Bo

    2017-01-01

    Background: Advanced life support (ALS) including resuscitation drugs improves return of spontaneous circulation after cardiac arrest. Resuscitation drugs are recommended to be administered at predefined time-points depending on whether the cardiac rhythm is shockable or non-shockable. Timing...... to administer drugs during shockable rhythm only. Similar, only one third knew when to administer drugs during non-shockable rhythm only. Knowledge on when to administer drugs in case of rhythm transition was poor (Figure 1).Conclusion: Advanced life support providers have poor knowledge of when to administer...... resuscitation drugs. Future studies should address methods to improve learning and skill retention of resuscitation drug administration.Author Disclosures: J. Johnsen: None. K.G. Lauridsen: None. B. Løfgren: None....

  4. Primary Health Care Providers' Perspectives: Facilitating Older Patients' Access to Community Support Services.

    Science.gov (United States)

    Ploeg, Jenny; Denton, Margaret; Hutchison, Brian; McAiney, Carrie; Moore, Ainsley; Brazil, Kevin; Tindale, Joseph; Wu, Amina; Lam, Annie

    2016-12-01

    The purpose of the study examined in this article was to understand how non-physician health care professionals working in Canadian primary health care settings facilitate older persons' access to community support services (CSSs). The use of CSSs has positive impacts for clients, yet they are underused from lack of awareness. Using a qualitative description approach, we interviewed 20 health care professionals from various disciplines and primary health care models about the processes they use to link older patients to CSSs. Participants collaborated extensively with interprofessional colleagues within and outside their organizations to find relevant CSSs. They actively engaged patients and families in making these linkages and ensured follow-up. It was troubling to find that they relied on out-of-date resources and inefficient search strategies to find CSSs. Our findings can be used to develop resources and approaches to better support primary health care providers in linking older adults to relevant CSSs.

  5. Primary care provider preferences for working with a collaborative support team

    Directory of Open Access Journals (Sweden)

    Flores Jennifer A

    2007-05-01

    Full Text Available Abstract Background Clinical interventions based on collaborative models require effective communication between primary care providers (PCPs and collaborative support teams. Despite growing interest in collaborative care, we have identified no published studies describing how PCPs prefer to communicate and interact with collaborative support teams. This manuscript examines the communication and interaction preferences of PCPs participating in an ongoing randomized clinical trial of a collaborative intervention for chronic pain and depression. Methods The trial is being conducted in five primary care clinics of a Veterans Affairs Medical Center. Twenty-one PCPs randomized to the study intervention completed a survey regarding preferences for interacting with the collaborative support team. Results A majority of PCPs identified email (95% and telephone calls (68% as preferred modes for communicating with members of the support team. In contrast, only 29% identified in-person communications as preferred. Most PCPs preferred that the care manager and physician pain specialist assess patients (76% and make initial treatment changes (71% without first conferring with the PCP. One-half wanted to be designated cosigners of all support team notes in the electronic medical record, one-half wanted to receive brief and focused information rather than in-depth information about their patients, and one-half wanted their practice nurses automatically included in communications. Panel size was strongly associated (p Conclusion The substantial variation in PCP communication preferences suggests the need for knowledge of these preferences when designing and implementing collaborative interventions. Additional research is needed to understand relationships between clinician and practice characteristics and interaction preferences.

  6. Prior Inoculation with Type B Strains of Francisella tularensis Provides Partial Protection against Virulent Type A Strains in Cottontail Rabbits

    Science.gov (United States)

    Brown, Vienna R.; Adney, Danielle R.; Olea-Popelka, Francisco; Bowen, Richard A.

    2015-01-01

    Francisella tularensis is a highly virulent bacterium that is capable of causing severe disease (tularemia) in a wide range of species. This organism is characterized into two distinct subspecies: tularensis (type A) and holarctica (type B) which vary in several crucial ways, with some type A strains having been found to be considerably more virulent in humans and laboratory animals. Cottontail rabbits have been widely implicated as a reservoir species for this subspecies; however, experimental inoculation in our laboratory revealed type A organisms to be highly virulent, resulting in 100% mortality following challenge with 50–100 organisms. Inoculation of cottontail rabbits with the same number of organisms from type B strains of bacteria was found to be rarely lethal and to result in a robust humoral immune response. The objective of this study was to characterize the protection afforded by a prior challenge with type B strains against a later inoculation with a type A strain in North American cottontail rabbits (Sylvilagus spp). Previous infection with a type B strain of organism was found to lengthen survival time and in some cases prevent death following inoculation with a type A2 strain of F. tularensis. In contrast, inoculation of a type A1b strain was uniformly lethal in cottontail rabbits irrespective of a prior type B inoculation. These findings provide important insight about the role cottontail rabbits may play in environmental maintenance and transmission of this organism. PMID:26474413

  7. Dental School Administrators' Attitudes Towards Providing Support Services for LGBT-Identified Students.

    Science.gov (United States)

    Behar-Horenstein, Linda S; Morris, Dustin R

    2015-08-01

    A lack of curriculum time devoted to teaching dental students about the needs of lesbian, gay, bisexual, and transgendered (LGBT) health care patient needs and biases against LGBT students and faculty have been reported. Understanding dental school administrators' attitudes about LGBT students' needs might provide further insight into these long-standing issues. The aims of this study were to develop a survey to assess dental administrators' attitudes regarding the support services they believe LGBT-identified students need, to identify dental schools' current diversity inclusion policies, and to determine what types of support dental schools currently provide to LGBT students. A survey developed with the aid of a focus group, cognitive interviewing, and pilot testing was sent to 136 assistant and associate deans and deans of the 65 U.S. and Canadian dental schools. A total of 54 responses from 43 (66%) schools were received from 13 deans, 29 associate deans, and 11 assistant deans (one participant did not report a position), for a 40% response rate. The findings suggest there is a considerable lack of knowledge or acknowledgment of LGBT dental students' needs. Future studies are needed to show the importance of creating awareness about meeting the needs of all dental student groups, perhaps through awareness campaigns initiated by LGBT students.

  8. Evaluation of Basic Life Support Training Program Provided for Nurses in A University Hospital

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    Banu Terzi

    2017-06-01

    Full Text Available Aims: This study was conducted to assess the efficiency of the basic life support (BLS training program provided for nurses in a university hospital. To evaluate the efficiency of the BLS training program provided for nurses in a university hospital. Methods: In this a quasi-experimental study, a total of 404 nurses who received BLS training were enrolled. The study was performed in two stages. In stage one, the participant nurses were given a pre-test that consisted of 25 questions, four points each, before the training on the first day of the 2-day BLS training. The post-test was conducted in addition to practical exams on manikins to determine nurses’ practice skills on BLS. Results: There was a statistically significant difference between the nurses with previous BLS training and the difference between their pre- and post-test results (p<0.05, and high statistically significant difference was found between the nurses with previous advanced life support (ALS training and the difference between their pre- and post-test results (p<0.001. Conclusion: Nurses should receive BLS training in hospitals and the training should be repeated on a regular basis. The BLS training that the nurses received in this study was effective and increased their knowledge level on BLS

  9. Effects of Providing Peer Support on Diabetes Management in People With Type 2 Diabetes.

    Science.gov (United States)

    Yin, Junmei; Wong, Rebecca; Au, Shimen; Chung, Harriet; Lau, Maggie; Lin, Laihar; Tsang, Chiuchi; Lau, Kampiu; Ozaki, Risa; So, Wingyee; Ko, Gary; Luk, Andrea; Yeung, Roseanne; Chan, Juliana C N

    2015-08-01

    We examined the effects of participating in a "train-the-trainer" program and being a peer supporter on metabolic and cognitive/psychological/behavioral parameters in Chinese patients with type 2 diabetes. In response to our invitation, 79 patients with fair glycemic control (HbA1c peer supporters. Of the 59 who completed the program successfully, 33 agreed to be peer supporters ("agreed trainees") and were each assigned to support 10 patients for 1 year, with a voluntary extension period of 3 additional years, while 26 trainees declined to be supporters ("refused trainees"). A group of 60 patients with fair glycemic control who did not attend the training program and were under usual care were selected as a comparison group. The primary outcome was the change in average HbA1c levels for the 3 groups from baseline to 6 months. At 6 months, HbA1c was unchanged in the trainees (at baseline, 7.1 ± 0.3%; at 6 months, 7.1 ± 1.1%) but increased in the comparison group (at baseline, 7.1 ± 0.5%; at 6 months, 7.3 ± 1.1%. P = .02 for between-group comparison). Self-reported self-care activities including diet adherence and foot care improved in the trainees but not the comparison group. After 4 years, HbA1c remained stable among the agreed trainees (at baseline, 7.0 ± 0.2%; at 4 years: 7.2 ± 0.6%), compared with increases in the refused trainees (at baseline, 7.1 ± 0.4%; at 4 years, 7.8 ± 0.8%) and comparison group (at baseline, 7.1 ± 0.5%; at 4 years, 8.1 ± 0.6%. P = .001 for between-group comparison). Patients with diabetes who engaged in providing ongoing peer support to other patients with diabetes improved their self-care while maintaining glycemic control over 4 years. © 2015 Annals of Family Medicine, Inc.

  10. Should Sabbath Prohibitions Be Overridden to Provide Emotional Support to a Sick Relative?

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    Chaya Greenberger

    2016-07-01

    Full Text Available Background There is a consensus among the halachic authorities that life-saving actions override Sabbath prohibitions. They are painstaking in securing that the sanctity of the Sabbath is maintained but that not a single life be lost. Objective This manuscript examines if and when a relative’s presence at the bedside of a seriously ill individual is potentially life-saving against the backdrop of the scientific literature. It specifically addresses the permissibility of traveling in a motorized vehicle, generally prohibited on the Sabbath, to be with one’s relative in hospital for the provision of emotional support. Methods Discourse of the halachic issues in the context of the scientific literature. Results Stress, mental or physical, has been determined as a potentially life-threatening condition in many disease entities. The literature attests to both the patient’s and the professionals’ perception of the curative potential of the presence of loved ones by advocating for the patient and relieving stress in the hospital experience. Emotional support from a loved one is perceived by some patients as vital to survival. There is halachic consensus that a patient’s perception of the emotional need for a relative’s presence is sufficient to permit overriding rabbinic prohibitions. Torah prohibitions, which may be overridden for medical needs, may be overridden for emotional support, providing a health professional or family member attests to the fulfilment of this specific need as diminishing the danger to the patient’s life. In certain cases, the latter contingency is unnecessary. Conclusions Emotional support has an impact on the patient’s health status; the degree to which its impact is strong enough to save life is still being studied. As more data from scientific studies emerge, they may be relevant to sharpening the halachic rulings with respect to the issue at hand.

  11. Should Sabbath Prohibitions Be Overridden to Provide Emotional Support to a Sick Relative?

    Science.gov (United States)

    Greenberger, Chaya; Mor, Pnina

    2016-07-28

    There is a consensus among the halachic authorities that life-saving actions override Sabbath prohibitions. They are painstaking in securing that the sanctity of the Sabbath is maintained but that not a single life be lost. This manuscript examines if and when a relative's presence at the bedside of a seriously ill individual is potentially life-saving against the backdrop of the scientific literature. It specifically addresses the permissibility of traveling in a motorized vehicle, generally prohibited on the Sabbath, to be with one's relative in hospital for the provision of emotional support. Discourse of the halachic issues in the context of the scientific literature. Stress, mental or physical, has been determined as a potentially life-threatening condition in many disease entities. The literature attests to both the patient's and the professionals' perception of the curative potential of the presence of loved ones by advocating for the patient and relieving stress in the hospital experience. Emotional support from a loved one is perceived by some patients as vital to survival. There is halachic consensus that a patient's perception of the emotional need for a relative's presence is sufficient to permit overriding rabbinic prohibitions. Torah prohibitions, which may be overridden for medical needs, may be overridden for emotional support, providing a health professional or family member attests to the fulfilment of this specific need as diminishing the danger to the patient's life. In certain cases, the latter contingency is unnecessary. Emotional support has an impact on the patient's health status; the degree to which its impact is strong enough to save life is still being studied. As more data from scientific studies emerge, they may be relevant to sharpening the halachic rulings with respect to the issue at hand.

  12. Pelvic Organ Support in Animals with Partial Loss of Fibulin-5 in the Vaginal Wall.

    Directory of Open Access Journals (Sweden)

    Kathleen Chin

    Full Text Available Compromise of elastic fiber integrity in connective tissues of the pelvic floor is most likely acquired through aging, childbirth-associated injury, and genetic susceptibility. Mouse models of pelvic organ prolapse demonstrate systemic deficiencies in proteins that affect elastogenesis. Prolapse, however, does not occur until several months after birth and is thereby acquired with age or after parturition. To determine the impact of compromised levels of fibulin-5 (Fbln5 during adulthood on pelvic organ support after parturition and elastase-induced injury, tissue-specific conditional knockout (cKO mice were generated in which doxycycline (dox treatment results in deletion of Fbln5 in cells that utilize the smooth muscle α actin promoter-driven reverse tetracycline transactivator and tetracycline responsive element-Cre recombinase (i.e., Fbln5f/f/SMA++-rtTA/Cre+, cKO. Fbln5 was decreased significantly in the vagina of cKO mice compared with dox-treated wild type or controls (Fbln5f/f/SMA++-rtTA/Cre-/-. In controls, perineal body length (PBL and bulge increased significantly after delivery but declined to baseline values within 6-8 weeks. Although overt prolapse did not occur in cKO animals, these transient increases in PBL postpartum were amplified and, unlike controls, parturition-induced increases in PBL (and bulge did not recover to baseline but remained significantly increased for 12 wks. This lack of recovery from parturition was associated with increased MMP-9 and nondetectable levels of Fbln5 in the postpartum vagina. This predisposition to prolapse was accentuated by injection of elastase into the vaginal wall in which overt prolapse occurred in cKO animals, but rarely in controls. Taken together, our model system in which Fbln5 is conditionally knock-downed in stromal cells of the pelvic floor results in animals that undergo normal elastogenesis during development but lose Fbln5 as adults. The results indicate that vaginal fibulin-5

  13. Lipid-anchored Synaptobrevin Provides Little or No Support for Exocytosis or Liposome Fusion.

    Science.gov (United States)

    Chang, Che-Wei; Chiang, Chung-Wei; Gaffaney, Jon D; Chapman, Edwin R; Jackson, Meyer B

    2016-02-05

    SNARE proteins catalyze many forms of biological membrane fusion, including Ca(2+)-triggered exocytosis. Although fusion mediated by SNAREs generally involves proteins anchored to each fusing membrane by a transmembrane domain (TMD), the role of TMDs remains unclear, and previous studies diverge on whether SNAREs can drive fusion without a TMD. This issue is important because it relates to the question of the structure and composition of the initial fusion pore, as well as the question of whether SNAREs mediate fusion solely by creating close proximity between two membranes versus a more active role in transmitting force to the membrane to deform and reorganize lipid bilayer structure. To test the role of membrane attachment, we generated four variants of the synaptic v-SNARE synaptobrevin-2 (syb2) anchored to the membrane by lipid instead of protein. These constructs were tested for functional efficacy in three different systems as follows: Ca(2+)-triggered dense core vesicle exocytosis, spontaneous synaptic vesicle exocytosis, and Ca(2+)-synaptotagmin-enhanced SNARE-mediated liposome fusion. Lipid-anchoring motifs harboring one or two lipid acylation sites completely failed to support fusion in any of these assays. Only the lipid-anchoring motif from cysteine string protein-α, which harbors many lipid acylation sites, provided support for fusion but at levels well below that achieved with wild type syb2. Thus, lipid-anchored syb2 provides little or no support for exocytosis, and anchoring syb2 to a membrane by a TMD greatly improves its function. The low activity seen with syb2-cysteine string protein-α may reflect a slower alternative mode of SNARE-mediated membrane fusion. © 2016 by The American Society for Biochemistry and Molecular Biology, Inc.

  14. Chronic kidney disease and support provided by home care services: a systematic review.

    Science.gov (United States)

    Aydede, Sema K; Komenda, Paul; Djurdjev, Ognjenka; Levin, Adeera

    2014-07-18

    Chronic diseases, such as chronic kidney disease (CKD), are growing in incidence and prevalence, in part due to an aging population. Support provided through home care services may be useful in attaining a more efficient and higher quality care for CKD patients. A systematic review was performed to identify studies examining home care interventions among adult CKD patients incorporating all outcomes. Studies examining home care services as an alternative to acute, post-acute or hospice care and those for long-term maintenance in patients' homes were included. Studies with only a home training intervention and those without an applied research component were excluded. Seventeen studies (10 cohort, 4 non-comparative, 2 cross-sectional, 1 randomized) examined the support provided by home care services in 15,058 CKD patients. Fourteen studies included peritoneal dialysis (PD), two incorporated hemodialysis (HD) and one included both PD and HD patients in their treatment groups. Sixteen studies focused on the dialysis phase of care in their study samples and one study included information from both the dialysis and pre-dialysis phases of care. Study settings included nine single hospital/dialysis centers and three regional/metropolitan areas and five were at the national level. Studies primarily focused on nurse assisted home care patients and mostly examined PD related clinical outcomes. In PD studies with comparators, peritonitis risks and technique survival rates were similar across home care assisted patients and comparators. The risk of mortality, however, was higher for home care assisted PD patients. While most studies adjusted for age and comorbidities, information about multidimensional prognostic indices that take into account physical, psychological, cognitive, functional and social factors among CKD patients was not easily available. Most studies focused on nurse assisted home care patients on dialysis. The majority were single site studies incorporating

  15. The partial mediation effect of satisfaction with social support and coping effectiveness on health-related quality of life and perceived stress long-term after heart transplantation

    Directory of Open Access Journals (Sweden)

    White-Williams C

    2014-12-01

    Full Text Available Connie White-Williams,1 Kathleen L Grady,2 Pariya Fazeli,1 Susan Myers,1 Linda Moneyham,3 Karen Meneses,3 Bruce Rybarczyk4 1University of Alabama Medical Center, Birmingham, AL, USA; 2Division of Cardiac Surgery, Department of Surgery, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA; 3School of Nursing, University of Alabama at Birmingham, Birmingham, AL, USA; 4Department of Psychology, Clinical Psychology Program, Virginia Commonwealth University, Richmond, VA, USA Abstract: The purpose of this research was to examine whether satisfaction with social support and coping effectiveness mediate the relationship between stress and health-related quality of life (HRQOL 5 years after heart transplantation. Data were collected from 212 heart transplant patients (80% male, 92% white, mean age 59.9 years at four United States sites using the Heart Transplant Stressor Scale, Social Support Index, Jalowiec Coping Scale, and Quality of Life Index. Using Baron and Kenny's approach, a series of regression equations for mediation revealed that both satisfaction with social support and coping partially mediated the relationship between perceived stress and HRQOL. Understanding the relationships of social support, stress, and coping on patients' HRQOL is important for the development of interventions to provide optimal patient care. Keywords: heart transplantation, social support, coping, stress, mediation

  16. Provider perceptions on HIV risk and prevention services within permanent supportive housing.

    Science.gov (United States)

    Wenzel, Suzanne L; Henwood, Benjamin; Harris, Taylor; Winetrobe, Hailey; Rhoades, Harmony

    2017-10-01

    Permanent supportive housing (PSH) is an evidence-based solution to homelessness for persons experiencing chronic or long-term homelessness and one or more physical or behavioral health problems. Health services through PSH typically focus on physical and behavioral health. With the exception of programs specifically designed for persons living with HIV/AIDS, little attention has focused on services through PSH to prevent transmission of HIV or other sexually transmitted infections (STIs), yet sexual risk behavior continues after homeless persons move into PSH. The purpose of this study was to investigate how PSH providers approach HIV prevention and the challenges they perceive surrounding HIV prevention in PSH. Results serve as a critical first step toward addressing the acceptability and feasibility of providing HIV/STI prevention services to PSH residents. As part of a longitudinal mixed methods study examining HIV risk and prevention behavior among homeless unaccompanied adults moving into PSH in Los Angeles, we conducted eleven focus groups with a total of 60 frontline staff across 10 PSH agencies. Thirty-three percent of focus group participants were African American, 32% were Hispanic, and 55% were women. Results suggest that provider awareness and knowledge of PrEP is very limited, and provision of formal HIV prevention programing for residents is perceived as challenging. Informal, ad hoc conversations with residents about sexual risk and HIV prevention do occur when providers have rapport with clients and perceive risk. There are significant gaps in HIV prevention services through PSH but also opportunities to enhance providers' efforts to promote the health of residents through prevention.

  17. The relationship between women's experiences of mistreatment at facilities during childbirth, types of support received and person providing the support in Lucknow, India.

    Science.gov (United States)

    Diamond-Smith, Nadia; Sudhinaraset, May; Melo, Jason; Murthy, Nirmala

    2016-09-01

    a growing body of literature has highlighted the prevalence of mistreatment that women experience around the globe during childbirth, including verbal and physical abuse, neglect, lack of support, and disrespect. Much of this has been qualitative. Research around the world suggests that support during childbirth can improve health outcomes and behaviours, and improve experiences. Support can be instrumental, informational, or emotional, and can be provided by a variety of people including family (husbands, mothers) or health providers of various professional levels. This study explores women's reported experiences of mistreatment during childbirth quantitatively, and how these varied by specific types of support available and provided by specific individuals. participants were women age 16-30 who had delivered infants in a health facility in the previous five years and were living in slums of Lucknow India. Data were collected on their experiences of mistreatment, the types of support they received, and who provided that support. women who reported lack of support were more likely to report mistreatment. Lack of support in regards to discussions with providers and provider information were most strongly associated with a higher mistreatment score. Women who received any type of support from their husband or a health worker were significantly more likely to report lower mistreatment scores. Receiving informational support from a mother/mother-in-law or emotional support from a health worker was also associated with lower mistreatment scores. However, receiving emotional support from a friend/neighbour/other family member was associated with a higher mistreatment score. women rely on different people to provide different types of support during childbirth in this setting. Some of these individuals provide specific types of support that ultimately improve a woman's overall experience of her childbirth. Interventions aiming to reduce mistreatment to women during

  18. Providing Data Management Support to NASA Airborne Field Studies through Streamlined Usability Design

    Science.gov (United States)

    Beach, A. L., III; Northup, E. A.; Early, A. B.; Chen, G.

    2016-12-01

    Airborne field studies are an effective way to gain a detailed understanding of atmospheric processes for scientific research on climate change and air quality relevant issues. One major function of airborne project data management is to maintain seamless data access within the science team. This allows individual instrument principal investigators (PIs) to process and validate their own data, which requires analysis of data sets from other PIs (or instruments). The project's web platform streamlines data ingest, distribution processes, and data format validation. In May 2016, the NASA Langley Research Center (LaRC) Atmospheric Science Data Center (ASDC) developed a new data management capability to help support the Korea U.S.-Air Quality (KORUS-AQ) science team. This effort is aimed at providing direct NASA Distributed Active Archive Center (DAAC) support to an airborne field study. Working closely with the science team, the ASDC developed a scalable architecture that allows investigators to easily upload and distribute their data and documentation within a secure collaborative environment. The user interface leverages modern design elements to intuitively guide the PI through each step of the data management process. In addition, the new framework creates an abstraction layer between how the data files are stored and how the data itself is organized(i.e. grouping files by PI). This approach makes it easy for PIs to simply transfer their data to one directory, while the system itself can automatically group/sort data as needed. Moreover, the platform is "server agnostic" to a certain degree, making deployment and customization more straightforward as hardware needs change. This flexible design will improve development efficiency and can be leveraged for future field campaigns. This presentation will examine the KORUS-AQ data portal as a scalable solution that applies consistent and intuitive usability design practices to support ingest and management of airborne

  19. Could implantable cardioverter defibrillators provide a human model supporting the learned helplessness theory of depression?

    Science.gov (United States)

    Goodman, M; Hess, B

    1999-01-01

    Affective symptoms were examined retrospectively in 25 patients following placement of implantable cardioverter defibrillators (ICD) which can produce intermittent shocks without warning in response to cardiac ventricular arrhythmias. The number of ICD random, uncontrollable discharge shocks and pre-ICD history of psychological distress (i.e., depression and/or anxiety) were documented in all patients using a demographics questionnaire and a standardized behavioral/psychological symptoms questionnaire (i.e., Symptom Checklist-90 Revised). ICD patients were dichotomized into two groups: those without a history of psychological distress prior to ICD (n = 18) and those with a history of psychological distress prior to ICD (n = 7). In ICD patients without a prior history, results indicated that quantity of ICD discharge shocks was significantly predictive of current reported depression (r = 0.45, p = 0.03) and current reported anxiety (r = 0.51, p = 0.02). Conversely, in patients with a reported history of psychological distress, there was no significant relationship found between quantity of discharge shocks and current reported depression or anxiety. This study may provide evidence in support of a human model of learned helplessness in that it supports the notion that exposure to an unavoidable and inescapable aversive stimulus was found to be related to patients' reported depression. Further studies may wish to prospectively consider a larger sample as well as a more comprehensive assessment of premorbid psychological symptoms.

  20. Occlusion for implant-supported fixed dental prostheses in partially edentulous patients: a literature review and current concepts.

    Science.gov (United States)

    Yuan, Judy Chia-Chun; Sukotjo, Cortino

    2013-04-01

    Implant treatment has become the treatment of choice to replace missing teeth in partially edentulous areas. Dental implants present different biological and biomechanical characteristics than natural teeth. Occlusion is considered to be one of the most important factors contributing to implant success. Most literature on implant occlusal concepts is based on expert opinion, anecdotal experiences, in vitro and animal studies, and only limited clinical research. Furthermore, scientific literature regarding implant occlusion, particularly in implant-supported fixed dental prostheses remains controversial. In this study, the current status of implant occlusion was reviewed and discussed. Further randomized clinical research to investigate the correlation between implant occlusion, the implant success rate, and its risk factors is warranted to determine best clinical practices.

  1. Elucidating mechanisms for insect body size: partial support for the oxygen-dependent induction of moulting hypothesis.

    Science.gov (United States)

    Kivelä, Sami M; Viinamäki, Sonja; Keret, Netta; Gotthard, Karl; Hohtola, Esa; Välimäki, Panu

    2018-01-25

    Body size is a key life history trait, and knowledge of its mechanistic basis is crucial in life history biology. Such knowledge is accumulating for holometabolous insects, whose growth is characterised and body size affected by moulting. According to the oxygen-dependent induction of moulting (ODIM) hypothesis, moult is induced at a critical mass at which oxygen demand of growing tissues overrides the supply from the tracheal respiratory system, which principally grows only at moults. Support for the ODIM hypothesis is controversial, partly because of a lack of proper data to explicitly test the hypothesis. The ODIM hypothesis predicts that the critical mass is positively correlated with oxygen partial pressure (PO2 ) and negatively with temperature. To resolve the controversy that surrounds the ODIM hypothesis, we rigorously test these predictions by exposing penultimate-instar Orthosia gothica (Lepidoptera: Noctuidae) larvae to temperature and moderate PO2  manipulations in a factorial experiment. The relative mass increment in the focal instar increased along with increasing PO2 , as predicted, but there was only weak suggestive evidence of the temperature effect. Probably owing to a high measurement error in the trait, the effect of PO2  on the critical mass was sex specific; high PO2  had a positive effect only in females, whereas low PO2  had a negative effect only in males. Critical mass was independent of temperature. Support for the ODIM hypothesis is partial because of only suggestive evidence of a temperature effect on moulting, but the role of oxygen in moult induction seems unambiguous. The ODIM mechanism thus seems worth considering in body size analyses. © 2018. Published by The Company of Biologists Ltd.

  2. A systematic review of retention of adult advanced life support knowledge and skills in healthcare providers.

    Science.gov (United States)

    Yang, Chih-Wei; Yen, Zui-Shen; McGowan, Jane E; Chen, Huiju Carrie; Chiang, Wen-Chu; Mancini, Mary E; Soar, Jasmeet; Lai, Mei-Shu; Ma, Matthew Huei-Ming

    2012-09-01

    Advanced life support (ALS) guidelines are widely adopted for healthcare provider training with recommendations for retraining every two years or longer. This systematic review studies the retention of adult ALS knowledge and skills following completion of an ALS course in healthcare providers. We retrieved original articles using Medline, CINAHL, Cochrane Library, and PubMed, and reviewed reference citations to identify additional studies. We extracted data from included articles using a structured approach and organized outcomes by evaluation method, and knowledge and skills retention. Among 336 articles retrieved, 11 papers were included. Most studies used multiple-choice questionnaires to evaluate knowledge retention and cardiac arrest simulation or other skills tests to evaluate skills retention. All studies reported variable rates of knowledge or skills deterioration over time, from 6 weeks to 2 years after training. Two studies noted retention of knowledge at 18 months and up to 2 years, and one reported skills retention at 3 months. Clinical experience, either prior to or after the courses, has a positive impact on retention of knowledge and skills. There is a lack of large well-designed studies examining the retention of adult ALS knowledge and skills in healthcare providers. The available evidence suggests that ALS knowledge and skills decay by 6 months to 1 year after training and that skills decay faster than knowledge. Additional studies are needed to help provide evidence-based recommendations for assessment of current knowledge and skills and need for refresher training to maximize maintenance of ALS competency. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  3. Provider order entry with integrated decision support: from academia to industry.

    Science.gov (United States)

    Giuse, D A

    2003-01-01

    To describe the evolution of a provider order entry system with integrated decision support, from a research prototype to full implementation at one academic center, and finally to a commercial product. Describe the institutional environment and planning process in which the system originated. Highlight the historical evolution of the provider entry system, and analyze its system architecture and functionality. Describe the requirements for successful design and deployment both within a single health care organization and as part of a commercial product line. Over a period of eight years the system evolved from a research prototype to a fully integrated order entry system in routine use on most inpatient units of a large academic medical center. Around 12,000 orders are entered every day into the computer system; 70% of those are entered directly by the responsible physician. The system embeds best-of-care practice guidelines, and is used to reduce resource utilization by limiting unnecessary testing and suggesting more effective or less costly therapeutic replacements. The system was recently acquired by a large HIS software vendor and is being rapidly implemented at numerous customer sites. Large-scale development or deployment of complex health information systems requires considerable organizational agreement and resources, as well as close attention to iterative system design that explicitly includes constant feedback from the user community. The transformation of such a system from a single-site success to a widely deployed product requires convergence of resources and needs.

  4. Primary Care Providers' Use of a Child Psychiatry Telephone Support Program.

    Science.gov (United States)

    Van Cleave, Jeanne; Holifield, Chloe; Perrin, James M

    2017-11-29

    The Massachusetts Child Psychiatry Access Project (MCPAP) provides telephone support from mental health specialists to primary care providers (PCPs). Understanding PCPs' use may inform implementation of similar programs. We sought to examine PCPs' decision-making process to use or not use MCPAP when encountering mental health problems. We analyzed data regarding calls from PCPs to MCPAP from October 1, 2010, to July 31, 2011, and interviewed 14 PCPs with frequent use (≥7 calls) and infrequent use (≤4 calls). PCPs were asked about recent patients with mental health problems, and they were asked to describe reasons for calling or not calling MCPAP. Frequent callers were asked what sustained use; infrequent callers were asked about alternative management strategies. Comparisons were made between these groups in qualitative analysis. PCPs (n = 993) made 6526 calls (mean = 6.6; median = 3). Factors influencing calling included: MCPAP's guidance is timely and tailored to individual scope of practice; MCPAP's ability to arrange therapy referrals exceeds PCPs' ability; providing a plan at point of care relieves anxious families; and MCPAP's assistance helps accommodate families' preference to keep mental health in primary care. Some infrequent callers had gained skills through MCPAP before 2010 and now called only for complex cases. Other reasons for infrequent calling: PCPs have other consultation sources, have fear of being asked to manage more than they are comfortable, or have misperceptions of MCPAP's offerings. MCPAP enhanced PCPs' ability to deliver mental health care consistent with families' preferences. PCPs applied knowledge gained from calls to subsequent patients. Promoting MCPAP components through outreach and tailoring guidance to PCPs' scope of practice may entice greater use. Copyright © 2018. Published by Elsevier Inc.

  5. Attrition of advanced trauma life support (ATLS) skills among ATLS instructors and providers in Mexico.

    Science.gov (United States)

    Azcona, Luis Am; Gutierrez, Guillermo E O; Fernandez, Cesar J P; Natera, Octavio M; Ruiz-Speare, Octavio; Ali, Jameel

    2002-09-01

    Mexico has had the Advanced Trauma Life Support (ATLS) program since 1986. We assessed the attrition of ATLS skills among ATLS providers and instructors in this country. Three groups (S, 16 students [new medical graduates enrolled for an ATLS course]; P, 33 providers; and I, 26 instructors [who had completed courses previously]) were evaluated. Group S read the manual before pretesting. Groups P and I were subdivided based on the length of time since the course had been completed: P1, less than 2 years (n = 22); P2, more than 2 years (n = 11); I1, less than 2 years (n = 16); and I2, more than 2 years (n = 10). Multiple-choice and psychomotor testing using ATLS scoring criteria were used. Affect was assessed post-ATLS for motivational factors, interactivity, and attitude toward trauma care. Multiple-choice test scores (means +/- SD) out of a maximum of 40 were as follows: S, 24.3 +/- 2.6; P1, 24.0 +/- 5.7; P2, 21.3 +/- 8.0; I1, 23.2 +/- 8.2; and I2, 24.0 +/- 7.2. Group S all passed the post-ATLS multiple-choice test (with correct answer percentages of 60.3% +/- 6.6% pre-ATLS versus 88.8% +/- 5.6% post-ATLS). An ATLS passing score of 80% correct answers was achieved in 2 of 33 for group P and 8 of 26 for group I (p ATLS group than in the P and I groups (p ATLS attitude to trauma care. Reading the manual alone yields similar cognitive but inferior psychomotor performance compared with subjects who completed the course previously. The majority of previous providers and instructors did not obtain a passing score (80%) in the multiple-choice test, but all the new providers passed the post-ATLS multiple-choice test, suggesting major attrition of cognitive skills but maintenance of psychomotor skills. Instructors had superior cognitive performance versus providers with worsening performance over time, but clinical skills performance was maintained at an equally high level by all groups. A very positive attitude toward ATLS prevailed among all participants.

  6. Fracture Strength of Three-Unit Implant Supported Fixed Partial Dentures with Excessive Crown Height Fabricated from Different Materials

    Directory of Open Access Journals (Sweden)

    Vahideh Nazari

    2017-01-01

    Full Text Available Objectives: Fracture strength is an important factor influencing the clinical long-term success of implant-supported prostheses especially in high stress situations like excessive crown height space (CHS. The purpose of this study was to compare the fracture strength of implant-supported fixed partial dentures (FPDs with excessive crown height, fabricated from three different materials.Materials and Methods: Two implants with corresponding abutments were mounted in a metal model that simulated mandibular second premolar and second molar. Thirty 3-unit frameworks with supportive anatomical design were fabricated using zirconia, nickel-chromium alloy (Ni-Cr, and polyetheretherketone (PEEK (n=10. After veneering, the CHS was equal to 15mm. Then; samples were axially loaded on the center of pontics until fracture in a universal testing machine at a crosshead speed of 0.5 mm/minute. The failure load data were analyzed by one-way ANOVA and Games-Howell tests at significance level of 0.05.Results: The mean failure loads for zirconia, Ni-Cr and PEEK restorations were 2086±362N, 5591±1200N and 1430±262N, respectively. There were significant differences in the mean failure loads of the three groups (P<0.001. The fracture modes in zirconia, metal ceramic and PEEK restorations were cohesive, mixed and adhesive type, respectively.Conclusions: According to the findings of this study, all implant supported three-unit FPDs fabricated of zirconia, metal ceramic and PEEK materials are capable to withstand bite force (even para-functions in the molar region with excessive CHS.Keywords: Dental Implants; Polyetheretherketone; Zirconium oxide; Dental Restoration Failure; Dental Porcelain

  7. Interleukin 1 genetic tests provide no support for reduction of preventive dental care.

    Science.gov (United States)

    Diehl, Scott R; Kuo, Fengshen; Hart, Thomas C

    2015-03-01

    It has been proposed that the PST and PerioPredict genetic tests that are based on polymorphisms in interleukin 1 (IL-1) genes identify a subset of patients who experience fewer tooth extractions if provided with 2 annual preventive visits. Economic analyses indicate rationing preventive care to only "high-risk" genotypes, smokers, patients with diabetes, or combinations of these risk factors would reduce the cost of dental care by $4.8 billion annually in the United States. Data presented in the study that claimed clinical utility for the PST and PerioPredict tests were obtained for reanalysis using logistic regression to assess whether the PST genetic test, smoking, diabetes, or number of preventive visits were risk factors for tooth extraction during a span of 16 years. Consistency of risk classification by the PST (version 1) and PerioPredict (version 2) genetic tests was evaluated in different ethnic groups from the 1000 Genomes database. Multivariate analyses revealed association of tooth extraction with diabetes (P preventive visits (P = .004), but no support for the PST genetic test (P = .96) nor indication that the benefit of 2 preventive visits was affected by this genetic test (P = .58). Classification of risk was highly inconsistent between the PST (version 1) and PerioPredict (version 2) genetic tests. Two annual preventive visits were supported as beneficial for all patients, and there was no evidence that the IL-1 PST genetic test has any effect on tooth extraction risk or influences the benefits of 2 annual preventive visits. Neither IL-1 PST nor PerioPredict genetic tests are useful for rationing preventive dental care. Further research is needed to identify genetic biomarkers with robust clinical validity and clinical utility to effectively personalize the practice of dentistry. Copyright © 2015 American Dental Association. Published by Elsevier Inc. All rights reserved.

  8. EDP Sciences and A&A: partnering to providing services to support the scientific community

    Science.gov (United States)

    Henri, Agnes

    2015-08-01

    Scholarly publishing is no longer about simply producing and packaging articles and sending out to subscribers. To be successful, as well as being global and digital, Publishers and their journals need to be fully engaged with their stakeholders (authors, readers, funders, libraries etc), and constantly developing new products and services to support their needs in the ever-changing environment that we work in.Astronomy & Astrophysics (A&A) is a high quality, major international Journal that belongs to the astronomical communities of a consortium of European and South American countries supported by ESO who sponsor the journal. EDP Sciences is a non-profit publisher belonging to several learned societies and is appointed by ESO to publish the journal.Over the last decade, as well as publishing the results of worldwide astronomical and astrophysical research, A&A and EDP Sciences have worked in partnership to develop a wide range of services for the authors and readers of A&A:- A specialist language editing service: to provide a clear and excellent level of English ensuring full understanding of the high-quality science.- A flexible and progressive Open Access Policy including Gold and Green options and strong links with arXiv.- Enriched articles: authors are able to enhance their articles using a wide range of rich media such as 3D models, videos and animations.Multiple publishing formats: allowing readers to browse articles on multiple devices including eReaders and Kindles.- “Scientific Writing for Young Astronomers”: In 2008 EDP Sciences and A&A set up the Scientific Writing for Young Astronomers (SWYA) School with the objective to teach early PhD Students how write correct and efficient scientific papers for different mediums (journals, proceedings, thesis manuscripts, etc.).

  9. Principals Supporting Teachers in Providing Language Instruction to English Learners in Elementary School

    Science.gov (United States)

    Munguia, Celia

    2017-01-01

    The purpose of the study was to examine the systems of support that principals establish at their school sites to support teachers with the academic achievement of the English learner population. Two schools from a single district were selected. Specific strategies, structures, and processes that support teachers and principals of English learners…

  10. Testing of tunnel support : dynamic load testing of rockbolt elements to provide data for safer support design.

    CSIR Research Space (South Africa)

    Ortlepp, WD

    1998-06-01

    Full Text Available forward has been accomplished in that it is now possible to use the same rational procedure for the design of tunnel support as is classically employed for the design of structures or machine components in more rigorous and precise engineering disciplines...

  11. Computer-Supported Feedback Message Tailoring for Healthcare Providers in Malawi: Proof-of-Concept

    Science.gov (United States)

    Landis-Lewis, Zach; Douglas, Gerald P; Hochheiser, Harry; Kam, Matthew; Gadabu, Oliver; Bwanali, Mwatha; Jacobson, Rebecca S

    2015-01-01

    Although performance feedback has the potential to help clinicians improve the quality and safety of care, healthcare organizations generally lack knowledge about how this guidance is best provided. In low-resource settings, tools for theory-informed feedback tailoring may enhance limited clinical supervision resources. Our objectives were to establish proof-of-concept for computer-supported feedback message tailoring in Malawi, Africa. We conducted this research in five stages: clinical performance measurement, modeling the influence of feedback on antiretroviral therapy (ART) performance, creating a rule-based message tailoring process, generating tailored messages for recipients, and finally analysis of performance and message tailoring data. We retrospectively generated tailored messages for 7,448 monthly performance reports from 11 ART clinics. We found that tailored feedback could be routinely generated for four guideline-based performance indicators, with 35% of reports having messages prioritized to optimize the effect of feedback. This research establishes proof-of-concept for a novel approach to improving the use of clinical performance feedback in low-resource settings and suggests possible directions for prospective evaluations comparing alternative designs of feedback messages. PMID:26958217

  12. Providing Open-Access Know How for Directors of Quantitative and Mathematics Support Centers

    Directory of Open Access Journals (Sweden)

    Michael Schuckers

    2017-01-01

    Full Text Available The purpose of this editorial is to introduce the quantitative literacy community to the newly published A Handbook for Directors of Quantitative and Mathematics Centers. QMaSCs (pronounced “Q-masks” can be broadly defined as centers that have supporting students in quantitative fields of study as part of their mission. Some focus only on calculus or mathematics; others concentrate on numeracy or quantitative literacy, and some do all of that. A QMaSC may be embedded in a mathematics department, or part of a learning commons, or a stand-alone center. There are hundreds of these centers in the U.S. The new handbook, which is the outgrowth of a 2013 NSF-sponsored, national workshop attended by 23 QMaSC directors from all quarters of the U.S., is available open access on the USF Scholar Commons and in hard copy from Amazon.com. This editorial by the handbook’s editors provides background and overview of the 20 detailed chapters on center leadership and management; community interactions; staffing, hiring and training; center assessment; and starting a center; and then a collection of ten case studies from research universities, four-year state colleges, liberal arts colleges, and a community college. The editorial ends by pointing out the need and potential benefits of a professional organization for QMaSC directors.

  13. Partial Oxidation of Hydrocarbons in a Segmented Bed Using Oxide-based Catalysts and Oxygen-conducting Supports

    Science.gov (United States)

    Smith, Mark W.

    Two objectives for the catalytic reforming of hydrocarbons to produce synthesis gas are investigated herein: (1) the effect of oxygen-conducting supports with partially substituted mixed-metal oxide catalysts, and (2) a segmented bed approach using different catalyst configurations. Excess carbon deposition was the primary cause of catalyst deactivation, and was the focus of the experiments for both objectives. The formation and characterization of deposited carbon was examined after reaction for one of the selected catalysts to determine the quantity and location of the carbon on the catalyst surface leading to deactivation. A nickel-substituted barium hexaaluminate (BNHA), with the formula BaAl 11.6Ni0.4O18.8, and a Rh-substituted lanthanum zirconate pyrochlore (LCZR) with the formula La1.89Ca0.11 Zr1.89Rh0.11, were combined with two different doped ceria supports. These supports were gadolinium-doped ceria (GDC) and zirconium-doped ceria (ZDC). The active catalyst phases were combined with the supports in different ratios using different synthesis techniques. The catalysts were characterized using several different techniques and were tested under partial oxidation (POX) of n-tetradecane (TD), a diesel fuel surrogate. It was found that the presence of GDC and ZDC reduced the formation of carbon for both catalysts; the optimal ratio of catalyst to support was different for the hexaaluminate and the pyrochlore; a loading of 20 wt% of the pyrochlore with ZDC produced the most stable performance in the presence of common fuel contaminants (>50 h); and, the incipient wetness impregnation synthesis method of applying the active catalyst to the support produced more stable product yields than the catalyst prepared by a solid-state mixing technique. Different hexaaluminate and pyrochlore catalysts were used in different configurations in a segmented bed approach. The first strategy was to promote the indirect reforming mechanism by placing a combustion catalyst in the

  14. The Effect of Providing Life Support on Nurses' Decision Making Regarding Life Support for Themselves and Family Members in Japan.

    Science.gov (United States)

    Shaku, Fumio; Tsutsumi, Madoka

    2016-12-01

    Decision making in terminal illness has recently received increased attention. In Japan, patients and their families typically make decisions without understanding either the severity of illness or the efficacy of life-supporting treatments at the end of life. Japanese culture traditionally directs the family to make decisions for the patient. This descriptive study examined the influence of the experiences of 391 Japanese nurses caring for dying patients and family members and how that experience changed their decision making for themselves and their family members. The results were mixed but generally supported the idea that the more experience nurses have in caring for the dying, the less likely they would choose to institute lifesupport measures for themselves and family members. The results have implications for discussions on end-of-life care. © The Author(s) 2016.

  15. Impact of prosthetic material on mid- and long-term outcome of dental implants supporting single crowns and fixed partial dentures: A systematic review and meta-analysis.

    Science.gov (United States)

    Abou-Ayash, Samir; Strasding, Malin; Rücker, Gerta; Att, Wael

    2017-01-01

    The impact of prosthetic material selection on implant survival is not clear. The current criteria for choosing a prosthetic material seem to be based on clinician preferences. This systematic review aims to evaluate the impact of restorative materials on the mid- and long-term survival of implants supporting single crowns and fixed partial dentures. Hand and MEDLINE searches were performed to identify relevant literature for single crowns (SC) and fixed partial dentures (FPD). Further inclusion criteria were a mean follow-up period of at least 3 years, the inclusion of at least 10 patients in a relevant study cohort, and a clear description of prosthesis type and prosthetic material. A total of 63 studies for the SC group and 11 studies for the FPD group were included. Full arch restorations were not included. The materials utilised in the SC group were metal-ceramic (precious and non-precious), lithium-disilicate, veneered zirconia, veneered alumina, and nanoceramics. The materials used in the FPD group were metal-ceramic (precious), veneered titanium, metal-resin (precious), and veneered zirconia. No significant impact on the prosthetic material relating to mid- or long-term implant survival was identified. Furthermore, there were no statistically significant differences between the survival rates of the dental prostheses made from different materials (SC and FPD group). Single crowns made of nanoceramics showed a higher risk for decementation relative to other materials (0.80, 95% CI [0.67; 0.89]; P material selection has no influence on mid- and long-term survival of implants restored with single crowns and fixed partial dentures. Similarly, the prosthetic material seems to have no significant impact on prosthetic survival rates. Further research is required to provide more evidence regarding the impact of the prosthetic material on long-term outcome. Conflict-of-interest statement: The authors declare that they have no conflict of interest.

  16. Monolayer-crystal streptavidin support films provide an internal standard of cryo-EM image quality

    Energy Technology Data Exchange (ETDEWEB)

    Han, Bong-Gyoon [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Watson, Zoe [Univ. of California, Berkeley, CA (United States); Cate, Jamie H. D. [Univ. of California, Berkeley, CA (United States); Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Glaeser, Robert M. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States)

    2017-03-01

    Analysis of images of biotinylated Escherichia coli 70S ribosome particles, bound to streptavidin affinity grids, demonstrates that the image-quality of particles can be predicted by the image-quality of the monolayer crystalline support film. Also, the quality of the Thon rings is a good predictor of the image-quality of particles, but only when images of the streptavidin crystals extend to relatively high resolution. When the estimated resolution of streptavidin was 5 Å or worse, for example, the ribosomal density map obtained from 22,697 particles went to only 9.5 Å, while the resolution of the map reached 4.0 Å for the same number of particles, when the estimated resolution of streptavidin crystal was 4 Å or better. It thus is easy to tell which images in a data set ought to be retained for further work, based on the highest resolution seen for Bragg peaks in the computed Fourier transforms of the streptavidin component. The refined density map obtained from 57,826 particles obtained in this way extended to 3.6 Å, a marked improvement over the value of 3.9 Å obtained previously from a subset of 52,433 particles obtained from the same initial data set of 101,213 particles after 3-D classification. These results are consistent with the hypothesis that interaction with the air-water interface can damage particles when the sample becomes too thin. Finally, streptavidin monolayer crystals appear to provide a good indication of when that is the case.

  17. Migrants and Mobile Technology Use: Gaps in the Support Provided by Current Tools

    Science.gov (United States)

    Epp, Carrie Demmans

    2017-01-01

    Our current understanding of how migrants use mobile tools to support their communication and language learning is inadequate. This study, therefore, explores the learner-initiated use of technologies to support their comprehension, production, and acquisition of English following migration to Canada. Information about migrant use of technologies…

  18. Providing Students with Interdisciplinary Support to Improve Their Organic Chemistry Posters

    Science.gov (United States)

    Widanski, Bozena; Thompson, Jo Ann; Foran-Mulcahy, Katie; Abafo, Amy

    2016-01-01

    A two-semester-long interdisciplinary support effort to improve student posters in organic chemistry lab is described. In the first semester, students' literature search report is supported by a workshop conducted by an Instruction Librarian. During the subsequent semester, a second workshop is presented by the Instruction Librarian, an English…

  19. The performance implications of outsourcing customer support to service providers in emerging versus established economies

    NARCIS (Netherlands)

    Raassens, N.; Wuyts, S.H.K.; Geyskens, I.

    Recent discussions in the business press query the contribution of customer-support outsourcing to firm performance. Despite the controversy surrounding its performance implications, customer-support outsourcing is still on the rise, especially to emerging markets. Against this backdrop, we study

  20. Transition from failing dentition to full-arch fixed implant-supported prosthesis with a staged approach using removable partial dentures: a case series.

    Science.gov (United States)

    Cortes, Arthur Rodriguez Gonzalez; Cortes, Djalma Nogueira; No-Cortes, Juliana; Arita, Emiko Saito

    2014-06-01

    The present retrospective case series is aimed at evaluating a staged approach using a removable partial denture (RPD) as an interim prosthesis in treatment to correct a failing dentition until such time as a full-arch fixed implant-supported prosthesis may be inserted. Eight patients, who had undergone maxillary full-arch rehabilitation with dental implants due to poor prognosis of their dentitions, were analyzed. All treatment included initial periodontal therapy and a strategic order of extraction of hopeless teeth. An RPD supported by selected teeth rehabilitated the compromised arch during implant osseointegration. These remaining teeth were extracted prior to definitive prosthesis delivery. Advantages and drawbacks of this technique were also recorded for the cases presented. Among the advantages provided by the staged approach are simplicity of fabrication, low cost, and ease of insertion. Additionally, RPD tooth support prevented contact between the interim prosthesis and healing abutments, promoting implant osseointegration. The main drawbacks were interference with speech and limited esthetic results. Implant survival rate was 100% within a follow-up of at least 1 year. The use of RPDs as interim prostheses allowed for the accomplishment of the analyzed rehabilitation treatments. It is a simple treatment alternative for patients with a low smile line. © 2013 by the American College of Prosthodontists.

  1. Comparison of partial least squares and support vector regressions for predicting leaf area index on a tropical grassland using hyperspectral data

    Science.gov (United States)

    Kiala, Zolo; Odindi, John; Mutanga, Onisimo; Peerbhay, Kabir

    2016-07-01

    Leaf area index (LAI) is a key biophysical parameter commonly used to determine vegetation status, productivity, and health in tropical grasslands. Accurate LAI estimates are useful in supporting sustainable rangeland management by providing information related to grassland condition and associated goods and services. The performance of support vector regression (SVR) was compared to partial least square regression (PLSR) on selected optimal hyperspectral bands to detect LAI in heterogeneous grassland. Results show that PLSR performed better than SVR at the beginning and end of summer. At the peak of the growing season (mid-summer), during reflectance saturation, SVR models yielded higher accuracies (R2=0.902 and RMSE=0.371 m2 m-2) than PLSR models (R2=0.886 and RMSE=0.379 m2 m-2). For the combined dataset (all of summer), SVR models were slightly more accurate (R2=0.74 and RMSE=0.578 m2 m-2) than PLSR models (R2=0.732 and RMSE=0.58 m2 m-2). Variable importance on the projection scores show that most of the bands were located in the near-infrared and shortwave regions of the electromagnetic spectrum, thus providing a basis to investigate the potential of sensors on aerial and satellite platforms for large-scale grassland LAI prediction.

  2. A Digital Framework to Support Providers and Patients in Diabetes Related Behavior Modification.

    Science.gov (United States)

    Abidi, Samina; Vallis, Michael; Piccinini-Vallis, Helena; Imran, Syed Ali; Abidi, Syed Sibte Raza

    2017-01-01

    We present Diabetes Web-Centric Information and Support Environment (D-WISE) that features: (a) Decision support tool to assist family physicians to administer Behavior Modification (BM) strategies to patients; and (b) Patient BM application that offers BM strategies and motivational interventions to engage patients. We take a knowledge management approach, using semantic web technologies, to model the social cognition theory constructs, Canadian diabetes guidelines and BM protocols used locally, in terms of a BM ontology that drives the BM decision support to physicians and BM strategy adherence monitoring and messaging to patients. We present the qualitative analysis of D-WISE usability by both physicians and patients.

  3. Biomechanical comparison of two different collar structured implants supporting 3-unit fixed partial denture: a 3-D FEM study.

    Science.gov (United States)

    Meriç, Gökçe; Erkmen, Erkan; Kurt, Ahmet; Eser, Atilim; Ozden, Ahmet Utku

    2012-01-01

    The purpose of the study was to compare the effects of two distinct collar geometries of implants on stress distribution in the bone as well as in the fixture-abutment complex, in the framework and in the veneering material of 3-unit fixed partial denture (FPD). The 3-dimensional finite element analysis method was selected to evaluate the stress distribution in the system composed of 3-unit FPD supported by two different dental implant systems with two distinct collar geometries; microthread collar structure (MCS) and non-microthread collar structure (NMCS). In separate load cases, 300 N vertical, 150 N oblique and 60 N horizontal, forces were utilized to simulate the multidirectional chewing forces. Tensile and compressive stress values in the cortical and cancellous bone and von Mises stresses in the fixture-abutment complex, in the framework and veneering material, were simulated as a body and investigated separately. In the cortical bone lower stress values were found in the MCS model, when compared with NMCS. In the cancellous bone, lower stress values were observed in the NMCS model when compared with MCS. In the implant-abutment complex, highest von Mises stress values were noted in the NMCS model; however, in the framework and veneering material, highest stress values were calculated in MCS model. MCS implants when compared with NMCS implants supporting 3-unit FPDs decrease the stress values in the cortical bone and implant-abutment complex. The results of the present study will be evaluated as a base for our ongoing FEA studies focused on stress distribution around the microthread and non-microthread collar geometries with various prosthesis design.

  4. Oral health-related quality of life in patients treated by implant-supported fixed dentures and removable partial dentures.

    Science.gov (United States)

    Furuyama, Chisako; Takaba, Masayuki; Inukai, Mika; Mulligan, Roseann; Igarashi, Yoshimasa; Baba, Kazuyoshi

    2012-08-01

    This study investigated the association between denture status [implant-supported fixed dentures (IDs) and removable partial dentures (RPDs)] and oral health-related quality of life (OHRQoL). Consecutive patients with IDs and RPDs were recruited from the Prosthodontics Departments at Showa University and Tokyo Medical and Dental University. The Japanese version of the Oral Health Impact Profile (OHIP-J-49) was administered to each subject. For each OHIP-J-49 question, the subjects were asked to indicate the frequency with which they had experienced a dental problem during the last month. Responses were recorded on a 5 point Likert rating scale, with 0 being never and 4, very often. Summary scores were calculated and regression analyses conducted to investigate the association between denture status and OHIP-J-49 summary score. In total 79 ID subjects (mean age±SD of 51.7±12.4 years, 44.3% men) and 109 RPD subjects (mean age of 66.5±8.6 years, 30% men) participated after giving informed consent. The regression analysis between the type of treatment and the OHIP-J-49 summary score revealed a significant association with a coefficient of 17.0 (Confidence interval, CI: 10.9-23.1). When age and duration of denture usage, which had significant associations with OHIP-J-49, were included in this model, the regression coefficient remained virtually unchanged at 17.4 (CI: 9.75-25.0), thus indicating little potential confounding by them. OHRQoL in patients with implant-supported fixed dentures is generally less impaired than it is in those patients with RPDs. © 2011 John Wiley & Sons A/S.

  5. PTC test bed upgrades to provide ACSES testing support capabilities at transportation technology center.

    Science.gov (United States)

    2015-06-01

    FRA Task Order 314 upgraded the Positive Train Control (PTC) Test Bed at the Transportation Technology Center to support : testing of PTC systems, components, and related equipment associated with the Advanced Civil Speed Enforcement System : (ACSES)...

  6. Should Sabbath Prohibitions Be Overridden to Provide Emotional Support to a Sick Relative?

    National Research Council Canada - National Science Library

    Greenberger, Chaya; Mor, Pnina

    2016-01-01

    .... It specifically addresses the permissibility of traveling in a motorized vehicle, generally prohibited on the Sabbath, to be with one's relative in hospital for the provision of emotional support...

  7. Support options provided and required for modeling with DynaLearn - A case study

    NARCIS (Netherlands)

    Or-Bach, R.; Bredeweg, B.

    2013-01-01

    Science educators strongly advocate the importance of scientific modeling within science education. Although widely advocated for students, modeling is a complex task involving integration of topics, "languages" and abstraction levels. Thus support for the modeling task and for developing modeling

  8. Spontaneously Breathing Extracorporeal Membrane Oxygenation Support Provides the Optimal Bridge to Lung Transplantation.

    Science.gov (United States)

    Schechter, Matthew Adam; Ganapathi, Asvin M; Englum, Brian R; Speicher, Paul J; Daneshmand, Mani A; Davis, R Duane; Hartwig, Matthew G

    2016-12-01

    Extracorporeal membrane oxygenation (ECMO) is being increasingly used as a bridge to lung transplantation. Small, single-institution series have described increased success using ECMO in spontaneously breathing patients compared with patients on ECMO with mechanical ventilation, but this strategy has not been evaluated on a large scale. Using the United Network for Organ Sharing database, all adult patients undergoing isolated lung transplantation from May 2005 through September 2013 were identified. Patients were categorized by their type of pretransplant support: no support, ECMO only, invasive mechanical ventilation (iMV) only, and ECMO + iMV. Kaplan-Meier survival analysis with log-rank testing was performed to compare survival based on type of preoperative support. A Cox regression model was used to determine whether type of preoperative support was independently associated with survival, using previously established predictors of survival as covariates. Approximately 12,403 primary adult pulmonary transplantations were included in this analysis. Sixty-five patients (0.52%) were on ECMO only, 612 (4.93%) required only iMV, 119 (0.96%) were on ECMO + iMV, and the remaining 11,607 (94.6%) required no invasive support before transplantation. One-year survival was decreased in all patients requiring support, regardless of type. However, mid-term survival was similar between patients on ECMO alone and those not on support but significantly worse with patients requiring iMV only or ECMO + iMV. In multivariable analysis, ECMO + iMV and iMV alone were independently associated with decreased survival compared with nonsupport patients, whereas ECMO alone was not significant. In patients with worsening pulmonary disease awaiting lung transplantation, those supported via ECMO with spontaneous breathing demonstrated improved survival compared with other bridging strategies.

  9. Language facilitates event memory in early childhood: Child comprehension, adult-provided linguistic support and delayed recall at 16 months.

    Science.gov (United States)

    Lukowski, Angela F; Phung, Janice N; Milojevich, Helen M

    2015-01-01

    Adult-provided supportive language facilitates memory for the past in preverbal and verbal children. Work conducted with 18-month-olds indicates that children benefit from supportive adult language when tested after a 4-week delay but not when tested immediately after sequence demonstration; moreover, findings reveal that supportive language provided only at test may be more facilitative of recall after a delay relative to supportive language provided only at encoding. In the present study, we examined whether child language comprehension abilities moderated the extent to which preverbal children benefitted from supportive language provided at encoding and test. The findings indicated that child language comprehension and supportive language provided at encoding were unassociated with performance at baseline or immediate imitation; however, the moderating effect of child language comprehension on adult-provided supportive language at encoding and test was observed after a 1-week delay. Correlations revealed continuous associations between general comprehension scores and recall performance after the 1-week delay on sequences presented in the most supportive condition at encoding. Taken together, the presented findings reveal that the complex interplay between language and cognition is established in early childhood, with foundational relations emerging before children are capable of verbally reporting on the past.

  10. Factors that influence evidence-based program sustainment for family support providers in child protection services in disadvantaged communities.

    Science.gov (United States)

    Hodge, Lauren M; Turner, Karen M T; Sanders, Matthew R; Forster, Michell

    2017-08-01

    This paper evaluates program, workplace and process factors associated with implementation and sustainment of an evidence-based parenting support program (EBP) in disadvantaged communities. Correlation analyses and binary logistic regressions were used to assess the associations between key implementation support factors and program implementation (at 18 months) and sustainment (at 36 months) post training with (N=35) Australian Aboriginal and Torres Strait Islander family support providers using the Triple P - Positive Parenting Program in Indigenous child protection agencies. This study demonstrated that for implementation at 18 months, there was a trend for implementing providers to report higher levels of partnership support, perceived program benefit, workplace support and workplace cohesion. However, the only significant relationship was with partnership support (r=.31 pprogram implementation. For sustained implementation at 36 months, no relationship was found between sustainment and program characteristics, workplace characteristics, supervision and peer support or sustainability planning. Supportive coaching was the only significant correlate (r=0.46, pp=0.009] in the program sustainment model. Overall, these findings suggest the need for further exploration of program and workplace variables and provide evidence to consider incorporating partnership support and supportive coaching in real world implementation models to improve the likelihood of EBP implementation and sustainment in Indigenous communities. Copyright © 2017 Elsevier Ltd. All rights reserved.

  11. Simulating partially illegal markets of private tanker water providers on the country level: A multi-agent, hydroeconomic case-study of Jordan

    Science.gov (United States)

    Klassert, C. J. A.; Yoon, J.; Gawel, E.; Klauer, B.; Sigel, K.; Talozi, S.; Lachaut, T.; Selby, P. D.; Knox, S.; Gorelick, S.; Tilmant, A.; Harou, J. J.; Mustafa, D.; Medellin-Azuara, J.; Rajsekhar, D.; Avisse, N.; Zhang, H.

    2016-12-01

    In arid countries around the world, markets of private small-scale water providers, mostly delivering water via tanker trucks, have emerged to balance the shortcomings of public water supply systems. While these markets can provide substantial contributions to meeting customers' water demands, they often partially rely on illegal water abstractions, thus imposing an unregulated and unmonitored strain on ground and surface water resources. Despite their important impacts on water users' welfare and resource sustainability, these markets are still poorly understood. We use a multi-agent, hydroeconomic simulation model, developed as part of the Jordan Water Project, to investigate the role of these markets in a country-wide case-study of Jordan. Jordan's water sector is characterized by a severe and growing scarcity of water resources, high intermittency in the public water network, and a strongly increasing demand due to an unprecedented refugee crisis. The tanker water market serves an important role in providing water from rural wells to households and commercial enterprises, especially during supply interruptions. In order to overcome the lack of direct data about this partially illegal market, we simulate demand and supply for tanker water. The demand for tanker water is conceptualized as a residual demand, remaining after a water user has depleted all available cheap and qualitatively reliable piped water. It is derived from residential and commercial demand functions on the basis of survey data. Tanker water supply is determined by farm simulation models calculating the groundwater pumping cost and the agricultural opportunity cost of tanker water. A market algorithm is then used to match rural supplies with users' demands, accounting for survey data on tanker operators' transport costs and profit expectations. The model is used to gain insights into the size of the tanker markets in all 89 subdistricts of Jordan and their responsiveness to various policy

  12. The emotional impact of errors or adverse events on healthcare providers in the NICU: The protective role of coworker support.

    Science.gov (United States)

    Winning, Adrien M; Merandi, Jenna M; Lewe, Dorcas; Stepney, Lois M C; Liao, Nancy N; Fortney, Christine A; Gerhardt, Cynthia A

    2017-07-26

    To examine the impact of errors or adverse events on emotional distress and professional quality of life in healthcare providers in the neonatal intensive care unit, and the moderating role of coworker support. Errors or adverse events can result in negative outcomes for healthcare providers. However, the role of coworker support in improving emotional and professional outcomes has not been examined. A cross-sectional online survey from a quality improvement initiative to train peer supporters in a neonatal intensive care unit. During 2015, 463 healthcare providers in a neonatal intensive care unit completed a survey assessing their experiences with an error or adverse event, anxiety, depression, professional quality of life and coworker support. Compared with those who did not experience an error or adverse event (58%), healthcare providers who observed (23%) or were involved (19%) in an incident reported higher levels of anxiety and secondary traumatic stress. Those who were involved in an event reported higher levels of depression and burnout. Differences between the three groups (no event, observation and involvement) for compassion satisfaction were non-significant. Perceived coworker support moderated the association between experiencing an event and both anxiety and depression. Specifically, experiencing an event was associated with higher levels of anxiety and depression when coworkers were perceived as low in supportiveness, but not when they were viewed as highly supportive. Findings suggest that errors or adverse events can have a harmful impact on healthcare providers and that coworker support may reduce emotional distress. © 2017 John Wiley & Sons Ltd.

  13. Does Vicarious Instigation Provide Support for Observational Learning Theories? A Critical Review.

    Science.gov (United States)

    Green, Gina; Osborne, J. Grayson

    1985-01-01

    Examines the theories of Aronfreed, Bandura, Berger, and Hygge. Also reviews experimental evidence published since 1962 which supports theories of observational learning of emotional behavior. While the theories posit that different conditions are necessary to vicarious instigation, most research does not test the theories in any direct way.…

  14. Potential For Plug-In Electric Vehicles To Provide Grid Support Services

    Energy Technology Data Exchange (ETDEWEB)

    Dias, F. G.; Luo, Y.; Mohanpurkar, M.; Hovsapian, R.; Scoffield, D.

    2017-04-01

    Since the modern-day introduction of plug-in electric vehicles (PEVs), scientists have proposed leveraging PEV battery packs as distributed energy resources for the electric grid. PEV charging can be controlled not only to provide energy for transportation but also to provide grid services and to facilitate the integration of renewable energy generation. With renewable generation increasing at an unprecedented rate, most of which is non-dispatchable and intermittent, the concept of using PEVs as controllable loads is appealing to electric utilities. This additional functionality could also provide value to PEV owners and drive PEV adoption. It has been widely proposed that PEVs can provide valuable grid services, such as load shifting to provide voltage regulation. The objective this work is to address the degree to which PEVs can provide grid services and mutually benefit the electric utilities, PEV owners, and auto manufacturers.

  15. Providing Staff Training and Programming to Support People with Disabilities: An Academic Library Case Study

    Science.gov (United States)

    Brannen, Michelle H.; Milewski, Steven; Mack, Thura

    2017-01-01

    This case study explores services academic libraries provide to students with disabilities and the impact these can have on the success and experience of these students. The study focuses on staff training and outreach programming. The authors examine the academic library literature surrounding these topics, provide examples of programming…

  16. Child Care Providers' Strategies for Supporting Healthy Eating: A Qualitative Approach

    Science.gov (United States)

    Lynch, Meghan; Batal, Malek

    2012-01-01

    Recent research has revealed child care settings and providers to be important influences on children's developing behaviors. Yet most research on children's nutritional development has focused on home settings and parents. Thus, through semistructured interviews with child care providers, this study aimed to develop a better understanding of the…

  17. A new hat for librarians: providing REDCap support to establish the library as a central data hub.

    Science.gov (United States)

    Read, Kevin; LaPolla, Fred Willie Zametkin

    2018-01-01

    REDCap, an electronic data capture tool, supports good research data management, but many researchers lack familiarity with the tool. While a REDCap administrator provided technical support and a clinical data management support unit provided study design support, a service gap existed. Librarians with REDCap expertise sought to increase and improve usage through outreach, workshops, and consultations. In collaboration with a REDCap administrator and the director of the clinical data management support unit, the role of the library was established in providing REDCap training and consultations. REDCap trainings were offered to the medical center during the library's quarterly data series, which served as a springboard for offering tailored REDCap support to researchers and research groups. Providing REDCap support has proved to be an effective way to associate the library with data-related activities in an academic medical center and identify new opportunities for offering data services in the library. By offering REDCap services, the library established strong partnerships with the Information Technology Department, Clinical Data Support Department, and Compliance Office by filling in training gaps, while simultaneously referring users back to these departments when additional expertise was required. These new partnerships continue to grow and serve to position the library as a central data hub in the institution.

  18. Current practice and knowledge of oral care for cancer patients: a survey of supportive health care providers

    NARCIS (Netherlands)

    Barker, Gerry J.; Epstein, Joel B.; Williams, Karen B.; Gorsky, Meir; Raber-Durlacher, Judith E.

    2005-01-01

    The Oral Care Study Section of the Multinational Association of Supportive Care in Cancer (MASCC) and the International Society for Oral Oncology (ISOO) conducted a survey on clinical practices of oral/dental management of cancer patients among supportive health care providers. The main purpose was

  19. The Relationship between Environmental Turbulence, Management Support, Organizational Collaboration, Information Technology Solution Realization, and Process Performance, in Healthcare Provider Organizations

    Science.gov (United States)

    Muglia, Victor O.

    2010-01-01

    The Problem: The purpose of this study was to investigate relationships between environmental turbulence, management support, organizational collaboration, information technology solution realization, and process performance in healthcare provider organizations. Method: A descriptive/correlational study of Hospital medical services process…

  20. Reframing cooperation: Challenges in overcoming tensions between professional services and volunteer organizations providing parenting support in immigrant communities

    NARCIS (Netherlands)

    Ponzoni, E.

    2015-01-01

    Volunteer organizations can potentially partner with mainstream professional services to provide better parenting support to immigrant parents. This qualitative study of cooperation between professional agencies and volunteer organizations known as migrant volunteer and community organizations

  1. A Reference Architecture for Providing Tools as a Service to Support Global Software Development

    DEFF Research Database (Denmark)

    Chauhan, Aufeef

    2014-01-01

    -based solutions. The restricted ability of the organizations to have desired alignment of tools with software engineering and development processes results in administrative and managerial overhead that incur increased development cost and poor product quality. Moreover, stakeholders involved in the projects have......Global Software Development (GSD) teams encounter challenges that are associated with distribution of software development activities across multiple geographic regions. The limited support for performing collaborative development and engineering activities and lack of sufficient support...... specific constraints regarding availability and deployments of the tools. The artifacts and data produced or consumed by the tools need to be governed according to the constraints and corresponding quality of service (QoS) parameters. In this paper, we present the research agenda to leverage cloud...

  2. Training Veterans to Provide Peer Support in a Weight-Management Program: MOVE!

    OpenAIRE

    Allicock, Marlyn; Haynes-Maslow, Lindsey; Carr, Carol; Orr, Melinda; Kahwati, Leila C; Weiner, Bryan J.; Kinsinger, Linda

    2013-01-01

    Introduction The Veterans Health Administration (VHA) has implemented MOVE!, a weight-management program for veterans designed to address the increasing proportion of overweight and obese veterans. The objective of our study was to determine whether peer support employing motivational interviewing (MI) could positively influence lifestyle changes, thus expanding the reach of the MOVE! program. We describe the initial evaluation of the peer training program. Methods We developed an MI peer cou...

  3. Providing effective support to “deep democracy”:  how can it realistically be done?

    Directory of Open Access Journals (Sweden)

    Jean Bossuyt

    2014-02-01

    Full Text Available Martin Dahinden’s article on “Democracy Promotion at the local level: Experiences, Perspectives and Policy of Swiss International Cooperation” comes at the right time. Democracy promotion is not a new topic on the agenda of the international (European community. Since the democratisation wave of the early 1990s that swept across the developing world, a wide range of donor-supported programmes, mobilising substantial funds, have sought to build institutions and nurture democratic values in hu...

  4. Influence of connection type on the biomechanical behavior of distal extension mandibular removable partial dentures supported by implants and natural teeth.

    Science.gov (United States)

    Xiao, Wei; Li, Zhiyong; Shen, Shiqian; Chen, Shaowu; Chen, Sulin; Wang, Jiawei

    2016-02-01

    Few studies are performed to evaluate the influence of connection type on the stress distribution of distal extension mandibular removable partial dentures (RPDs) supported by both implants and natural teeth. In this study, five three-dimensional finite element models were prepared to simulate mandibular bilateral partially edentulous arches. Four were RPDs supported by both implants and natural teeth, and the other one was RPDs supported only by natural teeth. The maximum equivalent (EQV) stress values of bone around implants, the abutments, and the mucosa displacements of the related supporting structures were measured. It was found that a non-rigid telescopic coping was more favorable to protect the implant than a rigid telescopic coping. Compared with other connection types, the easy resilient attachment (ERA) system seemed to be effective to associate implant without complications. However, the results obtained in the present study should be cautiously interpreted in the clinic.

  5. Providing support for problem-based learning in dentistry: the Manchester experience.

    Science.gov (United States)

    Hoad-Reddick, Gillian; Theaker, Elizabeth

    2003-02-01

    The introduction of problem-based learning (PBL) into any programme demands a period of adjustment on the part of faculty. Similarly, students new to PBL take time to adapt to what is, for the majority of them, an unfamiliar mode of learning. At Manchester, closed loop PBL is used throughout the first and second years of the dental programme; the method is interdisciplinary; there are no subject boundaries. Dental students work in groups of between 10 and 15, facilitated by a tutor from the Department of Biological Sciences, to research topics and share information in a mutually supportive environment. Each week a different problem forms the focus for learning. In this paper, we seek to describe the measures introduced in response to student feedback collected via routine meetings with the senior tutor, after meetings with their academic or personal tutors and through discussion at the staff students' committee, which we at Manchester have taken to facilitate the process of adaptation to PBL. Changes have been made in the areas of recruitment, pre-admission interviewing, induction (development of an induction booklet and communication skills module) and tutorial support (overhaul of personal tutor system and introduction of peer-assisted study (PAS) and personal and academic development programmes (PADPs)). Feedback on these changes, gathered via the routes described above, has been positive and continues to be central to our processes of development in these areas. Although the various ways in which PBL has been implemented worldwide may place limits on the transferability of our methods, this paper serves to illustrate some of the means available to support students in the transition to self-directed learning. The latter is not only an essential component of PBL but also something we should be seeking to foster in all students, no matter what philosophy and method of course delivery are utilized.

  6. A programmable rules engine to provide clinical decision support using HTML forms.

    Science.gov (United States)

    Heusinkveld, J; Geissbuhler, A; Sheshelidze, D; Miller, R

    1999-01-01

    The authors have developed a simple method for specifying rules to be applied to information on HTML forms. This approach allows clinical experts, who lack the programming expertise needed to write CGI scripts, to construct and maintain domain-specific knowledge and ordering capabilities within WizOrder, the order-entry and decision support system used at Vanderbilt Hospital. The clinical knowledge base maintainers use HTML editors to create forms and spreadsheet programs for rule entry. A test environment has been developed which uses Netscape to display forms; the production environment displays forms using an embedded browser.

  7. Providing Open-Access Know How for Directors of Quantitative and Mathematics Support Centers

    OpenAIRE

    Michael Schuckers; Mary B. O'Neill; Grace Coulombe

    2017-01-01

    The purpose of this editorial is to introduce the quantitative literacy community to the newly published A Handbook for Directors of Quantitative and Mathematics Centers. QMaSCs (pronounced “Q-masks”) can be broadly defined as centers that have supporting students in quantitative fields of study as part of their mission. Some focus only on calculus or mathematics; others concentrate on numeracy or quantitative literacy, and some do all of that. A QMaSC may be embedded in a mathematics departm...

  8. Workshop for Early Career Geoscience Faculty: Providing resources and support for new faculty to succeed

    Science.gov (United States)

    Hill, T. M.; Beane, R. J.; Macdonald, H.; Manduca, C. A.; Tewksbury, B. J.; Allen-King, R. M.; Yuretich, R.; Richardson, R. M.; Ormand, C. J.

    2015-12-01

    A vital strategy to educate future geoscientists is to support faculty at the beginning of their careers, thus catalyzing a career-long impact on the early-career faculty and on their future students. New faculty members are at a pivotal stage in their careers as they step from being research-focused graduate students and post-doctoral scholars, under the guidance of advisors, towards launching independent careers as professors. New faculty commonly, and not unexpectedly, feel overwhelmed as they face challenges to establish themselves in a new environment, prepare new courses, begin new research, and develop a network of support. The workshop for Early Career Geoscience Faculty: Teaching, Research, and Managing Your Career has been offered annually in the U.S. since 1999. The workshop is currently offered through the National Association of Geoscience Teachers On the Cutting Edge professional development program with support from the NSF, AGU and GSA. This five-day workshop, with associated web resources, offers guidance for incorporating evidence-based teaching practices, developing a research program, and managing professional responsibilities in balance with personal lives. The workshop design includes plenary and concurrent sessions, individual consultations, and personalized feedback from workshop participants and leaders. Since 1999, more than 850 U.S. faculty have attended the Early Career Geoscience Faculty workshop. Participants span a wide range of geoscience disciplines, and are in faculty positions at two-year colleges, four-year colleges, comprehensive universities and research universities. The percentages of women (~50%) and underrepresented participants (~8%) are higher than in the general geoscience faculty population. Multiple participants each year are starting positions after receiving all or part of their education outside the U.S. Collectively, participants report that they are better prepared to move forward with their careers as a result of

  9. Vaccination with a novel recombinant Leishmania antigen plus MPL provides partial protection against L. donovani challenge in experimental model of visceral leishmaniasis.

    Science.gov (United States)

    Bhardwaj, Suvercha; Vasishta, R K; Arora, Sunil K

    2009-01-01

    The acquisition of immunity following subclinical or resolved infection with the intracellular parasite Leishmania donovani suggests that vaccination could prevent visceral leishmaniasis. The characteristics and in vitro stimulating capability of the recombinant proteins expressed by previously identified clones on the basis of their capacity to stimulate an indigenously established Leishmania-specific cell line leading to high level of IFN-gamma suggested these to be potential candidates for immunoprophylaxis against leishmaniasis. In this study, we investigated the protective efficacy of purified recombinant proteins from two of the identified cDNA clones along with the adjuvant MPL, in a hamster model of experimental leishmaniasis. We demonstrate here that the immunization of animals with one of the recombinant proteins (rF14) having 97% similarity to C1 clone of L. chagasi ribosomal protein gene P0 (rLiP0) along with MPL provided partial protection against the virulent challenge of L. donovani. The absence of antigen-specific lymphoproliferative responses in these immunized animals may be responsible for the lack of complete and long-lasting protection.

  10. The Anterior Thalamus Provides A Subcortical Circuit Supporting Memory And Spatial Navigation

    Directory of Open Access Journals (Sweden)

    Shane M O‘Mara

    2013-08-01

    Full Text Available The anterior thalamic nuclei, a central component of Papez’ circuit, are generally assumed to be key constituents of the neural circuits responsible for certain categories of learning and memory. Supporting evidence for this contention is that damage to either of two brain regions, the medial temporal lobe and the medial diencephalon, is most consistently associated with anterograde amnesia. Within these respective regions, the hippocampal formation and the anterior thalamic nuclei (anteromedial, anteroventral, anterodorsal are the particular structures of interest. The extensive direct and indirect hippocampal-anterior thalamic interconnections and the presence of theta-modulated cells in both sites further support the hypothesis that these structures constitute a neuronal network crucial for memory and cognition. The major tool in understanding how the brain processes information is the analysis of neuronal output at each hierarchical level along the pathway of signal propagation coupled with neuroanatomical studies. Here, we discuss the electrophysiological properties of cells in the anterior thalamic nuclei with an emphasis on their role in spatial navigation. In addition, we describe neuroanatomical and functional relationships between the anterior thalamic nuclei and hippocampal formation.

  11. Fostering a supportive moral climate for health care providers: Toward cultural safety and equity

    Directory of Open Access Journals (Sweden)

    Adel F. Almutairi

    Full Text Available In Western forms of health care delivery around the globe, research tells us that nurses experience excessive workloads as they face increasingly complex needs in the populations they serve, professional conflicts, and alienation from leadership in health care bureaucracies. These problems are practical and ethical as well as cultural. Cultural conflicts can arise when health care providers and the populations they serve come from diverse economic, ethnic, and cultural backgrounds. The purpose in this paper is to draw from Almutairi’s research with health care teams in Saudi Arabia to show the complexity of culturally and morally laden interactions between health care providers and patients and their families. Then, I will argue for interventions that promote social justice and cultural safety for nurses, other health care providers, and the individuals, families, and communities they serve. This will include addressing international implications for nursing practice, leadership, policy and research. Keywords: Moral climate, Social justice, Equity, Cultural diversity

  12. Effect of framework material and vertical misfit on stress distribution in implant-supported partial prosthesis under load application: 3-D finite element analysis.

    Science.gov (United States)

    Bacchi, Ataís; Consani, Rafael Leonardo Xediek; Mesquita, Marcelo Ferraz; Dos Santos, Mateus Bertolini Fernandes

    2013-09-01

    This study evaluated the influence of framework material and vertical misfit on stress created in an implant-supported partial prosthesis under load application. The posterior part of a severely reabsorbed jaw with a fixed partial prosthesis above two osseointegrated titanium implants at the place of the second premolar and second molar was modeled using SolidWorks 2010 software. Finite element models were obtained by importing the solid model into an ANSYS Workbench 11 simulation. The models were divided into 15 groups according to their prosthetic framework material (type IV gold alloy, silver-palladium alloy, commercially pure titanium, cobalt-chromium alloy or zirconia) and vertical misfit level (10 µm, 50 µm and 100 µm). After settlement of the prosthesis with the closure of the misfit, simultaneous loads of 110 N vertical and 15 N horizontal were applied on the occlusal and lingual faces of each tooth, respectively. The data was evaluated using Maximum Principal Stress (framework, porcelain veneer and bone tissue) and a von Mises Stress (retention screw) provided by the software. As a result, stiffer frameworks presented higher stress concentrations; however, these frameworks led to lower stresses in the porcelain veneer, the retention screw (faced to 10 µm and 50 µm of the misfit) and the peri-implant bone tissues. The increase in the vertical misfit resulted in stress values increasing in all of the prosthetic structures and peri-implant bone tissues. The framework material and vertical misfit level presented a relevant influence on the stresses for all of the structures evaluated.

  13. Predictors of Quality and Commitment in Family Child Care: Provider Education, Personal Resources, and Support.

    Science.gov (United States)

    Weaver, Ruth Harding

    2002-01-01

    Examined the personal characteristics and resources in 65 licensed family child care providers' lives that influence developmentally enhancing caregiving and professional commitment. Unique predictors to higher quality of care were higher levels of formal education and training, college coursework in early childhood education, higher psychological…

  14. Beyond the Clinic: Providing Services, Supports, and Connections to Help Children and Their Families Thrive

    Science.gov (United States)

    Nolan, Kevin J., Jr.

    2013-01-01

    As one of the premier pediatric hospitals in the United States, Boston Children's Hospital serves a wide range of children and provides top quality medical care, including a program for deaf and hard of hearing children that extends services beyond the medical scope. Within this program is a unique and particularly critical position--that of…

  15. Providing Social Enterprises with Better Access to Public Procurement : The Development of Supportive Legal Frameworks

    NARCIS (Netherlands)

    Argyrou, A.

    2017-01-01

    This article discusses the issue of social enterprises gaining access to public procurement processes and contracts at the EU and national level. It primarily examines the opportunities for social enterprises to access public procurement contracts provided for in the Public Procurement Directive

  16. Views on Logistics, Candid Voices, Providing Responsive Logistics Support: Applying LEAN Thinking to Logistics

    Science.gov (United States)

    1999-10-01

    repair, production, transportation, etc.) must provide customers with what they need when they need it. It must also minimize the cost to the customer . What...repair, produce or purchase things based on forecasted demands. However, in order to minimize the cost to the customer , the logistics system must repair

  17. Providing a Supportive Alternative Education Environment for At-Risk Students

    Science.gov (United States)

    McGee, John J.; Lin, Fan-Yu

    2017-01-01

    Many factors cause student disengagement from school that subsequently result in high dropout rates. Alternative education (AE) programs provide a different pathway for at-risk youths who do not meet the goals, standards, and requirements of traditional educational settings. However, educational agencies have vastly different interpretations…

  18. Parenting During Residency: Providing Support for Dr Mom and Dr Dad.

    Science.gov (United States)

    Morris, Laura; Cronk, Nikole J; Washington, Karla T

    2016-02-01

    Parenting during family medicine residency is increasingly common. Relatively little is known about how the competing demands of work and family life affect residents. We conducted an exploratory qualitative study of parenting family medicine residents at one program in the Midwest utilizing focus groups to understand residents' perceptions of the positive and negative characteristics of their roles as physicians and parents. We used consensus coding to identify themes in the data and then developed a model to illustrate the relationships among the identified themes. Competing demands on their time require parenting family medicine residents to often make difficult choices, which result in both positive and negative outcomes for residents, their families, and their residency experience. Parenting family medicine residents experience numerous conflicts in their concurrent roles of learner, physician, and parent. Parenting-friendly residency training programs would likely offer valuable support for these individuals during this stressful life period.

  19. Using e-Coaching to Support an Early Intervention Provider's Implementation of a Functional Assessment-Based Intervention

    Science.gov (United States)

    Fettig, Angel; Barton, Erin E.; Carter, Alice S.; Eisenhower, Abbey S.

    2016-01-01

    This study examined the effects of e-coaching on the implementation of a functional assessment-based intervention delivered by an early intervention provider in reducing challenging behaviors during home visits. A multiple baseline design across behavior support plan components was used with a provider-child dyad. The e-coaching intervention…

  20. Use of an Online Community to Provide Support to Caregivers of People With Dementia

    OpenAIRE

    Pagán-Ortiz, Marta E.; Dharma E. Cortés; Rudloff, Noelle; Weitzman, Patricia; Levkoff, Sue

    2014-01-01

    One challenge faced by many family members caring for persons with dementia is lack of information about how to take care of others and themselves. This is especially important for persons from ethnic minority groups, since linguistically and culturally appropriate information is often not available. In response to these needs, we developed a website for Spanish-speaking caregivers. Cuidatecuidador.com provides bilingual information on dementia and caregiver issues. Content was developed and ...

  1. Development of an online information and support resource for adolescent idiopathic scoliosis patients considering surgery: perspectives of health care providers

    Directory of Open Access Journals (Sweden)

    Nicholas David

    2010-06-01

    Full Text Available Abstract Background Adolescents with idiopathic scoliosis who are considering spinal surgery face a major decision that requires access to in-depth information and support. Unfortunately, most online resources provide incomplete and inconsistent information and minimal social support. The aim of this study was to develop an online information and support resource for adolescent idiopathic scoliosis (AIS patients considering spinal surgery. Prior to website development, a user-based needs assessment was conducted. The needs assessment involved a total of six focus groups with three stakeholder groups: (1 post-operative AIS patients or surgical candidates (10-18 years (n = 11, (2 their parents (n = 6 and (3 health care providers (n = 11. This paper reports on the findings from focus groups with health care providers. Methods Focus group methodology was used to invite a range of perspectives and stimulate discussion. During audio-recorded focus groups, an emergent table of website content was presented to participants for assessment of relevance, viability and comprehensiveness in targeting global domains of need. Specifically, effective presentation of content, desired aspects of information and support, and discussions about the value of peer support and the role of health professionals were addressed. Focus group transcripts were then subject to content analysis through a constant comparative review and analysis. Results Two focus groups were held with health care providers, consisting of 5 and 6 members respectively. Clinicians provided their perceptions of the information and support needs of surgical patients and their families and how this information and support should be delivered using internet technology. Health care providers proposed four key suggestions to consider in the development of this online resource: (1 create the website with the target audience in mind; (2 clearly state the purpose of the website and organize website content

  2. Development of an online information and support resource for adolescent idiopathic scoliosis patients considering surgery: perspectives of health care providers.

    Science.gov (United States)

    Macculloch, Radha; Nyhof-Young, Joyce; Nicholas, David; Donaldson, Sandra; Wright, James G

    2010-06-29

    Adolescents with idiopathic scoliosis who are considering spinal surgery face a major decision that requires access to in-depth information and support. Unfortunately, most online resources provide incomplete and inconsistent information and minimal social support. The aim of this study was to develop an online information and support resource for adolescent idiopathic scoliosis (AIS) patients considering spinal surgery. Prior to website development, a user-based needs assessment was conducted. The needs assessment involved a total of six focus groups with three stakeholder groups: (1) post-operative AIS patients or surgical candidates (10-18 years) (n = 11), (2) their parents (n = 6) and (3) health care providers (n = 11). This paper reports on the findings from focus groups with health care providers. Focus group methodology was used to invite a range of perspectives and stimulate discussion. During audio-recorded focus groups, an emergent table of website content was presented to participants for assessment of relevance, viability and comprehensiveness in targeting global domains of need. Specifically, effective presentation of content, desired aspects of information and support, and discussions about the value of peer support and the role of health professionals were addressed. Focus group transcripts were then subject to content analysis through a constant comparative review and analysis. Two focus groups were held with health care providers, consisting of 5 and 6 members respectively. Clinicians provided their perceptions of the information and support needs of surgical patients and their families and how this information and support should be delivered using internet technology. Health care providers proposed four key suggestions to consider in the development of this online resource: (1) create the website with the target audience in mind; (2) clearly state the purpose of the website and organize website content to support the user; (3) offer a

  3. Water Transport with Ultralow Friction through Partially Exfoliated g-C3 N4 Nanosheet Membranes with Self-Supporting Spacers.

    Science.gov (United States)

    Wang, Yanjie; Li, Libo; Wei, Yanying; Xue, Jian; Chen, Huang; Ding, Li; Caro, Jürgen; Wang, Haihui

    2017-07-24

    Two-dimensional (2D) graphitic carbon nitride (g-C3 N4 ) nanosheets show brilliant application potential in numerous fields. Herein, a membrane with artificial nanopores and self-supporting spacers was fabricated by assembly of 2D g-C3 N4 nanosheets in a stack with elaborate structures. In water purification the g-C3 N4 membrane shows a better separation performance than commercial membranes. The g-C3 N4 membrane has a water permeance of 29 L m-2  h-1  bar-1 and a rejection rate of 87 % for 3 nm molecules with a membrane thickness of 160 nm. The artificial nanopores in the g-C3 N4 nanosheets and the spacers between the partially exfoliated g-C3 N4 nanosheets provide nanochannels for water transport while bigger molecules are retained. The self-supported nanochannels in the g-C3 N4 membrane are very stable and rigid enough to resist environmental challenges, such as changes to pH and pressure conditions. Permeation experiments and molecular dynamics simulations indicate that a novel nanofluidics phenomenon takes place, whereby water transport through the g-C3 N4 nanosheet membrane occurs with ultralow friction. The findings provide new understanding of fluidics in nanochannels and illuminate a fabrication method by which rigid nanochannels may be obtained for applications in complex or harsh environments. © 2017 Wiley-VCH Verlag GmbH & Co. KGaA, Weinheim.

  4. Identifying the Types of Support Needed by Interprofessional Teams Providing Pediatric End-of-Life Care: A Thematic Analysis.

    Science.gov (United States)

    Riotte, Clare O; Kukora, Stephanie K; Keefer, Patricia M; Firn, Janice I

    2017-10-13

    Despite the number of interprofessional team members caring for children at the end of life, little evidence exists on how institutions can support their staff in providing care in these situations. We sought to evaluate which aspects of the hospital work environment were most helpful for multidisciplinary team members who care for patients at the end of life and identify areas for improvement to better address staff needs. Qualitative thematic analysis was completed of free-text comments from a survey distributed to interprofessional staff members involved in the care of a recently deceased pediatric patient. A total of 2701 surveys were sent; 890 completed. Free-text responses were provided by 306 interprofessional team members. Interprofessional team members involved in the care of a child who died at a 348 bed academic children's hospital in the Midwestern United States. Realist thematic analysis of free-text responses was completed in Dedoose using a deductive and inductive approach with line-by-line coding. Descriptive statistics of demographic information was completed using Excel. Thematic analysis of the 306 free-text responses identified three main support-related themes. Interprofessional team members desire to have (1) support through educational efforts such as workshops, (2) support from colleagues, and (3) support through institutional practices. Providers who participate in end-of-life work benefit from ongoing support through education, interpersonal relationships, and institutional practices. Addressing these areas from an interprofessional perspective enables staff to provide the optimal care for patients, patients' families, and themselves.

  5. FINDER, A system providing complex decision support for commercial transport replanning operations

    Science.gov (United States)

    Bittermann, Vincent; Deker, Guy; Sassus, Pierre; Mielnik, Jean-Christophe; Jud, Jean-Marie

    1994-03-01

    Decision-aid systems, likely to appear in future aircraft generations, could play a central role in the cockpit thanks to the broad spectrum of functionalities and decision support facilities they will offer to the crew. As part of such systems, the exploratory FINDER mock-up is a knowledge based system (KBS) designed to help crew members continually optimize their flight plan by suggesting solutions considering exhaustive information related to flight context, either on pilot request or upon external information occurrence. The successful evaluation by Air France pilots of that first mock-up dedicated to diversion procedure on pilot request has led to the current development of an enhanced system with nominal enroute operations and real-time capabilities. Nominal enroute operations concern the optimization with respect to an evolutive constraining of favoring environment (due to weather, traffic or regulated areas, and ETOPS constraints). This study paves the way for a future flight assistant system concept which is already under investigation and may take place in SEXTANT Avionique's future development steps.

  6. Providing Palliative Care in a Swedish Support Home for People Who Are Homeless.

    Science.gov (United States)

    Håkanson, Cecilia; Sandberg, Jonas; Ekstedt, Mirjam; Kenne Sarenmalm, Elisabeth; Christiansen, Mats; Öhlén, Joakim

    2016-07-01

    Despite high frequencies of multiple, life-limiting conditions relating to palliative care needs, people who are homeless are one of the most underserved and rarely encountered groups in palliative care settings. Instead, they often die in care places where palliative competence is not available. In this qualitative single-case study, we explored the conditions and practices of palliative care from the perspective of staff at a Swedish support home for homeless people. Interpretive description guided the research process, and data were generated from repeated reflective conversations with staff in groups, individually, and in pairs. The findings disclose a person-centered approach to palliative care, grounded in the understanding of the person's health/illness and health literacy, and how this is related to and determinant on life as a homeless individual. Four patterns shape this approach: building trustful and family-like relationships, re-dignifying the person, re-considering communication about illness and dying, and re-defining flexible and pragmatic care solutions. © The Author(s) 2015.

  7. Providing Evidence-Based, Intelligent Support for Flood Resilient Planning and Policy: The PEARL Knowledge Base

    Directory of Open Access Journals (Sweden)

    George Karavokiros

    2016-09-01

    Full Text Available While flood risk is evolving as one of the most imminent natural hazards and the shift from a reactive decision environment to a proactive one sets the basis of the latest thinking in flood management, the need to equip decision makers with necessary tools to think about and intelligently select options and strategies for flood management is becoming ever more pressing. Within this context, the Preparing for Extreme and Rare Events in Coastal Regions (PEARL intelligent knowledge-base (PEARL KB of resilience strategies is presented here as an environment that allows end-users to navigate from their observed problem to a selection of possible options and interventions worth considering within an intuitive visual web interface assisting advanced interactivity. Incorporation of real case studies within the PEARL KB enables the extraction of (evidence-based lessons from all over the word, while the KB’s collection of methods and tools directly supports the optimal selection of suitable interventions. The Knowledge-Base also gives access to the PEARL KB Flood Resilience Index (FRI tool, which is an online tool for resilience assessment at a city level available to authorities and citizens. We argue that the PEARL KB equips authorities with tangible and operational tools that can improve strategic and operational flood risk management by assessing and eventually increasing resilience, while building towards the strengthening of risk governance. The online tools that the PEARL KB gives access to were demonstrated and tested in the city of Rethymno, Greece.

  8. Health provider experiences with galactagogues to support breastfeeding: a cross-sectional survey

    Directory of Open Access Journals (Sweden)

    Bazzano AN

    2016-11-01

    Full Text Available Alessandra N Bazzano,1 Lisa Littrell,1 Amelia Brandt,1 Shelley Thibeau,2 Kamala Thriemer,3 Katherine P Theall1 1Department of Global Community Health and Behavioral Sciences, Tulane University School of Public Health and Tropical Medicine, 2Ochsner Health System, New Orleans, LA, USA; 3MLT EpiConsult, Jingili, NT, Australia Background: Exclusive breastfeeding for infants up to 6 months is widely recommended, yet breastfeeding rates are relatively low in the US. The most common reason women stop breastfeeding early is a perceived insufficiency of milk. Galactagogues are herbal and pharmaceutical products that can help increase milk supply; however, data on their efficacy and safety is limited. Lactation consultants, obstetricians, and other health providers are an important point of contact for breastfeeding women experiencing challenges with lactation. This study explored providers’ perceptions, experiences, and practices in relation to galactagogue recommendation. Method: A cross-sectional survey was conducted among a convenience sample of English-speaking health providers in the US who counsel breastfeeding women and their infants. Results: More than 70% of respondents reported to recommend galactagogues. The most frequently recommended galactagogue was fenugreek with respondents indicating that they recommend it either ‘always’ (8.5% or ‘most of the time’ (14.9% and ‘sometimes’ (46.8%. More than 80% of the respondents indicated that galactagogues were useful for their clients and only one-third reported side effects. Reasons for refraining from recommending galactagogues were insufficient evidence of its efficacy and safety. Respondents reported a wide variety of sources of information used for their own education about galactagogues. Discussion: Despite little evidence regarding safety and efficacy, some galactagogues are widely recommended and often perceived to be useful. However, concerns about their efficacy and safety

  9. Use of an online community to provide support to caregivers of people with dementia.

    Science.gov (United States)

    Pagán-Ortiz, Marta E; Cortés, Dharma E; Rudloff, Noelle; Weitzman, Patricia; Levkoff, Sue

    2014-01-01

    One challenge faced by many family members caring for persons with dementia is lack of information about how to take care of others and themselves. This is especially important for persons from ethnic minority groups, because linguistically and culturally appropriate information is often not available. In response to these needs, we developed a web site for Spanish-speaking caregivers. Cuidatecuidador.com provides bilingual information on dementia and caregiver issues. Content was developed and then evaluated by caregivers residing in 3 countries. Findings suggest trends that exposure to information may be related to a higher sense of mastery and a reduction of depressive symptomatology.

  10. Scientific support, soil information and education provided by the Austrian Soil Science Society

    Science.gov (United States)

    Huber, Sigbert; Baumgarten, Andreas; Birli, Barbara; Englisch, Michael; Tulipan, Monika; Zechmeister-Boltenstern, Sophie

    2015-04-01

    The Austrian Soil Science Society (ASSS), founded in 1954, is a non-profit organisation aiming at furthering all branches of soil science in Austria. The ASSS provides information on the current state of soil research in Austria and abroad. It organizes annual conferences for scientists from soil and related sciences to exchange their recent studies and offers a journal for scientific publications. Annually, ASSS awards the Kubiena Research Prize for excellent scientific studies provided by young scientists. In order to conserve and improve soil science in the field, excursions are organized, also in cooperation with other scientific organisations. Due to well-established contacts with soil scientists and soil science societies in many countries, the ASSS is able to provide its members with information about the most recent developments in the field of soil science. This contributes to a broadening of the current scientific knowledge on soils. The ASSS also co-operates in the organisation of excursions and meetings with neighbouring countries. Several members of the ASSS teach soil science at various Austrian universities. More detail on said conferences, excursions, publications and awards will be given in the presentation. Beside its own scientific journal, published once or twice a year, and special editions such as guidebooks for soil classification, the ASSS runs a website providing information on the Society, its activities, meetings, publications, awards and projects. Together with the Environment Agency Austria the ASSS runs a soil platform on the internet. It is accessible for the public and thus informs society about soil issues. This platform offers a calendar with national and international soil events, contacts of soil related organisations and networks, information on national projects and publications. The society has access to products, information material and information on educational courses. Last but not least information on specific soil

  11. Preventing HIV by providing support for orphan girls to stay in school: does religion matter?

    Science.gov (United States)

    Hallfors, Denise D; Cho, Hyunsan; Iritani, Bonita J; Mapfumo, John; Mpofu, Elias; Luseno, Winnie K; January, James

    2013-01-01

    The paper examines the influence of religion on attitudes, behaviors, and HIV infection among rural adolescent women in Zimbabwe. We analyzed data from a 2007 to 2010 randomized controlled trial in rural eastern Zimbabwe testing whether school support can prevent HIV risk behaviors and related attitudes among rural adolescent orphan girls; supplementary data from the 2006 Zimbabwe Demographic and Health Survey (ZDHS) were also analyzed. The present study design is largely cross-sectional, using the most recent available survey data from the clinical trial to examine the association between religious affiliation and religiosity on school dropout, marriage, and related attitudes, controlling for intervention condition, age and orphan type. The ZDHS data examined the effect of religious denomination on marriage and HIV status among young rural women, controlling for age. Apostolic Church affiliation greatly increased the likelihood of early marriage compared to reference Methodist Church affiliation (odds ratio = 4.5). Greater religiosity independently reduced the likelihood of school dropout, increased gender equity attitudes and disagreement with early sex, and marginally reduced early marriage. Young rural Apostolic women in the ZDHS were nearly four times as likely to marry as teenagers compared to Protestants, and marriage doubled the likelihood of HIV infection. Findings contradict an earlier seminal study that Apostolics are relatively protected from HIV compared to other Christian denominations. Young Apostolic women are at increased risk of HIV infection through early marriage. The Apostolic Church is a large and growing denomination in sub-Saharan Africa and many Apostolic sects discourage medical testing and treatment in favor of faith healing. Since this can increase the risk of undiagnosed HIV infection for young married women and their infants in high prevalence areas, further study is urgently needed to confirm this emerging public health problem

  12. Deficiencies in postgraduate training for healthcare professionals who provide diabetes education and support

    DEFF Research Database (Denmark)

    Byrne, J. L.; Davies, Melanie J; Willaing, I.

    2017-01-01

    : The present study shows that healthcare professionals report being insufficiently equipped to provide diabetes self-management education, including emotional and psychological aspects of diabetes, and many are not receiving postgraduate training in any part (including medical care) of the management......Aims: To consider the global provision of self-management diabetes education and training for healthcare professionals using data from the second Diabetes Attitudes, Wishes and Needs (DAWN2) study. Methods: A total of 4785 healthcare professionals caring for people with diabetes were surveyed in 17...... in a domain was positively associated with a perceived need for further training. Communication skills, for example, listening (76.9%) and encouraging questions (76.1%), were the skills most widely used. Discussion of emotional issues was limited; 31–60% of healthcare professionals across the different...

  13. Ketosteroid isomerase provides further support for the idea that enzymes work by electrostatic preorganization.

    Science.gov (United States)

    Kamerlin, Shina C L; Sharma, Pankaz K; Chu, Zhen T; Warshel, Arieh

    2010-03-02

    One of the best systems for exploring the origin of enzyme catalysis has been the reaction of ketosteroid isomerase (KSI). Studies of the binding of phenolates to KSI have been taken as proof that the electrostatic preorganization effect only makes a minor contribution to the binding of the real, multiring, transition state (TS). However, our simulation study has determined that the difference between the phenolates and the TS arises from the fact that the nonpolar state of the phenolate can rotate freely relative to the oxyanion hole and thus loses the preorganization contribution. A recent study explored the reactivity of both small and multiring systems and concluded that their similar reactivity contradicts our preorganization idea. Herein, we establish that the available experiments in fact provide what is perhaps the best proof and clarification of the preorganization idea and its crucial role in enzyme catalysis. First, we analyze the binding energy and the pK(a) of equilenin and identify direct experimental evidence for our prediction about the differential electrostatic stabilization of the large TS and the small phenolates. Subsequently, we show that the similar reactivity of the small and large systems is also due to an electrostatic preorganization effect but that this effect only appears in the intermediate state because the TS is not free to rotate. This establishes the electrostatic origin of enzyme catalysis. We also clarify the crucial importance of having a well-defined physical concept when examining catalytic effects and the need for quantitative tools for analyzing such effects.

  14. Kelp transcriptomes provide robust support for interfamilial relationships and revision of the little known Arthrothamnaceae (Laminariales).

    Science.gov (United States)

    Jackson, Chris; Salomaki, Eric D; Lane, Christopher E; Saunders, Gary W

    2017-02-01

    If ever there were "charismatic megaflora" of the sea, the Laminariales (kelp) would undoubtedly meet that designation. From the Northeast Pacific kelp forests to the less diverse, but nonetheless dense, kelp beds ranging from the Arctic to the cold temperate waters of the Southern Hemisphere, kelp provide habitat structure and food for a variety of productive marine systems. Consequently, kelp are well represented in the literature, however, understanding their evolution has proven challenging. We used a 152-gene phylogenomics approach to better resolve the phylogeny of the "derived" kelp families (viz., Agaraceae, Alariaceae, Laminariaceae, and Lessoniaceae). The formerly unresolved Egregia menziesii firmly joined a significantly expanded Arthrothamnaceae including Arthrothamnus, Cymathaere, Ecklonia, Macrocystis, Nereocystis, Pelagophycus, Postelsia, Pseudolessonia, Saccharina, and Streptophyllopsis, which rendered both the Laminariaceae and Lessoniaceae monogeneric. A published eight-gene alignment, the most marker-rich prior to this study, was expanded and analyzed to facilitate inclusion of Aureophycus. Although the topology was unchanged at the family level between the transcriptome data set relative to eight-gene analyses, the superior resolving power of the former was clearly established. © 2016 Phycological Society of America.

  15. An enabling system for echocardiography providing adaptive support through behavioral analysis.

    Science.gov (United States)

    Trochim, S; Weidenbach, M; Pieper, S; Wick, C; Berlage, T

    2001-01-01

    Echocardiography requires the integrated application of a broad spectrum of cognitive and practical skills, e.g. diagnostic knowledge (symbolic), image interpretation (visual perception) and handling of the ultrasound probe (sensorimotor). This complex expertise is acquired through extensive practical training guided by a skilled cardiologist that is often incompatible with clinical reality. Especially for beginners, the most critical point during an echocardiographic examination is the steering of the ultrasound probe to navigate between different cardiological standard planes (sensorimotor skill) without loosing orientation. These transitions or "standard trajectories" can roughly be described by specific movement patterns. We propose an enabling system based on an Augmented Reality simulator for two-dimensional echocardiography imitating this apprenticeship [1]-[3]. During a simulated ultrasound examination the system monitors the activities of the trainee and analyzes the motion pattern of the ultrasound probe. The simulator reacts by mapping the motion patterns onto cognitive orientation demands and providing adaptive feedback in the form of context sensitive help (animations). It partly takes the role of the critical teacher.

  16. Catchment structure that supports organic matter providing a natural control on rising river nutrient concentrations

    Science.gov (United States)

    Stutter, Marc; Ibiyemi, Adekunle; Wang, Chen

    2017-04-01

    The connectivity of sources of pollution in catchments has been well studied and brings concepts such as pollution hotspots and critical source areas. However, consideration of the placement of other structures combating rising pollution impacts has been less considered. One such area that is receiving developing focus is the layout of riparian management and buffer strips. However, there are wider aspects of connectivity and landscape structure that can bring benefits to delivery and in-stream processing of pollution. These include wetlands, forests and the distribution of soils of differing connectivity of organic matter varying in bioavailability. Organic matter is a great modulator of catchment processes from controlling the potential of land use (e.g. constraints of soil organic matter and wetness on agricultural use), to the amount and form of nutrients leached from soils, to controls of dissolved organic matter on in-stream biology that responds to nutrient concentrations. As the fundamental control of ecosystem energy available for many heterotrophic processes it mediates uptake, recycling and speciation of N, P at many stages of the catchment from soils to waters; as such DOM can be considered as a nature-based solution exerting a background level of control on inorganic nutrients. This poster explores the role of different structural aspects of catchments that provide beneficial organic matter inputs to rivers. At the fine scale the lability of riparian soil and leaf litter DOC are considered. At a riparian management scale the local changes in buffer strip soil C and DOC relative to field soils are considered. At the largest scale spatial data are explored for riparian structure, forests, wetlands and soils differing in delivery and forms of C across major Scottish rivers and used as co-variates to explain differences in in-stream processing of nutrients.

  17. Does minimally invasive transsacral fixation provide anterior column support in adult scoliosis?

    Science.gov (United States)

    Anand, Neel; Baron, Eli M; Khandehroo, Babak

    2014-06-01

    Spinal fusion to the sacrum, especially in the setting of deformity and long constructs, is associated with high complication and pseudarthrosis rates. Transsacral discectomy, fusion, and fixation is a minimally invasive spine surgery technique that provides very rigid fixation. To date, this has been minimally studied in the setting of spinal deformity correction. We determined (1) the fusion rate of long-segment arthrodeses, (2) heath-related quality-of-life (HRQOL) outcomes (VAS pain score, Oswestry Disability Index [ODI], SF-36), and (3) the common complications and their frequency in adult patients with scoliosis undergoing transsacral fixation without supplemental pelvic fixation. Between April 2007 and May 2011, 92 patients had fusion of three or more segments extending to the sacrum for spinal deformity. Transsacral L5-S1 fusion without supplemental pelvic fixation was performed in 56 patients. Of these, 46 with complete data points and a minimum of 2 years of followup (mean, 48 months; range, 24-72 months; 18% of patients lost to followup) were included in this study. Nineteen of the 46 (41%) had fusions extending above the thoracolumbar junction, with one patient having fusion into the proximal thoracic spine (T3-S1). General indications for the use of transsacral fixation were situations where the fusion needed to be extended to the sacrum, such as spondylolisthesis, prior laminectomy, stenosis, oblique take-off, and disc degeneration at L5-S1. Contraindications included anatomic variations in the sacrum, vascular anomalies, prior intrapelvic surgery, and rectal fistulas or abscesses. Fusion rates were assessed by full-length radiographs and CT scanning. HRQOL data, including VAS pain score, ODI, and SF-36 scores, were assessed at all pre- and postoperative visits. Intraoperative and postoperative complications were noted. Forty-one of 46 patients (89%) developed a solid fusion at L5-S1. There were significant improvements in all HRQOL parameters. Eight

  18. Implementing Information and Communication Technology to Support Community Aged Care Service Integration: Lessons from an Australian Aged Care Provider

    Science.gov (United States)

    Georgiou, Andrew; Tariq, Amina; Prgomet, Mirela; Warland, Andrew; Armour, Pauline; Westbrook, Johanna I

    2017-01-01

    Introduction: There is limited evidence of the benefits of information and communication technology (ICT) to support integrated aged care services. Objectives: We undertook a case study to describe carelink+, a centralised client service management ICT system implemented by a large aged and community care service provider, Uniting. We sought to explicate the care-related information exchange processes associated with carelink+ and identify lessons for organisations attempting to use ICT to support service integration. Methods: Our case study included seventeen interviews and eleven observation sessions with a purposive sample of staff within the organisation. Inductive analysis was used to develop a model of ICT-supported information exchange. Results: Management staff described the integrated care model designed to underpin carelink+. Frontline staff described complex information exchange processes supporting coordination of client services. Mismatches between the data quality and the functions carelink+ was designed to support necessitated the evolution of new work processes associated with the system. Conclusions: There is value in explicitly modelling the work processes that emerge as a consequence of ICT. Continuous evaluation of the match between ICT and work processes will help aged care organisations to achieve higher levels of ICT maturity that support their efforts to provide integrated care to clients. PMID:29042851

  19. Parents' experiences of family functioning, health and social support provided by nurses--a pilot study in paediatric intensive care.

    Science.gov (United States)

    Hakio, Nora; Rantanen, Anja; Åstedt-Kurki, Päivi; Suominen, Tarja

    2015-02-01

    The objective of this study was to describe parents' experiences of family functioning, health and social support provided by nursing personnel, while their child was in intensive care, and to determine how social support was associated with family functioning and family health. Cross-sectional study. The data were collected by a self-administered questionnaire from 31 parents of critically ill children from 2010 to 2011. The data were analysed statistically. The parents considered their family functioning, health and social support provided by the nursing personnel to be good. The sub-area of family functioning that rated the lowest was strengths of family, whereas the lowest rated sub-area of family health was ill-being. Child's previous hospital treatments were associated with family health. Parents, whose child had already been in hospital care, reported more well-being and less ill-being than parents with children hospitalised for the first time. Parents' education was associated with family functioning, family health and social support given by the nurses. Weak positive correlation was also found between social support given by nurses and family health experienced by parents. There is a need to discuss how nursing care can further support parental resources. Copyright © 2014 Elsevier Ltd. All rights reserved.

  20. Implementing Information and Communication Technology to Support Community Aged Care Service Integration: Lessons from an Australian Aged Care Provider.

    Science.gov (United States)

    Douglas, Heather E; Georgiou, Andrew; Tariq, Amina; Prgomet, Mirela; Warland, Andrew; Armour, Pauline; Westbrook, Johanna I

    2017-04-10

    There is limited evidence of the benefits of information and communication technology (ICT) to support integrated aged care services. We undertook a case study to describe carelink+, a centralised client service management ICT system implemented by a large aged and community care service provider, Uniting. We sought to explicate the care-related information exchange processes associated with carelink+ and identify lessons for organisations attempting to use ICT to support service integration. Our case study included seventeen interviews and eleven observation sessions with a purposive sample of staff within the organisation. Inductive analysis was used to develop a model of ICT-supported information exchange. Management staff described the integrated care model designed to underpin carelink+. Frontline staff described complex information exchange processes supporting coordination of client services. Mismatches between the data quality and the functions carelink+ was designed to support necessitated the evolution of new work processes associated with the system. There is value in explicitly modelling the work processes that emerge as a consequence of ICT. Continuous evaluation of the match between ICT and work processes will help aged care organisations to achieve higher levels of ICT maturity that support their efforts to provide integrated care to clients.

  1. A pilot study examining the impact of care provider support program on resiliency, coping, and compassion fatigue in military health care providers.

    Science.gov (United States)

    Weidlich, Christopher P; Ugarriza, Doris N

    2015-03-01

    The Care Provider Support Program (CPSP) was created as a way to improve the resiliency of military health care providers. The purpose of this pilot study was to update what is currently known about the resiliency, coping, and compassion fatigue of military and civilian registered nurses, licensed practical nurses (LPNs), and medics who treat wounded Soldiers and whether these factors can be improved over a sustained period of time. A prospective cohort pilot study was implemented to investigate the long-term effects of CPSP training on military and civilian nurses, LPNs, and medics (n = 93) at an Army Medical Center utilizing the Connor-Davidson Resilience Scale, the Ways of Coping Questionnaire, and Professional Quality of Life Questionnaire. Twenty-eight participants returned follow-up questionnaires. CPSP was significant in reducing burnout as measured by the Professional Quality of Life questionnaire, leading to decreased compassion fatigue. CPSP training did not affect resiliency scores on the Connor-Davidson resilience scale or coping scores as measured by the Ways of Coping Questionnaire. on the basis of the results of this study, CPSP training was effective in reducing burnout, which often leads to decreased compassion fatigue in a group of military and civilian registered nurses, LPNs, and medics. Reprint & Copyright © 2015 Association of Military Surgeons of the U.S.

  2. A prospective 5-year study of fixed partial prostheses supported by implants with machined and TiO2-blasted surface

    DEFF Research Database (Denmark)

    Gotfredsen, K; Karlsson, U

    2001-01-01

    PURPOSE: The aim of the present study was to evaluate whether there was a difference between machined and TiO(2)-blasted implants regarding survival rate and marginal bone loss during a 5-year observation period. MATERIALS AND METHODS: A total of 133 implants (Astra Tech Dental Implants; Astra Tech...... AB, Mölndal, Sweden) were placed in 50 patients at 6 centers in 4 Scandinavian countries. Forty-eight implants were installed in the maxilla and 85 implants in the mandible. A randomization and a stratification were done, so that each fixed partial prosthesis was supported by at least 1 machined...... and 1 TiO(2)-blasted implant. The implant-supported fixed partial prostheses (ISFPP) were fabricated within 2 months after postoperative healing. A total of 52 ISFPP (17 maxillary, 35 mandibular) were inserted. The patients were clinically examined once a year for 5 years. At the annual follow...

  3. Innovations in basic life support education for healthcare providers: improving competence in cardiopulmonary resuscitation through self-directed learning.

    Science.gov (United States)

    Cason, Carolyn L; Kardong-Edgren, Suzan; Cazzell, Mary; Behan, Deborah; Mancini, Mary Elizabeth

    2009-01-01

    Providing cardiopulmonary resuscitation is an essential competency for nurses. Nurse educators involved in staff development and continuing education spend numerous hours offering basic life support courses and conducting performance improvement activities such as mock codes. This study provides evidence that cardiopulmonary resuscitation performance skills using self-directed learning methods are as good as or, on a number of parameters, better than those achieved with a more resource- and time-intensive traditional approach.

  4. Perceptions of Supported Employment Providers: What Students with Developmental Disabilities, Families, and Educators Need to Know for Transition Planning

    Science.gov (United States)

    Moon, Sherril; Simonsen, Monica L.; Neubert, Debra A.

    2011-01-01

    The purpose of this exploratory study was to survey community rehabilitation providers (CRPs) to determine their perceptions of the skills, experiences, and information that transitioning youth with developmental disabilities (DD) and their families need to access supported employment (SE) services. Supervisors of SE from 12 CRPs across one state…

  5. Support given to lecturers when providing mobile centric services in teaching and learning: a policy analysis perspective

    CSIR Research Space (South Africa)

    Chipangura, B

    2015-05-01

    Full Text Available The objective of this study is to examine the status of Higher Education Institutions (HEIs) policies in supporting lecturers when providing mobile centric services to students. The research was undertaken as a single case study within the Open...

  6. Emotional Literacy Support Assistants' Views on Supervision Provided by Educational Psychologists: What EPs Can Learn from Group Supervision

    Science.gov (United States)

    Osborne, Cara; Burton, Sheila

    2014-01-01

    The Educational Psychology Service in this study has responsibility for providing group supervision to Emotional Literacy Support Assistants (ELSAs) working in schools. To date, little research has examined this type of inter-professional supervision arrangement. The current study used a questionnaire to examine ELSAs' views on the supervision…

  7. Occlusion for implant-supported fixed dental prostheses in partially edentulous patients: a literature review and current concepts

    OpenAIRE

    Yuan, Judy Chia-Chun; Sukotjo, Cortino

    2013-01-01

    Implant treatment has become the treatment of choice to replace missing teeth in partially edentulous areas. Dental implants present different biological and biomechanical characteristics than natural teeth. Occlusion is considered to be one of the most important factors contributing to implant success. Most literature on implant occlusal concepts is based on expert opinion, anecdotal experiences, in vitro and animal studies, and only limited clinical research. Furthermore, scientific literat...

  8. Effect of the number of implants on stress distribution of anterior implant-supported fixed prostheses combined with a removable partial denture: a finite element analysis.

    Science.gov (United States)

    Mahshid, Minoo; Geramy, Allahyar; Ejlali, Massoud; Sedaghat Monfared, Majid; Rezvani Habib Abadi, Shirin

    2014-05-01

    The main goal of this study was to evaluate differences in stress distribution relevant to the number of implants under an anterior bridge when combined with a removable partial denture in the posterior region. Four three-dimensional finite element models (3D FEM) were designed from a mandible containing an implant-supported bridge extending between canines, and a bilateral distal extension removable partial denture. A nonrigid connection was selected as the attachment method between the partial denture and the anterior implant-supported fixed prosthesis; 2, 3, 4 and 5 implants supporting the bridge all with 10mm length and 3.8 mm diameter were assessed. With the aid of the finite element program ANSYS 8.0, the models were loaded and von Mises stresses were evaluated. In spongy bone, stress forces showed a decrease from 2 implants to 4 implants but showed an increase in the 5-implant model. Stresses on cortical bone of terminal implants were in similar range in the 2-, 3- and 4-implant models. While, in the 5-implant model the amount of stresses on terminal implants increased dramatically. The stresses on implants were nearly similar in all models, with the greatest amount on terminal implants. Within the limitations of this study, 2-, 3- and 4-implant models showed less stress on cortical and spongy bone in comparison with the 5-implant model. The stresses transferred to implants were nearly similar.

  9. Effect of the number of implants on stress distribution of anterior implant-supported fixed prostheses combined with a removable partial denture: a finite element analysis.

    Directory of Open Access Journals (Sweden)

    Minoo Mahshid

    2014-06-01

    Full Text Available The main goal of this study was to evaluate differences in stress distribution relevant to the number of implants under an anterior bridge when combined with a removable partial denture in the posterior region.Four three-dimensional finite element models (3D FEM were designed from a mandible containing an implant-supported bridge extending between canines, and a bilateral distal extension removable partial denture. A nonrigid connection was selected as the attachment method between the partial denture and the anterior implant-supported fixed prosthesis; 2, 3, 4 and 5 implants supporting the bridge all with 10mm length and 3.8 mm diameter were assessed. With the aid of the finite element program ANSYS 8.0, the models were loaded and von Mises stresses were evaluated.In spongy bone, stress forces showed a decrease from 2 implants to 4 implants but showed an increase in the 5-implant model. Stresses on cortical bone of terminal implants were in similar range in the 2-, 3- and 4-implant models. While, in the 5-implant model the amount of stresses on terminal implants increased dramatically. The stresses on implants were nearly similar in all models, with the greatest amount on terminal implants.Within the limitations of this study, 2-, 3- and 4-implant models showed less stress on cortical and spongy bone in comparison with the 5-implant model. The stresses transferred to implants were nearly similar.

  10. Mothers' and health visitors' perceptions of the support provided to mothers who have experienced domestic violence: A systematic review.

    Science.gov (United States)

    Eynon, Julia; Carrier, Judith; Rees, Sally; Cartwright, Annie

    2012-01-01

    Domestic violence has been described as a public health epidemic, with victims of domestic violence encountered in all health care settings. Within the United Kingdom the role of the health visitor (specialist community public health nurse) is to promote health in the whole community; every family with a child under five years has a named health visitor. Preparation for the health visitor role is unique to the United Kingdom. Health visitors are particularly well placed to identify and support mothers who are experiencing domestic violence. The objective of this review was to synthesise the best available evidence relating to support provided by UK health visitors for mothers who have experienced domestic violence, from both the mothers and the health visitors' perspectives. The participants of interest were mothers who have experienced domestic violence and health visitors who offer support to those mothers.The self reported experiences of health visitor support provided to mothers who have experienced domestic violence, from the perspective of both the mothers and the health visitors providing the support.This review considered studies that focus on qualitative data including, but not limited to, designs such as ethnography, phenomenology, grounded theory, action research and feminist research. Studies published up to April 2011 were included in the review. The search was restricted to English language studies. The databases searched were: Medline, CINAHL, PsycINFO, PsycARTICLES, EMBASE, British Nursing Index and Archive, ASSIA and TRIP. Studies were assessed for methodological quality using the standardised critical appraisal instruments from the Joanna Briggs Institute. Data were extracted using standardised data extraction tools from the Joanna Briggs Institute. Data synthesis used the Joanna Briggs Institute approach for meta-synthesis by meta-aggregation. Findings were synthesised into categories, which were aggregated into synthesised findings. Four

  11. Comparative analysis of speed's impact on muscle demands during partial body weight support motor-assisted elliptical training.

    Science.gov (United States)

    Burnfield, Judith M; Irons, Sonya L; Buster, Thad W; Taylor, Adam P; Hildner, Gretchen A; Shu, Yu

    2014-01-01

    Individuals with walking limitations often experience challenges engaging in functionally relevant exercise. An adapted elliptical trainer (motor to assist pedal movement, integrated body weight harness, ramps/stairs, and grab rails) has been developed to help individuals with physical disabilities and chronic conditions regain/retain walking capacity and fitness. However, limited published studies are available to guide therapeutic interventions. This repeated measures study examined the influence of motor-assisted elliptical training speed on lower extremity muscle demands at four body weight support (BWS) levels commonly used therapeutically for walking. Electromyography (EMG) and pedal trajectory data were recorded as ten individuals without known disability used the motor-assisted elliptical trainer at three speeds [20,40, 60 revolutions per minute (RPM)] during each BWS level (0%, 20%, 40%, 60%). Overall, the EMG activity (peak, mean, duration) in key stabilizer muscles (i.e., gluteus medius, gluteus maximus, vastus lateralis, medial gastrocnemius and soleus) recorded at 60 RPM exceeded those at 40 RPM, which were higher than values at 20 RPM in all but three situations (gluteus medius mean at 0% BWS, vastus lateralis mean at 20% BWS, soleus duration at 40% BWS); however, these differences did not always achieve statistical significance. Slower motor-assisted speeds can be used to accommodate weakness of gluteus medius, gluteus maximus, vastus lateralis, medial gastrocnemius and soleus. As strength improves, training at faster motor-assisted speeds may provide a means to progressively challenge key lower extremity stabilizers. Copyright © 2013 Elsevier B.V. All rights reserved.

  12. Providing Informal Care in Terminal Illness: An Analysis of Preferences for Support Using a Discrete Choice Experiment.

    Science.gov (United States)

    Hall, Jane; Kenny, Patricia; Hossain, Ishrat; Street, Deborah J; Knox, Stephanie A

    2014-08-01

    The trend for terminally ill patients to receive much of their end-of-life care at home necessitates the design of services to facilitate this. Care at home also requires that informal care be provided by family members and friends. This study investigated informal carers' preferences for support services to aid the development of end-of-life health care services. This cross-sectional study used 2 discrete choice experiments to ascertain the preferences of carers supporting patients with different levels of care need, determined by the assistance needed with personal care and labeled High Care (HC) and Low Care (LC). The sample included 168 informal carers of people receiving palliative care at home from 2 palliative care services in Sydney, Australia. Data were collected in face-to-face interviews; carers chose between 2 hypothetical plans of support services and their current services. Data were analyzed with generalized multinomial logit models that were used to calculate the impact of each attribute on the probability of a carer choosing a service plan. Preferred support included nursing services; the probability of choosing a plan increased significantly if it included nurse home visits and phone advice (P situation. The most valued services are those that support carers in their caregiving role; however, supportive care preferences vary with the different circumstances of patients and carers. © The Author(s) 2013.

  13. Support for partial lesions of the flexor tendons of the fingers: a retrospective study of 36 cases.

    Science.gov (United States)

    Maire, N; Hendriks, S; Gouzou, S; Liverneaux, P A; Facca, S

    2014-04-01

    The treatment of traumatic partial injuries of the flexor tendons of the fingers is seldom published. The only published clinical series states that the therapeutic approach depends on the existence or absence of a preoperative trigger. We hypothesized that the therapeutic attitude mainly depends on the percentage of the injured cross-section. Our retrospective series included 36 partial lesions of 31 fingers in 29 patients. The average age was 42 years, there were 19 men. We noted 8 lesions in zones I, 21 in zone II and 2 in zone III. The average percentage of the injured cross-section was 35% and ranged from 10% to 90%. If the lesion was less than 50% (29 tendons), a tangential resection was performed. If the lesion exceeded 50% (seven tendons), a direct suture was performed, supplemented by a running suture. At a follow-up of 34 months, the average pain on a visual analogue scale was 0.7. The average percentage of strength compared to the contralateral side was 93%. The Quick DASH score was 6.2. The range of motion averaged 214° with extremes ranging from 90° to 260°. We observed no cases of hypertrophic callus, neither through the MRI nor through the ultrasonography. Complications such as trigger finger, pseudoblocage or rupture were not observed. Based on our results, in case of partial injury of a flexor tendon, we propose to perform a tangential resection in cross-section lesions up to 50%, and a suture for those which exceeded 50%. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  14. Social support in the practices of informal providers: The case of patent and proprietary medicine vendors in Nigeria.

    Science.gov (United States)

    Sieverding, Maia; Liu, Jenny; Beyeler, Naomi

    2015-10-01

    The social and institutional environments in which informal healthcare providers operate shape their health and business practices, particularly in contexts where regulatory enforcement is weak. In this study, we adopt a social capital perspective to understanding the social networks on which proprietary and patent medicine vendors (PPMVs) in Nigeria rely for support in the operation of their shops. Data are drawn from 70 in-depth interviews with PPMVs in three states, including interviews with local leaders of the PPMV professional association. We find that PPMVs primarily relied on more senior colleagues and formal healthcare professionals for informational support, including information about new medicines and advice on how to treat specific cases of illness. For instrumental support, including finance, start-up assistance, and intervention with regulatory agencies, PPMVs relied on extended family, the PPMVs with whom they apprenticed, and the leaders of their professional association. PPMVs' networks also provided continual reinforcement of what constitutes good PPMV practice through admonishments to follow scope of practice limitations. These informal reminders, as well as monitoring activities conducted by the professional association, served to reinforce PPMVs' concern with avoiding negative customer health outcomes, which were perceived to be detrimental to their business reputations. That PPMVs' networks both encouraged practices to reduce the likelihood of poor health outcomes, and provided advice regarding customers' health conditions, highlights the potential impact of informal providers' access to different forms of social capital on their delivery of health services, as well as their success as microenterprises. Copyright © 2015 Elsevier Ltd. All rights reserved.

  15. Improving support for parents of children with hearing loss: provider training on use of targeted communication strategies.

    Science.gov (United States)

    Muñoz, Karen; Nelson, Lauri; Blaiser, Kristina; Price, Tanner; Twohig, Michael

    2015-02-01

    When proper protocols are followed, children who are identified with a permanent hearing loss early in life have opportunities to develop language on par with their typical hearing peers. Young children with hearing loss are dependent on their parents to manage intervention during early years critical to their development, and parents' ability to effectively integrate recommendations in daily life is foundational for intervention success. Audiologists and early intervention professionals not only need to provide current evidence-based services, but also must address parents' emotional and learning needs related to their child's hearing loss. This study explored practice patterns related to education and support provided to parents of children with hearing loss and the influence of an in-service training on provider attitudes. This study used a prepost design with a self-report questionnaire to identify practice patterns related to communication skills and support used by providers when working with parents of children with hearing loss. A total of 45 participants (21 professionals and 24 graduate students) currently working with children completed the pretraining questionnaire, and 29 participants (13 professionals and 16 graduate students) completed the postquestionnaire. Data were collected using an online questionnaire before the training and 1 mo after training. Descriptive analyses were done to identify trends, and paired-samples t-tests were used to determine changes pretraining to posttraining. Findings revealed that professionals most frequently teach skills to mothers (91%) and infrequently teach skills to fathers (19%) and other caregivers (10%). Professionals reported frequently collaborating with other intervention providers (76%) and infrequently collaborating with primary care physicians (19%). One-third of the professionals reported addressing symptoms of depression and anxiety as an interfering factor with the ability to implement management

  16. Theorizing E-Commerce Business Models: On the Impact of Partially and Fully Supported Transaction Phases on Customer Satisfaction and Loyalty

    Directory of Open Access Journals (Sweden)

    Maria Madlberger

    2017-03-01

    Full Text Available Although considerable research has been conducted on the definition and classification of e-commerce business models, little research has integrated the support and impact of distinct transaction phases within e-commerce business models. Indeed, any channel design decisions depend on the arrangement of the three transaction phases, viz. information phase, agreement phase and fulfilment phase. Whereas in literature, a complete support of transaction phases is implicitly assumed, in practice, e-commerce firms exist that consciously do not support all three transaction phases through the online channel. In cases for which only certain phases are supported in one channel, the customer is required to switch to another channel to complete the transaction. To gain an initial understanding of the relevance of transaction phases, we examine the influence of transaction phase support in one channel on satisfaction and reuse intention of an e-commerce website under consideration of users’ prior experiences. We conduct a laboratory experiment involving two e-commerce business models that differ only in the number of supported transaction phases via the online channel. Empirical data was analysed using a Bayesian network approach. Our analysis indicates the types of users who value partial support compared to those users who prefer full support of transaction phases. The results will assist firms in meeting future challenges regarding user engagement and attraction to their online stores.

  17. Registered nurse and health care chaplains experiences of providing the family support person role during family witnessed resuscitation.

    Science.gov (United States)

    James, Jayne; Cottle, Elita; Hodge, Reverend Debbie

    2011-02-01

    To provide an in-depth exploration regarding the Registered Nurse (RN) and Healthcare Chaplains' (HCC) perspective of the role of the family support person (FSP) during family witnessed resuscitation (FWR). A phenomenological approach utilising in-depth interviews were undertaken outside of the work setting. A purposive sample of 4 RN's and 3 HCC were recruited from four sites within the United Kingdom. All interviews were tape recorded, transcribed verbatim and analysed utilising Husserl's framework. Seven key themes emerged which included assessment, managing choice, navigating the setting, on-going commentary, coming to terms with death, conflicts and support. This study has provided an insight regarding the intense clinical engagement associated with the role of the FSP and highlighted the importance of this role for family member's optimal care and support. It is vital that adequate professional development is instigated and that support mechanisms are in place for those health care professionals (HCP) undertaking this role in order to help family members through this difficult experience. Copyright © 2010 Elsevier Ltd. All rights reserved.

  18. Providing support to surrogate decision-makers for people living with dementia: Healthcare professional, organisational and community responsibilities.

    Science.gov (United States)

    Shanley, Christopher; Fetherstonhaugh, Deirdre; McAuliffe, Linda; Bauer, Michael; Beattie, Elizabeth

    2017-09-01

    The prevalence of dementia will continue to increase with the ageing of the population. Many people living with dementia will reach a stage where surrogate decision-makers-mostly family carers-will need to make a range of decisions on their behalf. The aim of this study was to learn from surrogate decision-makers how they can be most effectively supported in this role. The study employed a qualitative design using semi-structured face-to-face or telephone interviews with a purposive sample of 34 surrogate decision-makers of people living with dementia. Transcripts of participant interviews were reviewed using a thematic approach to analysis. Four main themes were identified from this analysis: needing greater community awareness of dementia and its impact; intervening early in cognitive decline; relying on health professionals for ongoing support; and seeking and using support from wherever is relevant for each person. Based on this analysis and a review of the literature, we propose a wholistic set of recommendations for the support of surrogate decision-makers. Healthcare professionals need to help family carers understand the likely trajectory of dementia, including the significance of surrogate decision-making. They can support the person living with dementia and their surrogates to undertake advance care planning and they can act as empathic guides during this process. Health and community care organisations need to provide a "key worker" model wherever possible so that the person living with dementia and their surrogate decision-maker do not have to seek support from multiple staff members or organisations. Carer support programmes can routinely include information and resources about surrogate decision-making. Community and government organisations can help people prepare for the possibility of becoming surrogate decision-makers by promoting a greater public awareness and understanding of both dementia and advance care planning. © 2017 John Wiley & Sons Ltd.

  19. Adapting the Advanced Cardiac Life Support for the Experienced Provider (ACLS-EP course for emergency care education in Rwanda

    Directory of Open Access Journals (Sweden)

    William E. Cayley Jr

    2011-02-01

    Full Text Available The Advanced Cardiac Life Support for the Experienced Provider (ACLS-EP course uses a case-based curriculum to teach emergency resuscitation principles to experienced health care professionals. This article describes the adaptation of the ACLS-EP curriculum to be used in a family medicine training programme in Rwanda, including lessons learned and recommendations for future use of this material for emergency care education in the African setting.

  20. Surgeon assessment of renal preservation with partial nephrectomy provides information comparable to measurement of volume preservation with 3-dimensional image analysis.

    Science.gov (United States)

    Tobert, Conrad M; Boelkins, Bradley; Culver, Shannon; Mammen, Leena; Kahnoski, Richard J; Lane, Brian R

    2014-05-01

    The strongest predictors of renal function after partial nephrectomy are the preoperative glomerular filtration rate and the amount of preserved parenchyma. Measuring volume preservation by 3-dimensional imaging is accurate but time-consuming. Percent functional volume preservation was designed to replace surgeon assessment of volume preservation with a less labor intensive, objective assessment. We compared volume preservation with 3-dimensional imaging, percent functional volume preservation and surgeon assessment of volume preservation as predictors of renal function after partial nephrectomy. We calculated volume preservation with 3-dimensional imaging, percent functional volume preservation and surgeon assessment of volume preservation in 41 patients with preoperative and postoperative cross-sectional imaging available. Surgeon assessment was validated internally in another 75 patients. Short-term and long-term renal function was assessed with univariate and multivariate linear regression models. Median parenchymal preservation was 85% (range 37% to 105%) by 3-dimensional imaging, 91% (range 51% to 114%) by percent functional preservation and 88% (range 45% to 99%) by surgeon assessment. Each method strongly correlated with nadir glomerular filtration rate (r(2) = 0.75, 0.65 and 0.78) and latest glomerular filtration rate (r(2) = 0.65, 0.66 and 0.67, respectively, each p analysis revealed that age, preoperative glomerular filtration rate, renal nephrometry score and each assessment were significant predictors of renal function (p analysis parenchymal preservation was the strongest predictor (p comparable to those of more time intensive alternatives. We propose that surgeon assessment of volume preservation should be routinely reported to facilitate analysis of partial nephrectomy outcomes. Copyright © 2014 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  1. A 2-year report on maxillary and mandibular fixed partial dentures supported by Astra Tech dental implants. A comparison of 2 implants with different surface textures

    DEFF Research Database (Denmark)

    Karlsson, U; Gotfredsen, K; Olsson, C

    1998-01-01

    In 50 partially edentulous patients, 133 (48 maxillary; 85 mandibular) Astra Tech dental implants of 2 different surface textures (machined; TiO-blasted) were alternately installed, supporting 52 fixed partial dentures (FPDs). Before abutment connection 2 machined implants (1 mandibular; 1...... maxillary) were found to be non-osseointegrated and were replaced. Another implant could not be restored due to a technical complication. Two FPDs were remade because of technical complications, both because of abutment fractures. Thus, after 2 years in function, the cumulative survival rates were 97.......7% and 95.7% for implants and prostheses, respectively. There was no statistically significant difference in survival rate between the 2 types of implants, 100% (TiO-blasted) vs 95.3% (machined), P = 0.24. After 2 years in function, when both jaw and type of implants were combined, the mean (SD) marginal...

  2. Impact of supplemental training programs on improving medical students' confidence in providing diabetes self-management education and support.

    Science.gov (United States)

    Fazel, Maryam T; Fazel, Mohammad; Bedrossian, Nora L; Picazo, Fernando; Sobel, Julia D; Fazel, Mahdieh; Te, Charisse; Pendergrass, Merri L

    2017-01-01

    The purpose of this study was to evaluate the effectiveness of supplemental diabetes-related training modalities and volunteer activities in increasing first-year medical students' knowledge/comfort in providing diabetes self-management education and support (DSMES) to patients. A group of medical students developed supplemental diabetes-related training/volunteer programs. The training modalities included an optional 7-session interprofessionally taught Diabetes Enrichment Elective and a 3-hour endocrinologist-led training session intended to prepare students for involvement in an inpatient DSMES volunteer program. The volunteer program provided the students with the opportunity to provide DSMES to patients with diabetes admitted to an academic medical center. Those participating in any of the stated programs were compared to those with no such training regarding confidence in providing DSMES using an optional online survey. The results were analyzed by using Mann-Whitney U test and descriptive analyses. A total of 18 first-year medical students responded to the optional survey with a response rate of ~30% (10 of 33) among participants in any training/volunteer program. First-year medical students who attended any of the offered optional programs had statistically significant higher comfort level in 4 of the 6 areas assessed regarding providing DSMES compared with those with no such training (ptraining modalities/volunteer programs can provide benefit in providing medical students with practical knowledge while improving their confidence in providing DSMES to patients with diabetes.

  3. What do healthcare providers know about nutrition support? A survey of the knowledge, attitudes, and practice of pharmacists and doctors toward nutrition support in Malaysia.

    Science.gov (United States)

    Karim, Sarah A; Ibrahim, Baharudin; Tangiisuran, Balamurugan; Davies, J Graham

    2015-05-01

    Malnutrition is one of the health problems that can be prevented by appropriate nutrition care provided by healthcare providers. However, this practice is still lacking possibly because of the providers' inadequate knowledge. The aim of this study was to evaluate the self-reported knowledge, attitudes, and practices of pharmacists and doctors toward nutrition support in a tertiary care hospital setting. A validated questionnaire was distributed to all the doctors and pharmacists working in a tertiary hospital in Penang, Malaysia. Seven individuals including academics, general surgeons, and pharmacists performed the face and content validity. The questionnaire was piloted using 24 healthcare providers at a different hospital. Of 400 surveyed, 158 doctors and 72 pharmacists from various grades completed the questionnaire. More doctors (31.6%) than pharmacists (15.3%) reported adequate knowledge to perform patients' nutrition screening. However, in the knowledge assessment, pharmacists had a higher mean score (6.07 ± 1.77) than the doctors did (4.59 ± 1.87; P doctors have ambivalent attitudes toward nutrition support. Only 31.3% stated that they perform nutrition screening on admission, and half of them performed nutrition assessment during hospitalization. Inappropriate nutrition care might be due to the lack of guidelines and insufficient knowledge among doctors and pharmacists. Special nutrition training and education for both pharmacists and doctors should be established. © 2014 American Society for Parenteral and Enteral Nutrition.

  4. Provider Opinions and Experiences Regarding Development of a Social Support Assessment to Inform Hospital Discharge: The Going Home Toolkit.

    Science.gov (United States)

    Wallace, Andrea; Papke, Todd; Davisson, Erica; Spooner, Kara; Gassman, Laura

    Despite over three decades of research linking social support and optimal health outcomes, social support is not systematically assessed or addressed during clinical care. This study sought input from health care providers to inform the design of an intervention intended to facilitate assessment of social support in a way that could aid in anticipatory planning during the process of hospital discharge. Using a purposive sampling strategy, data were collected from providers in two acute care settings serving rural patients, one academic and one community based. Opinions about what an assessment of social support would seek to accomplish, what is currently done and by whom, and the preferred format for delivery were elicited during a series of individual and group interviews. During phase two, feasibility was assessed with three inpatient nurses over 3 clinical days. Field notes were analyzed throughout the project using rapid data analysis techniques. Health care providers endorsed the creation of an assessment and stated that target users would include all members of the discharge team (e.g., clinical nurses, case managers, discharge coordinators, hospitalists, and specialty care). They identified the need for a patient-family resource (vs. a traditional provider-facing assessment). Participants stated that, although both the information collected and the interview process would meet a need to increase patient engagement in inpatient settings, competing clinical demands would require a tool that was easily completed by patients and family and seen as directly informing clinical activities. To this end, although focusing on the eventual development of an electronic tool seemed valuable, a hard-copy resource was considered more feasible for patient use at the present time. The preliminary test of the resulting hard-copy "Going Home Toolkit" demonstrated potential feasibility and usefulness during clinical practice. There is need for not only assessing patients

  5. A train the trainer program for healthcare professionals tasked with providing psychosocial support to breast cancer survivors.

    Science.gov (United States)

    Park, Eunyoung; Yoon, Junghee; Choi, Eun-Kyung; Kim, Im Ryung; Kang, Danbee; Lee, Se-Kyung; Lee, Jeong Eon; Nam, Seok Jin; Ahn, Jin Seok; Visser, Adriaan; Cho, Juhee

    2018-01-06

    The objective of this study is to develop, implement, and evaluate a training program for healthcare providers to improve ability to provide psychosocial support to breast cancer survivors in Korea. Based on a needs assessment survey and in-depth interviews with breast cancer survivors, a multidisciplinary team developed two-day intensive training program as well as education materials and counseling notes. Participants' overall satisfaction was evaluated after the training. The training program included a total of 16 lectures held over the course of seven sessions. Forty-one nurses and 3 social workers participated in the training program. Mean age was 37.5(± 6.4) years, and on average, they had 11.1 (± 5.6) years of experience. Participants' overall satisfaction was good as following: program contents (4.04), trainee guidebook (3.82), location and environment (4.10), and program organization (4.19). Among the participants, 31 (70.4%) received certification after submitting real consultation cases after the training. Two day intensive training can provide a comprehensive and coordinated education to healthcare professionals for implementing survivorship care with an emphasis on psychosocial support. Furthermore, the program should resume as a periodic continuing education course for healthcare providers. Similar education for graduate students in oncology nursing would be beneficial.

  6. Supporting diverse data providers in the open water data initiative: Communicating water data quality and fitness of use

    Science.gov (United States)

    Larsen, Sara; Hamilton, Stuart; Lucido, Jessica M.; Garner, Bradley D.; Young, Dwane

    2016-01-01

    Shared, trusted, timely data are essential elements for the cooperation needed to optimize economic, ecologic, and public safety concerns related to water. The Open Water Data Initiative (OWDI) will provide a fully scalable platform that can support a wide variety of data from many diverse providers. Many of these will be larger, well-established, and trusted agencies with a history of providing well-documented, standardized, and archive-ready products. However, some potential partners may be smaller, distributed, and relatively unknown or untested as data providers. The data these partners will provide are valuable and can be used to fill in many data gaps, but can also be variable in quality or supplied in nonstandardized formats. They may also reflect the smaller partners' variable budgets and missions, be intermittent, or of unknown provenance. A challenge for the OWDI will be to convey the quality and the contextual “fitness” of data from providers other than the most trusted brands. This article reviews past and current methods for documenting data quality. Three case studies are provided that describe processes and pathways for effective data-sharing and publication initiatives. They also illustrate how partners may work together to find a metadata reporting threshold that encourages participation while maintaining high data integrity. And lastly, potential governance is proposed that may assist smaller partners with short- and long-term participation in the OWDI.

  7. A Smartphone Application Supporting Recovery from Heroin Addiction: Perspectives of Patients and Providers in China, Taiwan, and the USA.

    Science.gov (United States)

    Schulte, Marya; Liang, Di; Wu, Fei; Lan, Yu-Ching; Tsay, Wening; Du, Jiang; Zhao, Min; Li, Xu; Hser, Yih-Ing

    2016-09-01

    Smartphone-based interventions are increasingly used to support self-monitoring, self-management, and treatment and medication compliance in order to improve overall functioning and well-being. In attempting to develop a smartphone application (S-Health) that assists heroin-dependent patients in recovery, a series of focus groups (72 patients, 22 providers) were conducted in China, Taiwan, and the USA to obtain their perspectives on its acceptance and potential adoption. Data were analyzed according to the Diffusion of Innovation (DOI) theory of characteristics important to the adoption of innovation. Important to Relative Advantage, USA participants cited S-Health's potential ability to overcome logistical barriers, while those in China and Taiwan valued its potential to supplement currently limited services. In terms of Compatibility, participants across sites reported recovery needs and goals that such an application could be helpful in supporting; however, its utility during strong craving was questioned in China and Taiwan. Important factors relevant to Complexity included concerns about smartphone access and familiarity, individualization of content, and particularly in China and Taiwan, participants wanted assurance of privacy and security. The study results suggest a general acceptance, but also indicate cultural variations in access to therapeutic and other social support systems, legal repercussions of substance use, societal perceptions of addiction, and the role of family and other social support in recovery. Taking these factors into consideration is likely to increase diffusion as well as effectiveness of these smartphone-based interventions.

  8. Changing current practice in urological cancer care: Providing better information, advice and related support on work engagement.

    Science.gov (United States)

    MacLennan, S J; Murdoch, S E; Cox, T

    2017-09-01

    There is a growing body of evidence on the importance of work following a diagnosis of cancer and the need to provide better information, advice and related support to patients on work engagement. The aim of this study was to better understand the nature of those needs and to identify better ways to meet these for those with a urological cancer. The focus was on the issues that were common to three key stakeholder groups. Semi-structured interviews were conducted with stakeholders in North East Scotland: 12 individuals with kidney, bladder or prostate cancer, 10 healthcare providers and 10 managers from large organisations. Five key themes emerged from the Framework Analysis: perceived importance of work engagement; decision-making: treatment, work and cancer; roles and responsibilities; education and training; information, advice and support resources. The data confirmed that work engagement is important to those with urological cancer. It also made clear that the current provision of information and advice could be improved. Any such interventions should involve all three key stakeholder groups with greater clarity on their respective roles and responsibilities. Finally, any new system would be best integrated with existing care provision and supported by adequate education and training of those involved. © 2017 John Wiley & Sons Ltd.

  9. Translating sustainability from strategy to operations: how can decision support mod-els help logistics service providers to attain strategic as well as operational goals?

    NARCIS (Netherlands)

    Reinder Pieters; Stef Weijers; Hans-Heinrich Glöckner

    2010-01-01

    Decision Support Models could help Logistic Service Providers as a means to make transportation more sustainable. When researching this hypothesis, we discovered that Logistic Service Providers were reluctant to use Decision Support Models when making transportation more sustainable.

  10. A prospective 5-year study of fixed partial prostheses supported by implants with machined and TiO2-blasted surface

    DEFF Research Database (Denmark)

    Gotfredsen, K; Karlsson, U

    2001-01-01

    PURPOSE: The aim of the present study was to evaluate whether there was a difference between machined and TiO(2)-blasted implants regarding survival rate and marginal bone loss during a 5-year observation period. MATERIALS AND METHODS: A total of 133 implants (Astra Tech Dental Implants; Astra Tech...... AB, Mölndal, Sweden) were placed in 50 patients at 6 centers in 4 Scandinavian countries. Forty-eight implants were installed in the maxilla and 85 implants in the mandible. A randomization and a stratification were done, so that each fixed partial prosthesis was supported by at least 1 machined...

  11. Laparoscopic Partial Nephrectomy Supported by Training Involving Personalized Silicone Replica Poured in Three-Dimensional Printed Casting Mold.

    Science.gov (United States)

    Golab, Adam; Smektala, Tomasz; Kaczmarek, Krystian; Stamirowski, Remigiusz; Hrab, Michal; Slojewski, Marcin

    2017-04-01

    Most kidney neoplasms are found incidentally and qualify for nephron-sparing surgery. Laparoscopic approach is beneficial to these patients because of its minimally invasive approach. However, these operations are both difficult and require plenty of experience and extended training. Some stages of the operation are limited by permissible time of transient ischemia. We applied three-dimensional (3D) printing technology to create individual silicone models of kidney to be used for training in laparoscopic procedures before the actual surgeries. Three patients who qualified for laparoscopic partial nephrectomy were selected. Digital models of their kidneys with tumors were designed based on computed tomography scans, followed by creation of silicone models. These were cast into the forms printed in 3D. The proper surgery was preceded by an operation carried out in a silicone model of laparoscopic simulator in which the tumor was excised and lodged after tumorectomy was filled. Average time of the live kidney tumor operation was slightly shorter than that of the silicone model (16 versus 17 minutes). Relatively short period of ischemia did not exceed 9 minutes. One patient underwent surgery without closing the vascular pedicle. Experience gained during training with these silicone models improved the actual surgery and can reduce the need for/duration of intraoperative renal ischemia. We believe this training method can be successfully used in other procedures.

  12. Complete mouth reconstruction with implant-supported fixed partial dental prostheses fabricated with zirconia frameworks: a 4-year clinical follow-up.

    Science.gov (United States)

    Puri, Shweta; Parciak, Ewa C; Kattadiyil, Mathew T

    2014-09-01

    Few scientific reports regarding the success of complete mouth partial fixed dental prostheses frameworks fabricated with zirconia are available, especially when dental implants serve as the abutments. A complete mouth reconstruction with zirconia frameworks veneered with feldspathic porcelain is reported involving a 65-year-old white woman who presented with partial edentulism and an unrestorable remaining dentition. After examination, 14 implants were planned (8 in the maxillary arch and 6 in the mandibular arch), and implant-supported zirconia framework screw-retained partial fixed dental prostheses (ISZPFDPs) were fabricated and made in sections for easier retrievability and management. No major complications were encountered during follow-up appointments at 6-month intervals for 4 years. However, minor fractures of the veneering ceramic were noted 4 years after placement. The ISZPFDPs were well accepted by the patient and had a favorable outcome in terms of patient acceptability and success, despite some complications. Copyright © 2014 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

  13. Promoting Military Cultural Awareness in an Off-post Community of Behavioral Health and Social Support Service Providers

    Directory of Open Access Journals (Sweden)

    Christi Duette Luby

    2012-03-01

    Full Text Available Due to U.S. military Base Realignment and Closure (BRAC efforts and ongoing Overseas Contingency Operations, the number of military servicemembers and veterans seeking civilian-based services has increased. As the military presence grows in previously underrepresented areas, the need for culturally competent providers will also increase both on and off military installations. The purpose of this article is to promote military cultural awareness, while suggesting ways to enhance existing community behavioral health and social support services. It builds on a review of the extant literature and findings from a community assessment to introduce civilian providers to some specific issues affecting servicemembers and their families. A framework describes ways to increase military cultural competence and build community capacity to enhance civilian-based services. In addition, two appendices list some common military terminology and multiple training resources available through military organizations and websites.

  14. Treadmill interventions with partial body weight support in children under six years of age at risk of neuromotor delay.

    Science.gov (United States)

    Valentin-Gudiol, Marta; Mattern-Baxter, Katrin; Girabent-Farrés, Montserrat; Bagur-Calafat, Caritat; Hadders-Algra, Mijna; Angulo-Barroso, Rosa Maria

    2011-12-07

    example, treadmill versus no intervention, high intensity treadmill versus low intensity); the time of evaluation (during the intervention or at various intervals after intervention), and the parameters assessed. Due to the diversity of the studies, we were only able to use data from three studies in meta-analyses and these were limited to two outcomes: age of onset of independent walking and gross motor function.Evidence suggested that treadmill intervention could lead to earlier onset of independent walking when compared to no treadmill intervention (two studies; effect estimate -1.47; 95% confidence interval (CI): -2.97, 0.03), though these trials studied two different populations and children with Down syndrome seemed to benefit while it was not clear if this was the case for children at high risk of neuromotor disabilities. Another two studies, both in children with Down syndrome, compared different types of treadmill intervention: one compared treadmill intervention with and without orthotics, while the other compared high versus low intensity treadmill intervention. Both were inconclusive regarding the impact of these different protocols on the age at which children started to walk.There is insufficient evidence to determine whether treadmill intervention improves gross motor function (two studies; effect estimate 0.88; 95% CI: -4.54, 6.30). In the one study evaluating treadmill with and without orthotics, results suggested that adding orthotics might hinder gross motor progress (effect estimate -8.40; 95% CI: -14.55, -2.25).One study of children with Down syndrome measured the age of onset of assisted walking and reported those receiving the treadmill intervention were able to walk with assistance earlier than those who did not receive the intervention (effect estimate -74.00; 95% CI: -135.40, -12.60). Another study comparing high and low intensity treadmill was unable to conclude whether one was more effective than the other in helping children achieve supported

  15. Effects of computer-aided clinical decision support systems in improving antibiotic prescribing by primary care providers: a systematic review.

    Science.gov (United States)

    Holstiege, Jakob; Mathes, Tim; Pieper, Dawid

    2015-01-01

    To assess the effectiveness of computer-aided clinical decision support systems (CDSS) in improving antibiotic prescribing in primary care. A literature search utilizing Medline (via PubMed) and Embase (via Embase) was conducted up to November 2013. Randomized controlled trials (RCTs) and cluster randomized trials (CRTs) that evaluated the effects of CDSS aiming at improving antibiotic prescribing practice in an ambulatory primary care setting were included for review. Two investigators independently extracted data about study design and quality, participant characteristics, interventions, and outcomes. Seven studies (4 CRTs, 3 RCTs) met our inclusion criteria. All studies were performed in the USA. Proportions of eligible patient visits that triggered CDSS use varied substantially between intervention arms of studies (range 2.8-62.8%). Five out of seven trials showed marginal to moderate statistically significant effects of CDSS in improving antibiotic prescribing behavior. CDSS that automatically provided decision support were more likely to improve prescribing practice in contrast to systems that had to be actively initiated by healthcare providers. CDSS show promising effectiveness in improving antibiotic prescribing behavior in primary care. Magnitude of effects compared to no intervention, appeared to be similar to other moderately effective single interventions directed at primary care providers. Additional research is warranted to determine CDSS characteristics crucial to triggering high adoption by providers as a perquisite of clinically relevant improvement of antibiotic prescribing. © The Author 2014. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.comFor numbered affiliations see end of article.

  16. Support and services provided by public health regional surveillance teams to Local Health Departments in North Carolina.

    Science.gov (United States)

    Horney, Jennifer A; Markiewicz, Milissa; Meyer, Anne Marie; Macdonald, Pia D M

    2011-01-01

    Since 2001, many states have created regional structures in an effort to better coordinate/public health preparedness and response efforts, consolidate services, and supplement local government capacity. While several studies have identified specific benefits to regionalization, including enhanced networking, coordination, and communication, little research has examined the effect of regionalization on specific preparedness and response activities. To better understand the impact of regionalizing public health workforce assets in North Carolina, a survey aimed at documenting specific support and services that Public Health Regional Surveillance Teams(PHRSTs) provide to local health departments (LHDs) was developed and administered by the North Carolina Preparedness and Emergency Response Research Center, located at the North Carolina Institute for Public Health. Of80 potential types of assistance, 26 (33%) were received by 75% or more LHDs, including 9 related to communication and 7 related to exercises. There was significant variation by PHRST region in both the quantity and quality of support and services reported by LHDs. This variation could not be explained by county- or LHD-level variables. PHRST assistance to LHDs is largely focused on communication and liaison activities, regional exercises, and planning. On the basis of these findings, regionalization may provide North Carolina with benefits consistent with those found in other studies such as improved networking and coordination. However, further research is needed to identify whether regional variation is the result of varying capacity or priorities of the PHRSTs or LHDs and to determine how much variation is acceptable.

  17. Community, intervention and provider support influences on implementation: reflections from a South African illustration of safety, peace and health promotion

    Science.gov (United States)

    2014-01-01

    Background The development, implementation and evaluation of community interventions are important for reducing child violence and injuries in low- to middle-income contexts, with successful implementation critical to effective intervention outcomes. The assessment of implementation processes is required to identify the factors that influence effective implementation. This article draws on a child safety, peace and health initiative to examine key factors that enabled or hindered its implementation, in a context characterised by limited resources. Methods A case study approach was employed. The research team was made up of six researchers and intervention coordinators, who led the development and implementation of the Ukuphepha Child Study in South Africa, and who are also the authors of this article. The study used author observations, reflections and discussions of the factors perceived to influence the implementation of the intervention. The authors engaged in an in-depth and iterative dialogic process aimed at abstracting the experiences of the intervention, with a recursive cycle of reflection and dialogue. Data were analysed utilising inductive content analysis, and categorised using classification frameworks for understanding implementation. Results The study highlights key factors that enabled or hindered implementation. These included the community context and concomitant community engagement processes; intervention compatibility and adaptability issues; community service provider perceptions of intervention relevance and expectations; and the intervention support system, characterised by training and mentorship support. Conclusions This evaluation illustrated the complexity of intervention implementation. The study approach sought to support intervention fidelity by fostering and maintaining community endorsement and support, a prerequisite for the unfolding implementation of the intervention. PMID:25081088

  18. A Pilot Study to Examine the Feasibility and Potential Effectiveness of Using Smartphones to Provide Recovery Support for Adolescents.

    Science.gov (United States)

    Dennis, Michael L; Scott, Christy K; Funk, Rodney R; Nicholson, Lisa

    2015-01-01

    Smartphone applications can potentially provide recovery monitoring and support in real-time, real-life contexts. Study aims included determining feasibility of (a) adolescents completing ecological momentary assessments (EMAs) and utilizing phone-based ecological momentary interventions (EMIs); and (b) using EMA and EMI data to predict substance use in the subsequent week. Twenty-nine adolescents were recruited at discharge from residential treatment, regardless of their discharge status or length of stay. During the 6-week pilot, youth were prompted to complete an EMA at 6 random times per day and were provided access to a suite of recovery support EMI. Youth completed 87% of the 5580 EMAs. Based on use in the next 7 days, EMA observations were classified into 3 risk groups: "Current Use" in the past 30 minutes (3% of observations), "Unrecognized Risk" (42%), or "Recognized Risk" (55%). All youth had observations in 2 or more risk groups and 38% in all 3. Youth accessed an EMI on average 162 times each week. Participants were 31% female, 48% African American, 21% Caucasian, 7% Hispanic, and 24% Mixed/Other; average age was 16.6 years. During the 90 days prior to entering treatment, youth reported using alcohol (38%), marijuana (41%), and other drugs (7%). When compared with the "Recognized Risk" group's use in the following week (31%), both the "Unrecognized Risk" (50%, odds ratio [OR]=2.08) and "Current Use" (96%, OR=50.30) groups reported significantly higher rates of use in the next week. When an EMI was accessed 2 or more times within the hour following an EMA, the rate of using during the next week was significantly lower than when EMIs were not accessed (32% vs. 43%, OR=0.62). Results demonstrate the feasibility of using smartphones for recovery monitoring and support with adolescents, with potential to reduce use.

  19. Four-millimeter implants supporting fixed partial dental prostheses in the severely resorbed posterior mandible: two-year results.

    Science.gov (United States)

    Slotte, Christer; Grønningsaeter, Arne; Halmøy, Anne-Marie; Öhrnell, Lars-Olof; Stroh, Göran; Isaksson, Sten; Johansson, Lars-Åke; Mordenfeld, Arne; Eklund, Jan; Embring, Jan

    2012-05-01

    Reduced alveolar bone volume complicates implant dentistry. In this prospective multicenter study, a new, 4-mm long Straumann SLActive implant (Ø 4.1 mm) supporting a fixed dental prosthesis (FDP) in the severely resorbed posterior mandible was evaluated for two years. Thirty-two patients (11 men, 21 women; mean age 64.1 years) participated. Ten to 12 weeks after single-stage surgery, a screw-retained FDP was attached to three or four 4-mm implants. One hundred implants were inserted. Three failed at surgery and four were lost before loading. Twenty-eight patients received FDPs (93 implants). Two patients were discontinued because of secondary exclusion criteria; therefore, 26 patients were followed up from baseline (BL). After 1 year, one patient insisted on removal of all implants and one patient died because of nonstudy-related complications. Twenty-four patients (87 implants) were eligible for examination 2 years post-loading. All implants were found to be stable [survival rate 95.7% (confidence interval, CI 88.8-98.3) after 1 year and 92.3% (CI 84.5-96.2) after 2 years]. The mean change from BL to 12 months was - 0.43 mm (CI 0.31-0.59; p care to avoid overdrilling. Careful planning and design of the prosthetic construction is mandatory to prevent unfavorable occlusion and avoid harmful shear forces. This study showed that 4 mm implants can support an FDP in severely resorbed posterior mandibles for at least 2 years and with healthy peri-implant conditions. © 2011 Wiley Periodicals, Inc.

  20. Logistic support provided to Australian disaster medical assistance teams: results of a national survey of team members

    Science.gov (United States)

    Aitken, Peter; Leggat, Peter; Harley, Hazel; Speare, Richard; Leclercq, Muriel

    2012-01-01

    Background It is likely that calls for disaster medical assistance teams (DMATs) continue in response to international disasters. As part of a national survey, the present study was designed to evaluate the Australian DMAT experience and the need for logistic support. Methods Data were collected via an anonymous mailed survey distributed via State and Territory representatives on the Australian Health Protection Committee, who identified team members associated with Australian DMAT deployments from the 2004 Asian Tsunami disaster. Results The response rate for this survey was 50% (59/118). Most of the personnel had deployed to the South East Asian Tsunami affected areas. The DMAT members had significant clinical and international experience. There was unanimous support for dedicated logistic support with 80% (47/59) strongly agreeing. Only one respondent (2%) disagreed with teams being self sufficient for a minimum of 72 hours. Most felt that transport around the site was not a problem (59%; 35/59), however, 34% (20/59) felt that transport to the site itself was problematic. Only 37% (22/59) felt that pre-deployment information was accurate. Communication with local health providers and other agencies was felt to be adequate by 53% (31/59) and 47% (28/59) respectively, while only 28% (17/59) felt that documentation methods were easy to use and reliable. Less than half (47%; 28/59) felt that equipment could be moved easily between areas by team members and 37% (22/59) that packaging enabled materials to be found easily. The maximum safe container weight was felt to be between 20 and 40 kg by 58% (34/59). Conclusions This study emphasises the importance of dedicated logistic support for DMAT and the need for teams to be self sufficient for a minimum period of 72 hours. There is a need for accurate pre deployment information to guide resource prioritisation with clearly labelled pre packaging to assist access on site. Container weights should be restricted to between

  1. Supporting the minority physician pipeline: providing global health experiences to undergraduate students in the United States–Mexico border region

    Science.gov (United States)

    Burgos, Jose L.; Yee, Daniel; Csordas, Thomas; Vargas-Ojeda, Adriana C.; Segovia, Luis A.; Strathdee, Steffanie A.; Olivares-Nevarez, Jose A.; Ojeda, Victoria D.

    2015-01-01

    Background The sizeable US Latino population calls for increasing the pipeline of minority and bilingual physicians who can provide culturally competent care. Currently, only 5.5% of US providers are Hispanic/Latino, compared with 16% of the US population (i.e., >50.5 million persons). By 2060, it is predicted that about one-third of all US residents will be of Latino ethnicity. Activities and outcomes This article describes the Health Frontiers in Tijuana Undergraduate Internship Program (HFiT-UIP), a new quarterly undergraduate internship program based at a US–Mexico binational student-run free clinic and sponsored by the University of California, San Diego School of Medicine and the Universidad Autónoma de Baja California in Tijuana, Mexico. The HFiT-UIP provides learning opportunities for students and underrepresented minorities interested in medical careers, specifically Latino health. Discussion The HFiT-UIP might serve as a model for other educational partnerships across the US–Mexico border region and may help minority and other undergraduates seeking academic and community-based enrichment experiences. The HFiT-UIP can also support students’ desires to learn about Latino, border, and global health within resource-limited settings. PMID:26088189

  2. Supporting the minority physician pipeline: providing global health experiences to undergraduate students in the United States–Mexico border region

    Directory of Open Access Journals (Sweden)

    Jose L. Burgos

    2015-06-01

    Full Text Available Background: The sizeable US Latino population calls for increasing the pipeline of minority and bilingual physicians who can provide culturally competent care. Currently, only 5.5% of US providers are Hispanic/Latino, compared with 16% of the US population (i.e., >50.5 million persons. By 2060, it is predicted that about one-third of all US residents will be of Latino ethnicity. Activities and outcomes: This article describes the Health Frontiers in Tijuana Undergraduate Internship Program (HFiT-UIP, a new quarterly undergraduate internship program based at a US–Mexico binational student-run free clinic and sponsored by the University of California, San Diego School of Medicine and the Universidad Autónoma de Baja California in Tijuana, Mexico. The HFiT-UIP provides learning opportunities for students and underrepresented minorities interested in medical careers, specifically Latino health. Discussion: The HFiT-UIP might serve as a model for other educational partnerships across the US–Mexico border region and may help minority and other undergraduates seeking academic and community-based enrichment experiences. The HFiT-UIP can also support students’ desires to learn about Latino, border, and global health within resource-limited settings.

  3. Supporting the minority physician pipeline: providing global health experiences to undergraduate students in the United States-Mexico border region.

    Science.gov (United States)

    Burgos, Jose L; Yee, Daniel; Csordas, Thomas; Vargas-Ojeda, Adriana C; Segovia, Luis A; Strathdee, Steffanie A; Olivares-Nevarez, Jose A; Ojeda, Victoria D

    2015-01-01

    The sizeable US Latino population calls for increasing the pipeline of minority and bilingual physicians who can provide culturally competent care. Currently, only 5.5% of US providers are Hispanic/Latino, compared with 16% of the US population (i.e., >50.5 million persons). By 2060, it is predicted that about one-third of all US residents will be of Latino ethnicity. This article describes the Health Frontiers in Tijuana Undergraduate Internship Program (HFiT-UIP), a new quarterly undergraduate internship program based at a US-Mexico binational student-run free clinic and sponsored by the University of California, San Diego School of Medicine and the Universidad Autónoma de Baja California in Tijuana, Mexico. The HFiT-UIP provides learning opportunities for students and underrepresented minorities interested in medical careers, specifically Latino health. The HFiT-UIP might serve as a model for other educational partnerships across the US-Mexico border region and may help minority and other undergraduates seeking academic and community-based enrichment experiences. The HFiT-UIP can also support students' desires to learn about Latino, border, and global health within resource-limited settings.

  4. Flat and complex temperate reefs provide similar support for fish: Evidence for a unimodal species-habitat relationship.

    Science.gov (United States)

    Paxton, Avery B; Pickering, Emily A; Adler, Alyssa M; Taylor, J Christopher; Peterson, Charles H

    2017-01-01

    Structural complexity, a form of habitat heterogeneity, influences the structure and function of ecological communities, generally supporting increased species density, richness, and diversity. Recent research, however, suggests the most complex habitats may not harbor the highest density of individuals and number of species, especially in areas with elevated human influence. Understanding nuances in relationships between habitat heterogeneity and ecological communities is warranted to guide habitat-focused conservation and management efforts. We conducted fish and structural habitat surveys of thirty warm-temperate reefs on the southeastern US continental shelf to quantify how structural complexity influences fish communities. We found that intermediate complexity maximizes fish abundance on natural and artificial reefs, as well as species richness on natural reefs, challenging the current paradigm that abundance and other fish community metrics increase with increasing complexity. Naturally occurring rocky reefs of flat and complex morphologies supported equivalent abundance, biomass, species richness, and community composition of fishes. For flat and complex morphologies of rocky reefs to receive equal consideration as essential fish habitat (EFH), special attention should be given to detecting pavement type rocky reefs because their ephemeral nature makes them difficult to detect with typical seafloor mapping methods. Artificial reefs of intermediate complexity also maximized fish abundance, but human-made structures composed of low-lying concrete and metal ships differed in community types, with less complex, concrete structures supporting lower numbers of fishes classified largely as demersal species and metal ships protruding into the water column harboring higher numbers of fishes, including more pelagic species. Results of this study are essential to the process of evaluating habitat function provided by different types and shapes of reefs on the seafloor

  5. Flat and complex temperate reefs provide similar support for fish: Evidence for a unimodal species-habitat relationship.

    Directory of Open Access Journals (Sweden)

    Avery B Paxton

    Full Text Available Structural complexity, a form of habitat heterogeneity, influences the structure and function of ecological communities, generally supporting increased species density, richness, and diversity. Recent research, however, suggests the most complex habitats may not harbor the highest density of individuals and number of species, especially in areas with elevated human influence. Understanding nuances in relationships between habitat heterogeneity and ecological communities is warranted to guide habitat-focused conservation and management efforts. We conducted fish and structural habitat surveys of thirty warm-temperate reefs on the southeastern US continental shelf to quantify how structural complexity influences fish communities. We found that intermediate complexity maximizes fish abundance on natural and artificial reefs, as well as species richness on natural reefs, challenging the current paradigm that abundance and other fish community metrics increase with increasing complexity. Naturally occurring rocky reefs of flat and complex morphologies supported equivalent abundance, biomass, species richness, and community composition of fishes. For flat and complex morphologies of rocky reefs to receive equal consideration as essential fish habitat (EFH, special attention should be given to detecting pavement type rocky reefs because their ephemeral nature makes them difficult to detect with typical seafloor mapping methods. Artificial reefs of intermediate complexity also maximized fish abundance, but human-made structures composed of low-lying concrete and metal ships differed in community types, with less complex, concrete structures supporting lower numbers of fishes classified largely as demersal species and metal ships protruding into the water column harboring higher numbers of fishes, including more pelagic species. Results of this study are essential to the process of evaluating habitat function provided by different types and shapes of

  6. Opinions of Artistically Talented Eminent Adults on Supports Provided by the State for Gifted Children in the Arts

    Directory of Open Access Journals (Sweden)

    Faruk Levent

    2017-12-01

    Full Text Available The purpose of the study was to examine opinions of artists in music about state supports for students talented in music. Participants had state sup-ports in music when they were young. A phenomenological study was undertaken to interview the participants. They were interviewed face to face. Data was coded and content-analyzed and categorized by themes. The findings showed that all of the participants expressed that policies related to the education of gifted children in the field of arts in Turkey did not work anymore, losing functionality and effects and special services to be provided for artistically gifted students depended upon individuals who were in charge, showing that the policies were no longer useful. In addition, the participants stated that policies and practices have changed constantly as a result of changes in perceptions of educational politics and decision makers. Therefore, it is reasonable to claim that the greatest challenge in the education of students highly talented in the arts is the lack of a consistent and sustainable national policy

  7. Communication architecture for AAL. Supporting patient care by health care providers in AAL-enhanced living quarters.

    Science.gov (United States)

    Nitzsche, T; Thiele, S; Häber, A; Winter, A

    2014-01-01

    This article is part of the Focus Theme of Methods of Information in Medicine on "Using Data from Ambient Assisted Living and Smart Homes in Electronic Health Records". Concepts of Ambient Assisted Living (AAL) support a long-term health monitoring and further medical and other services for multi-morbid patients with chronic diseases. In Germany many AAL and telemedical applications exist. Synergy effects by common agreements for essential application components and standards are not achieved. It is necessary to define a communication architecture which is based on common definitions of communication scenarios, application components and communication standards. The development of a communication architecture requires different steps. To gain a reference model for the problem area different AAL and telemedicine projects were compared and relevant data elements were generalized. The derived reference model defines standardized communication links. As a result the authors present an approach towards a reference architecture for AAL-communication. The focus of the architecture lays on the communication layer. The necessary application components are identified and a communication based on standards and their extensions is highlighted. The exchange of patient individual events supported by an event classification model, raw and aggregated data from the personal home area over a telemedicine center to health care providers is possible.

  8. [Six years of Advanced Trauma Life Support (ATLS) in Germany: the 100th provider course in Hamburg].

    Science.gov (United States)

    Münzberg, M; Mahlke, L; Bouillon, B; Paffrath, T; Matthes, G; Wölfl, C G

    2010-07-01

    With over 1 million certified physicians in more than 50 countries worldwide, the Advanced Trauma Life Support (ATLS) concept is one of the most successful international education programs. The concept is simple, priority-orientated (ABCDE scheme) and assesses the situation of the trauma patient on the basis of vital signs to treat the life-threatening injuries immediately. With over 100 ATLS provider courses and 10 instruction courses accomplished in less than 6 years, no other land in the world has successfully established this concept in such a short time as Germany. Meanwhile nearly 1,600 colleagues have been trained and certified. Evaluation of the first 100 ATLS courses in Germany supports this concept. The total evaluation of all courses is 1.36 (1.06-1.8, n=100). The individual parts of the course were marked as followed: presentations 1.6 (1.0-2.81, n=100), practical skills stations 1.46 (1.0-2.4, n=100) and surgical skills stations 1.38 (1.0-2.38, n=100). In 2009 a total of 47 ATLS courses were accomplished which will clearly increase in 2010. Other ATLS formats, such as ATCN (Advanced Trauma Care for Nurses) and refresher courses are planned for the beginning of 2010.

  9. Perceived needs for support among care home staff providing end of life care for people with dementia: a qualitative study.

    Science.gov (United States)

    Vandrevala, T; Samsi, K; Rose, C; Adenrele, C; Barnes, C; Manthorpe, J

    2017-02-01

    The aim of the current exploratory study was to investigate the impact on care home staff when working with people with dementia at the end of life and to explore how they cope with this aspect of their work. With UK policy encouraging death in the place of residence, rather than hospital, more people with dementia are dying in care homes. A qualitative approach was employed; 20 care home staff working in five English care homes were interviewed. Thematic Analysis was used to analyse the data. Care home staff found the external demands on them and difficulties associated with interacting with people with dementia sometimes challenging, stressful and anxiety-provoking, particularly as residents approached end of life. Emotional aspects of caring for dying residents were sometimes heightened by close attachments with residents and their families. Staff were able to recognise these unmet needs and identified a need for further training and emotional support to manage these stressors. This study revealed rich and complex understandings of the practice dimensions of caring for people with dementia at the end of life and the impact these have on staff. There is a need to develop effective psychosocial interventions that focus on emotional support for care home staff. There will be challenges in providing this in employment settings that are generally low paid, low status, have high turnover and are reliant on temporary or migrant staff, where training is not rewarded, mandatory or culturally valued. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

  10. Providing Logistics Support to CDC-Deployed Staff for the Ebola Response in Liberia, Guinea, and Sierra Leone.

    Science.gov (United States)

    Dopson, Stephanie A; Rodriguez, Rockie; Rouse, Edward N

    2015-11-01

    The first Ebola cases in West Africa were reported by the Guinea Ministry of Health on March 23, 2014, and by June it became the largest recorded Ebola outbreak. Centers for Disease Control and Prevention field teams were deployed to West Africa, including in-country logistics staff who were critical for ensuring the movement of staff, equipment, and supplies to locations where public health knowledge and experience were applied to meet mission-related requirements. The logistics role was critical to creating the support for epidemiologists, medical doctors, laboratory staff, and health communicators involved in health promotion activities to successfully respond to the epidemic, both in the capital cities and in remote villages. Logistics personnel worked to procure equipment, such as portable video projectors, and have health promotion materials printed. Logistics staff also coordinated delivery of communication and health promotion materials to the embassy and provided assistance with distribution to various partners. © 2015 Society for Public Health Education.

  11. Controlling the hydrogenolysis of silica-supported tungsten pentamethyl leads to a class of highly electron deficient partially alkylated metal hydrides

    KAUST Repository

    Maity, Niladri

    2015-11-30

    The well-defined single-site silica-supported tungsten complex [([triple bond, length as m-dash]Si–O–)W(Me)5], 1, is an excellent precatalyst for alkane metathesis. The unique structure of 1 allows the synthesis of unprecedented tungsten hydrido methyl surface complexes via a controlled hydrogenolysis. Specifically, in the presence of molecular hydrogen, 1 is quickly transformed at −78 °C into a partially alkylated tungsten hydride, 4, as characterized by 1H solid-state NMR and IR spectroscopies. Species 4, upon warming to 150 °C, displays the highest catalytic activity for propane metathesis yet reported. DFT calculations using model systems support the formation of [([triple bond, length as m-dash]Si–O–)WH3(Me)2], as the predominant species at −78 °C following several elementary steps of hydrogen addition (by σ-bond metathesis or α-hydrogen transfer). Rearrangement of 4 occuring between −78 °C and room temperature leads to the formation of an unique methylidene tungsten hydride [([triple bond, length as m-dash]Si–O–)WH3([double bond, length as m-dash]CH2)], as determined by solid-state 1H and 13C NMR spectroscopies and supported by DFT. Thus for the first time, a coordination sphere that incorporates both carbene and hydride functionalities has been observed.

  12. Adenovirus vector-based multi-epitope vaccine provides partial protection against H5, H7, and H9 avian influenza viruses.

    Directory of Open Access Journals (Sweden)

    Ahmed O Hassan

    Full Text Available The emergence of H5, H7, and H9 avian influenza virus subtypes in humans reveals their pandemic potential. Although human-to-human transmission has been limited, the genetic reassortment of the avian and human/porcine influenza viruses or mutations in some of the genes resulting in virus replication in the upper respiratory tract of humans could generate novel pandemic influenza viruses. Current vaccines do not provide cross protection against antigenically distinct strains of the H5, H7, and H9 influenza viruses. Therefore, newer vaccine approaches are needed to overcome these potential threats. We developed an egg-independent, adenovirus vector-based, multi-epitope (ME vaccine approach using the relatively conserved immunogenic domains of the H5N1 influenza virus [M2 ectodomain (M2e, hemagglutinin (HA fusion domain (HFD, T-cell epitope of nucleoprotein (TNP. and HA α-helix domain (HαD]. Our ME vaccine induced humoral and cell-mediated immune responses and caused a significant reduction in the viral loads in the lungs of vaccinated mice that were challenged with antigenically distinct H5, H7, or H9 avian influenza viruses. These results suggest that our ME vaccine approach provided broad protection against the avian influenza viruses. Further improvement of this vaccine will lead to a pre-pandemic vaccine that may lower morbidity, hinder transmission, and prevent mortality in a pandemic situation before a strain-matched vaccine becomes available.

  13. Effect of cantilever length and alloy framework on the stress distribution in peri-implant area of cantilevered implant-supported fixed partial dentures

    Directory of Open Access Journals (Sweden)

    Valdey SUEDAM

    2016-04-01

    Full Text Available ABSTRACT Because many mechanical variables are present in the oral cavity, the proper load transfer between the prosthesis and the bone is important for treatment planning and for the longevity of the implant-supported fixed partial denture. Objectives To verify the stress generated on the peri-implant area of cantilevered implant-supported fixed partial dentures and the potential effects of such variable. Material and Methods A U-shaped polyurethane model simulating the mandibular bone containing two implants (Ø 3.75 mm was used. Six groups were formed according to the alloy’s framework (CoCr or PdAg and the point of load application (5 mm, 10 mm and 15 mm of cantilever arm. A 300 N load was applied in pre-determined reference points. The tension generated on the mesial, lingual, distal and buccal sides of the peri-implant regions was assessed using strain gauges. Results Two-way ANOVA and Tukey statistical tests were applied showing significant differences (p<0.05 between the groups. Pearson correlation test (p<0.05 was applied showing positive correlations between the increase of the cantilever arm and the deformation of the peri-implant area. Conclusions This report demonstrated the CoCr alloy shows larger compression values compared to the PdAg alloy for the same distances of cantilever. The point of load application influences the deformation on the peri-implant area, increasing in accordance with the increase of the lever arm.

  14. Removable partial dentures: clinical concepts.

    Science.gov (United States)

    Bohnenkamp, David M

    2014-01-01

    This article provides a review of the traditional clinical concepts for the design and fabrication of removable partial dentures (RPDs). Although classic theories and rules for RPD designs have been presented and should be followed, excellent clinical care for partially edentulous patients may also be achieved with computer-aided design/computer-aided manufacturing technology and unique blended designs. These nontraditional RPD designs and fabrication methods provide for improved fit, function, and esthetics by using computer-aided design software, composite resin for contours and morphology of abutment teeth, metal support structures for long edentulous spans and collapsed occlusal vertical dimensions, and flexible, nylon thermoplastic material for metal-supported clasp assemblies. Copyright © 2014 Elsevier Inc. All rights reserved.

  15. Protein Based Molecular Markers Provide Reliable Means to Understand Prokaryotic Phylogeny and Support Darwinian Mode of Evolution

    Directory of Open Access Journals (Sweden)

    Vaibhav eBhandari

    2012-07-01

    Full Text Available The analyses of genome sequences have led to the proposal that lateral gene transfers (LGTs among prokaryotes are so widespread that they disguise the interrelationships among these organisms. This has led to questioning whether the Darwinian model of evolution is applicable to the prokaryotic organisms. In this review, we discuss the usefulness of taxon-specific molecular markers such as conserved signature indels (CSIs and conserved signature proteins (CSPs for understanding the evolutionary relationships among prokaryotes and to assess the influence of LGTs on prokaryotic evolution. The analyses of genomic sequences have identified large numbers of CSIs and CSPs that are unique properties of different groups of prokaryotes ranging from phylum to genus levels. The species distribution patterns of these molecular signatures strongly support a tree-like vertical inheritance of the genes containing these molecular signatures that is consistent with phylogenetic trees. Recent detailed studies in this regard on Thermotogae and Archaea, which are reviewed here, have identified large numbers of CSIs and CSPs that are specific for the species from these two taxa and a number of their major clades. The genetic changes responsible for these CSIs (and CSPs initially likely occurred in the common ancestors of these taxa and then vertically transferred to various descendants. Although some CSIs and CSPs in unrelated groups of prokaryotes were identified, their small numbers and random occurrence has no apparent influence on the consistent tree-like branching pattern emerging from other markers. These results provide evidence that although LGT is an important evolutionary force, it does not mask the tree-like branching pattern of prokaryotes or understanding of their evolutionary relationships. The identified CSIs and CSPs also provide novel and highly specific means for identification of different groups of microbes and for taxonomical and biochemical

  16. Dying at home: a qualitative study of family carers' views of support provided by GPs community staff.

    Science.gov (United States)

    Seamark, David; Blake, Susan; Brearley, Sarah G; Milligan, Christine; Thomas, Carol; Turner, Mary; Wang, Xu; Payne, Sheila

    2014-12-01

    Dying at home is the preference of many patients with life-limiting illness. This is often not achieved and a key factor is the availability of willing and able family carers. To elicit family carers' views about the community support that made death at home possible. Qualitative study in East Devon, North Lancashire, and Cumbria. Participants were bereaved family carers who had provided care at the end of life for patients dying at home. Semi-structured interviews were conducted 6-24 months after the death. Fifty-nine bereaved family carers were interviewed (54% response rate; 69% female). Two-thirds of the patients died from cancer with median time of home care being 5 months and for non-cancer patients the median time for home care was 30 months. An overarching theme was of continuity of care that divided into personal, organisational, and informational continuity. Large numbers and changes in care staff diluted personal continuity and failure of the GPs to visit was viewed negatively. Family carers had low expectations of informational continuity, finding information often did not transfer between secondary and primary care and other care agencies. Organisational continuity when present provided comfort and reassurance, and a sense of control. The requirement for continuity in delivering complex end-of-life care has long been acknowledged. Family carers in this study suggested that minimising the number of carers involved in care, increasing or ensuring personal continuity, and maximising the informational and organisational aspects of care could lead to a more positive experience. © British Journal of General Practice 2014.

  17. Extracellular matrix inspired surface functionalization with heparin, fibronectin and VEGF provides an anticoagulant and endothelialization supporting microenvironment

    Energy Technology Data Exchange (ETDEWEB)

    Wang, Xue [Key Laboratory of Advanced Technology for Materials of Chinese Education Ministry, School of Materials Science and Engineering, Southwest Jiaotong University, Chengdu (China); Liu, Tao [Key Laboratory of Advanced Technology for Materials of Chinese Education Ministry, School of Materials Science and Engineering, Southwest Jiaotong University, Chengdu (China); Jiangsu Provincial Key Laboratory for Interventional Medical Devices, Huaiyin Institute of Technology, Huai’an (China); Chen, Yuan [Key Laboratory of Advanced Technology for Materials of Chinese Education Ministry, School of Materials Science and Engineering, Southwest Jiaotong University, Chengdu (China); Zhang, Kun [Key Laboratory of Advanced Technology for Materials of Chinese Education Ministry, School of Materials Science and Engineering, Southwest Jiaotong University, Chengdu (China); School of Life Science, Zhengzhou University, Zhengzhou (China); Maitz, Manfred F. [Key Laboratory of Advanced Technology for Materials of Chinese Education Ministry, School of Materials Science and Engineering, Southwest Jiaotong University, Chengdu (China); Leibniz Institute of Polymer Research Dresden, Max Bergmann Center of Biomaterials, Hohe Str. 06, 01069 Dresden (Germany); Pan, Changjiang [Jiangsu Provincial Key Laboratory for Interventional Medical Devices, Huaiyin Institute of Technology, Huai’an (China); Chen, Junying, E-mail: chenjy@263.net [Key Laboratory of Advanced Technology for Materials of Chinese Education Ministry, School of Materials Science and Engineering, Southwest Jiaotong University, Chengdu (China); Huang, Nan [Key Laboratory of Advanced Technology for Materials of Chinese Education Ministry, School of Materials Science and Engineering, Southwest Jiaotong University, Chengdu (China)

    2014-11-30

    Highlights: • Surface modification with fibronectin, heparin and VEGF could selectively anticoagulant and promote endothelialization. • The bioactivity of biomolecules was more efficiently maintained via specific intermolecular interaction. • Poly-l-lysine interlayer was more feasible and the degradation product had no harm to human body. - Abstract: The biocompatibility of currently used coronary artery stent is still far from perfect, which closely related to insufficient endothelialization and thrombus formation. In this study, heparin, fibronectin and VEGF were immobilized on Ti surface to construct a multifunctional microenvironment with favorable properties to inhibit thrombosis formation and promote endothelialization simultaneously. The microenvironment on Ti surface was characterized in detail and demonstrated that the Hep/Fn/VEGF biofunctional coating was constructed successfully on Ti surface. The influence of surface properties such as chemical composition, roughness, hydrophilicity, and binding density of biomolecules on the performances of hemocompatibility and cytocompatibility was evaluated and discussed. Modified surface significantly enhanced the AT III binding density and prolonged the clotting time. In vitro platelet adhesion and activation assays further proved that the modified surface presented favorable anti-coagulant property. In addition, the proliferation of endothelial progenitor cells (EPCs) and endothelial cells (ECs) on the Hep/Fn/VEGF biofunctional coating was significantly promoted. In conclusion, the Hep/Fn/VEGF biofunctional coating was successfully constructed with desirable anticoagulant and endothelialization supporting properties. This work may provide a promising approach for biofunctional surface modification of coronary artery stent to acquire a desired multifunctional microenvironment.

  18. Preventing HIV transmission among Iranian prisoners: Initial support for providing education on the benefits of harm reduction practices

    Science.gov (United States)

    Eshrati, Babak; Asl, Rahim Taghizadeh; Dell, Colleen Anne; Afshar, Parviz; Millson, Peggy Margaret E; Kamali, Mohammad; Weekes, John

    2008-01-01

    Background Harm reduction is a health-centred approach that seeks to reduce the health and social harms associated with high-risk behaviors, such as illicit drug use. The objective of this study is to determine the association between the beliefs of a group of adult, male prisoners in Iran about the transmission of HIV and their high-risk practices while in prison. Methods A cross-sectional study was conducted in 2004. The study population was a random selection of 100 men incarcerated at Rajaei-Shahr prison. The data were collected through a self-administered questionnaire. Focus group discussions were held at the prison to guide the design of the questionnaire. The relationship between components of the Health Belief Model (HBM) and prisoners' risky HIV-related behaviors was examined. Results Calculating Pearson's correlation coefficient, a significant, positive association was found between the benefit component of the HBM and prisoners not engaging in HIV high-risk behaviors. Conclusion Educational harm reduction initiatives that promote the effectiveness of strategies designed to reduce the risk of HIV transmission may decrease prisoners' high-risk behaviors. This finding provides initial support for the Iran prison system's current offering of HIV/AIDS harm reduction programming and suggests the need to offer increased education about the effectiveness of HIV prevention practices. PMID:18541032

  19. Computerised provider order entry combined with clinical decision support systems to improve medication safety: a narrative review.

    Science.gov (United States)

    Ranji, Sumant R; Rennke, Stephanie; Wachter, Robert M

    2014-09-01

    Adverse drug events (ADEs) are a major cause of morbidity in hospitalised and ambulatory patients. Computerised provider order entry (CPOE) combined with clinical decision support systems (CDSS) are being widely implemented with the goal of preventing ADEs, but the effectiveness of these systems remains unclear. We searched the specialised database Agency for Healthcare Research and Quality (AHRQ) Patient Safety Net to identify reviews of the effect of CPOE combined with CDSS on ADE rates in inpatient and outpatient settings. We included systematic and narrative reviews published since 2008 and controlled clinical trials published since 2012. We included five systematic reviews, one narrative review and two controlled trials. The existing literature consists mostly of studies of homegrown systems conducted in the inpatient setting. CPOE+CDSS was consistently reported to reduce prescribing errors, but does not appear to prevent clinical ADEs in either the inpatient or outpatient setting. Implementation of CPOE+CDSS profoundly changes staff workflow, and often leads to unintended consequences and new safety issues (such as alert fatigue) which limit the system's safety effects. CPOE+CDSS does not appear to reliably prevent clinical ADEs. Despite more widespread implementation over the past decade, it remains a work in progress. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  20. Preventing HIV transmission among Iranian prisoners: Initial support for providing education on the benefits of harm reduction practices

    Directory of Open Access Journals (Sweden)

    Millson Peggy

    2008-06-01

    Full Text Available Abstract Background Harm reduction is a health-centred approach that seeks to reduce the health and social harms associated with high-risk behaviors, such as illicit drug use. The objective of this study is to determine the association between the beliefs of a group of adult, male prisoners in Iran about the transmission of HIV and their high-risk practices while in prison. Methods A cross-sectional study was conducted in 2004. The study population was a random selection of 100 men incarcerated at Rajaei-Shahr prison. The data were collected through a self-administered questionnaire. Focus group discussions were held at the prison to guide the design of the questionnaire. The relationship between components of the Health Belief Model (HBM and prisoners' risky HIV-related behaviors was examined. Results Calculating Pearson's correlation coefficient, a significant, positive association was found between the benefit component of the HBM and prisoners not engaging in HIV high-risk behaviors. Conclusion Educational harm reduction initiatives that promote the effectiveness of strategies designed to reduce the risk of HIV transmission may decrease prisoners' high-risk behaviors. This finding provides initial support for the Iran prison system's current offering of HIV/AIDS harm reduction programming and suggests the need to offer increased education about the effectiveness of HIV prevention practices.

  1. Zoe's Story: Exploring the Complexity of "Help-Providing" and "Help-Receiving" Relationships on the "Front-Line" of Family Support

    Science.gov (United States)

    Leese, Maggie

    2013-01-01

    The subject of engaging mothers in appropriate family support continues to be debated and this paper explores the complex factors that influenced one mother's willingness to accept support. In addition, it captures how her family support worker built and sustained a "help-providing" and "help-receiving" relationship despite the…

  2. A Development of the Decision Support System for the Optimum Cogeneration Planning Under the Constraints of the Economic Efficiency and Partial Load Properties for the Commercial Building

    Science.gov (United States)

    Ishida, Takeshi; Mori, Shunsuke; Douwaki, Kiyoshi

    It is said that the cogeneration system (CGS) is an effective countermeasure for energy saving and CO2 reduction in the commercial building. However, the economic, energy and environmental efficiency of CGS varies so much depending on the annual load factor and the demand patterns of heat and electric power. In this research, we develop a model to evaluate the optimum decision on the capacity and the operating pattern of CGS by nonlinear mixing integer programming in order to formulate the partial load properties of CGS in practical operation, since the existing optimization models without partial load properties could have generated too optimistic evaluation of CGS. The compatibility between the economy and the energy saving of the CGS implementation planning has been the problem. Our system proposes a new measure to develop an optimal energy saving system under the constraint of economic efficiency as the investment recovery years of CGS for the commercial building. Our system has been applied to the case of hotel building. The results show us that the optimum CGS capacity planning generated by our model provides more effective solution compared to the existing simulation tools used generally without optimization capability.

  3. Prediction of retention indices for frequently reported compounds of plant essential oils using multiple linear regression, partial least squares, and support vector machine.

    Science.gov (United States)

    Yan, Jun; Huang, Jian-Hua; He, Min; Lu, Hong-Bing; Yang, Rui; Kong, Bo; Xu, Qing-Song; Liang, Yi-Zeng

    2013-08-01

    Retention indices for frequently reported compounds of plant essential oils on three different stationary phases were investigated. Multivariate linear regression, partial least squares, and support vector machine combined with a new variable selection approach called random-frog recently proposed by our group, were employed to model quantitative structure-retention relationships. Internal and external validations were performed to ensure the stability and predictive ability. All the three methods could obtain an acceptable model, and the optimal results by support vector machine based on a small number of informative descriptors with the square of correlation coefficient for cross validation, values of 0.9726, 0.9759, and 0.9331 on the dimethylsilicone stationary phase, the dimethylsilicone phase with 5% phenyl groups, and the PEG stationary phase, respectively. The performances of two variable selection approaches, random-frog and genetic algorithm, are compared. The importance of the variables was found to be consistent when estimated from correlation coefficients in multivariate linear regression equations and selection probability in model spaces. © 2013 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  4. Zirconia-based dental crown to support a removable partial denture: a three-dimensional finite element analysis using contact elements and micro-CT data.

    Science.gov (United States)

    Rocha, Eduardo Passos; Anchieta, Rodolfo Bruniera; de Almeida, Erika Oliveira; Freitas, Amilcar Chagas; Martini, Ana Paula; Sotto-Maior, Bruno Sales; Luersen, Marco Antonio; Ko, Ching Chang

    2015-01-01

    Veneer fracture is the most common complication in zirconia-based restorations. The aim of this study was to evaluate the mechanical behavior of a zirconia-based crown in a lower canine tooth supporting removable partial denture (RPD) prosthesis, varying the bond quality of the veneer/coping interface. Microtomography (μCT) data of an extracted left lower canine were used to build the finite element model (M) varying the core material (gold core - MAu; zirconia core - MZi) and the quality of the veneer/core interface (complete bonded - MZi; incomplete bonded - MZi-NL). The incomplete bonding condition was only applied for zirconia coping by using contact elements (Target/Contact) with 0.3 frictional coefficients. Stress fields were obtained using Ansys Workbench 10.0. The loading condition (L = 1 N) was vertically applied at the base of the RPD prosthesis metallic support towards the dental apex. Maximum principal (σmax) and von Mises equivalent (σvM) stresses were obtained. The σmax (MPa) for the bonded condition was similar between gold and zirconia cores (MAu, 0.42; MZi, 0.40). The incomplete bonded condition (MZi-NL) raised σmax in the veneer up to 800% (3.23 MPa) in contrast to the bonded condition. The peak of σvM increased up to 270% in the MZi-NL. The incomplete bond condition increasing the stress in the veneer/zirconia interface.

  5. Predator diversity and abundance provide little support for the enemies hypothesis in forests of high tree diversity.

    Directory of Open Access Journals (Sweden)

    Andreas Schuldt

    Full Text Available Predatory arthropods can exert strong top-down control on ecosystem functions. However, despite extensive theory and experimental manipulations of predator diversity, our knowledge about relationships between plant and predator diversity--and thus information on the relevance of experimental findings--for species-rich, natural ecosystems is limited. We studied activity abundance and species richness of epigeic spiders in a highly diverse forest ecosystem in subtropical China across 27 forest stands which formed a gradient in tree diversity of 25-69 species per plot. The enemies hypothesis predicts higher predator abundance and diversity, and concomitantly more effective top-down control of food webs, with increasing plant diversity. However, in our study, activity abundance and observed species richness of spiders decreased with increasing tree species richness. There was only a weak, non-significant relationship with tree richness when spider richness was rarefied, i.e. corrected for different total abundances of spiders. Only foraging guild richness (i.e. the diversity of hunting modes of spiders was positively related to tree species richness. Plant species richness in the herb layer had no significant effects on spiders. Our results thus provide little support for the enemies hypothesis--derived from studies in less diverse ecosystems--of a positive relationship between predator and plant diversity. Our findings for an important group of generalist predators question whether stronger top-down control of food webs can be expected in the more plant diverse stands of our forest ecosystem. Biotic interactions could play important roles in mediating the observed relationships between spider and plant diversity, but further testing is required for a more detailed mechanistic understanding. Our findings have implications for evaluating the way in which theoretical predictions and experimental findings of functional predator effects apply to species

  6. Predator Diversity and Abundance Provide Little Support for the Enemies Hypothesis in Forests of High Tree Diversity

    Science.gov (United States)

    Schuldt, Andreas; Both, Sabine; Bruelheide, Helge; Härdtle, Werner; Schmid, Bernhard; Zhou, Hongzhang; Assmann, Thorsten

    2011-01-01

    Predatory arthropods can exert strong top-down control on ecosystem functions. However, despite extensive theory and experimental manipulations of predator diversity, our knowledge about relationships between plant and predator diversity—and thus information on the relevance of experimental findings—for species-rich, natural ecosystems is limited. We studied activity abundance and species richness of epigeic spiders in a highly diverse forest ecosystem in subtropical China across 27 forest stands which formed a gradient in tree diversity of 25–69 species per plot. The enemies hypothesis predicts higher predator abundance and diversity, and concomitantly more effective top-down control of food webs, with increasing plant diversity. However, in our study, activity abundance and observed species richness of spiders decreased with increasing tree species richness. There was only a weak, non-significant relationship with tree richness when spider richness was rarefied, i.e. corrected for different total abundances of spiders. Only foraging guild richness (i.e. the diversity of hunting modes) of spiders was positively related to tree species richness. Plant species richness in the herb layer had no significant effects on spiders. Our results thus provide little support for the enemies hypothesis—derived from studies in less diverse ecosystems—of a positive relationship between predator and plant diversity. Our findings for an important group of generalist predators question whether stronger top-down control of food webs can be expected in the more plant diverse stands of our forest ecosystem. Biotic interactions could play important roles in mediating the observed relationships between spider and plant diversity, but further testing is required for a more detailed mechanistic understanding. Our findings have implications for evaluating the way in which theoretical predictions and experimental findings of functional predator effects apply to species-rich forest

  7. Unsplinted implants and teeth supporting maxillary removable partial dentures retained by telescopic crowns: a retrospective study with >6 years of follow-up.

    Science.gov (United States)

    Frisch, Eberhard; Ratka-Krüger, Petra; Wenz, Hans-Jürgen

    2015-09-01

    Data regarding tooth- and implant-supported maxillary removable partial dentures (TIRPDs) are scarce. The objective of this research was to perform a retrospective evaluation of the clinical long-term outcome of maxillary TIRPDs rigidly retained via telescopic crowns in patients undergoing supportive post-implant therapy (SIT). The inclusion criteria were met by 26 patients restored with maxillary TIRPDs between 1997 and 2011 in a private practice. Primary crowns (Marburg double crowns, MDCs) on teeth were cemented, whereas those on implants were screw-retained. Using patient records and data from a cross-sectional clinical examination in 2013, the survival rates of the teeth, implants and prostheses, together with the biological and technical complications, were analyzed. After 6.12 ± 3.80 (range: 2-16) years of loading, 23 non-smoking patients with 23 dentures supported by 60 implants and 66 teeth were available for assessment. Nine teeth (survival rate: 86.36%) were lost, whereas 1 implant (survival rate: 98.36%) failed because of peri-implantitis. Although 30 implants (50%) in 16 patients (69.57%) showed bleeding on probing (BOP+), no further peri-implantitis was observed. The mean peri-implant probing depth (PPD) was 3.68 ± 0.71 mm. All dentures were functional and required technical maintenance efforts amounting to 0.128 treatments per patient per year (T/P/Y). Within the limitations of this study, we conclude that TIRPDs retained via MDCs may represent a viable treatment option for patients with residual maxillary teeth. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  8. The hybrid assisted limb (HAL) for Care Support, a motion assisting robot providing exoskeletal lumbar support, can potentially reduce lumbar load in repetitive snow-shoveling movements.

    Science.gov (United States)

    Miura, Kousei; Kadone, Hideki; Koda, Masao; Abe, Tetsuya; Endo, Hirooki; Murakami, Hideki; Doita, Minoru; Kumagai, Hiroshi; Nagashima, Katsuya; Fujii, Kengo; Noguchi, Hiroshi; Funayama, Toru; Kawamoto, Hiroaki; Sankai, Yoshiyuki; Yamazaki, Masashi

    2017-12-15

    An excessive lumbar load with snow-shoveling is a serious problem in snowfall areas. Various exoskeletal robots have been developed to reduce lumbar load in lifting work. However, few studies have reported the attempt of snow-shoveling work using exoskeletal robots. The purpose of the present study was to test the hypothesis that the HAL for Care Support robot would reduce lumbar load in repetitive snow-shoveling movements. Nine healthy male volunteers performed repetitive snow-shoveling movements outdoors in a snowfall area for as long as possible until they were fatigued. The snow-shoveling trial was performed under two conditions: with and without HAL for Care Support. Outcome measures were defined as the lumbar load assessed by the VAS of lumbar fatigue after the snow-shoveling trial and the snow-shoveling performance, including the number of scoops, and snow shoveling time and distance. The mean of VAS of lumbar fatigue, the number of scoops, and snow-shoveling time and distance without HAL for Care Support were 75.4 mm, 50.3, 145 s, and 9.6 m, while with HAL for Care Support were 39.8 mm, 144, 366 s, and 35.4 m. The reduction of lumbar fatigue and improvement of snow-shoveling performance using HAL for Care Support were statistically significant. There was no adverse event during snow-shoveling with HAL for Care Support. In conclusion, the HAL for Care Support can reduce lumbar load in repetitive snow-shoveling movements. Copyright © 2017 Elsevier Ltd. All rights reserved.

  9. Partial priapism

    DEFF Research Database (Denmark)

    Hoyerup, Peter; Azawi, Nessn Htum

    2013-01-01

    With only 34 prior cases in world literature, partial priapism (PP), also called partial segmental thrombosis of the corpus cavernosum, is a rare urological condition. The aetiology and treatment of PP is still unclear, but bicycle riding, trauma, drug usage, sexual intercourse, haematological...

  10. Costs and difficulties of recruiting patients to provide e-health support: pilot study in one primary care trust

    National Research Council Canada - National Science Library

    Jones, Ray B; O'Connor, Anita; Brelsford, Jade; Parsons, Neil; Skirton, Heather

    2012-01-01

    .... Previous research in outpatients suggested that anonymous personal email support may help patients with long term conditions to use e-health, but recruiting earlier in their 'journey' may benefit patients...

  11. Effective strategies to provide adolescent sexual and reproductive health services and to increase demand and community support.

    Science.gov (United States)

    Denno, Donna M; Hoopes, Andrea J; Chandra-Mouli, Venkatraman

    2015-01-01

    Access to youth friendly health services is vital for ensuring sexual and reproductive health (SRH) and well-being of adolescents. This study is a descriptive review of the effectiveness of initiatives to improve adolescent access to and utilization of sexual and reproductive health services (SRHS) in low- and middle-income countries. We examined four SRHS intervention types: (1) facility based, (2) out-of-facility based, (3) interventions to reach marginalized or vulnerable populations, (4) interventions to generate demand and/or community acceptance. Outcomes assessed across the four questions included uptake of SRHS or sexual and reproductive health commodities and sexual and reproductive health biologic outcomes. There is limited evidence to support the effectiveness of initiatives that simply provide adolescent friendliness training for health workers. Data are most ample (10 initiatives demonstrating weak but positive effects and one randomized controlled trial demonstrating strong positive results on some outcome measures) for approaches that use a combination of health worker training, adolescent-friendly facility improvements, and broad information dissemination via the community, schools, and mass media. We found a paucity of evidence on out-of-facility-based strategies, except for those delivered through mixed-use youth centers that demonstrated that SRHS in these centers are neither well used nor effective at improving SRH outcomes. There was an absence of studies or evaluations examining outcomes among vulnerable or marginalized adolescents. Findings from 17 of 21 initiatives assessing demand-generation activities demonstrated at least some association with adolescent SRHS use. Of 15 studies on parental and other community gatekeepers' approval of SRHS for adolescents, which assessed SRHS/commodity uptake and/or biologic outcomes, 11 showed positive results. Packages of interventions that train health workers, improve facility adolescent friendliness

  12. You can't always give what you want: the challenge of providing social support to low self-esteem individuals.

    Science.gov (United States)

    Marigold, Denise C; Cavallo, Justin V; Holmes, John G; Wood, Joanne V

    2014-07-01

    It can be challenging for support providers to facilitate effective social support interactions even when they have the best intentions. In the current article, we examine some reasons for this difficulty, with a focus on support recipients' self-esteem as a crucial variable. We predicted that recipients' receptiveness to support would be influenced by both support strategy and recipient self-esteem and that receptiveness in turn would impact providers' perceived caregiving efficacy and relationship quality. Study 1 (hypothetical scenarios), Study 2 (confederate interaction), and Study 3 (reports of recently received support) showed that individuals with low self-esteem (LSEs) are less receptive than are individuals with high self-esteem (HSEs) to support that positively reframes their experience but are equally receptive to support that validates their negative feelings. In Study 4, providers demonstrated some knowledge that positive reframing would be less helpful to LSEs than to HSEs but indicated equal intention to give such support. Study 5 showed that, in a real interaction, friends were indeed equally likely to offer positive reframing to both LSEs and HSEs but were less likely to offer validation to LSEs. LSEs were less accepting of such support, and in turn providers felt worse about the interaction, about themselves, and about their friendship more broadly. Study 6 confirmed that recipients' receptivity to support directly influenced providers' experience of a support interaction as well as their self- and relationship evaluations. The findings illustrate how well-meaning support attempts that do not match recipients' particular preferences may be detrimental to both members of the dyad.

  13. Stability indicating analysis of bisacodyl by partial least squares regression, spectral residual augmented classical least squares and support vector regression chemometric models: A comparative study

    Directory of Open Access Journals (Sweden)

    Ibrahim A. Naguib

    2011-12-01

    Full Text Available Partial least squares regression (PLSR, spectral residual augmented classical least squares (SRACLS and support vector regression (SVR are three different chemometric models. These models are subjected to a comparative study that highlights their inherent characteristics via applying them to analysis of bisacodyl in the presence of its reported degradation products monoacetyl bisacodyl (I and desacetyl bisacodyl (II, in raw material. For proper analysis, a 3 factor 3 level experimental design was established resulting in a training set of 9 mixtures containing different ratios of the interfering species. A linear test set consisting of 6 mixtures was used to validate the prediction ability of the suggested models. To test the generalisation ability of the models, some extra mixtures were prepared that are outside the concentration space of the training set. To test the ability of models to handle nonlinearity in spectral response, another set of nonlinear samples was prepared. The paper highlights model transfer to other labs under other conditions as well. This paper aims to manifest the advantages of SRACLS and SVR over PLSR model, where SRACLS can tackle future changes without the need for tedious recalibration, while SVR is a more robust and general model, with high ability to model nonlinearity in spectral response, though like PLSR is needing recalibration. The results presented indicate the ability of the three models to analyse bisacodyl in the presence of its degradation products in raw material with high accuracy and precision; where SVR gives the best results at all tested conditions compared to other models.

  14. External support to local institutions: providing political leverage to weaker groups, or sustaining traditional relations of power?

    DEFF Research Database (Denmark)

    Nygaard, Ivan

    2008-01-01

    economic resources. The study thus enhances our understanding of mechanisms for access to local donor-supported institutions. Il existe tout un pan de la littérature qui montre que les institutions appuyées par les bailleurs de fonds en Afrique Subsaharienne (ASS) sont accaparées par les élites locales...

  15. The effectiveness of proactive telephone support provided to breastfeeding mothers of preterm infants : study protocol for a randomized controlled trial

    OpenAIRE

    Ericson, Jenny; Eriksson, Mats; Hellström-Westas, Lena; Hagberg, Lars; Hoddinott, Pat; Flacking, Renée

    2013-01-01

    Background: Although breast milk has numerous benefits for infants' development, with greater effects in those born preterm (at < 37 gestational weeks), mothers of preterm infants have shorter breastfeeding duration than mothers of term infants. One of the explanations proposed is the difficulties in the transition from a Neonatal Intensive Care Unit (NICU) to the home environment. A person-centred proactive telephone support intervention after discharge from NICU is expected to promote mo...

  16. Supporting the minority physician pipeline: providing global health experiences to undergraduate students in the United States–Mexico border region

    OpenAIRE

    Jose L. Burgos; Yee, Daniel; Csordas, Thomas; Vargas-Ojeda, Adriana C.; Luis A. Segovia; Strathdee, Steffanie A.; Olivares-Nevarez, Jose A.; Ojeda, Victoria D.

    2015-01-01

    Background: The sizeable US Latino population calls for increasing the pipeline of minority and bilingual physicians who can provide culturally competent care. Currently, only 5.5% of US providers are Hispanic/Latino, compared with 16% of the US population (i.e., >50.5 million persons). By 2060, it is predicted that about one-third of all US residents will be of Latino ethnicity.Activities and outcomes: This article describes the Health Frontiers in Tijuana Undergraduate Internship Program...

  17. Rhetoric or reality? What nurse practitioners do to provide self-management support in outpatient clinics: an ethnographic study.

    Science.gov (United States)

    Ter Maten-Speksnijder, Ada J; Dwarswaard, Jolanda; Meurs, Pauline L; van Staa, AnneLoes

    2016-11-01

    To describe how nurse practitioners enact their role in outpatient consultations, and how this compares to their perception of their responsibility for patients with chronic conditions. Nurse practitioners working with patients with chronic conditions seek to support them in self-managing their diseases. An ethnographic study. Episodic participant observations (in total 48 hours) were carried out combined with formal interviews. The study population consisted of a purposive sample of nurse practitioners working in five outpatient clinics related to chronic care in one university medical centre in the Netherlands. Two different types of clinics were selected, namely (1) for patients with episodic flare-ups and (2) for patients with diseases requiring life-saving procedures. The nurse practitioners perceived the monitoring of patients' treatment as their main professional responsibility. Four monitoring strategies could be distinguished: 'assessing health conditions', 'connecting with patients', 'prioritising treatment in daily living' and 'educating patients'. While nurse practitioners considered building a relationship with their patients of utmost importance, their consultations were mostly based on a conventional medical model of medical history taking. Little attention was paid to the social, psychological and behavioural dimensions of illness. Nurse practitioners in this study seemed quite successful in their extension into medical territory, but moving patients' illness perceptions to the background was not conducive to self-management support. By their medical subspecialty expertise, nurse practitioners have a major role in the longitudinal process of the management of chronic diseases' treatment. Supporting patients to reduce the impact of the disease and its complications requires nurse practitioners to develop new coaching strategies designed to meet patients' individual needs. © 2016 John Wiley & Sons Ltd.

  18. Neuroanatomic overlap between intelligence and cognitive factors: morphometry methods provide support for the key role of the frontal lobes.

    Science.gov (United States)

    Colom, Roberto; Burgaleta, Miguel; Román, Francisco J; Karama, Sherif; Alvarez-Linera, Juan; Abad, Francisco J; Martínez, Kenia; Quiroga, Ma Ángeles; Haier, Richard J

    2013-05-15

    Evidence from neuroimaging studies suggests that intelligence differences may be supported by a parieto-frontal network. Research shows that this network is also relevant for cognitive functions such as working memory and attention. However, previous studies have not explicitly analyzed the commonality of brain areas between a broad array of intelligence factors and cognitive functions tested in the same sample. Here fluid, crystallized, and spatial intelligence, along with working memory, executive updating, attention, and processing speed were each measured by three diverse tests or tasks. These twenty-one measures were completed by a group of one hundred and four healthy young adults. Three cortical measures (cortical gray matter volume, cortical surface area, and cortical thickness) were regressed against psychological latent scores obtained from a confirmatory factor analysis for removing test and task specific variance. For cortical gray matter volume and cortical surface area, the main overlapping clusters were observed in the middle frontal gyrus and involved fluid intelligence and working memory. Crystallized intelligence showed an overlapping cluster with fluid intelligence and working memory in the middle frontal gyrus. The inferior frontal gyrus showed overlap for crystallized intelligence, spatial intelligence, attention, and processing speed. The fusiform gyrus in temporal cortex showed overlap for spatial intelligence and attention. Parietal and occipital areas did not show any overlap across intelligence and cognitive factors. Taken together, these findings underscore that structural features of gray matter in the frontal lobes support those aspects of intelligence related to basic cognitive processes. Copyright © 2013 Elsevier Inc. All rights reserved.

  19. Challenges to Providing a Successful Central Configuration Service to Support CERN’s New Controls Diagnostics and Monitoring System

    CERN Document Server

    Makonnen, Z; Zaharieva, Z

    2014-01-01

    The Controls Diagnostic and Monitoring service (DIAMON) provides monitoring and diagnostics tools to the operators in the CERN Control Centre. A recent reengineering presented the opportunity to restructure its data management and to integrate it with the central Controls Configuration Service (CCS). The CCS provides the Configuration Management for the Controls System for all accelerators at CERN. The new facility had to cater for the configuration management of all agents monitored by DIAMON, (>3000 computers of different types), provide deployment information, relations between metrics, and historical information. In addition, it had to be integrated into the operational CCS, while ensuring stability and data coherency. An important design decision was to largely reuse the existing infrastructure in the CCS and adapt the DIAMON data management to it e.g. by using the device/property model through a Virtual Devices framework to model the DIAMON agents. This article will show how these challenging requiremen...

  20. The Application of the DMC Strategy and Experience to Provide Additional Support to a European Global Monitoring System Programme

    Science.gov (United States)

    Cutter, M. A.; Giwa, S. C.; Graham, K. L.; Hodgson, D. J.; Mackin, S.; Sweeting, M. N.; Vanotti, M.; Regan, A.

    2008-08-01

    Surrey Satellite Technology Ltd has reviewed the ability of small satellites to provide additional capability to the presently defined Global Monitoring for Environment and Security (GMES) space segment, allowing the broadest set of user requirements to be met. User- focused services have been compared with the instruments defined for the currently proposed Sentinels. SSTL has developed the Disaster Monitoring Constellation (DMC) of small satellites at a very low cost, which provide land-focused data products in the visible wavebands with daily access capability. The study undertaken by SSTL for the European Space Agency analysed the DMC operational concept in a GMES context, reviewing a range of possible services with different payload configurations on small satellite platforms. One concept was selected and an appropriate payload definition derived. The chosen mission concept was based on the provision of near time operational oceanography information using a constellation of small satellites. The aim is to provide sea surface height, significant wave height and wind speed.

  1. THE INFLUENCE OF IMPLEMENTING THE STRATEGIC POLICY IN CREATING BUSINESS CLIMATE, BUSINESS ENVIRONMENT AND PROVIDING SUPPORT FACILITIES TOWARDS BUSINESS EMPOWERMENT ON SMALL MEDIUM CRAFT ENTERPRISES IN AMBON INDONESIA

    Directory of Open Access Journals (Sweden)

    Josef Papilaya

    2015-04-01

    Full Text Available This study aims at analyzing and explaining whether there was the influence of implementing the strategic policy in creating business climate, business environment and providing support facilities towards empowerment on small and medium enterprises as well as whether there is synchronously influence of implementing the strategic policy in creating business climate, business environment and providing support facilities for business empowerment on small and medium scale enterprises through a survey in the city of Ambon. The results show, that there is a positive and significant effect of implementing the strategic policy in creating business climate to empower small and medium enterprises. There is a positive and significant effect on the business environment toward the empowerment of small and medium enterprises, there is a positive and significant effect of providing support facilities toward the empowerment of small and medium enterprises, and there is a positive and significant simultaneously effect in business climate, business environment and support facilities for business towards the empowerment of small business in Ambon city. Empowerment programs are conducted to maintain a conducive business climate, including: 1. the innovation promotion, 2. enhancing human resources through training development; 3. providing financial support, 4. giving support to the marketing strategy, 5. opening the business partnership. While the supporting facilities granted to small and medium enterprises including: 1. giving the fishing boat for the Fishermen, 2. providing the workshop (machine shop service facilities to small crafts business Enterprises, 3. establish vendors for small enterprises, 4. provide the area for street vendors, 5. provide tents for merchants culinary who work at night. Providing the assistance to encourage the business climate and create conducive business environment.

  2. Costs and difficulties of recruiting patients to provide e-health support: pilot study in one primary care trust

    Directory of Open Access Journals (Sweden)

    Jones Ray B

    2012-03-01

    Full Text Available Abstract Background Better use of e-health services by patients could improve outcomes and reduce costs but there are concerns about inequalities of access. Previous research in outpatients suggested that anonymous personal email support may help patients with long term conditions to use e-health, but recruiting earlier in their 'journey' may benefit patients more. This pilot study explored the feasibility and cost of recruiting patients for an e-health intervention in one primary care trust. Methods The sample comprised 46 practices with total patient population of 250,000. We approached all practices using various methods, seeking collaboration to recruit patients via methods agreed with each practice. A detailed research diary was kept of time spent recruiting practices and patients. Researcher time was used to estimate costs. Patients who consented to participate were offered email support for their use of the Internet for health. Results Eighteen practices agreed to take part; we recruited 27 patients, most (23/27 from five practices. Practices agreed to recruit patients for an e-health intervention via waiting room leaflets (16, posters (16, practice nurses (15, doctors giving patients leaflets (5, a study website link (7, inclusion in planned mailshots (2, and a special mailshot to patients selected from practice computers (1. After low recruitment response we also recruited directly in five practices through research assistants giving leaflets to patients in waiting rooms. Ten practices recruited no patients. Those practices that were more difficult to recruit were less likely to recruit patients. Leaving leaflets for practice staff to distribute and placing posters in the practice were not effective in recruiting patients. Leaflets handed out by practice nurses and website links were more successful. The practice with lowest costs per patient recruited (£70 used a special mailshot to selected patients. Conclusion Recruitment via

  3. [Dietary training for school food service providers in support of the Acuerdo Nacional para la Salud Alimentaria].

    Science.gov (United States)

    Muñoz-Dávila, Carolina; Rangel-Peniche, Diana Beatriz

    2015-01-01

    To address the problem of overweight and obesity in Mexico, in 2010 the Acuerdo Nacional para la Salud Alimentaria was published. At school level, food service providers were considered essential to comply with certain commitments. The goal of this intervention was to train school food service providers in school eating establishments (SEE) as to the criteria in the general guidelines for the sale and distribution of food in schools of basic education. 13 SEE in San Luis Potosi participated. Based on an initial diagnosis, a class-workshop of 5 sessions was designed. Knowledge regarding food was evaluated at the beginning and end of the sessions. The percentage of adherence regarding general hygiene and food preparation and distribution was obtained at the beginning, one month, and two months post-intervention. School food service providers had little knowledge on the objectives of the Acuerdo in food groups and combination, as well as reading labels; there were significant changes in the last two after intervention. The initial percentage of overall hygiene compliance was 60 %, with an increase of almost 20 % post-training. The preparation and distribution of food did not show significant changes. School food service providers acquired knowledge about the guidelines that a SEE comply with, without putting them into practice, given the economic impact that it implies.

  4. Supporting Early Childhood Educators' Use of Embedded Communication Strategies by Providing Feedback via Bug-in-Ear Technology

    Science.gov (United States)

    Riggie, Jennifer

    2013-01-01

    The purpose of this study was to examine the relationship between coaching provided with bug-in-ear technology, the frequency of the early childhood educators' use of targeted communication strategies and children's expressive communication. Four multiple-baseline single-case design experiments were completed to evaluate these relationships.…

  5. Which Cognitive Processes Support Learning during Small-Group Discussion? The Role of Providing Explanations and Listening to Others

    Science.gov (United States)

    van Blankenstein, Floris M.; Dolmans, Diana H. J. M.; van der Vleuten, Cees P. M.; Schmidt, Henk G.

    2011-01-01

    Seventy students participated in an experiment to measure the effects of either providing explanations or listening during small group discussions on recall of related subject-matter studied after the discussion. They watched a video of a small group discussing a problem. In the first experimental condition, the video was stopped at various points…

  6. Enhancing Context Analysis with Intelligence in Providing e-Health Services: Less Infrastructure Dependency in Supporting Cardio-Vascular Patients

    NARCIS (Netherlands)

    Verbraeck, A.; Widya, I.A.; Shishkov, Boris; Cordeiro, J.; Ranchordas, A.

    2009-01-01

    In Europe, we observe an increasing number of people with health problems, who could theoretically receive care outside of a hospital when their condition could be properly monitored. Not being able to provide this monitoring leads to an increasing pressure on an already overcrowded hospital system

  7. The PTSD Practitioner Registry: An Innovative Tracking, Dissemination, and Support Tool for Providers in Military and Nonmilitary settings

    Science.gov (United States)

    2017-10-01

    engineering, and the academic world on areas such as:  improving public knowledge, attitudes, skills, and abilities;  changing behavior, practices...previously reported in writing , provide the following additional information or state, “Nothing to Report,” if applicable: Changes in approach...Describe partner organizations – academic institutions, other nonprofits, industrial or commercial firms, state or local governments, schools or

  8. A Context-Aware Ubiquitous Learning Approach for Providing Instant Learning Support in Personal Computer Assembly Activities

    Science.gov (United States)

    Hsu, Ching-Kun; Hwang, Gwo-Jen

    2014-01-01

    Personal computer assembly courses have been recognized as being essential in helping students understand computer structure as well as the functionality of each computer component. In this study, a context-aware ubiquitous learning approach is proposed for providing instant assistance to individual students in the learning activity of a…

  9. Peer mentoring supports the learning needs of nurses providing palliative care in a rural acute care setting.

    Science.gov (United States)

    Rabbetts, Lyn

    2017-06-02

    A specific set of assessment scales can underpin the management of distressing symptoms of patients requiring palliative care. A research assistant supported nurses working in a rural hospital setting during the introduction of these scales. A secondary analysis was conducted to further explore the qualitative data of a previously reported mixed-method study. In particular, the experiences of nurses working alongside a research assistant in the facilitation of using a new assessment form. Purposeful sampling was employed: participating nurses were invited to attend one of three focus group meetings. Data analysis revealed three main themes: a contact person, coach/mentor and extra help initiatives. Three to four subthemes corresponded with each main theme. Findings suggest nurses benefit from having someone to assist in learning about new documentation. Nurses respond positively to mentorship and practical guidance when integrating a new assessment form into routine evidence-based practice.

  10. Treadmill training with partial body weight support compared with conventional gait training for low-functioning children and adolescents with nonspastic cerebral palsy: a two-period crossover study.

    Science.gov (United States)

    Su, Ivan Y W; Chung, Kenny K Y; Chow, Daniel H K

    2013-12-01

    Partial body weight-supported treadmill training has been shown to be effective in gait training for patients with neurological disorders such as spinal cord injuries and stroke. Recent applications on children with cerebral palsy were reported, mostly on spastic cerebral palsy with single subject design. There is lack of evidence on the effectiveness of such training for nonspastic cerebral palsy, particularly those who are low functioning with limited intellectual capacity. This study evaluated the effectiveness of partial body weight-supported treadmill training for improving gross motor skills among these clients. A two-period randomized crossover design with repeated measures. A crossover design following an A-B versus a B-A pattern was adopted. The two training periods consisted of 12-week partial body weight-supported treadmill training (Training A) and 12-week conventional gait training (Training B) with a 10-week washout in between. Ten school-age participants with nonspastic cerebral palsy and severe mental retardation were recruited. The Gross Motor Function Measure-66 was administered immediately before and after each training period. Significant improvements in dimensions D and E of the Gross Motor Function Measure-66 and the Gross Motor Ability Estimator were obtained. Our findings revealed that the partial body weight-supported treadmill training was effective in improving gross motor skills for low-functioning children and adolescents with nonspastic cerebral palsy. .

  11. The Impact of Learning Style on Healthcare Providers' Preference for Voice Advisory Manikins versus Live Instructors in Basic Life Support Training

    Science.gov (United States)

    DiGiovanni, Lisa Marie

    2013-01-01

    The American Heart Association's HeartCode[TM] Healthcare Provider (HCP) Basic Life Support (BLS) e-learning program with voice-advisory manikins was implemented in an acute care hospital as the only teaching method offered for BLS certification. On course evaluations, healthcare provider staff commented that the VAM technology for skills practice…

  12. Mental Health Support Provided Throughout the Bariatric Surgery Clinical Pathway in French Specialized Care Centers for Obesity.

    Science.gov (United States)

    Lamore, Kristopher; Kaci, Sandra S; Czernichow, Sébastien; Bretault, Marion; Bouillot, Jean-Luc; Naudé, Anne-Jeanne; Gribe-Ouaknine, Sandra; Carette, Claire; Flahault, Cécile

    2017-03-01

    Pre-operative psychological assessment is recommended by international guidelines for bariatric surgery candidates. Thereby, service teams caring for bariatric patients should include at least one mental health provider (e.g., a psychologist or psychiatrist). The objective of this study was to evaluate the psychology and psychiatry resources and practices in the 37 specialized obesity centers (CSOs) created by the French Ministry of Health. CSO coordinators were contacted by e-mail to collect general information on the centers (e.g., number of bariatric operations). Secondly, psychologists and psychiatrists of each center completed an anonymous questionnaire assessing their professional practices and their organization of care pathways. The vast majority of CSO coordinators (81%, n = 26/32) answered our survey. These results show significant differences and shortages in terms of the psychology/psychiatry resources available. Most of the psychologists (n = 26/31) and psychiatrists (n = 10/10) stated that they systematically meet new patients only before surgery (56%) or both before and after the operation (30%); however, some psychologists and psychiatrists (14%) do not systematically meet all the patients (before and/or after surgery). Nevertheless, all the professionals provide psychology assessments, and about 75% of them offer a psychological follow-up, indicating a similarity regarding the practices of psychologists and psychiatrists. Our results highlight the place of psychological/psychiatric evaluations in French CSOs and emphasize the absence of mental health providers in several of these services. Post-operative psychological follow-up is not usually provided. It would be appropriate to create clear recommendations for post-operative psychological or psychiatric long-term follow-up.

  13. Development of a National Consensus for Tactical Emergency Medical Support (TEMS) Training Programs--Operators and Medical Providers.

    Science.gov (United States)

    Schwartz, Richard; Lerner, Brooke; Llwewllyn, Craig; Pennardt, Andre; Wedmore, Ian; Callaway, David; Wightman, John; Casillas, Raymond; Eastman, Alex; Gerold, Kevin; Giebner, Stephen; Davidson, Robert; Kamin, Richard; Piazza, Gina; Bollard, Glenn; Carmona, Phillip; Sonstrom, Ben; Seifarth, William; Nicely, Barbara; Croushorn, John; Carmona, Richard

    2014-01-01

    Tactical teams are at high risk of sustaining injuries. Caring for these casualties in the field involves unique requirements beyond what is provided by traditional civilian emergency medical services (EMS) systems. Despite this need, the training objectives and competencies are not uniformly agreed to or taught. An expert panel was convened that included members from the Departments of Defense, Homeland Security, Justice, and Health and Human Services, as well as federal, state, and local law-enforcement officers who were recruited through requests to stakeholder agencies and open invitations to individuals involved in Tactical Emergency Medical Services (TEMS) or its oversight. Two face-to-face meetings took place. Using a modified Delphi technique, previously published TEMS competencies were reviewed and updated. The original 17 competency domains were modified and the most significant changes were the addition of Tactical Emergency Casualty Care (TECC), Tactical Familiarization, Legal Aspects of TEMS, and Mass Casualty Triage to the competency domains. Additionally, enabling and terminal learning objectives were developed for each competency domain. This project has developed a minimum set of medical competencies and learning objectives for both tactical medical providers and operators. This work should serve as a platform for ensuring minimum knowledge among providers, which will serve enhance team interoperability and improve the health and safety of tactical teams and the public. 2014.

  14. The benefit of meeting a stranger: experiences with emotional support provided by nurses among Danish-born and migrant cancer patients.

    Science.gov (United States)

    Kristiansen, M; Tjørnhøj-Thomsen, T; Krasnik, A

    2010-07-01

    Research among cancer patients has shown that emotional support in informal relationships may be difficult to access because of a fear or lack of knowledge about cancer. Consequently, formal relationships with healthcare professionals may be important sources of support. This study explores needs for and experiences with emotional support provided by nurses as well as prerequisites for the provision of support among Danish-born and migrant cancer patients. We conducted narrative interviews with 18 adult Danish-born and migrant cancer patients. Patients were recruited from a variety of places in a purposive strategic sampling process. Analysis was inspired by phenomenological methods and Simmel's theoretical concept of "the stranger". Both Danish-born and migrant patients perceived the support delivered by healthcare professionals as available, empathic and valuable. Prerequisites for providing emotional support were 1) setting aside time for the patient to feel safe and able to verbalise emotional concerns, 2) continuity in relationships with healthcare professionals, and 3) nurses' ability to understand the patient's emotional reactions without creating additional distress. Being positioned as a stranger to the patient gives nurses a unique position from which to provide emotional support during cancer treatment. Thus, formal relationships with healthcare professionals are of great importance for many cancer patients.

  15. Gene expression suggests conserved aspects of Hox gene regulation in arthropods and provides additional support for monophyletic Myriapoda.

    Science.gov (United States)

    Janssen, Ralf; Budd, Graham E

    2010-07-05

    Antisense transcripts of Ultrabithorax (aUbx) in the millipede Glomeris and the centipede Lithobius are expressed in patterns complementary to that of the Ubx sense transcripts. A similar complementary expression pattern has been described for non-coding RNAs (ncRNAs) of the bithoraxoid (bxd) locus in Drosophila, in which the transcription of bxd ncRNAs represses Ubx via transcriptional interference. We discuss our findings in the context of possibly conserved mechanisms of Ubx regulation in myriapods and the fly.Bicistronic transcription of Ubx and Antennapedia (Antp) has been reported previously for a myriapod and a number of crustaceans. In this paper, we show that Ubx/Antp bicistronic transcripts also occur in Glomeris and an onychophoran, suggesting further conserved mechanisms of Hox gene regulation in arthropods.Myriapod monophyly is supported by the expression of aUbx in all investigated myriapods, whereas in other arthropod classes, including the Onychophora, aUbx is not expressed. Of the two splice variants of Ubx/Antp only one could be isolated from myriapods, representing a possible further synapomorphy of the Myriapoda.

  16. Gene expression suggests conserved aspects of Hox gene regulation in arthropods and provides additional support for monophyletic Myriapoda

    Directory of Open Access Journals (Sweden)

    Janssen Ralf

    2010-07-01

    Full Text Available Abstract Antisense transcripts of Ultrabithorax (aUbx in the millipede Glomeris and the centipede Lithobius are expressed in patterns complementary to that of the Ubx sense transcripts. A similar complementary expression pattern has been described for non-coding RNAs (ncRNAs of the bithoraxoid (bxd locus in Drosophila, in which the transcription of bxd ncRNAs represses Ubx via transcriptional interference. We discuss our findings in the context of possibly conserved mechanisms of Ubx regulation in myriapods and the fly. Bicistronic transcription of Ubx and Antennapedia (Antp has been reported previously for a myriapod and a number of crustaceans. In this paper, we show that Ubx/Antp bicistronic transcripts also occur in Glomeris and an onychophoran, suggesting further conserved mechanisms of Hox gene regulation in arthropods. Myriapod monophyly is supported by the expression of aUbx in all investigated myriapods, whereas in other arthropod classes, including the Onychophora, aUbx is not expressed. Of the two splice variants of Ubx/Antp only one could be isolated from myriapods, representing a possible further synapomorphy of the Myriapoda.

  17. Providing support at time of death from cancer: results of a 5-year post-bereavement group study.

    Science.gov (United States)

    Clark, Paul G; Brethwaite, Drucilla S; Gnesdiloff, Sabine

    2011-01-01

    Despite advances in the quality and availability of hospice and palliative care for people with end stage cancers, research addressing the psychosocial needs of family members and concerned others during the dying process has been limited primarily to caregivers. In addition, many of these studies focused on the recently bereaved. In this study, the authors sought to broaden that perspective by examining the psychosocial needs of secondary survivors, a term that applies to caregivers, family members, and others who felt a caring bond with a dying person. A qualitative exploration of needs expressed by secondary survivors following the conclusion of a structured 8-week psychoeducational grief group experience revealed that secondary cancer survivors experience a sense of isolation and powerlessness that is often unrecognized by physicians, nurses, oncology social workers, or other health care professionals. Furthermore, these secondary survivors needed support that extends well beyond activities that are traditionally associated with the physical and emotional care of the dying. Social work intervention strategies directed toward helping secondary survivors assert personal needs, develop greater proximity with the health care team, and prepare for the processes associated with end-of-life may be helpful later during bereavement.

  18. Comparison of the quality of basic life support provided by rescuers trained using the 2005 or 2010 ERC guidelines

    Directory of Open Access Journals (Sweden)

    Jones Christopher M

    2012-08-01

    Full Text Available Abstract Introduction Effective delivery of cardiopulmonary resuscitation (CPR and prompt defibrillation following sudden cardiac arrest (SCA is vital. Updated guidelines for adult basic life support (BLS were published in 2010 by the European Resuscitation Council (ERC in an effort to improve survival following SCA. There has been little assessment of the ability of rescuers to meet the standards outlined within these new guidelines. Methods We conducted a retrospective analysis of the performance of first year healthcare students trained and assessed using either the new 2010 ERC guidelines or their 2005 predecessor, within the University of Birmingham, United Kingdom. All students were trained as lay rescuers during a standardised eight hour ERC-accredited adult BLS course. Results We analysed the examination records of 1091 students. Of these, 561 were trained and assessed using the old 2005 ERC guidelines and 530 using the new 2010 guidelines. A significantly greater proportion of candidates failed in the new guideline group (16.04% vs. 11.05%; p  Conclusions The new ERC guidelines lead to a greater proportion of lay rescuers performing chest compressions at an erroneously fast rate and may therefore worsen BLS efficacy. Additional study is required in order to define the clinical impact of compressions performed to a greater depth and at too fast a rate.

  19. DC microgrids with energy storage systems and demand response for providing support to frequency regulation of electrical power systems

    DEFF Research Database (Denmark)

    Basic, Hrvoje; Dragicevic, Tomislav; Pandzic, Hrvoje

    2017-01-01

    Frequency regulation of electric power systems efficiency depends on response time and on power reserves for frequency regulation. As integration of non-dispatchable renewable generation in the power system results with increased need for power reserves from fast responding power units, the idea...... of using aggregated DC microgrids in frequency regulation is presented. Model proposed in this work is based on using battery energy storage, combined with demand response for achieving efficient usage of battery energy storage. It is shown that large number of DC microgrids can provide sufficient....

  20. Emerging Business Models in Education Provisioning: A Case Study on Providing Learning Support as Education-as-a-Service

    Directory of Open Access Journals (Sweden)

    Loina Prifti

    2017-09-01

    Full Text Available This study aims to give a deeper understanding on emerging business models in the context of education. Industry 4.0/the Industrial Internet in general and especially recent advances in cloud computing enable a new kind of service offering in the education sector and lead to new business models for education: Education-as-a-Service (EaaS. Within EaaS, learning, and teaching contents are delivered as services. By combining a literature review with a qualitative case study, this paper makes a three-fold contribution to the field of business models in education: First, we provide a theoretical definition for a common understanding of EaaS. Second, we present the state-of-the-art research on this new paradigm. Third, in the case study we describe a “best practices” business model of an existing EaaS provider. These insights build a theoretical foundation for further research in this area. The paper concludes with a research agenda for further research in this emerging field.

  1. The need for social support provided by the non-profit cancer societies throughout different phases in the cancer trajectory and its integration into public healthcare.

    Science.gov (United States)

    Yli-Uotila, Tiina; Kaunonen, Marja; Pylkkänen, Liisa; Suominen, Tarja

    2016-04-01

    To describe the phases of the cancer trajectory when social support, in the form of electronic counselling services, as provided by the non-profit cancer societies, is needed, as well as how these services are integrated into the cancer care in public healthcare. In this descriptive qualitative study a purposive sample of patients with cancer (n = 12) were interviewed. The data were content analysed inductively. Social support was needed when emotional well-being was weakened, when the body broke, when the care pathway induced unawareness, and when empowerment needed strengthening. There was no need for social support when well-being was considered in balance. The electronic counselling services were integrated into cancer care by supporting the patient with cancer emotionally, developing the informational expertise of the patient with cancer, expanding the opportunities for support, and supporting public healthcare. Integration required improvements to the actions of the patients and various actors involved in the healthcare system. There was no integration due to the health status of the patient and the sufficiency of the primary support sources. The received social support was not integrated into the actual cancer treatment process of the patient with cancer in the public healthcare system. The phases of support needed in the cancer trajectory as defined by the patient differ from the traditional biomedical phases of treatment. Copyright © 2016 Elsevier Ltd. All rights reserved.

  2. Discrepancies Between the Supports Needed for Discharge of Patients With Terminal Cancer to Family Caregivers and What Supports Were Actually Provided in Japan: Assessment of Palliative Care Unit Nurses.

    Science.gov (United States)

    Oosono, Yasufumi; Yokoyama, Kazuhito; Itoh, Hiroaki; Enomoto, Miyuki; Ishiwata, Miki

    2017-01-01

    Even if patients with terminal cancer hope to spend the rest of their lives at home, they are often unable to leave the hospital early due to their family caregivers' anxiety. This study aimed to investigate in Japan the discrepancies between the supports needed by and actually provided by palliative care unit nurses (PCUNs) to the family caregivers for discharge of patients with terminal cancer. In this cross-sectional study, self-administered questionnaires including 6-point Likert-type scales assessing the reasons for difficulties in transition to home-based care were distributed to 1227 PCUNs. Using paired t tests, the differences between the scores on perceived importance and actual supports to family caregivers were examined. The supports actually provided were classified by factor analysis. The relationships between the PCUNs' characteristics and mean scores on the supports in each category were examined using multiple regression analysis. A total of 1023 (83.4%) completed questionnaires were returned. Scores on the actually provided supports for discharge to family caregivers were consistently and significantly lower than the corresponding scores on perceived importance for all 57 items ( P care, receiving necessary training, cooperating with palliative care staff, and cooperating with local service providers were significantly associated with higher levels of actual supply of supports to family caregivers. Our findings suggest that PCUNs need to be encouraged to provide further support to family caregivers for the discharge of patients with terminal cancer.

  3. Development of a Website Providing Evidence-Based Information About Nutrition and Cancer: Fighting Fiction and Supporting Facts Online.

    Science.gov (United States)

    van Veen, Merel Rebecca; Beijer, Sandra; Adriaans, Anika Maria Alberdina; Vogel-Boezeman, Jeanne; Kampman, Ellen

    2015-09-08

    Although widely available, the general public, cancer patients, and cancer survivors have difficulties accessing evidence-based information on nutrition and cancer. It is challenging to distinguish myths from facts, and sometimes conflicting information can be found in different places. The public and patients would benefit from evidence-based, correct, and clear information from an easily recognizable source. The aim of this project is to make scientific information available for the general public, cancer patients, and cancer survivors through a website. The aim of this paper is to describe and evaluate the development of the website as well as related statistics 1st year after its launch. To develop the initial content for the website, the website was filled with answers to frequently asked questions provided by cancer organizations and the Dutch Dietetic Oncology Group, and by responding to various fiction and facts published in the media. The website was organized into 3 parts, namely, nutrition before (prevention), during, and after cancer therapy; an opportunity for visitors to submit specific questions regarding nutrition and cancer was included. The website was pretested by patients, health care professionals, and communication experts. After launching the website, visitors' questions were answered by nutritional scientists and dieticians with evidence- or eminence-based information on nutrition and cancer. Once the website was live, question categories and website statistics were recorded. Before launch, the key areas for improvement, such as navigation, categorization, and missing information, were identified and adjusted. In the 1st year after the launch, 90,111 individuals visited the website, and 404 questions were submitted on nutrition and cancer. Most of the questions were on cancer prevention and nutrition during the treatment of cancer. The website provides access to evidence- and eminence-based information on nutrition and cancer. As can be

  4. Collaborating with a social housing provider supports a large cohort study of the health effects of housing conditions.

    Science.gov (United States)

    Baker, Michael G; Zhang, Jane; Blakely, Tony; Crane, Julian; Saville-Smith, Kay; Howden-Chapman, Philippa

    2016-02-16

    Despite the importance of adequate, un-crowded housing as a prerequisite for good health, few large cohort studies have explored the health effects of housing conditions. The Social Housing Outcomes Worth (SHOW) Study was established to assess the relationship between housing conditions and health, particularly between household crowding and infectious diseases. This paper reports on the methods and feasibility of using a large administrative housing database for epidemiological research and the characteristics of the social housing population. This prospective open cohort study was established in 2003 in collaboration with Housing New Zealand Corporation which provides housing for approximately 5% of the population. The Study measures health outcomes using linked anonymised hospitalisation and mortality records provided by the New Zealand Ministry of Health. It was possible to match the majority (96%) of applicant and tenant household members with their National Health Index (NHI) number allowing linkage to anonymised coded data on their hospitalisations and mortality. By December 2011, the study population consisted of 11,196 applicants and 196,612 tenants. Half were less than 21 years of age. About two-thirds identified as Māori or Pacific ethnicity. Household incomes were low. Of tenant households, 44% containing one or more smokers compared with 33% for New Zealand as a whole. Exposure to household crowding, as measured by a deficit of one or more bedrooms, was common for applicants (52%) and tenants (38%) compared with New Zealanders as whole (10%). This project has shown that an administrative housing database can be used to form a large cohort population and successfully link cohort members to their health records in a way that meets confidentiality and ethical requirements. This study also confirms that social housing tenants are a highly deprived population with relatively low incomes and high levels of exposure to household crowding and environmental

  5. Development of a Website Providing Evidence-Based Information About Nutrition and Cancer: Fighting Fiction and Supporting Facts Online

    Science.gov (United States)

    Beijer, Sandra; Adriaans, Anika Maria Alberdina; Vogel-Boezeman, Jeanne; Kampman, Ellen

    2015-01-01

    Background Although widely available, the general public, cancer patients, and cancer survivors have difficulties accessing evidence-based information on nutrition and cancer. It is challenging to distinguish myths from facts, and sometimes conflicting information can be found in different places. The public and patients would benefit from evidence-based, correct, and clear information from an easily recognizable source. Objective The aim of this project is to make scientific information available for the general public, cancer patients, and cancer survivors through a website. The aim of this paper is to describe and evaluate the development of the website as well as related statistics 1st year after its launch. Methods To develop the initial content for the website, the website was filled with answers to frequently asked questions provided by cancer organizations and the Dutch Dietetic Oncology Group, and by responding to various fiction and facts published in the media. The website was organized into 3 parts, namely, nutrition before (prevention), during, and after cancer therapy; an opportunity for visitors to submit specific questions regarding nutrition and cancer was included. The website was pretested by patients, health care professionals, and communication experts. After launching the website, visitors’ questions were answered by nutritional scientists and dieticians with evidence- or eminence-based information on nutrition and cancer. Once the website was live, question categories and website statistics were recorded. Results Before launch, the key areas for improvement, such as navigation, categorization, and missing information, were identified and adjusted. In the 1st year after the launch, 90,111 individuals visited the website, and 404 questions were submitted on nutrition and cancer. Most of the questions were on cancer prevention and nutrition during the treatment of cancer. Conclusions The website provides access to evidence- and eminence

  6. A critical review of the use of technology to provide psychosocial support for children and young people with long-term conditions.

    Science.gov (United States)

    Aldiss, Susie; Baggott, Christina; Gibson, Faith; Mobbs, Sarah; Taylor, Rachel M

    2015-01-01

    Advances in technology have offered health professionals alternative mediums of providing support to patients with long-term conditions. This critical review evaluated and assessed the benefit of electronic media technologies in supporting children and young people with long-term conditions. Of 664 references identified, 40 met the inclusion criteria. Supportive technology tended to increase disease-related knowledge and improve aspects of psychosocial function. Supportive technology did not improve quality of life, reduce health service use or decrease school absences. The poor methodological quality of current evidence and lack of involvement of users in product development contribute to the uncertainty that supportive technology is beneficial. Copyright © 2015 Elsevier Inc. All rights reserved.

  7. Self-reported diabetes self-management competence and support from healthcare providers in achieving autonomy are negatively associated with diabetes distress in adults with Type 1 diabetes.

    Science.gov (United States)

    Mohn, J; Graue, M; Assmus, J; Zoffmann, V; B Thordarson, H; Peyrot, M; Rokne, B

    2015-11-01

    To investigate the associations of self-perceived competence in diabetes management and autonomy support from healthcare providers with diabetes distress in adults with Type 1 diabetes mellitus that is not optimally controlled [HbA(1c) ≥ 64 mmol/mol (8.0%)]. This cross-sectional study comprised blood sampling and three self-report questionnaires, the Problem Areas in Diabetes scale, the Perceived Competence in Diabetes Scale and a measure of autonomy support by healthcare providers, the Health Care Climate Questionnaire. We fitted blockwise linear regression models to assess the associations between Problem Areas in Diabetes score and the variables of interest (autonomy support and perceived diabetes competence), controlling for clinical and sociodemographic variables. Of the study sample [n = 178; mean age 36.7 (±10.7) years], 31.5% had long-term complications and 43.2% reported elevated (≥40) Problem Areas in Diabetes scores. A significant negative association was found between autonomy support and Problem Areas in Diabetes score (B = -3.61, P = 0.001), indicating that lower autonomy support was associated with greater diabetes distress. When perceived competence was controlled, it mediated the association of autonomy support with diabetes distress, reducing it to non-significance. There was a significant negative association between perceived competence and Problem Areas in Diabetes score (B = -8.89, P autonomy support and diabetes distress; autonomy support was associated with increased perceived competence, which, in turn, was associated with reduced distress. Healthcare providers' communication styles enhancing perceived competence through autonomy support may contribute to effective treatment for people with Type 1 diabetes and suboptimum glycaemic control. © 2015 The Authors. Diabetic Medicine Published by John Wiley & Sons Ltd on behalf of Diabetes UK.

  8. Project quality assurance plan for research and development services provided by Oak Ridge National Laboratory in support of the Hanford Grout Disposal Program

    Energy Technology Data Exchange (ETDEWEB)

    Spence, R.D.; Gilliam, T.M.

    1991-11-01

    This Project Quality Assurance Plan (PQAP) is being published to provide the sponsor with referenceable documentation for work conducted in support of the Hanford WHC Grout Disposal Program. This plan, which meets NQA-1 requirements, is being applied to work performed at Oak Ridge National Laboratory (ORNL) during FY 1991 in support of this program. It should also be noted that with minor revisions, this plan should be applicable to other projects involving research and development that must comply with NQA-1 requirements.

  9. Beginning partial differential equations

    CERN Document Server

    O'Neil, Peter V

    2011-01-01

    A rigorous, yet accessible, introduction to partial differential equations-updated in a valuable new edition Beginning Partial Differential Equations, Second Edition provides a comprehensive introduction to partial differential equations (PDEs) with a special focus on the significance of characteristics, solutions by Fourier series, integrals and transforms, properties and physical interpretations of solutions, and a transition to the modern function space approach to PDEs. With its breadth of coverage, this new edition continues to present a broad introduction to the field, while also addres

  10. A model to identify mathematics topics in MXit lingo to provide tutors quick access to supporting documentation

    Directory of Open Access Journals (Sweden)

    Laurie Butgereit

    2011-11-01

    Full Text Available Dr MathTM is a mobile, online tutoring system where learners can use MXitTM on their mobile phones to receive help with their mathematics homework from volunteer tutors. These conversations between learners and Dr Math are held in MXit lingo. MXit lingo is a heavily abbreviated, English-like language that is evolving between users of mobile phones that communicate using MXit. The Dr Math project has been running since January 2007 and uses volunteer tutors who are mostly university students who readily understand and use MXit lingo. However, due to the large number of simultaneous conversations that the tutors are often involved in and the diversity of topics discussed, it would often be beneficial to provide assistance regarding the mathematics topic to the tutors. This article explains how the μ model identifies the mathematics topic in the conversation. The model identifies appropriate mathematics topics in just over 75% of conversations in a corpus of conversations identified to be about mathematics topics in the school curriculum.

  11. Becoming successful entrepreneurs. Bangladesh. ADB supports pioneering family-based approach to provide micro-credit and skills training.

    Science.gov (United States)

    Molitor, C

    1996-01-01

    The Thana Resource Development and Employment Project (TRDEP), built upon the successful experience of the Grameen Bank and other nongovernmental organizations, is a comprehensive poverty alleviation scheme implemented by the government of Bangladesh and targeted to the poorest segment of Bangladeshi society. The project provides soft loans to landless poor for income-generating activities involving non-crop livelihoods and trades. The loans are granted at an 18% interest rate including a 2% charge which goes into a risk fund. The poorest of poor are eligible to receive loans as long as each borrowing unit is a self-help group comprised of five members of one family and each member of the group assumes the responsibility of paying each other member's loan. Each member of a borrowing group may receive loans in the amount of Taka 3000-5000 (US$75-125). The loans are then repayable in 50 equal installments over the course of 1 year. One member's default disqualifies all other group members from receiving future credit until the default is cleared. TRDEP borrowers have started small, successful entrepreneurial activities with their loans as capital.

  12. A Randomized Controlled Trial Provides Evidence to Support Aromatherapy to Minimize Anxiety in Women Undergoing Breast Biopsy.

    Science.gov (United States)

    Trambert, Renee; Kowalski, Mildred Ortu; Wu, Betty; Mehta, Nimisha; Friedman, Paul

    2017-10-01

    Aromatherapy has been used to reduce anxiety in a variety of settings, but usefulness associated with breast biopsies has not been documented. This study was conducted in women undergoing image-guided breast biopsy. We explored the use of two different aromatherapy scents, compared to placebo, aimed at reducing anxiety with the intent of generating new knowledge. This was a randomized, placebo-controlled study of two different types of external aromatherapy tabs (lavender-sandalwood and orange-peppermint) compared with a matched placebo-control delivery system. Anxiety was self-reported before and after undergoing a breast biopsy using the Spielberger State Anxiety Inventory Scale. Eighty-seven women participated in this study. There was a statistically significant reduction in self-reported anxiety with the use of the lavender-sandalwood aromatherapy tab compared with the placebo group (p = .032). Aromatherapy tabs reduced anxiety during image-guided breast biopsy. The completion of the biopsy provided some relief from anxiety in all groups. The use of aromatherapy tabs offers an evidence-based nursing intervention to improve adaptation and reduce anxiety for women undergoing breast biopsy. Lavender-sandalwood aromatherapy reduced anxiety and promoted adaptation more than orange-peppermint aromatherapy or placebo. © 2017 Sigma Theta Tau International.

  13. Beginning partial differential equations

    CERN Document Server

    O'Neil, Peter V

    2014-01-01

    A broad introduction to PDEs with an emphasis on specialized topics and applications occurring in a variety of fields Featuring a thoroughly revised presentation of topics, Beginning Partial Differential Equations, Third Edition provides a challenging, yet accessible,combination of techniques, applications, and introductory theory on the subjectof partial differential equations. The new edition offers nonstandard coverageon material including Burger's equation, the telegraph equation, damped wavemotion, and the use of characteristics to solve nonhomogeneous problems. The Third Edition is or

  14. Partial gigantism

    Directory of Open Access Journals (Sweden)

    М.М. Karimova

    2017-05-01

    Full Text Available A girl with partial gigantism (the increased I and II fingers of the left foot is being examined. This condition is a rare and unresolved problem, as the definite reason of its development is not determined. Wait-and-see strategy is recommended, as well as correcting operations after closing of growth zones, and forming of data pool for generalization and development of schemes of drug and radial therapeutic methods.

  15. Self-reported diabetes self-management competence and support from healthcare providers in achieving autonomy are negatively associated with diabetes distress in adults with Type 1 diabetes

    DEFF Research Database (Denmark)

    Mohn, J; Graue, M; Assmus, J

    2015-01-01

    AIM: To investigate the associations of self-perceived competence in diabetes management and autonomy support from healthcare providers with diabetes distress in adults with Type 1 diabetes mellitus that is not optimally controlled [HbA(1c) ≥ 64 mmol/mol (8.0%)]. METHODS: This cross-sectional study...... comprised blood sampling and three self-report questionnaires, the Problem Areas in Diabetes scale, the Perceived Competence in Diabetes Scale and a measure of autonomy support by healthcare providers, the Health Care Climate Questionnaire. We fitted blockwise linear regression models to assess...... the associations between Problem Areas in Diabetes score and the variables of interest (autonomy support and perceived diabetes competence), controlling for clinical and sociodemographic variables. RESULTS: Of the study sample [n = 178; mean age 36.7 (±10.7) years], 31.5% had long-term complications and 43...

  16. Review of inputs provided to Jason Associates Corporation in support of RWEV-REP-001, the Analysis of Postclosure Groundwater Impacts report.

    Energy Technology Data Exchange (ETDEWEB)

    Bryan, Charles R.; Weck, Philippe F.; Vaughn, Palmer; Arnold, Bill Walter

    2014-04-01

    Report RWEV-REP-001, Analysis of Postclosure Groundwater Impacts for a Geologic Repository for the Disposal of Spent Nuclear Fuel and High Level Radioactive Waste at Yucca Mountain, Nye County, Nevada was issued by the DOE in 2009 and is currently being updated. Sandia National Laboratories (SNL) provided support for the original document, performing calculations and extracting data from the Yucca Mountain Performance Assessment Model that were used as inputs to the contaminant transport and dose calculations by Jason Associates Corporation, the primary developers of the DOE report. The inputs from SNL were documented in LSA-AR-037, Inputs to Jason Associates Corporation in Support of the Postclosure Repository Supplemental Environmental Impact Statement. To support the updating of the original Groundwater Impacts document, SNL has reviewed the inputs provided in LSA-AR-037 to verify that they are current and appropriate for use. The results of that assessment are documented here.

  17. Supporting adherence to oral anticancer agents: clinical practice and clues to improve care provided by physicians, nurse practitioners, nurses and pharmacists

    NARCIS (Netherlands)

    Timmers, L.; Boons, C.C.; Verbrugghe, M.; Bemt, B.J.F van den; Hecke, A. Van; Hugtenburg, J.G.

    2017-01-01

    BACKGROUND: Healthcare provider (HCP) activities and attitudes towards patients strongly influence medication adherence. The aim of this study was to assess current clinical practices to support patients in adhering to treatment with oral anticancer agents (OACA) and to explore clues to improve the

  18. Retrospective analysis of porcelain failures of metal ceramic crowns and fixed partial dentures supported by 729 implants in 152 patients: patient-specific and implant-specific predictors of ceramic failure.

    Science.gov (United States)

    Kinsel, Richard P; Lin, Dongming

    2009-06-01

    Porcelain fracture associated with an implant-supported, metal ceramic crown or fixed partial denture occurs at a higher rate than in tooth-supported restorations, according to the literature. Implant-specific and patient-specific causes of ceramic failure have not been fully evaluated. The purpose of this retrospective study was to evaluate the potential statistical predictors for porcelain fracture of implant-supported, metal ceramic restorations. Over a 6-month period, a consecutive series of patients having previously received implant-supported, metal ceramic fixed restorations were examined during periodic recall appointments. The number of supporting implants, number of dental units, type of restoration, date of prosthesis insertion, location in the dental arch, opposing dentition, type of occlusion, presence of parafunctional habits, use of an occlusal protective device, presence or absence of ceramic fractures, gender, and age were recorded for each patient. The generalized estimating equation (GEE) approach was used for the intrasubject correlated measurements analysis of categorical outcomes (presence or absence of ceramic fractures) to determine which patient- and implant-specific factors would predict porcelain fracture (alpha=.05). Data were collected from 152 patients representing 998 dental units (390 single crowns and 94 fixed partial dentures) supported by 729 implants. Porcelain fractures of 94 dental units occurred in 35 patients. The fractures were significantly (Pimplant-supported metal ceramic restorations, bruxism, and not wearing a protective occlusal device. Metal ceramic prostheses (single crown or fixed partial dentures) had approximately 7 times higher odds of porcelain fracture (odds ratio (OR)=7.06; 95% confidence interval (CI): 2.57 to 19.37) and 13 times greater odds of a fracture requiring either repair or replacement (OR=13.95; 95% CI: 2.25 to 86.41) when in occlusion with another implant-supported restoration, as compared to

  19. The nature of parent support provided by parent mentors for families with deaf/hard-of-hearing children: voices from the start.

    Science.gov (United States)

    Narr, Rachel Friedman; Kemmery, Megan

    2015-01-01

    This study used a qualitative design to explore parent mentors' summaries of conversations with more than 1,000 individual families of deaf and hard-of-hearing (DHH) children receiving parent-to-parent support as part of an existing family support project. Approximately 35% of the families were Spanish speaking. Five parent mentors who have DHH children provided varied support primarily via the telephone to families with DHH children, frequently birth to age 3. The nature and types of support provided were examined and resulted in an in-depth analysis of the summary notes prepared by the parent mentors. The notes were coded using a mixed-methods software application. Three topics were the most prevalent within the conversations between parent mentors and family members: hearing-related topics, early intervention, and multiple disabilities. Several differences emerged between English-speaking and Spanish-speaking families receiving support. Implications and the significance of this study are discussed. © The Author 2014. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  20. Association Between Perceived Health Care Provider Support and Satisfaction with Insulin Pumps in Children with Type 1 Diabetes Mellitus: Opportunities for Pharmacists

    Directory of Open Access Journals (Sweden)

    Laura Brooke Jowers

    2015-01-01

    Full Text Available Purpose: The purpose of this pilot study was to describe parents’ perceived healthcare provider support for integrating technology, satisfaction with insulin pump use in their child with T1DM, and the relationship between parents’ perceived healthcare provider support and satisfaction with insulin pump use. Methods: A cross-sectional, correlational design was used to collect data for the present study. The study was conducted through an Internet survey among Mid-South parents who have a child with T1DM, 18 years old or younger using an insulin pump and/or continuous glucose monitoring (CGM. Frequencies, descriptive statistics, and correlation coefficients were calculated. Results: Most of the parents surveyed used an endocrinologist/pediatric endocrinologist as their primary diabetes healthcare provider and considered three to four healthcare professionals as part of the diabetes healthcare team who helped them utilize insulin pumps and advanced technologies. Parents (23.4% indicated a pharmacist was part of the healthcare team who helped them utilize technology. Parents appeared to perceive support for using insulin pumps; however, there is room for improvement. The more perceived support for integrating technology, the more satisfied the parents were with using insulin pumps (r=0.431, p=0.005. Conclusions: Results from this study suggest that parents and children need continued education, support and training to integrate insulin pumps into diabetes self-management. As more patients attempt to adopt insulin pumps and other advanced technologies, it will be important for pharmacists to support the adoption and integration of these technologies and be knowledgeable and helpful if asked about technology-related challenges.   Type: Student Project

  1. Social Support and Motivation to Transfer as Predictors of Training Transfer: Testing Full and Partial Mediation Using Meta-Analytic Structural Equation Modelling

    Science.gov (United States)

    Reinhold, Sarah; Gegenfurtner, Andreas; Lewalter, Doris

    2018-01-01

    Social support and motivation to transfer are important components in conceptual models on transfer of training. Previous research indicates that both support and motivation influence transfer. To date, however, it is not yet clear if social support influences transfer of training directly, or if this influence is mediated by motivation to…

  2. [Acrylic resin removable partial dentures

    NARCIS (Netherlands)

    Baat, C. de; Witter, D.J.; Creugers, N.H.J.

    2011-01-01

    An acrylic resin removable partial denture is distinguished from other types of removable partial dentures by an all-acrylic resin base which is, in principle, solely supported by the edentulous regions of the tooth arch and in the maxilla also by the hard palate. When compared to the other types of

  3. Dying patients' need for emotional support and personalized care from physicians: perspectives of patients with terminal illness, families, and health care providers.

    Science.gov (United States)

    Wenrich, Marjorie D; Curtis, J Randall; Ambrozy, Donna A; Carline, Jan D; Shannon, Sarah E; Ramsey, Paul G

    2003-03-01

    This study addressed the emotional and personal needs of dying patients and the ways physicians help or hinder these needs. Twenty focus groups were held with 137 individuals, including patients with chronic and terminal illnesses, family members, health care workers, and physicians. Content analyses were performed based on grounded theory. Emotional support and personalization were 2 of the 12 domains identified as important in end-of-life care. Components of emotional support were compassion, responsiveness to emotional needs, maintaining hope and a positive attitude, and providing comfort through touch. Components of personalization were treating the whole person and not just the disease, making the patient feel unique and special, and considering the patient's social situation. Although the levels of emotional support and personalization varied, there was a minimal level, defined by compassion and treating the whole person and not just the disease, that physicians should strive to meet in caring for all dying patients. Participants also identified intermediate and advanced levels of physician behavior that provide emotional and personal support.

  4. Why patient summaries in electronic health records do not provide the cognitive support necessary for nurses' handoffs on medical and surgical units: insights from interviews and observations.

    Science.gov (United States)

    Staggers, Nancy; Clark, Lauren; Blaz, Jacquelyn W; Kapsandoy, Seraphine

    2011-09-01

    Patient care handoffs are cognitively intense activities, especially on medical and surgical units where nurses synthesize information across an average of four to five patients every shift. The objective of this study was to examine handoffs and nurses' use of computerized patient summary reports in an electronic health record after computerized provider order entry (CPOE) was installed. We observed and audio taped 93 patient handoffs on 25 occasions on 5 acute care units in 2 different facilities sharing a vendor's electronic health record. We found that the computerized patient summary report and the electronic health record were minimally used during the handoff and that the existing patient summary reports did not provide adequate cognitive support for nurses. The patient summary reports were incomplete, rigid and did not offer "at a glance" information, or help nurses encode information. We make recommendations about a redesign of patient summary reports and technology to support the cognitive needs of nurses during handoffs at the change of shift.

  5. Improving health worker performance of abortion services: an assessment of post-training support to providers in India, Nepal and Nigeria.

    Science.gov (United States)

    Benson, Janie; Healy, Joan; Dijkerman, Sally; Andersen, Kathryn

    2017-11-21

    Health worker performance has been the focus of numerous interventions and evaluation studies in low- and middle-income countries. Few have examined changes in individual provider performance with an intervention encompassing post-training support contacts to improve their clinical practice and resolve programmatic problems. This paper reports the results of an intervention with 3471 abortion providers in India, Nepal and Nigeria. Following abortion care training, providers received in-person visits and virtual contacts by a clinical and programmatic support team for a 12-month period, designed to address their individual practice issues. The intervention also included technical assistance to and upgrades in facilities where the providers worked. Quantitative measures to assess provider performance were established, including: 1) Increase in service provision; 2) Consistent service provision; 3) Provision of high quality of care through use of World Health Organization-recommended uterine evacuation technologies, management of pain and provision of post-abortion contraception; and 4) Post-abortion contraception method mix. Descriptive univariate analysis was conducted, followed by examination of the bivariate relationships between all independent variables and the four dependent performance outcome variables by calculating unadjusted odds ratios, by country and overall. Finally, multivariate logistic regression was performed for each outcome. Providers received an average of 5.7 contacts. Sixty-two percent and 46% of providers met measures for consistent service provision and quality of care, respectively. Fewer providers achieved an increased number of services (24%). Forty-six percent provided an appropriate postabortion contraceptive mix to clients. Most providers met the quality components for use of WHO-recommended abortion methods and provision of pain management. Factors significantly associated with achievement of all measures were providers working in

  6. Key components of a service model providing early childhood support for women attending opioid treatment clinics: an Australian state health service review.

    Science.gov (United States)

    Harvey, Susan R; Schmied, Virginia; Nicholls, Daniel; Dahlen, Hannah

    2012-09-01

    To report the findings of a service review--specifically the strategy to provide early childhood services 'on site' at opioid treatment clinics to address access difficulties. Child and family health nurses are skilled in the assessment and support of families during early childhood. However, women with a history of substance abuse are often cautious when engaging with universal and other health services, with the result that the infant may miss recommended developmental screening and early referral to improve health outcomes. In 2006, an internal review was undertaken of the integration of early childhood and parenting services at opioid treatment clinics in a large Area Health Service of New South Wales, Australia. A qualitative study design, using semi-structured interview questions was used. Data were collected via six focus groups (4-15 participants in each group) and individual interview of child and family health nurses, nurse unit managers and clinical staff (n=58). Three key components of a model for providing early childhood support in collaboration with opioid treatment services were identified. First, the importance of building a trusting relationship between the woman and the child and family health nurses, second, maintaining continuity of care and a multidisciplinary/multiagency approach, and finally the importance of staff education, support and professional development. The provision of early childhood and parenting services on site, as part of a multidisciplinary 'one stop shop' approach to service delivery was a clear recommendation of the review. Reduction of access difficulties to specialised early childhood support is of benefit to clients, community health services attempting to provide a service to this difficult to reach population and to drug and alcohol services seeking to provide a high level of holistic care for clients. © 2012 Blackwell Publishing Ltd.

  7. Social pedagogy as a model to provide support for siblings of children with intellectual disabilities: A report of the views of the children and young people using a sibling support group.

    Science.gov (United States)

    Carter, Sid; Cook, James; Sutton-Boulton, Gary; Ward, Vicki; Clarke, Steve

    2016-03-01

    The experiences of non-disabled children growing up with a sibling with an intellectual disability vary considerably, with reported impact ranging from increased mental health problems through evaluations of life enhancement. However, there is evidence that the net impact is neutral to positive, which was supported by the findings of this report of a service evaluation survey. The value of providing support to those young siblings is however clear. An established method of support is within a group of peers who also have a sibling with an intellectual disability, though no specific method for running this type of group has yet been fully explored. This article reports the views of 39 children taking part in such a group, analysing their perspective through a proposed model for the operation of sibling groups: social pedagogy. It was found that the closer the group's activities were to social pedagogy, the more supported the children and young people felt. © The Author(s) 2015.

  8. Symbiotic bacteria are responsible for diet-induced mating preference in Drosophila melanogaster, providing support for the hologenome concept of evolution.

    Science.gov (United States)

    Sharon, Gil; Segal, Daniel; Zilber-Rosenberg, Ilana; Rosenberg, Eugene

    2011-01-01

    Diet-induced mating preference in Drosophila melanogaster results from amplification of the commensal bacterium Lactobacillus plantarum, providing a new role for gut microbiota and support for the hologenome concept of evolution. When the flies were treated with antibiotics prior to changing their diet, mating preference did not occur. These data also indicate that other potentially beneficial bacteria could be irreversibly lost by antibiotic treatment and that their replacement could provide a health benefit. We suggest that D. melanogaster can be a useful model organism to study the activities of gut microbiota and their interaction with the immune system.

  9. A Reflection on the Work of an Educational Psychologist in Providing Supervision for a Team of Community Based Support Workers, Supporting Families with Vulnerable Adolescents at Risk of Exclusion from School

    Science.gov (United States)

    Maxwell, Tim

    2013-01-01

    The evolving role of the educational psychologist (EP) is discussed with an emphasis on the supervision provided for a team of support workers for vulnerable adolescents, working within a Local Service Team. This development is considered in the context of the Every Child Matters (DfES, 2004) agenda and the Farrell, Woods, Lewis, Rooney, Squire…

  10. Supporting students' scientific explanations: A case study investigating the synergy focusing on a teacher's practices when providing instruction and using mobile devices

    Science.gov (United States)

    Delen, Ibrahim

    Engage students in constructing scientific practices is a critical component of science instruction. Therefore a number of researchers have developed software programs to help students and teachers in this hard task. The Zydeco group, designed a mobile application called Zydeco, which enables students to collect data inside and outside the classroom, and then use the data to create scientific explanations by using claim-evidence-reasoning framework. Previous technologies designed to support scientific explanations focused on how these programs improve students' scientific explanations, but these programs ignored how scientific explanation technologies can support teacher practices. Thus, to increase our knowledge how different scaffolds can work together, this study aimed to portray the synergy between a teacher's instructional practices (part 1) and using supports within a mobile devices (part 2) to support students in constructing explanations. Synergy can be thought of as generic and content-specific scaffolds working together to enable students to accomplish challenging tasks, such as creating explanations that they would not normally be able to do without the scaffolds working together. Providing instruction (part 1) focused on understanding how the teacher scaffolds students' initial understanding of the claim-evidence-reasoning (CER) framework. The second component of examining synergy (part 2: using mobile devices) investigated how this teacher used mobile devices to provide feedback when students created explanations. The synergy between providing instruction and using mobile devices was investigated by analyzing a middle school teacher's practices in two different units (plants and water quality). Next, this study focused on describing how the level of synergy influenced the quality of students' scientific explanations. Finally, I investigated the role of focused teaching intervention sessions to inform teacher in relation to students' performance. In

  11. Interventions to improve the self-management support health professionals provide for people with progressive neurological conditions: protocol for a realist synthesis.

    Science.gov (United States)

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

    2017-03-20

    Supporting self-management among people with long-term conditions is recognised as an important component of healthcare. Progressive neurological conditions (PNCs), for example, Parkinson's disease and multiple sclerosis are associated with problems such as fatigue and cognitive impairment which may make self-management more challenging. Health professionals may need to develop specific skills in order to provide effective self-management support for these patients. The review aims to develop explanatory theories about how health professional-targeted interventions to improve self-management support provision for people with PNCs operate in different circumstances. A realist synthesis of the evidence is proposed. There are 2 priority questions for the review to address. These relate to the role of a shared concept of self-management support within the healthcare team, and the need to tailor the support provided to the requirements of people with PNCs. Key stakeholders will be involved throughout the process. The initial search strategy uses terms relating to (1) self-management, (2) health professionals and (3) PNCs. Searching, data extraction and synthesis will occur in parallel. Studies will be prioritised for inclusion based on anticipated contribution to generating explanatory theories. Key informant interviews are planned to direct supplementary searches and help further refine the theories developed. Results will be expressed in the form of context-mechanism-outcome configurations. Publication guidelines on realist synthesis will be followed. The results will be published in a peer-reviewed journal and made available to organisations involved in the provision of health professional training. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  12. Using Patient-Generated Health Data From Mobile Technologies for Diabetes Self-Management Support: Provider Perspectives From an Academic Medical Center.

    Science.gov (United States)

    Nundy, Shantanu; Lu, Chen-Yuan E; Hogan, Patrick; Mishra, Anjuli; Peek, Monica E

    2014-01-01

    Mobile health and patient-generated health data are promising health IT tools for delivering self-management support in diabetes, but little is known about provider perspectives on how best to integrate these programs into routine care. We explored provider perceptions of a patient-generated health data report from a text-message-based diabetes self-management program. The report was designed to relay clinically relevant data obtained from participants' responses to self-assessment questions delivered over text message. Likert-type scale response surveys and in-depth interviews were conducted with primary care physicians and endocrinologists who pilot tested the patient-generated health data report in an actual clinical encounter. Interview guides were designed to assess providers' perceptions of the feasibility and utility of patient-generated health data in routine clinical practice. Interviews were audiotaped, transcribed, and analyzed using the constant comparative method. Twelve providers successfully piloted the summary report in clinic. Although only a minority of providers felt the report changed the care they provided (3 of 12 or 25%), most were willing to use the summary report in a future clinical encounter (9 of 12 or 75%). Perceived benefits of patient-generated health data included agenda setting, assessment of self-care, and identification of patient barriers. Major themes discussed included patient selection, reliability of patient-generated health information, and integration into clinical workflow. Providers perceived multiple benefits of patient-generated health data in overcoming common barriers to self-management support in clinical practice and found the summary report feasible and usable in a clinical context. © 2014 Diabetes Technology Society.

  13. Assessing clinical support and inter-professional interactions among front-line primary care providers in remote communities in northern Canada: a pilot study

    Directory of Open Access Journals (Sweden)

    Stephanie K. Young

    2016-09-01

    Full Text Available Background: Primary care in remote communities in northern Canada is delivered primarily by nurses who receive clinical support from physicians in regional centres and the patient transportation system. To improve continuity, quality and access to care in remote northern communities, it is important to understand the perspectives of front-line providers and the complex challenges they face. Objective: To design and implement a survey of primary care providers to identify issues relating to inter-professional communication, clinical support and patient evacuation. Methods: In collaboration with the territorial government and regional health authority partners, we developed a 21-item self-administered questionnaire survey, which could be completed online. The survey was sent to 218 physicians and nurses who were employed in the Northwest Territories (NWT at the time of the survey and were involved in sending patients out of the community and/or receiving patients. The survey also contained an open-ended question at the end seeking comments regarding primary health care. Results: The overall low response rate of 39% among nurses and 19% among physicians threatens the validity of the quantitative results. The majority of providers were satisfied with their ability to communicate with other providers in a timely manner, their freedom to make clinical decisions and their overall experience practicing in the NWT. The patient transfer system appears to work from both the sender and receiver perspectives. However, a common theme reported by nurses was that physicians providing clinical advice, especially short-term locums, were not familiar with the local situation, whilst physicians at the receiving end remarked that the clinical information provided to them often lacked clarity. Conclusions: Important lessons were learnt from the pilot study, especially in better engagement of providers in planning and dissemination. The questionnaire design and the

  14. Partially ordered models

    NARCIS (Netherlands)

    Fernandez, R.; Deveaux, V.

    2010-01-01

    We provide a formal definition and study the basic properties of partially ordered chains (POC). These systems were proposed to model textures in image processing and to represent independence relations between random variables in statistics (in the later case they are known as Bayesian networks).

  15. Assessment of the quality of antenatal care services provided by health workers using a mobile phone decision support application in northern Nigeria: a pre/post-intervention study.

    Science.gov (United States)

    McNabb, Marion; Chukwu, Emeka; Ojo, Oluwayemisi; Shekhar, Navendu; Gill, Christopher J; Salami, Habeeb; Jega, Farouk

    2015-01-01

    Given the shortage of skilled healthcare providers in Nigeria, frontline community health extension workers (CHEWs) are commonly tasked with providing maternal and child health services at primary health centers. In 2012, we introduced a mobile case management and decision support application in twenty primary health centers in northern Nigeria, and conducted a pre-test/post-test study to assess whether the introduction of the app had an effect on the quality of antenatal care services provided by this lower-level cadre. Using the CommCare mobile platform, the app dynamically guides CHEWs through antenatal care protocols and collects client data in real time. Thirteen health education audio clips are also embedded in the app for improving and standardizing client counseling. To detect changes in quality, we developed an evidence-based quality score consisting of 25 indicators, and conducted a total of 266 client exit interviews. We analyzed baseline and endline data to assess changes in the overall quality score as well as changes in the provision of key elements of antenatal care. Overall, the quality score increased from 13.3 at baseline to 17.2 at endline (peducation. These study results suggest that the introduction of a low-cost mobile case management and decision support application can spur behavior change and improve the quality of services provided by a lower level cadre of healthcare workers. Future research should employ a more rigorous experimental design to explore potential longer-term effects on client health outcomes.

  16. The Tulip GT® airway versus the facemask and Guedel airway: a randomised, controlled, cross-over study by Basic Life Support-trained airway providers in anaesthetised patients.

    Science.gov (United States)

    Shaikh, A; Robinson, P N; Hasan, M

    2016-03-01

    We performed a randomised, controlled, cross-over study of lung ventilation by Basic Life Support-trained providers using either the Tulip GT® airway or a facemask with a Guedel airway in 60 anaesthetised patients. Successful ventilation was achieved if the provider produced an end-tidal CO2 > 3.5 kPa and a tidal volume > 250 ml in two of the first three breaths, within 60 sec and within two attempts. Fifty-seven (95%) providers achieved successful ventilation using the Tulip GT compared with 35 (58%) using the facemask (p Tulip GT and facemask, the mean (SD) end-tidal CO2 was 5.0 (0.7) kPa vs 2.5 (1.5) kPa, tidal volume was 494 (175) ml vs 286 (186) ml and peak inspiratory pressure was 18.3 (3.4) cmH2 O vs 13.6 (7) cmH2 O respectively (all p Tulip GT airway. These results are similar to a previous manikin study using the same protocol, suggesting a close correlation between human and manikin studies for this airway device. We conclude that the Tulip GT should be considered as an adjunct to airway management both within and outside hospitals when ventilation is being undertaken by Basic Life Support-trained airway providers. © 2015 The Association of Anaesthetists of Great Britain and Ireland.

  17. HIV Care Providers' Attitudes regarding Mobile Phone Applications and Web-Based Dashboards to support Patient Self-Management and Care Coordination: Results from a Qualitative Feasibility Study.

    Science.gov (United States)

    Swendeman, Dallas; Farmer, Shu; Mindry, Deborah; Lee, Sung-Jae; Medich, Melissa

    2016-10-01

    In-depth qualitative interviews were conducted with healthcare providers (HCPs) from five HIV medical care coordination teams in a large Los Angeles County HIV clinic, including physicians, nurses, and psychosocial services providers. HCPs reported on the potential utility, acceptability, and barriers for patient self-monitoring and notifications via mobile phones, and web-based dashboards for HCPs. Potential benefits included: 1) enhancing patient engagement, motivation, adherence, and self-management; and 2) improving provider-patient relationships and HCP care coordination. Newly diagnosed and patients with co-morbidities were highest priorities for mobile application support. Facilitators included universal mobile phone ownership and use of smartphones or text messaging. Patient-level barriers included concerns about low motivation and financial instability for consistent use by some patients. Organizational barriers, cited primarily by physicians, included concerns about privacy protections, easy dashboard access, non-integrated electronic records, and competing burdens in limited appointment times. Psychosocial services providers were most supportive of the proposed mobile tools.

  18. Qualitative study to explore the health and well-being impacts on adults providing informal support to female domestic violence survivors.

    Science.gov (United States)

    Gregory, Alison; Feder, Gene; Taket, Ann; Williamson, Emma

    2017-03-24

    Domestic violence (DV) is hazardous to survivors' health, from injuries sustained and from resultant chronic physical and mental health problems. Support from friends and relatives is significant in the lives of DV survivors; research shows associations between positive support and the health, well-being and safety of survivors. Little is known about how people close to survivors are impacted. The aim of this study was exploratory, with the following research question: what are the health and well-being impacts on adults who provide informal support to female DV survivors? A qualitative study using semistructured interviews conducted face to face, by telephone or using Skype. A thematic analysis of the narratives was carried out. Community-based, across the UK. People were eligible to take part if they had had a close relationship (either as friend, colleague or family member) with a woman who had experienced DV, and were aged 16 or over during the time they knew the survivor. Participants were recruited via posters in community venues, social media and radio advertisement. 23 participants were recruited and interviewed; the majority were women, most were white and ages ranged from mid-20s to 80. Generated themes included: negative impacts on psychological and emotional well-being of informal supporters, and related physical health impacts. Some psychological impacts were over a limited period; others were chronic and had the potential to be severe and enduring. The impacts described suggested that those providing informal support to survivors may be experiencing secondary traumatic stress as they journey alongside the survivor. Friends and relatives of DV survivors experience substantial impact on their own health and well-being. There are no direct services to support this group. These findings have practical and policy implications, so that the needs of informal supporters are legitimised and met. Published by the BMJ Publishing Group Limited. For permission to

  19. Joint interpretation of seismic tomography and new magnetotelluric results provide evidence for support of high topography in the Southern Rocky Mountains and High Plains of eastern Colorado, USA

    Science.gov (United States)

    Feucht, D. W.; Sheehan, A. F.; Bedrosian, P.

    2015-12-01

    A recent magnetotelluric (MT) survey in central Colorado, USA, when interpreted alongside existing seismic tomography, reveals potential mechanisms of support for high topography both regionally and locally. Broadband and long period magnetotelluric data were collected at twenty-three sites along a 330 km E-W profile across the Southern Rocky Mountains and High Plains of central North America as part of the Deep RIFT Electrical Resistivity (DRIFTER) experiment. Remote-reference data processing yielded high quality MT data over a period range of 100 Hz to 10,000 seconds. A prominent feature of the regional geo-electric structure is the Denver Basin, which contains a thick package of highly conductive shales and porous sandstone aquifers. One-dimensional forward modeling was performed on stations within the Denver Basin to estimate depth to the base of this shallow conductor. Those estimates were then used to place a horizontal penalty cut in the model mesh of a regularized two-dimensional inversion. Two-dimensional modeling of the resistivity structure reveals two major anomalous regions in the lithosphere: 1) a high conductivity region in the crust under the tallest peaks of the Rocky Mountains and 2) a lateral step increase in lithospheric resistivity beneath the plains. The Rocky Mountain crustal anomaly coincides with low seismic wave speeds and enhanced heat flow and is thus interpreted as evidence of partial melt and/or high temperature fluids emplaced in the crust by tectonic activity along the Rio Grande Rift. The lateral variation in the mantle lithosphere, while co-located with a pronounced step increase in seismic velocity, appears to be a gradational boundary in resistivity across eastern Colorado and could indicate a small degree of compositional modification at the edge of the North American craton. These inferred conductivity mechanisms, namely crustal melt and modification of mantle lithosphere, likely contribute to high topography locally in the

  20. Identifying effective behavioural components of Intervention and Comparison group support provided in SMOKing cEssation (IC-SMOKE) interventions: a systematic review protocol.

    Science.gov (United States)

    de Bruin, Marijn; Viechtbauer, Wolfgang; Eisma, Maarten C; Hartmann-Boyce, Jamie; West, Robert; Bull, Eleanor; Michie, Susan; Johnston, Marie

    2016-05-04

    Systematic reviews of behaviour change interventions for smoking cessation vary in scope, quality, and applicability. The current review aims to generate more accurate and useful findings by (1) a detailed analysis of intervention elements that change behaviour (i.e. behaviour change techniques (BCTs)) and potential moderators of behaviour change (i.e. other intervention and sample characteristics) and (2) assessing and controlling for variability in support provided to comparison groups in smoking cessation trials. A systematic review will be conducted of randomized controlled trials of behaviour change interventions for smoking cessation in adults (with or without pharmacological support), with a minimum follow-up of 6 months, published after 1995. Eligible articles will be identified through the Cochrane Tobacco Addiction Group Specialized Register. Study authors will be asked for detailed descriptions of smoking cessation support provided to intervention and comparison groups. All data will be independently coded by two researchers. The BCT taxonomy v1 (tailored to smoking cessation interventions) and template for intervention description and replication criteria will be used to code intervention characteristics. Data collection will further include sample and trial characteristics and outcome data (smoking cessation rates). Multilevel mixed-effects meta-regression models will be used to examine which BCTs and/or BCT clusters delivered to intervention and comparison groups explain smoking cessation rates in treatment arms (and effect sizes) and what key moderators of behaviour change are. Predicted effect sizes of each intervention will be computed assuming all interventions are compared against comparison groups receiving the same levels of behavioural support (i.e. low, medium, and high levels). Multi-disciplinary advisory board members (policymakers, health care providers, and (ex-)smokers) will provide strategic input throughout the project to ensure the

  1. Theorizing E-Commerce Business Models: On the Impact of Partially and Fully Supported Transaction Phases on Customer Satisfaction and Loyalty

    OpenAIRE

    Maria Madlberger; Sabine Matook

    2017-01-01

    Although considerable research has been conducted on the definition and classification of e-commerce business models, little research has integrated the support and impact of distinct transaction phases within e-commerce business models. Indeed, any channel design decisions depend on the arrangement of the three transaction phases, viz. information phase, agreement phase and fulfilment phase. Whereas in literature, a complete support of transaction phases is implicitly assumed, in practice, e...

  2. Methanol partial oxidation reformer

    Science.gov (United States)

    Ahmed, Shabbir; Kumar, Romesh; Krumpelt, Michael

    1999-01-01

    A partial oxidation reformer comprising a longitudinally extending chamber having a methanol, water and an air inlet and an outlet. An igniter mechanism is near the inlets for igniting a mixture of methanol and air, while a partial oxidation catalyst in the chamber is spaced from the inlets and converts methanol and oxygen to carbon dioxide and hydrogen. Controlling the oxygen to methanol mole ratio provides continuous slightly exothermic partial oxidation reactions of methanol and air producing hydrogen gas. The liquid is preferably injected in droplets having diameters less than 100 micrometers. The reformer is useful in a propulsion system for a vehicle which supplies a hydrogen-containing gas to the negative electrode of a fuel cell.

  3. Methanol partial oxidation reformer

    Science.gov (United States)

    Ahmed, S.; Kumar, R.; Krumpelt, M.

    1999-08-24

    A partial oxidation reformer is described comprising a longitudinally extending chamber having a methanol, water and an air inlet and an outlet. An igniter mechanism is near the inlets for igniting a mixture of methanol and air, while a partial oxidation catalyst in the chamber is spaced from the inlets and converts methanol and oxygen to carbon dioxide and hydrogen. Controlling the oxygen to methanol mole ratio provides continuous slightly exothermic partial oxidation reactions of methanol and air producing hydrogen gas. The liquid is preferably injected in droplets having diameters less than 100 micrometers. The reformer is useful in a propulsion system for a vehicle which supplies a hydrogen-containing gas to the negative electrode of a fuel cell. 7 figs.

  4. Does the use of a university lecturer as a visiting tutor support learning and assessment during physiotherapy students' clinical placements? A survey of higher education institution providers.

    Science.gov (United States)

    Dean, M; Levis, A

    2016-12-01

    To establish the rationale for using a lecturer as a visiting tutor, and to identify the activities undertaken during clinical placements to support student learning and assessment in practice. A secure electronic survey was used to incorporate qualitative and quantitative data collection procedures. Thirty-three higher education institution (HEI) providers of physiotherapy education in the UK, registered with the Chartered Society of Physiotherapy. UK HEI physiotherapy placement coordinators. A questionnaire was used to examine HEI perceptions. A pilot focus group consultation informed the questionnaire content. Surveys were analysed based on the proportion of responses to closed questions on an adapted Likert scale, with further thematic analysis of open questions. All 25 respondents (25/33, 76%) indicated their provision of support for students and clinical educators throughout their clinical placements. 'Face-to-face' engagement during the placement visit was viewed as essential to guide the clinical educator to provide a consistent approach to learning and assessment strategies; ensuring cohesion between theoretical and clinical components of the curriculum was viewed as a core objective by visiting academic tutors. However, the emergent themes highlighted key differences between HEIs' perspectives of what this support for clinical placement learning should entail. The majority of HEIs endorse the use of a lecturer as a visiting tutor to inform and maintain the standard of learning and assessment within the clinical placement. However, the value of this interaction requires confirmation via other stakeholders, and exploration of other forms of non-face-to-face support processes warrant further investigation. Copyright © 2015 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.

  5. Algebraic partial Boolean algebras

    CERN Document Server

    Smith, D

    2003-01-01

    Partial Boolean algebras, first studied by Kochen and Specker in the 1960s, provide the structure for Bell-Kochen-Specker theorems which deny the existence of non-contextual hidden variable theories. In this paper, we study partial Boolean algebras which are 'algebraic' in the sense that their elements have coordinates in an algebraic number field. Several of these algebras have been discussed recently in a debate on the validity of Bell-Kochen-Specker theorems in the context of finite precision measurements. The main result of this paper is that every algebraic finitely-generated partial Boolean algebra B(T) is finite when the underlying space H is three-dimensional, answering a question of Kochen and showing that Conway and Kochen's infinite algebraic partial Boolean algebra has minimum dimension. This result contrasts the existence of an infinite (non-algebraic) B(T) generated by eight elements in an abstract orthomodular lattice of height 3. We then initiate a study of higher-dimensional algebraic partial...

  6. A CONTEXT AWARE BASED PRE-HANDOFF SUPPORT APPROACH TO PROVIDE OPTIMAL QOS FOR STREAMING APPLICATIONS OVER VEHICULAR AD HOC NETWORKS – HOSA

    Directory of Open Access Journals (Sweden)

    K. RAMESH BABU

    2015-06-01

    Full Text Available Large variations in network Quality of Service (QoS such as bandwidth, latency, jitter, and reliability may occur during media transfer over vehicular ad hoc networks (VANET. Usage of VANET over mobile and wireless computing applications experience “bursty” QoS behavior during the execution over distributed network scenarios. Applications such as streaming media services need to adapt their functionalities to any change in network status. Moreover, an enhanced software platform is necessary to provide adaptive network management services to upper software components. HOSA, a handoff service broker based architecture for QoS adaptation over VANET supports in providing awareness. HOSA is structured as a middleware platform both to provide QoS awareness to streaming applications as well to manage dynamic ad hoc network resources with support over handoff in an adaptive fashion. HOSA is well analyzed over routing schemes such as TIBSCRPH, SIP and ABSRP where performance of HOSA was measured using throughput, traffic intensity and end to end delay. HOSA has been analyzed using JXTA development toolkit over C++ implemented classes to demonstrate its performance over varying node mobility established using vehicular mobility based conference application.

  7. Change in inflammatory parameters in prefrail and frail persons obtaining physical training and nutritional support provided by lay volunteers: A randomized controlled trial.

    Directory of Open Access Journals (Sweden)

    Sandra Haider

    Full Text Available The aim of the study was to compare the effects of home visits with physical training and nutritional support on inflammatory parameters to home visits with social support alone within a randomized controlled trial. Prefrail and frail persons received home visits from lay volunteers twice a week for 12 weeks. Participants in the physical training and nutritional intervention group (PTN, n = 35 conducted two sets of six strength exercises and received nutritional support. The social support group (SoSu, n = 23 received visits only. TNF-α, IL-6, CRP, and total leukocyte count were assessed at baseline and after 12 weeks. Changes over time within groups were analyzed with paired t-tests; differences between groups were analyzed with ANCOVA for repeated measurements. In the PTN group, IL-6 and CRP remained stable, whereas in the SoSu group, IL-6 increased significantly from a median value of 2.6 pg/l (min-max = 2.0-10.2 to 3.0 pg/l (min-max = 2.0-20.8, and CRP rose from 0.2 mg/dl (min-max = 0.1-0.9 to 0.3 mg/dl (min-max = 0.1-3.0 after 12 weeks. In CRP, a significant difference between groups was found. TNF-α and total leukocyte count did not change in either the PTN group or the SoSu group. Persons showing an increase in physical performance (OR 4.54; 95% CI = 1.33-15.45 were more likely to have constant or decreased IL-6 values than persons who showed no improvement. In conclusion, in non-robust older adults, a physical training and nutritional support program provided by lay volunteers can delay a further increase in some inflammatory parameters.

  8. Assessment of the quality of antenatal care services provided by health workers using a mobile phone decision support application in northern Nigeria: a pre/post-intervention study.

    Directory of Open Access Journals (Sweden)

    Marion McNabb

    Full Text Available Given the shortage of skilled healthcare providers in Nigeria, frontline community health extension workers (CHEWs are commonly tasked with providing maternal and child health services at primary health centers. In 2012, we introduced a mobile case management and decision support application in twenty primary health centers in northern Nigeria, and conducted a pre-test/post-test study to assess whether the introduction of the app had an effect on the quality of antenatal care services provided by this lower-level cadre.Using the CommCare mobile platform, the app dynamically guides CHEWs through antenatal care protocols and collects client data in real time. Thirteen health education audio clips are also embedded in the app for improving and standardizing client counseling. To detect changes in quality, we developed an evidence-based quality score consisting of 25 indicators, and conducted a total of 266 client exit interviews. We analyzed baseline and endline data to assess changes in the overall quality score as well as changes in the provision of key elements of antenatal care.Overall, the quality score increased from 13.3 at baseline to 17.2 at endline (p<0.0001, out of a total possible score of 25, with the most significant improvements related to health counseling, technical services provided, and quality of health education.These study results suggest that the introduction of a low-cost mobile case management and decision support application can spur behavior change and improve the quality of services provided by a lower level cadre of healthcare workers. Future research should employ a more rigorous experimental design to explore potential longer-term effects on client health outcomes.

  9. [Removable partial dentures. Oral functions and types].

    Science.gov (United States)

    Creugers, N H J; de Baat, C

    2009-11-01

    A removable partial denture enables the restoration or improvement of 4 oral functions: aesthetics, mandibular stability, mastication, and speech. However, wearing a removable partial denture should not cause oral comfort to deteriorate. There are 3 types of removable partial dentures: acrylic tissue-supported dentures, dentures with cast metal frameworks en dentures with cast metal frameworks and (semi)precision attachments. Interrupted tooth arches,free-ending tooth arches, and a combination of interrupted as well as free-ending tooth arches can be restored using these dentures. Well-known disadvantages of removable partial dentures are problematic oral hygiene, negative influence on the remaining dentition and limited oral comfort. Due to the advanced possibilities of fixed tooth- or implant-supported partial dentures, whether or not free-ending, or tooth- as well as implant-supported partial dentures, the indication of removable partial dentures is restricted. Nevertheless, for the time being the demand for removable partial dentures is expected to continue.

  10. Legislation should support optimal breastfeeding practices and access to low-cost, high-quality complementary foods: Indonesia provides a case study.

    Science.gov (United States)

    Soekarjo, Damayanti; Zehner, Elizabeth

    2011-10-01

    It is important to support women to exclusively breastfeed for 6 months and continue breastfeeding for 24 months and beyond. It is also necessary to provide the poor with access to affordable ways to improve the quality of complementary foods. Currently, many countries do not have the legal and policy environment necessary to support exclusive and continued breastfeeding. Legislative and policy changes are also necessary for introducing complementary food supplements, allowing them to be marketed to those who need them, and ensuring that marketing remains appropriate and in full compliance with the International Code of Marketing of Breastmilk Substitutes. This paper aims to illustrate the above with examples from Indonesia and to identify legislative requirements for supporting breastfeeding and enabling appropriate access to high-quality complementary food supplements for children 6-24 months of age. Requirements include improved information, training, monitoring and enforcement systems for the International Code of Marketing of Breastmilk Substitutes; implementation and monitoring of the Baby-Friendly Hospital Initiative; establishment of a registration category for complementary food supplements to enhance availability of high-quality, low-cost fortified products to help improve young child feeding; clear identification and marketing of these products as complementary food supplements for 6-24-month-olds so as to promote proper use and not interfere with breastfeeding. © 2011 Blackwell Publishing Ltd.

  11. Supporting adherence to oral anticancer agents: clinical practice and clues to improve care provided by physicians, nurse practitioners, nurses and pharmacists.

    Science.gov (United States)

    Timmers, Lonneke; Boons, Christel C L M; Verbrugghe, Mathieu; van den Bemt, Bart J F; Van Hecke, Ann; Hugtenburg, Jacqueline G

    2017-02-10

    Healthcare provider (HCP) activities and attitudes towards patients strongly influence medication adherence. The aim of this study was to assess current clinical practices to support patients in adhering to treatment with oral anticancer agents (OACA) and to explore clues to improve the management of medication adherence. A cross-sectional, observational study among HCPs in (haemato-)oncology settings in Belgium and the Netherlands was conducted in 2014 using a composite questionnaire. A total of 47 care activities were listed and categorised into eight domains. HCPs were also asked about their perceptions of adherence management on the items: insight into adherence, patients' communication, capability to influence, knowledge of consequences and insight into causes. Validated questionnaires were used to assess beliefs about medication (BMQ) and shared decision making (SDM-Q-doc). In total, 208 HCPs (29% male) participated; 107 from 51 Dutch and 101 from 26 Belgian hospitals. Though a wide range of activities were reported, certain domains concerning medication adherence management received less attention. Activities related to patient knowledge and adverse event management were reported most frequently, whereas activities aimed at patient's self-efficacy and medication adherence during ongoing use were frequently missed. The care provided differed between professions and by country. Belgian physicians reported more activities than Dutch physicians, whereas Dutch nurses and pharmacists reported more activities than Belgian colleagues. The perceptions of medication adherence management were related to the level of care provided by HCPs. SDM and BMQ outcomes were not related to the care provided. Enhancing the awareness and perceptions of medication adherence management of HCPs is likely to have a positive effect on care quality. Care can be improved by addressing medication adherence more directly e.g., by questioning patients about (expected) barriers and discussing

  12. Comparison of silica-supported MoO{sub 3} and V{sub 2}O{sub 5} catalysts in the selective partial oxidation of methane

    Energy Technology Data Exchange (ETDEWEB)

    Faraldos, M.; Banares, M.A.; Fierro, J.L.G. [Instituto de Catalisis y Petroleoquimica, Madrid (Spain)] [and others

    1996-05-01

    The catalytic effects of molybdenum oxide and vanadium oxide catalysts supported on silica have been investigated for a wide range of metal loadings in the selective oxidation of methane. Vanadium oxide catalysts tend to be more active, but produce less formaldehyde. 49 refs., 7 figs.

  13. Partial gravity habitat study

    Science.gov (United States)

    Capps, Stephen; Lorandos, Jason; Akhidime, Eval; Bunch, Michael; Lund, Denise; Moore, Nathan; Murakawa, Kiosuke

    1989-01-01

    The purpose of this study is to investigate comprehensive design requirements associated with designing habitats for humans in a partial gravity environment, then to apply them to a lunar base design. Other potential sites for application include planetary surfaces such as Mars, variable-gravity research facilities, and a rotating spacecraft. Design requirements for partial gravity environments include locomotion changes in less than normal earth gravity; facility design issues, such as interior configuration, module diameter, and geometry; and volumetric requirements based on the previous as well as psychological issues involved in prolonged isolation. For application to a lunar base, it is necessary to study the exterior architecture and configuration to insure optimum circulation patterns while providing dual egress; radiation protection issues are addressed to provide a safe and healthy environment for the crew; and finally, the overall site is studied to locate all associated facilities in context with the habitat. Mission planning is not the purpose of this study; therefore, a Lockheed scenario is used as an outline for the lunar base application, which is then modified to meet the project needs. The goal of this report is to formulate facts on human reactions to partial gravity environments, derive design requirements based on these facts, and apply the requirements to a partial gravity situation which, for this study, was a lunar base.

  14. Effect of the metal nature on the reaction mechanism of the partial oxidation of ethanol over CeO{sub 2}-supported Pt and Rh catalysts

    Energy Technology Data Exchange (ETDEWEB)

    Silva, A.M.; Barandas, A.P.M.G.; Mattos, L.V.; Noronha, F.B. [Instituto Nacional de Tecnologia (INT), Av. Venezuela 82, CEP 20081-312, Rio de Janeiro (Brazil); Costa, L.O.O. [Instituto Nacional de Tecnologia (INT), Av. Venezuela 82, CEP 20081-312, Rio de Janeiro (Brazil); Instituto Militar de Engenharia, Praca General Tiburcio, 80 Praia Vermelha, Rio de Janeiro 22290-270 (Brazil); Borges, L.E.P. [Instituto Militar de Engenharia, Praca General Tiburcio, 80 Praia Vermelha, Rio de Janeiro 22290-270 (Brazil)

    2008-04-15

    In this work, the effect of the metal nature on the reaction mechanism of the partial oxidation of ethanol on Pt/CeO{sub 2} and Rh/CeO{sub 2} catalysts was studied by using diffuse reflectance infrared spectroscopy (DRIFTS) analyses. The results showed that the nature of the metal affected the reaction mechanism. On Pt/CeO{sub 2} catalyst, adsorption of ethanol gives rise to ethoxy species, which can be decomposed, producing CH{sub 4}, H{sub 2} and CO, and dehydrogenated, forming acetaldehyde. The acetaldehyde species are dehydrogenated to acetyl species or may desorb. The acetyl species can be oxidized to acetate species or can be decomposed, forming CH{sub 4}, H{sub 2} and CO. Furthermore, the acetate species previously formed can be decomposed to CH{sub 4}, CO and/or oxidized to CO{sub 2} via carbonate species. On the other hand, for Rh-based catalyst, the ethoxy species can be also dehydrogenated to a cyclic compound (oxametallacycle). This intermediate is dissociated to CO, CH{sub x} and C{sub x}, which are oxidized to CO{sub 2}. Furthermore, it was observed that the oxidation of acetyl species to acetate species and the formation of CO{sub 2} are favored depending on the presence of the O{sub 2} in the feed on Pt/CeO{sub 2} and Rh/CeO{sub 2} catalysts, respectively. (author)

  15. A Knowledge-Modeling Approach to Integrate Multiple Clinical Practice Guidelines to Provide Evidence-Based Clinical Decision Support for Managing Comorbid Conditions.

    Science.gov (United States)

    Abidi, Samina

    2017-10-26

    Clinical management of comorbidities is a challenge, especially in a clinical decision support setting, as it requires the safe and efficient reconciliation of multiple disease-specific clinical procedures to formulate a comorbid therapeutic plan that is both effective and safe for the patient. In this paper we pursue the integration of multiple disease-specific Clinical Practice Guidelines (CPG) in order to manage co-morbidities within a computerized Clinical Decision Support System (CDSS). We present a CPG integration framework-termed as COMET (Comorbidity Ontological Modeling & ExecuTion) that manifests a knowledge management approach to model, computerize and integrate multiple CPG to yield a comorbid CPG knowledge model that upon execution can provide evidence-based recommendations for handling comorbid patients. COMET exploits semantic web technologies to achieve (a) CPG knowledge synthesis to translate a paper-based CPG to disease-specific clinical pathways (CP) that include specialized co-morbidity management procedures based on input from domain experts; (b) CPG knowledge modeling to computerize the disease-specific CP using a Comorbidity CPG ontology; (c) CPG knowledge integration by aligning multiple ontologically-modeled CP to develop a unified comorbid CPG knowledge model; and (e) CPG knowledge execution using reasoning engines to derive CPG-mediated recommendations for managing patients with comorbidities. We present a web-accessible COMET CDSS that provides family physicians with CPG-mediated comorbidity decision support to manage Atrial Fibrillation and Chronic Heart Failure. We present our qualitative and quantitative analysis of the knowledge content and usability of COMET CDSS.

  16. Robot-assisted partial nephrectomy: Superiority over laparoscopic partial nephrectomy.

    Science.gov (United States)

    Shiroki, Ryoichi; Fukami, Naohiko; Fukaya, Kosuke; Kusaka, Mamoru; Natsume, Takahiro; Ichihara, Takashi; Toyama, Hiroshi

    2016-02-01

    Nephron-sparing surgery has been proven to positively impact the postoperative quality of life for the treatment of small renal tumors, possibly leading to functional improvements. Laparoscopic partial nephrectomy is still one of the most demanding procedures in urological surgery. Laparoscopic partial nephrectomy sometimes results in extended warm ischemic time and severe complications, such as open conversion, postoperative hemorrhage and urine leakage. Robot-assisted partial nephrectomy exploits the advantages offered by the da Vinci Surgical System to laparoscopic partial nephrectomy, equipped with 3-D vision and a better degree in the freedom of surgical instruments. The introduction of the da Vinci Surgical System made nephron-sparing surgery, specifically robot-assisted partial nephrectomy, safe with promising results, leading to the shortening of warm ischemic time and a reduction in perioperative complications. Even for complex and challenging tumors, robotic assistance is expected to provide the benefit of minimally-invasive surgery with safe and satisfactory renal function. Warm ischemic time is the modifiable factor during robot-assisted partial nephrectomy to affect postoperative kidney function. We analyzed the predictive factors for extended warm ischemic time from our robot-assisted partial nephrectomy series. The surface area of the tumor attached to the kidney parenchyma was shown to significantly affect the extended warm ischemic time during robot-assisted partial nephrectomy. In cases with tumor-attached surface area more than 15 cm(2) , we should consider switching robot-assisted partial nephrectomy to open partial nephrectomy under cold ischemia if it is imperative. In Japan, a nationwide prospective study has been carried out to show the superiority of robot-assisted partial nephrectomy to laparoscopic partial nephrectomy in improving warm ischemic time and complications. By facilitating robotic technology, robot-assisted partial nephrectomy

  17. PARTIAL SUPPORT OF THE COMMITTEE OF ATOMIC, MOLECULAR, AND OPTICAL SCIENCES Final Report for the period September 30, 2008 to June 30, 2014

    Energy Technology Data Exchange (ETDEWEB)

    Lancaster, James

    2015-06-29

    This report is the final report for the 2008-2014 cycle of DOE support for the Committee on Atomic, Molecular, and Optical Sciences. Highlights of the committee’s activities over this period included: • Meetings of the committee were held semiannually (Washington, DC in April and Irvine, CA in October) for four of the six years and annually the last two years (Washington, DC in April). • Committee meetings included half-day focus sessions on each of the areas identified in the last AMO decadal survey as having great scientific promise and short summaries of the focus session were prepared and delivered to sponsoring agencies. • CAMOS initiated a study that has been funded on high intensity lasers. DOE support for CAMOS has been of central importance to the committee’s ability to continue to fulfill its mandate to the Board on Physics and Astronomy and to the wider atomic, molecular, and optical sciences research community.

  18. Programas e intervenciones de apoyo a los cuidadores informales en España Supporting programs and interventions for informal care providers in Spain

    Directory of Open Access Journals (Sweden)

    Mª Pilar Torres Egea

    2008-03-01

    Full Text Available Cuidar a personas con dependencia es una responsabilidad que implica a los familiares más directos. El cuidado individualizado suele recaer en una persona a quien se identifica como el cuidador principal. La sobrecarga que genera el cuidado continuado hace preciso que este cuidador reciba un soporte de los profesionales del ámbito sanitario y/o social. Desde el sector formal se realizan diversos programas e intervenciones, individuales o grupales, para dar soporte a los cuidadores de personas con dependencia. El presente trabajo analiza las publicaciones científicas, aparecidas en los últimos diez años, que tratan sobre diferentes programas e intervenciones de soporte a los cuidadores informales, y que surgen de la preocupación de diferentes profesionales por la calidad de vida y la salud de los cuidadores.Taking care of dependent people is a task the performance of which involves the family members. Individualized care burden is normally borne on only one person, who is identified as the main caregiver. The burden that these care activities generate makes necessary that care provider receives professional assistance from healthcare and social experts. From the formal area some programs and interventions, from both individuals and groups, are conducted to support care providers for dependent people. This work analyzes scientific publications, appeared in the last ten years, which focus on some programs and interventions to support non-professional caregivers and which arise out of some professionals worries for care providers health and quality of life.

  19. Acti-Tape™ (elastic therapeutic tape as compared with a knee guard in providing support to the knee joint: an open-label, randomized, crossover study

    Directory of Open Access Journals (Sweden)

    Hui HK

    2014-04-01

    Full Text Available Hoong Keong Hui,1 Narayan J Karne,2 Navneet Sonawane31Nutriworks Ltd, Kowloon, Hong Kong; 2Karne Hospital, Pune, India; 3Vedic Lifesciences Pvt Ltd, Mumbai, IndiaStudy design: Randomized, open-label, crossover, controlled study.Background: Elastic taping methods are used to provide support to the musculoskeletal system in athletes. Acti-Tape™ (an elastic therapeutic tape has been marketed for the last 2–3 years and has shown good results in providing support to the joints. This pilot study was planned to collect data on the clinical outcomes and to assess if a single tape application of Acti-Tape over the knee joint could provide benefits similar to a traditionally used knee guard.Methods: Thirteen subjects aged 30–65 years visiting an orthopedic center in Pune, India who were suffering from osteoarthritis were randomly assigned to either Acti-Tape (n=6 or a knee guard (n=7 in the first intervention period (6 days and were crossed over to the other group in the second intervention period (6 days after a washout of 1 day. Main outcome measures were change from day 0 to day 6 in pain visual analog score (VAS; timed up and go (TUG, medial step down (MSD, and unilateral anterior reach (UAR tests; and subject's preference.Results: Data for all the 13 subjects were pooled and analyzed by Student's t-test as treatment-by-period interaction was not significant by analysis of variance (P>0.05. The changes (mean ± standard deviation after using Acti-Tape and a knee guard, respectively, were pain VAS, –10±5.4 versus (vs –11.5±5.83; TUG, –0.62±1.33 vs –0.46±1.56; UAR, 0.15±1.07 vs 0.75±0.44; and MSD, 1.08±095 vs 0.85±1.14. These were statistically significant with both devices for pain VAS, UAR, and MSD, but not for TUG. Between the treatments however, no statistically significant difference was seen. Eleven of 13 (85% subjects preferred Acti-Tape for future use (P<0.05 by McNemar’s χ2 test. No safety concerns were reported by the

  20. Racial disparities in birth care: Exploring the perceived role of African-American women providing midwifery care and birth support in the United States.

    Science.gov (United States)

    Guerra-Reyes, Lucia; Hamilton, Lydia J

    2017-02-01

    Midwifery care has been linked to positive birth outcomes. Despite the broad racial disparities in maternal and infant outcomes in the United States (US), little is known about the role of minority women in either providing or receiving this type of care. A vibrant community of minority women, who self-identify as providing these services, exists online. In this exploratory study we ask how they describe their role; view their practice; and position themselves in the broader discussions of racial health disparities in the US. Using an internet mediated qualitative design we analyse online narratives from self-described African-American nurse-midwives, lay midwives and birth assistants; we found 28 unique websites. We collected and analysed narrative material from each site. We used a thematic analysis approach to identify recurrent and emergent themes in relation to the study question. Narratives identified a strong link to the past, as providers viewed their practice in a historical perspective linking African roots, to the diaspora, and to current African-American struggles. Providers engaged both in direct clinical work, and in activist roles. Advocacy efforts sought to expand numbers of minority birth care workers and to extend the benefits of woman-centred birth care to underserved communities. Results demonstrate the continued existence and important role of diverse types of African-American birth care providers in minority communities in the US. Recognition, support, and increasing the number of midwives of colour is important in tackling racial inequalities in health. Further research should explore minority access to woman-centred care. Copyright © 2016 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

  1. Partial Cooperative Equilibria: Existence and Characterization

    Directory of Open Access Journals (Sweden)

    Amandine Ghintran

    2010-09-01

    Full Text Available We study the solution concepts of partial cooperative Cournot-Nash equilibria and partial cooperative Stackelberg equilibria. The partial cooperative Cournot-Nash equilibrium is axiomatically characterized by using notions of rationality, consistency and converse consistency with regard to reduced games. We also establish sufficient conditions for which partial cooperative Cournot-Nash equilibria and partial cooperative Stackelberg equilibria exist in supermodular games. Finally, we provide an application to strategic network formation where such solution concepts may be useful.

  2. An evaluation of partial depth dry bottom-feed vibro stone columns to support shallow footings in deep soft clay deposits.

    OpenAIRE

    Serridge, Colin J.

    2013-01-01

    Ground Improvement using vibro stone columns is gaining increasing acceptance on\\ud marginal soft clay sites as a sustainable foundation solution, particularly for lightly\\ud loaded low-rise structures supported by shallow, narrow footings. Most experience in\\ud this context however has been with widespread loads and use of the wet top-feed stone\\ud column technique, which has now been largely superseded, on environmental grounds,\\ud by the dry bottom-feed technique, and for which no signific...

  3. Supporting Emergency Medical Care Teams with an Integrated Status Display Providing Real-Time Access to Medical Best Practices, Workflow Tracking, and Patient Data.

    Science.gov (United States)

    Wu, PoLiang; Nam, Min-Young; Choi, Jeonghwan; Kirlik, Alex; Sha, Lui; Berlin, Richard B

    2017-10-17

    The work of a hospital's medical staff is safety critical and often occurs under severe time constraints. To provide timely and effective cognitive support to medical teams working in such contexts, guidelines in the form of best practice workflows for healthcare have been developed by medical organizations. However, the high cognitive load imposed in such stressful and rapidly changing environments poses significant challenges to the medical staff or team in adhering to these workflows. In collaboration with physicians and nurses from Carle Foundation Hospital, we first studied and modeled medical team's individual responsibilities and interactions in cardiac arrest resuscitation and decomposed their overall task into a set of distinct cognitive tasks that must be specifically supported to achieve successful human-centered system design. We then developed a medical Best Practice Guidance (BPG) system for reducing medical teams' cognitive load, thus fostering real-time adherence to best practices. We evaluated the resulting system with physicians and nurses using a professional patient simulator used for medical training and certification. The evaluation results point to a reduction of cognitive load and enhanced adherence to medical best practices.

  4. Do student nurses feel a lack of comfort in providing support for Lesbian, Gay, Bisexual or Questioning adolescents: what factors influence their comfort level?

    Science.gov (United States)

    Richardson, Brian P; Ondracek, Anton E; Anderson, Dee

    2017-05-01

    The aim of this study was to find out if student nurses feel comfortable in caring by providing support for Lesbian, Gay, Bisexual or Questioning adolescents and what factors influence their level of comfort. Research indicates that nurses and nursing students experience varying levels of comfort when caring for adults who are Lesbian, Gay, Bisexual or Questioning: adult patients feel that nurse's attitudes change towards them once they disclose their sexuality. There has been minimal research to date on nursing attitudes to working with adolescents who are Lesbian, Gay, Bisexual or Questioning. Both quantitative and qualitative methods were used in this descriptive study. Questionnaires were completed by 152 nursing students and nine took part in semi-structured focus groups. A two-way ANOVA was used to analyse the questionnaires. Thematic analysis was used to identify the themes arising from the focus groups. Data were collected between August 2013 - July 2014. The results and findings of the study were that student nurse's felt discomfort in providing support; due to a lack of knowledge of Lesbian, Gay or Bisexual sexuality, personal and religious beliefs and the perceptions of others. However, all students indicated they had a positive attitude towards Lesbian, Gay, Bisexual and Questioning adolescents. More needs to be done to raise self-awareness and improve the level of knowledge in relation to Lesbian, Gay and Bisexual issues amongst student nurses. Educational institutions and practice areas need to recognize this fact and reflect this in their educational programmes. © 2016 John Wiley & Sons Ltd.

  5. Parent Perceptions of How Nurse Encounters Can Provide Caring Support for the Family in Early Acute Care Following Children’s Severe Traumatic Brain Injury

    Science.gov (United States)

    Roscigno, Cecelia I.

    2016-01-01

    Objective A child’s severe traumatic brain injury (TBI) creates a family crisis requiring extensive cultural, informational, psychological, and environmental support. Nurses need to understand parents’ expectations of caring in early acute care so they can tailor their attitudes, beliefs, and behaviors appropriately to accommodate the family’s needs. Methods In a previous qualitative study of 42 parents or caregivers from 37 families of children with moderate to severe TBI, parents of children with severe TBI (n = 25) described their appraisals of nurse caring and uncaring behaviors in early acute care. Swanson’s theory of caring was used to categorize parents’ descriptions in order to inform nursing early acute care practices and family-centered care. Results Caring nurse encounters included: (a) involving parents in the care of their child and reflecting on all socio-cultural factors shaping family resources and responses (knowing); (b) respecting that family grief can be co-mingled with resilience, and that parents are typically competent to be involved in decision-making (maintaining belief); (d) actively listening and engaging parents in order to fully understand family values and needs (being with); (e) decreasing parents’ workload to get information, emotional support, and providing a safe cultural, psychological, and physical environment for the family (doing for), and; (f) providing anticipatory guidance to navigate the early acute care system and giving assistance to learn and adjust to their situation (enabling). Conclusion Application of Swanson’s caring theory is prescriptive in helping individual nurses and early acute care systems to meet important family needs following children’s severe TBI. PMID:26871242

  6. Fertility and contraceptive decision-making and support for HIV infected individuals: client and provider experiences and perceptions at two HIV clinics in Uganda

    Directory of Open Access Journals (Sweden)

    Wanyenze Rhoda K

    2013-02-01

    Full Text Available Abstract Background Some people living with HIV/AIDS (PLHIV want to have children while others want to prevent pregnancies; this calls for comprehensive services to address both needs. This study explored decisions to have or not to have children and contraceptive preferences among PLHIV at two clinics in Uganda. Methods This was a qualitative cross-sectional study. We conducted seventeen focus group discussions and 14 in-depth interviews with sexually active adult men and women and adolescent girls and boys, and eight key informant interviews with providers. Overall, 106 individuals participated in the interviews; including 84 clients through focus group discussions. Qualitative latent content analysis technique was used, guided by key study questions and objectives. A coding system was developed before the transcripts were examined. Codes were grouped into categories and then themes and subthemes further identified. Results In terms of contraceptive preferences, clients had a wide range of preferences; whereas some did not like condoms, pills and injectables, others preferred these methods. Fears of complications were raised mainly about pills and injectables while cost of the methods was a major issue for the injectables, implants and intrauterine devices. Other than HIV sero-discordance and ill health (which was cited as transient, the decision to have children or not was largely influenced by socio-cultural factors. All adult men, women and adolescents noted the need to have children, preferably more than one. The major reasons for wanting more children for those who already had some were; the sex of the children (wanting to have both girls and boys and especially boys, desire for large families, pressure from family, and getting new partners. Providers were supportive of the decision to have children, especially for those who did not have any child at all, but some clients cited negative experiences with providers and information gaps for

  7. Enhancement of brain plasticity and recovery of locomotive function after lumbar spinal cord stimulation in combination with gait training with partial weight support in rats with cerebral ischemia.

    Science.gov (United States)

    Choi, Yoon-Hee; Lee, Shi-Uk

    2017-05-01

    Lumbar spinal cord stimulation (LSCS) is reportedly effective for the recovery of locomotive intraspinal neural network, motor cortex and basal ganglia in animals with complete spinal cord injury and parkinsonism. We evaluated the effect of LSCS in combination with gait training on the recovery of locomotive function and brain plasticity using a rat model of brain ischemia. Adult male Sprague Dawley rats with ischemia were randomly assigned into one of four groups: sham treatment (group 1), LSCS only (group 2), LSCS with gait training and 50% (group 3) and 80% (group 4) of body weight support. Evaluations before randomization and 4weeks after intervention included motor scoring index, real-time PCR and Western blot. Motor scoring index was significantly improved after the intervention in groups 2 and 3. The ratio of phospho-protein kinase C (PKC) to PKC measured in the infarcted area tended to be higher in groups 3 and 4. Protein expression of mGluR2 and mRNA expression of mGluR1 measured in the contralateral cortex were lower in groups 3 and 4. The ratio of phospho-Akt to Akt and mRNA expression of vascular endothelial growth factor measured in the ischemic border zone were higher in group 2. The mRNA expression of MAP1b measured in the infarcted area was significantly higher in group 2. The findings suggest that LSCS and gait training with an adequate amount of body weight support may promote brain plasticity and facilitate the functional recovery. Copyright © 2017 Elsevier B.V. All rights reserved.

  8. An imaging informatics-based ePR (electronic patient record) system for providing decision support in evaluating dose optimization in stroke rehabilitation

    Science.gov (United States)

    Liu, Brent J.; Winstein, Carolee; Wang, Ximing; Konersman, Matt; Martinez, Clarisa; Schweighofer, Nicolas

    2012-02-01

    Stroke is one of the major causes of death and disability in America. After stroke, about 65% of survivors still suffer from severe paresis, while rehabilitation treatment strategy after stroke plays an essential role in recovery. Currently, there is a clinical trial (NIH award #HD065438) to determine the optimal dose of rehabilitation for persistent recovery of arm and hand paresis. For DOSE (Dose Optimization Stroke Evaluation), laboratory-based measurements, such as the Wolf Motor Function test, behavioral questionnaires (e.g. Motor Activity Log-MAL), and MR, DTI, and Transcranial Magnetic Stimulation (TMS) imaging studies are planned. Current data collection processes are tedious and reside in various standalone systems including hardcopy forms. In order to improve the efficiency of this clinical trial and facilitate decision support, a web-based imaging informatics system has been implemented together with utilizing mobile devices (eg, iPAD, tablet PC's, laptops) for collecting input data and integrating all multi-media data into a single system. The system aims to provide clinical imaging informatics management and a platform to develop tools to predict the treatment effect based on the imaging studies and the treatment dosage with mathematical models. Since there is a large amount of information to be recorded within the DOSE project, the system provides clinical data entry through mobile device applications thus allowing users to collect data at the point of patient interaction without typing into a desktop computer, which is inconvenient. Imaging analysis tools will also be developed for structural MRI, DTI, and TMS imaging studies that will be integrated within the system and correlated with the clinical and behavioral data. This system provides a research platform for future development of mathematical models to evaluate the differences between prediction and reality and thus improve and refine the models rapidly and efficiently.

  9. Usability evaluation of pharmacogenomics clinical decision support aids and clinical knowledge resources in a computerized provider order entry system: a mixed methods approach.

    Science.gov (United States)

    Devine, Emily Beth; Lee, Chia-Ju; Overby, Casey L; Abernethy, Neil; McCune, Jeannine; Smith, Joe W; Tarczy-Hornoch, Peter

    2014-07-01

    Pharmacogenomics (PGx) is positioned to have a widespread impact on the practice of medicine, yet physician acceptance is low. The presentation of context-specific PGx information, in the form of clinical decision support (CDS) alerts embedded in a computerized provider order entry (CPOE) system, can aid uptake. Usability evaluations can inform optimal design, which, in turn, can spur adoption. The study objectives were to: (1) evaluate an early prototype, commercial CPOE system with PGx-CDS alerts in a simulated environment, (2) identify potential improvements to the system user interface, and (3) understand the contexts under which PGx knowledge embedded in an electronic health record is useful to prescribers. Using a mixed methods approach, we presented seven cardiologists and three oncologists with five hypothetical clinical case scenarios. Each scenario featured a drug for which a gene encoding drug metabolizing enzyme required consideration of dosage adjustment. We used Morae(®) to capture comments and on-screen movements as participants prescribed each drug. In addition to PGx-CDS alerts, 'Infobutton(®)' and 'Evidence' icons provided participants with clinical knowledge resources to aid decision-making. Nine themes emerged. Five suggested minor improvements to the CPOE user interface; two suggested presenting PGx information through PGx-CDS alerts using an 'Infobutton' or 'Evidence' icon. The remaining themes were strong recommendations to provide succinct, relevant guidelines and dosing recommendations of phenotypic information from credible and trustworthy sources; any more information was overwhelming. Participants' median rating of PGx-CDS system usability was 2 on a Likert scale ranging from 1 (strongly agree) to 7 (strongly disagree). Usability evaluation results suggest that participants considered PGx information important for improving prescribing decisions; and that they would incorporate PGx-CDS when information is presented in relevant and

  10. The Lower Sevier River Basin Crop Monitor and Forecast Decision Support System: Exploiting Landsat Imagery to Provide Continuous Information to Farmers and Water Managers

    Science.gov (United States)

    Torres-Rua, A. F.; Walker, W. R.; McKee, M.

    2013-12-01

    The last century has seen a large number of innovations in agriculture such as better policies for water control and management, upgraded water conveyance, irrigation, distribution, and monitoring systems, and better weather forecasting products. In spite of this, irrigation management and irrigation water deliveries by farmers/water managers is still based on factors like water share amounts, tradition, and past experience on irrigation. These factors are not necessarily related to the actual crop water use; they are followed because of the absence of related information provided in a timely manner at an affordable cost. Thus, it is necessary to develop means to deliver continuous and personalized information about crop water requirements to water users/managers at the field and irrigation system levels so managers at these levels can better quantify the required versus available water for irrigation during the irrigation season. This study presents a new decision support system (DSS) platform that addresses the absence of information on actual crop water requirements and crop performance by providing continuous updated farm-based crop water use along with other farm performance indicators such as crop yield and farm management to irrigators and water managers. This DSS exploits the periodicity of the Landsat Satellite Mission (8 to 16 days, depending on the period of interest) to provide remote monitoring at the individual field and irrigation system levels. The Landsat satellite images are converted into information about crop water use, yield performance and field management through application of state-of-the-art semi-physical and statistical algorithms that provide this information at a pixel basis that are ultimately aggregated to field and irrigation system levels. A version of the DSS has been implemented for the agricultural lands in the Lower Sevier River, Utah, and has been operational since the beginning of the 2013 irrigation season. The main goal of

  11. Effects of a computerized provider order entry and a clinical decision support system to improve cefazolin use in surgical prophylaxis: a cost saving analysis

    Directory of Open Access Journals (Sweden)

    Okumura LM

    2016-09-01

    Full Text Available Background: Computerized Provider Order Entry (CPOE and Clinical Decision Support System (CDSS help practitioners to choose evidence-based decisions, regarding patients’ needs. Despite its use in developed countries, in Brazil, the impact of a CPOE/CDSS to improve cefazolin use in surgical prophylaxis was not assessed yet. Objective: We aimed to evaluate the impact of a CDSS to improve the use of prophylactic cefazolin and to assess the cost savings associated to inappropriate prescribing. Methods: This is a cross-sectional study that compared two different scenarios: one prior CPOE/CDSS versus after software implementation. We conducted twelve years of data analysis (3 years prior and 9 years after CDSS implementation, where main outcomes from this study included: cefazolin Defined Daily Doses/100 bed-days (DDD, crude costs and product of costs-DDD (cost-DDD/100 bed-days. We applied a Spearman rho non-parametric test to assess the reduction of cefazolin consumption through the years. Results: In twelve years, 84,383 vials of cefazolin were dispensed and represented 38.89 DDD/100 bed-days or USD 44,722.99. Surgical wards were the largest drug prescribers and comprised >95% of our studied sample. While in 2002, there were 6.31 DDD/100 bed-days, 9 years later there was a reduction to 2.15 (p<0.05. In a scenario without CDSS, the hospital would have consumed 75.72 DDD/100 bed-days, which is equivalent to USD 116 998.07. It is estimated that CDSS provided USD 50,433.39 of cost savings. Conclusion: The implementation of a CPOE/CDSS helped to improve prophylactic cefazolin use by reducing its consumption and estimated direct costs.

  12. The complete mitochondrial genome of the onychophoran Epiperipatus biolleyi reveals a unique transfer RNA set and provides further support for the ecdysozoa hypothesis.

    Science.gov (United States)

    Podsiadlowski, Lars; Braband, Anke; Mayer, Georg

    2008-01-01

    Onychophora (velvet worms) play a crucial role in current discussions on position of arthropods. The ongoing Articulata/Ecdysozoa debate is in need of additional ground pattern characters for Panarthropoda (Arthropoda, Tardigrada, and Onychophora). Hence, Onychophora is an important outgroup taxon in resolving the relationships among arthropods, irrespective of whether morphological or molecular data are used. To date, there has been a noticeable lack of mitochondrial genome data from onychophorans. Here, we present the first complete mitochondrial genome sequence of an onychophoran, Epiperipatus biolleyi (Peripatidae), which shows several characteristic features. Specifically, the gene order is considerably different from that in other arthropods and other bilaterians. In addition, there is a lack of 9 tRNA genes usually present in bilaterian mitochondrial genomes. All these missing tRNAs have anticodon sequences corresponding to 4-fold degenerate codons, whereas the persisting 13 tRNAs all have anticodons pairing with 2-fold degenerate codons. Sequence-based phylogenetic analysis of the mitochondrial protein-coding genes provides a robust support for a clade consisting of Onychophora, Priapulida, and Arthropoda, which confirms the Ecdysozoa hypothesis. However, resolution of the internal ecdysozoan relationships suffers from a cluster of long-branching taxa (including Nematoda and Platyhelminthes) and a lack of data from Tardigrada and further nemathelminth taxa in addition to nematodes and priapulids.

  13. Providers with Limited Experience Perform Better in Advanced Life Support with Assistance Using an Interactive Device with an Automated External Defibrillator Linked to a Ventilator.

    Science.gov (United States)

    Busch, Christian Werner; Qalanawi, Mohammed; Kersten, Jan Felix; Kalwa, Tobias Johannes; Scotti, Norman Alexander; Reip, Wikhart; Doehn, Christoph; Maisch, Stefan; Nitzschke, Rainer

    2015-10-01

    Medical teams with limited experience in performing advanced life support (ALS) or with a low frequency of cardiopulmonary resuscitation (CPR) while on duty, often have difficulty complying with CPR guidelines. This study evaluated whether the quality of CPR of trained medical students, who served as an example of teams with limited experience in ALS, could be improved with device assistance. The primary outcome was the hands-off time (i.e., the percentage of the entire CPR time without chest compressions). The secondary outcome was seven time intervals, which should be as short as possible, and the quality of ventilations and chest compressions on the mannequin. We compared standard CPR equipment to an interactive device with visual and acoustic instructions for ALS workflow measures to guide briefly trained medical students through the ALS algorithm in a full-scale mannequin simulation study with a randomized crossover study design. The study equipment consisted of an automatic external defibrillator and ventilator that were electronically linked and communicating as a single system. Included were regular medical students in the third to sixth years of medical school of one class who provided written informed consent for voluntary participation and for the analysis of their CPR performance data. No exclusion criteria were applied. For statistical measures of evaluation we used an analysis of variance for crossover trials accounting for treatment effect, sequence effect, and carry-over effect, with adjustment for prior practical experience of the participants. Forty-two medical students participated in 21 CPR sessions, each using the standard and study equipment. Regarding the primary end point, the study equipment reduced the hands-off time from 40.1% (95% confidence interval [CI] 36.9-43.4%) to 35.6% (95% CI 32.4-38.9%, p = 0.031) compared with the standard equipment. Within the prespecified secondary end points, study equipment reduced the time interval until

  14. The Nature of Parent Support Provided by Parent Mentors for Families with Deaf/Hard-of-Hearing Children: Voices from the Start

    Science.gov (United States)

    Friedman Narr, Rachel; Kemmery, Megan

    2015-01-01

    This study used a qualitative design to explore parent mentors' summaries of conversations with more than 1,000 individual families of deaf and hard-of-hearing (DHH) children receiving parent-to-parent support as part of an existing family support project. Approximately 35% of the families were Spanish speaking. Five parent mentors who have…

  15. Motivational support provided via email improves the effectiveness of internet-delivered self-help treatment for insomnia: A randomized trial

    NARCIS (Netherlands)

    Lancee, J.; van den Bout, J.; Sorbi, M.J.; van Straten, A.

    2013-01-01

    Internet-delivered treatment is effective for insomnia, but little is known about the beneficial effects of support. The aim of the current study was to investigate the additional effects of low-intensity support to an internet-delivered treatment for insomnia. Two hundred and sixty-two participants

  16. Motivational support provided via email improves the effectiveness of internet-delivered self-help treatment for insomnia: A randomized trial.

    NARCIS (Netherlands)

    Lancee, J.; van den Bout, J.; Sorbi, M.J.; van Straten, A.

    2013-01-01

    Internet-delivered treatment is effective for insomnia, but little is known about the beneficial effects of support. The aim of the current study was to investigate the additional effects of low-intensity support to an internet-delivered treatment for insomnia. Two hundred and sixty-two participants

  17. Partially ordered algebraic systems

    CERN Document Server

    Fuchs, Laszlo

    2011-01-01

    Originally published in an important series of books on pure and applied mathematics, this monograph by a distinguished mathematician explores a high-level area in algebra. It constitutes the first systematic summary of research concerning partially ordered groups, semigroups, rings, and fields. The self-contained treatment features numerous problems, complete proofs, a detailed bibliography, and indexes. It presumes some knowledge of abstract algebra, providing necessary background and references where appropriate. This inexpensive edition of a hard-to-find systematic survey will fill a gap i

  18. Research electronic data capture (REDCap)—A metadata-driven methodology and workflow process for providing translational research informatics support

    National Research Council Canada - National Science Library

    Harris, Paul A; Taylor, Robert; Thielke, Robert; Payne, Jonathon; Gonzalez, Nathaniel; Conde, Jose G

    2009-01-01

    Research electronic data capture (REDCap) is a novel workflow methodology and software solution designed for rapid development and deployment of electronic data capture tools to support clinical and translational research. We present: (1...

  19. Do clinical decision-support reminders for medical providers improve isoniazid preventative therapy prescription rates among HIV-positive adults? Study protocol for a randomized controlled trial.

    Science.gov (United States)

    Green, Eric P; Catalani, Caricia; Diero, Lameck; Carter, E Jane; Gardner, Adrian; Ndwiga, Charity; Keny, Aggrey; Owiti, Philip; Israelski, Dennis; Biondich, Paul

    2015-04-09

    This document describes a research protocol for a study designed to estimate the impact of implementing a reminder system for medical providers on the use of isoniazid preventative therapy (IPT) for adults living with HIV in western Kenya. People living with HIV have a 5% to 10% annual risk of developing active tuberculosis (TB) once infected with TB bacilli, compared to a 5% lifetime risk in HIV-negative people with latent TB infection. Moreover, people living with HIV have a 20-fold higher risk of dying from TB. A growing body of literature suggests that IPT reduces overall TB incidence and is therefore of considerable benefit to patients and the larger community. However, in 2009, of the estimated 33 million people living with HIV, only 1.7 million (5%) were screened for TB, and about 85,000 (0.2%) were offered IPT. This study will examine the use of clinical decision-support reminders to improve rates of initiation of preventative treatment in a TB/HIV co-morbid population living in a TB endemic area. This will be a pragmatic, parallel-group, cluster-randomized superiority trial with a 1:1 allocation to treatment ratio. For the trial, 20 public medical facilities that use clinical summary sheets generated from an electronic medical records system will participate as clusters. All HIV-positive adult patients who complete an initial encounter at a study cluster and at least one return encounter during the study period will be included in the study cohort. The primary endpoint will be IPT prescription at 3 months post the initial encounter. We will conduct both individual-level and cluster-level analyses. Due to the nature of the intervention, the trial will not be blinded. This study will contribute to the growing evidence base for the use of electronic health interventions in low-resource settings to promote high-quality clinical care, health system optimization and positive patient outcomes. Trial registration ClinicalTrials.gov NCT01934309, registered 29

  20. Informatics and Decisions support in Galway Bay (SmartBay) using ERDDAP, OGC Technologies and Third Party Data Sources to Provide Services to the Marine Community.

    Science.gov (United States)

    Delaney, Conor; Gaughan, Paul; Smyth, Damian

    2013-04-01

    The global marine sector generates and consumes vast quantities of operational and forecast data on a daily basis. One of the key challenges facing the sector relates to the management and transformation of that data into knowledge. The Irish Marine Institute (MI) generates oceanographic and environmental data on a regular and frequent basis. This data comes from operational ocean models run on the MI's high performance computer (HPC) and various environmental observation sensors systems. Some of the data published by the Marine Institute is brokered by the Environmental Research Division's Data Access Program (ERDDAP) data broker, which is a broker technology that uses technology based on OPeNDAP and Open Geospatial Consortium (OGC) standards. The broker provides a consistent web service interface to the data services of the Marine Institute; these services include wave, tide and weather sensors and numerical model output. An ERDDAP server publishes data in a number of standard and developer friendly ways, including some OGC formats. The data on the MI ERDDAP (http://erddap.marine.ie) server is published as OpenData. The marine work package of the FP7 funded ENVIROFI project (http://www.envirofi.eu/) has used the ERDDAP data broker as a core resource in the development of its Marine Asset management decision Support Tool (MAST) portal and phone App. Communication between MAST and ERDDAP is via a Uniform Resource Identifier (Linked Data). A key objective of the MAST prototype is to demonstrate the potential of next-generation dynamic web-based products and services and how they can be harnessed to facilitate growth of both the marine and IT sectors. The use case driving the project is the management of ocean energy assets in the marine environment. In particular the provision of information that aid in the decision making process surrounding maintenance at sea. This question is common to any offshore industry and solution proposed here is applicable to other users

  1. Motivational support provided via email improves the effectiveness of internet-delivered self-help treatment for insomnia: a randomized trial.

    Science.gov (United States)

    Lancee, Jaap; van den Bout, Jan; Sorbi, Marjolijn J; van Straten, Annemieke

    2013-12-01

    Internet-delivered treatment is effective for insomnia, but little is known about the beneficial effects of support. The aim of the current study was to investigate the additional effects of low-intensity support to an internet-delivered treatment for insomnia. Two hundred and sixty-two participants were randomized to an internet-delivered intervention for insomnia with (n = 129) or without support (n = 133). All participants received an internet-delivered cognitive behavioral treatment for insomnia. In addition, the participants in the support condition received weekly emails. Assessments were at baseline, post-treatment, and 6-month follow-up. Both groups effectively ameliorated insomnia complaints. Adding support led to significantly higher effects on most sleep measures (d = 0.3-0.5; p support significantly enhances the benefits of internet-delivered treatment for insomnia on several variables. It appears that motivational feedback increases the effect of the intervention and encourages more participants to complete the intervention, which in turn improves its effectiveness. Copyright © 2013 Elsevier Ltd. All rights reserved.

  2. [Acrylic resin removable partial dentures].

    Science.gov (United States)

    de Baat, C; Witter, D J; Creugers, N H J

    2011-01-01

    An acrylic resin removable partial denture is distinguished from other types of removable partial dentures by an all-acrylic resin base which is, in principle, solely supported by the edentulous regions of the tooth arch and in the maxilla also by the hard palate. When compared to the other types of removable partial dentures, the acrylic resin removable partial denture has 3 favourable aspects: the economic aspect, its aesthetic quality and the ease with which it can be extended and adjusted. Disadvantages are an increased risk of caries developing, gingivitis, periodontal disease, denture stomatitis, alveolar bone reduction, tooth migration, triggering of the gag reflex and damage to the acrylic resin base. Present-day indications are ofa temporary or palliative nature or are motivated by economic factors. Special varieties of the acrylic resin removable partial denture are the spoon denture, the flexible denture fabricated of non-rigid acrylic resin, and the two-piece sectional denture. Furthermore, acrylic resin removable partial dentures can be supplied with clasps or reinforced by fibers or metal wires.

  3. Do nursing homes for older people have the support they need to provide end-of-life care? A mixed methods enquiry in England.

    Science.gov (United States)

    Seymour, Jane E; Kumar, Arun; Froggatt, Katherine

    2011-03-01

    Nursing homes are a common site of death, but older residents receive variable quality of end-of-life care. We used a mixed methods design to identify external influences on the quality of end-of-life care in nursing homes. Two qualitative case studies were conducted and a postal survey of 180 nursing homes surrounding the case study sites. In the case studies, qualitative interviews were held with seven members of nursing home staff and 10 external staff. Problems in accessing support for end-of-life care reported in the survey included variable support by general practitioners (GPs), reluctance among GPs to prescribe appropriate medication, lack of support from other agencies, lack of out of hours support, cost of syringe drivers and lack of access to training. Most care homes were implementing a care pathway. Those that were not rated their end-of-life care as in need of improvement or as average. The case studies suggest that critical factors in improving end-of-life care in nursing homes include developing clinical leadership, developing relationships with GPs, the support of 'key' external advocates and leverage of additional resources by adoption of care pathway tools.

  4. Autothermal and partial oxidation reformer-based fuel processor, method for improving catalyst function in autothermal and partial oxidation reformer-based processors

    Science.gov (United States)

    Ahmed, Shabbir; Papadias, Dionissios D.; Lee, Sheldon H. D.; Ahluwalia, Rajesh K.

    2013-01-08

    The invention provides a fuel processor comprising a linear flow structure having an upstream portion and a downstream portion; a first catalyst supported at the upstream portion; and a second catalyst supported at the downstream portion, wherein the first catalyst is in fluid communication with the second catalyst. Also provided is a method for reforming fuel, the method comprising contacting the fuel to an oxidation catalyst so as to partially oxidize the fuel and generate heat; warming incoming fuel with the heat while simultaneously warming a reforming catalyst with the heat; and reacting the partially oxidized fuel with steam using the reforming catalyst.

  5. Partial secretome analysis of Caldariomyces fumago reveals extracellular production of the CPO co-substrate H2O2and provides a coproduction concept for CPO and glucose oxidase.

    Science.gov (United States)

    Buchhaupt, Markus; Lintz, Karin; Hüttmann, Sonja; Schrader, Jens

    2018-01-10

    The culture supernatant of Caldariomyces fumago strains grown in a minimal medium with fructose contains mainly the biotechnologically relevant enzyme chloroperoxidase (CPO) and only minor amounts of other proteins. Our approach to identify the nature of these proteins via peptide mass fingerprinting and transcriptome analysis demonstrated the presence of putative glycosyl hydrolase and glucose oxidase (GOx) enzymes. These activities had been described earlier as parts of the fungus´ halogenation machinery, as they provide CPO with the co-substrate H 2 O 2 . The GOx activity was found to have a pH optimum of 5. Compared to the wild type values, GOx activity and glucose-driven MCD chlorination activity in the culture of a white mutant were found to be strongly increased to values of 1-2 U mL -1 . As most CPO-catalyzed peroxidation reactions also show pH optima at around 5, the C. fumago culture supernatant can provide a highly convenient CPO/GOx source for many reactions with in situ H 2 O 2 production.

  6. Computational Toxicology as Implemented by the U.S. EPA: Providing High Throughput Decision Support Tools for Screening and Assessing Chemical Exposure, Hazard and Risk

    Science.gov (United States)

    Computational toxicology is the application of mathematical and computer models to help assess chemical hazards and risks to human health and the environment. Supported by advances in informatics, high-throughput screening (HTS) technologies, and systems biology, the U.S. Environ...

  7. Working together to promote diabetes control : A practical guide for diabetes health care providers in establishing a working alliance to achieve self-management support

    NARCIS (Netherlands)

    Jones, Allan; Vallis, Michael; Cooke, Debbie; Pouwer, F.

    2016-01-01

    The quality of the "patient-carer" relationship is the foundation of self-management support and has been shown to influence treatment outcome in relation to psychological and somatic illness, including diabetes. It has long been accepted within applied psychology that the quality of the

  8. The death of patients with terminal cancer: the distress experienced by their children and medical professionals who provide the children with support care.

    Science.gov (United States)

    Otani, Hiroyuki; Ozawa, Miwa; Morita, Tatsuya; Kawami, Ayako; Sharma, Sahana; Shiraishi, Keiko; Oshima, Akira

    2016-02-04

    Few studies have been conducted on the experiences of children of terminally ill patients or hospital-based medical professionals supporting such children. This study explored distress among individuals whose parents died of cancer in childhood and among hospital-based medical professionals supporting such children. A qualitative study. The sample was 12 adults whose parents had died of cancer in childhood and 20 hospital-based medical professionals supporting children of patients' with terminal cancer. In-depth interviews were conducted, focusing on the distress experienced by the participants. The data were analysed thematically. Among adults whose parents died of cancer in childhood, we identified themes related to the period before death (eg, concealing the parent's illness), the time of death (eg, alienation due to isolation from the parent), soon after death (eg, fear and shock evoked by the bizarre circumstances, regrets regarding the relationship with the deceased parent before death), several years thereafter (ie, distinctive reflection during adolescence, prompted by the parent's absence) and the present time (ie, unresolved feelings regarding losing the parent). We identified seven themes among the medical professionals (eg, lack of knowledge/experience with children, the family's attempts to shield the child from the reality of death, estrangement from the family once they leave the hospital). An important finding of the study is that the participants' grief reaction to their parents' deaths during childhood was prolonged. Moreover, hospital medical professionals may find it difficult to directly support affected children. Comprehensive support involving organisations (eg, local communities) may be necessary for children who have lost a parent. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  9. Partial tooth gear bearings

    Science.gov (United States)

    Vranish, John M. (Inventor)

    2010-01-01

    A partial gear bearing including an upper half, comprising peak partial teeth, and a lower, or bottom, half, comprising valley partial teeth. The upper half also has an integrated roller section between each of the peak partial teeth with a radius equal to the gear pitch radius of the radially outwardly extending peak partial teeth. Conversely, the lower half has an integrated roller section between each of the valley half teeth with a radius also equal to the gear pitch radius of the peak partial teeth. The valley partial teeth extend radially inwardly from its roller section. The peak and valley partial teeth are exactly out of phase with each other, as are the roller sections of the upper and lower halves. Essentially, the end roller bearing of the typical gear bearing has been integrated into the normal gear tooth pattern.

  10. How can information systems provide support to nurses’ hand hygiene performance? Using gamification and indoor location to improve hand hygiene awareness and reduce hospital infections

    National Research Council Canada - National Science Library

    Marques, Rita; Gregório, João; Pinheiro, Fernando; Póvoa, Pedro; da Silva, Miguel Mira; Lapão, Luís Velez

    2017-01-01

    .... To raise awareness regarding hand hygiene compliance, individual behaviour change and performance optimization, we aimed to develop a gamification solution that collects data and provides real-time...

  11. Immediate restoration of fixed partial prostheses supported by one-piece narrow-diameter selective laser sintering implants: a 2-year prospective study in the posterior jaws of 16 patients.

    Science.gov (United States)

    Mangano, Francesco; Pozzi-Taubert, Samuele; Zecca, Piero A; Luongo, Giuseppe; Sammons, Rachel L; Mangano, Carlo

    2013-08-01

    Selective laser sintering (SLS) is a new technique that allows implants to be produced by annealing titanium powder microparticles in a focused laser beam, according to a computer-generated model. The aim of this study was to evaluate the survival and success rate of immediately restored 1-piece narrow-diameter SLS implants, placed in the posterior jaws, after 2 years of functional loading. At the 2-year follow-up examination, several parameters were assessed. Success criteria included absence of pain, suppuration, exudation, implant mobility; distance between the implant shoulder and the first visible bone-to-implant contact <2.0 mm; and absence of prosthetic complications. Thirty-seven implants were placed in the posterior jaws (14 maxilla, 23 mandible) of 16 patients (9 males, 7 females). The prosthetic restorations comprised 16 immediately restored fixed partial prostheses. No implant failure occurred, resulting in a 100% survival rate. The implant success was 94.6%, and the mean distance between the implant shoulder and the first visible bone-to-implant contact (DIB) was 0.4 ± 0.3 mm. This study supports the hypothesis that 1-piece narrow-diameter SLS implants can be used in fixed prosthetic rehabilitations in the posterior regions of both jaws with a predictable positive outcome.

  12. Do nursing homes for older people have the support they need to provide end-of-life care? A mixed methods enquiry in England

    OpenAIRE

    Seymour, Jane E; Kumar, Arun; Froggatt, Katherine

    2011-01-01

    Nursing homes are a common site of death, but older residents receive variable quality of end-of-life care. We used a mixed methods design to identify external influences on the quality of end-of-life care in nursing homes. Two qualitative case studies were conducted and a postal survey of 180 nursing homes surrounding the case study sites. In the case studies, qualitative interviews were held with seven members of nursing home staff and 10 external staff. Problems in accessing support for en...

  13. Medicare Provider Data - Hospice Providers

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Hospice Utilization and Payment Public Use File provides information on services provided to Medicare beneficiaries by hospice providers. The Hospice PUF...

  14. Tripled coincidence and fixed point results in partial metric spaces

    Directory of Open Access Journals (Sweden)

    Hassen Aydi

    2012-10-01

    Full Text Available In this paper, we introduce the concept of W-compatiblity of mappings F : X × X × X ! X and g : X ! X and based on this notion, we obtain tripled coincidence and common tripled fixed point results in the setting of partial metric spaces. The presented results generalize and extend several well known comparable results in the existing literature. We also provide an example to support our results.

  15. Conceptualizing RTI in 21st-Century Secondary Science Classrooms: Video Games' Potential to Provide Tiered Support and Progress Monitoring for Students with Learning Disabilities

    Science.gov (United States)

    Marino, Matthew T.; Beecher, Constance C.

    2010-01-01

    Secondary schools across the United States are adopting response to intervention (RTI) as a means to identify students with learning disabilities (LD) and provide tiered instructional interventions that benefit all students. The majority of current RTI research focuses on students with reading difficulties in elementary school classrooms.…

  16. The Relationship of Repeated Technical Assistance Support Visits to the Delivery of Positive Health, Dignity, and Prevention (PHDP) Messages by Healthcare Providers in Mozambique: A Longitudinal Multilevel Analysis.

    Science.gov (United States)

    Gutin, Sarah A; Amico, K Rivet; Hunguana, Elsa; Munguambe, António Orlando; Rose, Carol Dawson

    Positive health, dignity, and prevention (PHDP) is Mozambique's strategy to engage clinicians in the delivery of prevention messages to their HIV-positive clients. This national implementation strategy uses provider trainings on offering key messages and focuses on intervening on 9 evidence-based risk reduction areas. We investigated the impact of longitudinal technical assistance (TA) as an addition to this basic training. We followed 153 healthcare providers in 5 Mozambican provinces over 6 months to evaluate the impact of on-site, observation-based TA on PHDP implementation. Longitudinal multilevel models were estimated to model change in PHDP message delivery over time among individual providers. With each additional TA visit, providers delivered about 1 additional PHDP message ( P < .001); clinicians and nonclinicians started at about the same baseline level, but clinicians improved more quickly ( P = .004). Message delivery varied by practice sector; maternal and child health sectors outperformed other sectors. Longitudinal TA helped reach the programmatic goals of the PHDP program in Mozambique.

  17. Providing instrumental social support is more beneficial to reduce mortality risk among the elderly with low educational level in Taiwan: a 12-year follow-up national longitudinal study.

    Science.gov (United States)

    Liao, C C; Yeh, C J; Lee, S H; Liao, W C; Liao, M Y; Lee, M C

    2015-04-01

    To evaluate whether the effects of providing or receiving social support are more beneficial to reduce mortality risk among the elderly with different educational levels. In this long-term prospective cohort study, data were retrieved from the Taiwan Longitudinal Study on Aging. This study was initiated from 1996 until 2007. The complete data from 1492 males and 1177 females aged ≥67 years were retrieved. Participants received financial, instrumental, and emotional support, and they actively provided instrumental and emotional support to others and involved in social engagement. Education attainment was divided into two levels: high and low. The low education level included illiterate and elementary school. The high education level included junior high school to senior high school and above college. Cox regression analysis was used to examine the association between providing or receiving social support on mortality with different educational levels. The average age of the participants in 1996 was 73.0 (IQR=8.0) years, and the median survival following years (1996-2007) of participants was 10.3 (IQR=6.7) years. Most participants were low educational level including illiterate (39.3%) and elementary school (41.2%). Participants with high educational level tend to be younger and more male significantly. On the contrary, participants with low educational level tend to have significant more poor income, more depression, more cognition impairment, more with IADL and ADL disability than high educational level. Most participants received instrumental support from others (95.5%) and also provided emotional support to others (97.7%). Providing instrumental support can reduce 17% of mortality risk among the elderly with a low level of education after adjusting several covariates [Hazard ratio (HR) = 0.83; 95% confidence interval (CI) = 0.70-0.99; p = 0.036]. Providing instrumental social support to others confer benefits to the giver and prolong life expectancy among the

  18. Improving the quality of paediatric malaria diagnosis and treatment by rural providers in Myanmar: an evaluation of a training and support intervention.

    Science.gov (United States)

    Aung, Tin; Longfield, Kim; Aye, Nyo Me; San, Aung Kyaw; Sutton, Thea S; Montagu, Dominic

    2015-10-09

    This study evaluates the effectiveness of a training programme for improving the diagnostic and treatment quality of the most complex service offered by Sun Primary Health (SPH) providers, paediatric malaria. The study further assesses whether any quality improvements were sustained over the following 12 months. The study took place in 13 townships in central Myanmar between January 2011 and October 2012. A total of 251 community health workers were recruited and trained in the provision of paediatric and adult malaria diagnosis and treatment; 197 were surveyed in all three rounds: baseline, 6 and 12 months. Townships were selected based on a lack of alterative sources of medical care, averaging 20 km from government or private professional health care treatment facilities. Seventy percent of recruits were assistant nurse midwives or had other basic health training; the rest had no health training experience. Recruits were evaluated on their ability to properly diagnosis and treat a simulated 5-year-old patient using a previously validated method known as Observed Simulated Patient. A trained observer scored SPH providers on a scale of 1-100, based on WHO and Myanmar MOH established best practices. During a pilot test, 20 established private physicians operating in malaria-endemic areas of Myanmar scored an average of 70/100. Average quality scores of newly recruited SPH providers prior to training (baseline) were 12/100. Six months after training, average quality scores were 48/100. This increase was statistically significant (p training, providers were retested and average quality scores were 45/100 (R3-R1, p training programme was able to improve the quality of paediatric malaria care significantly, and to maintain that improvement over time. Quality of care remains lower than that of trained physicians; however, SPH providers operate in rural areas where no trained physicians operate. More research is needed to establish acceptable and achievable levels of

  19. Partial oral treatment of endocarditis

    DEFF Research Database (Denmark)

    Iversen, Kasper; Høst, Nis; Bruun, Niels Eske

    2013-01-01

    Guidelines for the treatment of left-sided infective endocarditis (IE) recommend 4 to 6 weeks of intravenous antibiotics. Conversion from intravenous to oral antibiotics in clinically stabilized patients could reduce the side effects associated with intravenous treatment and shorten the length...... of hospital stay. Evidence supporting partial oral therapy as an alternative to the routinely recommended continued parenteral therapy is scarce, although observational data suggest that this strategy may be safe and effective....

  20. Social Pedagogy as a Model to Provide Support for Siblings of Children with Intellectual Disabilities: A Report of the Views of the Children and Young People Using a Sibling Support Group

    Science.gov (United States)

    Carter, Sid; Cook, James; Sutton-Boulton, Gary; Ward, Vicki; Clarke, Steve

    2016-01-01

    The experiences of non-disabled children growing up with a sibling with an intellectual disability vary considerably, with reported impact ranging from increased mental health problems through evaluations of life enhancement. However, there is evidence that the net impact is neutral to positive, which was supported by the findings of this report…

  1. Temperature-Sensitive Cav1.2 Calcium Channels Support Intrinsic Firing of Pyramidal Neurons and Provide a Target for the Treatment of Febrile Seizures

    Science.gov (United States)

    Radzicki, Daniel; Yau, Hau-Jie; Pollema-Mays, Sarah L.; Mlsna, Lauren; Cho, Kangho; Koh, Sookyong

    2013-01-01

    Febrile seizures are associated with increased brain temperature and are often resistant to treatments with antiepileptic drugs, such as carbamazepine and phenytoin, which are sodium channel blockers. Although they are clearly correlated with the hyperthermic condition, the precise cellular mechanisms of febrile seizures remain unclear. We performed patch-clamp recordings from pyramidal cells in acute rat brain slices at temperatures up to 40°C and found that, at ≥37°C, L-type calcium channels are active at unexpectedly hyperpolarized potentials and drive intrinsic firing, which is also supported by a temperature-dependent, gadolinium-sensitive sodium conductance. Pharmacological data, RT-PCR, and the current persistence in Cav1.3 knock-out mice suggested a critical contribution of Cav1.2 subunits to the temperature-dependent intrinsic firing, which was blocked by nimodipine. Because intrinsic firing may play a critical role in febrile seizures, we tested the effect of nimodipine in an in vivo model of febrile seizures and found that this drug dramatically reduces both the incidence and duration of febrile seizures in rat pups, suggesting new possibilities of intervention for this important pathological condition. PMID:23761887

  2. Polyandrous females provide sons with more competitive sperm: Support for the sexy-sperm hypothesis in the rattlebox moth (Utetheisa ornatrix).

    Science.gov (United States)

    Egan, Andrea L; Hook, Kristin A; Reeve, H Kern; Iyengar, Vikram K

    2016-01-01

    Given the costs of multiple mating, why has female polyandry evolved? Utetheisa ornatrix moths are well suited for studying multiple mating in females because females are highly polyandrous over their life span, with each male mate transferring a substantial spermatophore with both genetic and nongenetic material. The accumulation of resources might explain the prevalence of polyandry in this species, but another, not mutually exclusive, possibility is that females mate multiply to increase the probability that their sons will inherit more-competitive sperm. This latter "sexy-sperm" hypothesis posits that female multiple mating and male sperm competitiveness coevolve via a Fisherian runaway process. We tested the sexy-sperm hypothesis by using competitive double matings to compare the sperm competition success of sons of polyandrous versus monandrous females. In accordance with sexy-sperm theory, we found that in 511 offspring across 17 families, the male whose polyandrous mother mated once with each of three different males sired significantly more of all total offspring (81%) than did the male whose monandrous mother was mated thrice to a single male. Interestingly, sons of polyandrous mothers had a significantly biased sex ratio of their brood toward sons, also in support of the hypothesis. © 2015 The Author(s). Evolution © 2015 The Society for the Study of Evolution.

  3. Cystic partially differentiated nephroblastoma.

    Science.gov (United States)

    Puvaneswary, M; Macintosh, J; Cassey, J

    2006-06-01

    Cystic partially differentiated nephroblastoma is a relatively rare tumour of the kidney usually affecting infants. Cystic Wilms' tumour and multilocular cystic nephroma should be distinguished from cystic partially differentiated nephroblastoma. Multilocular cystic nephroma is a benign tumour whereas cystic Wilms' tumour is at the malignant end of the range of classification of such tumours. Cystic partially differentiated nephroblastoma may undergo local recurrence but there is no report of metastasis.

  4. Partially composite Goldstone Higgs boson

    DEFF Research Database (Denmark)

    Alanne, Tommi; Franzosi, Diogo Buarque; Frandsen, Mads T.

    2017-01-01

    We consider a model of dynamical electroweak symmetry breaking with a partially composite Goldstone Higgs boson. The model is based on a strongly interacting fermionic sector coupled to a fundamental scalar sector via Yukawa interactions. The SU(4)×SU(4) global symmetry of these two sectors...... is broken to a single SU(4) via Yukawa interactions. Electroweak symmetry breaking is dynamically induced by condensation due to the strong interactions in the new fermionic sector which further breaks the global symmetry SU(4)→Sp(4). The Higgs boson arises as a partially composite state which is an exact...... Goldstone boson in the limit where SM interactions are turned off. Terms breaking the SU(4) global symmetry explicitly generate a mass for the Goldstone Higgs boson. The model realizes in different limits both (partially) composite Higgs and (bosonic) technicolor models, thereby providing a convenient...

  5. In Vitro Comparison of Marginal and Internal Fit of Press-on-Metal Ceramic (PoM) Restorations with Zirconium-Supported and Conventional Metal Ceramic Fixed Partial Dentures Before and After Veneering.

    Science.gov (United States)

    Varol, Seda; Kulak-Özkan, Yasemin

    2015-07-01

    To compare marginal and internal fit between 3- and 4-unit press-on-metal (PoM) ceramic, zirconia-supported, and conventional metal ceramic fixed partial dentures (FPDs) before and after veneering. Ten pieces for each 3- and 4-unit MC, IPS InLine PoM, and IPS e.max ZirCAD/Zir Press FPDs were produced. Cross-sections from silicone replicas were examined and measured with a light microscope. Occlusal, axial, intermarginal, and marginal mean adaptation scores of cross-sectioned replicas and means of measurements obtained from 4 sites were calculated independently. Mean values for molars were 78.44 ± 32.01 μm (MC), 89.84 ± 29.20 μm (PoM), and 85.17 ± 28.49 μm (Zir). Premolar values were 76.08 ± 27.92 μm (MC), 89.94 ± 23.49 μm (PoM), and 87.18 ± 28.25 μm (Zir). No difference existed between the means of 3- and 4-unit FPDs except the molar-intermarginal region. The mean value of 4-unit FPDs (93.88 ± 25.41 μm) was less than the 3-unit FPDs (103.68 ± 24.55 μm) at the molar-inter marginal region. A gap increase was observed in all sites except the molar-axio-occlusal region after veneering. According to the mean difference, gap increases at the molar-marginal, molar-intermarginal, and premolar-intermarginal regions were statistically significant. A statistical difference was found at the molar-marginal region for 4-unit MCR (p = 0.041) and 4-unit PoM FPDs (p = 0.042) before and after veneering. Gap increase after veneering of 4-unit metal ceramics at molar-intermarginal, premolar-marginal, and premolar-intermarginal regions (p = 0.020; p = 0.015; p = 0.004) was significant. The gap measurements of the IPS InLine PoM and IPS e.max ZirCAD/Zir Press groups were all clinically acceptable. No studies on marginal and internal fit in the IPS InLine PoM system have been published to date. This study should be supported with future studies. No significant increase was observed after press-veneering the IPS e.max ZirCAD frameworks with an IPS e.max ZirPress material

  6. Benefits and Limitations of Text Messages to Stimulate Higher Learning Among Community Providers: Participants' Views of an mHealth Intervention to Support Continuing Medical Education in Vietnam.

    Science.gov (United States)

    Sabin, Lora L; Larson Williams, Anna; Le, Bao Ngoc; Herman, Augusta R; Viet Nguyen, Ha; Albanese, Rebecca R; Xiong, Wenjun; Shobiye, Hezekiah Oa; Halim, Nafisa; Tran, Lien Thi Ngoc; McNabb, Marion; Hoang, Hai; Falconer, Ariel; Nguyen, Tam Thi Thanh; Gill, Christopher J

    2017-06-27

    A randomized controlled trial was conducted in 2015 to evaluate a mobile continuing medical education (mCME) intervention that provided daily text messages to community-based physicians' assistants (CBPAs) in Thai Nguyen Province, Vietnam. Although the intervention failed to improve medical knowledge over a 6-month period, a companion qualitative study provided insights on the views and experiences of intervention participants. We conducted focus group discussions (FGDs) and in-depth interviews (IDIs) among participants randomized to receive text messages containing either simple medical facts or quiz questions. Trained interviewers collected data immediately following the conclusion of the trial in December 2015. Using semi-structured question guides, respondents were queried on their views of the intervention, positive and negative, and perceived impacts of the intervention. During analysis, after learning that the intervention had failed to increase knowledge among participants, we also examined reasons for lack of improvement in medical knowledge. All analyses were performed in NVivo using a thematic approach. A total of 70 CBPAs engaged in one of 8 FGDs or an IDI. One-half were men; average age among all respondents was 40 years. Most (81%) practiced in rural settings and most (51%) focused on general medicine. The mean length of work experience was 3 years. All respondents made positive comments about the intervention; convenience, relevance, and quick feedback (quiz format) were praised. Downsides encompassed lack of depth of information, weak interaction, technology challenges, and challenging/irrelevant messages. Respondents described perceived impacts encompassing increased motivation, knowledge, collegial discussions, Internet use to search for more information, and clinical skills. Overall, they expressed a desire for the intervention to continue and recommended expansion to other medical professionals. Overreliance on the text messages, lack of

  7. Does additional support provided through e-mail or SMS in a Web-based Social Marketing program improve children's food consumption? A Randomized Controlled Trial.

    Science.gov (United States)

    Rangelov, Natalie; Della Bella, Sara; Marques-Vidal, Pedro; Suggs, L Suzanne

    2018-02-16

    The FAN Social Marketing program was developed to improve dietary and physical activity habits of families with children in Ticino, Switzerland. The aim of this study was to examine if the effects of the program on children's food intake differed by intervention group. Effects of the FAN program were tested through a Randomized Controlled Trial. The program lasted 8 weeks, during which participants received tailored communication about nutrition and physical activity. Families were randomly allocated to one of three groups, where the parent received the intervention by the Web (G1), Web + e-mail (G2) or Web + SMS (G3). Children in all groups received tailored print letters by post. Children's food consumption was assessed at baseline and immediate post intervention using a 7-day food diary. Generalized linear mixed models with child as a random effect and with time, treatment group, and the time by treatment interaction as fixed effects were used to test the impact of the intervention. Analyses were conducted with a sample of 608 children. After participating in FAN the marginal means of daily consumption of fruit changed from 0.95 to 1.12 in G1, from 0.82 to 0.94 in G2, and from 0.93 to 1.18 in G3. The margins of the daily consumption of sweets decreased in each group (1.67 to 1.56 in G1, 1.71 to 1.49 in G2, and 1.72 to 1.62 in G3). The change in vegetable consumption observed from pre to post intervention in G3 (from 1.13 to 1.21) was significantly different from that observed in G1 (from 1.21 to 1.17). A well-designed Web-based Social Marketing intervention complemented with print letters can help improve children's consumption of water, fruit, soft drinks, and sweets. The use of SMS to support greater behavior change, in addition to Web-based communication, resulted only in a small significant positive change for vegetables, while the use of e-mail in addition to Web did not result in any significant difference. The trial was retrospectively registered in the

  8. Genome-wide and Ordered-Subset linkage analyses provide support for autism loci on 17q and 19p with evidence of phenotypic and interlocus genetic correlates

    Directory of Open Access Journals (Sweden)

    Folstein Susan E

    2005-01-01

    these milestones and it revealed significantly increased LOD* scores at 19p13. Conclusions Our results further support 19p13 as harboring an autism susceptibility locus, confirm other linkage findings at 17q11.2, and demonstrate the need to analyze more discreet trait-based subsets of complex phenotypes to improve ability to detect genetic effects.

  9. Mobile phone messages to provide support to women during the home phase of medical abortion in South Africa: a randomised controlled trial.

    Science.gov (United States)

    Constant, Deborah; de Tolly, Katherine; Harries, Jane; Myer, Landon

    2014-09-01

    Home use of misoprostol for medical abortion is more convenient for many women than in-clinic use but requires management of abortion symptoms at home without provider backup. This study evaluated whether automated text messages to women undergoing medical abortion can reduce anxiety and emotional discomfort, and whether the messages can better prepare women for symptoms they experience. A multisite randomized controlled trial was conducted in which women undergoing early medical abortion were allocated to receive standard of care (SOC) only (n=235) or SOC+a messaging intervention (n=234). Consenting women were interviewed at the clinic after taking mifepristone and again at their follow-up clinic visit 2-3 weeks later; the intervention group received text messages over the duration of this period. Emotional outcomes were evaluated using the Hospital Anxiety and Depression Scale, Adler's 12-item emotional scale and the Impact of Event Scale-Revised. Preparedness for the abortion symptoms and overall satisfaction with the procedure were assessed using 4-point Likert-type scales. Between baseline and follow-up, anxiety decreased more (p=0.013), and less emotional stress was experienced (adjusted for baseline anxiety, p=0.015), in the intervention compared to the SOC group. Participants in the intervention group were also more likely to report that they felt very well prepared for the bleeding (peffects (p=0.027) they experienced. Acceptability and other negative emotions relating to the abortion did not differ between study groups. Ninety-nine percent of the intervention group stated that they would recommend the messages to a friend having the same procedure. Text messages to women following mifepristone administration for early medical abortion may assist them in managing symptoms and appear highly acceptable to recipients. This randomized controlled trial provides evidence for the effectiveness of text messages following mifepristone administration in

  10. Siberian Earth System Science Cluster - A web-based Geoportal to provide user-friendly Earth Observation Products for supporting NEESPI scientists

    Science.gov (United States)

    Eberle, J.; Gerlach, R.; Hese, S.; Schmullius, C.

    2012-04-01

    To provide earth observation products in the area of Siberia, the Siberian Earth System Science Cluster (SIB-ESS-C) was established as a spatial data infrastructure at the University of Jena (Germany), Department for Earth Observation. This spatial data infrastructure implements standards published by the Open Geospatial Consortium (OGC) and the International Organizsation for Standardization (ISO) for data discovery, data access, data processing and data analysis. The objective of SIB-ESS-C is to faciliate environmental research and Earth system science in Siberia. The region for this project covers the entire Asian part of the Russian Federation approximately between 58°E - 170°W and 48°N - 80°N. To provide discovery, access and analysis services a webportal was published for searching and visualisation of available data. This webportal is based on current web technologies like AJAX, Drupal Content Management System as backend software and a user-friendly surface with Drag-n-Drop and further mouse events. To have a wide range of regular updated earth observation products, some products from sensor MODIS at the satellites Aqua and Terra were processed. A direct connection to NASA archive servers makes it possible to download MODIS Level 3 and 4 products and integrate it in the SIB-ESS-C infrastructure. These data can be downloaded in a file format called Hierarchical Data Format (HDF). For visualisation and further analysis, this data is reprojected, converted to GeoTIFF and global products clipped to the project area. All these steps are implemented as an automatic process chain. If new MODIS data is available within the infrastructure this process chain is executed. With the link to a MODIS catalogue system, the system gets new data daily. With the implemented analysis processes, timeseries data can be analysed, for example to plot a trend or different time series against one another. Scientists working in this area and working with MODIS data can make use

  11. Why choose Random Forest to predict rare species distribution with few samples in large undersampled areas? Three Asian crane species models provide supporting evidence

    Directory of Open Access Journals (Sweden)

    Chunrong Mi

    2017-01-01

    Full Text Available Species distribution models (SDMs have become an essential tool in ecology, biogeography, evolution and, more recently, in conservation biology. How to generalize species distributions in large undersampled areas, especially with few samples, is a fundamental issue of SDMs. In order to explore this issue, we used the best available presence records for the Hooded Crane (Grus monacha, n = 33, White-naped Crane (Grus vipio, n = 40, and Black-necked Crane (Grus nigricollis, n = 75 in China as three case studies, employing four powerful and commonly used machine learning algorithms to map the breeding distributions of the three species: TreeNet (Stochastic Gradient Boosting, Boosted Regression Tree Model, Random Forest, CART (Classification and Regression Tree and Maxent (Maximum Entropy Models. In addition, we developed an ensemble forecast by averaging predicted probability of the above four models results. Commonly used model performance metrics (Area under ROC (AUC and true skill statistic (TSS were employed to evaluate model accuracy. The latest satellite tracking data and compiled literature data were used as two independent testing datasets to confront model predictions. We found Random Forest demonstrated the best performance for the most assessment method, provided a better model fit to the testing data, and achieved better species range maps for each crane species in undersampled areas. Random Forest has been generally available for more than 20 years and has been known to perform extremely well in ecological predictions. However, while increasingly on the rise, its potential is still widely underused in conservation, (spatial ecological applications and for inference. Our results show that it informs ecological and biogeographical theories as well as being suitable for conservation applications, specifically when the study area is undersampled. This method helps to save model-selection time and effort, and allows robust and rapid

  12. Direct Visualization of RNA-DNA Primer Removal from Okazaki Fragments Provides Support for Flap Cleavage and Exonucleolytic Pathways in Eukaryotic Cells.

    Science.gov (United States)

    Liu, Bochao; Hu, Jiazhi; Wang, Jingna; Kong, Daochun

    2017-03-24

    During DNA replication in eukaryotic cells, short single-stranded DNA segments known as Okazaki fragments are first synthesized on the lagging strand. The Okazaki fragments originate from ∼35-nucleotide-long RNA-DNA primers. After Okazaki fragment synthesis, these primers must be removed to allow fragment joining into a continuous lagging strand. To date, the models of enzymatic machinery that removes the RNA-DNA primers have come almost exclusively from biochemical reconstitution studies and some genetic interaction assays, and there is little direct evidence to confirm these models. One obstacle to elucidating Okazaki fragment processing has been the lack of methods that can directly examine primer removal in vivo In this study, we developed an electron microscopy assay that can visualize nucleotide flap structures on DNA replication forks in fission yeast ( Schizosaccharomyces pombe ). With this assay, we first demonstrated the generation of flap structures during Okazaki fragment processing in vivo The mean and median lengths of the flaps in wild-type cells were ∼51 and ∼41 nucleotides, respectively. We also used yeast mutants to investigate the impact of deleting key DNA replication nucleases on these flap structures. Our results provided direct in vivo evidence for a previously proposed flap cleavage pathway and the critical function of Dna2 and Fen1 in cleaving these flaps. In addition, we found evidence for another previously proposed exonucleolytic pathway involving RNA-DNA primer digestion by exonucleases RNase H2 and Exo1. Taken together, our observations suggest a dual mechanism for Okazaki fragment maturation in lagging strand synthesis and establish a new strategy for interrogation of this fascinating process. © 2017 by The American Society for Biochemistry and Molecular Biology, Inc.

  13. How can information systems provide support to nurses' hand hygiene performance? Using gamification and indoor location to improve hand hygiene awareness and reduce hospital infections.

    Science.gov (United States)

    Marques, Rita; Gregório, João; Pinheiro, Fernando; Póvoa, Pedro; da Silva, Miguel Mira; Lapão, Luís Velez

    2017-01-31

    Hospital-acquired infections are still amongst the major problems health systems are facing. Their occurrence can lead to higher morbidity and mortality rates, increased length of hospital stay, and higher costs for both hospital and patients. Performing hand hygiene is a simple and inexpensive prevention measure, but healthcare workers' compliance with it is often far from ideal. To raise awareness regarding hand hygiene compliance, individual behaviour change and performance optimization, we aimed to develop a gamification solution that collects data and provides real-time feedback accurately in a fun and engaging way. A Design Science Research Methodology (DSRM) was used to conduct this work. DSRM is useful to study the link between research and professional practices by designing, implementing and evaluating artifacts that address a specific need. It follows a development cycle (or iteration) composed by six activities. Two work iterations were performed applying gamification components, each using a different indoor location technology. Preliminary experiments, simulations and field studies were performed in an Intensive Care Unit (ICU) of a Portuguese tertiary hospital. Nurses working on this ICU were in a focus group during the research, participating in several sessions across the implementation process. Nurses enjoyed the concept and considered that it allows for a unique opportunity to receive feedback regarding their performance. Tests performed on the indoor location technology applied in the first iteration regarding distances estimation presented an unacceptable lack of accuracy. Using a proximity-based technique, it was possible to identify the sequence of positions, but beacons presented an unstable behaviour. In the second work iteration, a different indoor location technology was explored but it did not work properly, so there was no chance of testing the solution as a whole (gamification application included). Combining automated monitoring

  14. ForWarn: A Cross-Cutting Forest Resource Management and Decision Support System Providing the Capacity to Identify and Track Forest Disturbances Nationally

    Science.gov (United States)

    Hargrove, W. W.; Spruce, J.; Norman, S.; Christie, W.; Hoffman, F. M.

    2012-12-01

    The Eastern Forest Environmental Threat Assessment Center and Western Wildland Environmental Assessment Center of the USDA Forest Service have collaborated with NASA Stennis Space Center to develop ForWarn, a forest monitoring tool that uses MODIS satellite imagery to produce weekly snapshots of vegetation conditions across the lower 48 United States. Forest and natural resource managers can use ForWarn to rapidly detect, identify, and respond to unexpected changes in the nation's forests caused by insects, diseases, wildfires, severe weather, or other natural or human-caused events. ForWarn detects most types of forest disturbances, including insects, disease, wildfires, frost and ice damage, tornadoes, hurricanes, blowdowns, harvest, urbanization, and landslides. It also detects drought, flood, and temperature effects, and shows early and delayed seasonal vegetation development. Operating continuously since January 2010, results show ForWarn to be a robust and highly capable tool for detecting changes in forest conditions. ForWarn is the first national-scale system of its kind based on remote sensing developed specifically for forest disturbances. It has operated as a prototype since January 2010 and has provided useful information about the location and extent of disturbances detected during the 2011 growing season, including tornadoes, wildfires, and extreme drought. The ForWarn system had an official unveiling and rollout in March 2012, initiated by a joint NASA and USDA press release. The ForWarn home page has had 2,632 unique visitors since rollout in March 2012, with 39% returning visits. ForWarn was used to map tornado scars from the historic April 27, 2011 tornado outbreak, and detected timber damage within more than a dozen tornado tracks across northern Mississippi, Alabama, and Georgia. ForWarn is the result of an ongoing, substantive cooperation among four different government agencies: USDA, NASA, USGS, and DOE. Disturbance maps are available on the

  15. Memoization in Type-Directed Partial Evaluation

    DEFF Research Database (Denmark)

    Balat, Vincent; Danvy, Olivier

    2002-01-01

    the functions and type-directed partial evaluation provides a convenient setting to obtain the normal form of their composition. However, off-the-shelf type-directed partial evaluation turns out to yield gigantic normal forms. We identify that this gigantism is due to redundancies, and that these redundancies...

  16. Memorization in Type-Directed Partial Evaluation

    DEFF Research Database (Denmark)

    Balat, Vincent; Danvy, Olivier

    2002-01-01

    the functions and type-directed partial evaluation provides a convenient setting to obtain the normal form of their composition. However, off-the-shelf type-directed partial evaluation turns out to yield gigantic normal forms. We identify that this gigantism is due to redundancies, and that these redundancies...

  17. Partial migration in fishes: causes and consequences

    DEFF Research Database (Denmark)

    Chapman, B.B.; Hulthén, K.; Brodersen, J.

    2012-01-01

    Partial migration, where only some individuals from a population migrate, has been widely reported in a diverse range of animals. In this paper, what is known about the causes and consequences of partial migration in fishes is reviewed. Firstly, the ultimate and proximate drivers of partial...... migration are reflected upon: what ecological factors can shape the evolution of migratory dimorphism? How is partial migration maintained over evolutionary timescales? What proximate mechanisms determine whether an individual is migratory or remains resident? Following this, the consequences of partial...... migration are considered, in an ecological and evolutionary context, and also in an applied sense. Here it is argued that understanding the concept of partial migration is crucial for fisheries and ecosystem managers, and can provide information for conservation strategies. The review concludes...

  18. Bifurcation and stability for a nonlinear parabolic partial differential equation

    Science.gov (United States)

    Chafee, N.

    1973-01-01

    Theorems are developed to support bifurcation and stability of nonlinear parabolic partial differential equations in the solution of the asymptotic behavior of functions with certain specified properties.

  19. Motor axonal regeneration after partial and complete spinal cord transection

    National Research Council Canada - National Science Library

    Lu, Paul; Blesch, Armin; Graham, Lori; Wang, Yaozhi; Samara, Ramsey; Banos, Karla; Haringer, Verena; Havton, Leif; Weishaupt, Nina; Bennett, David; Fouad, Karim; Tuszynski, Mark H

    2012-01-01

    We subjected rats to either partial midcervical or complete upper thoracic spinal cord transections and examined whether combinatorial treatments support motor axonal regeneration into and beyond the lesion...

  20. Steganalysis Using Partially Ordered Markov Models

    Science.gov (United States)

    Davidson, Jennifer; Jalan, Jaikishan

    The field of steganalysis has blossomed prolifically in the past few years, providing the community with a number of very good blind steganalyzers. Features for blind steganalysis are generated in many different ways, typically using statistical measures. This paper presents a new image modeling technique for steganalysis that uses as features the conditional probabilities described by a stochastic model called a partially ordered Markov model (POMM). The POMM allows concise modeling of pixel dependencies among quantized discrete cosine transform coefficients. We develop a steganalyzer based on support vector machines that distinguishes between cover and stego JPEG images using 98 POMM features. We show that the proposed steganalyzer outperforms two comparative Markov-based steganalyzers [25,6] and outperforms a third steganalyzer [23] on half of the tested classes, by testing our approach with many different image databases on five embedding algorithms, with a total of 20,000 images.

  1. Hyperbolic partial differential equations

    CERN Document Server

    Witten, Matthew

    1986-01-01

    Hyperbolic Partial Differential Equations III is a refereed journal issue that explores the applications, theory, and/or applied methods related to hyperbolic partial differential equations, or problems arising out of hyperbolic partial differential equations, in any area of research. This journal issue is interested in all types of articles in terms of review, mini-monograph, standard study, or short communication. Some studies presented in this journal include discretization of ideal fluid dynamics in the Eulerian representation; a Riemann problem in gas dynamics with bifurcation; periodic M

  2. Dynamic Conductivity and Partial Ionization in Warm, Dense Hydrogen

    Science.gov (United States)

    Zaghoo, M.; Silvera, I. F.

    2017-10-01

    A theoretical description for optical conduction experiments in dense fluid hydrogen is presented. Different quantum statistical approaches are used to describe the mechanism of electron transport in hydrogen's high-temperature dense phase. We show that at the onset of the metallic transition, optical conduction could be described by a strong rise in the atomic polarizability, resulting from increased ionization; whereas in the highly degenerate limit, the Ziman weak-scattering model better describes the observed saturation of reflectance. In the highly degenerate region, the inclusion of partial ionization effects provides excellent agreement with experimental results. Hydrogen's fluid metallic state is revealed to be a partially ionized free-electron plasma. These results provide a crucial benchmark for ab initio calculations as well as an important guide for future experiments. Research supported by DOE Stockpile Stewardship Academic Alliance Program, Grant DE-FG52-10NA29656, and NASA Earth and Space Science Fellowship Program, Award NNX14AP17H.

  3. Partial knee replacement - slideshow

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/presentations/100225.htm Partial knee replacement - series—Normal anatomy To use the sharing ... A.M. Editorial team. Related MedlinePlus Health Topics Knee Replacement A.D.A.M., Inc. is accredited ...

  4. Theory of short periodic orbits for partially open quantum maps.

    Science.gov (United States)

    Carlo, Gabriel G; Benito, R M; Borondo, F

    2016-07-01

    We extend the semiclassical theory of short periodic orbits [M. Novaes et al., Phys. Rev. E 80, 035202(R) (2009)PLEEE81539-375510.1103/PhysRevE.80.035202] to partially open quantum maps, which correspond to classical maps where the trajectories are partially bounced back due to a finite reflectivity R. These maps are representative of a class that has many experimental applications. The open scar functions are conveniently redefined, providing a suitable tool for the investigation of this kind of system. Our theory is applied to the paradigmatic partially open tribaker map. We find that the set of periodic orbits that belongs to the classical repeller of the open map (R=0) is able to support the set of long-lived resonances of the partially open quantum map in a perturbative regime. By including the most relevant trajectories outside of this set, the validity of the approximation is extended to a broad range of R values. Finally, we identify the details of the transition from qualitatively open to qualitatively closed behavior, providing an explanation in terms of short periodic orbits.

  5. Global Partial Likelihood for Nonparametric Proportional Hazards Models.

    Science.gov (United States)

    Chen, Kani; Guo, Shaojun; Sun, Liuquan; Wang, Jane-Ling

    2010-01-01

    As an alternative to the local partial likelihood method of Tibshirani and Hastie and Fan, Gijbels, and King, a global partial likelihood method is proposed to estimate the covariate effect in a nonparametric proportional hazards model, λ(t|x) = exp{ψ(x)}λ(0)(t). The estimator, ψ̂(x), reduces to the Cox partial likelihood estimator if the covariate is discrete. The estimator is shown to be consistent and semiparametrically efficient for linear functionals of ψ(x). Moreover, Breslow-type estimation of the cumulative baseline hazard function, using the proposed estimator ψ̂(x), is proved to be efficient. The asymptotic bias and variance are derived under regularity conditions. Computation of the estimator involves an iterative but simple algorithm. Extensive simulation studies provide evidence supporting the theory. The method is illustrated with the Stanford heart transplant data set. The proposed global approach is also extended to a partially linear proportional hazards model and found to provide efficient estimation of the slope parameter. This article has the supplementary materials online.

  6. Flexible Thermoplastic Denture Base Materials for Aesthetical Removable Partial Denture Framework

    OpenAIRE

    Singh, Kunwarjeet; Aeran, Himanshu; Kumar, Narender; Gupta, Nidhi

    2013-01-01

    Conventional fixed partial dentures, implant supported Fixed Partial Dentures (FDPs) and removable partial dentures are the most common treatment modalities for the aesthetic and functional rehabilitation of partially edentulous patients. Although implants and FDP have certain advantages over removable partial dentures, in some cases, removable partial dentures may be the only choice which is available. Removable cast partial dentures are used as definitive removable prostheses when indicated...

  7. Laparoscopic Partial Hepatectomy: Animal Experiments

    Directory of Open Access Journals (Sweden)

    Haruhiro Inoue

    1995-01-01

    Full Text Available As a first step in firmly establishing laparoscopic hepatectomy, we introduce a porcine model of laparoscopic partial hepatectomy. This procedure has been successfully performed under the normal-pressure or low-pressure pneumoperitoneum condition supported by the full-thickness abdominal wall lifting technique. An ultrasonic dissector combined with electrocautery, newly developed by Olympus Optical Corporation (Japan was effectively utilized in facilitating safe and smooth incisions into the liver parenchyma. Although indications for this procedure seem to be limited only to peripheral lesions and not to central lesions, clinical application of this method may be useful for some patients in the near future.

  8. Painleve property for partial differential equations

    Energy Technology Data Exchange (ETDEWEB)

    Weiss, J.; Tabor, M.; Carnevale, G.

    1983-03-01

    In this paper we define the Painleve property for partial differential equations and show how it determines, in a remarkably simple manner, the integrability, the Baecklund transforms, the linearizing transforms, and the Lax pairs of three well-known partial differential equations (Burgers' equation, KdV equation, and the modified KdV equation). This indicates that the Painleve property may provide a unified description of integrable behavior in dynamical systems (ordinary and partial differential equations), while, at the same time, providing an efficient method for determining the integrability of particular systems.

  9. The marketing of partial hospitalization.

    Science.gov (United States)

    Millsap, P; Brown, E; Kiser, L; Pruitt, D

    1987-09-01

    Health-care professionals are currently operating in the context of a rapidly changing health-care delivery system, including the move away from inpatient services to outpatient services in order to control costs. Those who practice in partial-hospital settings are in a position to offer effective, cost-efficient services; however, there continue to be obstacles which hinder appropriate utilization of the modality. The development and use of a well-designed marketing plan is one strategy for removing these obstacles. This paper presents a brief overview of the marketing process, ideas for developing a marketing plan, and several examples of specific marketing strategies as well as ways to monitor their effectiveness. Partial-hospital providers must take an active role in answering the calls for alternative sources of psychiatric care. A comprehensive, education-oriented marketing approach will increase the public's awareness of such alternatives and enable programs to survive in a competitive environment.

  10. Introduction to partial differential equations

    CERN Document Server

    Borthwick, David

    2016-01-01

    This modern take on partial differential equations does not require knowledge beyond vector calculus and linear algebra. The author focuses on the most important classical partial differential equations, including conservation equations and their characteristics, the wave equation, the heat equation, function spaces, and Fourier series, drawing on tools from analysis only as they arise.Within each section the author creates a narrative that answers the five questions: (1) What is the scientific problem we are trying to understand? (2) How do we model that with PDE? (3) What techniques can we use to analyze the PDE? (4) How do those techniques apply to this equation? (5) What information or insight did we obtain by developing and analyzing the PDE? The text stresses the interplay between modeling and mathematical analysis, providing a thorough source of problems and an inspiration for the development of methods.

  11. Develop a Prototype Personal Health Record Application (PHR-A) that Captures Information About Daily Living Important for Diabetes and Provides Decision Support with Actionable Advice for Diabetes Self Care

    Science.gov (United States)

    2015-09-01

    testing your blood sugar or taking your medications.There are also surveys that ask what you believe about diabetes and how your mood has been. When you...Diary, Activity Diary, and Medications Log to see how those components of diabetes self-care affect your blood sugar . As with the other tabs, the Blood...Living Important for Diabetes and Provides Decision Support with Actionable Advice for Diabetes Self Care”. PRINCIPAL INVESTIGATOR: Dr. Stephanie Fonda

  12. Partial differential equations

    CERN Document Server

    Evans, Lawrence C

    2010-01-01

    This text gives a comprehensive survey of modern techniques in the theoretical study of partial differential equations (PDEs) with particular emphasis on nonlinear equations. The exposition is divided into three parts: representation formulas for solutions; theory for linear partial differential equations; and theory for nonlinear partial differential equations. Included are complete treatments of the method of characteristics; energy methods within Sobolev spaces; regularity for second-order elliptic, parabolic, and hyperbolic equations; maximum principles; the multidimensional calculus of variations; viscosity solutions of Hamilton-Jacobi equations; shock waves and entropy criteria for conservation laws; and, much more.The author summarizes the relevant mathematics required to understand current research in PDEs, especially nonlinear PDEs. While he has reworked and simplified much of the classical theory (particularly the method of characteristics), he primarily emphasizes the modern interplay between funct...

  13. Dynamics of partial control.

    Science.gov (United States)

    Sabuco, Juan; Sanjuán, Miguel A F; Yorke, James A

    2012-12-01

    Safe sets are a basic ingredient in the strategy of partial control of chaotic systems. Recently we have found an algorithm, the sculpting algorithm, which allows us to construct them, when they exist. Here we define another type of set, an asymptotic safe set, to which trajectories are attracted asymptotically when the partial control strategy is applied. We apply all these ideas to a specific example of a Duffing oscillator showing the geometry of these sets in phase space. The software for creating all the figures appearing in this paper is available as supplementary material.

  14. Finding associations among histone modifications using sparse partial correlation networks.

    Directory of Open Access Journals (Sweden)

    Julia Lasserre

    Full Text Available Histone modifications are known to play an important role in the regulation of transcription. While individual modifications have received much attention in genome-wide analyses, little is known about their relationships. Some authors have built Bayesian networks of modifications, however most often they have used discretized data, and relied on unrealistic assumptions such as the absence of feedback mechanisms or hidden confounding factors. Here, we propose to infer undirected networks based on partial correlations between histone modifications. Within the partial correlation framework, correlations among two variables are controlled for associations induced by the other variables. Partial correlation networks thus focus on direct associations of histone modifications. We apply this methodology to data in CD4+ cells. The resulting network is well supported by common knowledge. When pairs of modifications show a large difference between their correlation and their partial correlation, a potential confounding factor is identified and provided as explanation. Data from different cell types (IMR90, H1 is also exploited in the analysis to assess the stability of the networks. The results are remarkably similar across cell types. Based on this observation, the networks from the three cell types are integrated into a consensus network to increase robustness. The data and the results discussed in the manuscript can be found, together with code, on http://spcn.molgen.mpg.de/index.html.

  15. Motor Axonal Regeneration After Partial and Complete Spinal Cord Transection

    Science.gov (United States)

    Lu, Paul; Blesch, Armin; Graham, Lori; Wang, Yaozhi; Samara, Ramsey; Banos, Karla; Haringer, Verena; Havton, Leif; Weishaupt, Nina; Bennett, David; Fouad, Karim; Tuszynski, Mark H.

    2012-01-01

    We subjected rats to either partial mid-cervical or complete upper thoracic spinal cord transections and examined whether combinatorial treatments support motor axonal regeneration into and beyond the lesion. Subjects received cAMP injections into brainstem reticular motor neurons to stimulate their endogenous growth state, bone marrow stromal cell grafts in lesion sites to provide permissive matrices for axonal growth, and brain-derived neurotrophic factor (BDNF) gradients beyond the lesion to stimulate distal growth of motor axons. Findings were compared to several control groups. Combinatorial treatment generated motor axon regeneration beyond both C5 hemisection and complete transection sites. Yet despite formation of synapses with neurons below the lesion, motor outcomes worsened after partial cervical lesions and spasticity worsened after complete transection. These findings highlight the complexity of spinal cord repair, and the need for additional control and shaping of axonal regeneration. PMID:22699902

  16. Fundamental partial compositeness

    DEFF Research Database (Denmark)

    Sannino, Francesco; Strumia, Alessandro; Tesi, Andrea

    2016-01-01

    We construct renormalizable Standard Model extensions, valid up to the Planck scale, that give a composite Higgs from a new fundamental strong force acting on fermions and scalars. Yukawa interactions of these particles with Standard Model fermions realize the partial compositeness scenario. Unde...

  17. Partial Biotinidase Deficiency

    OpenAIRE

    J Gordon Millichap

    1990-01-01

    The symptoms, biochemical features and inheritance pattern of partial biotinidase deficiency have been studied at the Departments of Human Genetics and Pediatrics, Medical College of Virginia, Richmond, VA; the State Laboratory Institute, Massachusetts Department of Public Health; Massachusetts General Hospital, Boston; the Lincoln Clinic, NB; and the Division of Human Genetics, university of Maryland School of Medicine, Baltimore.

  18. Partially Hidden Markov Models

    DEFF Research Database (Denmark)

    Forchhammer, Søren Otto; Rissanen, Jorma

    1996-01-01

    Partially Hidden Markov Models (PHMM) are introduced. They differ from the ordinary HMM's in that both the transition probabilities of the hidden states and the output probabilities are conditioned on past observations. As an illustration they are applied to black and white image compression wher...

  19. Honesty in partial logic

    NARCIS (Netherlands)

    W. van der Hoek (Wiebe); J.O.M. Jaspars; E. Thijsse

    1995-01-01

    textabstractWe propose an epistemic logic in which knowledge is fully introspective and implies truth, although truth need not imply epistemic possibility. The logic is presented in sequential format and is interpreted in a natural class of partial models, called balloon models. We examine the

  20. Partial Remission Definition

    DEFF Research Database (Denmark)

    Andersen, Marie Louise Max; Hougaard, Philip; Pörksen, Sven

    2014-01-01

    OBJECTIVE: To validate the partial remission (PR) definition based on insulin dose-adjusted HbA1c (IDAA1c). SUBJECTS AND METHODS: The IDAA1c was developed using data in 251 children from the European Hvidoere cohort. For validation, 129 children from a Danish cohort were followed from the onset...

  1. Worlds of Events: Deduction with Partial Knowledge about Causality

    Directory of Open Access Journals (Sweden)

    Seyed Hossein Haeri

    2016-08-01

    Full Text Available Interactions between internet users are mediated by their devices and the common support infrastructure in data centres. Keeping track of causality amongst actions that take place in this distributed system is key to provide a seamless interaction where effects follow causes. Tracking causality in large scale interactions is difficult due to the cost of keeping large quantities of metadata; even more challenging when dealing with resource-limited devices. In this paper, we focus on keeping partial knowledge on causality and address deduction from that knowledge. We provide the first proof-theoretic causality modelling for distributed partial knowledge. We prove computability and consistency results. We also prove that the partial knowledge gives rise to a weaker model than classical causality. We provide rules for offline deduction about causality and refute some related folklore. We define two notions of forward and backward bisimilarity between devices, using which we prove two important results. Namely, no matter the order of addition/removal, two devices deduce similarly about causality so long as: (1 the same causal information is fed to both. (2 they start bisimilar and erase the same causal information. Thanks to our establishment of forward and backward bisimilarity, respectively, proofs of the latter two results work by simple induction on length.

  2. Management of partial traumatic hemipelvectomy.

    Science.gov (United States)

    Wang, Guodong; Zhou, Dongsheng; Shen, Wun-Jer; Xin, Maoyuan; He, Jiliang; Li, Qinghu; Tan, Guoqing

    2013-11-01

    Partial traumatic hemipelvectomy is a devastating condition. Although by definition the affected limb is not totally transected from the trunk because of retained soft tissue, the reported mortality rate is actually higher than in complete traumatic hemipelvectomy. Between January 2000 and December 2011, a total of 917 patients were admitted to the authors' institution for pelvic fracture. Seven of these patients met the criteria for partial traumatic hemipelvectomy. All 7 patients had multiple associated injuries and met the criteria for Baskett class IV hypovolemic shock on arrival at the emergency department. The amount of bleeding was the greatest issue, and control of hemorrhage and rapid blood transfusion were the initial goals. Abdominal aorta balloon occlusion, laparotomy and packing, and pelvic external fixation were useful to control bleeding. Two patients died during the initial resuscitation phase. Angiography (digital subtraction or computed tomographic) was performed in 4 patients but did not provide any treatment-altering information. Limb preservation was attempted in 2 patients; both of these patients eventually required hindquarter amputation. One patient died, and the second patient survived after a difficult postoperative course. The best results were obtained in 3 patients who underwent completion of the hindquarter amputation within 24 hours of trauma. All patients became wheelchair dependent, and no patient was able to return to work. Early completion of hindquarter amputation after hemorrhaging has been controlled is recommended in patients with partial traumatic hemipelvectomy. Angiography did not prove useful in decision making. Copyright 2013, SLACK Incorporated.

  3. Partially composite Goldstone Higgs boson

    Science.gov (United States)

    Alanne, Tommi; Franzosi, Diogo Buarque; Frandsen, Mads T.

    2017-11-01

    We consider a model of dynamical electroweak symmetry breaking with a partially composite Goldstone Higgs boson. The model is based on a strongly interacting fermionic sector coupled to a fundamental scalar sector via Yukawa interactions. The SU (4 )×SU (4 ) global symmetry of these two sectors is broken to a single SU(4) via Yukawa interactions. Electroweak symmetry breaking is dynamically induced by condensation due to the strong interactions in the new fermionic sector which further breaks the global symmetry SU (4 )→Sp (4 ). The Higgs boson arises as a partially composite state which is an exact Goldstone boson in the limit where SM interactions are turned off. Terms breaking the SU(4) global symmetry explicitly generate a mass for the Goldstone Higgs boson. The model realizes in different limits both (partially) composite Higgs and (bosonic) technicolor models, thereby providing a convenient unified framework for phenomenological studies of composite dynamics. It is also a dynamical extension of the recent elementary Goldstone Higgs model.

  4. Numerical Analysis of Partial Differential Equations

    CERN Document Server

    Lui, S H

    2011-01-01

    A balanced guide to the essential techniques for solving elliptic partial differential equations Numerical Analysis of Partial Differential Equations provides a comprehensive, self-contained treatment of the quantitative methods used to solve elliptic partial differential equations (PDEs), with a focus on the efficiency as well as the error of the presented methods. The author utilizes coverage of theoretical PDEs, along with the nu merical solution of linear systems and various examples and exercises, to supply readers with an introduction to the essential concepts in the numerical analysis

  5. Synchronizing Strategies under Partial Observability

    DEFF Research Database (Denmark)

    Larsen, Kim Guldstrand; Laursen, Simon; Srba, Jiri

    2014-01-01

    Embedded devices usually share only partial information about their current configurations as the communication bandwidth can be restricted. Despite this, we may wish to bring a failed device into a given predetermined configuration. This problem, also known as resetting or synchronizing words, has...... been intensively studied for systems that do not provide any information about their configurations. In order to capture more general scenarios, we extend the existing theory of synchronizing words to synchronizing strategies, and study the synchronization, short-synchronization and subset...

  6. Partially composite Higgs models

    DEFF Research Database (Denmark)

    Alanne, Tommi; Buarque Franzosi, Diogo; Frandsen, Mads T.

    2018-01-01

    constraints. A small part of parameter space around the classically conformal limit is stable up to the Planck scale. This is however already strongly disfavored by LHC results. in different limits, the models realize both (partially) composite-Higgs and (bosonic) technicolor models and a dynamical extension......We study the phenomenology of partially composite-Higgs models where electroweak symmetry breaking is dynamically induced, and the Higgs is a mixture of a composite and an elementary state. The models considered have explicit realizations in terms of gauge-Yukawa theories with new strongly...... interacting fermions coupled to elementary scalars and allow for a very SM-like Higgs state. We study constraints on their parameter spaces from vacuum stability and perturbativity as well as from LHC results and find that requiring vacuum stability up to the compositeness scale already imposes relevant...

  7. Dual Component Removable Partial Denture shows improved ...

    African Journals Online (AJOL)

    Dual Component Removable Partial Denture (DuCo RPD) is composed of a double base; lower and upper. The lower base, where the artificial teeth are attached, acts as a support and is in contact with the alveolar ridges and oral mucosa. Clasps are designed on the upper base, which acts towards the retention and ...

  8. Arthroscopic partial medial meniscectomy

    Directory of Open Access Journals (Sweden)

    Dašić Žarko

    2011-01-01

    Full Text Available Background/Aim. Meniscal injuries are common in professional or recreational sports as well as in daily activities. If meniscal lesions lead to physical impairment they usually require surgical treatment. Arthroscopic treatment of meniscal injuries is one of the most often performed orthopedic operative procedures. Methods. The study analyzed the results of arthroscopic partial medial meniscectomy in 213 patients in a 24-month period, from 2006, to 2008. Results. In our series of arthroscopically treated medial meniscus tears we noted 78 (36.62% vertical complete bucket handle lesions, 19 (8.92% vertical incomplete lesions, 18 (8.45% longitudinal tears, 35 (16.43% oblique tears, 18 (8.45% complex degenerative lesions, 17 (7.98% radial lesions and 28 (13.14% horisontal lesions. Mean preoperative International Knee Documentation Committee (IKDC score was 49.81%, 1 month after the arthroscopic partial medial meniscectomy the mean IKDC score was 84.08%, and 6 months after mean IKDC score was 90.36%. Six months after the procedure 197 (92.49% of patients had good or excellent subjective postoperative clinical outcomes, while 14 (6.57% patients subjectively did not notice a significant improvement after the intervention, and 2 (0.93% patients had no subjective improvement after the partial medial meniscectomy at all. Conclusion. Arthroscopic partial medial meniscetomy is minimally invasive diagnostic and therapeutic procedure and in well selected cases is a method of choice for treatment of medial meniscus injuries when repair techniques are not a viable option. It has small rate of complications, low morbidity and fast rehabilitation.

  9. Mergers by Partial Acquisition

    OpenAIRE

    Lindqvist, Tobias

    2004-01-01

    This paper evaluates partial acquisition strategies. The model allows for buying a share of a firm before the actual acquisition takes place. Holding a share in a competing firm before the acquisition of another firm, outsider-toehold, eliminates the insiders' dilemma, i.e. profitable mergers do not occur. This strategy may thus be more profitable for a buyer than acquiring entire firms at once. Furthermore, the insiders' dilemma arises from the assumption of a positive externality on the out...

  10. Partial migration in fishes: causes and consequences.

    Science.gov (United States)

    Chapman, B B; Hulthén, K; Brodersen, J; Nilsson, P A; Skov, C; Hansson, L-A; Brönmark, C

    2012-07-01

    Partial migration, where only some individuals from a population migrate, has been widely reported in a diverse range of animals. In this paper, what is known about the causes and consequences of partial migration in fishes is reviewed. Firstly, the ultimate and proximate drivers of partial migration are reflected upon: what ecological factors can shape the evolution of migratory dimorphism? How is partial migration maintained over evolutionary timescales? What proximate mechanisms determine whether an individual is migratory or remains resident? Following this, the consequences of partial migration are considered, in an ecological and evolutionary context, and also in an applied sense. Here it is argued that understanding the concept of partial migration is crucial for fisheries and ecosystem managers, and can provide information for conservation strategies. The review concludes with a reflection on the future opportunities in this field, and the avenues of research that are likely to be fruitful to shed light on the enduring puzzle of partial migration in fishes. © 2012 The Authors. Journal of Fish Biology © 2012 The Fisheries Society of the British Isles.

  11. Family-centredness of professionals who support people with profound intellectual and multiple disabilities: validation of the Dutch 'Measure of Processes of Care for Service Providers' (MPOC-SP-PIMD).

    Science.gov (United States)

    Jansen, Suzanne L G; van der Putten, Annette A J; Post, Wendy J; Vlaskamp, Carla

    2014-07-01

    A Dutch version of the 'Measure of Processes of Care for Service Providers' (MPOC-SP) was developed to determine the extent to which professionals apply the principles of family-centred care in the rehabilitation of children with physical disabilities. However, no data were available on the reliability and construct validity of this instrument when it comes to supporting people with profound intellectual and multiple disabilities (PIMD). This study aimed to validate an adapted version of the Dutch MPOC-SP for assessing the family-centred behaviours of professionals who support this group (MPOC-SP-PIMD). A total of 105 professionals took part in the study. A Mokken scale analysis was conducted to determine whether the instrument satisfied the assumptions of both monotone homogeneity and double monotonicity. Loevinger's scalability coefficient (H) was used for the scalability of the entire scale and of each item separately. Rho was calculated as a measure of the internal consistency of the scales. The analyses resulted in two scales: a nine-item scale interpreted as 'Showing Interpersonal Sensitivity', with H=.39 and rho=.76, and a seven-item scale interpreted as 'Treating People Respectfully', with H=.49 and rho=.78. A validated version of the MPOC-SP-PIMD, suitable for supporting people with PIMD, consists of a subset of two scales from the original Dutch MPOC-SP. This instrument can be used to compare the family-centredness of professionals with parent's expectations and views. This information can be used in practice to match the support to the needs of the parents and family of the child with PIMD. Copyright © 2014 Elsevier Ltd. All rights reserved.

  12. Partially coherent lensfree tomographic microscopy⋄

    Science.gov (United States)

    Isikman, Serhan O.; Bishara,