Access to care for children with emotional/behavioral difficulties.
Henning-Smith, Carrie; Alang, Sirry
2016-06-01
Emotional/behavioral difficulties (EBDs) are increasingly diagnosed in children, constituting some of the most common chronic childhood conditions. Left untreated, EBDs pose long-term individual and population-level consequences. There is a growing evidence of disparities in EBD prevalence by various demographic characteristics. This article builds on this research by examining disparities in access to medical care for children with EBD. From 2008 to 2011, using data from the US National Health Interview Survey (N = 31,631) on sample children aged 4-17, we investigate (1) whether having EBD affects access to care (modeled as delayed care due to cost and difficulty making an appointment) and (2) the role demographic characteristics, health insurance coverage, and frequency of service use play in access to care for children with EBD. Results indicate that children with EBD experience issues in accessing care at more than twice the rate of children without EBD, even though they are less likely to be uninsured than their counterparts without EBD. In multivariable models, children with EBD are still more likely to experience delayed care due to cost and difficulty making a timely appointment, even after adjusting for frequency of health service use, insurance coverage, and demographic characteristics. © The Author(s) 2015.
McMurray, Sharon; O'Callaghan, Paul; McVeigh, Claire
2018-02-01
This paper considers two major concerns centring on the Joint Council for Qualifications (JCQ) regulations for access arrangement and reasonable adjustments and qualifications for teachers who take on the role of Level 7 access arrangements assessor. Thus, the paper is divided into two parts. First, the JCQ 2017-2018 regulations are critically evaluated highlighting the areas of need for which greater clarity and more extensive detail is required in these regulations. The second part of the paper discusses the findings of research on teacher competence in test administration, scoring, and reporting. Drawing on evidence from the first stage of this research, McMurray, O'Callaghan, and McVeigh highlight the extensive formative process required to build a high-level skill set required for competent assessment involving the use of high level tests and also the specialist knowledge required to analyse and accurately report assessment findings to make recommendations for students with specific literacy difficulties. Recommendations are provided both at policy and practice levels regarding the content of courses and the assessment involving the use of high level tests and also the specialist knowledge required to analyse and accurately report assessment findings to make recommendations for students with specific literacy difficulties. The authors provide recommendations for test publishers, course providers, and assessors. Copyright © 2018 John Wiley & Sons, Ltd.
Dale, Craig M; Smith, Orla; Burry, Lisa; Rose, Louise
2018-04-01
Oral care of intubated patients is essential to the prevention of infection and patient discomfort. However, barriers to oral access and delivery of oral care have received little attention. To determine prevalence and predictors of oral access difficulty. A prospective, observational, multi-center study. Four intensive care units in Toronto, Canada. Adult patients orally intubated for ≥48 h. We screened consecutive admissions once a week to identify eligible participants. We observed each patient and asked the patient's nurse about presence or absence of difficulty accessing the mouth to deliver oral care across three categories: (1) visualizing inside the mouth; (2) obtaining patient cooperation, or (3) inserting instruments for delivery of oral care. We asked nurses to identify presence of patient behaviors contributing to oral access difficulty and perceived level of difficulty on a Likert response scale. We examined patient and treatment characteristics associated with extreme difficulty (i.e., difficulty in all 3 categories) using a generalized estimating equation regression model. A total of 428 patients were observed, 58% admitted with a medical diagnosis. More than half (57%) had ≥2 oral devices up to maximum of 4. Oral care difficulty was identified in 83% of patients and rated as moderate to high for 217 (51%). Difficulty concerned visibility (74%), patient cooperation (55%), and space to insert instruments (53%). Patient behaviors contributing difficulty included coughing/gagging (60%), mouth closing (49%), biting (45%) and localizing (27%) during care. Variables associated with extreme difficulty included neurological (OR 1.92, 95% CI 1.42-2.60) or trauma admission (OR 1.83, 95% CI 1.16-2.89), lack of pain assessment or treatment in the 4 h prior to oral care (OR 1.43, 95% CI 1.14-1.80), more oral devices (OR 1.40, 95% CI 1.05-1.87), and duration of intubation (OR 1.05, 95% CI 1.01-1.10). Absence of documented agitation in the 4 h prior to
Zhou, Yin; Abel, Gary; Warren, Fiona; Roland, Martin; Campbell, John; Lyratzopoulos, Georgios
2015-05-01
It is believed that some patients are more likely to use out-of-hours primary care services because of difficulties in accessing in-hours care, but substantial evidence about any such association is missing. We analysed data from 567,049 respondents to the 2011/2012 English General Practice Patient Survey who reported at least one in-hours primary care consultation in the preceding 6 months. Of those respondents, 7% also reported using out-of-hours primary care. We used logistic regression to explore associations between use of out-of-hours primary care and five measures of in-hours access (ease of getting through on the telephone, ability to see a preferred general practitioner, ability to get an urgent or routine appointment and convenience of opening hours). We illustrated the potential for reduction in use of out-of-hours primary care in a model where access to in-hours care was made optimal. Worse in-hours access was associated with greater use of out-of-hours primary care for each access factor. In multivariable analysis adjusting for access and patient characteristic variables, worse access was independently associated with increased out-of-hours use for all measures except ease of telephone access. Assuming these associations were causal, we estimated that an 11% relative reduction in use of out-of-hours primary care services in England could be achievable if access to in-hours care were optimal. This secondary quantitative analysis provides evidence for an association between difficulty in accessing in-hours care and use of out-of-hours primary care services. The findings can motivate the development of interventions to improve in-hour access. 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.
People with Hemianopia Report Difficulty with TV, Computer, Cinema Use, and Photography.
Costela, Francisco M; Sheldon, Sarah S; Walker, Bethany; Woods, Russell L
2018-05-01
Our survey found that participants with hemianopia report more difficulties watching video in various formats, including television (TV), on computers, and in a movie theater, compared with participants with normal vision (NV). These reported difficulties were not as marked as those reported by people with central vision loss. The aim of this study was to survey the viewing experience (e.g., frequency, difficulty) of viewing video on TV, computers and portable visual display devices, and at the cinema of people with hemianopia and NV. This information may guide vision rehabilitation. We administered a cross-sectional survey to investigate the viewing habits of people with hemianopia (n = 91) or NV (n = 192). The survey, consisting of 22 items, was administered either in person or in a telephone interview. Descriptive statistics are reported. There were five major differences between the hemianopia and NV groups. Many participants with hemianopia reported (1) at least "some" difficulty watching TV (39/82); (2) at least "some" difficulty watching video on a computer (16/62); (3) never attending the cinema (30/87); (4) at least some difficulty watching movies in the cinema (20/56), among those who did attend the cinema; and (5) never taking photographs (24/80). Some people with hemianopia reported methods that they used to help them watch video, including video playback and head turn. Although people with hemianopia report more difficulty with viewing video on TV and at the cinema, we are not aware of any rehabilitation methods specifically designed to assist people with hemianopia to watch video. The results of this survey may guide future vision rehabilitation.
Self-reported difficulty in conceiving as a measure of infertility.
Dick, M-L B; Bain, C J; Purdie, D M; Siskind, V; Molloy, D; Green, A C
2003-12-01
This study aimed to explore the meaning and potential use of women's self-reported difficulties in conceiving as a measure of infertility in epidemiological studies, and to compare women's stated reasons for infertility with information in their medical records. Data were available from a population-based case-control study of ovarian cancer involving 1638 women. The sensitivity and specificity of women's self-reported infertility were calculated against their estimated fertility status based on detailed reproductive histories. Self-reported reasons for infertility were compared with diagnoses documented in women's medical records. The sensitivity of women's self-reported difficulty in conceiving was 66 and 69% respectively when compared with calendar-derived and self-reported times taken trying to conceive; its specificity was 95%. Forty-one (23%) of the 179 women for whom medical records were available had their self-reported fertility problem confirmed. Self-reported infertility causes could be compared with diagnoses in medical records for only 22 of these women. Self-reported difficulty conceiving is a useful measure of infertility for quantifying the burden of fertility problems experienced in the community. Validation of reasons for infertility is unlikely to be feasible through examination of medical records. Improved education of the public regarding the availability and success rates of infertility treatments is proposed.
Self-reported learning difficulties and dietary intake in Norwegian adolescents.
Øverby, Nina Cecilie; Lüdemann, Eva; Høigaard, Rune
2013-11-01
The academic performance of children impacts future educational attainment which may increase socioeconomic status which again influences their health. One of several factors that might affect academic performance is the diet. The aim of this study was to investigate the cross sectional relation between diet and self-reported reading-, writing-, and mathematical difficulties in Norwegian adolescents. In total, 475 ninth- and tenth-grade students out of 625 eligible ones from four different secondary schools in three different municipalities in Vest-Agder County, Norway, participated, giving a participation rate of 77%. The students filled in a questionnaire with food frequency questions of selected healthy and unhealthy food items, questions of meal frequency and different learning difficulties. Regular breakfast was significantly associated with decreased odds of both writing and reading difficulties (OR: 0.44 (0.2-0.8), p = 0.01) and mathematical difficulties (OR: 0.33 (0.2-0.6), p ≤ 0.001). In addition, having lunch, dinner and supper regularly were associated with decreased odds of mathematical difficulties. Further, a high intake of foods representing a poor diet (sugar-sweetened soft drinks, sweets, chocolate, savory snacks, pizza and hot dogs) was significantly associated with increased odds of mathematical difficulties. Having a less-frequent intake of unhealthy foods and not skipping meals are associated with decreased odds of self-reported learning difficulties in Norwegian adolescents in this study. The results of this study support the need for a larger study with a more representative sample.
Difficulties reported by hiv-infected patients using antiretroviral therapy in brazil
Directory of Open Access Journals (Sweden)
Mark Drew Crosland Guimarães
2008-01-01
Full Text Available OBJECTIVE: To describe the degree of difficulty that HIV-infected patients have with therapy treatment. INTRODUCTION: Patients’ perceptions about their treatment are a determinant factor for improved adherence and a better quality of life. METHODS: Two cross-sectional analyses were conducted in public AIDS referral centers in Brazil among patients initiating treatment. Patients interviewed at baseline, after one month, and after seven months following the beginning of treatment were asked to classify and justify the degree of difficulty with treatment. Logistic regression was used for analysis. RESULTS: Among 406 patients initiating treatment, 350 (86.2% and 209 (51.5% returned for their first and third visits, respectively. Treatment perceptions ranged from medium to very difficult for 51.4% and 37.3% on the first and third visits, respectively. The main difficulties reported were adverse reactions to the medication and scheduling. A separate logistic regression indicated that the HIV-seropositive status disclosure, symptoms of anxiety, absence of psychotherapy, higher CD4+ cell count (> 200/mm³ and high (> 4 adverse reaction count reported were independently associated with the degree of difficulty in the first visit, while CDC clinical category A, pill burden (> 7 pills, use of other medications, high (> 4 adverse reaction count reported and low understanding of medical orientation showed independent association for the third visit. CONCLUSIONS: A significant level of difficulty was observed with treatment. Our analyses suggest the need for early assessment of difficulties with treatment, highlighting the importance of modifiable factors that may contribute to better adherence to the treatment protocol.
2011-01-01
Background This paper analyses the relationship between public perceptions of access to general practitioners (GPs) surgeries and hospitals against health status, car ownership and geographic distance. In so doing it explores the different dimensions associated with facility access and accessibility. Methods Data on difficulties experienced in accessing health services, respondent health status and car ownership were collected through an attitudes survey. Road distances to the nearest service were calculated for each respondent using a GIS. Difficulty was related to geographic distance, health status and car ownership using logistic generalized linear models. A Geographically Weighted Regression (GWR) was used to explore the spatial non-stationarity in the results. Results Respondent long term illness, reported bad health and non-car ownership were found to be significant predictors of difficulty in accessing GPs and hospitals. Geographic distance was not a significant predictor of difficulty in accessing hospitals but was for GPs. GWR identified the spatial (local) variation in these global relationships indicating locations where the predictive strength of the independent variables was higher or lower than the global trend. The impacts of bad health and non-car ownership on the difficulties experienced in accessing health services varied spatially across the study area, whilst the impacts of geographic distance did not. Conclusions Difficulty in accessing different health facilities was found to be significantly related to health status and car ownership, whilst the impact of geographic distance depends on the service in question. GWR showed how these relationships were varied across the study area. This study demonstrates that the notion of access is a multi-dimensional concept, whose composition varies with location, according to the facility being considered and the health and socio-economic status of the individual concerned. PMID:21787394
Current nuclear employees with psychological difficulties: prevalence, assessment, and disposition
International Nuclear Information System (INIS)
Sajwaj, T.; Chardos, S.; Lavin, P.; Ford, T.; McGee, R.K.
1987-01-01
Although industry standards and federal regulations require employees of nuclear power plants to demonstrate psychological stability and sound judgment before being initially granted unescorted access to the plant, it is obvious that emotional difficulties can develop subsequently. The development of emotional problems in current plant employees raises concerns about the safety of the public and the plant, the effectiveness of the organizations, the loss of important technical skills and experience, and the human cost to the employee and his/her family. This paper reports the experience of the Tennessee Valley Authority (TVA) in cases of reconsideration of psychological clearance of unescorted access, i.e., the review of psychological clearances of nuclear plant employees who have developed psychological difficulties
Complication with Intraosseous Access: Scandinavian Users’ Experience
Hallas, Peter; Brabrand, Mikkel; Folkestad, Lars
2013-01-01
Introduction: Intraosseous access (IO) is indicated if vascular access cannot be quickly established during resuscitation. Complication rates are estimated to be low, based on small patient series, model or cadaver studies, and case reports. However, user experience with IO use in real-life emergency situations might differ from the results in the controlled environment of model studies and small patient series. We performed a survey of IO use in real-life emergency situations to assess users’ experiences of complications. Methods: An online questionnaire was sent to Scandinavian emergency physicians, anesthesiologists and pediatricians. Results: 1,802 clinical cases of IO use was reported by n=386 responders. Commonly reported complications with establishing IO access were patient discomfort/pain (7.1%), difficulties with penetration of periosteum with IO needle (10.3%), difficulties with aspiration of bone marrow (12.3%), and bended/broken needle (4.0%). When using an established IO access the reported complications were difficulties with injection fluid and drugs after IO insertion (7.4%), slow infusion (despite use of pressure bag) (8.8%), displacement after insertion (8.5%), and extravasation (3.7%). Compartment syndrome and osteomyelitis occurred in 0.6% and 0.4% of cases respectively. Conclusion: In users’ recollection of real-life IO use, perceived complications were more frequent than usually reported from model studies. The perceived difficulties with using IO could affect the willingness of medical staff to use IO. Therefore, user experience should be addressed both in education of how to use, and research and development of IOs. PMID:24106537
Complication with Intraosseous Access: Scandinavian Users' Experience
Directory of Open Access Journals (Sweden)
Peter Hallas
2013-09-01
Full Text Available Introduction: Intraosseous access (IO is indicated if vascular access cannot be quickly established during resuscitation. Complication rates are estimated to be low, based on small patient series, model or cadaver studies, and case reports. However, user experience with IO use in real-life emergency situations might differ from the results in the controlled environment of model studies and small patient series. We performed a survey of IO use in real-life emergency situations to assess users’ experiences of complications.Methods: An online questionnaire was sent to Scandinavian emergency physicians, anesthesiologists and pediatricians.Results: 1,802 clinical cases of IO use was reported by n=386 responders. Commonly reported complications with establishing IO access were patient discomfort/pain (7.1%, difficulties with penetration of periosteum with IO needle (10.3%, difficulties with aspiration of bone marrow (12.3%, and bended/broken needle (4.0%. When using an established IO access the reported complications were difficulties with injection fluid and drugs after IO insertion (7.4%, slow infusion (despite use of pressure bag (8.8%, displacement after insertion (8.5%, and extravasation (3.7%. Compartment syndrome and osteomyelitis occurred in 0.6% and 0.4% of cases respectively.Conclusion: In users’ recollection of real-life IO use, perceived complications were more frequent than usually reported from model studies. The perceived difficulties with using IO could affect the willingness of medical staff to use IO. Therefore, user experience should be addressed both in education of how to use, and research and development of IOs. [West J Emerg Med. 2013;14(5:440–443.
Diagnosing companies in financial difficulty based on the auditor’s report
Directory of Open Access Journals (Sweden)
Robert Zenzerović
2016-04-01
Full Text Available The approach used in this paper expands on existing research that focuses on devising prediction models for companies experiencing financial difficulties and which in turn serves as a criteria-based diagnosis tool for distinguishing healthy companies from those facing seriously financial difficulties. It draws on auditors’ reports on company financial statements that emphasize a company’s ability to continue as a going concern as the main criterion used to distinguish companies experiencing financial difficulties from companies that are not. Two closely-related hypotheses were tested in this paper. First, the authors tested the hypothesis that an auditor’s report accompanied by an explanatory paragraph pointing out issues associated with the going concern assumption is the proper criterion for differentiating companies experiencing financial difficulties from those that are not. Second, the central assumption that is tested relates to a combination of financial ratios whereby authors presume that an appropriate combination of financial ratios is a good analytical tool for distinguishing companies experiencing serious financial difficulties from those that are not. Research results conducted among 191 companies listed on the Zagreb Stock Exchange confirm both hypotheses. The LRA model – a diagnosis tool for identifying companies with financial problems, was also derived using logistic regression analysis. The statistical adequacy and quality of the model was tested using measures like Nagelkerke R2, type 1 and type 2 errors that appear when calculating the classification ability of the model. All measures indicated that model was statistically sufficient and validated its use as a diagnosis tool in recognizing the companies facing financial difficulties.
Male professional footballers' experiences of mental health difficulties and help-seeking.
Wood, Susan; Harrison, Lesley K; Kucharska, Jo
2017-05-01
Male professional footballers (soccer) represent an at-risk population of developing mental health difficulties and not accessing professional support. One in four current footballers report mental health difficulties. Higher prevalence is reported after retirement. This qualitative study aimed to provide in-depth insight into male professional footballers' lived experiences of mental health difficulties and help-seeking. Seven participants were interviewed. Data were analysed using interpretative phenomenological analysis. One superordinate theme emerged; 'Survival'. This related to survival in the professional football world, of mental health difficulties and after transition into the 'real world'. Six subordinate themes are explored alongside literature pertaining to male mental health, identity, injury, transition, and emotional development. Shame, stigma, fear and level of mental health literacy (knowledge of mental health and support) were barriers to help-seeking. Support for professional footballers' mental wellbeing requires improvement. Recommendations are made for future research, mental health education and support.
Accessing and Selecting Word Meaning in Autism Spectrum Disorder
Henderson, L. M.; Clarke, P. J.; Snowling, M. J.
2011-01-01
Background: Comprehension difficulties are commonly reported in autism spectrum disorder (ASD) but the causes of these difficulties are poorly understood. This study investigates how children with ASD access and select meanings of ambiguous words to test four hypotheses regarding the nature of their comprehension difficulties: semantic deficit,…
Sonik, Rajan A.; Parish, Susan L.; Akorbirshoev, Ilhom; Son, Esther; Rosenthal, Eliana
2014-01-01
Purpose: To provide estimates for the prevalence of parent-reported speech-language difficulties in U.S. children, and to describe the levels of health care access and material hardship in this population. Method: We tabulated descriptive and bivariate statistics using cross-sectional data from the 2007 and 2011/2012 iterations of the National…
Accessing VA Healthcare During Large-Scale Natural Disasters.
Der-Martirosian, Claudia; Pinnock, Laura; Dobalian, Aram
2017-01-01
Natural disasters can lead to the closure of medical facilities including the Veterans Affairs (VA), thus impacting access to healthcare for U.S. military veteran VA users. We examined the characteristics of VA patients who reported having difficulty accessing care if their usual source of VA care was closed because of natural disasters. A total of 2,264 veteran VA users living in the U.S. northeast region participated in a 2015 cross-sectional representative survey. The study used VA administrative data in a complex stratified survey design with a multimode approach. A total of 36% of veteran VA users reported having difficulty accessing care elsewhere, negatively impacting the functionally impaired and lower income VA patients.
Discrimination, Other Psychosocial Stressors, and Self-Reported Sleep Duration and Difficulties
Slopen, Natalie; Williams, David R.
2014-01-01
Objectives: To advance understanding of the relationship between discrimination and sleep duration and difficulties, with consideration of multiple dimensions of discrimination, and attention to concurrent stressors; and to examine the contribution of discrimination and other stressors to racial/ ethnic differences in these outcomes. Design: Cross-sectional probability sample. Setting: Chicago, IL. Participants: There were 2,983 black, Hispanic, and white adults. Measurements and Results: Outcomes included self-reported sleep duration and difficulties. Discrimination, including racial and nonracial everyday and major experiences of discrimination, workplace harassment and incivilities, and other stressors were assessed via questionnaire. In models adjusted for sociodemographic characteristics, greater exposure to racial (β = -0.14)) and nonracial (β = -0.08) everyday discrimination, major experiences of discrimination attributed to race/ethnicity (β = -0.17), and workplace harassment and incivilities (β = -0.14) were associated with shorter sleep (P stressors (i.e., acute events, childhood adversity, and financial, community, employment, and relationship stressors). Racial (β = 0.04) and non-racial (β = 0.05) everyday discrimination and racial (β = 0.04) and nonracial (β = 0.04) major experiences of discrimination, and workplace harassment and incivilities (β = 0.04) were also associated with more (log) sleep difficulties, and associations between racial and nonracial everyday discrimination and sleep difficulties remained after adjustment for other stressors (P 0.05). Conclusions: Discrimination was associated with shorter sleep and more sleep difficulties, independent of socioeconomic status and other stressors, and may account for some of the racial/ethnic differences in sleep. Citation: Slopen N; Williams DR. Discrimination, other psychosocial stressors, and self-reported sleep duration and difficulties. SLEEP 2014;37(1):147-156. PMID:24381373
Difficulties in emotion regulation and risky driving among Lithuanian drivers.
Šeibokaitė, Laura; Endriulaitienė, Auksė; Sullman, Mark J M; Markšaitytė, Rasa; Žardeckaitė-Matulaitienė, Kristina
2017-10-03
Risky driving is a common cause of traffic accidents and injuries. However, there is no clear evidence of how difficulties in emotion regulation contribute to risky driving behavior, particularly in small post-Soviet countries. The present study aimed to investigate the relationship between difficulties in emotion regulation and self-reported risky driving behavior in a sample of Lithuanian drivers. A total of 246 nonprofessional Lithuanian drivers participated in a cross-sectional survey. Difficulties in emotion regulation were assessed using the Difficulties in Emotion Regulation Scale (DERS; Gratz and Roemer 2004), and risky driving behavior was assessed using the Manchester Driver Behaviour Questionnaire (DBQ; Lajunen et al. 2004). Males scored higher than females in aggressive violations and ordinary violations. Females scored higher for the nonacceptance of emotional responses, whereas males had more difficulties with emotional awareness than females. More difficulties in emotion regulation were positively correlated with driving errors, lapses, aggressive violations, and ordinary violations for both males and females. Structural equation modeling showed that difficulties in emotion regulation explained aggressive and ordinary violations more clearly than lapses and errors. When controlling for interactions among the distinct regulation difficulties, difficulties with impulse control and difficulties engaging in goal-directed behavior predicted risky driving. Furthermore, nonacceptance of emotional responses and limited access to emotion regulation strategies were related to less violations and more driving errors. Emotion regulation difficulties were associated with the self-reported risky driving behaviors of Lithuanian drivers. This provides useful hints for improving driver training programs in order to prevent traffic injuries.
Francis, Wendy S; Tokowicz, Natasha; Kroll, Judith F
2014-01-01
Repetition priming was used to assess how proficiency and the ease or difficulty of lexical access influence bilingual translation. Two experiments, conducted at different universities with different Spanish-English bilingual populations and materials, showed repetition priming in word translation for same-direction and different-direction repetitions. Experiment 1, conducted in an English-dominant environment, revealed an effect of translation direction but not of direction match, whereas Experiment 2, conducted in a more balanced bilingual environment, showed an effect of direction match but not of translation direction. A combined analysis on the items common to both studies revealed that bilingual proficiency was negatively associated with response time (RT), priming, and the degree of translation asymmetry in RTs and priming. An item analysis showed that item difficulty was positively associated with RTs, priming, and the benefit of same-direction over different-direction repetition. Thus, although both participant accuracy and item accuracy are indices of learning, they have distinct effects on translation RTs and on the learning that is captured by the repetition-priming paradigm.
Students' Motivation to Access Academic Advising Services
Henning, Marcus A.
2009-01-01
The interrelationships between motivation for choosing a program of study, intention to access academic advisors, academic difficulty, and actual appointments with academic advisors were based on student self-reports of motivation and intentions. In addition, academic achievement measures and data on student access to academic advisors were…
Validity of a Protocol for Adult Self-Report of Dyslexia and Related Difficulties
Snowling, Margaret; Dawes, Piers; Nash, Hannah; Hulme, Charles
2012-01-01
Background There is an increased prevalence of reading and related difficulties in children of dyslexic parents. In order to understand the causes of these difficulties, it is important to quantify the risk factors passed from parents to their offspring. Method 417 adults completed a protocol comprising a 15-item questionnaire rating reading and related skills and a scale assessing ADHD symptoms; 344 completed reading, nonword reading and spelling tests. Results A confirmatory factor analysis with four factors (Reading, Word Finding, Attention and Hyperactivity) provided a reasonable fit to the data. The Reading Factor showed robust correlations with measured literacy skills. Adults who reported as dyslexic, or rated their reading difficulties as more severe, gained lower scores on objective measures of literacy skills. Although the sensitivity of the new scale was acceptable, it tended to miss some cases of low literacy. Conclusions Self-report scales of reading and of attention difficulties are useful for identifying adults with reading and attention difficulties which may confer risks on their children of related problems. It is important for research following children at family risk of dyslexia to be aware of these effects. Copyright © 2012 John Wiley & Sons, Ltd. PMID:22271419
Spyridakou, Chrysa; Luxon, Linda M; Bamiou, Doris E
2012-07-01
To compare self-reported symptoms of difficulty hearing speech in noise and hyperacusis in adults with auditory processing disorders (APDs) and normal controls; and to compare self-reported symptoms to objective test results (speech in babble test, transient evoked otoacoustic emission [TEOAE] suppression test using contralateral noise). A prospective case-control pilot study. Twenty-two participants were recruited in the study: 10 patients with reported hearing difficulty, normal audiometry, and a clinical diagnosis of APD; and 12 normal age-matched controls with no reported hearing difficulty. All participants completed the validated Amsterdam Inventory for Auditory Disability questionnaire, a hyperacusis questionnaire, a speech in babble test, and a TEOAE suppression test using contralateral noise. Patients had significantly worse scores than controls in all domains of the Amsterdam Inventory questionnaire (with the exception of sound detection) and the hyperacusis questionnaire (P reported symptoms of difficulty hearing speech in noise and speech in babble test results in the right ear (ρ = 0.624, P = .002), and between self-reported symptoms of hyperacusis and TEOAE suppression test results in the right ear (ρ = -0.597 P = .003). There was no significant correlation between the two tests. A strong correlation was observed between right ear speech in babble and patient-reported intelligibility of speech in noise, and right ear TEOAE suppression by contralateral noise and hyperacusis questionnaire. Copyright © 2012 The American Laryngological, Rhinological, and Otological Society, Inc.
Complication with intraosseous access
DEFF Research Database (Denmark)
Hallas, Peter; Brabrand, Mikkel; Folkestad, Lars
2013-01-01
with aspiration of bone marrow (12.3%), and bended/broken needle (4.0%). When using an established IO access the reported complications were difficulties with injection fluid and drugs after IO insertion (7.4%), slow infusion (despite use of pressure bag) (8.8%), displacement after insertion (8...
Discrimination, other psychosocial stressors, and self-reported sleep duration and difficulties.
Slopen, Natalie; Williams, David R
2014-01-01
To advance understanding of the relationship between discrimination and sleep duration and difficulties, with consideration of multiple dimensions of discrimination, and attention to concurrent stressors; and to examine the contribution of discrimination and other stressors to racial/ ethnic differences in these outcomes. Cross-sectional probability sample. Chicago, IL. There were 2,983 black, Hispanic, and white adults. Outcomes included self-reported sleep duration and difficulties. Discrimination, including racial and nonracial everyday and major experiences of discrimination, workplace harassment and incivilities, and other stressors were assessed via questionnaire. In models adjusted for sociodemographic characteristics, greater exposure to racial (β = -0.14)) and nonracial (β = -0.08) everyday discrimination, major experiences of discrimination attributed to race/ethnicity (β = -0.17), and workplace harassment and incivilities (β = -0.14) were associated with shorter sleep (P discrimination attributed to race/ethnicity and sleep duration (β = -0.09, P discrimination and racial (β = 0.04) and nonracial (β = 0.04) major experiences of discrimination, and workplace harassment and incivilities (β = 0.04) were also associated with more (log) sleep difficulties, and associations between racial and nonracial everyday discrimination and sleep difficulties remained after adjustment for other stressors (P discrimination (P > 0.05). Discrimination was associated with shorter sleep and more sleep difficulties, independent of socioeconomic status and other stressors, and may account for some of the racial/ethnic differences in sleep.
Gratz, Kim L; Tull, Matthew T; Matusiewicz, Alexis M; Breetz, Alisa A; Lejuez, C W
2013-10-01
Despite a robust association between borderline personality disorder (BPD) and emotion dysregulation, evidence of within-BPD group differences in emotion regulation (ER) difficulties highlights the need to examine factors that increase the risk for ER difficulties within BPD. One factor that warrants consideration is co-occurring avoidant personality disorder (AVPD), the presence of which is associated with worse outcomes in and outside of BPD and theorized to interfere with adaptive ER. Thus, this study examined if co-occurring AVPD among women with BPD is associated with heightened ER difficulties (assessed across self-report, behavioral, and physiological domains). Participants included 39 women with BPD (13 with co-occurring AVPD) and 18 women without BPD. Although results revealed no significant differences in overall self-reported ER difficulties (or the specific dimensions involving emotional clarity and the control of behaviors when distressed) between BPD participants with and without AVPD (with both groups reporting greater ER difficulties than non-BPD participants), other ER difficulties were found to be heightened among BPD participants with AVPD. Specifically, BPD participants with (vs. without) AVPD reported greater difficulties accessing effective ER strategies, evidenced less willingness to experience distress on a laboratory stressor, and exhibited a greater decrease in high frequency heart rate variability in response to this stressor (indicative of poor ER capacity). Findings add to the literature on ER difficulties in BPD, suggesting that co-occurring AVPD within BPD may be associated with a lower capacity for regulating distress and greater difficulties accessing effective ER strategies, potentially leading to greater efforts to avoid emotional distress. PsycINFO Database Record (c) 2013 APA, all rights reserved.
Robotic single-access splenectomy using the Da Vinci Single-Site® platform: a case report.
Corcione, Francesco; Bracale, Umberto; Pirozzi, Felice; Cuccurullo, Diego; Angelini, Pier Luigi
2014-03-01
Single-access laparoscopic splenectomy can offer patients some advantages. It has many difficulties, such as instrument clashing, lack of triangulation, odd angles and lack of space. The Da Vinci Single-Site® robotic surgery platform could decrease these difficulties. We present a case of single-access robotic splenectomy using this device. A 37 year-old female with idiopathic thrombocytopenic purpura was operated on with a single-site approach, using the Da Vinci Single-Site robotic surgery device. The procedure was successfully completed in 140 min. No intraoperative and postoperative complications occurred. The patient was discharged from hospital on day 3. Single-access robotic splenectomy seems to be feasible and safe using the new robotic single-access platform, which seems to overcome certain limits of previous robotic or conventional single-access laparoscopy. We think that additional studies should also be performed to explore the real cost-effectiveness of the platform. Copyright © 2013 John Wiley & Sons, Ltd.
Adolescent Bullying and Sleep Difficulties
Directory of Open Access Journals (Sweden)
Simon C. Hunter
2014-11-01
Full Text Available This study evaluated whether adolescents who report having been bullied, being bullies, or report both being a bully and being bullied experience more sleep difficulties than children uninvolved in bullying. The study drew upon cognitive theories of insomnia, investigating whether the extent to which young people report worrying about bullying can moderate associations between victimization and sleep difficulties. Participants were 5420 adolescents who completed a self-report questionnaire. Pure Victims (OR = 1.72, 95% CI [1.07, 2.75], Pure Bullies (OR = 1.80, 95% CI [1.16, 2.81], and Bully-Victims (OR = 2.90, 95% CI [1.17, 4.92] were all more likely to experience sleep difficulties when compared to uninvolved young people. The extent to which young people reported worrying about being bullied did not moderate the links between victimization and sleep difficulties. In this way, bullying is clearly related to sleep difficulties among adolescents but the conceptual reach of the cognitive model of insomnia in this domain is questioned.
Epidemiological profile of patients with nephropathy and the difficulties in access to treatment
Directory of Open Access Journals (Sweden)
Rafaella Maria Monteiro Sampaio
2013-03-01
Full Text Available Objective: To describe the epidemiological profile of patients undergoing treatment for renal replacement therapy in dialysis modality, and to identify the difficulties in its realization. Methods: This is a cross-sectional study conducted in Itapipoca-CE, comprising 35 patients with chronic renal failure (CRF. The general data was analyzed descriptively using absolute and percentage frequencies. Results: The epidemiological profile of patients shows a higher frequency of: males (19 - 54.3% aged between 31 and 60 (24 - 68.6%, low education (29 - 82.8%, family incomes of 1 to 2 minimum wages (25 - 71.4%, living in houses of masonry (30 - 85.7% with treated water provided in their homes (17 - 48.6%. The main signs and symptoms that led to seeking medical consultation were: general weakness (21 - 60.0%, nausea (19 - 54.3%, edema (18 - 51.4% and lack of appetite (14 - 40.0%. The features most frequently mentioned by the patients as probable causes to CRF were: association of hypertension with diabetes mellitus (11 - 31.4%, hypertension (9 - 25.7% and glomerulonephritis (5 - 14.3%. Most patients reported difficulty in obtaining medical appointment (25 - 71.4% and scheduling/receiving exams (20 - 57.1%. Conclusion: The epidemiological profile of patients studied is marked by a low socioeconomic status. As aggravating factors to this situation, there was the difficulty in getting appointments, scheduling and performing diagnostic tests, which undermines the treatment.
Researching Learning Difficulties: A Guide for Practitioners
Porter, Jill; Lacey, Penny
2005-01-01
The aim of this book is to provide a source for teachers and other professionals working with children and adults with learning difficulties and disabilities that will enable them to: (1) access selected recent and relevant research in the field of learning difficulties, drawn from a range of disciplines and groups of people; (2) reflect on…
Takasaki, Hiroshi; Treleaven, Julia; Johnston, Venerina; Jull, Gwendolen
2013-08-15
Cross-sectional. To conduct a preliminary analysis of the physical, cognitive, and psychological domains contributing to self-reported driving difficulty after adjusting for neck pain, dizziness, and relevant demographics in chronic whiplash-associated disorders (WAD) using hierarchical regression modeling. Pain is a risk factor for car crashes, and dizziness may affect fitness to drive. Both symptoms are common in chronic WAD and difficulty driving is a common complaint in this group. Chronic WAD is often accompanied by physical, cognitive, and psychological impairments. These impairments may contribute to self-reported driving difficulty beyond neck pain, dizziness, and relevant demographics. Forty individuals with chronic WAD participated. Dependent variables were the magnitude of self-reported driving difficulty assessed in the strategic, tactical, and operational levels of the Neck Pain Driving Index. Three models were developed to assess the contributions of independent variables (physical, cognitive, and psychological domains) to each of the 3 dependent variables after adjusting for neck pain intensity, dizziness, and driving demographics. The measures included were: physical domain-range and maximum speed of head rotation, performances during gaze stability, eye-head coordination, and visual dependency tests; cognitive domain-self-reported cognitive symptoms including fatigue and the trail making tests; and psychological domain-general stress, traumatic stress, depression, and fear of neck movements and driving. Symptom duration was relevant to driving difficulty in the strategic and tactical levels. The cognitive domain increased statistical power to estimate the strategic and operational levels (P < 0.1) beyond other contributors. The physical domain increased statistical power to estimate the tactical level (P < 0.1) beyond other contributors. Physical and cognitive impairments independently contributed to self-reported driving difficulty in chronic WAD
Anmyr, Lena; Larsson, Kjerstin; Olsson, Mariann; Freijd, Anders
2012-08-01
The aim was to explore and compare how children with cochlear implants, their parents, and their teachers perceive the children's mental health in terms of emotional and behavioral strengths and difficulties. The self-report, parents', and teachers' versions of the Strengths and Difficulties Questionnaire (SDQ) were used to assess the mental health of 22 children with cochlear implants. The children's assessments were then compared to the parents' and 17 teachers' assessments. The data were analyzed using the SPSS software package. Total difficulties (p=.000), emotional symptoms (p=.000), and conduct problems (p=.007) were greater according to the children than according to parents and teachers. Younger children (9 years, n=12) reported more emotional symptoms than older children (12 and 15 years, n=10). Almost a quarter of the children rated themselves in a way indicating mental ill-health. Parents and teachers each indicated mental ill-health for one child. Children with cochlear implants express greater concerns about their mental health than their parents and teachers do. This is important knowledge for adults in families, schools, and health care in order to support these children and offer treatment when needed. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.
Accessibility to health services by persons with disabilities.
Castro, Shamyr Sulyvan; Lefèvre, Fernando; Lefèvre, Ana Maria Cavalcanti; Cesar, Chester Luiz Galvão
2011-02-01
To analyze the difficulties in accessibility to health services experienced by persons with disabilities. A qualitative study was performed with individuals who reported having a certain type of disability (paralysis or amputation of limbs; low vision, unilateral or total blindness; low hearing, unilateral or total deafness). A total of 25 individuals (14 women) were interviewed in the city of São Paulo, Southeastern Brazil, between June and August 2007, responding to questions about transportation and accessibility to health services. Collective Subject Discourse was the methodology used to analyze results and analyses were performed with the Qualiquantisoft software. The analysis of discourses on transportation to health services revealed a diversity in terms of the user going to the service alone or accompanied; using a private car, public transportation or ambulance or walking; and requiring different times to arrive at the service. With regard to the difficulties in accessibility to health services, there were reports of delayed service, problems with parking, and lack of ramps, elevators, wheelchairs, doctors and adapted toilets. Individuals with a certain type of disability used various means of transportation, requiring someone to accompany them in some cases. Problems with accessibility to health services were reported by persons with disabilities, contradicting the principle of equity, a precept of the Brazilian Unified Health System.
Difficulties in daily life reported by patients with homonymous visual field defects
Heutink, Jochem; de Haan, Gera; Melis-Dankers, Bart; Brouwer, Wiebo; Tucha, Oliver
2015-01-01
Background: Homonymous visual field defects (HVFDs) are a common consequence of posterior brain injury and may have a substantial influence on ADL and participation in society. In this study we analysed self-reported visionrelated difficulties in daily life in a group of patients with HVFDs.
Zhang, Hui; Wang, Zhenhong; You, Xuqun; Lü, Wei; Luo, Yun
2015-09-01
The aim of the current study was to examine the direct and interactive effects of two types of narcissism (overt and covert) and respiratory sinus arrhythmia (RSA) reactivity on emotion regulation difficulties in 227 undergraduate students. Overt and covert narcissism and emotion regulation difficulties were assessed with self-report measures (narcissistic personality inventory (NPI)-16, hypersensitive narcissism scale (HSNS), and difficulties in emotion regulation scale (DERS)), and physiological data were measured during the baseline, stress (a public-speaking task), and recovery periods in the laboratory. Results indicated that overt narcissism was negatively related to a lack of emotional awareness and emotional clarity, whereas covert narcissism was positively related to overall emotion regulation difficulties, nonacceptance of emotional responses, impulse control difficulties, limited access to emotion regulation strategies, and a lack of emotional clarity. RSA reactivity in response to a mock job interview moderated the associations between covert narcissism (as a predictor) and overall emotion regulation difficulties and impulse control difficulties (as outcomes). This finding showed that a greater stress-induced RSA decrease may serve as a protective factor and ameliorate the effect of covert narcissism on individuals' emotion regulation difficulties. Copyright © 2015 Elsevier B.V. All rights reserved.
Repair of traumatic tricuspid insufficiency via minimally invasive port access.
Kasahara, Hirofumi; Kudo, Mikihiko; Kawajiri, Hiroyuki; Yozu, Ryohei
2010-04-01
We report on a successful tricuspid valve plasty using port-access minimally invasive cardiac surgery (MICS) for severe traumatic tricuspid insufficiency caused by blunt chest trauma suffered 15 years previously. A combination repair procedure, consisting of cleft closures, plication of the anteroseptal commissure, and ring annuloplasty, was necessary to achieve valve competence and proved possible via port access without difficulty. Port-access MICS is an alternative approach for tricuspid valve surgery.
Undergraduate ESL Students’ Difficulties in Writing the Introduction for Research Reports
Directory of Open Access Journals (Sweden)
Mirrah Diyana Binti Maznun
2017-02-01
Full Text Available This study was conducted to investigate the difficulties encountered by undergraduate ESL students in writing the introduction section of their project reports. Five introduction sections of bachelor of arts students, majoring in English language, were analyzed and a lecturer was interviewed regarding the areas of the students’ weaknesses. Swales’ create-a-research-space (cars model was used as the analytical framework of the study. The results revealed that students confronted problems in writing their introduction for each move especially for move 2, which consists of counter claiming, indicating research gap, raising questions from previous research and continuing tradition. It was also found that the students had difficulty in writing the background of the study, theoretical framework, and statement of the problem which indicated their unawareness of the appropriate rhetorical structure of the introduction section.
The global burden of visual difficulty in low, middle, and high income countries.
Directory of Open Access Journals (Sweden)
Ellen E Freeman
Full Text Available Using a world-wide, population-based dataset of adults, we sought to determine the frequency of far visual difficulty and its associated risk factors.The World Health Survey (WHS was conducted in 70 countries throughout the world in 2003 using a random, multi-stage, stratified, cluster sampling design of adults ages 18 years and older. Far vision was assessed by asking "In the last 30 days, how much difficulty did you have in seeing and recognizing a person you know across the road (i.e. from a distance of about 20 meters?". Responses included none, mild, moderate, severe, or extreme/unable. The income status of countries was estimated using gross national income per capita data from 2003 from the World Bank. Prevalence and regression estimates were adjusted to account for the complex sample design.21% of adults reported any visual difficulty. The rate varied by the income status of the country with the percentage who had any visual difficulty being 24%, 23%, and 13% in low, middle, and high income countries, respectively. Five percent of people reported severe or extreme visual difficulty with rates in low, middle, and high income countries of 6%, 5%, and 2% respectively. Risk factors for visual difficulty included older age, female sex, poorer socioeconomic status, little to no formal education, and diabetes (P<0.05.One out of five adults in the WHS reported some degree of far visual difficulty. Given the importance of vision to living an independent life, better access to quality eye care services and life course factors affecting vision health (e.g. repeated eye infections, diet lacking vitamin A must receive adequate attention and resources, especially in low and middle income countries.
50 CFR 660.313 - Open access fishery-recordkeeping and reporting.
2010-10-01
... 50 Wildlife and Fisheries 9 2010-10-01 2010-10-01 false Open access fishery-recordkeeping and... West Coast Groundfish-Open Access Fisheries § 660.313 Open access fishery—recordkeeping and reporting... to open access fisheries. (b) Declaration reports for vessels using nontrawl gear. Declaration...
Surgical difficulties for Total Knee Replacement in Stickler syndrome: A case report
Verma, Gopalkrishna G; Zarough, Adel; Suraliwala, KH
2008-01-01
Stickler syndrome is believed to be the most common connective tissue disorder in Europe and the USA. Severe osteoarthritis sets in at very early age in 3rd to 4th decade of life necessitating joint arthroplasty. This case report highlights the intraoperative surgical difficulties faced by the surgeon and the planning needed for the operation. PMID:18816376
Screening Bilingual Preschoolers for Language Difficulties: Utility of Teacher and Parent Reports
Pua, Emmanuel Peng Kiat; Lee, Mary Lay Choo; Rickard Liow, Susan J.
2017-01-01
Purpose: The utility of parent and teacher reports for screening 3 types of bilingual preschoolers (English-first language [L1]/Mandarin-second language[L2], Mandarin-L1/English-L2, or Malay-L1/English-L2) for language difficulty was investigated in Singapore with reference to measures of reliability, validity, sensitivity, and specificity in an…
Kinds of access: different methods for report reveal different kinds of metacognitive access
Overgaard, Morten; Sandberg, Kristian
2012-01-01
In experimental investigations of consciousness, participants are asked to reflect upon their own experiences by issuing reports about them in different ways. For this reason, a participant needs some access to the content of her own conscious experience in order to report. In such experiments, the reports typically consist of some variety of ratings of confidence or direct descriptions of one's own experiences. Whereas different methods of reporting are typically used interchangeably, recent experiments indicate that different results are obtained with different kinds of reporting. We argue that there is not only a theoretical, but also an empirical difference between different methods of reporting. We hypothesize that differences in the sensitivity of different scales may reveal that different types of access are used to issue direct reports about experiences and metacognitive reports about the classification process. PMID:22492747
Access to bank finance for Scottish SMEs.
North, David J.; Baldock, Robert; Deakins, David; Whittam, Geoff
2008-01-01
There is evidence that some SMEs may still face difficulties in accessing bank finance from lenders (CEEDR, 2007). This paper reports an in-depth study into demand and supply side issues relating to access to bank finance by Scottish SMEs and whether there is still market\\ud failure associated with good, bankable business cases from SMEs that do not receive finance. We argue that our study utilises innovative methodology and is relatively rare as a robust study in this area. We combine demand...
Benfer, Katherine A; Weir, Kelly A; Ware, Robert S; Davies, Peter S W; Arvedson, Joan; Boyd, Roslyn N; Bell, Kristie L
2017-11-01
To determine the most accurate parent-reported indicators for detecting (1) feeding/swallowing difficulties and (2) undernutrition in preschool-aged children with cerebral palsy (CP). This was a longitudinal, population-based study, involving 179 children with CP, aged 18 to 60 months (mean 34.1mo [SD 11.9] at entry, 111 males, 68 females [Gross Motor Function Classification System level I, 84; II, 23; III, 28; IV, 18; V, 26], 423 data points). Feeding/swallowing difficulties were determined by the Dysphagia Disorders Survey and 16 signs suggestive of pharyngeal phase impairment. Undernutrition was indicated by height-weight and skinfold composite z-scores less than -2. Primary parent-reported indicators included mealtime duration, mealtime stress, concern about growth, and respiratory problems. Other indicators were derived from a parent feeding questionnaire, including 'significant difficulty eating and drinking'. Data were analysed using multilevel mixed-effects regression and diagnostic statistics. Primary parent-reported indicators associated with feeding/swallowing were 'moderate-severe parent stress' (odds ratio [OR]=3.2 [95% confidence interval {CI} 1.3-7.8]; ppalsy. Most accurate screening questions were 0-10 scales for 'difficulty eating' and 'difficulty drinking'. Supplementation of these scales with additional indicators would improve detection. © 2017 Mac Keith Press.
Amante, Daniel J; Hogan, Timothy P; Pagoto, Sherry L; English, Thomas M; Lapane, Kate L
2015-04-29
The insurance mandate of the Affordable Care Act has increased the number of people with health coverage in the United States. There is speculation that this increase in the number of insured could make accessing health care services more difficult. Those who are unable to access care in a timely manner may use the Internet to search for information needed to answer their health questions. The aim was to determine whether difficulty accessing health care services for reasons unrelated to insurance coverage is associated with increased use of the Internet to obtain health information. Survey data from 32,139 adults in the 2011 National Health Interview Study (NHIS) were used in this study. The exposure for this analysis was reporting difficulty accessing health care services or delaying getting care for a reason unrelated to insurance status. To define this exposure, we examined 8 questions that asked whether different access problems occurred during the previous 12 months. The outcome for this analysis, health information technology (HIT) use, was captured by examining 2 questions that asked survey respondents if they used an online health chat room or searched the Internet to obtain health information in the previous 12 months. Several multinomial logistic regressions estimating the odds of using HIT for each reported access difficulty were conducted to accomplish the study objective. Of a survey population of 32,139 adults, more than 15.90% (n=5109) reported experiencing at least one access to care barrier, whereas 3.63% (1168/32,139) reported using online health chat rooms and 43.55% (13,997/32,139) reported searching the Internet for health information. Adults who reported difficulty accessing health care services for reasons unrelated to their health insurance coverage had greater odds of using the Internet to obtain health information. Those who reported delaying getting care because they could not get an appointment soon enough (OR 2.2, 95% CI 1.9-2.5), were
Kinds of access: Different methods for report reveal different kinds of metacognitive access
DEFF Research Database (Denmark)
Overgaard, Morten; Sandberg, Kristian
2012-01-01
that there is not only a theoretical, but also an empirical difference between different methods of reporting. We hypothesize that differences in the sensitivity of different scales may reveal that different types of access are used to issue direct reports about experiences and metacognitive reports about...
Access 2007 forms and reports for dummies
Underdahl, Brian
2013-01-01
Do you have tons and tons of data on your computer but you're not quite sure how to make heads or tails of them-or even organize them? Are you using Access as spreadsheet rather than what it was really meant for? If you have trouble finding meaning in your data, then Access 2007 Forms & Reports for Dummies let you discover the wonders of this highly useful program. This no-nonsense guide gets right down to business by showing you the easy way to use this powerful tool. It gets you started with selective, targeted queries; forms that improve efficiency; and reports that communicate-while sparin
Providers' Access of Imaging Versus Only Reports: A System Log File Analysis.
Jung, Hye-Young; Gichoya, Judy Wawira; Vest, Joshua R
2017-02-01
An increasing number of technologies allow providers to access the results of imaging studies. This study examined differences in access of radiology images compared with text-only reports through a health information exchange system by health care professionals. The study sample included 157,256 historical sessions from a health information exchange system that enabled 1,670 physicians and non-physicians to access text-based reports and imaging over the period 2013 to 2014. The primary outcome was an indicator of access of an imaging study instead of access of a text-only report. Multilevel mixed-effects regression models were used to estimate the association between provider and session characteristics and access of images compared with text-only reports. Compared with primary care physicians, specialists had an 18% higher probability of accessing actual images instead of text-only reports (β = 0.18; P < .001). Compared with primary care practice settings, the probability of accessing images was 4% higher for specialty care practices (P < .05) and 8% lower for emergency departments (P < .05). Radiologists, orthopedists, and neurologists accounted for 79% of all the sessions with actual images accessed. Orthopedists, radiologists, surgeons, and pulmonary disease specialists accessed imaging more often than text-based reports only. Consideration for differences in the need to access images compared with text-only reports based on the type of provider and setting of care are needed to maximize the benefits of image sharing for patient care. Copyright © 2016 American College of Radiology. Published by Elsevier Inc. All rights reserved.
Stack-Cutler, Holly L.; Parrila, Rauno K.; Torppa, Minna
2016-01-01
We examined the impact of the number of comorbid difficulties, social support, and community support on life satisfaction and academic achievement among 120 university students or recent graduates with self-reported reading difficulties. Participants completed a questionnaire assessing perceived social support, perceived community support, the…
Insurance + Access ≠ Health Care: Typology of Barriers to Health Care Access for Low-Income Families
DeVoe, Jennifer E.; Baez, Alia; Angier, Heather; Krois, Lisa; Edlund, Christine; Carney, Patricia A.
2007-01-01
PURPOSE Public health insurance programs have expanded coverage for the poor, and family physicians provide essential services to these vulnerable populations. Despite these efforts, many Americans do not have access to basic medical care. This study was designed to identify barriers faced by low-income parents when accessing health care for their children and how insurance status affects their reporting of these barriers. METHODS A mixed methods analysis was undertaken using 722 responses to an open-ended question on a health care access survey instrument that asked low-income Oregon families, “Is there anything else you would like to tell us?” Themes were identified using immersion/crystallization techniques. Pertinent demographic attributes were used to conduct matrix coded queries. RESULTS Families reported 3 major barriers: lack of insurance coverage, poor access to services, and unaffordable costs. Disproportionate reporting of these themes was most notable based on insurance status. A higher percentage of uninsured parents (87%) reported experiencing difficulties obtaining insurance coverage compared with 40% of those with insurance. Few of the uninsured expressed concerns about access to services or health care costs (19%). Access concerns were the most common among publicly insured families, and costs were more often mentioned by families with private insurance. Families made a clear distinction between insurance and access, and having one or both elements did not assure care. Our analyses uncovered a 3-part typology of barriers to health care for low-income families. CONCLUSIONS Barriers to health care can be insurmountable for low-income families, even those with insurance coverage. Patients who do not seek care in a family medicine clinic are not necessarily getting their care elsewhere. PMID:18025488
Evaluation of ultrasound-guided vascular access in dogs.
Chamberlin, Scott C; Sullivan, Lauren A; Morley, Paul S; Boscan, Pedro
2013-01-01
To describe the technique and determine the feasibility, success rate, perceived difficulty, and time to vascular access using ultrasound guidance for jugular vein catheterization in a cardiac arrest dog model. Prospective descriptive study. University teaching hospital. Nine Walker hounds. A total of 27 jugular catheterizations were performed postcardiac arrest using ultrasound guidance. Catheterizations were recorded based on the order in which they were performed and presence/absence of a hematoma around the vein. Time (minutes) until successful vascular access and perceived difficulty in achieving vascular access (scale of 1 = easy to 10 = difficult) were recorded for each catheterization. Mean time to vascular access was 1.9 minutes (95% confidence interval, 1.1-3.4 min) for catheterizations without hematoma, versus 4.3 minutes (1.8-10.1 min) for catheterizations with hematoma (P = 0.1). Median perceived difficulty was 2 of 10 (range 1-7) for catheterizations without hematoma, versus 2 of 10 (range 1-8) for catheterizations with hematoma (P = 0.3). A learning curve was evaluated by comparing mean time to vascular access and perceived difficulty in initial versus subsequent catheterizations. Mean time to vascular access was 2.5 minutes (1.0-6.4 min) in the initial 13 catheterizations versus 3.3 minutes (1.5-7.5 min) in the subsequent 14 catheterizations (P = 0.6). Median perceived difficulty in the first 13 catheterizations (3, range 1-8) was significantly greater (P = 0.049) than median perceived difficulty in the subsequent 14 catheterizations (2, range 1-6). Ultrasound-guided jugular catheterization is associated with a learning curve but is successful in obtaining rapid vascular access in dogs. Further prospective studies are warranted to confirm the utility of this technique in a clinical setting. © Veterinary Emergency and Critical Care Society 2013.
Oyserman, Daphna; Elmore, Kristen; Novin, Sheida; Fisher, Oliver; Smith, George C.
2018-01-01
Does experiencing difficulty bolster or undermine future self-images, strategies to get there and actual performance? We build on four insights from prior research to predict that accessible interpretation-of-experienced-difficulty mindset shapes identity and performance. First, people have two different interpretation-of-experienced-difficulty mindsets available in memory; their difficulty-as-impossibility mindset focuses attention on difficulty as implying low odds and their difficulty-as-importance mindset focuses attention on difficulty as implying high value. Second, people are sensitive to contextual cues as to which mindset to apply to understand their experienced difficulty. Third, people apply the mindset that comes to mind unless they have reason to question why it is “on-the-mind.” Fourth, social class can be thought of as a chronic context influencing how much people endorse each interpretation-of-experienced-difficulty mindset. We used subtle primes to guide participants’ attention toward either a difficulty-as-importance or a difficulty-as-impossibility mindset (N = 591). Participants guided toward a difficulty-as-importance mindset performed better on difficult academic tasks (Studies 1, 2) than participants guided toward a difficulty-as-impossibility mindset; whether they had more school-focused possible identities and linked strategies depended on sample (Studies 3, 4). For college students, the effect of guided interpretation-of-experienced-difficulty mindset was not moderated by how much participants agreed with that mindset (Studies 1, 3, 4). College students mostly disagreed with a difficulty-as-impossibility mindset, but making that mindset accessible undermined their performance and sometimes their possible identities anyway. In contrast, middle school students (a younger and lower social class sample) were more likely to agree with a difficulty-as-impossibility mindset. In this sample (Study 2), we found an effect of mindset
Tinnitus and Sleep Difficulties After Cochlear Implantation.
Pierzycki, Robert H; Edmondson-Jones, Mark; Dawes, Piers; Munro, Kevin J; Moore, David R; Kitterick, Pádraig T
To estimate and compare the prevalence of and associations between tinnitus and sleep difficulties in a sample of UK adult cochlear implant users and those identified as potential candidates for cochlear implantation. The study was conducted using the UK Biobank resource, a population-based cohort of 40- to 69-year olds. Self-report data on hearing, tinnitus, sleep difficulties, and demographic variables were collected from cochlear implant users (n = 194) and individuals identified as potential candidates for cochlear implantation (n = 211). These "candidates" were selected based on (i) impaired hearing sensitivity, inferred from self-reported hearing aid use and (ii) impaired hearing function, inferred from an inability to report words accurately at negative signal to noise ratios on an unaided closed-set test of speech perception. Data on tinnitus (presence, persistence, and related distress) and on sleep difficulties were analyzed using logistic regression models controlling for gender, age, deprivation, and neuroticism. The prevalence of tinnitus was similar among implant users (50%) and candidates (52%; p = 0.39). However, implant users were less likely to report that their tinnitus was distressing at its worst (41%) compared with candidates (63%; p = 0.02). The logistic regression model suggested that this difference between the two groups could be explained by the fact that tinnitus was less persistent in implant users (46%) compared with candidates (72%; p reported difficulties with sleep were similar among implant users (75%) and candidates (82%; p = 0.28), but participants with tinnitus were more likely to report sleep difficulties than those without (p explanation is supported by the similar prevalence of sleep problems among implant users and potential candidates for cochlear implantation, despite differences between the groups in tinnitus persistence and related emotional distress. Cochlear implantation may therefore not be an appropriate intervention
Stappenbeck, Cynthia A.; Davis, Kelly Cue; Cherf, Nicholas; Gulati, Natasha K.; Kajumulo, Kelly F.
2017-01-01
Because of high rates of heavy drinking and dating violence (psychological or physical aggression toward a dating partner) among college men, we examined whether emotion regulation difficulties moderated the association between heavy drinking and dating violence perpetration. One hundred and fifty-eight men were recruited from a large northwestern US university between April 2014 and August 2014. Participants completed an online survey that assessed their emotion regulation difficulties as well as their past year history of heavy episodic drinking (HED; consuming 5+ drinks in 2 hours) and dating violence perpetration. Generalized linear models revealed that the positive association between HED and dating violence perpetration was stronger for men with greater impulse control difficulties and for those who reported limited access to emotion regulation strategies. In addition to continued efforts to reduce heavy drinking among college men, interventions targeting emotion regulation difficulties should be incorporated into standard dating violence intervention and prevention efforts to further reduce the likelihood of dating violence perpetration in this population. PMID:29147076
LTER network data access policy revision: report and recommendations.
James Brunt; Peter McCartney; Stuart Gage; Don. Henshaw
2004-01-01
This document is a report on work carried out to update the LTER Network Data Access Policy. The current LTER Network Data Access Policy, approved by the coordinating committee in 1997, has been in use since 1990. An analysis of the current policies related to the release, access, and use of LTER data has been undertaken by a sub-committee of the LTER Network...
Patient-reported access to primary care in Ontario: effect of organizational characteristics.
Muggah, Elizabeth; Hogg, William; Dahrouge, Simone; Russell, Grant; Kristjansson, Elizabeth; Muldoon, Laura; Devlin, Rose Anne
2014-01-01
To describe patient-reported access to primary health care across 4 organizational models of primary care in Ontario, and to explore how access is associated with patient, provider, and practice characteristics. Cross-sectional survey. One hundred thirty-seven randomly selected primary care practices in Ontario using 1 of 4 delivery models (fee for service, established capitation, reformed capitation, and community health centres). Patients included were at least 18 years of age, were not severely ill or cognitively impaired, were not known to the survey administrator, had consenting providers at 1 of the participating primary care practices, and were able to communicate in English or French either directly or through a translator. Patient-reported access was measured by a 4-item scale derived from the previously validated adult version of the Primary Care Assessment Tool. Questions were asked about physician availability during and outside of regular office hours and access to health information via telephone. Responses to the scale were normalized, with higher scores reflecting greater patient-reported access. Linear regressions were used to identify characteristics independently associated with access to care. Established capitation model practices had the highest patient-reported access, although the difference in scores between models was small. Our multilevel regression model identified several patient factors that were significantly (P = .05) associated with higher patient-reported access, including older age, female sex, good-to-excellent self-reported health, less mental health disability, and not working. Provider experience (measured as years since graduation) was the only provider or practice characteristic independently associated with improved patient-reported access. This study adds to what is known about access to primary care. The study found that established capitation models outperformed all the other organizational models, including reformed
Devoe, Jennifer E; Baez, Alia; Angier, Heather; Krois, Lisa; Edlund, Christine; Carney, Patricia A
2007-01-01
Public health insurance programs have expanded coverage for the poor, and family physicians provide essential services to these vulnerable populations. Despite these efforts, many Americans do not have access to basic medical care. This study was designed to identify barriers faced by low-income parents when accessing health care for their children and how insurance status affects their reporting of these barriers. A mixed methods analysis was undertaken using 722 responses to an open-ended question on a health care access survey instrument that asked low-income Oregon families, "Is there anything else you would like to tell us?" Themes were identified using immersion/crystallization techniques. Pertinent demographic attributes were used to conduct matrix coded queries. Families reported 3 major barriers: lack of insurance coverage, poor access to services, and unaffordable costs. Disproportionate reporting of these themes was most notable based on insurance status. A higher percentage of uninsured parents (87%) reported experiencing difficulties obtaining insurance coverage compared with 40% of those with insurance. Few of the uninsured expressed concerns about access to services or health care costs (19%). Access concerns were the most common among publicly insured families, and costs were more often mentioned by families with private insurance. Families made a clear distinction between insurance and access, and having one or both elements did not assure care. Our analyses uncovered a 3-part typology of barriers to health care for low-income families. Barriers to health care can be insurmountable for low-income families, even those with insurance coverage. Patients who do not seek care in a family medicine clinic are not necessarily getting their care elsewhere.
Mental Health, Access, and Equity in Higher Education
Directory of Open Access Journals (Sweden)
Jennifer Martin
2010-03-01
Full Text Available This paper tackles the difficult and often not openly discussed This paper tackles the difficult and often not openly discussed topic of access and equity in higher education for people with mental health difficulties. Recent legislative and policy developments in mental health, disability, anti-discrimination and education mean that all students who disclose a mental health condition can expect fair and equitable treatment. However the findings of an exploratory study at an Australian university reveal that just under two thirds of the 54 students who reported mental health difficulties did not disclose this to staff due to fears of discrimination at university and in future employment. Students who did disclose felt supported when staff displayed a respectful attitude and provided appropriate advice and useful strategies for them to remain engaged in university studies when experiencing mental health difficulties.
Srilatha, Adepu; Doshi, Dolar; Reddy, Madupu Padma; Kulkarni, Suhas; Reddy, Bandari Srikanth
2016-01-01
Oral health has strong biological, psychological, and social projections, which influence the quality of life. Thus, developing a common vision and a comprehensive approach to address children's social, emotional, and behavioral health needs is an integral part of the child and adolescent's overall health. To assess and compare the behavior and emotional difficulties among 15-year-olds and to correlate it with their dentition status based on gender. Study Settings and Design: A cross-sectional questionnaire study among 15-year-old schoolgoing children in six private schools in Dilsukhnagar, Hyderabad, India. The behavior and emotional difficulties were assessed using self-reported Strengths and Difficulties Questionnaire (SDQ). The dentition status was recorded by the criteria given by the World Health Organization (WHO) in the Basic Oral Health Survey Assessment Form (1997). Independent Student's t-test was used for comparison among the variables. Correlation between scales of SDQ and dentition status was done using Karl Pearson's correlation coefficient method. Girls reported more emotional problems and good prosocial behavior and males had more conduct problems, hyperactivity, peer problems, and total difficulty problems. Total decayed-missing-filled teeth (DMFT) and decayed component were significantly and positively correlated with total difficulty, emotional symptom, and conduct problems scale while missing component was correlated with the hyperactivity scale and filled component with prosocial behavior. DMFT and its components showed an association with all scales of SDQ except for peer problem scale. Thus, the oral health of children was significantly influenced by behavioral and emotional difficulties; so, changes in the mental health status will affect the oral health of children.
DIFFICULTIES RELATED TO THE FINANCIAL POSITION REPORTING INTO THE PUBLIC SECTOR IN ROMANIA
Aurelia ŞTEFĂNESCU
2014-01-01
Within the context of a turbulent economic environment with impact on the vulnerability of the public sector entities, the stakeholders’ needs of information are focussed on the assessment of liquidities and their solvency, on the sustenability of service offerring, as well as on the capacity of the entities to answer a dynamic environment in terms of cost, quality and continuity. In this respect, the current study has as objective to identify the difficulties of reporting the financial posit...
Tran, Bach Xuan; Boggiano, Victoria L; Nguyen, Cuong Tat; Nguyen, Long Hoang; Le Nguyen, Anh Tuan; Latkin, Carl A
2017-07-17
Methadone maintenance treatment (MMT) patients face unique costs associated with their healthcare expenditures. As such, it is important that these patients have access to health insurance (HI) to help them pay for both routine and unforeseen health services. In this study, we explored factors related to health insurance enrollment and utilization among MMT patients, to move Vietnam closer to universal coverage among this patient population. A cross-sectional study was conducted with 1003 patients enrolled in MMT in five clinics in Hanoi and Nam Dinh provinces. Patients were asked a range of questions about their health, health expenditures, and health insurance access and utilization. We used multivariate logistic regressions to determine factors associated with health insurance access among participants. The majority of participants (nearly 80%) were not currently enrolled in health insurance at the time of the study. Participants from rural regions were significantly more likely than urban participants to report difficulty using HI. Family members of participants from rural regions were more likely to have overall poor service quality through health insurance compared with family members of participants from urban regions. Overall, 37% of participants endorsed a lack of information about HI, nearly 22% of participants reported difficulty accessing HI, 22% reported difficulty using HI, and more than 20% stated they had trouble paying for HI. Older, more highly educated, and employed participants were more likely to have an easier time accessing HI than their younger, less well educated, and unemployed counterparts. HIV-positive participants were more likely to have sufficient information about health insurance options. Our study highlights the dearth of health insurance utilization among MMT patients in northern Vietnam. It also sheds light on factors associated with increased access to and utilization of health insurance among this underserved population. These
Subject Access Project. Third Quarterly Report.
Atherton, Pauline
This third quarterly report for the period January to March 1977 describes the production schedule, records, and estimated costs and times in creating the Subject Access Project data base. Plans for on-line use of the data base and search strategy design are outlined. A table of specifications for preparing the data base for on-line searching is…
Revocable Anonymous Access to the Internet?
Claessens, Joris; Diaz, Claudia; Goemans, Caroline; Preneel, Bart; Vandewalle, Joos; Dumortier, Jos
2003-01-01
Users of telecommunications networks are concerned about privacy, and desire anonymous access, while some organizations are concerned about how this anonymous access might be abused. Proposes a solution for revocable anonymous access to the Internet. Presents some legal background and motivation for such a solution. Indicates some difficulties and…
Directory of Open Access Journals (Sweden)
Adepu Srilatha
2016-01-01
Full Text Available Background: Oral health has strong biological, psychological, and social projections, which influence the quality of life. Thus, developing a common vision and a comprehensive approach to address children′s social, emotional, and behavioral health needs is an integral part of the child and adolescent′s overall health. Aim: To assess and compare the behavior and emotional difficulties among 15-year-olds and to correlate it with their dentition status based on gender. Study Settings and Design: A cross-sectional questionnaire study among 15-year-old schoolgoing children in six private schools in Dilsukhnagar, Hyderabad, India. Materials and Methods: The behavior and emotional difficulties were assessed using self-reported Strengths and Difficulties Questionnaire (SDQ. The dentition status was recorded by the criteria given by the World Health Organization (WHO in the Basic Oral Health Survey Assessment Form (1997. Statistical Analysis: Independent Student′s t-test was used for comparison among the variables. Correlation between scales of SDQ and dentition status was done using Karl Pearson′s correlation coefficient method. Results: Girls reported more emotional problems and good prosocial behavior and males had more conduct problems, hyperactivity, peer problems, and total difficulty problems. Total decayed-missing-filled teeth (DMFT and decayed component were significantly and positively correlated with total difficulty, emotional symptom, and conduct problems scale while missing component was correlated with the hyperactivity scale and filled component with prosocial behavior. Conclusion: DMFT and its components showed an association with all scales of SDQ except for peer problem scale. Thus, the oral health of children was significantly influenced by behavioral and emotional difficulties; so, changes in the mental health status will affect the oral health of children.
Esmaeeli, Zahra; Lundetrae, Kjersti; Kyle, Fiona E
2018-02-01
Research has linked family risk (FR) of reading difficulties (RD) with children's difficulties in emergent literacy development. This study is the first to apply parents' self-report of RD as a proxy for FR in a large sample (n = 1171) in order to test group differences in children's emergent literacy. Emergent literacy, the home literacy environment and children's interest in literacy and letters were compared across different groups of FR children around the school entry. The FR children performed lower in emergent literacy compared with not-FR children. Furthermore, when comparing FR children with one parent reporting RD and children with both parents reporting RD, moderate group differences were found in Emergent Literacy. Finally, parents' self-report of RD was a significant contributor of emergent literacy after controlling for the home literacy environment, children's gender, their interest in literacy and letters, months in kindergarten, vocabulary and parents' education. Our findings suggest that schools should monitor the reading development of children with parents self-reporting RD closely - especially if both parents self-report RD. © 2017 The Authors. Dyslexia published by John Wiley & Sons Ltd. © 2017 The Authors. Dyslexia published by John Wiley & Sons Ltd.
Health Literacy and Access to Care
Janke, Alex
2016-01-01
Despite well-documented links between low health literacy, low rates of health insurance coverage, and poor health outcomes, there has been almost no research on the relationship between low health literacy and self-reported access to care. This study analyzed a large, nationally representative sample of community-dwelling adults ages 50 and older to estimate the relationship between low health literacy and self-reported difficulty obtaining care. We found that individuals with low health literacy were significantly more likely than individuals with adequate health literacy to delay or forego needed care or to report difficulty finding a provider, even after controlling for other factors including health insurance coverage, employment, race/ethnicity, poverty, and general cognitive function. They were also more likely to lack a usual source of care, although this result was only marginally significant after controlling for other factors. The results show that in addition to any obstacles that low health literacy creates within the context of the clinical encounter, low health literacy also reduces the probability that people get in the door of the health care system in a timely way. PMID:27043757
Difficulties faced by family physicians in primary health care centers in Jeddah, Saudi Arabia
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Sahar H Mumenah
2015-01-01
Full Text Available Aim: The aim was to determine the difficulties faced by family physicians, and compare how satisfied those working with the Ministry of Health (MOH are with their counterparts who work at some selected non-MOH hospitals. Methods: An analytical, cross-sectional study was conducted at King Abdulaziz University Hospital, King Faisal Specialist Hospital and Research Center (KFSH and RC, and 40 MOH primary health care centers across Jeddah. A structured multi-item questionnaire was used to collect demographic data and information on the difficulties family physicians face. The physicians′ level of satisfaction and how it was affected by the difficulties was assessed. Results: Women constituted 71.9% of the sample. Problems with transportation formed one of the main difficulties encountered by physicians. Compared to non-MOH physician, a significantly higher proportion of MOH physicians reported unavailability of radiology technicians (P = 0.011 and radiologists (P < 0.001, absence of the internet and computer access (P < 0.001, unavailability of laboratory services (P = 0.004, reagents (P = 0.001, X-ray equipment (P = 0.027, ultrasound equipment (P < 0.001, an electronic medical records system (P < 0.001, insufficient laboratory tests (P = 0.0001, and poor building maintenance (P < 0.001. Family physicians with the MOH were less satisfied with their jobs compared with non-MOH physicians (P = 0.032. Conclusion: MOH family physicians encountered difficulties relating to staff, services, and infrastructure, which consequently affected their level of satisfaction.
Difficulty buying food, BMI, and eating habits in young children.
Fuller, Anne; Maguire, Jonathon L; Carsley, Sarah; Chen, Yang; Lebovic, Gerald; Omand, Jessica; Parkin, Patricia; Birken, Catherine S
2018-01-22
To determine whether parent report of difficulty buying food was associated with child body mass index (BMI) z-score or with eating habits in young children. This was a cross-sectional study in primary care offices in Toronto, Ontario. Subjects were children aged 1-5 years and their caregivers, recruited through the TARGet Kids! Research Network from July 2008 to August 2011. Regression models were developed to test the association between parent report of difficulty buying food because of cost and the following outcomes: child BMI z-score, parent's report of child's intake of fruit and vegetables, fruit juice and sweetened beverages, and fast food. Confounders included child's age, sex, birth weight, maternal BMI, education, ethnicity, immigration status, and neighbourhood income. The study sample consisted of 3333 children. Data on difficulty buying food were available for 3099 children, and 431 of these (13.9%) were from households reporting difficulty buying food. There was no association with child BMI z-score (p = 0.86). Children from households reporting difficulty buying food (compared with never having difficulty buying food) had increased odds of consuming three or fewer servings of fruits and vegetables per day (odds ratio [OR]: 1.31, 95% confidence interval [CI]: 1.03-1.69), more than one serving of fruit juice/sweetened beverage per day (OR: 1.60, 95% CI: 1.28-2.00), and, among children 1-2 years old, one or more servings of fast food per week (OR: 2.91, 95% CI: 1.67-5.08). Parental report of difficulty buying food is associated with less optimal eating habits in children but not with BMI z-score.
Accession Medical Standards Analysis and Research Activity (AMSARA), 2016 Annual Report
2016-11-01
NOTES The original document contains color photos. And four Supplemental Applicants and Accessions tables for: Army, Air Force, Marine, and Navy 14...accession characteristics and risk of attrition in the accessed population. T\\.VO manuscripts focus on the Assessment of Recruit Motivation and Strength...programs to improve military readiness by maximizing both the accession and retention of motivated and capable recruits. This report provides abstracts
Verrill, L; Zhang, Y; Kane, R
2013-10-01
Individuals with coeliac disease (CD) and those with noncoeliac gluten sensitivity (GS) have reported difficulty following a gluten-free diet (GFD); however, few studies have explored the link between the food label, gluten-free (GF) claims and the difficulty associated with following a GFD. The present study surveyed adults with CD (n = 1,583) and adults with GS (n = 797) about their reported difficulty following a GFD, including assessing the role of food labels and GF claims, as well as other factors known to contribute to this difficulty. A two-sample t-test and chi-squared tests for equality of means or proportions were used for the descriptive data and ordinal logistic regression (OLR) was used to model associations. On average, individuals with GS reported slightly more difficulty following the GFD than did participants with CD. According to the OLR results, reading the food label often was significantly associated with less reported difficulty following a GFD, whereas consuming packaged processed foods and looking for GF claims more often were significantly associated with more reported difficulty for both respondent groups. Individuals with GS may rely more heavily on the GF claim for information about a product's gluten content. Individuals with CD, on the other hand, may be more experienced food label readers and may rely more on the ingredient list for finding GF foods. More studies are needed aiming to understand the role of the food label in facilitating consumers' ability to follow a GFD. Published 2013. This article is a U.S. Government work and is in the public domain in the USA.
Barriers to Maori sole mothers’ primary health care access
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Lee R
2013-12-01
Full Text Available INTRODUCTION: International research consistently shows that sole mothers experience poorer health and suboptimal health care access. New Zealand studies on sole mothers' health report similar findings. The aim of this exploratory research was to better understand the experiences of Maori sole mothers' access to health services, particularly primary health care, for personal health needs. METHODS: This qualitative study employed a general inductive design informed by a Kaupapa Maori approach, providing guidance on appropriate cultural protocols for recruiting and engaging Maori participants. Distributing written information and snowballing techniques were used to purposively recruit seven Maori sole mothers. Data collection involved semi-structured interviews which were digitally recorded and transcribed verbatim. Data were analysed using general inductive thematic analysis to identify commonalities and patterns in participants' experiences. FINDINGS: The dominant themes that emerged captured and described participants' experiences in accessing health care. The major barrier to access reported was cost. Compounding cost, transport difficulties and location or scheduling of services were additional barriers to health service accessibility. Child-related issues also posed a barrier, including prioritising children's needs and childcare over personal health needs. CONCLUSION: The findings illuminate Maori sole mothers' experiences of accessing health care and the complex socioeconomic inequalities affecting access options and uptake of services. Further investigation of barriers to access is needed. The study has implications for addressing barriers to access at policy, funding and practice levels to improve health outcomes and equitable health care access for Maori sole mothers.
Difficulties in emotion regulation in patients with eating disorders.
Ruscitti, Catherine; Rufino, Katrina; Goodwin, Natalie; Wagner, Rebecca
2016-01-01
A defining characteristic of eating disorders (EDs) is difficulty with emotion regulation (ER). Previous research indicates that ED subtypes demonstrate differing ER difficulties. Specifically, individuals with Anorexia Nervosa (AN) or Bulimia Nervosa (BN) show greater impairment in their ability to regulate emotions in areas such as achieving goals while upset, reacting impulsively to distress, and effectively using coping strategies, as compared to those with Binge Eating Disorder (BED). However, limited research includes the diagnostic category of Eating Disorder, Not Otherwise Specified (EDNOS). The aim of this study was to better understand ER difficulties for all ED diagnoses, especially EDNOS. It was hypothesized that patients with EDs will demonstrate similar ER difficulties as psychiatric patients without EDs and that patients with EDNOS will be similar in their total level of ER difficulties but will differ in their specific types of difficulties in ER as compared to patients with other EDs. Participants included 404 adults presenting to an inpatient psychiatric hospital. Psychiatric diagnoses, including EDs, were determined using the Structured Clinical Interview for DSM Disorders. Differences in specific and overall difficulties with ER were examined across psychiatric patients using the multidimensional Difficulties in Emotion Regulation Scale. Results of this study indicate that individuals with EDs have greater ER difficulties in most domains of ER and that those with BED and EDNOS demonstrate the most significant differences in ER as compared to psychiatric patients without EDs. Additionally, it was found that ED subtypes typically did not differ in terms of specific difficulties in ER. One exception emerged indicating that individuals with BED demonstrated significantly greater difficulty on the Limited Access to Emotion Regulation Strategies subscale as compared to those with EDNOS. Researchers were able to clarify difficulties in ER across ED
Djurhuus, Sune; Hansen, Henning Sten; Aadahl, Mette; Glümer, Charlotte
2014-01-01
Active commuters have lower risk of chronic disease. Understanding which of the, to some extent, modifiable characteristics of public transportation that facilitate its use is thus important in a public health perspective. The aim of the study was to examine the association between individual public transportation accessibility and self-reported active commuting, and whether the associations varied with commute distance, age, and gender. Twenty-eight thousand nine hundred twenty-eight commuters in The Capital Region of Denmark reported self-reported time spent either walking or cycling to work or study each day and the distance to work or study. Data were obtained from the Danish National Health Survey collected in February to April 2010. Individual accessibility by public transportation was calculated using a multi-modal network in a GIS. Multilevel logistic regression was used to analyze the association between accessibility, expressed as access area, and being an active commuter. Public transport accessibility area based on all stops within walking and cycling distance was positively associated with being an active commuter. Distance to work, age, and gender modified the associations. Residing within 10 km commute distance and in areas of high accessibility was associated with being an active commuter and meeting the recommendations of physical activity. For the respondents above 29 years, individual public transportation accessibility was positively associated with being an active commuter. Women having high accessibility had significantly higher odds of being an active commuter compared to having a low accessibility. For men, the associations were insignificant. This study extends the knowledge about the driving forces of using public transportation for commuting by examining the individual public transportation accessibility. Findings suggest that transportation accessibility supports active commuting and planning of improved public transit accessibility
DIFFICULTIeS OF TOTAL HIP REPLACEMENT IN PATIENTS WITH ANKYLOSING SPONDYLITIS (case report
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R. M. Tikhilov
2016-01-01
Full Text Available A distinctive feature of patients with ankylosing spondylitis is the formation of hip ankylosis in an extremely unfavorable functional position combined with upset of sagittal balance of the body along with a thoracolumbar kyphosis. Treatment of these patients poses considerable technical difficulties and is often associated with complications. The authors report a clinical case of a female 40 years old patient with confirmed rhizomelic spondylitis. The patient mainly complained of fixed malposition of the right lower extremity (hip ankylosis in extreme 1450 flexion and 1500 abduction combined with a severe fixed spine deformity (thoracic kyphosis 920, lumbar lordosis 170. Considering significant sagittal balance disorder it was decided to go for a two-stage procedure. Total hip arthroplasty of the right joint was performed at the first stage. At the second stage the authors corrected thoracolumbar spinal deformity by Th12 (type PSO 4 and L2 (type PSO 3 wedge resections and converging resected vertebral bodies by a multilevel fixation system with transpedicular support elements. The interval between the stages was 11 months. Two-stage treatment of this patient al-lowed to avoid adverse postoperative complications and to achieve a significant functional improvement in one year after treatment started. The sum of points before and after the treat-ment amounted respectively to 46 and 79 on Harris Hip Score, 17 and 38 points on Oxford Hip Score (OHS. To summarize, comprehensive treatment with planning of all subsequent steps prior to hip replacement is the method of choice for avoidance of postoperative complications in patients with ankylosing spondylitis accompanied by a significant upset of sagittal balance.
Simonsick, E M; Guralnik, J M; Fried, L P
1999-06-01
To determine how severity of walking difficulty and sociodemographic, psychosocial, and health-related factors influence walking behavior in disabled older women. Cross-sectional analyses of baseline data from the Women's Health and Aging Study (WHAS). An urban community encompassing 12 contiguous zip code areas in the eastern portion of Baltimore City and part of Baltimore County, Maryland. A total of 920 moderately to severely disabled community-resident women, aged 65 years and older, identified from an age-stratified random sample of Medicare beneficiaries. Walking behavior was defined as minutes walked for exercise and total blocks walked per week. Independent variables included self-reported walking difficulty, sociodemographic factors, psychological status (depression, mastery, anxiety, and cognition), and health-related factors (falls and fear of falling, fatigue, vision and balance problems, weight, smoking, and cane use). Walking at least 8 blocks per week was strongly negatively related to severity of walking difficulty. Independent of difficulty level, older age, black race, fatigue, obesity, and cane use were also negatively associated with walking; living alone and high mastery had a positive association with walking. Even among functionally limited women, sociocultural, psychological, and health-related factors were independently associated with walking behavior. Thus, programs aimed at improving walking ability need to address these factors in addition to walking difficulties to maximize participation and compliance.
Do People With Psychosis Have Specific Difficulties Regulating Emotions?
Lincoln, Tania M; Hartmann, Maike; Köther, Ulf; Moritz, Steffen
2015-01-01
Difficulties in emotion regulation (ER) are present in psychotic disorders, but their precise nature is not yet fully understood and it is unclear which difficulties are unique to psychosis compared with other disorders. This study investigated whether ER difficulties in psychosis are more prominent for the ability to modify emotions or for the ability to tolerate and accept them. Furthermore, it investigated whether ER difficulties occur for sadness, anxiety, anger and shame likewise. ER skills were assessed in participants with psychotic disorders (n = 37), participants with depression (n = 30) and healthy controls (n = 28) using the Emotion Regulation Skill Questionnaire that asks participants to rate the intensity of different emotions over the past week and the skills employed to handle each of them. Compared with healthy controls, participants with psychosis showed reduced skills related to awareness, understanding and acceptance of potentially distressing emotions, but not in the ability to modify them. These differences remained significant after controlling for depression. Participants with psychosis showed reduced ER skills in regard to all of the assessed emotions compared with the healthy controls, despite the fact that they only reported sadness as being significantly more intense. The participants with depression showed a similar pattern of ER skills to the psychosis sample, although with a tendency towards even more pronounced difficulties. It is concluded that psychosis is characterized by difficulties in using specific ER skills related to awareness, understanding and acceptance to regulate anger, shame, anxiety and sadness. These difficulties are not unique to psychosis but nevertheless present a promising treatment target. The participants with psychosis found it more difficult to be aware of their emotions, to understand them and to accept them than the healthy control group. However, they reported equal skills when it came to
SMES' SECTOR ACCESS TO FINANCE: AN OVERVIEW
Directory of Open Access Journals (Sweden)
Roman Angela
2011-07-01
Full Text Available Through their contribution to the creation of added value and new jobs, the small and medium enterprises (SMEs have a significant role in the economic and social development of a country. However, these enterprises are facing numerous obstacles that limit their performance, growth and development. Among the difficulties faced by SMEs, the access to finance is often reported as a major obstacle to the deployment and expansion of their activity. The access to finance is crucial for efficient allocation of financial resources and entrepreneurial development, which explains the major interest given to this subject both by the academic literature and the policy makers. The paper aims to highlight the difficulties faced by SMEs in securing financing resources, emphasizing the differences between countries and also between SMEs and large enterprises. Knowing the difficulties in SMEs financing is essential for policy makers in order to design and implement appropriate measures, which will help to improve the access to financing for these enterprises. Thus, another issue addressed, synthetically, in this paper aims the measures taken by public authorities in order to support the access to financing for SMEs. The research methodology used in this paper starts with a literature review in order to highlight the importance of the subject addressed in our research. The analysis conducted in this paper is based on data and statistics provided mainly by the World Bank surveys, by certain empirical studies and by the National Council of Small and Medium Sized Private Enterprises in Romania. Based on the methodology used, the paper indicates the difficulties in SMEs financing and the crucial importance of enhancing the public authorities concerns regarding their alleviation, especially by adopting measures focused on increasing financial development, which would ensure greater availability of financing for businesses and thus economic growth. The limited
Learning Difficulty and Learner Identity: A Symbiotic Relationship
Hirano, Eliana
2009-01-01
This paper reports on a longitudinal case study of an adult EFL learner who perceived himself as having difficulty learning English. Both learning difficulty and learner identity are viewed as being constructed in discursive interactions throughout one's life and, hence, amenable to reconstruction. Data collected from classroom interactions,…
DIFFICULTIES RELATED TO THE FINANCIAL POSITION REPORTING INTO THE PUBLIC SECTOR IN ROMANIA
Directory of Open Access Journals (Sweden)
Aurelia ŞTEFĂNESCU
2014-11-01
Full Text Available Within the context of a turbulent economic environment with impact on the vulnerability of the public sector entities, the stakeholders’ needs of information are focussed on the assessment of liquidities and their solvency, on the sustenability of service offerring, as well as on the capacity of the entities to answer a dynamic environment in terms of cost, quality and continuity. In this respect, the current study has as objective to identify the difficulties of reporting the financial position into the public sector in Romania. In order to reach the proposed objective, an interpretative research methodology was used. The results of this study has pointed out that the prevalence of divergences between the national view versus IPSAS in terms of reporting the financial position into the public sector limits the informational value and its relevance both for the management of the entities and their stakeholders.
Workplace bullying and sleep difficulties: a 2-year follow-up study.
Hansen, Ase Marie; Hogh, Annie; Garde, Anne Helene; Persson, Roger
2014-04-01
The aims of the present study were to investigate whether being subjected to bullying and witnessing bullying at the workplace was associated with concurrent sleep difficulties, whether frequently bullied/witnesses have more sleep difficulties than occasionally bullied/witnesses, and whether there were associations between being subjected to bullying or witnessing bullying at the workplace and subsequent sleep difficulties. A total of 3,382 respondents (67 % women and 33 % men) completed a baseline questionnaire about their psychosocial work environment and health. The overall response rate was 46 %. At follow-up 2 years later, 1671 of those responded to a second questionnaire (49 % of the 3,382 respondents at baseline). Sleep difficulties were measured in terms of disturbed sleep, awakening problems, and poor quality of sleep. Bullied persons and witnesses reported more sleep difficulties than those who were neither bullied nor witnesses to bullying at baseline. Frequently bullied/witnesses reported more sleep difficulties than respondents who were occasionally bullied or witnessing bullying at baseline. Further, odds ratios for subsequent sleep difficulties were increased among the occasionally bullied, but not among witnesses. However, the associations weakened when adjusting for sleep difficulties at baseline. Being subjected to occasional bullying at baseline was predictive of subsequent sleep difficulties. Witnessing bullying at baseline did not predict sleep difficulties at follow-up.
Barriers to accessing low vision services.
Pollard, Tamara L; Simpson, John A; Lamoureux, Ecosse L; Keeffe, Jill E
2003-07-01
To investigate barriers to accessing low vision services in Australia. Adults with a vision impairment (vision difficulties, duration of vision loss and satisfaction with vision and also examined issues of awareness of low vision services and referral to services. Focus groups were also conducted with vision impaired (Vision Australia Foundation. The discussions were recorded and transcribed. The questionnaire revealed that referral to low vision services was associated with a greater degree of vision loss (p = 0.002) and a greater self-perception of low vision (p = 0.005) but that referral was not associated with satisfaction (p = 0.144) or difficulties related to vision (p = 0.169). Participants with mild and moderate vision impairment each reported similar levels of difficulties with daily activities and satisfaction with their vision (p > 0.05). However, there was a significant difference in the level of difficulties experienced with daily activities between those with mild-moderate and severe vision impairment (p low vision services related to awareness of services among the general public and eye care professionals, understanding of low vision and the services available, acceptance of low vision, the referral process, and transport. In addition to the expected difficulties with lack of awareness of services by people with low vision, many people do not understand what the services provide and do not identify themselves as having low vision. Knowledge of these barriers, from the perspective of people with low vision, can now be used to guide the development and content of future health-promotion campaigns.
DEFF Research Database (Denmark)
Hvolby, Allan; Jørgensen, Jan; Bilenberg, Niels
2008-01-01
OBJECTIVES: To describe actigraphically detected and parent-reported sleep problems in nonmedicated children with attention-deficit/hyperactivity disorder (ADHD); to clarify whether or not comorbid oppositional defiant disorder contributes to sleep difficulties; and to compare objectively measured...... subjects. Average sleep onset latencies were 26.3 minutes in the ADHD group, 18.6 minutes in the psychiatric control group, and 13.5 minutes in the healthy reference group. There was no apparent relationship between sleep problems and comorbid oppositional defiant disorder. We found discrepancies between...... the objectively measured sleep variables and those reported by parents, who overestimated sleep onset latency. CONCLUSIONS: The results of this study allow us to conclude that some children with ADHD have impaired sleep that cannot be referred to comorbid oppositional defiant disorder. However, it is important...
Performance analysis of quantum access network using code division multiple access model
International Nuclear Information System (INIS)
Hu Linxi; Yang Can; He Guangqiang
2017-01-01
A quantum access network has been implemented by frequency division multiple access and time division multiple access, while code division multiple access is limited for its difficulty to realize the orthogonality of the code. Recently, the chaotic phase shifters were proposed to guarantee the orthogonality by different chaotic signals and spread the spectral content of the quantum states. In this letter, we propose to implement the code division multiple access quantum network by using chaotic phase shifters and synchronization. Due to the orthogonality of the different chaotic phase shifter, every pair of users can faithfully transmit quantum information through a common channel and have little crosstalk between different users. Meanwhile, the broadband spectra of chaotic signals efficiently help the quantum states to defend against channel loss and noise. (paper)
Managing social difficulties: roles and responsibilities of patients and staff.
Wright, Penny; Bingham, Laura; Taylor, Sally; Hanif, Naheed; Podmore, Emma; Velikova, Galina
2012-01-01
Implementation of guidance on assessment and management of psychosocial and supportive-care problems or needs will be successful only if consideration is given to existing skills, experience and expectations of staff and patients. This study examines the roles and responsibilities of staff, patients and families in relation to management of social difficulties and proposes a pathway for response. A qualitative study was performed using staff and patient interviews. Seventeen doctors and 16 nurses were interviewed using patient scenarios and a support service questionnaire. Patients (n = 41) completed a screening questionnaire (the Social Difficulties Inventory) and were interviewed. Interviews were audio-recorded, transcribed and subjected to a Framework analysis. Analysis examined (1) actions taken by staff and patients in response to social difficulties, (2) reasons given for action taken and (3) perceptions of staff and patients of who was responsible for taking action. Staff were confident concerning clinically related issues (i.e. mobility) but more hesitant concerning difficulties related to money, work and family concerns. Patients liked to cope with problems on their own where possible, would have liked information or support from staff but were uncertain how to access this. Results led to development of a hierarchy of interventions in response to detected social difficulties. For routine assessment of social difficulties, patients, nurses and doctors will have to work collaboratively, with nurses taking a lead in discussion. For specific clinically related problems doctors would play a more primary role. Copyright © 2010 John Wiley & Sons, Ltd.
Spoor, Dana L.
1997-01-01
Argues that barrier-free designs should be incorporated in the first steps of school facility planning to avoid the difficulties in meeting Americans with Disabilities Act (ADA) guidelines during renovations. Explains why not all barriers need be removed to make a facility accessible to everyone. Discusses issues involving ADA guidelines and child…
Leggett, Amanda N; Polenick, Courtney A; Maust, Donovan T; Kales, Helen C
2018-03-19
Falls and hospitalizations are adverse health events commonly experienced by persons with dementia (PWDs). These events often require urgent care from a family caregiver and may increase caregiver stress. We examine falls and hospitalizations among PWDs as predictors of caregivers' reported care-related emotional difficulty, in addition to care-related stressors. Cross-sectional telephone survey of 652 informal caregivers for PWDs. A multinomial logistic regression examined falls (last month) and hospitalizations (prior year) experienced by PWDs as predictors of caregivers' care-related emotional difficulty, accounting for demographic characteristics and primary and secondary caregiving stressors. Over 20% of caregivers reported high levels of care-related emotional difficulty. Controlling for demographic characteristics and primary and secondary caregiving stressors, the PWD's prior month fall was significantly associated with greater care-related emotional difficulty; the PWD's hospitalizations were not associated with care-related emotional difficulty. Approximately 30% of PWDs had experienced a past year hospitalization and prior month fall, and one in five caregivers reported high emotional difficulty related to care. Although secondary strains and resources of caregiving were strong predictors of care-related emotional difficulty, PWDs' falls represent a significant stressor that increases odds of caregiver emotional difficulty over and above other strains. Consequently, a fall experienced by a PWD may represent a key time for clinicians to assess caregiver well-being.
Young people with features of gender dysphoria: Demographics and associated difficulties.
Holt, Vicky; Skagerberg, Elin; Dunsford, Michael
2016-01-01
This article presents the findings from a cross-sectional study on demographic variables and associated difficulties in 218 children and adolescents (Mean age = 14 years, SD = 3.08, range = 5-17 years), with features of gender dysphoria, referred to the Gender Identity Development Service (GIDS) in London during a 1-year period (1 January 2012-31 December 2012). Data were extracted from patient files (i.e. referral letters, clinical notes and clinician reports). The most commonly reported associated difficulties were bullying, low mood/depression and self-harming. There was a gender difference on some of the associated difficulties with reports of self-harm being significantly more common in the natal females and autism spectrum conditions being significantly more common in the natal males. The findings also showed that many of the difficulties increased with age. Findings regarding demographic variables, gender dysphoria, sexual orientation and family features are reported, and limitations and implications of the cross-sectional study are discussed. In conclusion, young people with gender dysphoria often present with a wide range of associated difficulties which clinicians need to take into account, and our article highlights the often complex presentations of these young people. © The Author(s) 2014.
Dental care access among individuals with Down syndrome: a Malaysian scenario.
Abdul Rahim, Farah Salwa; Mohamed, Alizae Marny; Marizan Nor, Murshida; Saub, Roslan
2014-11-01
The purpose of this cross-sectional study was to assess the legal representatives' perceptions on dental care access of individuals with Down syndrome (DS) compared to their non-DS siblings in Peninsular Malaysia. This cross-sectional study was conducted throughout community-based rehabilitation centers (CBRC) and the Down Syndrome Organization. Legal representatives of individuals with DS within the criteria were given a structured and validated questionaire. This study demonstrated that individuals with DS (76.9%) significantly utilized more health services than non-DS siblings (23.1%). The service most regularly used was speech therapy followed by opthalmology and dental services. Twenty-five per cent of respondents reported difficulty in finding dental care services for their DS child and 46.9% admitted that healthcare for their DS child took more time. The majority of DS individuals received less complex dental treatment and none received any orthodontic treatment, despite their severe occlusal problems. A high proportion of parents appear to be able to access dental and medical care for their DS child. However, some parents perceived difficulty in finding oral healthcare.
Children's caregiving of HIV-infected parents accessing treatment in ...
African Journals Online (AJOL)
Children's caregiving of HIV-infected parents accessing treatment in western Kenya: challenges and ... Log in or Register to get access to full text downloads. ... The research draws attention to the difficulties and opportunities of strengthening ...
Communication difficulties in children identified with psychiatric problems
Helland, Wenche Andersen
2010-01-01
Several studies have pointed to an overlap between different developmental psychopathological conditions and language impairments, and difficulties with communication have been identified in children of various diagnostic backgrounds. This thesis is based on three empirical studies, and the purposes are to investigate communication difficulties as reported by parents, in children identified with psychiatric problems as well as to evaluate a Norwegian adaptation of the Children’...
Knobloch, Leanne K; Knobloch-Fedders, Lynne M; Yorgason, Jeremy B; Ebata, Aaron T; McGlaughlin, Patricia C
2017-08-01
This study drew on the relational turbulence model to investigate how the interpersonal dynamics of military couples predict parents' reports of the reintegration difficulty of military children upon homecoming after deployment. Longitudinal data were collected from 118 military couples once per month for 3 consecutive months after reunion. Military couples reported on their depressive symptoms, characteristics of their romantic relationship, and the reintegration difficulty of their oldest child. Results of dyadic growth curve models indicated that the mean levels of parents' depressive symptoms (H1), relationship uncertainty (H2), and interference from a partner (H3) were positively associated with parents' reports of military children's reintegration difficulty. These findings suggest that the relational turbulence model has utility for illuminating the reintegration difficulty of military children during the postdeployment transition. (PsycINFO Database Record (c) 2017 APA, all rights reserved).
Mian, Oxana; Pong, Raymond
2012-11-01
To determine whether better access to FP services decreases the likelihood of emergency department (ED) use among the Ontario population. Population-based telephone survey. Ontario. A total of 8502 Ontario residents aged 16 years and older. Emergency department use in the 12 months before the survey. Among the general population, having a regular FP was associated with having better access to FPs for immediate care (P FPs for immediate care at least once a year; 63.1% of them had seen FPs without difficulties and were significantly less likely to use EDs than those who did not see FPs or had difficulties accessing physicians when needed (OR = 0.62, P FPs (P FPs for immediate care among the general population. Further research is needed to understand what accounts for a higher likelihood of ED use among those with regular FPs, new immigrants, residents of northern and rural areas of Ontario, and people with low socioeconomic status when actual access and sociodemographic characteristics have been taken into consideration. More important, this study demonstrates a need of distinguishing between potential and actual access to care, as having a regular FP and having timely and effective access to FP care might mean different things and have different effects on ED use.
Handwriting difficulties in juvenile idiopathic arthritis: a pilot study.
Haberfehlner, Helga; Visser, Bart; Daffertshofer, Andreas; van Rossum, Marion Aj; Roorda, Leo D; van der Leeden, Marike; Dekker, Joost; Hoeksma, Agnes F
2011-01-01
The aim of the present study was to describe handwriting difficulties of primary school children with juvenile idiopathic arthritis (JIA), and to investigate possible correlations with hand function and writing performance. In a cross-sectional approach, 15 children with JIA and reported handwriting difficulties were included together with 15 healthy matched controls. Impairments (signs of arthritis or tenosynovitis, reduced grip force and limited range of motion of the wrist (wrist-ROM)), activity limitations (reduced quality and speed of handwriting, pain during handwriting), and participation restrictions (perceived handwriting difficulties at school) were assessed and analysed. Although selected by the presence of handwriting difficulties, the majority of the JIA children (73%) had no active arthritis of the writing hand, and only minor hand impairments were found. Overall, the JIA children performed well during the short handwriting test, but the number of letters they wrote per minute decreased significantly during the 5-minute test, compared to the healthy controls. JIA patients had significantly higher pain scores on a 100 mm Visual Analogue Scale, compared to the healthy controls. The actual presence of arthritis, and limitation in grip force and wrist-ROM did not correlate with reported participation restrictions with regard to handwriting at school. The JIA children reported pain during handwriting, and inability to sustain handwriting for a longer period of time. The results of this pilot study show that JIA children with handwriting difficulties, experience their restrictions mainly through pain and the inability to sustain handwriting for a longer period of time. No correlations could be found with impairments.
2010-10-12
... DEPARTMENT OF ENERGY Notice of Availability of Report on Data Access and Privacy Issues Related to... report entitled, ``Data Access and Privacy Issues Related to Smart Grid Technologies.'' In this report... report entitled, ``Data Access and Privacy Issues Related to Smart Grid Technologies,'' DOE considered...
Motor and Coordination Difficulties in Children with Emotional and Behavioural Difficulties
Hill, Elisabeth; Pratt, Michelle L; Kanji, Zara; Bartoli, Alice Jones
2017-01-01
To date, very few studies have explored the incidence of motor impairment amongst children with social, emotional and behavioural difficulties (social, emotional and mental health (SEMH); formerly SEBD in England). Following research that suggests an increase in motor difficulties in young children and adolescents with SEMH difficulties, this…
Wagner, Jan-Samuel; DiBonaventura, Marco D; Chandran, Arthi B; Cappelleri, Joseph C
2012-10-17
Difficulty sleeping is common among patients with fibromyalgia (FM); however, its impact on health-related quality of life (HRQoL) is not well understood. The aim of the current study was to assess the burden of sleep difficulty symptoms on HRQoL among patients with FM. The current study included data from the 2009 National Health and Wellness Survey (N=75,000), which is a cross-sectional, Internet-based survey representative of the adult US population. The prevalence of sleep difficulty symptoms among patients with FM (n=2,196) were compared with matched controls (n=2,194), identified using propensity-score matching. Additionally, the relationship between the number of sleep difficulty symptoms (none, one, or two or more) and HRQoL (using the SF-12v2) was assessed using regression modeling, controlling for demographic and health history variables. Of the 2,196 patients with FM, 11.2% reported no sleep difficulty symptoms, 25.7% reported one sleep difficulty symptom, and 63.05% reported two or more sleep difficulty symptoms. The prevalence of sleep difficulty symptoms was significantly higher than matched controls. Patients with one and two sleep difficulty symptoms both reported significantly worse HRQoL summary and domain scores relative to those with no sleep difficulty symptoms (all p<.05). Further, the relationship between sleep difficulty symptoms and HRQoL was significantly different between those with FM than matched controls, suggesting a uniqueness of the burden of sleep difficulties within the FM population. Among the FM population, sleep difficulty symptoms were independently associated with clinically-meaningful decrements in mental and physical HRQoL. These results suggest that greater emphasis in the treatment of sleep difficulty symptoms among the FM population may be warranted.
Idiopathic chondrolysis - diagnostic difficulties
International Nuclear Information System (INIS)
Kozlowski, K.; Scougall, J.; Royal Alexandra Hospital for Children, Sydney
1984-01-01
Four cases of idiopathic chondrolysis of the hip in three white girls and one Maori girl are reported. The authors stress the causes why a disease with characteristic clinical and radiographic appearances and normal biochemical findings presents diagnostic difficulties. It is suspected that idiopathic chondrolysis is a metabolic disorder of chondrocytes, triggered by environment circumstances in susceptible individuals. Idiopathic chondrolysis is probably one of the most common causes of coxarthrosis in women. (orig.)
Rural mental health workforce difficulties: a management perspective.
Moore, T; Sutton, K; Maybery, D
2010-01-01
The recruitment, retention and training of mental health workers is of major concern in rural Australia, and the Gippsland region of Victoria is no exception. Previous studies have identified a number of common factors in these workforce difficulties, including rurality, difficulties of access to professional development and training, and professional and personal isolation. However, those previous studies have often focused on medicine and been based on the perspectives of practitioners, and have almost ignored the perspectives of managers of rural mental health services. The study reported in this article sought to contribute to the development of a more sustainable and effective regional mental health workforce by complementing earlier insights with those of leading administrators, managers and senior clinicians in the field. The study took a qualitative approach. It conducted semi-structured in-person interviews with 24 managers of health/mental-health services and senior administrators and clinicians working in organisations of varying sizes in the public and private sectors. Thematic content analysis of the transcribed interviews identified core difficulties these managers experienced in the recruitment, retention and training of employees. The study found that some of the issues commonly resulting in difficulties in recruiting, retaining and developing a trained workforce in rural areas, such as rurality (implying personal and professional isolation, distances to deliver service and small organisations) and a general shortage of trained personnel, are significant in Gippsland. Through its focus on the perspectives of leaders in the management of rural mental health services, however, the study found other key issues that contribute to workforce difficulties. Many, including the unattractive nature of mental health work, the fragmented administration of the mental health system, short-term and tied funding, and shortcomings in training are external to
Directory of Open Access Journals (Sweden)
Betania Allen-Leigh
2017-07-01
Full Text Available Objective. Report prevalence of functioning difficulties and disabilities among Mexican adolescent women 15-17 years old and identify differences in characteristics of those with and without a functioning difficulty or disability Materials and methods. Using data from the National Survey of Boys, Girls and Women in Mexico 2015 we estimated prevalence of functioning difficulties and disability and used chi square tests for independence and logistic regression to explore associations between this condition and various characteristics. Results. Of Mexican adolescent women 15-17 years old, 11.1% had a functioning difficulty or disability. The group of domains of functioning difficulty and disability with by far the highest prevalence was socio-emotional and behavioral functioning difficulties or disability with 8.6%. Being employed, rural residence and self-reported depression symptoms were associated with having functioning difficulties or disability. Conclusions. This survey constitutes an important initial step in collecting data on functioning difficulty and disability in Mexico although larger samples should be studied.
[Access to care for vulnerable populations].
Geeraert, Jérémy; Rivollier, Elisabeth
2014-11-01
Accessing hospital care is a privilege for a growing proportion of the population in situations of economic and social precarity. It is therefore important that caregivers understand these difficulties in order to adapt their nursing approach.
OPTICA: Our Path Together Initiating Cultural Access. Final Report.
Jackson, Susan, Comp.
This final report describes the activities and outcomes of OPTICA (Our Path Together Initiating Cultural Access) programs. For each program an information sheet indicates the goal, total participation, status of the goal, and activities of the program. Programs included: (1) Hands On: ASL Creative Story Telling, a program that used children's…
Jee, Sandra H; Szilagyi, Moira; Conn, Anne-Marie; Nilsen, Wendy; Toth, Sheree; Baldwin, Constance D; Szilagyi, Peter G
2011-05-01
To assess the effectiveness of social-emotional screening in the primary care setting for youths in foster care. The setting was a primary care practice for all youth in home-based foster care in 1 county. Subjects were youths, aged 11 to 17 years, and their foster parents; both completed a Strengths and Difficulties Questionnaire at well-child visits. The Strengths and Difficulties Questionnaire is a previously validated 25-item tool that has 5 domains: emotional symptoms; conduct problems; hyperactivity/inattention; peer problems; and prosocial behaviors and an overall total difficulties score. We first compared youth versus parent Strengths and Difficulties Questionnaire scores and then assessed the accuracy of these Strengths and Difficulties Questionnaire scores by comparing them in a subsample of youths (n = 50) with results of home-based structured clinical interviews using the Children's Interview for Psychiatric Syndromes. Of 138 subjects with both youth and parent reports, 78% had prosocial behaviors (strengths), and 70% had 1 or more social-emotional problems. Parents reported significantly more conduct problems (38% vs 16%; P youth. The Strengths and Difficulties Questionnaire had better agreement with the Children's Interview for Psychiatric Syndromes (n = 50) for any Strengths and Difficulties Questionnaire-identified problem for combined youth and foster-parent reports (93%), compared with youth report alone (54%) or parent report alone (71%). Although most youths in foster care have social-emotional problems, most have strengths as well. Youth and foster-parent perspectives on these problems differ. Systematic social-emotional screening in primary care that includes both youth and parent reports can identify youths who may benefit from services.
Perceived importance and difficulty of online activities among visually impaired persons in Nigeria.
Okonji, Patrick Emeka; Okiki, Olatokunbo Christopher; Ogwezzy, Darlington
2018-03-26
This study investigated perceived relevance of and difficulties in access to day-to-day online activities among visually impaired computer users who used screen readers. The 98 participants in the study were grouped into visually impaired adults (VIA; aged 20-59, n = 60) and visually impaired older adults (VIOA; aged 60 and over, n = 38). Data were collected in structured interview questionnaires with Likert scales exploring ratings of perceived importance and difficulty of access to eleven (11) online platforms of various internet activities. Analyses revealed that the two groups did not differ significantly in ratings of perceived importance of 4 major online activities, namely; Sending or reading email (p = 0.5224), Online banking (p = 0.2833), Online shopping (p = 0.1829), and Health information seeking (p = 0.1414). The topmost rated activity of priority among both groups was sending and reading emails. Findings also show that, apart from sending and reading emails, activities rated as important were mostly perceived as difficult to access. The implications of the study for inclusive design and strategies and/or interventions to encourage uptake of internet use among the visually impaired population are discussed.
Access to electronic health knowledge in five countries in Africa: a descriptive study
Directory of Open Access Journals (Sweden)
Honorati Masanja
2007-05-01
Full Text Available Abstract Background Access to medical literature in developing countries is helped by open access publishing and initiatives to allow free access to subscription only journals. The effectiveness of these initiatives in Africa has not been assessed. This study describes awareness, reported use and factors influencing use of on-line medical literature via free access initiatives. Methods Descriptive study in four teaching hospitals in Cameroon, Nigeria, Tanzania and Uganda plus one externally funded research institution in The Gambia. Survey with postgraduate doctors and research scientists to determine Internet access patterns, reported awareness of on-line medical information and free access initiatives; semi structured interviews with a sub-sample of survey participants to explore factors influencing use. Results In the four African teaching hospitals, 70% of the 305 postgraduate doctors reported textbooks as their main source of information; 66% had used the Internet for health information in the last week. In two hospitals, Internet cafés were the main Internet access point. For researchers at the externally-funded research institution, electronic resources were their main source, and almost all had used the Internet in the last week. Across all 333 respondents, 90% had heard of PubMed, 78% of BMJ on line, 49% the Cochrane Library, 47% HINARI, and 19% BioMedCentral. HINARI use correlates with accessing the Internet on computers located in institutions. Qualitative data suggested there are difficulties logging into HINARI and that sometimes it is librarians that limit access to passwords. Conclusion Text books remain an important resource for postgraduate doctors in training. Internet use is common, but awareness of free-access initiatives is limited. HINARI and other initiatives could be more effective with strong institutional endorsement and management to promote and ensure access.
., Sutarto; ., Isnalita; ., Habiburrochman
2008-01-01
Financial report is a tool for business entity to deliver information to stakeholders. Thedifference of user’s interests causes that the financial report needs to be audited by theindependent auditor, to make sure fairness and conform with accounting standard. Thecooperatives managers must conduct the rule stated in accounting standard. Thus, thatthe Accountability, Technical Difficulty, Measurement Difficulty are the basic to realizethe implementation of cooperative accounting standard. The ...
Habiburrahman, Sutarto Isnalita
2008-01-01
Financial report is a tool for business entity to deliver information to stakeholders. Thedifference of user's interests causes that the financial report needs to be audited by theindependent auditor, to make sure fairness and conform with accounting standard. Thecooperatives managers must conduct the rule stated in accounting standard. Thus, thatthe Accountability, Technical Difficulty, Measurement Difficulty are the basic to realizethe implementation of cooperative accounting standard. The...
The investor access to the presented financial reports
Mejzlik, Ladislav; Durianova, Gabriela; Velechovska, Lenka
2011-01-01
The paper deals with the investor and potential investor access to the presented financial information of the companies. The accesibility and reliatbility of the financial information is one of the essential aspects of investor decision making. The text treats with the possibilities of presenting financial statements with focus on the internet as suitable place which is used very often nowadays. Timeliness and the form of the financial report submitting is harmonized in t...
Identifying and addressing student difficulties with the ideal gas law
Kautz, Christian Hans
This dissertation reports on an in-depth investigation of student understanding of the ideal gas law. The research and curriculum development were mostly conducted in the context of algebra- and calculus-based introductory physics courses and a sophomore-level thermal physics course. Research methods included individual demonstration interviews and written questions. Student difficulties with the quantities: pressure, volume, temperature, and the number of moles were identified. Data suggest that students' incorrect and incomplete microscopic models about gases contribute to the difficulties they have in answering questions posed in macroscopic terms. In addition, evidence for general reasoning difficulties is presented. These research results have guided the development of curriculum to address the student difficulties that have been identified.
Becker, Andreas; Wang, Biyao; Kunze, Barbara; Otto, Christiane; Schlack, Robert; Hölling, Heike; Ravens-Sieberer, Ulrike; Klasen, Fionna; Rogge, Jana; Isensee, Corinna; Rothenberger, Aribert; Bella Study Group, The
2018-05-30
This study served to establish German norms for the Strengths and Difficulties Questionnaire self-report (SDQ-S) by using data from a representative epidemiological sample from the German National Health Interview and Examination Survey for Children and Adolescents (KiGGS study). Although the German version of the SDQ has been widely used and normative data for the parent version (SDQ-P) exist, no German norms for the self-report version have been reported, so that practitioners had to rely on the available British norms. In addition, we investigated whether sex- and age-specific norms are necessary. At the baseline of the KiGGS study, SDQ-S ratings were collected from n = 6,726 children and adolescents between 11 and 17 years (n = 3,440 boys und n = 3,286 girls). We assessed the internal consistency and age/sex effects of the SDQ-S. Confirmatory factor analysis was conducted to assess the factor structure of the SDQ-S. Banding scores were developed to differentiate children and adolescents with levels of difficulties and categorized them as "normal," "borderline," and "abnormal." General as well as age- and sex-specific bandings were created for both total score and subscales of SDQ-S. In addition, the German norms of the SDQ-S were compared with those of the UK, Norway, and Thailand. The five-factor solution of the SDQ-S (including Emotional symptoms, Conduct problems, Hyperactivity/Inattention, Peer problems, and Prosocial behavior) provided a satisfactory fit to the data. Moderate internal consistencies (Cronbach's α) were observed for the scales Emotional symptoms, Hyperactivity/Inattention, and Total difficulties score, whereas insufficient internal consistency was found for the scales Peer problems and Conduct problems. However, using McDonald's ω as a more appropriate measure of homogeneity, internal consistencies were found to be satisfactory for all subscales and for Total difficulties. Normative banding scores were established conservatively to avoid
Hämäläinen, H Pauliina; Suni, Jaana H; Pasanen, Matti E; Malmberg, Jarmo J; Miilunpalo, Seppo I
2006-06-01
The functional independence of elderly populations deteriorates with age. Several tests of physical performance have been developed for screening elderly persons who are at risk of losing their functional independence. The purpose of the present study was to investigate whether several components of health-related fitness (HRF) are valid in predicting the occurrence of self-reported mobility difficulties (MD) among high-functioning older adults. Subjects were community-dwelling men and women, born 1917-1941, who participated in the assessment of HRF [6.1-m (20-ft) walk, one-leg stand, backwards walk, trunk side-bending, dynamic back extension, one-leg squat, 1-km walk] and who were free of MD in 1996 (no difficulties in walking 2- km, n=788; no difficulties in climbing stairs, n=647). Postal questionnaires were used to assess the prevalence of MD in 1996 and the occurrence of new MD in 2002. Logistic regression analysis was used as the statistical method. Both inability to perform the backwards walk and a poorer result in it were associated with risk of walking difficulties in the logistic model, with all the statistically significant single test items included. Results of 1-km walk time and one-leg squat strength test were also associated with risk, although the squat was statistically significant only in two older birth cohorts. Regarding stair-climbing difficulties, poorer results in the 1-km walk, dynamic back extension and one-leg squat tests were associated with increased risk of MD. The backwards walk, one-leg squat, dynamic back extension and 1-km walk tests were the best predictors of MD. These tests are recommended for use in screening high-functioning older people at risk of MD, as well as to target physical activity counseling to those components of HRF that are important for functional independence.
Flouzat-Lachaniette, Charles-Henri; Delblond, William; Poignard, Alexandre; Allain, Jérôme
2013-04-01
After a first anterior approach to the lumbar spine, formation of adhesions of soft tissues to the spine increases the surgical difficulties and potential for iatrogenic injury during the revision exposure. The objective of this study was to identify the intraoperative difficulties and postoperative complications associated with revision anterior lumbar spine procedures in a single institution. This is a retrospective review of 25 consecutive anterior revision lumbar surgeries in 22 patients (7 men and 15 women) operated on between 1998 and 2011. Patients with trauma or malignancies were excluded. The mean age of the patients at the time of revision surgery was 56 years (range 20-80 years). The complications were analyzed depending on the operative level and the time between the index surgery and the revision. Six major complications (five intraoperatively and one postoperatively) occurred in five patients (20 %): three vein lacerations (12 %) and two ureteral injuries (8 %), despite the presence of a double-J ureteral stent. The three vein damages were repaired or ligated by a vascular surgeon. One of the two ureteral injuries led to a secondary nephrectomy after end-to-end anastomosis failure; the other necessitated secondary laparotomy for small bowel obstruction. Anterior revision of the lumbar spine is technically challenging and is associated with a high rate of vascular or urologic complications. Therefore, the potential complications of the procedure must be weighted against its benefits. When iterative anterior lumbar approach is mandatory, exposure should be performed by an access surgeon in specialized centers that have ready access to vascular and urologic surgeons.
Difficulties in Learning Inheritance and Polymorphism
Liberman, Neomi; Beeri, Catriel; Kolikant, Yifat Ben-David
2011-01-01
This article reports on difficulties related to the concepts of inheritance and polymorphism, expressed by a group of 22 in-service CS teachers with an experience with the procedural paradigm, as they coped with a course on OOP. Our findings are based on the analysis of tests, questionnaires that the teachers completed in the course, as well as on…
Comparison of access to medicines between Klang Valley and East ...
African Journals Online (AJOL)
The study found that access to medicine for children (N = 325) in the households ... centres, poor households may experience similar difficulty with those ... their health-seeking behavior. Section C ..... research studies are currently being planned to study access to .... conspiracy theories on vaccination intentions. PloS One.
van Dijke, Annemiek; van der Hart, Onno; van Son, Maarten; Bühring, Martina; van der Heijden, Peter; Ford, Julian D
2013-01-01
To study difficulties in emotional functioning in two mental disorders that have been associated with difficulties in identifying and modulating emotions: borderline personality disorder (BPD) and somatoform disorder (SoD). In 472 psychiatric inpatients, difficulties in emotional functioning were measured using the Bermond-Vorst Alexithymia Questionnaire. Profiles of difficulties in emotional functioning were identified, suggesting that patients diagnosed with BPD with or without SoD were more likely to report difficulty identifying emotions and less likely to report reduced ability to fantasize or 'pensée opératoire' (externally oriented thinking) than patients diagnosed with SoD only and patients with mixed anxiety and affective disorders. SoD patients were more likely to report reduced ability to phantasize or pensée opératoire than difficulty identifying emotions. Patients with mixed anxiety and affective disorders were more likely to report reduced ability to experience emotions than patients diagnosed with BPD and/or SoD. By using a finer-grained perspective on difficulties in emotional functioning some evidence was found for the existence of cognitive-emotional profiles that may provide more clinically relevant information than alexithymia as just a unitary construct. Further research on cognitive-emotional profiles of difficulties in emotional functioning is needed to advance the understanding, diagnosis and treatment of mental disorders. Copyright © 2012 S. Karger AG, Basel.
Subjective executive difficulties – a study using the Dysexecutive Questionnaire
Directory of Open Access Journals (Sweden)
Ewa Małgorzata Szepietowska
2018-03-01
Full Text Available Introduction: Subjective executive difficulties, understood as a sense of disruption of planning, control and correction of one’s own activity, is often reported by healthy as well as clinical individuals. Self-report measures such as the Dysexecutive Questionnaire (DEX-S are used to assess the severity of this feeling. The diagnostic value of this method is debated due to the numerous factors affecting the beliefs on executive deficits. Aim of the study: With reference to inconclusive data concerning the underlying factors of subjective executive deficits and the value of self-report measures the following aims of the present study were established: a determination of the demographic, clinical and cognitive characteristics of individuals with various levels of subjective executive difficulties, b finding which of these variables contribute to the risk of subjective executive difficulties increase. Material and methods: The study included 213 adult individuals. DEX-S as well as measures of cognitive assessment (Montreal Cognitive Assessment, MoCA; subtests of the Wechsler Adult Intelligence Scale-Revised, WAIS-R and depressive mood assessment [Geriatric Depression Scale (Short Form, GDS-15] were used. Demographic variables (age, gender and educational level as well as clinical variables (lack of/presence of central nervous system disease history, including lateralised brain pathology were also taken into consideration. Based on DEX-S results a cluster analysis was performed and two groups of subjects with a different level of subjective executive difficulties were identified: low-severity group (individuals reporting no complaints regarding executive deficits and high-severity group (individuals with complaints. Group comparisons demonstrated that individuals complaining about executive deficits have a higher depressive mood index and lower scores on some subtests used to assess cognitive functions. The results of logistic regression analysis
DIFFICULTIES IN TEACHING AND LEARNING GRAMMAR IN AN EFL CONTEXT
Directory of Open Access Journals (Sweden)
Abdu Mohammed Al-Mekhlafi
2011-07-01
Full Text Available The role of grammar instruction in an ESL/EFL context has been for decades a major issue for students and teachers alike. Researchers have debated whether grammar should be taught in the classroom and students, for their part, have generally looked upon grammar instruction as a necessary evil at best, and an avoidable burden at worst. The paper reports a study undertaken to investigate the difficulties teachers face in teaching grammar to EFL students as well as those faced by students in learning it, in the teachers' perception. The study aimed to find out whether there are significant differences in teachers' perceptions of difficulties in relation to their gender, qualification, teaching experience, and the level they teach in school, thus providing insights into their own and their students' difficulties. Mean scores and t-test were used to interpret the data. The main findings are reported with implications.
DEFF Research Database (Denmark)
Djurhuus, Sune; Hansen, Henning Sten; Aadahl, Mette
2014-01-01
BACKGROUND: Active commuters have lower risk of chronic disease. Understanding which of the, to some extent, modifiable characteristics of public transportation that facilitate its use is thus important in a public health perspective. The aim of the study was to examine the association between...... individual public transportation accessibility and self-reported active commuting, and whether the associations varied with commute distance, age, and gender. METHODS: Twenty-eight thousand nine hundred twenty-eight commuters in The Capital Region of Denmark reported self-reported time spent either walking...... or cycling to work or study each day and the distance to work or study. Data were obtained from the Danish National Health Survey collected in February to April 2010. Individual accessibility by public transportation was calculated using a multi-modal network in a GIS. Multilevel logistic regression was used...
2010-07-01
... confidentiality of, Statements of Account, Verification Auditor's Reports, and other verification information... GENERAL PROVISIONS § 201.29 Access to, and confidentiality of, Statements of Account, Verification Auditor... Account, including the Primary Auditor's Reports, filed under 17 U.S.C. 1003(c) and access to a Verifying...
Tobia, Valentina; Fasola, Anna; Lupieri, Alice; Marzocchi, Gian Marco
2016-01-01
This study aimed to explore the spatial numerical association of response codes (SNARC), the flanker, and the numerical distance effects in children with mathematical difficulties. From a sample of 720 third, fourth, and fifth graders, 60 children were selected and divided into the following three groups: typically developing children (TD; n = 29), children with mathematical difficulties only (MD only; n = 21), and children with mathematical and reading difficulties (MD+RD; n = 10). Children were tested with a numerical Eriksen task that was built to assess SNARC, numerical distance, and flanker (first and second order congruency) effects. Children with MD only showed stronger SNARC and second order congruency effects than did TD children, whereas the numerical distance effects were similar across the three groups. Finally, the first order congruency effect was associated with reading difficulties. These results showed that children with mathematical difficulties with or without reading difficulties were globally more impaired when spatial incompatibilities were presented. © Hammill Institute on Disabilities 2014.
How specific are specific comprehension difficulties?
DEFF Research Database (Denmark)
Rønberg, Louise Flensted-Jensen; Petersen, Dorthe Klint
2016-01-01
as measured on a phonological coding measure. However, the proportion was smaller than the often reported 10-15 % and even smaller when average sight word recognition was also set as a criterion for word reading ability. Compared to average comprehenders, the poor comprehenders’ sight word recognition......This study explores the occurrence of poor comprehenders, i.e., children identified with reading comprehension difficulties in spite of age-appropriate word reading skills. It supports the findings that some children do show poor reading comprehension in spite of age-appropriate word reading...... and daily reading of literary texts were significantly below that of average readers. This study indicates that a lack of reading experience and, likewise, a lack of fluent word reading may be important factors in understanding nine-year-old poor comprehenders’ difficulties....
[IgE myeloma. Laboratory typing difficulties].
Bovone, Nora S; Fuente, María Cristina; Gastiazoro, Ana María; Alfonso, Graciela; Freitas, María Josefina
2014-01-01
The IgE multiple myeloma is a rare neoplasm of plasma cell accounting for 0.01% of all plasma cell dyscrasias. They are generally of more aggressive development and to date there are no more than 50 cases published in current literature. Laboratory studies are, in these cases, essential for the classification of the monoclonal component in serum and urine. The aim of this presentation is to report a patient diagnosed with IgE myeloma and to point out that the laboratory difficulties noted in these rare cases can lead to an erroneous report.
Vella, Stewart A; Cliff, Dylan P; Magee, Christopher A; Okely, Anthony D
2015-05-01
This paper assessed the associations between sports participation and the development of psychological strengths and difficulties during childhood. Two-year follow up study of a sample of 4042 Australian children who were followed from age 8 years to 10 years. Parents reported children's participation in organised sports, and completed the Strengths and Difficulties Questionnaire. Univariate general linear models were used to examine the association between changes in sports participation and psychological strengths and difficulties at 10 years, adjusting for psychological strengths and difficulties at age 8. Children who maintained participation in sport had lower rates of parent-reported psychological difficulties at 10 years compared with children who dropped out of sport. Less internalising problems were also reported for children who participated in organised sports compared to children who dropped out of sports and children who did not participate in sports. These relationships did not differ by BMI, socioeconomic status, or parental education. Greater psychological difficulties are experienced by children who drop out of sports, and greater social and emotional problems are experienced by children who drop out of sports and who do not participate in organised sports. Due consideration should be given to the quality and implementation of sporting programs to ensure that they provide benefits to mental health. Due consideration should also be given to the potential psychological difficulties being experienced by children who drop out of organised sports as a higher level of psychological difficulties may be experienced prior to or subsequent to dropout. Copyright © 2014 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.
Title III Evaluation Report for the Access Road System
International Nuclear Information System (INIS)
H.R. Montalvo
1998-01-01
The objective of this evaluation is to provide recommendations to ensure consistency between the technical baseline requirements, baseline design, and the as-constructed Access Roads. Recommendations for resolving discrepancies between the as-constructed system, the technical baseline requirements, and the baseline design are included in this report. Cost and Schedule estimates are provided for all recommended modifications. This report does not address items which do not meet current safety or code requirements. These items are identified to the CMO and immediate action is taken to correct the situation. The report does identify safety and code items for which the A/E is recommending improvements. The recommended improvements will exceed the minimum requirements of applicable code and safety guide lines. These recommendations are intended to improve and enhance the operation and maintenance of the facility
RANKING THE SPECTATORS’ DIFFICULTIES IN PURCHASING ELECTRONIC TICKETS OF FOOTBALL PREMIER LEAGUE
Directory of Open Access Journals (Sweden)
Ahmad Narimani
2017-04-01
Full Text Available This study aimed to rank the spectators’ difficulties in buying electronic tickets of football premier league matches at Azadi stadium. The population consisted of all spectators of Esteghlal-Persepolis match in the fifteenth league at Azadi stadium (N= 100000. According to Morgan table and using simple random sampling method, 500 participants were selected as sample. A researcher-made questionnaire was used for collecting the data; its face validity was confirmed by 15 experts and performing a pilot study on 30 subjects, its Cronbach’s alpha was calculated to be 0.86. Using SPSS 22, the descriptive and inferential (including Friedman test statistics was applied for analyzing the data. The findings showed that there was a significant difference between rankings of difficulties in buying electronic tickets of Football premier league matches at Azadi Stadium. The difficulties were ranked as: problem in ticket systems, early selling out of electronic tickets, lack of confidence to electronic ticket sale, lack of skill to work with the internet, low speed of internet, and lack of access to the internet
Khosravani, Vahid; Sharifi Bastan, Farangis; Ghorbani, Fatemeh; Kamali, Zoleikha
2017-08-01
The aim of this study was to assess the mediating effects of difficulties in emotion regulation (DER) on the relations of negative and positive affects to craving in alcoholic patients. 205 treatment-seeking alcoholic outpatients were included. DER, positive and negative affects as well as craving were evaluated by the Difficulties in Emotion Regulation Scale (DERS), the Positive/Negative Affect Scales, and the Obsessive Compulsive Drinking Scale (OCDS) respectively. Clinical factors including depression and severity of alcohol dependence were investigated by the Alcohol Use Disorders Identification Test (AUDIT) and the Beck Depression Inventory-II (BDI-II) respectively. Results revealed that both increased negative affect and decreased positive affect indirectly influenced craving through limited access to emotion regulation strategies. It was concluded that limited access to emotion regulation strategies may be important in predicting craving for alcoholics who experience both increased negative affect and decreased positive affect. This suggests that treatment and prevention efforts focused on increasing positive affect, decreasing negative affect and teaching effective regulation strategies may be critical in reducing craving in alcoholic patients. Copyright © 2017 Elsevier Ltd. All rights reserved.
Sleep difficulties and academic performance in Norwegian higher education students.
Hayley, Amie C; Sivertsen, Børge; Hysing, Mari; Vedaa, Øystein; Øverland, Simon
2017-12-01
Sleep difficulties are common among university students and may detrimentally affect academic outcomes. Despite this, remarkably little information is currently available during this critical developmental period of early adulthood, and thus, the direct effect on measurable domains of academic ability and proficiency is equivocal. To evaluate the associations between difficulties initiating and maintaining sleep (DIMS) and subjective and objective academic performance in a large sample of university students. A total of 12,915 students who participated in large student survey in Norway from 24 February 2014 to 27 March 2014. DIMS was assessed by the Hopkins Symptoms Checklist (HSCL-25), and academic outcomes included failed examinations, delayed study progress, and school-related self-efficacy (General Self-Efficacy Scale). Difficulties initiating and maintaining sleep was independently associated with increased odds for poor school performance for all academic outcomes. Reporting 'extreme' DIMS was associated with increased odds of reporting delayed study progress (adjusted odds ratio [OR] = 1.25, 95% CI 1.01-1.57, p academic outcomes as well as poorer self-rated academic proficiency among higher education students. Amelioration of sleep difficulties may improve overall academic performance and health outcomes in affected students. © 2017 The British Psychological Society.
Prospects for Vascular Access Education in Developing Countries: Current Situation in Cambodia.
Naganuma, Toshihide; Takemoto, Yoshiaki
2017-01-01
We report our activities training doctors on vascular access procedures at International University (IU) Hospital in Cambodia through a program facilitated by Ubiquitous Blood Purification International, a nonprofit organization that provides medical support to developing countries in the field of dialysis medicine. Six doctors from Japan have been involved in the education of medical personnel at IU, and we have collectively visited Cambodia about 15 times from 2010 to 2016. In these visits, we have performed many operations, including 42 for arteriovenous fistula, 1 arteriovenous graft, and 1 percutaneous transluminal angioplasty. Stable development and management of vascular access is increasingly required in Cambodia due to increased use of dialysis therapy, and training of doctors in this technique is urgently required. However, we have encountered several difficulties that need to be addressed, including (1) the situation of personnel receiving this training, (2) problems with facilities, including medical equipment and drugs, (3) financial limitations, and (4) problems with management of vascular access. © 2017 S. Karger AG, Basel.
Vohra, Rini; Madhavan, Suresh; Sambamoorthi, Usha; St Peter, Claire
2014-10-01
This cross-sectional study examined perceived access to services, quality of care, and family impact reported by caregivers of children aged 3-17 years with autism spectrum disorders, as compared to caregivers of children with other developmental disabilities and other mental health conditions. The 2009-2010 National Survey of Children with Special Health Care Needs was utilized to examine the association between child's special needs condition and three outcomes (N = 18,136): access to services (difficulty using services, difficulty getting referrals, lack of source of care, and inadequate insurance coverage), quality of care (lack of care coordination, lack of shared decision making, and no routine screening), and family impact (financial, employment, and time-related burden). Multivariate logistic regressions were performed to compare caregivers of children with autism spectrum disorders to caregivers of children with developmental disabilities (cerebral palsy, Down syndrome, developmental delay, or intellectual disability), mental health conditions (attention deficit hyperactivity disorder, anxiety, behavioral/conduct problems, or depression), or both developmental disabilities and mental health conditions. Caregivers of children with autism spectrum disorders were significantly more likely to report difficulty using services, lack of source of care, inadequate insurance coverage, lack of shared decision making and care coordination, and adverse family impact as compared to caregivers of children with developmental disabilities, mental health conditions, or both. © The Author(s) 2013.
Portegijs, Erja; Viljanen, Anne; Iwarsson, Susanne; Rantanen, Taina
2016-01-01
Background Environmental barriers increase risk for mobility difficulties in old age. Mobility difficulty is preceded by a phase where people try to postpone a difficulty through mobility modification. We studied whether perceived environmental mobility barriers outdoors correlate with mobility modification and mobility difficulty, predict development of mobility difficulty over a two-year follow-up, and whether mobility modification alleviates the risk for difficulty. Methods At baseline, 848 people aged 75–90 were interviewed face-to-face. Telephone follow-up interviews were conducted one (n = 816) and two years (n = 761) later. Environmental barriers to mobility were self-reported using a15-item structured questionnaire at baseline, summed and divided into tertiles (0, 1 and 2 or more barriers). Mobility difficulty was assessed as self-reported ability to walk 2 km at all assessment points and categorized into ‘no difficulty’, ‘no difficulty but mobility modifications’ (reducing frequency, stopping walking, using an aid, slowing down or resting during the performance) and ‘difficulty’. Results At baseline, 212 participants reported mobility modifications and 356 mobility difficulties. Those reporting one or multiple environmental barriers had twice the odds for mobility modifications and up to five times the odds for mobility difficulty compared to those reporting no environmental barriers. After multiple adjustments for health and functioning, reporting multiple environmental barriers outdoors continued to predict the development of incident mobility difficulty over the two-year follow-up. Mobility modifications attenuated the association. Conclusion For older people who successfully modify their performance, environmental influence on incident mobility difficulty can be diminished. Older people use mobility modification to alleviate environmental press on mobility. PMID:27104750
Parents' difficulties with decisions about childhood immunisation.
Austin, Helen; Campion-Smith, Charles; Thomas, Sarah; Ward, William
2008-10-01
Uptake of childhood immunisation fluctuates in the UK. Convenience, access and parents' relationships with professionals influence uptake. This study explores the decision-making by parents about their children's immunisation through focus groups with analysis to identify categories of concern. Issues raised in focus groups included fear, risk, anger, worry and guilt, confusion, difficulty of decision-making and trust of professionals. The parents of completely and incompletely immunised children shared areas of concern, but there were also significant differences. There was a subset of parents of incompletely immunised children who had decided that their children would not have full immunisation, and this group had little trust in information provided by healthcare professionals. Simply providing more information is unlikely to change their decision.
Impact of Psychosocial Environment on Young Children's Emotional and Behavioral Difficulties.
Grazuleviciene, Regina; Andrusaityte, Sandra; Petraviciene, Inga; Balseviciene, Birute
2017-10-24
Objective: The impact of maternal psychosocial stress on young children's mental difficulties is unclear. This study investigated the joint effects of the socioeconomic status and parent-child relationships on emotional and behavioral difficulties in preschool children. Methods: The case-control study included 1416 mothers and their 4-6 year-old children pairs, living in Kaunas city, Lithuania. The parent-child relationships were measured using the Parent-Child Dysfunctional Interaction subscale. Children's mental health difficulties were assessed by the Strengths and Difficulties Questionnaire. We used logistic regression models to indicate the strength of the associations. Results: Lower socioeconomic status women more often than higher ones reported pathological mother-child relations. Low education level was associated with statistically significant increase adjusted odds ratios for emotional symptoms and total behavioral difficulties. With reference to the group of better-educated mothers and normal mother-child relations, low education and pathological mother-child relations statistically significantly increased the risk of total difficulties in 4-6 year-old children; the adjusted odds ratios were 2.45; 95% CI 1.51-3.99. Conclusions: Pathological mother-child relations strengthened the effect of lower education on the increased risk of emotional and behavioral difficulties in preschool-age children. Measures oriented towards health behavior and psychosocial difficulties management may decrease children's emotional and behavioral difficulties.
Water sanitation, access, use and self-reported diarrheal disease in rural Honduras.
Halder, Gabriela E; Bearman, Gonzalo; Sanogo, Kakotan; Stevens, Michael P
2013-01-01
Only 79% of individuals living in rural Honduras use improved water sources. Inadequate drinking water quality is related to diarrheal illness, which in Honduras contributes to 18.6 episodes of diarrhea per child year in children under five years of age. The purpose of this study was to examine and compare access to drinking water and sanitation, as well as self-reported diarrheal disease incidence among three proximal communities in the Department of Yoro area of Honduras. An 11-item language-specific, interviewer-administered, anonymous questionnaire was administered to 263 randomly selected adults attending a June 2011 medical brigade held in the communities of Coyoles, La Hicaca, and Lomitas. Chi-square with Fisher exact tests were utilized to compare water access, sanitation, and self-reported diarrheal incidence among these communities. Coyoles and La Hicaca used private faucets as their primary water sources. Coyoles had the greatest use of bottled water. Lomitas used rivers as their primary water source, and did not use bottled water. Mostly, females were responsible for acquiring water. Usage of multiple water sanitation methods was most common in Coyoles, while no sanitation method was most common in Lomitas. In Lomitas and La Hicaca, water filters were mostly provided via donation by non-governmental organizations. Lomitas had the highest reported incidence of diarrhea among self and other household members. Critical differences in water access, sanitation, and self-reported diarrheal incidence among three geographically distinct, yet proximal, communities highlights the need for targeted interventions even in geographically proximal rural areas.
Memory Abilities in Children with Mathematical Difficulties: Comorbid Language Difficulties Matter
Reimann, Giselle; Gut, Janine; Frischknecht, Marie-Claire; Grob, Alexander
2013-01-01
The present study investigated cognitive abilities in children with difficulties in mathematics only (n = 48, M = 8 years and 5 months), combined mathematical and language difficulty (n = 27, M = 8 years and 1 month) and controls (n = 783, M = 7 years and 11 months). Cognitive abilities were measured with seven subtests, tapping visual perception,…
The Association between Access to Public Transportation and Self-Reported Active Commuting
DEFF Research Database (Denmark)
Djurhuus, Sune; Hansen, Henning S; Aadahl, Mette
2014-01-01
Active commuting provides routine-based regular physical activity which can reduce the risk of chronic diseases. Using public transportation involves some walking or cycling to a transit stop, transfers and a walk to the end location and users of public transportation have been found to accumulate...... more moderate physical activity than non-users. Understanding how public transportation characteristics are associated with active transportation is thus important from a public health perspective. This study examines the associations between objective measures of access to public transportation...... and self-reported active commuting. Self-reported time spent either walking or cycling commuting each day and the distance to workplace were obtained for adults aged 16 to 65 in the Danish National Health Survey 2010 (n = 28,928). Access to public transportation measures were computed by combining GIS...
Chhabra, H S; Bhalla, A M
2015-11-01
To assess the influence of financial constraints on access to different components of spinal cord injury (SCI) management in various socio-economic strata of the Indian population. Indian Spinal Injuries Centre (ISIC). One hundred fifty SCI individuals who came for follow-up at ISIC between March 2009 and March 2013 with at least 1 year of community exposure after discharge were included in the study. Socio-economic classification was carried out according to the Kuppuswamy scale, a standard scale for the Indian population. A self-designed questionnaire was administered. No sample was available from the lower group. There was a statistically significant difference (PSCI management. Aided upper lower group was dependent on welfare schemes for in-hospital treatment but could not access other components of management once discharged. Unaided upper lower group either faced severe difficulty or could not access management. Majority of lower middle group faced severe difficulty. Upper middle group was equally divided into facing severe, moderate or no difficulty. Most patients in the upper group faced no difficulty, whereas some faced moderate and a small number of severe difficulty. Financial constraints affected all components of SCI management in all except the upper group. The results of the survey suggest that a very large percentage of the Indian population would find it difficult to access comprehensive SCI management and advocate extension of essential medical coverage to unaided upper lower, lower middle and upper middle groups.
Nipp, Ryan D; Shui, Amy M; Perez, Giselle K; Kirchhoff, Anne C; Peppercorn, Jeffrey M; Moy, Beverly; Kuhlthau, Karen; Park, Elyse R
2018-03-29
Cancer survivors face ongoing health issues and need access to affordable health care, yet studies examining health care access and affordability in this population are lacking. To evaluate health care access and affordability in a national sample of cancer survivors compared with adults without cancer and to evaluate temporal trends during implementation of the Affordable Care Act. We used data from the National Health Interview Survey from 2010 through 2016 to conduct a population-based study of 30 364 participants aged 18 years or older. We grouped participants as cancer survivors (n = 15 182) and those with no reported history of cancer, whom we refer to as control respondents (n = 15 182), matched on age. We excluded individuals reporting a cancer diagnosis prior to age 18 years and those with nonmelanoma skin cancers. We compared issues with health care access (eg, delayed or forgone care) and affordability (eg, unable to afford medications or health care services) between cancer survivors and control respondents. We also explored trends over time in the proportion of cancer survivors reporting these difficulties. Of the 30 364 participants, 18 356 (57.4%) were women. The mean (SD) age was 63.5 (23.5) years. Cancer survivors were more likely to be insured (14 412 [94.8%] vs 13 978 [92.2%], P care (odds ratio [OR], 1.38; 95% CI, 1.16-1.63), forgone medical care (OR, 1.76; 95% CI, 1.45-2.12), and/or inability to afford medications (OR, 1.77; 95% CI, 1.46-2.14) and health care services (OR, 1.46; 95% CI, 1.27-1.68) (P care decreased each year (B = 0.47; P = .047), and the proportion of those needing and not getting medical care also decreased each year (B = 0.35; P = .04). In addition, the proportion of cancer survivors who reported being unable to afford prescription medication decreased each year (B=0.66; P = .004) and the proportion of those unable to afford at least 1 of 6 services decreased each year (B = 0
LENUS (Irish Health Repository)
Cotter, P
2014-11-01
This study examined victimisation, substance misuse, relationships, sexual activity, mental health difficulties and suicidal behaviour among adolescents with sexual orientation concerns in comparison to those without such concerns. 1112 Irish students (mean age 14 yrs) in 17 mixed-gender secondary schools completed a self-report questionnaire with standardised scales and measures of psychosocial difficulties. 58 students (5%) reported having concerns regarding their sexual orientation. Compared with their peers, they had higher levels of mental health difficulties and a markedly-increased prevalence of attempted suicide (29% vs. 2%), physical assault (40% vs. 8%), sexual assault (16%vs. 1%) and substance misuse. Almost all those (90%) with sexual orientation concerns reported having had sex compared to just 4% of their peers. These results highlight the significant difficulties associated with sexual orientation concerns in adolescents in Ireland. Early and targeted interventions are essential to address their needs.
The association between access to public transportation and self-reported active commuting.
Djurhuus, Sune; Hansen, Henning S; Aadahl, Mette; Glümer, Charlotte
2014-12-05
Active commuting provides routine-based regular physical activity which can reduce the risk of chronic diseases. Using public transportation involves some walking or cycling to a transit stop, transfers and a walk to the end location and users of public transportation have been found to accumulate more moderate physical activity than non-users. Understanding how public transportation characteristics are associated with active transportation is thus important from a public health perspective. This study examines the associations between objective measures of access to public transportation and self-reported active commuting. Self-reported time spent either walking or cycling commuting each day and the distance to workplace were obtained for adults aged 16 to 65 in the Danish National Health Survey 2010 (n = 28,928). Access to public transportation measures were computed by combining GIS-based road network distances from home address to public transit stops an integrating their service level. Multilevel logistic regression was used to examine the association between access to public transportation measures and active commuting. Distance to bus stop, density of bus stops, and number of transport modes were all positively associated with being an active commuter and with meeting recommendations of physical activity. No significant association was found between bus services at the nearest stop and active commuting. The results highlight the importance of including detailed measurements of access to public transit in order to identify the characteristics that facilitate the use of public transportation and active commuting.
The Association between Access to Public Transportation and Self-Reported Active Commuting
Directory of Open Access Journals (Sweden)
Sune Djurhuus
2014-12-01
Full Text Available Active commuting provides routine-based regular physical activity which can reduce the risk of chronic diseases. Using public transportation involves some walking or cycling to a transit stop, transfers and a walk to the end location and users of public transportation have been found to accumulate more moderate physical activity than non-users. Understanding how public transportation characteristics are associated with active transportation is thus important from a public health perspective. This study examines the associations between objective measures of access to public transportation and self-reported active commuting. Self-reported time spent either walking or cycling commuting each day and the distance to workplace were obtained for adults aged 16 to 65 in the Danish National Health Survey 2010 (n = 28,928. Access to public transportation measures were computed by combining GIS-based road network distances from home address to public transit stops an integrating their service level. Multilevel logistic regression was used to examine the association between access to public transportation measures and active commuting. Distance to bus stop, density of bus stops, and number of transport modes were all positively associated with being an active commuter and with meeting recommendations of physical activity. No significant association was found between bus services at the nearest stop and active commuting. The results highlight the importance of including detailed measurements of access to public transit in order to identify the characteristics that facilitate the use of public transportation and active commuting.
Murphy, Esther
2017-01-01
This article presents findings from a recent national study supported by Association for Higher Education Access & Disability and the National Learning Network (2016) to investigate the experiences of students with mental health difficulties in higher education in Ireland. The data investigation was a combination of both survey and qualitative…
Attribution Style of Adolescents with School-Reported Social, Emotional and Behavioural Difficulties
Maras, P. F.; Moon, A.; Gridley, N.
2014-01-01
The aim of the study was to investigate the relationships between attribution style and social, emotional and behavioural difficulties (SEBDs), and to explore differences in attribution tendencies between adolescents with and without SEBDs. In total, 72 adolescents attending a school in London were recruited; 27 were receiving support for SEBDs…
Geetha Lakshmi Sreerama; Sai Varun Matavalum; Paraiveedu Arumugam Chandresekharan; Veronica Thunga
2015-01-01
Context: Despite policies to make health care accessible to all, it is not universally accessible. Frequent evaluation of barriers to accessibility of health care services paves path for improvement. Hence, present study is undertaken to evaluate the factors and public health policies influencing health care access to rural people in Chittoor District, Andhra Pradesh, which can be interpolated for other regions. Aims: To assess knowledge, perceptions, availing of public health care services, ...
Report Focuses on Integrity and Accessibility of Research Data
Showstack, Randy
2009-08-01
Rapid advances in digital technologies and enormous increases in the amount of data generated by research projects and a variety of instruments and sensors are providing new research opportunities. These advances, however, also can present challenges for ensuring that digital technologies are not used inappropriately and for managing an increasing amount of data, according to a new report issued by the U.S. National Academy of Sciences, National Academy of Engineering, and Institute of Medicine on 22 July. The new report, entitled “Ensuring the integrity, accessibility, and stewardship of research data in the digital age,” provides general principles and recommendations about the handling of research data. The report notes that the development of policies, standards, and infrastructure “is a critically important task” that will require a sustained effort from stakeholders including researchers, research institutions and sponsors, and professional societies and journals.
Feeding Difficulties in Children with Esophageal Atresia.
Mahoney, Lisa; Rosen, Rachel
2016-06-01
The current available literature evaluating feeding difficulties in children with esophageal atresia was reviewed. The published literature was searched through PubMed using a pre-defined search strategy. Feeding difficulties are commonly encountered in children and adults with repaired esophageal atresia [EA]. The mechanism for abnormal feeding includes both esophageal and oropharyngeal dysphagia. Esophageal dysphagia is commonly reported in patients with EA and causes include dysmotility, anatomic lesions, esophageal outlet obstruction and esophageal inflammation. Endoscopic evaluation, esophageal manometry and esophograms can be useful studies to evaluate for causes of esophageal dysphagia. Oropharyngeal dysfunction and aspiration are also important mechanisms for feeding difficulties in patients with EA. These patients often present with respiratory symptoms. Videofluoroscopic swallow study, salivagram, fiberoptic endoscopic evaluation of swallowing and high-resolution manometry can all be helpful tools to identify aspiration. Once diagnosed, management goals include reduction of aspiration during swallowing, reducing full column reflux into the oropharynx and continuation of oral feeding to maintain skills. We review specific strategies which can be used to reduce aspiration of gastric contents, including thickening feeds, changing feeding schedule, switching formula, trialing transpyloric feeds and fundoplication. Copyright © 2015 Elsevier Ltd. All rights reserved.
Alencar Albuquerque, Grayce; de Lima Garcia, Cintia; da Silva Quirino, Glauberto; Alves, Maria Juscinaide Henrique; Belém, Jameson Moreira; dos Santos Figueiredo, Francisco Winter; da Silva Paiva, Laércio; do Nascimento, Vânia Barbosa; da Silva Maciel, Érika; Valenti, Vitor Engrácia; de Abreu, Luiz Carlos; Adami, Fernando
2016-01-14
The relationship between users and health services is considered essential to strengthen the quality of care. However, the Lesbian, Gay, Bisexual, and Transgender population suffer from prejudice and discrimination in access and use of these services. This study aimed to identify the difficulties associated with homosexuality in access and utilization of health services. A systematic review conducted using PubMed, Cochrane, SciELO, and LILACS, considering the period from 2004 to 2014. The studies were evaluated according to predefined inclusion and exclusion criterias. Were included manuscripts written in English or Portuguese, articles examining the Lesbian, Gay, Bisexual, and Transgender population's access to health services and original articles with full text available online. The electronic databases search resulted in 667 studies, of which 14 met all inclusion criteria. Quantitative articles were predominant, showing the country of United States of America to be the largest producer of research on the topic. The studies reveal that the homosexual population have difficulties of access to health services as a result of heteronormative attitudes imposed by health professionals. The discriminatory attendance implies in human rights violations in access to health services. The non-heterosexual orientation was a determinant factor in the difficulties of accessing health care. A lot must still be achieved to ensure access to health services for sexual minorities, through the adoption of holistic and welcoming attitudes. The results of this study highlight the need for larger discussions about the theme, through new research and debates, with the aim of enhancing professionals and services for the health care of Lesbian, Gay, Bisexual, and Transgender Persons.
Student difficulties with Gauss' law
Kanim, Stephen
2000-09-01
Many students in introductory courses have difficulty solving Gauss' law problems. Through interviews with students and analysis of solutions to homework and examination questions we have identified some specific conceptual difficulties that often contribute to students' inability to solve quantitative Gauss' law problems. We give examples of common difficulties and discuss instructional implications.
Energy Technology Data Exchange (ETDEWEB)
Weller, Heiko [Robert Bosch, LLC, Farmington Hills, MI (United States)
2015-04-01
The ACCESS project addressed the development, testing, and demonstration of the proposed advanced technologies and the associated emission and fuel economy improvement at an engine dynamometer and on a full-scale vehicle. Improve fuel economy by 25% with minimum performance penalties Achieve SULEV level emissions with gasoline Demonstrate multi-mode combustion engine management system
Impact of Psychosocial Environment on Young Children’s Emotional and Behavioral Difficulties
Directory of Open Access Journals (Sweden)
Regina Grazuleviciene
2017-10-01
Full Text Available Objective: The impact of maternal psychosocial stress on young children’s mental difficulties is unclear. This study investigated the joint effects of the socioeconomic status and parent-child relationships on emotional and behavioral difficulties in preschool children. Methods: The case-control study included 1416 mothers and their 4–6 year-old children pairs, living in Kaunas city, Lithuania. The parent-child relationships were measured using the Parent-Child Dysfunctional Interaction subscale. Children’s mental health difficulties were assessed by the Strengths and Difficulties Questionnaire. We used logistic regression models to indicate the strength of the associations. Results: Lower socioeconomic status women more often than higher ones reported pathological mother-child relations. Low education level was associated with statistically significant increase adjusted odds ratios for emotional symptoms and total behavioral difficulties. With reference to the group of better-educated mothers and normal mother-child relations, low education and pathological mother-child relations statistically significantly increased the risk of total difficulties in 4–6 year-old children; the adjusted odds ratios were 2.45; 95% CI 1.51–3.99. Conclusions: Pathological mother-child relations strengthened the effect of lower education on the increased risk of emotional and behavioral difficulties in preschool-age children. Measures oriented towards health behavior and psychosocial difficulties management may decrease children’s emotional and behavioral difficulties.
Feeding difficulties in children with food protein-induced gastrointestinal allergies.
Meyer, Rosan; Rommel, Nathalie; Van Oudenhove, Lukas; Fleming, Catharine; Dziubak, Robert; Shah, Neil
2014-10-01
There is paucity of data on the prevalence of feeding difficulties in Food Protein-Induced Gastrointestinal Allergies (FPIGA) and their clinical characteristics. However, it is a commonly reported problem by clinicians. We set out to establish the occurrence of feeding difficulties in children with FPIGA, the association with gastrointestinal and extra-intestinal symptoms and number of foods eliminated from the diet. This retrospective observational analysis was performed in patients seen between 2002 and 2009 at Great Ormond Street Children's Hospital, Gastroenterology Department, London. Medical records where FPIGA was documented using the terms from the National Institute of Allergy and Infectious Disease and National Institute of Clinical Excellence and confirmed using an elimination diet, followed by a challenge were included. Feeding difficulties were assessed using a criteria previously used in healthy toddlers in the UK. Data from 437 children (203 female) were collected. Significantly more children with feeding difficulties presented with abdominal distention and bloating (P = 0.002), vomiting (P foods eliminated from the diet in the children with/without feeding difficulties (P = 0.028). Clinical manifestations like vomiting, constipation, rectal bleeding, weight loss, and the presence of extra-intestinal manifestations in addition to the number of foods avoided are in our FPIGA population linked to feeding difficulties. © 2014 Journal of Gastroenterology and Hepatology Foundation and Wiley Publishing Asia Pty Ltd.
Readability Formulas and User Perceptions of Electronic Health Records Difficulty: A Corpus Study.
Zheng, Jiaping; Yu, Hong
2017-03-02
Electronic health records (EHRs) are a rich resource for developing applications to engage patients and foster patient activation, thus holding a strong potential to enhance patient-centered care. Studies have shown that providing patients with access to their own EHR notes may improve the understanding of their own clinical conditions and treatments, leading to improved health care outcomes. However, the highly technical language in EHR notes impedes patients' comprehension. Numerous studies have evaluated the difficulty of health-related text using readability formulas such as Flesch-Kincaid Grade Level (FKGL), Simple Measure of Gobbledygook (SMOG), and Gunning-Fog Index (GFI). They conclude that the materials are often written at a grade level higher than common recommendations. The objective of our study was to explore the relationship between the aforementioned readability formulas and the laypeople's perceived difficulty on 2 genres of text: general health information and EHR notes. We also validated the formulas' appropriateness and generalizability on predicting difficulty levels of highly complex technical documents. We collected 140 Wikipedia articles on diabetes and 242 EHR notes with diabetes International Classification of Diseases, Ninth Revision code. We recruited 15 Amazon Mechanical Turk (AMT) users to rate difficulty levels of the documents. Correlations between laypeople's perceived difficulty levels and readability formula scores were measured, and their difference was tested. We also compared word usage and the impact of medical concepts of the 2 genres of text. The distributions of both readability formulas' scores (Preadability predictions and laypeople's perceptions were weak. Furthermore, despite being graded at similar levels, documents of different genres were still perceived with different difficulty (Preadability formulas' predictions did not align with perceived difficulty in either text genre. The widely used readability formulas were
The Situation of Open Access Institutional Repositories in Spain: 2009 Report
Melero, Remedios; Abadal, Ernest; Abad, Francisca; Rodriguez-Gairin, Josep Manel
2009-01-01
Introduction: The DRIVER I project drew up a detailed report of European repositories based on data gathered in a survey in which Spain's participation was very low. This created a highly distorted image of the implementation of repositories in Spain. This study aims to analyse the current state of Spanish open-access institutional repositories…
Special needs children with speech and hearing difficulties: prevalence and unmet needs.
Kenney, Mary Kay; Kogan, Michael D
2011-01-01
The purpose of this study was to establish prevalences and sociodemographic characteristics associated with parent-reported speech and hearing difficulties among children with special health care needs (CSHCN); determine unmet needs for therapy, hearing aids, and communication devices; and examine the association between unmet needs and resources such as health insurance, early intervention/special education, and a medical home. Data were analyzed for 300,910 children without special health care needs and 40,723 CSHCN from the 2005-2006 National Survey of Children with Special Health Care Needs. Prevalence, sociodemographic characteristics, and unmet needs for 7132 CSHCN with speech difficulties and 1982 CSHCN with hearing difficulties were assessed. Logistic regression was used to determine the associations between unmet needs for therapy or hearing/communication devices and resources for addressing needs for therapy, hearing, and communication aids. The parent-reported prevalence of speech difficulty among CSHCN in the general population was 2.9% and approximately 20% among all CSHCN, in contrast to the lower prevalence of hearing difficulty (0.7% and 5%, respectively). Relative unmet need was greatest for communication devices and least for hearing aids. The strongest association with reducing unmet needs was having a medical home, and the most significant aspect of medical home was having effective care coordination. Having a medical home is significantly associated with fewer unmet needs for therapy and hearing/communication devices among CSHCN with speech and hearing difficulties. Care coordination may constitute an important factor that allows the primary care provider to link with services that CSHCN with communication problems require. Published by Elsevier Inc.
DEFF Research Database (Denmark)
Herriott, Richard
2012-01-01
A report on how nine rail builder, operators and transport designers deal with design for accessibility......A report on how nine rail builder, operators and transport designers deal with design for accessibility...
Handwriting difficulties in juvenile idiopathic arthritis: a pilot study
Haberfehlner, Helga; Visser, Bart; Daffertshofer, Andreas; van Rossum, Marion Aj; Roorda, Leo D.; van der Leeden, Marike; Dekker, Joost; Hoeksma, Agnes F.
2011-01-01
The aim of the present study was to describe handwriting difficulties of primary school children with juvenile idiopathic arthritis (JIA), and to investigate possible correlations with hand function and writing performance. In a cross-sectional approach, 15 children with JIA and reported handwriting
Transcatheter closure of a large patent ductus arteriosus using jugular access in an infant.
Fernandes, Precylia; Assaidi, Anass; Baruteau, Alban-Elouen; Fraisse, Alain
2018-03-01
Trans-catheter device closure of patent ductus arteriosus (PDA) via femoral route is the commonly used, safe and effective procedure. Trans-jugular approach has been successfully used in older children with interrupted inferior vena cava. We report a case of successful occlusion of PDA using Amplatzer duct occluder (ADO) via trans-jugular approach following difficulties encountered in gaining femoral venous access. A 6-month-old male infant, weighing 8 kg was admitted for percutaneous catheter closure of PDA. Echocardiogram showed a 4.5 mm duct and left heart dilatation. Femoral venous access was not possible; therefore, we decided to use a trans-jugular approach. The duct was occluded using 8/6 mm ADO. Successful closure of the duct was confirmed with an aortogram. Post procedure echocardiogram showed no residual shunt across the duct. We highlight that trans-catheter closure of PDA using jugular venous access is safe and effective even in infants.
Open access natural gas transportation: A progress report on FERC implementation
International Nuclear Information System (INIS)
Anon.
1990-01-01
This article is a progress report on the Federal Energy Regulatory Commission's implementation of a US Court of Appeals decision upholding open access natural gas transportation. The five issues addressed by the court are identified and discussed. Take or Pay (TOP) contract modification, the crediting mechanism, pregranted abandonment, contract demand reduction, TOP cost passthrough are also discussed
Parental depressive symptoms and childhood cancer: the importance of financial difficulties.
Creswell, Paul D; Wisk, Lauren E; Litzelman, Kristin; Allchin, Adelyn; Witt, Whitney P
2014-02-01
Research suggests a relationship between caring for a child with cancer and psychological distress in caregivers. Less evident is the role which financial difficulties might play in this relationship. We sought to determine if caring for a child with cancer was related to clinically relevant depressive symptoms among parents, whether or not financial difficulties mediated this relationship, and if financial difficulties were independently associated with symptoms of depression among parents of children with cancer. Data are from 215 parents of children diagnosed with cancer or brain tumors (n = 75) and a comparison group of parents of healthy children (n = 140). Multiple logistic regression analyses were used to assess the factors associated with reporting clinically relevant depressive symptoms. Caring for a child with cancer was associated with increased odds of clinically relevant depressive symptoms in parents (OR = 4.93; 95 % CI 1.97-12.30), controlling for covariates. The mediating effect of financial burden on this relationship was not statistically significant. However, among parents of children with cancer, negative financial life events increased the likelihood of reporting symptoms of depression (OR = 4.89; 95 % CI 1.26-18.96). Caring for a child with cancer was associated with depressive symptoms for parents. Financial difficulties were the strongest correlate of these symptoms among parents of children with cancer. Our results suggest that it may not only be the burden of caring for the child with cancer but also the associated financial difficulties that contribute to a higher likelihood of depressive symptoms in parents.
Stress and suicidal ideation among adolescents having academic difficulty
Directory of Open Access Journals (Sweden)
Priti Arun
2017-01-01
Full Text Available Background and Objectives: Academically typically achieving adolescents were compared with students having academic difficulty on stress and suicidal ideas. Materials and Methods: In a cross-sectional study, 75 academically typically achieving adolescents were compared with 105 students with academic difficulty and 52 students with specific learning disability (SLD. Academic functioning was assessed using teacher's screening instrument, intelligence quotient, and National Institute of Mental Health and Neurosciences index for SLD. Stress and suicidal ideas were assessed using general health questionnaire, suicide risk-11, and Mooney Problem Checklist (MPC. Appropriate statistical methods were applied. Results: Three groups were comparable on age, gender, mother's working status, being only child, nuclear family, self-reported academic decline, and type of school. About half of adolescents reported psychological problems on General Health Questionnaire (mean score >3 in all the groups. Academically typically achieving adolescents showed higher stressors in peer relationships, planning for future and suicidal ideation compared to adolescents with academic difficulty. Adolescents face stress regarding worry about examinations, family not understanding what child has to do in school, unfair tests, too much work in some subjects, afraid of failure in school work, not spending enough time in studies, parental expectations, wanting to be more popular, worried about a family member, planning for the future, and fear of the future. Significant positive correlation was seen between General Health Questionnaire scores and all four subscales of MPC. Suicidal ideas showed a negative correlation with MPC. Interpretations and Conclusions: Adolescents experience considerable stress in multiple areas irrespective of their academic ability and performance. Hence, assessment and management of stress among adolescents must extend beyond academic difficulties.
DEFF Research Database (Denmark)
Christensen, Mette Krogh; O'Neill, Lotte; Hansen, Dorthe Høgh
2016-01-01
Background The majority of studies on prevalence and characteristics of residents in difficulty have been conducted in English-speaking countries and the existing literature may not reflect the prevalence and characteristics of residents in difficulty in other parts of the world such as the Scand...... in a healthcare system. From our perspective, further sociological and pedagogical investigations in educational cultures across settings and specialties could inform our understanding of and knowledge about pitfalls in residents’ and doctors’ socialization into the healthcare system....
Difficulties of diabetic patients in the illness control: feelings and behaviors
Péres, Denise Siqueira; Santos, Manoel Antônio dos; Zanetti, Maria Lúcia; Ferronato, Antônio Augusto
2007-01-01
This study aimed to identify difficulties diabetic patients face during treatment in controlling the disease. A total of 24 diabetic patients, attended in the Nurse Educational Center for Adults and Elders in 2003, participated in the study. The data was collected individually, through a written report guided by a question previously elaborated, on a pre-scheduled date. The Content Analysis technique was used in the data analysis. The results showed several difficulties related to the treatme...
Tjelta, Thomas; Ritchie, Deborah; Amos, Amanda
2017-11-07
Reducing young people's access to cigarettes is a key element of smoking prevention policies. This article explores how young people source cigarettes following the increase in the UK minimum age of sale from 16 to 18 years. Semi-structured individual, paired and triadic interviews with 60 disadvantaged young people aged between 12 and 17. Participants were recruited from clubs and voluntary organizations offering advice and support to disadvantaged young people. Most participants said they sourced cigarettes from shops, but understandings of "buying cigarettes from shops" included using intermediaries for proxy purchases. Access from social sources was contingent on reciprocation, and blackmarket sources were avoided. The distinction between potential and actual sources reflected participants concerns about their presentation of self. Those who bought cigarettes directly from shops accrued status and power in negotiating social hierarchies. Participants therefore highlighted their smoking related competencies, that is, ability to secure regular retail access to tobacco, while downplaying the significant difficulties they experienced. The presentational dimension of youth cigarette access highlights a need for caution in associating self-reported changes in young people's cigarette sources straightforwardly with access policies. The conflation of direct retail purchases with proxy purchases, and the interrelationship between commercial and social cigarette sources also raises issues for interpreting data on "usual" cigarette sources from national surveys. Findings suggest that some young people may still be both reliant on making retail cigarette purchases following the increase in the age of sale in the United Kingdom, and experiencing significant difficulties making these. This study highlights the self-presentational dimension of youth cigarette access in a particular community context, and the important distinction between the apparent range of sources
DeThorne, Laura Segebart; Hart, Sara A.; Petrill, Stephen A.; Deater-Deckard, Kirby; Thompson, Lee Anne; Schatschneider, Chris; Davison, Megan Dunn
2006-01-01
Purpose: This study examined (a) the extent of genetic and environmental influences on children's articulation and language difficulties and (b) the phenotypic associations between such difficulties and direct assessments of reading-related skills during early school-age years. Method: Behavioral genetic analyses focused on parent-report data…
Reardon, Tessa; Harvey, Kate; Young, Bridget; O'Brien, Doireann; Creswell, Cathy
2018-01-25
Anxiety disorders are among the most common mental health disorders experienced by children, but only a minority of these children access professional help. Understanding the difficulties parents face seeking support for child anxiety disorders could inform targeted interventions to improve treatment access. The aims of the study were to identify barriers and facilitators to seeking and accessing professional support for child anxiety disorders, and ways to minimise these barriers. A qualitative interview study was conducted with parents of 16 children (aged 7-11 years) with anxiety disorders identified through screening in schools. Barriers and facilitators were identified in relation to four distinct stages in the help-seeking process: parents recognising the anxiety difficulty, parents recognising the need for professional support, parents contacting professionals, and families receiving professional support. Barriers and facilitators at each stage related to the child's difficulties, the role of the parent, and parent perceptions of professionals and services. Findings illustrate the need (1) for readily available tools to help parents and professionals identify clinically significant anxiety in children, (2) to ensure that families and professionals can easily access guidance on the help-seeking process and available support, and (3) to ensure existing services offer sufficient provision for less severe difficulties that incorporates direct support for parents.
Children with Special Health Care Needs in CHIP: Access, Use, and Child and Family Outcomes.
Zickafoose, Joseph S; Smith, Kimberly V; Dye, Claire
2015-01-01
To assess how the Children's Health Insurance Program (CHIP) affects outcomes for children with special health care needs (CSHCN). We used data from a survey of parents of recent and established CHIP enrollees conducted from January 2012 through March 2013 as part of a congressionally mandated evaluation of CHIP. We identified CSHCN in the sample using the Child and Adolescent Health Measurement Initiative's CSHCN screener. We compared the health care experiences of established CHIP enrollees to the pre-enrollment experiences of previously uninsured and privately insured recent CHIP enrollees, controlling for observable characteristics. Parents of 4142 recent enrollees and 5518 established enrollees responded to the survey (response rates, 46% recent enrollees and 51% established enrollees). In the 10 survey states, about one-fourth of CHIP enrollees had a special health care need. Compared to being uninsured, parents of CSHCN who were established CHIP enrollees reported greater access to and use of medical and dental care, less difficulty meeting their child's health care needs, fewer unmet needs, and better dental health status for their child. Compared to having private insurance, parents of CSHCN who were established CHIP enrollees reported similar levels of access to and use of medical and dental care and unmet needs, and less difficulty meeting their child's health care needs. CHIP has significant benefits for eligible CSHCN and their families compared to being uninsured and appears to have some benefits compared to private insurance. Copyright © 2015 Academic Pediatric Association. All rights reserved.
Complication of Hemodialysis Access: A Case Report of Venous Hypertension
Directory of Open Access Journals (Sweden)
Sadegh Asadi
2018-03-01
Full Text Available Vascular access for dialysis is essential for these patients with end-stage renal disease, improvements in hemodialysis managment have lead to extended life expectancy. The creation and maintenance of hemoaccess occupies a significant portion of most vascular and general surgery practices.Venous hypertension due to arteriovenous fistula is usually secondary to venous outlet obstruction. Side to side proximal artery arteriovenous fistula serves as a certain cause of hemodialysis, but it is rarely reported as a peripheral venous hypertension cause. We are reporting a case with developed venous hypertension having dermal injuries in the arm. The patient underwent successful side-to-side radio cephalic fistula creation in the snuffbox a year ago.
Computer skills and internet use in adults aged 50-74 years: influence of hearing difficulties.
Henshaw, Helen; Clark, Daniel P A; Kang, Sujin; Ferguson, Melanie A
2012-08-24
The use of personal computers (PCs) and the Internet to provide health care information and interventions has increased substantially over the past decade. Yet the effectiveness of such an approach is highly dependent upon whether the target population has both access and the skill set required to use this technology. This is particularly relevant in the delivery of hearing health care because most people with hearing loss are over 50 years (average age for initial hearing aid fitting is 74 years). Although PC skill and Internet use by demographic factors have been examined previously, data do not currently exist that examine the effects of hearing difficulties on PC skill or Internet use in older adults. To explore the effect that hearing difficulty has on PC skill and Internet use in an opportunistic sample of adults aged 50-74 years. Postal questionnaires about hearing difficulty, PC skill, and Internet use (n=3629) were distributed to adults aged 50-74 years through three family physician practices in Nottingham, United Kingdom. A subsample of 84 respondents completed a second detailed questionnaire on confidence in using a keyboard, mouse, and track pad. Summed scores were termed the "PC confidence index." The PC confidence index was used to verify the PC skill categories in the postal questionnaire (ie, never used a computer, beginner, and competent). The postal questionnaire response rate was 36.78% (1298/3529) and 95.15% (1235/1298) of these contained complete information. There was a significant between-category difference for PC skill by PC confidence index (PInternet use was greater in the younger respondents (50-62 years) than in the older respondents (63-74 years). The younger group's PC and Internet use was 81.0% and 60.9%, respectively; the older group's PC and Internet use was 54.0% and 29.8%, respectively. Those with slight hearing difficulties in the older group had significantly greater odds of PC use compared to those with no hearing
Students’ difficulties in probabilistic problem-solving
Arum, D. P.; Kusmayadi, T. A.; Pramudya, I.
2018-03-01
There are many errors can be identified when students solving mathematics problems, particularly in solving the probabilistic problem. This present study aims to investigate students’ difficulties in solving the probabilistic problem. It focuses on analyzing and describing students errors during solving the problem. This research used the qualitative method with case study strategy. The subjects in this research involve ten students of 9th grade that were selected by purposive sampling. Data in this research involve students’ probabilistic problem-solving result and recorded interview regarding students’ difficulties in solving the problem. Those data were analyzed descriptively using Miles and Huberman steps. The results show that students have difficulties in solving the probabilistic problem and can be divided into three categories. First difficulties relate to students’ difficulties in understanding the probabilistic problem. Second, students’ difficulties in choosing and using appropriate strategies for solving the problem. Third, students’ difficulties with the computational process in solving the problem. Based on the result seems that students still have difficulties in solving the probabilistic problem. It means that students have not able to use their knowledge and ability for responding probabilistic problem yet. Therefore, it is important for mathematics teachers to plan probabilistic learning which could optimize students probabilistic thinking ability.
Alone? Perceived social support and chronic interpersonal difficulties in suicidal elders.
Harrison, Katrin E; Dombrovski, Alexandre Y; Morse, Jennifer Q; Houck, Patricia; Schlernitzauer, Maryann; Reynolds, Charles F; Szanto, Katalin
2010-05-01
Social networks may protect depressed elders against suicidal behavior. However, conflict in important relationships may undermine the sense of social support, potentially negating the protective effects. Thus, we investigated the role of chronic interpersonal difficulties and perceived social support in depressed elders with and without suicidal thoughts and attempts. 106 individuals aged 60 years and older participated in this cross-sectional, case-control study. They were placed in three groups: suicidal depressed, non-suicidal depressed and non-depressed. Following a detailed clinical characterization, we assessed perceived social support (Interpersonal Support Evaluation List), and chronic interpersonal difficulties (Inventory of Interpersonal Problems). Using general linear models, we explored the relationship between suicidal thoughts/attempts, social support, and chronic interpersonal difficulties. We also examined whether lower perceived social support explained the relationship between chronic interpersonal difficulties and suicidal thoughts/attempts. Suicidal depressed elders reported the lowest levels of perceived social support (belonging, tangible support, and self-esteem) and higher levels of chronic interpersonal difficulties (struggle against others and interpersonal hostility), compared to both non-suicidal depressed and non-depressed elders. The relationship between chronic interpersonal difficulties and suicidal behavior was partially explained by low perceived social support. The experience of strong affects, interpersonal struggle, and hostility in relationships may undermine the sense of social support in depressed elders, possibly leading them to contemplate or attempt suicide. Depressed elders with a history of interpersonal difficulties need to be carefully monitored for suicidal behavior.
Barriers and opportunities to access international resources for ...
International Development Research Centre (IDRC) Digital Library (Canada)
But tobacco control does not appear to be a health and development priority for the national government and development stakeholders in Bolivia. The Ministry of Health and civil organizations have experience difficulties in accessing international resources for tobacco control. At the same time, there is neither clear ...
The role of simulation in designing for universal access
DEFF Research Database (Denmark)
Keates, Simeon; Looms, Peter
2014-01-01
the difficulty of finding and recruiting suitable participants. Simulation aids offer a potentially cost-effective replacement or complement to participatory design. This paper examines a number of the issues associated with the use of simulation aids when designing for Universal Access. It concludes...
Transmission access issues: Present and future
International Nuclear Information System (INIS)
Bahl, P.K.; Gray, R.G.
1992-01-01
In recent years, the electric industry has undergone dramatic changes as the federal and state governments have encouraged bulk power production by Independent Power Producers (IPPS) and Qualified Facilities (QFs). With decentralization and the consequent competition in the field of bulk power production, there has emerged the problem of non-utility generators (NUGS) and of transmission dependent utilities accessing the existing transmission systems owned by electric utilities. This paper presents current and future issues related to transmission access by IPPS, QFs and transmission dependent utilities. These issues include: (a) impact on system reliability, (b) impact of pricing strategies, (c) changes in state and federal regulations, (d) transmission proposals by various entities, (e) present access arrangements, (f) formation of the Western Systems Power Pool (WSPP), and (g) siting difficulties. The transmission access problem warrants consideration of transmission services, coordination among electric utilities, joint planning on a regional basis, and accommodation of IPPs and NUGs
Small and Medium Enterprises` (SMEs) Access to Finance: Philippines
Aldaba, Rafaelita M.
2012-01-01
Based on a survey of 97 firms in the garments, textiles, automotive, electrical and electronics, and food manufacturing industries; the paper highlights the difficulties faced by small and medium enterprises (SMEs) in accessing finance. For both firms with access to finance as well as those that did not make any finance request, financing obstacles posed as one of the top four serious problems for the growth of their businesses. The survey indicates the continued dependence of SMEs on interna...
Sun, Sanjun
2012-01-01
Accurate assessment of a text's level of translation difficulty is critical for translator training and accreditation, translation research, and the language industry as well. Traditionally, people rely on their general impression to gauge a text's translation difficulty level. If the evaluation process is to be more effective and the…
International Nuclear Information System (INIS)
Landsberg, H.H.
1993-01-01
This paper assesses what may be the underlying reasons for the Clinton administration's recent failure to pass the Btu Tax on energy sources and the current difficulties that this Administration is experiencing in acquiring nation wide consensus on a gasoline tax proposal. Two difficulties stand out - regional differences in climate and thus winter heating requirements, and the differences from state to state in transportation system preferences. The paper cites the positive aspects of energy taxation by noting the petroleum industry's efforts to develop a new less polluting reformulated gasoline
Wang, Shinmin; Gathercole, Susan E.
2013-01-01
The current study investigated the cause of the reported problems in working memory in children with reading difficulties. Verbal and visuospatial simple and complex span tasks, and digit span and reaction times tasks performed singly and in combination, were administered to 46 children with single word reading difficulties and 45 typically…
Enabling Pupils with Learning Difficulties to Reflect on Their Own Thinking.
Powell, Stuart D.; Makin, Michael
1994-01-01
Reports on a study of the impact of metacognition among 10 middle school-aged British students with learning difficulties. Finds that student awareness and subsequent control over thought processes were enhanced through self-reporting and self-appraisal. Examines this kind of reflection on enhanced learning capabilities and self-esteem. (CFR)
Information Access for Disabled Students
Cypaite, Asta; Šerkšnien, Justina; Rudžioniene, Jurgita
2008-01-01
Disabled students who makes relatively small part of the academic society are in risk to disappear among all other students, due to their communication and mobility difficulties have less possibilities to satisfy their needs, ensuring their rights to qualitative studies, equal opportunities in the labor market and social integration. A topic about information accessibility for disabled students is extremely important because of their information exclusion in their study process at the un...
Hearing acuity as a predictor of walking difficulties in older women.
Viljanen, Anne; Kaprio, Jaakko; Pyykkö, Ilmari; Sorri, Martti; Koskenvuo, Markku; Rantanen, Taina
2009-12-01
To examine whether hearing acuity correlates with walking ability and whether impaired hearing at baseline predicts new self-reported walking difficulties after 3 years. Prospective follow-up. Research laboratory and community. Four hundred thirty-four women aged 63 to 76. Hearing was measured using clinical audiometry. A person was defined as having a hearing impairment if a pure-tone average of thresholds at 0.5 to 4 kHz in the better ear was 21 dB or greater. Maximal walking speed was measured over 10 m (m/s), walking endurance as the distance (m), covered in 6 minutes and difficulties in walking 2 km according to self-report. At baseline, women with hearing impairment (n=179) had slower maximal walking speed (1.7 +/- 0.3 m/s vs 1.8 +/- 0.3 m/s, P=.007), lower walking endurance (520 +/- 75 m vs 536 +/- 75 m, P=.08), and more selfreported major difficulties in walking 2 km (12.8% vs 5.5%, P=.02) than those without hearing impairment. During follow-up, major walking difficulties developed for 33 participants. Women with hearing impairment at baseline had a twice the age-adjusted risk for new walking difficulties as those without hearing impairment (odds ratio=2.04, 95% confidence interval=0.96-4.33). Hearing acuity correlated with mobility, which may be explained by the association between impaired hearing and poor balance and greater risk for falls, both of which underlie decline in mobility. Prevention of hearing loss is not only important for the ability to communicate, but may also have more wide-ranging influences on functional ability.
Conti-Ramsden, Gina; Mok, Pearl L H; Pickles, Andrew; Durkin, Kevin
2013-11-01
Adolescents with specific language impairment (SLI) are at a greater risk of emotional and behavioral problems compared to their typically developing (TD) peers, but little is known about their self-perceived strengths and difficulties. In this study, the self-reported social, emotional and behavioral functioning of 139 adolescents with a history of SLI and 124 TD individuals at age 16 was examined. The self-report version of the Strengths and Difficulties Questionnaire (SDQ) was used to assess their prosocial behavior and levels of peer, emotional and behavioral difficulties. Associations of these areas of functioning with gender, verbal and non-verbal skills were also investigated. Adolescents with a history of SLI were more likely than their TD peers to report higher levels of peer problems, emotional symptoms, hyperactivity and conduct problems. The majority of adolescents in both groups (87% SLI and 96% TD), however, reported prosocial behavior within the typical range. Difficulty with peer relations was the strongest differentiator between the groups, with the odds of reporting borderline or abnormally high levels of peer problems being 12 times higher for individuals with a history of SLI. Adolescents with poorer receptive language skills were also more likely to report higher levels of emotional and behavioral difficulties. The findings of this study identify likely traits that may lead to referral to services. Copyright © 2013 The Authors. Published by Elsevier Ltd.. All rights reserved.
Energy Technology Data Exchange (ETDEWEB)
NONE
1964-08-15
An unusual hydrological investigation is being carried out in Kenya by IAEA, at Lake Chala, a volcanic crater with no visible inlet or outlet. The problem is to determine whether the lake has any connection with a number of springs near Taveta, some six miles distant: this relationship is important in assessing the possibility of expanding the Taveta irrigation scheme. Questions of water rights and utilization are involved, since the lake is situated on the Tanganyikan border. The method adopted is that of labelling the waters of the lake with small quantities of water containing radioactive hydrogen (tritium). There are some special features in this instance, one being the difficulty of access. The lake is entirely surrounded by steep cliffs. A track was cut by British Army engineers, and the boat and all supplies were taken down by this route. Another problem was presented by the depth of the lake, which amounts to 300 feet. It is necessary to ensure the regular mixing of the tritium throughout. This has been done by means of hundreds of plastic bottles, which were dropped from the boat at regular intervals as it made a series of carefully-plotted traverses. Each bottle had a weight attached, and was perforated by two small holes. By this means, as the bottle sank the contents were progressively released until it reached the bottom, thus ensuring an even diffusion of tritium throughout the lake.
Reported Design Processes for Accessibility in Rail Transport
DEFF Research Database (Denmark)
Herriott, Richard; Cook, Sharon
2014-01-01
requirements with the aim of maximising accessibility in products and services. A review of ID literature has mainly developed in the arena of product design and design for assistive technology. Accessibility is a fundamental requirement in public transport (PT) yet there exists little research on design...... for accessibility or ID in this area. How is accessibility and the needs of users accounted for in rail transport design? This paper analyses interviews with rolling stock producers, operators and design consultancies. These conducted to determine if ID design methods are used explicitly and the extent to which...
Addressing the Difficulties of Learners in the Reading Class ...
African Journals Online (AJOL)
This study evaluates reading comprehension instruction at senior high schools in Accra. Classroom observation was used to identify the techniques used by teachers in the reading class and questionnaire was used to collect information from learners about the difficulties they have in understanding text. It reports that the ...
Massachusetts health reform and access for children with special health care needs.
Smith, Anna Jo; Chien, Alyna T
2014-08-01
Children with special health care needs (CSHCN) face unique challenges in accessing affordable health care. Massachusetts implemented major health reform in 2006; little is known about the impact of this state's health reform on uninsurance, access to care, and financial protection for privately and publicly insured CSHCN. We used a difference-in-differences (DD) approach to compare uninsurance, access to primary and specialty care, and financial protection in Massachusetts versus other states and Washington, DC before and after Massachusetts health reform. Parent-reported data were used from the 2005-2006 and 2009-2010 National Survey of Children with Special Health Care Needs and adjusted for age, gender, race/ethnicity, non-English language at home, and functional difficulties. Postreform, living in Massachusetts was not associated with significant decreases in uninsurance or increases in access to primary care for CSHCN. For privately insured CSHCN, Massachusetts was associated with increased access to specialists (DD = 6.0%; P ≤ .001) postreform. For publicly insured CSHCN, however, there was a significant decrease in access to prescription medications (DD = -7.2%; P = .003) postreform. Living in Massachusetts postreform was not associated with significant changes in financial protection compared with privately or publicly insured CSHCN in other states. Massachusetts health reform likely improved access to specialists for privately insured CSHCN but did not decrease instances of uninsurance, increase access to primary care, or improve financial protection for CSHCN in general. Comparable provisions within the Affordable Care Act may produce similarly modest outcomes for CSHCN. Copyright © 2014 by the American Academy of Pediatrics.
Alcohol and Difficulty Conceiving in the SUN Cohort: A Nested Case-Control Study.
Lopez-del Burgo, Cristina; Gea, Alfredo; de Irala, Jokin; Martínez-González, Miguel A; Chavarro, Jorge E; Toledo, Estefania
2015-07-27
The role of alcohol on fertility remains unclear. We aimed to investigate the association between alcohol and specific alcoholic beverages consumption and the risk of difficulty getting pregnant. We used a case-control study nested within the Seguimiento Universidad de Navarra (SUN) cohort, a prospective, dynamic and multipurpose cohort of 21,705 Spanish university graduates, followed biennially with mailed questionnaires. We identified 686 case-control pairs, matched for age and time in the cohort. Cases were women reporting difficulty getting pregnant. Controls did not consult due to difficulty conceiving and had at least one child during follow-up. After adjustment for potential confounders, we found no association between self-reported difficulty getting pregnant and the number of alcoholic beverages consumed per week, (Odds Ratio [OR] > 5 drinks/week vs. none = 1.04, 95% Confidence Interval [CI] = 0.72-1.51). No association between types of alcoholic beverage and difficulty conceiving (OR > 5 drinks of wine/week vs. none = 1.16, 95% CI = 0.72-1.88; OR > 5 drinks of beer/week vs. none = 1.06, 95% CI = 0.82-1.37; OR > 5 drinks of spirits/week vs. none = 1.24, 95% CI = 0.84-1.64) was observed. In conclusion, we found no association between alcohol intake and risk of consulting a physician due to difficulty conceiving. More studies are needed to clearly elucidate the effects of alcohol intake on women's fertility. In the meantime, recommendations about alcohol intake to couples trying to conceive have to be given cautiously.
Alcohol and Difficulty Conceiving in the SUN Cohort: A Nested Case-Control Study
Directory of Open Access Journals (Sweden)
Cristina Lopez-del Burgo
2015-07-01
Full Text Available The role of alcohol on fertility remains unclear. We aimed to investigate the association between alcohol and specific alcoholic beverages consumption and the risk of difficulty getting pregnant. We used a case-control study nested within the Seguimiento Universidad de Navarra (SUN cohort, a prospective, dynamic and multipurpose cohort of 21,705 Spanish university graduates, followed biennially with mailed questionnaires. We identified 686 case-control pairs, matched for age and time in the cohort. Cases were women reporting difficulty getting pregnant. Controls did not consult due to difficulty conceiving and had at least one child during follow-up. After adjustment for potential confounders, we found no association between self-reported difficulty getting pregnant and the number of alcoholic beverages consumed per week, (Odds Ratio [OR] > 5 drinks/week vs. none = 1.04, 95% Confidence Interval [CI] = 0.72–1.51. No association between types of alcoholic beverage and difficulty conceiving (OR > 5 drinks of wine/week vs. none = 1.16, 95% CI = 0.72–1.88; OR > 5 drinks of beer/week vs. none = 1.06, 95% CI = 0.82–1.37; OR > 5 drinks of spirits/week vs. none = 1.24, 95% CI = 0.84–1.64 was observed. In conclusion, we found no association between alcohol intake and risk of consulting a physician due to difficulty conceiving. More studies are needed to clearly elucidate the effects of alcohol intake on women’s fertility. In the meantime, recommendations about alcohol intake to couples trying to conceive have to be given cautiously.
Benefits of Location-Based Access Control:A Literature Study
van Cleeff, A.; Pieters, Wolter; Wieringa, Roelf J.
2010-01-01
Location-based access control (LBAC) has been suggested as a means to improve IT security. By 'grounding' users and systems to a particular location, attackers supposedly have more difficulty in compromising a system. However, the motivation behind LBAC and its potential benefits have not been
Akizuki, Kazunori; Ohashi, Yukari
2015-10-01
The relationship between task difficulty and learning benefit was examined, as was the measurability of task difficulty. Participants were required to learn a postural control task on an unstable surface at one of four different task difficulty levels. Results from the retention test showed an inverted-U relationship between task difficulty during acquisition and motor learning. The second-highest level of task difficulty was the most effective for motor learning, while learning was delayed at the most and least difficult levels. Additionally, the results indicate that salivary α-amylase and the performance dimension of the National Aeronautics and Space Administration-Task Load Index (NASA-TLX) are useful indices of task difficulty. Our findings suggested that instructors may be able to adjust task difficulty based on salivary α-amylase and the performance dimension of the NASA-TLX to enhance learning. Copyright © 2015 Elsevier B.V. All rights reserved.
Wilson, Samuel J; Garner, John C; Loprinzi, Paul D
2016-06-01
Studies have looked at the individual associations of sensory impairment on balance, but no population-based studies have examined their combined association on balance and difficulty with falls. Thus, the purpose of this study was to examine both the independent associations and combined associations of visual impairment, peripheral neuropathy, and self-reported hearing loss with the odds of reporting difficulty with falls and functional balance. Data from the 2003-2004 National Health and Nutrition Examination Survey were used. Vision and peripheral neuropathy were objectively measured, and hearing was self-reported. Balance testing consisted of a modified Romberg test. After exclusions, 1662 (40-85years of age) participants provided complete data on the study variables. Sensory impairment was associated with perceived difficulty of falls and functional balance. Participants who presented a single sensory impairment had 29% reduced odds of having functional balance (95% CI=0.54-0.93, p=0.01) and increased odds of reporting difficulty with falls by 61% (95% CI=0.99-2.60, p=0.05). Moreover, our multisensory models showed some evidence of a dose-response relationship, in that sensory impairment of multiple sensory systems was associated with worse balance (OR =0.59, CI=0.35-1.00, p=0.05) and perceived difficulty of falls (OR =5.02, 95% CI=1.99-12.66, p=0.002) when compared to those with less sensory impairment. Multiple sensory impairment is associated with significantly higher odds of both reporting difficulty with falls and balance dysfunction, which may lead to a subsequent fall, ultimately compromising the individual's health. Copyright © 2016 Elsevier Inc. All rights reserved.
McDonagh, Lorraine K; Nielsen, Elly-Jean; McDermott, Daragh T; Davies, Nathan; Morrison, Todd G
2018-01-01
Current understandings of sexual difficulties originate from a model that is based on the study of heterosexual men and women. Most research has focused on sexual difficulties experienced by heterosexual men incapable of engaging in vaginal penetration. To better understand men's perceptions and experiences of sexual difficulties, seven focus groups and 29 individual interviews were conducted with gay (n = 22), bisexual (n = 5), and heterosexual (n = 25) men. In addition, the extent to which difficulties reported by gay and bisexual men differ from heterosexual men was explored. Data were analyzed using thematic analysis applying an inductive approach. Two intercorrelated conceptualizations were identified: penis function (themes: medicalization, masculine identity, psychological consequences, coping mechanisms) and pain (themes: penile pain, pain during receptive anal sex). For the most part, gay, bisexual, and heterosexual men reported similar sexual difficulties; differences were evident regarding alternative masculinity, penis size competition, and pain during receptive anal sex. The results of this study demonstrate the complexity of men's sexual difficulties and the important role of sociocultural, interpersonal, and psychological factors. Limitations and suggested directions for future research are outlined.
Doolan, Emma L; Bryant, Richard A; Liddell, Belinda J; Nickerson, Angela
2017-08-01
This study investigated the conceptualization of emotion regulation difficulties in a sample of refugees with varying levels of posttraumatic stress (PTS), and examined whether specific emotion regulation difficulties were associated with PTS severity. Refugees were administered an abbreviated version of the Difficulties in Emotion Regulation Scale, the PTSD Symptom Scale - Interview Version, and the Harvard Trauma Questionnaire. Confirmatory Factor Analysis was used to examine model fit for the 6-factor model originally proposed by the developers of the DERS and the more recently proposed 5-factor model that excludes the awareness subscale. Both models displayed adequate fit. After controlling for age, gender, time in Australia, and trauma exposure, the clarity and strategies subscales were significantly associated with PTS severity. The association between impaired emotional clarity and reduced agency related to accessing regulation strategies and PTS severity in this refugee sample highlights the need for further research to assess interventions that target these disruptions in refugees. Copyright © 2017 Elsevier Ltd. All rights reserved.
Interviewing Ghanaian Educational Elites: Strategies for Access, Commitment, and Engagement
Hope Pius Nudzor
2013-01-01
A review of the research methodology literature suggests that owing to the difficulty of gaining access to and obtaining commitments from elites, social scientists less frequently use them as research respondents, opting instead to investigate those over whom power is exercised. This article provides insights into some intricacies of elite interviewing. It recounts the experience of a novice researcher in his quest to gain access to and interview elite individuals within the Ghanaian educatio...
[Access to high-cost drugs in Brazil from the perspective of physicians, pharmacists and patients].
Rover, Marina Raijche Mattozo; Vargas-Pelaez, Claudia Marcela; Rocha Farias, Mareni; Nair Leite, Silvana
2016-01-01
To explore perceptions on access to medication supplied by the Specialized Component of Pharmaceutical Assistance (CEAF) within the Brazilian Unified Health System (which includes high-cost drugs) by the actors involved in the healthcare services of this component. A descriptive, qualitative study was carried out by using a focal group with 7 users and 11 semi-structured interviews with health professionals (physicians and pharmacist) in the state of Santa Catarina. According to the participants, access to medicines had improved. Two main perceptions of the CEAF Clinical Guidelines were identified: the requirements constitute a bureaucracy that limits access, and the requisites increase the demand for tests and specialized healthcare services, exceeding the capacity of the healthcare services network. These assumptions generated the search for other means of access that revealed a lack of information and understanding of the right to health among the users. In addition, according to the participants, because of the difficulties of accessing services as a whole, full access to CEAF medicines is a goal that remains to be achieved. Although access to CEAF medicines has improved, there are still some difficulties in guaranteeing treatment access and comprehensiveness. Copyright © 2016 SESPAS. Published by Elsevier Espana. All rights reserved.
Does better access to FPs decrease the likelihood of emergency department use?
Mian, Oxana; Pong, Raymond
2012-01-01
Abstract Objective To determine whether better access to FP services decreases the likelihood of emergency department (ED) use among the Ontario population. Design Population-based telephone survey. Setting Ontario. Participants A total of 8502 Ontario residents aged 16 years and older. Main outcome measures Emergency department use in the 12 months before the survey. Results Among the general population, having a regular FP was associated with having better access to FPs for immediate care (P FPs for immediate care at least once a year; 63.1% of them had seen FPs without difficulties and were significantly less likely to use EDs than those who did not see FPs or had difficulties accessing physicians when needed (OR = 0.62, P FPs (P FPs for immediate care among the general population. Further research is needed to understand what accounts for a higher likelihood of ED use among those with regular FPs, new immigrants, residents of northern and rural areas of Ontario, and people with low socioeconomic status when actual access and sociodemographic characteristics have been taken into consideration. More important, this study demonstrates a need of distinguishing between potential and actual access to care, as having a regular FP and having timely and effective access to FP care might mean different things and have different effects on ED use. PMID:23152473
Farrell, Meagan T.; Zahodne, Laura B.; Stern, Yaakov; Dorrejo, Jhedy; Yeung, Philip; Cosentino, Stephanie
2014-01-01
Objectives To assess the influence of subjective word-finding difficulty on Alzheimer’s disease (AD) patients’ likelihood of engaging in social leisure activities. Design Analysis of data collected from the second cohort of the Multicenter Study of Predictors of Disease Course in Alzheimer’s disease. Setting Four study sites in the U.S. and France. Participants Individuals diagnosed with mild to moderate AD (N = 236) Measurements On separate questionnaires, patients were asked to 1) report whether had trouble finding the right word when speaking (subjective word-finding difficulty), and 2) rate their frequency and enjoyment of both social and nonsocial leisure activities. Objective language measures included object naming and verbal fluency. Measures of dependence, depression, cognitive status, age, sex, and education were also included as covariates in regression analyses. Results Over half (52%) of the sample reported word-finding difficulty, and subjective complaints were correlated with poorer verbal fluency scores. Subjective word-finding difficulty was uniquely related to social activity measures. Endorsers of word-finding difficulty reported reduced frequency and enjoyment of social leisure activities, controlling for covariates. In contrast, engagement in nonsocial activities was associated with higher age and depression scores, but was not related to word-finding complaints. These results were corroborated by the caregivers’ reports, and occurred above and beyond the effect of objective word-finding ability. Conclusion AD patients who are aware of increasing word-finding failures are less likely to participate in and enjoy socially-oriented leisure activities. This finding may have significant implications for clinical and health outcomes in AD. A failure to evaluate subjective language complaints could result in social withdrawal symptoms, thereby threatening the patient’s quality of life as well as increasing caregiver burden. Importantly
Workplace bullying and sleep difficulties
DEFF Research Database (Denmark)
Hansen, Åse Marie; Hogh, Annie; Garde, Anne Helene
2014-01-01
PURPOSE: The aims of the present study were to investigate whether being subjected to bullying and witnessing bullying at the workplace was associated with concurrent sleep difficulties, whether frequently bullied/witnesses have more sleep difficulties than occasionally bullied....../witnesses, and whether there were associations between being subjected to bullying or witnessing bullying at the workplace and subsequent sleep difficulties. METHODS: A total of 3,382 respondents (67 % women and 33 % men) completed a baseline questionnaire about their psychosocial work environment and health....... The overall response rate was 46 %. At follow-up 2 years later, 1671 of those responded to a second questionnaire (49 % of the 3,382 respondents at baseline). Sleep difficulties were measured in terms of disturbed sleep, awakening problems, and poor quality of sleep. RESULTS: Bullied persons and witnesses...
Player Modeling for Intelligent Difficulty Adjustment
Missura, Olana; Gärtner, Thomas
In this paper we aim at automatically adjusting the difficulty of computer games by clustering players into different types and supervised prediction of the type from short traces of gameplay. An important ingredient of video games is to challenge players by providing them with tasks of appropriate and increasing difficulty. How this difficulty should be chosen and increase over time strongly depends on the ability, experience, perception and learning curve of each individual player. It is a subjective parameter that is very difficult to set. Wrong choices can easily lead to players stopping to play the game as they get bored (if underburdened) or frustrated (if overburdened). An ideal game should be able to adjust its difficulty dynamically governed by the player’s performance. Modern video games utilise a game-testing process to investigate among other factors the perceived difficulty for a multitude of players. In this paper, we investigate how machine learning techniques can be used for automatic difficulty adjustment. Our experiments confirm the potential of machine learning in this application.
The factor structure of the Strengths and Difficulties Questionnaire (SDQ in Greek adolescents
Directory of Open Access Journals (Sweden)
Rotsika Vasiliki
2009-08-01
Full Text Available Abstract Background The Strengths and Difficulties Questionnaire (SDQ is a practical, economic and user-friendly screening instrument of emotional and behavioural problems in children and adolescents. This study was aimed primarily at evaluating the factor structure of the Greek version of the SDQ. Methods A representative nationwide sample of 1,194 adolescents (11 to 17 years old completed the questionnaire. Confirmatory factor analysis (CFA was conducted to assess the factor structure of the SDQ. Results CFA supported the original five-factor structure. The modification of the model provided some improvements. Internal consistency was acceptable for total difficulties, emotional symptoms and prosocial behaviour scale, moderate for hyperactivity/inattention scale and inadequate for peer and conduct problems scale. Older adolescents (aged 15 to 17 years reported more hyperactivity/inattention and conduct problems than younger ones (aged 11 to 14 years and girls reported more emotional symptoms and less prosocial behaviour problems than boys. Adolescents of low socioeconomic status (SES reported more difficulties than those of medium and high SES. Conclusion The Greek SDQ could be potentially considered as a community-wide screening instrument for adolescents' emotional and behavioural problems.
The role of materialism on social, emotional and behavioural difficulties for British adolescents
Maras, Pam; Moon, Amy; Gupta, Taveeshi; Gridley, Nicole
2015-01-01
The relationship between materialism and social-emotional behavioural difficulties (SEBDs) was assessed by comparing a sample of adolescents receiving in-school behavioural support with adolescents not receiving any support. All participants completed the Youth Materialism Scale and the Strengths and Difficulties Questionnaire. Binary logistic regression indicated that adolescents who reported higher levels of materialism were more likely to be classified into a group considered ‘at-risk’ for...
Blink activity and task difficulty.
Tanaka, Y; Yamaoka, K
1993-08-01
This study investigated the relationship between task difficulty and blink activity, which includes blink rate, blink amplitude, and blink duration. Two kinds of tasks established two levels of difficulty. In Exp. 1, a mental arithmetic task was used to examine the relationship. Analysis showed that blink rate for a difficult task was significantly higher than that for an easier one. In Exp. 2, a letter-search task (hiragana Japanese alphabet) was used while the other conditions were the same as those in Exp. 1; however, the results of this experiment were not influenced by the difficulty of the task. As results indicate that blink rate is related to not only difficulty but also the nature of the task, the nature of the task is probably dependent on a mechanism in information processing. The results for blink amplitude and blink duration showed no systematic change during either experiment.
Difficulties concerning Diabetes Mellitus Type 1 in children and adolescents
Directory of Open Access Journals (Sweden)
Tatiana Rebouças Moreira
2016-01-01
Full Text Available Objective: to evaluate the knowledge on diabetes in children and adolescents and the difficulties regarding the disease. Methods: a quantitative study with 40 patients from 6 to 17 years older who were subjected on a questionnaire based on self-care behaviors proposed by the American Association of Diabetes Educators. Results: the average age was 11.6 years with predominance of the female gender (57.5%, most attending grade school (80.0%, naming the parents as primary caregivers (72.5%. Regarding the knowledge about the disease, the item with the highest percentage of errors was about the pathophysiology of Diabetes Mellitus type 1. On the difficulties related to the treatment, food control and application of insulin had higher frequency. Conclusion:the study revealed a high percentage of correct answers among the participants, suggesting knowledge about the disease. Nevertheless, they reported food control and insulin therapy as the main difficulties related to treatment.
On the golden road : Open access publishing in particle physics
CERN. Geneva
2007-01-01
The particle physics community has over the last 15 years achieved so-called full green open access through the wide dissemination ofpreprints via arXiv, a central subject repository managed by Cornell University. However, green open access does not alleviate the economical difficulties of libraries as these still are expected to offer access to versions of record of the peer-reviewed literature. For this reason the particle physics community is now addressing the issue of gold open access by converting a set of the existing core journals to open access. A working party works now to bring together funding agencies, laboratories and libraries into a single consortium, called SCOAP3 (Sponsoring Consortium for Open access Publishing in Particle Physics). This consortium will engage with publishers towards building a sustainable model for open access publishing. In this model, subscription fees from multiple institutions are replaced with contracts with publishers of open access journals where the SCOAP3 consort...
On the golden road Open access publishing in particle physics
CERN. Geneva; Yeomans, Joanne
2007-01-01
The particle physics community has over the last 15 years achieved so-called full green open access through the wide dissemination ofpreprints via arXiv, a central subject repository managed by Cornell University. However, green open access does not alleviate the economical difficulties of libraries as these still are expected to offer access to versions of record of the peer-reviewed literature. For this reason the particle physics community is now addressing the issue of gold open access by converting a set of the existing core journals to open access. A working party works now to bring together funding agencies, laboratories and libraries into a single consortium, called SCOAP3 (Sponsoring Consortium for Open access Publishing in Particle Physics). This consortium will engage with publishers towards building a sustainable model for open access publishing. In this model, subscription fees from multiple institutions are replaced with contracts with publishers of open access journals where the SCOAP3 consorti...
Lynskey, M T; Fergusson, D M
1997-12-01
The aims of this study were to identify the factors which discriminated young people exposed to childhood sexual abuse (CSA) who developed psychiatric disorder or adjustment difficulties in young adulthood from those young people exposed to CSA who did not develop psychiatric disorder or adjustment difficulties by age 18. Data were gathered on a birth cohort of 1,025 New Zealand children studied from birth to the age of 18 on (a) exposure to CSA; (b) patterns of psychiatric disorder and adjustment difficulties at age 18 years; (c) factors that may have influenced responses to CSA including characteristics of the abuse, parental bonding, parental characteristics, and adolescent peer affiliations. Just over 10% of the cohort reported CSA. Those reporting CSA were at increased risks of a range of difficulties at age 18 (depression, anxiety, conduct disorder, alcohol abuse/dependence, other substance abuse/dependence, post sexual abuse trauma, attempted suicide). However, not all of those exposed to CSA developed difficulties and approximately a quarter of those exposed to CSA did not meet criteria for any adjustment difficulty. Further analysis suggested that the extent of adjustment difficulties in those exposed to CSA was influenced by two additional factors: (a) the extent of affiliations with delinquent or substance using peers in adolescence; and (b) the extent of paternal care or support in childhood. The findings of this study suggest that while young people exposed to CSA are at increased risks of psychiatric disorder and adjustment difficulties in young adulthood, not all individuals exposed to CSA will develop adjustment difficulties. Important factors protecting against the development of adjustment difficulties in young people experiencing CSA appear to be the nature and quality of peer and family relationships.
Directory of Open Access Journals (Sweden)
Paula Kersten
2016-10-01
Full Text Available Abstract Background Screening children for behavioural difficulties requires the use of a tool that is culturally valid. We explored the cross-cultural acceptability and utility of the Strengths and Difficulties Questionnaire for pre-school children (aged 3–5 as perceived by families in New Zealand. Methods A qualitative interpretive descriptive study (focus groups and interviews in which 65 participants from five key ethnic groups (New Zealand European, Māori, Pacific, Asian and other immigrant parents took part. Thematic analysis using an inductive approach, in which the themes identified are strongly linked to the data, was employed. Results Many parents reported they were unclear about the purpose of the tool, affecting its perceived value. Participants reported not understanding the context in which they should consider the questions and had difficulty understanding some questions and response options. Māori parents generally did not support the questionnaire based approach, preferring face to face interaction. Parents from Māori, Pacific Island, Asian, and new immigrant groups reported the tool lacked explicit consideration of children in their cultural context. Parents discussed the importance of timing and multiple perspectives when interpreting scores from the tool. Conclusions In summary, this study posed a number of challenges to the use of the Strengths and Difficulties Questionnaire in New Zealand. Further work is required to develop a tool that is culturally appropriate with good content validity.
Kersten, Paula; Dudley, Margaret; Nayar, Shoba; Elder, Hinemoa; Robertson, Heather; Tauroa, Robyn; McPherson, Kathryn M
2016-10-12
Screening children for behavioural difficulties requires the use of a tool that is culturally valid. We explored the cross-cultural acceptability and utility of the Strengths and Difficulties Questionnaire for pre-school children (aged 3-5) as perceived by families in New Zealand. A qualitative interpretive descriptive study (focus groups and interviews) in which 65 participants from five key ethnic groups (New Zealand European, Māori, Pacific, Asian and other immigrant parents) took part. Thematic analysis using an inductive approach, in which the themes identified are strongly linked to the data, was employed. Many parents reported they were unclear about the purpose of the tool, affecting its perceived value. Participants reported not understanding the context in which they should consider the questions and had difficulty understanding some questions and response options. Māori parents generally did not support the questionnaire based approach, preferring face to face interaction. Parents from Māori, Pacific Island, Asian, and new immigrant groups reported the tool lacked explicit consideration of children in their cultural context. Parents discussed the importance of timing and multiple perspectives when interpreting scores from the tool. In summary, this study posed a number of challenges to the use of the Strengths and Difficulties Questionnaire in New Zealand. Further work is required to develop a tool that is culturally appropriate with good content validity.
Crea, Katherine; Dissanayake, Cheryl; Hudry, Kristelle
2016-10-01
Family-related predictors of mental health problems were investigated among 30 toddlers at familial high-risk for autism spectrum disorders (ASD) and 28 controls followed from age 2- to 3-years. Parents completed the self-report Depression Anxiety Stress Scales and the parent-report Behavior Assessment System for Children. High-risk toddlers were assessed for ASD at 3-years. Parent stress and proband mental health difficulties predicted concurrent toddler mental health difficulties at 2-years, but only baseline proband internalising problems continued to predict toddler internalising problems at 3-years; high-risk status did not confer additional risk. Baseline toddler mental health difficulties robustly predicted later difficulties, while high-risk status and diagnostic outcome conferred no additional risk. A family systems perspective may be useful for understanding toddler mental health difficulties.
Lindén, Anita; Lexell, Jan; Lund, Maria Larsson
2010-12-01
Using everyday technology (ET) is a prerequisite for activities and participation at home and in the community. It is well known that persons with an acquired brain injury (ABI) can have limitations in activities of daily living but our knowledge of their difficulties using ET is not known. Thirty-six persons (27 men and 9 women, mean age 44 years, age range 26-60) with an ABI (2-10 years post injury) were interviewed, using the Everyday Technology Use Questionnaire (ETUQ), about their perceived difficulties using ET and how these difficulties influenced their everyday activities and their possibilities to participate at home and in the community. A majority (78%) of the persons reported difficulties using ET. The most common difficulties were related to the use of telecommunication and computers. Despite these difficulties, a majority still used most objects and services independently. Twenty-six participants (72%) perceived that their difficulties using ET influenced their everyday activities and their possibility to participate at home and in the community. The results indicate that rehabilitation following an ABI should consider whether clients' use of ET influences their activity and participation and adopt interventions accordingly. The results also indicate that difficulties using ET need to be considered in the design of community services to prevent societal barriers.
Kuhn, Kurt W.; Cambron, Jerrilyn
2013-01-01
Objective The purpose of this report is to describe chiropractic management, using a brain-based model of care, of a teen who had migraine headaches and several social and learning difficulties. Clinical features A 15-year-old adolescent boy with a chronic history of migraines and more than 10 years of learning and behavioral difficulties, including attention-deficit/hyperactivity disorder, obsessive compulsive disorder, and Tourette syndrome, presented for chiropractic care. Intervention and outcome The patient received spinal manipulation and was given home physical coordination activities that were contralateral to the side of the involved basal ganglia and ipsilateral to the involved cerebellum, along with interactive metronome training. Quantitative changes were noted in neurological soft signs, tests of variables of attention Conners’ Parent Rating Scale, the California Achievement Test, grade point, and reduction of medications. The patient reported qualitative improvements in tics, attention, reading, vision, health, relationships with his peers and his family, and self-esteem. Conclusion The patient with migraine headaches and learning difficulties responded well to the course of chiropractic care. This study suggests that there may be value in a brain-based model of care in the chiropractic management of conditions that are beyond musculoskeletal in nature. PMID:24396330
Sexual dysfunctions and difficulties in denmark: prevalence and associated sociodemographic factors
DEFF Research Database (Denmark)
Christensen, Birgitte S; Grønbaek, Morten; Osler, Merete
2011-01-01
Sexual dysfunctions and difficulties are common experiences that may impact importantly on the perceived quality of life, but prevalence estimates are highly sensitive to the definitions used. We used questionnaire data for 4415 sexually active Danes aged 16-95 years who participated in a national......%), and dyspareunia (0.1%); among women: lubrication insufficiency (7%), anorgasmia (6%), dyspareunia (3%), and vaginismus (0.4%). Highest frequencies of sexual dysfunction were seen in men above age 60 years and women below age 30 years or above age 50 years. In logistic regression analysis, indicators of economic...... health and morbidity survey in 2005 to estimate the prevalence of sexual dysfunctions and difficulties and to identify associated sociodemographic factors. Overall, 11% (95% CI, 10-13%) of men and 11% (10-13%) of women reported at least one sexual dysfunction (i.e., a frequent sexual difficulty...
Posttraumatic stress, difficulties in emotion regulation, and coping-oriented marijuana use.
Bonn-Miller, Marcel O; Vujanovic, Anka A; Boden, Matthew Tyler; Gross, James J
2011-01-01
In an effort to better understand factors that may explain prior findings of a positive relation between posttraumatic stress symptom severity and coping-oriented marijuana use motivation, the present study tested whether the association between posttraumatic stress symptom severity and marijuana use coping motives is mediated by difficulties in emotion regulation. Participants were 79 (39 women; M(age) = 22.29 years, SD = 6.99) community-recruited adults who reported (1) lifetime exposure to at least one posttraumatic stress disorder Criterion A traumatic event and (2) marijuana use in the past 30 days. Results indicated that difficulties in emotion regulation, as indexed by the Difficulties in Emotion Regulation Scale (Gratz & Roemer, 2004), fully mediated the association between posttraumatic stress symptom severity and marijuana use coping motives. Implications for the treatment of co-occurring posttraumatic stress and marijuana use are discussed.
Perceived Sexual Difficulties and Sexual Counseling in Men and Women Across Heart Diagnoses
DEFF Research Database (Denmark)
Rundblad, Lucas; Zwisler, Ann Dorthe; Johansen, Pernille Palm
2017-01-01
-reported using single-item questions, and factors associated with sexual difficulties were collected from the survey and national registers. RESULTS: The study population consisted of 1,549 men and 807 women (35-98 years old) with heart failure (n = 243), ischemic heart disease (n = 1,036), heart valve surgery...... for improved information and counseling about sex and relationships for patients. STRENGTHS AND LIMITATIONS: This large nationwide survey of men and women combined a survey with administrative data from national registries. However, this study used non-validated single-item questions to assess sexual......BACKGROUND: Ischemic heart disease and heart failure often lead to sexual difficulties in men, but little is known about the sexual difficulties in women and patients with other heart diagnoses or the level of information patients receive about the risk of sexual difficulties. AIM: To investigate...
Sexual touching and difficulties with sexual arousal and orgasm among U.S. older adults.
Galinsky, Adena M
2012-08-01
Little is known about the non-genitally-focused sexual behavior of those experiencing sexual difficulties. The objective of this study was to review the theory supporting a link between sexual touching and difficulties with sexual arousal and orgasm, and to examine associations between these constructs among older adults in the United States. The data were from the 2005-2006 National Social Life Health and Aging Project, which surveyed 3,005 community-dwelling men and women ages 57-85 years. The 1,352 participants who had had sex in the past year reported on their frequency of sexual touching and whether there had been a period of several months or more in the past year when they were unable to climax, had trouble getting or maintaining an erection (men) or had trouble lubricating (women). Women also reported how often they felt sexually aroused during partner sex in the last 12 months. The odds of being unable to climax were greater by 2.4 times (95% CI 1.2-4.8) among men and 2.8 times (95% CI 1.4-5.5) among women who sometimes, rarely or never engaged in sexual touching, compared to those who always engaged in sexual touching, controlling for demographic factors and physical health. These results were attenuated but persisted after controlling for emotional relationship satisfaction and psychological factors. Similar results were obtained for erectile difficulties among men and subjective arousal difficulties among women, but not lubrication difficulties among women. Infrequent sexual touching is associated with arousal and orgasm difficulties among older adults in the United States.
Directory of Open Access Journals (Sweden)
Magdalena Ferster
2015-12-01
Full Text Available Compliance with gluten-free diet is the basic method for controlling coeliac disease in patients regardless of their age. It may be, however, challenging to follow in daily life. The prevalence of the disease (approx. 1% of European population is affected makes it an important public health problem. Aim of the study: Investigating the difficulties and obstacles related to compliance with gluten-free diet by children and adult patients living in Upper Silesia region. Material and method: The study included 30 mothers of children with coeliac disease (Group I and 30 adult coeliac disease patients (Group II. The patients kept a gluten-free diet. Data were obtained in an anonymous survey drawn up for the purpose of this study, conducted in 2010. Results: The respondents reported a very limited access to gluten-free meals in mass-catering establishments (76.7% of the participants in Group II, and 70% children at nurseries, kindergartens and schools, lack of adequate food product labelling (93% in both groups, difficulties experienced in social life (60% in Group II, difficulties experienced when travelling within Poland (76.7% in Group II and abroad (83.3% in Group II, and no existing reimbursement plan for the high diet costs (16.7% in Group I vs. 26.7% in Group II. Conclusions: 1 The necessity of compliance with gluten-free diet causes a lot of difficulties in everyday life to patients with coeliac disease and parents of children suffering from coeliac disease. Proper treatment requires their identification by the attending physician. 2 Improved food labelling as regards gluten content as well as inclusion of gluten-free meals in the menu of food-serving establishments will contribute to improved quality of life of children and adults suffering from coeliac disease. 3 Associations of patients on a gluten-free diet should continue their efforts to have high costs of this diet refunded.
Mastoidectomy: anatomical parameters x surgical difficulty
Directory of Open Access Journals (Sweden)
Pereira Júnior, Anastácio Rodrigues
2012-01-01
Full Text Available Introduction: The lowered temporal meninges and/ or anterior sigmoid sinus are contiditions that can determine surgical difficulties in performing mastoidectomy. Objective: To correlate in the tomography the extent of the prolapse of the sigmoid sinus and of temporal meninges with the surgical difficulty in the mastoidectomy. Method: The tomographic measurements of prolapse sigmoid and of temporal meninges were correlated with the presence or non-presence of the surgical difficulty observed during the mastoidectomy procedure in patients with ostomatoiditis chronic (n=30. Form of study: Contemporary cohort transverse. Results: In 10 patients were observed surgical difficulty distributed as: due to prolapse of the sigmoid sinus (n = 2 or temporal meninges prolapse (n = 7 or both (n = 1. In patients in which the surgical difficulty was due to sigmoid sinus prolapse, the tomography distance of the anterior border of the sigmoid sinus to posterior wall of external auditory canal was lower than 9 mm. In patients in which surgical difficulty was due to temporal meninges prolapse, the tomographic distance to the upper plane of the petrous bone was 7 mm. Conclusion: The computerized tomography distance between the temporal meninges and the upper plane of the petrous bone 7 mm and the distance of the anterior border of the sigmoid sinus to posterior wall of external auditory canal was lower than 9 mm are predictive to the surgical difficulties to perform mastoidectomy.
Hearing loss and speech perception in noise difficulties in Fanconi anemia
Verheij, Emmy; Oomen, Karin P.Q.; Smetsers, Stephanie E.; van Zanten, Gijsbert A.; Speleman, Lucienne
2017-01-01
Objectives/Hypothesis: Fanconi anemia is a hereditary chromosomal instability disorder. Hearing loss and ear abnormalities are among the many manifestations reported in this disorder. In addition, Fanconi anemia patients often complain about hearing difficulties in situations with background noise
Brain Regions Underlying Word Finding Difficulties in Temporal Lobe Epilepsy
Trebuchon-Da Fonseca, Agnes; Guedj, Eric; Alario, F-Xavier; Laguitton, Virginie; Mundler, Olivier; Chauvel, Patrick; Liegeois-Chauvel, Catherine
2009-01-01
Word finding difficulties are often reported by epileptic patients with seizures originating from the language dominant cerebral hemisphere, for example, in temporal lobe epilepsy. Evidence regarding the brain regions underlying this deficit comes from studies of peri-operative electro-cortical stimulation, as well as post-surgical performance.…
Crosier, David; Horvath, Anna; Kerpanova, Viera; Kocanova, Daniela; Riiheläinen, Jari Matti
2014-01-01
The report sheds light on current national and institutional policies and practices aimed at increasing and widening access, reducing student dropout, and improving the employability of higher education graduates in Europe. The primary objective is to support Member States in their reform efforts by outlining and analysing national policies, and…
Speech comprehension difficulties in chronic tinnitus and its relation to hyperacusis
Directory of Open Access Journals (Sweden)
Veronika Vielsmeier
2016-12-01
Full Text Available AbstractObjectiveMany tinnitus patients complain about difficulties regarding speech comprehension. In spite of the high clinical relevance little is known about underlying mechanisms and predisposing factors. Here, we performed an exploratory investigation in a large sample of tinnitus patients to (1 estimate the prevalence of speech comprehension difficulties among tinnitus patients, to (2 compare subjective reports of speech comprehension difficulties with objective measurements in a standardized speech comprehension test and to (3 explore underlying mechanisms by analyzing the relationship between speech comprehension difficulties and peripheral hearing function (pure tone audiogram, as well as with co-morbid hyperacusis as a central auditory processing disorder. Subjects and MethodsSpeech comprehension was assessed in 361 tinnitus patients presenting between 07/2012 and 08/2014 at the Interdisciplinary Tinnitus Clinic at the University of Regensburg. The assessment included standard audiological assessment (pure tone audiometry, tinnitus pitch and loudness matching, the Goettingen sentence test (in quiet for speech audiometric evaluation, two questions about hyperacusis, and two questions about speech comprehension in quiet and noisy environments (How would you rate your ability to understand speech?; How would you rate your ability to follow a conversation when multiple people are speaking simultaneously?. Results Subjectively reported speech comprehension deficits are frequent among tinnitus patients, especially in noisy environments (cocktail party situation. 74.2% of all investigated patients showed disturbed speech comprehension (indicated by values above 21.5 dB SPL in the Goettingen sentence test. Subjective speech comprehension complaints (both in general and in noisy environment were correlated with hearing level and with audiologically-assessed speech comprehension ability. In contrast, co-morbid hyperacusis was only correlated
Energy Technology Data Exchange (ETDEWEB)
Alcala Fazio, E.; Alvarez Fernandez, N.
2016-07-01
The objective of the Project is to define an experimental protocol for the accessibility assessment of the transport vehicles, by analysing the evolution of the effort and time variables consumed by a target group –Persons of Reduced Mobility (PMRs). This protocol consisted in tests of accessibility on a sample of 6 passenger cars (class M1) by 8 elderly people carrying a heart rate monitor, and whose access manoeuvres were recorded by video cameras. Based on the Hilloskorpi et al. [1] model and by developing a method of truncation of the heart rate (HR) tests records - eliminating the component of the work biologically needed by the organism to keep its basal metabolic rate from the work each person performed – it was possible to evaluate how much energy each individual invested in each access manoeuver. Immediately after each test, and after the whole round of vehicles, each participant was surveyed for a subjective assessment of the difficulty of accessing to the cars. According to each of the above results, the HR objective measurements and the subjective opinion about the ease of access experienced by each individual, the vehicles were ranked by order of accessibility to the front and rear seats. The result of both rankings showed the orders of the similar vehicles, the potential of the method and a fair closeness between its results and the subjective, but real and unequivocal, judgments of the participants. (Author)
Directory of Open Access Journals (Sweden)
Messerli M
2017-09-01
Full Text Available Markus Messerli,1,2 Rebecca Aschwanden,1 Michael Buslau,2 Kurt E Hersberger,1 Isabelle Arnet1 1Pharmaceutical Care Research Group, Department of Pharmaceutical Sciences, University of Basel, Basel, Switzerland; 2European Centre for the Rehabilitation of Scleroderma, Reha Rheinfelden, Rheinfelden, Switzerland Objectives: To assess subjective swallowing difficulties (SD with medication intake and their practical consequences in patients suffering from systemic sclerosis (SSc with a novel self-report questionnaire.Design and setting: Based on a systematic literature review, we developed a self-report questionnaire and got it approved by an expert panel. Subsequently, we sent the questionnaire by post mail to SSc patients of the European Center for the Rehabilitation of Scleroderma Rheinfelden, Switzerland.Participants: Patients were eligible if they were diagnosed with SSc, treated at the center, and were of age ≥18 years at the study start.Main outcome measures: Prevalence and pattern of SD with oral medication intake, including localization and intensity of complaints.Results: The questionnaire consisted of 30 items divided into five sections Complaints, Intensity, Localization, Coping strategies, and Adherence. Of the 64 SSc patients eligible in 2014, 43 (67% returned the questionnaire. Twenty patients reported SD with medication intake (prevalence 47%, either currently (11; 26% or in the past that had been overcome (9; 21%. Self-reported SD were localized mostly in the larynx (43% and esophagus (34%. They were of moderate (45% or strong to unbearable intensity (25%. Modification of the dosage form was reported in 40% of cases with SD. Adherence was poor for 20 (47% patients and was not associated with SD (p=0.148.Conclusion: Our novel self-report questionnaire is able to assess the pattern of complaints linked to medication intake, that is, localization and intensity. It may serve as a guide for health care professionals in selecting the most
Cosma Emil; Jeflea Victor
2010-01-01
By using Word, Excel or PowerPoint one can automate routine operations using the VBA language (Visual Basic for Applications). This language is also used in Access, allowing access to data stored in tables or queries. Thus, Access and VBA resources can be used together. Access is designed for programming forms and reports (among other things), so there won’t be found any of the VBA editor’s specific forms.
Reported Design Processes for Accessibility in Rail Transport
DEFF Research Database (Denmark)
Herriott, Richard; Cook, Sharon
2014-01-01
Accessibility is a fundamental requirement in public transport (PT) yet there exists little research on design for accessibility or inclusive design (ID) in this area. This paper sets out to discover what methods are used in the rail sector to achieve accessibility goals and to examine how far...... these methods deviate from user-centred and ID norms. Semi-structured interviews were conducted with nine rolling stock producers, operators and design consultancies. The purpose was to determine if ID design methods are used explicitly and the extent to which the processes used conformed to ID (if at all......). The research found that the role of users in the design process of manufacturers was limited and that compliance with industry standards was the dominant means to achieving accessibility goals. Design consultancies were willing to apply more user-centred design if the client requested it. Where operators were...
Yeo, Han Gyeol; Lee, Seong Jae; Hyun, Jung Keun
2015-01-01
Spasmodic dysphonia is defined as a focal laryngeal disorder characterized by dystonic spasms of the vocal cord during speech. We described a case of a 22-year-old male patient who presented complaining of idiopathic difficulty swallowing that suddenly developed 6 months ago. The patient also reported pharyngolaryngeal pain, throat discomfort, dyspnea, and voice change. Because laryngoscopy found no specific problems, an electrodiagnostic study and videofluoroscopic swallowing study (VFSS) were performed to find the cause of dysphagia. The VFSS revealed continuous twitch-like involuntary movement of the laryngeal muscle around the vocal folds. Then, he was diagnosed with spasmodic dysphonia by VFSS, auditory-perceptual voice analysis, and physical examination. So, we report the first case of spasmodic dysphonia accompanied with difficulty swallowing that was confirmed by VFSS. PMID:25932430
Kritzinger, Janis; Schneider, Marguerite; Swartz, Leslie; Braathen, Stine Hellum
2014-03-01
To explore whether there are other factors besides communication difficulties that hamper access to health care services for deaf patients. Qualitative methodology using semi-structured interviews with 16 deaf participants from the National Institute for the Deaf in Worcester and 3 Key informants from the Worcester area, South Africa. Communication difficulties were found to be a prominent barrier in accessing health care services. In addition to this interpersonal factors including lack of independent thought, overprotectedness, non-questioning attitude, and lack of familial communication interact with communication difficulties in a way that further hampers access to health care services. These interpersonal factors play a unique role in how open and accepting health services feel to deaf patients. Health care services need to take cognizance of the fact that providing sign language interpreters in the health care setting will not necessarily make access more equitable for deaf patients, as they have additional barriers besides communication to overcome before successfully accessing health care services. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.
Sexual Touching and Difficulties with Sexual Arousal and Orgasm Among U.S. Older Adults
2013-01-01
Little is known about the non-genitally-focused sexual behavior of those experiencing sexual difficulties. The objective of this study was to review the theory supporting a link between sexual touching and difficulties with sexual arousal and orgasm, and to examine associations between these constructs among older adults in the United States. The data were from the 2005–2006 National Social Life Health and Aging Project, which surveyed 3,005 community-dwelling men and women ages 57–85 years. The 1,352 participants who had had sex in the past year reported on their frequency of sexual touching and whether there had been a period of several months or more in the past year when they were unable to climax, had trouble getting or maintaining an erection (men) or had trouble lubricating (women). Women also reported how of ten they felt sexually aroused during partner sex in the last 12 months. The odds of being unable to climax were greater by 2.4 times (95% CI 1.2–4.8) among men and 2.8 times (95% CI 1.4–5.5) among women who sometimes, rarely or never engaged in sexual touching, compared to those who always engaged in sexual touching, controlling for demographic factors and physical health. These results were attenuated but persisted after controlling for emotional relationship satisfaction and psychological factors. Similar results were obtained for erectile difficulties among men and subjective arousal difficulties among women, but not lubrication difficulties among women. Infrequent sexual touching is associated with arousal and orgasm difficulties among older adults in the United States. PMID:22160881
Retrospective Basic Parent-Child Communication Difficulties and Risk of Depression in Deaf Adults.
Kushalnagar, Poorna; Bruce, Sheila; Sutton, Tina; Leigh, Irene W
2017-02-01
This paper describes the relationship between retrospective communication difficulties and current depressive symptomatology. A total of 143 deaf/hard-of-hearing late adolescents and adults (64 % White; 55 % female) completed questionnaires related to parent communication, language history and current psychological functioning. Logistic regression models were used to estimate the likelihood of having depression that is associated with understanding parents' communication after controlling for gender, hearing level, and language history. Significant odds ratio indicated that the difficulties in understanding basic communication with parents increased the odds of depression symptomatology. The odds ratio indicates that when holding all other variables constant, the odds of reporting depression were at least 8 times higher for those who reported being able to understand some to none of what the same-sex parent said. For the different-gender parent, only the mother's communication with the male individual was associated with depression. Although our study findings suggest that DHH men and women with history of communication difficulties at home are at risk for depression in adulthood, they do not provide information on the causal mechanisms linking communication difficulties early in life and depression later in life. Greater attention should be given to promoting healthy communication between DHH girls and their mothers as well as DHH boys and their fathers, which might reduce the impact on later emergence of depression in the DHH individual.
Report #18-P-0030, October 30, 2017. Weaknesses in the Identity and Access Management and Incident Response metric domains leave the CSB vulnerable to attacks occurring and not being detected in a timely manner.
Multisensory perceptual learning is dependent upon task difficulty.
De Niear, Matthew A; Koo, Bonhwang; Wallace, Mark T
2016-11-01
There has been a growing interest in developing behavioral tasks to enhance temporal acuity as recent findings have demonstrated changes in temporal processing in a number of clinical conditions. Prior research has demonstrated that perceptual training can enhance temporal acuity both within and across different sensory modalities. Although certain forms of unisensory perceptual learning have been shown to be dependent upon task difficulty, this relationship has not been explored for multisensory learning. The present study sought to determine the effects of task difficulty on multisensory perceptual learning. Prior to and following a single training session, participants completed a simultaneity judgment (SJ) task, which required them to judge whether a visual stimulus (flash) and auditory stimulus (beep) presented in synchrony or at various stimulus onset asynchronies (SOAs) occurred synchronously or asynchronously. During the training session, participants completed the same SJ task but received feedback regarding the accuracy of their responses. Participants were randomly assigned to one of three levels of difficulty during training: easy, moderate, and hard, which were distinguished based on the SOAs used during training. We report that only the most difficult (i.e., hard) training protocol enhanced temporal acuity. We conclude that perceptual training protocols for enhancing multisensory temporal acuity may be optimized by employing audiovisual stimuli for which it is difficult to discriminate temporal synchrony from asynchrony.
An Open Access future? Report from the eurocancercoms project
Kenney, R; Warden, R
2011-01-01
In March 2011, as part of the background research to the FP7 Eurocancercoms project, the European Association for Cancer Research (EACR) conducted an online survey of its members working in Europe to discover their experiences of and attitudes to the issues surrounding academic publishing and Open Access. This paper presents the results from this survey and compares them to the results from a much larger survey on the same topic from the Study of Open Access Publishing (SOAP). The responses from both surveys show very positive attitudes to the Open Access publishing route; perhaps the most challenging statistic from the EACR survey is that 88% of respondents believe that publicly funded research should be made available to be read and used without access barriers As a conclusion and invitation to further discussion, this paper also contributes to the debate around subscription and Open Access publishing, supporting the case for accelerating the progress towards Open Access publishing of cancer research articles as a particularly supportive way of assisting all researchers to make unhindered progress with their work. PMID:22276063
Access problem to UNIQA’s extranet portal
HR Department
2008-01-01
UNIQA would like to inform members of the Health Insurance Scheme that they are temporarily unable to access the EXTRANET portal, via which, amongst other things, they may consult reimbursement notifications. The difficulty is that once the user name and password have been entered to access the secure site, the user is redirected to the same initial screen without any error notification. UNIQA’s computing department has been informed of the problem and is carrying out investigations. We will be informed as soon as the problem has been solved (via the Bulletin and the CHIS site http://cern.ch/chis). UNIQA apologises in advance for any inconvenience caused by this technical problem.
Incident and Trafficking Database: New Systems for Reporting and Accessing State Information
International Nuclear Information System (INIS)
Dimitrovski, D.; Kittley, S.
2015-01-01
The IAEA's Incident and Trafficking Database (ITDB) is the Agency's authoritative source for information on incidents in which nuclear and other radioactive material is out of national regulatory control. It was established in 1995 and, as of June 2014, 126 States participate in the ITDB programme. Currently, the database contains over 2500 confirmed incidents, out of which 21% involve nuclear material, 62% radioactive source and 17% radioactively contaminated material. In recent years, the system for States to report incidents to the ITDB has been evolving — moving from fax-based to secure email and most recently to secure on-line reporting. A Beta version of the on-line system was rolled out this June, offering a simple, yet secure, communication channel for member states to provide information. In addition the system serves as a central hub for information related to official communication of the IAEA with Member States so some communication that is traditionally shared by e-mail does not get lost when ITDB counterparts change. In addition the new reporting system incorporates optional features that allow multiple Member State users to collaboratively contribute toward an INF. States are also being given secure on-line access to a streamlined version of the ITDB. This improves States' capabilities to retrieve and analyze information for their own purposes. In addition, on-line access to ITDB statistical information on incidents is available to States through an ITDB Dashboard. The dashboard contains aggregate information on number and types of incidents, material involved, as well some other statistics related to the ITDB that is typically provided in the ITDB Quarterly reports. (author)
Chan, Wallace Chi Ho; Kwan, Chi Wai; Chi, Iris
2015-01-01
This study examined the relationship between depression and pain, and the moderating effect of communication difficulty on this relationship, among community-dwelling older adults in Hong Kong. We used logistic regression to analyze secondary data regarding 12,402 Chinese older adults applying for long-term care service in Hong Kong in 2012. Approximately 30% of participants were depressed and 37% experienced communication difficulty. Depression was associated with increased pain. Communication difficulty was found to moderate the relationship between depression and pain. Pain scores increased more when individuals who experienced communication difficulty reported being depressed, compared to those who did not experience communication difficulty. The moderating effect of communication difficulty may be explained by the interaction between depression and communication difficulty. Participants who were depressed and concurrently experienced communication difficulty may be more likely to catastrophize their pain and may tend to report or experience more pain. Health care professionals need to be aware of the different effects of communication difficulty on the pain experiences of older adults. Psychosocial intervention may be provided to minimize older adults' communication barriers to pain management.
Conner, Lindsey; Gunstone, Richard
2004-12-01
This paper reports on a qualitative case study investigation of the knowledge and use of learning strategies by 16 students in a final year high school biology class to expand their conscious knowledge of learning. Students were provided with opportunities to engage in purposeful inquiry into the biological, social and ethical aspects of cancer. A constructivist approach was implemented to access prior content and procedural knowledge in various ways. Students were encouraged to develop evaluation of their learning skills independently through activities that promoted metacognition. Those students who planned and monitored their work produced essays of higher quality. The value and difficulties of promoting metacognitive approaches in this context are discussed, as well as the idea that metacognitive processes are difficult to research, because they have to be conscious in order to be identified by the learner, thereby making them accessible to the researcher.
Workplace-based assessments of junior doctors: do scores predict training difficulties?
Mitchell, Colin; Bhat, Sarita; Herbert, Anne; Baker, Paul
2011-12-01
Workplace-based assessment (WPBA) is an increasingly important part of postgraduate medical training and its results may be used as evidence of professional competence. This study evaluates the ability of WPBA to distinguish UK Foundation Programme (FP) doctors with training difficulties and its effectiveness as a surrogate marker for deficiencies in professional competence. We conducted a retrospective observational study using anonymised records for 1646 trainees in a single UK postgraduate deanery. Data for WPBAs conducted from August 2005 to April 2009 were extracted from the e-portfolio database. These data included all scores submitted by trainees in FP years 1 and 2 on mini-clinical evaluation exercise (mini-CEX), case-based discussion (CbD), direct observation of procedural skills (DOPS) and mini-peer assessment tool (mini-PAT) assessments. Records of trainees in difficulty, as identified by their educational supervisors, were tagged as index cases. Main outcome measures were odds ratios (ORs) for associations between mean WPBA scores and training difficulties. Further analyses by the reported aetiology of the training difficulty (health-, conduct- or performance-related) were performed. Of the 1646 trainees, 92 had been identified as being in difficulty. Mean CbD and mini-CEX scores were lower for trainees in difficulty and an association was found between identified training difficulties and average scores on the mini-CEX (OR = 0.54; p = 0.034) and CbD (OR = 0.39; p = 0.002). A receiver operator characteristic curve analysis of mean WPBA scores for diagnosing 'in difficulty' status yielded an area under the curve of 0.64, indicating weak predictive value. There was no statistical evidence that mean scores on DOPS and mini-PAT assessments differed between the two groups. Analysis of a large dataset of WPBA scores revealed significant associations between training difficulties and lower mean scores on both the mini-CEX and CbD. Models show that using WPBA
A foot in the door: access to asylum in South Africa
Vigneswaran, D.
2008-01-01
Asylum seekers in South Africa experience extreme difficulties lodging their claimsat the Department of Home Affairs. This paper utilises new survey data to measurethe extent of the Department’s failures to provide access to the status determination process. The principal finding is that South
Maurage, Pierre; Timary, Philippe de; D'Hondt, Fabien
2017-08-01
Emotional and interpersonal impairments have been largely reported in alcohol-dependence, and their role in its development and maintenance is widely established. However, earlier studies have exclusively focused on group comparisons between healthy controls and alcohol-dependent individuals, considering them as a homogeneous population. The variability of socio-emotional profiles in this disorder thus remains totally unexplored. The present study used a cluster analytic approach to explore the heterogeneity of affective and social disorders in alcohol-dependent individuals. 296 recently-detoxified alcohol-dependent patients were first compared with 246 matched healthy controls regarding self-reported emotional (i.e. alexithymia) and social (i.e. interpersonal problems) difficulties. Then, a cluster analysis was performed, focusing on the alcohol-dependent sample, to explore the presence of differential patterns of socio-emotional deficits and their links with demographic, psychopathological and alcohol-related variables. The group comparison between alcohol-dependent individuals and controls clearly confirmed that emotional and interpersonal difficulties constitute a key factor in alcohol-dependence. However, the cluster analysis identified five subgroups of alcohol-dependent individuals, presenting distinct combinations of alexithymia and interpersonal problems ranging from a total absence of reported impairment to generalized socio-emotional difficulties. Alcohol-dependent individuals should no more be considered as constituting a unitary group regarding their affective and interpersonal difficulties, but rather as a population encompassing a wide variety of socio-emotional profiles. Future experimental studies on emotional and social variables should thus go beyond mere group comparisons to explore this heterogeneity, and prevention programs proposing an individualized evaluation and rehabilitation of these deficits should be promoted. Copyright © 2017
Does spinal excitability scale to the difficulty of the dual-task?
Day, Devon M; Boivin, Mario T; Adkin, Allan L; Tokuno, Craig D
2017-08-01
This study examined whether spinal excitability, as measured by the soleus Hoffmann reflex (H-reflex), is scaled to the difficulty level of the dual-task being performed. Twenty-two participants completed a combination of three balance task and three secondary cognitive (visuo-motor) task difficulty levels for a total of nine dual-task conditions. An additional eight participants were tested while performing the same three balance task difficulty levels on its own (i.e., single-tasking). The balance task required participants to maintain their balance on a fixed or rotating stabilometer while the visuo-motor task required participants to respond to moving targets presented on a monitor. Throughout each single- and dual-task trial, H-reflexes were elicited from the soleus. Although dual-task performance, as quantified by visuo-motor task accuracy as well as the root mean square of the stabilometer position and velocity, decreased by 10-34% with increasing dual-task difficulty (p dual-task conditions (p = 0.483-0.758). This contrasts to when participants performed the balance task as a single-task, where the H-reflex amplitude decreased by ~25% from the easy to the hard balance task difficulty level (p = 0.037). In contrast to the commonly reported finding of a reduced soleus H-reflex amplitude when individuals perform a less posturally stable task by itself, the results indicate that spinal excitability is not modulated as a function of dual-task difficulty. It is possible that when an individual's attentional resource capacity is exceeded during dual-tasking, they become ineffective in regulating spinal excitability for balance control.
Lexical Difficulty--Using Elicited Imitation to Study Child L2
Campfield, Dorota E.
2017-01-01
This paper reports a post-hoc analysis of the influence of lexical difficulty of cue sentences on performance in an elicited imitation (EI) task to assess oral production skills for 645 child L2 English learners in instructional settings. This formed part of a large-scale investigation into effectiveness of foreign language teaching in Polish…
Energy Technology Data Exchange (ETDEWEB)
Yang, Seung Koo [Seoul National University College of Medicine, Seoul (Korea, Republic of); Yoon, Chang Jin [Dept. of Radiology, Seoul National University Bundang Hospital, Seongnam (Korea, Republic of)
2016-09-15
Stenosis of the pancreatico-enteric anastomosis is one of the major complications of pancreaticoduodenectomy (PD). Endoscopic stent placement, has limited success rate as a nonsurgical treatment due to altered gastrointestinal anatomy. Percutaneous treatment is rarely attempted due to the technical difficulty in accessing the pancreatic duct. We reported a case of pancreaticojejunostomy stenosis after PD, in which a pancreatic stent was successfully placed using a rendezvous technique with a dual percutaneous approach.
International Nuclear Information System (INIS)
Yang, Seung Koo; Yoon, Chang Jin
2016-01-01
Stenosis of the pancreatico-enteric anastomosis is one of the major complications of pancreaticoduodenectomy (PD). Endoscopic stent placement, has limited success rate as a nonsurgical treatment due to altered gastrointestinal anatomy. Percutaneous treatment is rarely attempted due to the technical difficulty in accessing the pancreatic duct. We reported a case of pancreaticojejunostomy stenosis after PD, in which a pancreatic stent was successfully placed using a rendezvous technique with a dual percutaneous approach
Identifying Student Difficulties with Entropy, Heat Engines, and the Carnot Cycle
Smith, Trevor I.; Christensen, Warren M.; Mountcastle, Donald B.; Thompson, John R.
2015-01-01
We report on several specific student difficulties regarding the second law of thermodynamics in the context of heat engines within upper-division undergraduate thermal physics courses. Data come from ungraded written surveys, graded homework assignments, and videotaped classroom observations of tutorial activities. Written data show that students…
Directory of Open Access Journals (Sweden)
Ines eWolz
2015-06-01
Full Text Available Objective: The aims of the study were to 1 validate the Difficulties in Emotion Regulation Scale (DERS in a sample of Spanish adults with and without eating disorders, and 2 explore the role of emotion regulation difficulties in eating disorders, including its mediating role in the relation between key personality traits and ED severity Methods: 134 patients (121 female, mean age = 29 years with anorexia nervosa (n = 30, bulimia nervosa (n = 54, binge eating (n = 20, or Other Specified Feeding or Eating Disorders (n = 30 and 74 healthy control participants (51 female, mean age = 21 years reported on general psychopathology, eating disorder severity, personality traits and difficulties in emotion regulation. Exploratory and confirmatory factor analyses were conducted to examine the psychometrics of the DERS in this Spanish sample (Aim 1. Additionally, to examine the role of emotion regulation difficulties in eating disorders (Aim 2, differences in emotion regulation difficulties across eating disorder subgroups were examined and structural equation modeling was used to explore the interrelations among emotion regulation, personality traits, and eating disorder severity. Results: Results support the validity and reliability of the DERS within this Spanish adult sample and suggest that this measure has a similar factor structure in this sample as in the original sample. Moreover, emotion regulation difficulties were found to differ as a function of eating disorder subtype and to mediate the relation between two specific personality traits (i.e., high harm avoidance and low self-directedness and eating disorder severity. Conclusions: Personality traits of high harm avoidance and low self-directedness may increase vulnerability to eating disorder pathology indirectly, through emotion regulation difficulties.
Bonanno, Rina A; Hymel, Shelley
2013-05-01
Although recent research has demonstrated significant links between involvement in cyber bullying and various internalizing difficulties, there exists debate as to whether these links are independent of involvement in more traditional forms of bullying. The present study systematically examined the association between involvement in cyber bullying, as either a victim or a bully, and both depressive symptomatology and suicidal ideation. Self-report data were collected from 399 (57% female) Canadian adolescents in grades 8-10 (mean age = 14.2 years, SD = .91 years). Results indicated that involvement in cyber bullying, as either a victim or a bully, uniquely contributed to the prediction of both depressive symptomatology and suicidal ideation, over and above the contribution of involvement in traditional forms of bullying (physical, verbal, relational). Given the ever increasing rate of accessibility to technology in both schools and homes, these finding underscore the importance of addressing cyber bullying, with respect to both research and intervention, as a unique phenomenon with equally unique challenges for students, parents, school administrators and researchers alike.
Hairi, Noran N; Bulgiba, Awang; Peramalah, Devi; Mudla, Izzuna
2013-01-01
Managing stairs is a challenging activity of daily living (ADL) for older people. This study aims to examine the association between visual impairment and difficulty in managing stairs among older people living alone and those living with others. A population-based cross sectional study was conducted in rural Malaysia from 2007 till 2008. Seven hundred and sixty five older people aged 60 years and over underwent eye examination for visual impairment. Visual acuity criteria were used to define visual impairment. Presenting visual acuity was assessed using a standard metric Snellen Chart of E type. Difficulty in managing stairs was measured according to a question drawn from the Barthel Index which asks "do you need help in climbing stairs". Overall, the prevalence of difficulty in managing stairs among older people in our population was 135 (18.3%, 95% CI 15.7-21.2). After adjusting for important confounders the odds ratio (OR) for visual impairment and difficulty in managing stairs among older people living alone was 5.04 (95% CI 2.27, 10.62). Among older people living with others, the adjusted OR for visual impairment and difficulty in managing stairs was 3.10 (95% CI 1.52, 6.80). In a sample of older people aged 60 years and over, those living alone with visual impairment had greater difficulty in managing stairs than those living with others. Identification of these groups of older people is useful for targeting interventions. Copyright © 2012 Elsevier Inc. All rights reserved.
The behaviour and self-esteem of children with specific speech and language difficulties.
Lindsay, G; Dockrell, J
2000-12-01
Children with specific speech and language difficulties (SSLD) may have associated difficulties that impair their access to the curriculum, and their social relationships at home and in school. (i) To identify the range of additional problems experienced by children with SSLD in different educational contexts; (ii) to consider the relationship between these problems and the child's current language status and (iii) to consider the child's self-esteem and the extent to which self-esteem is associated with the primary language problem or other associated difficulties. Sixty-nine children (17 girls, 52 boys) aged 7-8 years (Year 3) who had been identified as having SSLD, 59 from two local education authorities and 10 from regional special schools for children with severe speech and language difficulties. The children were assessed on a range of cognitive, language and educational measures; children and teachers completed a measure of the children's self-esteem (Pictorial Scale of Perceived Competence and Social Acceptance); teachers and parents completed a behavioural questionnaire (Strengths and Difficulties Questionnaire (SDQ); teachers also completed a further rating scale which included a behaviour subscale (Junior Rating Scale: JRS). The children's behaviour was rated as significantly different from the norm on both the SDQ and JRS, with the parents more likely to rate the child as having problems, but also as having prosocial behaviour. Both teachers and parents tended to rate the boys as having more problems than girls on the SDQ, with significant differences for the parents' ratings occurring on the total score and the hyperactivity and conduct problems scales. The children had positive self perceptions, which were comparable to the standardisation sample, and generally significantly higher than those of the teachers. The language and educational attainment scores of the children in special and mainstream schools were generally not significantly different, but
[Innovative medicines and market access agreements].
Toumi, M; Zard, J; Duvillard, R; Jommi, C
2013-09-01
Market Access Agreements (MAA) for drugs have emerged in response to the need to control health expenditures, as well as to the uncertainty about the true benefit of a drug. It is possible to group MAA in two types of agreements: financial agreements and outcome-based agreements. MAA is a growing trend and is shifting towards conditional access. However, the willingness to use these contracts and their implementation differ across countries, and some are still resistant to put them in place. The MAA challenges to overcome encompass the complexity of the schemes, the administrative burden and the difficulty of evaluating MAA. It is likely that these agreements might experience further evolution in the future to become a faster pathway for therapeutic innovations, at a fair price. Copyright © 2013 Elsevier Masson SAS. All rights reserved.
A foot in the door: access to asylum in South Africa
Vigneswaran, D.
2008-01-01
Asylum seekers in South Africa experience extreme difficulties lodging their claims at the Department of Home Affairs. This paper utilizes new survey data to measure the extent of the Department’s failures to provide access to the status determination process. The principal finding is that South
Patients' perceptions on losing access to FPs: qualitative study.
Freeman, Tom; Brown, Judith Belle; Reid, Graham; Stewart, Moira; Thind, Amardeep; Vingilis, Evelyn
2013-04-01
To examine the health care-related experiences of individuals who have lost their FPs. A qualitative design using phenomenology. Southwestern Ontario. Eighteen participants (9 women and 9 men, with a mean age of 48.9 years) from urban or rural areas who had lost their FPs. Semistructured interviews were conducted, which were audiotaped and transcribed verbatim. An iterative approach using immersion and crystallization was employed for analysis. Participants reported having lost their FPs because of reasons specific to their physicians (eg, illness, retirement, career change) or system issues (eg, poor remuneration for FPs, cutbacks in health care leading to physician emigration). Participants described feelings of loss, abandonment, frustration, and anger related to losing their physicians. They expressed concerns about the difficulty of getting prescription medications, lack of continuity of care related to medical records, and preventive care. They faced considerable hurdles in accessing primary health care, turning to walk-in clinics and emergency departments despite concerns about quality and fragmentation of care. Some of those with chronic medical conditions prevailed upon specialists to help meet primary health care needs. Losing access to FPs evoked a variety of strong feelings among these participants. They engaged in a number of strategies to meet their primary care needs but not without reservations. In a health care system appropriately built on primary health care, the lack of access to FPs is regarded as the loss of a basic right to care.
Mactaggart, Islay; Schmidt, Wolf-Peter; Bostoen, Kristof; Chunga, Joseph; Danquah, Lisa; Halder, Amal Krishna; Parveen Jolly, Saira; Polack, Sarah; Rahman, Mahfuzar; Snel, Marielle; Kuper, Hannah; Biran, Adam
2018-01-01
Objectives To assess access to adequate water, sanitation and hygiene (WASH) among people with disabilities at the household and individual level. Design Cross-sectional surveys. Setting Data were included from five district-level or regional-level surveys: two in Bangladesh (Bangladesh-1, Bangladesh-2), and one each in Cameroon, Malawi and India. Participants 99 252 participants were sampled across the datasets (range: 3567–75 767), including 2494 with disabilities (93–1374). Outcome Prevalence of access to WASH at household and individual level. Data analysis Age/sex disaggregated disability prevalence estimates were calculated accounting for survey design. The Unicef/WHO Joint Monitoring Programme definitions were used to classify facilities as improved/unimproved. Multivariable logistic regression was undertaken to compare between households with/without a person with a disability, and to identify predictors of access among people with disabilities. Results There were no differences in access to improved sanitation or water sources between households with/without members with disabilities across the datasets. In Bangladesh-2, households including a person with a disability were more likely to share facilities with other households (OR 1.3, 95% CI 1.1 to 1.5). Households with people with disabilities were more likely to spend >30 min (round-trip) collecting drinking water than households without in both Cameroon (OR 1.8, 95% CI 1.0 to 3.4) and India (OR 2.3, 95% CI 1.2 to 4.7). Within households, people with disabilities reported difficulties collecting water themselves (23%–80% unable to) and accessing the same sanitation facilities as other household members, particularly without coming into contact with faeces (up to 47% in Bangladesh-2). These difficulties were most marked for people with more severe impairments. Conclusions People with disabilities may not have poorer access to WASH at the household level, but may have poorer quality of access
de Vries, P. J.; Davids, E. L.; Mathews, C.; Aarø, L. E.
2017-01-01
This study evaluated the psychometric properties of the Strengths and Difficulties Questionnaire Self-Report (SDQ-S) in South African adolescents, and compared findings with data from the UK, Australia and China. A sample of 3451 South African adolescents in grade 8, the first year of secondary
School difficulties in childhood and risk of overweight and obesity in young adulthood
DEFF Research Database (Denmark)
Lissau, I; Sørensen, T I
1993-01-01
Cross-sectional studies of adult males have shown that intelligence test score and educational level are inversely correlated to obesity. This study prospectively assessed whether school difficulties in the third school grade are related to the risk of overweight and obesity in young adulthood....... In 1974, body weight, height and social background were ascertained in 987 randomly-selected Copenhagen third graders. For each child, information about learning difficulties, scholastic proficiency, special education received, scholarly difficulties, reduced hearing, speech handicap, and speech...... or hearing education received was obtained. When the subjects were 20-21 years old, they reported their height and weight. The risk of being obese (above the 95th percentile of body mass index distribution) in young adulthood was assessed by logistic regression analysis taking social background, body mass...
Do dyslexics have auditory input processing difficulties?
DEFF Research Database (Denmark)
Poulsen, Mads
2011-01-01
Word production difficulties are well documented in dyslexia, whereas the results are mixed for receptive phonological processing. This asymmetry raises the possibility that the core phonological deficit of dyslexia is restricted to output processing stages. The present study investigated whether....... The finding suggests that input processing difficulties are associated with the phonological deficit, but that these difficulties may be stronger above the level of phoneme perception.......Word production difficulties are well documented in dyslexia, whereas the results are mixed for receptive phonological processing. This asymmetry raises the possibility that the core phonological deficit of dyslexia is restricted to output processing stages. The present study investigated whether...... a group of dyslexics had word level receptive difficulties using an auditory lexical decision task with long words and nonsense words. The dyslexics were slower and less accurate than chronological age controls in an auditory lexical decision task, with disproportionate low performance on nonsense words...
Health and health care access for Syrian refugees living in İstanbul.
Torun, Perihan; Mücaz Karaaslan, Meltem; Sandıklı, Büşra; Acar, Ceyda; Shurtleff, Ellyn; Dhrolia, Sophia; Herek, Bülent
2018-04-09
The study was conducted to assess the health needs of urban refugees living in İstanbul. A mixed methods approach was adopted to interview Syrian women from households, doctors, decision makers and NGO representatives. The data were collected between June and October 2015. The main challenges were the cost of living in İstanbul, increased rent and language barrier. Almost half (49.6%) of the interviewed women did not know about free health care rights for Syrians. In the last 30 days preceding the interview, 58.6% of the participants sought health care primarily through state hospitals, primary health care centres and pharmacies. The participants had difficulty in accessing health care due to the language barrier and a lack of knowledge of the Turkish health care system. Waiting time at hospitals and negative attitudes of health care staff reduced satisfaction in these services. In relation to life in Turkey, the main issues for Syrian refugees were not directly related to health. They have been given the right to access health care, although had many difficulties in understanding and accessing services in a crowded city.
Difficulties in achieving public acceptance of nuclear energy in Poland
International Nuclear Information System (INIS)
Latek, S.
1993-01-01
Both the surveys and other social phenomena (establishment of a Polish Nucleonic Society, change in the tone by the mass media, access to other nations' experience) provide some grounds for a moderately optimistic (for nuclear energy prospect in Poland) conclusion of this paper. Unfortunately, one also has to be aware of hazards to that vision. The continuing economic crisis and the resulting fall in energy demand exerts no pressure on investing in energy. Environmental movements still have a considerable authority among the society. The unstable political situation in this part of Europe aggravated by the lack of sufficient guarantees against uncontrolled use of nuclear weapons also a negative impact on the awareness and attitudes of people. All these matters- signs of hope and difficulties- are great challenges to us. We will seek to meet them
Communication difficulties perceived by parents of children with developmental disorders.
Sun, Ingrid Ya I; Fernandes, Fernanda Dreux Miranda
2014-01-01
The child's inclusion in his/her social-cultural context is very important to his/her adaptation and well-being. The family has a major role as a facilitator of this process. Therefore the difficulties of these families in communicating with children with communication disorders are an important issue to be assessed in order to support orientations to families. The present study aimed to identify and compare communication difficulties perceived by parents of children with Down Syndrome (DS), Autism Spectrum Disorders (ASD) and Specific Language Impairment (SLI). Information was gathered with the use of a questionnaire with 24 questions regarding the perception of parents about their child communication disorders and the difficulties they identify. The questions were divided into four domains: 1 - Parents' personal difficulties; 2 - Parents' impression about themselves regarding their child; 3 - Parents' impressions about other persons' reactions to their child and 4 - Parents' impression about their child. Sixty parents were the subjects of this study: 20 had children with DS, 20 with SLI and 20 with ASD. All children had ages between 6 and 12 years. It was possible to observe that there was significant difference between the parents of ASD children with those of DS and SLI on the second, third and fourth domains. The questionnaire is effective to the identification of the communication disorders of ASD children based on their parents' reports but not to other developmental disorders.
D'Souza, Clive; Paquet, Victor L; Lenker, James A; Steinfeld, Edward
2017-11-13
Low ridership of public transit buses among wheeled mobility device users suggests the need to identify vehicle design conditions that are either particularly accommodating or challenging. The objective of this study was to determine the effects of low-floor bus interior seating configuration and passenger load on wheeled mobility device user-reported difficulty, overall acceptability and design preference. Forty-eight wheeled mobility users evaluated three interior design layouts at two levels of passenger load (high vs. low) after simulating boarding and disembarking tasks on a static full-scale low-floor bus mockup. User self-reports of task difficulty, acceptability and design preference were analyzed across the different test conditions. Ramp ascent was the most difficult task for manual wheelchair users relative to other tasks. The most difficult tasks for users of power wheelchairs and scooters were related to interior circulation, including moving to the securement area, entry and positioning in the securement area and exiting the securement area. Boarding and disembarking at the rear doorway was significantly more acceptable and preferred compared to the layouts with front doorways. Understanding transit usability barriers, perceptions and preferences among wheeled mobility users is an important consideration for clinicians who recommend mobility-related device interventions to those who use public transportation. Implications for Rehabilitation In order to maximize community participation opportunities for wheeled mobility users, clinicians should consider potential public transit barriers during the processes of wheelchair device selection and skills training. Usability barriers experienced by wheeled mobility device users on transit vehicles differ by mobility device type and vehicle configurations. Full-scale environment simulations are an effective means of identifying usability barriers and design needs in people with mobility impairments and may
Fear of moving outdoors and development of outdoor walking difficulty in older people.
Rantakokko, Merja; Mänty, Minna; Iwarsson, Susanne; Törmäkangas, Timo; Leinonen, Raija; Heikkinen, Eino; Rantanen, Taina
2009-04-01
To study which individual characteristics and environmental factors correlate with fear of moving outdoors and whether fear of moving outdoors predicts development of mobility limitation. Observational prospective cohort study and cross-sectional analyses. Community and research center. Seven hundred twenty-seven community-living people aged 75 to 81 were interviewed at baseline, of whom 314 took part in a 3.5-year follow-up. Fear of moving outdoors and its potential individual and environmental correlates were assessed at baseline. Perceived difficulties in walking 0.5 km and 2 km were assessed twice a year over a 3.5-year period. At baseline, 65% of the women and 29% of the men reported fear of moving outdoors. Poor socioeconomic status; musculoskeletal diseases; slow walking speed; and the presence of poor street conditions, hills in the nearby environment, and noisy traffic correlated with fear of moving outdoors. At the first 6-month follow-up, participants with fear of moving outdoors had more than four times the adjusted risk (odds ratio (OR)=4.6, 95% confidence interval (CI)=1.92-11.00) of developing difficulties in walking 0.5 km and a three times greater adjusted risk (OR=3.10, 95% CI=1.49-6.46) for developing difficulty in walking 2 km compared with those without fear. The difference in the prevalence of walking difficulties remained statistically significant over the 3.5-year follow-up (P=.02 and P=.009, respectively). Fear of moving outdoors is common in older adults and increases the risk of developing self-reported difficulties in walking 0.5 km and 2 km. Knowledge about individual and environmental factors underlying fear of moving outdoors and finding ways to alleviate fear of moving outdoors are important for community planning and prevention of disability.
[Accessible health information: a question of age?].
Loos, E F
2012-04-01
Aging and digitalisation are important trends which have their impact on information accessibility. Accessible information about products and services is of crucial importance to ensure that all citizens can participate fully as active members of society. Senior citizens who have difficulties using new media run the risk of exclusion in today's information society. Not all senior citizens, however, encounter problems with new media. Not by a long shot. There is much to be said for 'aged heterogeneity', the concept that individual differences increase as people age. In two explorative qualitative case studies related to accessible health information--an important issue for senior citizens--that were conducted in the Netherlands, variables such as gender, education level and frequency of internet use were therefore included in the research design. In this paper, the most important results of these case studies will be discussed. Attention will be also paid to complementary theories (socialisation, life stages) which could explain differences in information search behaviour when using old or new media.
Emotional regulation difficulties and premenstrual symptoms among Israeli students.
Reuveni, Inbal; Dan, Rotem; Segman, Ronen; Evron, Ron; Laufer, Sofia; Goelman, Gadi; Bonne, Omer; Canetti, Laura
2016-12-01
Premenstrual dysphoric disorder (PMDD) is a severe form of premenstrual syndrome (PMS) reported to affect 3-8 % of women of reproductive age and resulting in marked emotional and occupational impairment. Despite its prevalence, the etiology of PMDD is largely unknown, and patients remain mostly undiagnosed and poorly treated. It has been suggested that PMDD is a manifestation of underlying depressive disorder which is associated with the inability to regulate emotions in an adaptive manner. Therefore, we hypothesized that women with PMDD would exhibit increased difficulty with emotional regulation. A total of 648 female Israeli college students were assessed by the Premenstrual Symptoms Screening Tool (PSST) and the Difficulties in Emotion Regulation Scale (DERS). Of these women, 166 (25.6 %) met the criteria for PMS. Sixty-four (9.9 %) suffered from PMDD. More emotion regulation deficits were observed in the PMDD and PMS groups compared to the control group. Furthermore, there were more emotional regulation deficits among the predominantly psychological and mixed symptom subtype compared to the predominantly physical symptom subtype group. This is the first study to report an association between emotional dysregulation and PMDD. These findings may lead to development of more individually tailored treatment protocols focused on improving emotional regulation techniques.
Student Difficulties in Learning Density: A Distributed Cognition Perspective
Xu, Lihua; Clarke, David
2012-08-01
Density has been reported as one of the most difficult concepts for secondary school students (e.g. Smith et al. 1997). Discussion about the difficulties of learning this concept has been largely focused on the complexity of the concept itself or student misconceptions. Few, if any, have investigated how the concept of density was constituted in classroom interactions, and what consequences these interactions have for individual students' conceptual understanding. This paper reports a detailed analysis of two lessons on density in a 7th Grade Australian science classroom, employing the theory of Distributed Cognition (Hollan et al. 1999; Hutchins 1995). The analysis demonstrated that student understanding of density was shaped strongly by the public classroom discussion on the density of two metal blocks. It also revealed the ambiguities associated with the teacher demonstration and the student practical work. These ambiguities contributed to student difficulties with the concept of density identified in this classroom. The results of this study suggest that deliberate effort is needed to establish shared understanding not only about the purpose of the activities, but also about the meaning of scientific language and the utility of tools. It also suggests the importance of appropriate employment of instructional resources in order to facilitate student scientific understanding.
Hearing difficulty and tinnitus among U.S. workers and non-workers in 2007.
Masterson, Elizabeth A; Themann, Christa L; Luckhaupt, Sara E; Li, Jia; Calvert, Geoffrey M
2016-04-01
Hearing loss and tinnitus are two potentially debilitating physical conditions affecting many people in the United States. The purpose of this study was to estimate the prevalence of hearing difficulty, tinnitus, and their co-occurrence within U.S. Data from the 2007 National Health Interview Survey (NHIS) were examined. Weighted prevalence and adjusted prevalence ratios for self-reported hearing difficulty, tinnitus, and their co-occurrence were estimated and compared by demographic, among workers with and without occupational noise exposure, and across industries and occupations. Seven percent of U.S. workers never exposed to occupational noise had hearing difficulty, 5% had tinnitus and 2% had both conditions. However, among workers who had ever been exposed to occupational noise, the prevalence was 23%, 15%, and 9%, respectively (P Hearing difficulty and tinnitus are prevalent in the U.S.; especially among noise-exposed workers. Improved strategies for hearing conservation or better implementation are needed. Published 2016. This article is a U.S. Government work and is in the public domain in the USA.
Kerns, Ellen; Masterson, Elizabeth A; Themann, Christa L; Calvert, Geoffrey M
2018-03-14
The purpose of this study was to estimate the prevalence of occupational noise exposure, hearing difficulty and cardiovascular conditions within US industries and occupations, and to examine any associations of these outcomes with occupational noise exposure. National Health Interview Survey data from 2014 were examined. Weighted prevalence and adjusted prevalence ratios of self-reported hearing difficulty, hypertension, elevated cholesterol, and coronary heart disease or stroke were estimated by level of occupational noise exposure, industry, and occupation. Twenty-five percent of current workers had a history of occupational noise exposure (14% exposed in the last year), 12% had hearing difficulty, 24% had hypertension, 28% had elevated cholesterol; 58%, 14%, and 9% of these cases can be attributed to occupational noise exposure, respectively. Hypertension, elevated cholesterol, and hearing difficulty are more prevalent among noise-exposed workers. Reducing workplace noise levels is critical. Workplace-based health and wellness programs should also be considered. Published 2018. This article is a U.S. Government work and is in the public domain in the USA.
Ndumele, Chima D; Cohen, Michael S; Cleary, Paul D
2017-10-01
Medicaid recipients have consistently reported less timely access to specialists than patients with other types of coverage. By 2018, state Medicaid agencies will be required by the Center for Medicare and Medicaid Services (CMS) to enact time and distance standards for managed care organizations to ensure an adequate supply of specialist physicians for enrollees; however, there have been no published studies of whether these policies have significant effects on access to specialty care. To compare ratings of access to specialists for adult Medicaid and commercial enrollees before and after the implementation of specialty access standards. We used Consumer Assessment of Healthcare Providers and Systems survey data to conduct a quasiexperimental difference-in-differences (DID) analysis of 20 163 nonelderly adult Medicaid managed care (MMC) enrollees and 54 465 commercially insured enrollees in 5 states adopting access standards, and 37 290 MMC enrollees in 5 matched states that previously adopted access standards. Reported access to specialty care in the previous 6 months. Seven thousand six hundred ninety-eight (69%) Medicaid enrollees and 28 423 (75%) commercial enrollees reported that it was always or usually easy to get an appointment with a specialist before the policy implementation (or at baseline) compared with 11 889 (67%) of Medicaid enrollees in states that had previously implemented access standards. Overall, there was no significant improvement in timely access to specialty services for MMC enrollees in the period following implementation of standard(s) (adjusted difference-in-differences, -1.2 percentage points; 95% CI, -2.7 to 0.1), nor was there any impact of access standards on insurance-based disparities in access (0.6 percentage points; 95% CI, -4.3 to 5.4). There was heterogeneity across states, with 1 state that implemented both time and distance standards demonstrating significant improvements in access and reductions in disparities
Differences in Emotion Regulation Difficulties Across Types of Eating Disorders During Adolescence.
Weinbach, Noam; Sher, Helene; Bohon, Cara
2017-11-04
Emotion regulation appears to play a key role in eating disorders. However, prior attempts to associate specific emotion regulation abilities with specific types of eating disorders resulted in inconsistent findings. Moreover, far less is known about emotion regulation in eating disorders during adolescence, a critical period of emotional development. The current study addresses this gap, comparing emotion regulation characteristics between adolescents with restrictive types of eating disorders and those with binge eating or purging types of eating disorders. Ninety-eight adolescents with eating disorders (49 with restrictive and 49 with binge eating/purging eating disorders) completed a set of questionnaires including the Difficulties in Emotion Regulation Scale (DERS). The results revealed that binge eating/purging types of eating disorders were associated with greater difficulties in a variety of emotion regulation dimensions including impulse control, goal-directed behavior and access to effective emotion regulation strategies. Awareness and clarity of emotions were also worse in the binge eating/purging types of eating disorders, but this difference did not remain when comorbid psychopathology measures were controlled for. Moreover, the emotion regulation profile of adolescents with anorexia nervosa-binging/purging type was more similar to that of adolescents with bulimia nervosa than to that of adolescents with anorexia nervosa-restrictive type. While both restrictive and binge eating/purging eating disorders have been associated with emotion regulation difficulties, the current study shows that the presence of binge eating or purging episodes is linked with greater severity of emotion regulation deficits among adolescents with eating disorders.
Herbolsheimer, Florian; Riepe, Matthias W; Peter, Richard
2018-02-21
Numerous studies have reported weak or moderate correlations between self-reported and accelerometer-assessed physical activity. One explanation is that self-reported physical activity might be biased by demographic, cognitive or other factors. Cognitive function is one factor that could be associated with either overreporting or underreporting of daily physical activity. Difficulties in remembering past physical activities might result in recall bias. Thus, the current study examines whether the cognitive function is associated with differences between self-reported and accelerometer-assessed physical activity. Cross-sectional data from the population-based Activity and Function in the Elderly in Ulm study (ActiFE) were used. A total of 1172 community-dwelling older adults (aged 65-90 years) wore a uniaxial accelerometer (activPAL unit) for a week. Additionally, self-reported physical activity was assessed using the LASA Physical Activity Questionnaire (LAPAQ). Cognitive function was measured with four items (immediate memory, delayed memory, recognition memory, and semantic fluency) from the Consortium to Establish a Registry for Alzheimer's Disease Total Score (CERAD-TS). Mean differences of self-reported and accelerometer-assessed physical activity (MPA) were associated with cognitive function in men (r s = -.12, p = .002) but not in women. Sex-stratified multiple linear regression analyses showed that MPA declined with high cognitive function in men (β = -.13; p = .015). Results suggest that self-reported physical activity should be interpreted with caution in older populations, as cognitive function was one factor that explained the differences between objective and subjective physical activity measurements.
Heine, Chyrisse; Browning, Colette; Cowlishaw, Sean; Kendig, Hal
2013-10-01
The aims of the present study were to describe the trajectories of self-reported hearing difficulties over time, and evaluate the impacts of age, sex, lifestyle factors and social activity, in explaining individual differences in patterns of change over time. As part of the Melbourne Longitudinal Studies on Healthy Aging (MELSHA) Program, the hearing status of 947 adults aged 65 years and older, across five measurement periods (over 10 years), were analyzed using Latent Growth Curve Modeling analysis. A multidimensional survey was also administered, which included questions relating to sociodemographic variables, self-reported hearing difficulties, nutrition, smoking habits and level of social activity. Although there was a general increase in hearing difficulties over time, older age, poor nutrition, a lifetime of smoking and increased social activity predicted more rapid increases in hearing difficulty over time. Findings support the importance of lifestyle factors in reducing the rate of perceived hearing difficulties in older people, and provide further evidence of the links between lifestyle and sensory loss in older people. Poor nutrition and smoking are areas that both clinicians and public health professionals should address in their work with older people. © 2013 Japan Geriatrics Society.
Wong, Terry T.-Y.; Ho, Connie S.-H.; Tang, Joey
2017-01-01
Developmental dyscalculia (DD) is a specific learning disability in mathematics that affects around 6% of the population. Currently, the core deficit of DD remains unknown. While the number sense deficit hypothesis suggests that the core deficit of DD lies in the inability to represent nonsymbolic numerosity, the access deficit hypothesis suggests…
Mamikonian-Zarpas, Ani; Laganá, Luciana
2015-12-01
Functional status is often defined by cumulative scores across indices of independence in performing basic and instrumental activities of daily living (ADL/IADL), but little is known about the unique relationship of each daily activity item with the fall outcome. The purpose of this retrospective study was to examine the level of relative risk for a future fall associated with difficulty with performing various tasks of normal daily functioning among older adults who had fallen at least once in the past 12 months. The sample was comprised of community-dwelling individuals 70 years and older from the 1984-1990 Longitudinal Study of Aging by Kovar, Fitti, and Chyba (1992). Risk analysis was performed on individual items quantifying 6 ADLs and 7 IADLs, as well as 10 items related to mobility limitations. Within a subsample of 1,675 older adults with a history of at least one fall within the past year, the responses of individuals who reported multiple falls were compared to the responses of participants who had a single fall and reported 1) difficulty with walking and/or balance (FRAIL group, n = 413) vs. 2) no difficulty with walking or dizziness (NDW+ND group, n = 415). The items that had the strongest relationships and highest risk ratios for the FRAIL group (which had the highest probabilities for a future fall) included difficulty with: eating (73%); managing money (70%); biting or chewing food (66%); walking a quarter of a mile (65%); using fingers to grasp (65%); and dressing without help (65%). For the NDW+ND group, the most noteworthy items included difficulty with: bathing or showering (79%); managing money (77%); shopping for personal items (75%); walking up 10 steps without rest (72%); difficulty with walking a quarter of a mile (72%); and stooping/crouching/kneeling (70%). These findings suggest that individual items quantifying specific ADLs and IADLs have substantive relationships with the fall outcome among older adults who have difficulty with walking
Mamikonian-Zarpas, Ani; Laganá, Luciana
2016-01-01
Functional status is often defined by cumulative scores across indices of independence in performing basic and instrumental activities of daily living (ADL/IADL), but little is known about the unique relationship of each daily activity item with the fall outcome. The purpose of this retrospective study was to examine the level of relative risk for a future fall associated with difficulty with performing various tasks of normal daily functioning among older adults who had fallen at least once in the past 12 months. The sample was comprised of community-dwelling individuals 70 years and older from the 1984–1990 Longitudinal Study of Aging by Kovar, Fitti, and Chyba (1992). Risk analysis was performed on individual items quantifying 6 ADLs and 7 IADLs, as well as 10 items related to mobility limitations. Within a subsample of 1,675 older adults with a history of at least one fall within the past year, the responses of individuals who reported multiple falls were compared to the responses of participants who had a single fall and reported 1) difficulty with walking and/or balance (FRAIL group, n = 413) vs. 2) no difficulty with walking or dizziness (NDW+ND group, n = 415). The items that had the strongest relationships and highest risk ratios for the FRAIL group (which had the highest probabilities for a future fall) included difficulty with: eating (73%); managing money (70%); biting or chewing food (66%); walking a quarter of a mile (65%); using fingers to grasp (65%); and dressing without help (65%). For the NDW+ND group, the most noteworthy items included difficulty with: bathing or showering (79%); managing money (77%); shopping for personal items (75%); walking up 10 steps without rest (72%); difficulty with walking a quarter of a mile (72%); and stooping/crouching/kneeling (70%). These findings suggest that individual items quantifying specific ADLs and IADLs have substantive relationships with the fall outcome among older adults who have difficulty with
Difficulties faced by family physicians in primary health care centers in Jeddah, Saudi Arabia.
Mumenah, Sahar H; Al-Raddadi, Rajaa M
2015-01-01
The aim was to determine the difficulties faced by family physicians, and compare how satisfied those working with the Ministry of Health (MOH) are with their counterparts who work at some selected non-MOH hospitals. An analytical, cross-sectional study was conducted at King Abdulaziz University Hospital, King Faisal Specialist Hospital and Research Center (KFSH and RC), and 40 MOH primary health care centers across Jeddah. A structured multi-item questionnaire was used to collect demographic data and information on the difficulties family physicians face. The physicians' level of satisfaction and how it was affected by the difficulties was assessed. Women constituted 71.9% of the sample. Problems with transportation formed one of the main difficulties encountered by physicians. Compared to non-MOH physician, a significantly higher proportion of MOH physicians reported unavailability of radiology technicians (P = 0.011) and radiologists (P building maintenance (P < 0.001). Family physicians with the MOH were less satisfied with their jobs compared with non-MOH physicians (P = 0.032). MOH family physicians encountered difficulties relating to staff, services, and infrastructure, which consequently affected their level of satisfaction.
Children with Speech Difficulties: A survey of clinical practice in the Western Cape
Directory of Open Access Journals (Sweden)
Michelle Pascoe
2010-12-01
Full Text Available This paper is based on a study by Joffe and Pring (2008 which investigated assessment and therapy methods used by Speech Language Therapists (SLTs in the United Kingdom for children with phonological difficulties. Joffe and Pring reported SLTs’ most favoured assessments and therapy approaches in that context. Children with speech difficulties are likely to form a considerable part of SLT caseloads in South Africa, but the choice of assessments may not be so clearcut given the linguistic diversity of the region and the fact that few assessments have been developed specifically for the SA population. Linked to difficulties with assessment, selection of intervention approaches may also pose challenges. This study aimed to investigate the methods of assessment and intervention used by SLTs in the Western Cape when working with children with speech difficulties. A questionnaire was sent to SLTs working with pre and/ or primary school- aged children. Twenty-nine clinicians of varying experience responded. The majority of SLTs (89% use informal assessment tools in combination with formal assessment. When using formal assessments, more than 50% of SLTs make modifications to better suit the population. Participants use a variety of intervention approaches, often in combination, and based on a child’s individual profile of difficulties and available resources. Forty-six percent of SLTs felt unsure about the selection of assessments and intervention for bi/multilingual children with speech difficulties. SLTs suggested that guidelines about accepted / typical speech development in the region would be helpful for their clinical practice. Clinical implications of the findings are discussed together with some suggestions for developing knowledge of children’s speech difficulties in the South African context.
Accessibility of health clubs for people with mobility disabilities and visual impairments.
Rimmer, James H; Riley, Barth; Wang, Edward; Rauworth, Amy
2005-11-01
We sought to examine the accessibility of health clubs to persons with mobility disabilities and visual impairments. We assessed 35 health clubs and fitness facilities as part of a national field trial of a new instrument, Accessibility Instruments Measuring Fitness and Recreation Environments (AIMFREE), designed to assess accessibility of fitness facilities in the following domains: (1) built environment, (2) equipment, (3) swimming pools, (4) information, (5) facility policies, and (6) professional behavior. All facilities had a low to moderate level of accessibility. Some of the deficiencies concerned specific Americans with Disabilities Act guidelines pertaining to the built environment, whereas other deficiency areas were related to aspects of the facilities' equipment, information, policies, and professional staff. Persons with mobility disabilities and visual impairments have difficulty accessing various areas of fitness facilities and health clubs. AIMFREE is an important tool for increasing awareness of these accessibility barriers for people with disabilities.
The Human Genome Project: Information access, management, and regulation. Final report
Energy Technology Data Exchange (ETDEWEB)
McInerney, J.D.; Micikas, L.B.
1996-08-31
The Human Genome Project is a large, internationally coordinated effort in biological research directed at creating a detailed map of human DNA. This report describes the access of information, management, and regulation of the project. The project led to the development of an instructional module titled The Human Genome Project: Biology, Computers, and Privacy, designed for use in high school biology classes. The module consists of print materials and both Macintosh and Windows versions of related computer software-Appendix A contains a copy of the print materials and discs containing the two versions of the software.
Dyscalculia and Access Arrangements for Exams and Assessments. NIACE Briefing Sheet 87
National Institute of Adult Continuing Education, 2009
2009-01-01
Dyscalculia is considered to be a learning difficulty or difference. It is increasingly being recognised and "diagnosed" within adult learning. However, practitioners are often unclear about whether learners who are considered to have dyscalculia are entitled to access arrangements for examinations and assessments, and which access…
Mendes, Marcílio S; de Moraes, Josué
2014-11-01
In recent years, vector-borne and zoonotic diseases have become a major challenge for public health. Dengue fever and leptospirosis are the most important communicable diseases in Brazil based on their prevalence and the healthy life years lost from disability. The primary strategy for preventing human exposure to these diseases is effective insect and rodent control in and around the home. However, health authorities have difficulties in controlling vector-borne and zoonotic diseases because residents often refuse access to their homes. This study discusses aspects related to the activities performed by Brazilian health authorities to combat vector-borne and zoonotic diseases, particularly difficulties in relation to the legal aspect, which often impede the quick and effective actions of these professionals. How might it be possible to reconcile the need to preserve public health and the rule on the inviolability of the home, especially in the case of abandoned properties or illegal residents and the refusal of residents to allow the health authority access? Do residents have the right to hinder the performance of health workers even in the face of a significant and visible focus of disease transmission? This paper argues that a comprehensive legal plan aimed at the control of invasive vector-borne and zoonotic diseases including synanthropic animals of public health importance should be considered. In addition, this paper aims to bridge the gap between lawyers and public health professionals and to facilitate communication between them. Copyright © 2014 Elsevier B.V. All rights reserved.
Desirable difficulties in vocabulary learning
Bjork, RA; Kroll, JF
2015-01-01
© 2015 by the Board of Trustees of the University of Illinois. In this article we discuss the role of desirable difficulties in vocabulary learning from two perspectives, one having to do with identifying conditions of learning that impose initial challenges to the learner but then benefit later retention and transfer, and the other having to do with the role of certain difficulties that are intrinsic to language processes, are engaged during word learning, and reflect how language is underst...
Accession Medical Standards Analysis and Research Activity (AMSARA), 2014 Annual Report
2016-02-02
were accessed with a history of medical disqualification that was either remediated prior to accession or waived, 6% accessed with a waiver, and 3...disability discharge in the first year of service. Among National Guard accessions between 2008 and 2013, 15% accessed with a history of previous...intellectual efficiency, non- delinquency , optimism, order, self-control, sociability, tolerance, and physical conditioning, which is a dimension created
Modelling Question Difficulty in an A Level Physics Examination
Crisp, Victoria; Grayson, Rebecca
2013-01-01
"Item difficulty modelling" is a technique used for a number of purposes such as to support future item development, to explore validity in relation to the constructs that influence difficulty and to predict the difficulty of items. This research attempted to explore the factors influencing question difficulty in a general qualification…
Students’ difficulties in solving linear equation problems
Wati, S.; Fitriana, L.; Mardiyana
2018-03-01
A linear equation is an algebra material that exists in junior high school to university. It is a very important material for students in order to learn more advanced mathematics topics. Therefore, linear equation material is essential to be mastered. However, the result of 2016 national examination in Indonesia showed that students’ achievement in solving linear equation problem was low. This fact became a background to investigate students’ difficulties in solving linear equation problems. This study used qualitative descriptive method. An individual written test on linear equation tasks was administered, followed by interviews. Twenty-one sample students of grade VIII of SMPIT Insan Kamil Karanganyar did the written test, and 6 of them were interviewed afterward. The result showed that students with high mathematics achievement donot have difficulties, students with medium mathematics achievement have factual difficulties, and students with low mathematics achievement have factual, conceptual, operational, and principle difficulties. Based on the result there is a need of meaningfulness teaching strategy to help students to overcome difficulties in solving linear equation problems.
Access to destinations : annual accessibility measure for the Twin Cities Metropolitan Region.
2012-11-01
This report summarizes previous phases of the Access to Destinations project and applies the techniques developed : over the course of the project to conduct an evaluation of accessibility in the Twin Cities metropolitan region for : 2010. It describ...
Determinants of footwear difficulties in people with plantar heel pain.
Sullivan, Justin; Pappas, Evangelos; Adams, Roger; Crosbie, Jack; Burns, Joshua
2015-01-01
Plantar heel pain is a common foot disorder aggravated by weight-bearing activity. Despite considerable focus on therapeutic interventions such as orthoses, there has been limited investigation of footwear-related issues in people with plantar heel pain. The aim of this study was to investigate whether people with plantar heel pain experience footwear-related difficulties compared to asymptomatic individuals, as well as identifying factors associated with footwear comfort, fit and choice. The footwear domain of the Foot Health Status Questionnaire (FHSQ) was assessed in 192 people with plantar heel pain and 69 asymptomatic controls. The plantar heel pain group was also assessed on a variety of measures including: foot posture, foot strength and flexibility, pedobarography and pain level. A univariate analysis of covariance, with age as the covariate, was used to compare the heel pain and control groups on the FHSQ footwear domain score. A multiple regression model was then constructed to investigate factors associated with footwear scores among participants with plantar heel pain. When compared to asymptomatic participants, people with plantar heel pain reported lower FHSQ footwear domain scores (mean difference -24.4; p footwear scores were associated with maximum force beneath the postero-lateral heel during barefoot walking, toe flexor strength and gender. People with plantar heel pain experience difficulty with footwear comfort, fit and choice. Reduced heel loading during barefoot walking, toe flexor weakness and female gender are all independently associated with reports of footwear difficulties in people with heel pain. Increased focus, in both clinical and research settings, is needed to address footwear-related issues in people with plantar heel pain.
Directory of Open Access Journals (Sweden)
Melati Purba Bestari
2018-01-01
Full Text Available Modern libraries are characterized by the diversity of information services to users, including to fulfill the information needs of researchers. Fulfill the information requirements for this research group is very important because the information provided affect the quality of research. Library of STIE Perbanas Surabaya efforts to fulfill the information needs of researchers is to provide research resources through the provision of access annual and financial report for go public company. To provide convenience to users who do research and need annual and financial report for go public, library of STIE Perbanas Surabaya provide easy access through online catalog. To fulfill the annual and financial report for go public company, library tracking data on Indonesian stock exchange and go public company. Library attempts to provide easy access to information is expected to support a process that requires researchers and annual and financial report data so as to improve the quality and quantity of scientific works in the field of economics science, especially for subject of banking, finance and business.
Directory of Open Access Journals (Sweden)
Melati Purba Bestari
2016-07-01
Full Text Available Modern libraries are characterized by the diversity of information services to users, including to fulfill the information needs of researchers. Fulfilling the information requirements for this research group is very important because the information provided affect the quality of research. Library of STIE Perbanas Surabaya efforts to fulfill the information needs of researchers is to provide research resources through the provision of access annual and financial report for go public company. To provide convenience to users who do research and need annual and financial report for go public, library of STIE Perbanas Surabaya provide easy access through online catalog. To fulfill the annual and financial report for go public company, library tracked data on Indonesian stock exchange and go public company. Library attempts to provide easy access to information is expected to support a process that requires researchers and annual and financial report data so as to improve the quality and quantity of scientific works in the field of economics science, especially for subject of banking, finance and business.
Electricity (in)accessibility to the urban poor in developing countries
DEFF Research Database (Denmark)
Singh, Rozita; Wang, Xiao; Mendoza, Juan Carlos
2015-01-01
More than half of the world’s population now lives in urban areas. The difficulties involved in providing new urban residents with a wide variety of services reveals a new face of poverty, one in which urban communities cannot access or afford basic modern energy services for their development...... and empowerment. As an enabler of development processes, access to electricity in urban and peri-urban contexts plays a key role in providing possibilities and solutions to the urban poor. Energy poverty is no longer a rural-only phenomenon, and a concerted effort is needed to find solutions. Taking...... this into account, the Global Network on Energy for Sustainable Development (GNESD) initiated the Urban Peri-Urban Energy Access (UPEA) project in 2006. The objective was to understand the barriers to energy access in the context of the urban poor in seven countries. Barriers from both the supply and demand sides...
Accessibility to Specialized Public Oral Health Services from the Perspective of Brazilian Users
de Castro, Ricardo Dias; Rangel, Marianne de Lucena; da Silva, Marcos André Azevedo; de Lucena, Brunna Thaís Lucwu; Cavalcanti, Alessandro Leite; Bonan, Paulo Rogério Ferreti; Oliveira, Julyana de Araújo
2016-01-01
The Specialized Dental Clinics (SDCs) represent the first government initiative in Latin America aimed at providing specialized oral health services. This study sought to evaluate the organizational accessibility to specialized oral health care services in Brazil and to understand the factors that may be associated with accessibility from the user’s perspective. This epidemiological, cross-sectional and quantitative study was conducted by means of interviews with individuals who sought specialized public oral health services in the city of João Pessoa, Paraíba, Brazil, and consisted of a sample of 590 individuals. Users expressed a favorable view of the classification and resolutive nature of specialized services offered by Brazilian public health. The binary logistic regression analysis revealed weak points highlighting the difficulty involved in obtaining such treatments leading to unfavorable evaluations. In the resolutive nature item, difficulty in accessing the location, queues and lack of materials and equipment were highlighted as statistically significant unfavorable aspects. While many of the users considered the service to be resolutive, weaknesses were mentioned that need to be detected to promote improvements and to prevent other health models adopted worldwide from reproducing the same flaws. PMID:27775584
Radiologic percutaneous gastrostomy and gastroenterostomy: Indications, results, and difficulties
International Nuclear Information System (INIS)
Casola, G.; Van Sonnenberg, E.; Sukthankar, R.; Varney, R.A.; Stavas, J.; Cohen, M.; Christensen, R.A.; Wittich, G.R.
1987-01-01
This paper summarizes the authors' experience with 130 radiologic percutaneous gastrostomies (PG) and percutaneous gastroenterostomies (PGE). Procedures were accomplished successfully in 127 of 130 candidates. One case was unsuccessful and two were unfeasible. Indications were for feeding, decompression, or both. Underlying diseases included neurologic disorders, head and neck and esophageal tumors, pelvic and abdominal malignancies, trauma, and a variety of other diseases. Various guidance systems, techniques, and catheters were used. Complications occurred in 8%, most being minor. Three patients were operated on after PG/PGE-two had peritonitis, one due to tube dislodgment. Difficulties were encountered at different portions of the procedure. During catheter insertion the following problems were most common: (1) the access route was difficult because of overlying colon, (2) inability to insert a nasogastric tube in patients with esophageal carcinoma or large head and neck tumors, (3) inability to keep the stomach distended in patients with increased motility and those with surgical gastroenterostomies (Billroth I or II), (4) high position of the residual stomach in patients with hemigastrectomy, (5) the presence of ascites or peritoneal tumor anterior to the stomach in patients with ovarian carcinoma, and (6) tenting or herniation of the anterior wall of the stomach during dilatation. Difficulties that were encountered following catheter insertion included (1) chemical peritonitis from leakage of gastric juices, (2) peritonities from leakage of gastric feedings, (3) leakage around the skin entry site in patients with ascites, (4) catheters backing out and forming an intraperitorial loop, (5) catheters kinking and becoming occluded, and (6) catheters being pulled out
LENUS (Irish Health Repository)
Prabhu, Neeta T
2010-03-01
The goal of this study was to elicit the views of patients or parents\\/caregivers of patients with disabilities regarding access to dental care. A questionnaire was generated both from interviews with patients\\/parents\\/caregivers already treated under sedation or general anesthesia as well as by use of the Delphi technique with other stakeholders. One hundred thirteen patients from across six community dental clinics and one dental hospital were included. Approximately, 38% of the subjects used a general dental practitioner and 35% used the community dental service for their dental care, with only 27% using the hospital dental services. Overall waiting time for an appointment at the secondary care setting was longer than for the primary care clinics. There was a high rate of parent\\/caregiver satisfaction with dental services and only five patients reported any difficulty with travel and access to clinics. This study highlights the need for a greater investment in education and training to improve skills in the primary dental care sector.
Markey, Karen
This report describes the pilot data collections and post-questionnaire interview activities of the Council on Library Resources (CLR)/Online Computer Library Center (OCLC) Online Public Access Project. The background of the project is briefly described, the purpose and adminstration of the post-questionnaire interviews are outlined, and pilot…
Difficulties in Balint groups: a qualitative study of leaders' experiences.
Kjeldmand, Dorte; Holmström, Inger
2010-11-01
Balint groups (BGs) are a means of enhancing competence in the physician-patient relationship and are also regarded as beneficial for GPs' mental health. However, voluntary BGs are still few, some members terminate their participation, and problems are reported in obligatory groups in residency programmes. This raises questions about possible negative aspects of BGs. To examine difficulties in BGs as experienced by BG leaders. Qualitative study using interviews. Eight BG leaders from five countries were interviewed. The interviews focused on the informants' experiences of difficulties in their groups and were analysed with a systematic text-condensation method. Three categories of difficulties emerged from the analysis: 1) the individual physician having needs, vulnerabilities, and defences; 2) the group (including the leader) having problems of hidden agendas, rivalries, and frames; and 3) the surrounding environment defining the conditions of the group. BGs were found to fit into modern theories of small groups as complex systems. They are submitted to group dynamics that are sometimes malicious, and are exposed to often tough environmental conditions. Professionally conducted BGs seem to be a gentle, efficient method to train physicians, but with limitations. Participation of a member demands psychological stability and an open mind. BGs need support from the leadership of healthcare organisations in order to exist.
Paralympics 2012 Legacy: Accessible Housing and Disability Equality or Inequality?
Ahmed, Nadia
2013-01-01
The golden summer of sport is now over, but what is the legacy of London 2012 for disabled people? Nadia Ahmed, a disabled student, discusses the difficulties she has faced in finding accessible accommodation in London. She argues that while the Games are over, the United Kingdom still has lots of hurdles to leap when it comes to disability. The…
Walking modality, but not task difficulty, influences the control of dual-task walking.
Wrightson, J G; Smeeton, N J
2017-10-01
During dual-task gait, changes in the stride-to-stride variability of stride time (STV) are suggested to represent the allocation of cognitive control to walking [1]. However, contrasting effects have been reported for overground and treadmill walking, which may be due to differences in the relative difficulty of the dual task. Here we compared the effect of overground and treadmill dual-task walking on STV in 18 healthy adults. Participants walked overground and on a treadmill for 120s during single-task (walking only) and dual-task (walking whilst performing serial subtractions in sevens) conditions. Dual-task effects on STV, cognitive task (serial subtraction) performance and perceived task difficulty were compared between walking modalities. STV was increased during overground dual-task walking, but was unchanged during treadmill dual-task walking. There were no differences in cognitive task performance or perceived task difficulty. These results show that gait is controlled differently during overground and treadmill dual-task walking. However, these differences are not solely due to differences in task difficulty, and may instead represent modality dependent control strategies. Copyright © 2017 Elsevier B.V. All rights reserved.
Holes in the safety net: a case study of access to prescription drugs and specialty care.
Stanley, Ava; Cantor, Joel C; Guarnaccia, Peter
2008-07-01
The health care safety net in the United States is intended to fill gaps in health care services for uninsured and other vulnerable populations. This paper presents a case study of New Brunswick, NJ, a small city rich in safety net resources, to examine the adequacy of the American model of safety net care. We find substantial gaps in access to care despite the presence of a medical school, an abundance of primary care and specialty physicians, two major teaching hospitals, a large federally qualified health center and other safety net resources in this community of about 50,000 residents. Using a blend of random-digit-dial and area probability sampling, a survey of 595 households was conducted in 2001 generating detailed information about the health, access to care, demographic and other characteristics of 1,572 individuals. Confirming the great depth of the New Brunswick health care safety net, the survey showed that more than one quarter of local residents reported a hospital or community clinic as their usual source of care. Still, barriers to prescription drugs were reported for 11.0% of the area population and more than two in five (42.8%) local residents who perceived a need for specialty care reported difficulty getting those services. Bivariate analyses show significantly elevated risk of access problems among Hispanic and black residents, those in poor health, those relying on hospital and community clinics or with no usual source of care, and those living at or below poverty. In multivariate analysis, lack of health insurance was the greatest risk factor associated with both prescription drug and specialty access problems. Few local areas can claim the depth of safety net resources as New Brunswick, NJ, raising serious concerns about the adequacy of the American safety net model, especially for people with complex and chronic health care needs.
Patel, Drasti; Koehmstedt, Christine; Jones, Rebecca; Coffey, Nathan T; Cai, Xinsheng; Garfinkel, Steven; Shaewitz, Dahlia M; Weinstein, Ali A
2017-01-01
Research examining the utilization of evidence-based practice (EBP) specifically among rehabilitation clinicians is limited. The objective of this study was to examine how various rehabilitative clinicians including physical therapists, occupational therapists, rehabilitation counselors, and physiatrists are gaining access to literature and whether they are able to implement the available research into practice. A total of 21 total clinicians were interviewed via telephone. Using NVivo, a qualitative analysis of the responses was performed. There were similarities found with respect to the information-seeking behaviors and translation of research across the different clinician types. Lack of time was reported to be a barrier for both access to literature and implementation of research across all clinician types. The majority of clinicians who reported having difficulty with utilizing the published literature indicated that the literature was not applicable to their practice, the research was not specific enough to be put into practice, or the research found was too outdated to be relevant. In addition, having a supportive work environment aided in the search and utilization of research through providing resources central to assisting clinicians in gaining access to health information. Our study identified several barriers that affect EBP for rehabilitation clinicians. The findings suggest the need for researchers to ensure that their work is applicable and specific to clinical practice for implementation to occur.
The role of sensorimotor difficulties in autism spectrum conditions
Directory of Open Access Journals (Sweden)
Penelope Hannant
2016-08-01
Full Text Available AbstractIn addition to difficulties in social communication, current diagnostic criteria for autism spectrum conditions (ASC also incorporate sensorimotor difficulties; repetitive motor movements and atypical reactivity to sensory input (APA, 2013. This paper explores whether sensorimotor difficulties are associated with the development and maintenance of symptoms in ASC. Firstly, studies have shown difficulties coordinating sensory input into planning and executing movement effectively in ASC. Secondly, studies have shown associations between sensory reactivity and motor coordination with core ASC symptoms, suggesting these areas each strongly influence the development of social and communication skills. Thirdly, studies have begun to demonstrate that sensorimotor difficulties in ASC could account for reduced social attention early in development, with a cascading effect on later social, communicative and emotional development. These results suggest that sensorimotor difficulties not only contribute to non-social difficulties such as narrow circumscribed interests, but also to the development of social behaviours such as effectively coordinating eye contact with speech and gesture, interpreting others’ behaviour and responding appropriately. Further research is needed to explore the link between sensory and motor difficulties in ASC, and their contribution to the development and maintenance of ASC.
Li, Kin-Kit; Cardinal, Bradley J; Vuchinich, Samuel
2009-03-01
This study examined the effect of health worry (i.e., cognitive aspect of anxiety resulting from concern for health) on walking difficulty in a nationally representative sample (N = 7,527) of older adults (M age = 76.83 years). The study further tested whether physical activity mediates the effect of health worry on walking difficulty in a 6-year follow-up design. Results of a mediation analysis using structural equation modeling showed that people with a high degree of health worry engaged in less physical activity (beta = -.24, p < .001), and people who participated in less physical activity were more likely to report walking difficulty at the 6-year follow-up (beta = -.22, p < .001). There was a significant indirect effect from health worry to walking difficulty through physical activity (beta = .05, p < .001), controlling for demographic, psychosocial, and health related factors. Results suggested that inducing threat and worry may not be effective for physical activity promotion in the older population. More promising coping and regulation strategies are discussed.
Hinchliff, Sharron; Tetley, Josie; Lee, David; Nazroo, James
2018-02-01
There is a growing body of evidence demonstrating that sexual activity is important to the quality of life of older adults, and that it can be influenced by physical, psychological, and social factors. However, older adults' experiences of sexual difficulties remain relatively unexplored. This article draws on qualitative data collected as part of the English Longitudinal Study of Ageing (ELSA). Participants answered a Sexual Relationships and Activities Questionnaire (SRA-Q), which included an open comment box for further details, 1,084 (1/7) of which were completed. These data were analyzed using Template Analysis, and findings on the experiences of sexual difficulties are presented in this article. Sexual difficulties were contextualized within the couple relationship and could be detrimental to the relationship, particularly if the partner would not seek professional help. Participants reported that sexual difficulties could also have a negative impact on psychological well-being, described mainly as frustration, depression, and sadness. For some participants the supportive nature of their relationship buffered these impacts. Few had sought professional help; those who had reported helpful and unhelpful experiences. These findings add to the limited evidence base and have implications for health care in the context of global aging and a growing recognition of older adults' sexual rights.
How University Students with Reading Difficulties Are Supported in Achieving Their Goals
Stack-Cutler, Holly L.; Parrila, Rauno K.; Jokisaari, Markku; Nurmi, Jari-Erik
2015-01-01
We examine (a) what social ties university students with a history of reading difficulty (RD) report assisting them to achieve their goals, (b) outlets available for developing social ties, (c) resources mobilized within these relationships, and (d) the impact of social ties' status on academic achievement. Participants were 107 university…
DEFF Research Database (Denmark)
Overgaard, Morten; Sandberg, Kristian
2014-01-01
that there is not only a theoretical, but also an empirical difference between different methods of reporting. We hypothesise that differences in the sensitivity of different scales may reveal that different types of access are used to issue direct reports about experiences and metacognitive reports about...
Correlation between oro and hypopharynx shape and position with endotracheal intubation difficulty
Directory of Open Access Journals (Sweden)
Daher Rabadi
2014-12-01
Full Text Available Background and objective: Prediction of intubation difficulty can save patients from major preoperative morbidity or mortality. The purpose of this paper is to assess the correlation between oro-hypo pharynx position, neck size, and length with endotracheal intubation difficulty. The study also explored the diagnostic value of Friedman Staging System in prediction cases with difficult intubation. Method: The consecutive 500 ASA (I, II adult patients undergoing elective surgery were evaluated for oro and hypopharynx shape and position by modified Mallampati, Cormack and Lehane score as well as Friedman obstructive sleep apnea classification systems. Neck circumference and length were also measured. All cases were intubated by a single anesthesiologist who was uninformed of the above evaluation and graded intubation difficulty in visual analog score. Correlation between these findings and difficulty of intubation was assessed. Sensitivity, Specificity, Positive and Negative Predictive Values were also reported. Results: Cormack-Lehane grade had the strongest correlation with difficulty of intubation followed by Friedman palate position. Friedman palate position was the most sensitive and had higher positive and negative predictive values than modified Mallampati classification. Cormack-Lehane grade was found to be the most specific with the highest negative predictive value among the four studied classifications. Conclusion: Friedman palate position is a more useful, valuable and sensitive test compared to the modified Mallampati screening test for pre-anesthetic prediction of difficult intubation where its involvement in Multivariate model may raise the accuracy and diagnostic value of preoperative assessment of difficult airway.
Hearing loss and speech perception in noise difficulties in Fanconi anemia.
Verheij, Emmy; Oomen, Karin P Q; Smetsers, Stephanie E; van Zanten, Gijsbert A; Speleman, Lucienne
2017-10-01
Fanconi anemia is a hereditary chromosomal instability disorder. Hearing loss and ear abnormalities are among the many manifestations reported in this disorder. In addition, Fanconi anemia patients often complain about hearing difficulties in situations with background noise (speech perception in noise difficulties). Our study aimed to describe the prevalence of hearing loss and speech perception in noise difficulties in Dutch Fanconi anemia patients. Retrospective chart review. A retrospective chart review was conducted at a Dutch tertiary care center. All patients with Fanconi anemia at clinical follow-up in our hospital were included. Medical files were reviewed to collect data on hearing loss and speech perception in noise difficulties. In total, 49 Fanconi anemia patients were included. Audiograms were available in 29 patients and showed hearing loss in 16 patients (55%). Conductive hearing loss was present in 24.1%, sensorineural in 20.7%, and mixed in 10.3%. A speech in noise test was performed in 17 patients; speech perception in noise was subnormal in nine patients (52.9%) and abnormal in two patients (11.7%). Hearing loss and speech perception in noise abnormalities are common in Fanconi anemia. Therefore, pure tone audiograms and speech in noise tests should be performed, preferably already at a young age, because hearing aids or assistive listening devices could be very valuable in developing language and communication skills. 4. Laryngoscope, 127:2358-2361, 2017. © 2016 The American Laryngological, Rhinological and Otological Society, Inc.
Who helps the leaders? Difficulties experienced by cancer support group leaders.
Kirsten, Laura; Butow, Phyllis; Price, Melanie; Hobbs, Kim; Sunquist, Kendra
2006-07-01
Cancer support groups are an important source of support for cancer patients, yet little is known about the challenges and training needs of both professionally trained and untrained leaders. The aim of this study was to discover the difficulties experienced and training desired by cancer support group leaders. Twenty-seven leaders of 34 cancer support groups participated in focus groups or individual interviews. Groups were purposively selected as representative of 173 support groups identified in New South Wales which were for adults with cancer and/or their adult carers and were not therapeutic or education-only groups. Difficulties identified included dealing with people's different communication styles and needs; dealing with recurrence, metastases and death; practical issues, including resources, setting the programme and funding security; maintaining personal balance and preventing burn out; establishing group credibility; dealing with group cycles; and leading groups in rural areas. Leaders also identified benefits and rewards from group leadership such as contributing to others' well-being, self-development and insight into others' lives. Non-professionally trained leaders experienced more difficulties, particularly in dealing with group process and practical issues. Difficulties identified were related both to working with a cancer population specifically and to working with groups in general. While some issues were common to both health professionals and non-health professionals, non-health professionals reported greater supportive needs. Clear guidelines, targeted training and development of better methods of support to reduce the stress and burn out experienced by group leaders are needed.
Wilkin, Holley A; Ball-Rokeach, Sandra J
2011-04-01
Health issues disproportionately affect Latinos, but variations within this ethnic group may mean that some Latinos are harder to reach with health messages than others. This paper introduces a methodology grounded in communication infrastructure theory to better target 'hard-to-reach' audiences. A random digit dialing telephone survey of 739 Latinos living in two Los Angeles communities was conducted. The relationships between health access difficulties and connections to an integrated storytelling network as well as individual health communication source connections were explored. Findings suggest that Latinos who are connected to an integrated storytelling network report marginally greater ease finding healthcare, despite not being any more likely to have insurance or a regular place for healthcare. Latinos who have health access problems tended to rely more upon Spanish-language television for health information. In addition, those without healthcare access problems are more likely to indicate that they use health professionals, the Internet, mainstream TV and printed materials like health pamphlets for health information. The theoretical and methodological contributions of this work, its major findings, implications, limitations and policy guidelines are discussed.
Sahin, Esin; Yagbasan, Rahmi
2012-01-01
This study aims at diagnosing which subjects pre-service physics teachers have difficulty understanding in introductory physics courses and what accounts for these difficulties. A questionnaire consisting of two qualitative questions was used to collect data for this study. The questionnaire was administered to 101 pre-service physics teachers who…
Friedlander, Myrna L.; Siegel, Sheri M.
1990-01-01
Tested theoretical link between difficulties with separation-individuation and cognitive-behavioral indicators characteristic of anorexia nervosa and bulimia. Assessed 124 college women using three self-report measures. Results suggest strong relation between 2 sets of variables and support theoretical assertions about factors that contribute to…
Rare malposition following left jugular vein catheterization: Case reports and a literature review.
Wang, Lin; Liu, Zhangsuo; Wang, Changan; Liu, Dongwei; Yuan, Yiqiang
2015-01-01
The number of patients requiring chronic hemodialysis via a tunneled cuffed catheter is increasing. The right internal jugular vein (IJV) is generally the preferred site of percutaneous insertion. In certain situations, for example, in patients with a history of multiple access failures, catheterization of the left IJV is an important option. In this report, we present two rare cases of catheter malposition after left IJV catheterization; catheter adjustments, with the help of chest radiographs, resulted in a positive outcome in both cases. These cases exemplify the difficulties associated with left IJV catheterization, of which there are few reports in the published literature.
Lara-Mendes, Sônia T de O; Barbosa, Camila de Freitas M; Santa-Rosa, Caroline C; Machado, Vinícius C
2018-05-01
The aim of this study was to describe a guided endodontic technique that facilitates access to root canals of molars presenting with pulp calcifications. A 61-year-old woman presented to our service with pain in the upper left molar region. The second and third left molars showed signs of apical periodontitis confirmed by the cone-beam computed tomographic (CBCT) scans brought to us by the patient at the initial appointment. Conventional endodontic treatment was discontinued given the difficulty in locating the root canals. Intraoral scanning and the CBCT scans were used to plan the access to the calcified canals by means of implant planning software. Guides were fabricated through rapid prototyping and allowed for the correct orientation of a cylindrical drill used to provide access through the calcifications. Second to that, the root canals were prepared with reciprocating endodontic instruments and rested for 2 weeks with intracanal medication. Subsequently, canals were packed with gutta-percha cones using the hydraulic compression technique. Permanent restorations of the access cavities were performed. By comparing the tomographic images, the authors observed a drastic reduction of the periapical lesions as well as the absence of pain symptoms after 3 months. This condition was maintained at the 1-year follow-up. The guided endodontic technique in maxillary molars was shown to be a fast, safe, and predictable therapy and can be regarded as an excellent option for the location of calcified root canals, avoiding failures in complex cases. Copyright © 2018 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.
Postoperative Feeding Difficulties after Repair of Congenital ...
African Journals Online (AJOL)
Of these, 24 (37.5%) developed feeding difficulties in the immediate post operative period. The causes of the feeding difficulties were Gastro-oesophageal reflux (GOR) 9, Recurrent diaphragmatic hernia 8, Adhesive intestinal obstruction 4, Poor intestinal motility 2, Campylobacter enteritis, 1, Hypertrophic pyloric stenosis, 1.
A study of HIV positive undocumented African migrants' access to health services in the UK.
Whyte, James; Whyte, Maria D; Hires, Kimberly
2015-01-01
Newly immigrated persons, whatever their origin, tend to fall in the lower socioeconomic levels. In fact, failure of an asylum application renders one destitute in a large proportion of cases, often resulting in a profound lack of access to basic necessities. With over a third of HIV positive failed asylum seekers reporting no income, and the remainder reporting highly limited resources, poverty is a reality for the vast majority. The purpose of the study was to determine the basic social processes that guide HIV positive undocumented migrant's efforts to gain health services in the UK. The study used the Grounded Theory Approach. Theoretical saturation occurred after 16 participants were included in the study. The data included reflections of the prominent factors related to the establishment of a safe and productive life and the ability of individuals to remain within the UK. The data reflected heavily upon the ability of migrants to enter the medical care system during their asylum period, and on an emerging pattern of service denial after loss on immigration appeal. The findings of this study are notable in that they have demonstrated sequence of events along a timeline related to the interaction between the asylum process and access to health-related services. The results reflect that African migrants maintain a degree of formal access to health services during the period that they possess legal access to services and informal access after the failure of their asylum claim. The purpose of this paper is to examine the basic social processes that characterize efforts to gain access to health services among HIV positive undocumented African migrants to the UK. The most recent estimates indicate that there are a total of 618,000 migrants who lack legal status within the UK. Other studies have placed the number of undocumented migrants within the UK in the range of 525,000-950,000. More than 442,000 are thought to dwell in the London metropolitan area. Even in
Exploring communication difficulties in pediatric hematology: oncology nurses.
Citak, Ebru Akgun; Toruner, Ebru Kilicarslan; Gunes, Nebahat Bora
2013-01-01
Communication plays an important role for the well being of patients, families and also health care professionals in cancer care. Conversely, ineffective communication may cause depression, increased anxiety, hopelessness and decreased of quality life for patients, families and also nurses. This study aimed to explore communication difficulties of pediatric hematology/oncology nurses with patients and their families, as well as their suggestions about communication difficulties. It was conducted in a pediatric hematology/oncology hospital in Ankara, Turkey. Qualitative data were collected by focus groups, with 21 pediatric hematology/oncology nursing staff from three groups. Content analysis was used for data analysis. Findings were grouped in three main categories. The first category concerned communication difficulties, assessing problems in responding to questions, ineffective communication and conflicts with the patient's families. The second was about the effects of communication difficulties on nurses and the last main category involved suggestions for empowering nurses with communication difficulties, the theme being related to institutional issues. Nurses experience communication difficulties with children and their families during long hospital stays. Communication difficulties particularly increase during crisis periods, like at the time of first diagnosis, relapse, the terminal stage or on days with special meaning such as holidays. The results obtained indicate that pediatric nurses and the child/family need to be supported, especially during crisis periods. Feeling of empowerment in communication will improve the quality of care by reducing the feelings of exhaustion and incompetence in nurses.
Sufrinko, Alicia; Pearce, Kelly; Elbin, R J; Covassin, Tracey; Johnson, Eric; Collins, Michael; Kontos, Anthony P
2015-04-01
Researchers have reported that sleep duration is positively related to baseline neurocognitive performance. However, researchers have yet to examine the effect of preinjury sleep difficulties on postconcussion impairments. To compare neurocognitive impairment and symptoms of athletes with preinjury sleep difficulties to those without after a sport-related concussion (SRC). Cohort study; Level of evidence, 3. The sample included 348 adolescent and adult athletes (age, mean ± SD, 17.43 ± 2.34 years) with a diagnosed SRC. The sample was divided into 2 groups: (1) 34 (10%) participants with preinjury sleep difficulties (sleeping less as well as having trouble falling asleep; SLEEP SX) and (2) 231 (66%) participants without preinjury sleep difficulties (CONTROL). The remaining 84 (24%) participants with minimal sleep difficulties (1 symptom) were excluded. Participants completed the Immediate Postconcussion Assessment and Cognitive Test (ImPACT) and Postconcussion Symptom Scale (PCSS) at baseline and 3 postinjury intervals (2, 5-7, and 10-14 days after injury). A series of repeated-measures analyses of covariance with Bonferroni correction, controlling for baseline non-sleep-related symptoms, were conducted to compare postinjury neurocognitive performance between groups. Follow-up exploratory t tests examined between-group differences at each time interval. A series of analyses of variance were used to examine total PCSS score, sleep-related, and non-sleep-related symptoms across time intervals between groups. Groups differed significantly in PCSS scores across postinjury intervals for reaction time (P SLEEP SX group performing worse than controls at 5-7 days (mean ± SD, 0.70 ± 0.32 [SLEEP SX], 0.60 ± 0.14 [CONTROL]) and 10-14 days (0.61 ± 0.17 [SLEEP SX]; 0.57 ± 0.10 [CONTROL]) after injury. Groups also differed significantly on verbal memory performance (P = .04), with the SLEEP SX (68.21 ± 18.64) group performing worse than the CONTROL group (76.76 ± 14
Report #2006-P-00005, December 14, 2005. Controls needed to be improved in areas such as visitor access to facilities, use of contractor access badges, and general physical access to the NCC, computer rooms outside the NCC, and media storage rooms.
Late Emerging Reading Difficulties in English Language Learners
Garcia, Nicole Marie
2015-01-01
Research has identified a group of students who do not begin to exhibit reading difficulties until fourth or fifth grade, suggesting late-emerging reading difficulties. Considering that these students do not show signs of reading difficulties in early grades, attempting to identify these students early becomes problematic. Additionally, little is known regarding the characteristics of late-emerging reading deficits within English language learner (ELL) populations. The purpose of this study w...
Stieg, Kerstin; Pavlovic, Karlo
2012-01-01
The glossary „Open Access from A to Z“ comprises essential key terms on Open Access such as arXiv, The Berlin Declaration on Open Access to Knowledge in the Sciences and Humanities, the Budapest Open Access Initiative (BOAI), Creative Commons (CC), the Directory of Open Access Books (DOAB), the Directory of Open Access Journals (DOAJ), the Directory of Open Access Repositories (OpenDOAR), the EU project Digital Repository Infrastructure Vision for European Research (DRIVER), the Finch Report,...
Hagberg, Bibbi; Billstedt, Eva; Nydén, Agneta; Gillberg, Christopher
2015-08-01
A specific overlap between Asperger syndrome (AS) and nonverbal learning difficulties (NLD) has been proposed, based on the observation that, as a group, people with AS tend to have significantly higher verbal IQ (VIQ) than performance IQ (PIQ), one of the core features of NLD. The primary aim was to assess the longer term outcome of NLD--broken down into persistent and transient forms. The present study of 68 individuals was performed in the context of a larger prospective longitudinal study to late adolescence/early adult life of 100 boys with AS. Using self- and parent-report measures, we studied the longer term outcome of the NLD (defined as VIQ > PIQ by 15 points) as regards social communication, repetitive behaviour, attention, and executive function (EF) was studied. Three subgroups were identified: (1) Persistent NLD (P-NLD), (2) Childhood "only" NLD (CO-NLD) and (3) Never NLD (NO-NLD). The P-NLD group had the worst outcome overall. The CO-NLD group had better reported EF scores than the two other AS subgroups. There were no differences between the subgroups regarding social communication, repetitive behaviour, or attentional skills. Low PIQ increased the risk of ADHD symptoms. In the context of AS in males, P-NLD carries a relatively poor outcome, particularly with regard to self-reported EF. However, CO-NLD appears to entail a significantly better outcome. The results underscore the importance of analysing the cognitive profile both at diagnosis and after several years, so as to be able to formulate a realistic prognosis.
[Measurement of carotenoids by high pressure liquid chromatography: from difficulties to solutions].
Steghens, J P; Lyan, B; Le Moel, G; Galabert, C; Fayol, V; Faure, H; Grolier, P; Cheribi, N; Dubois, F; Nabet, F
2000-01-01
The measurement of serum carotenoids by HPLC has been largely improved during the last 10 years. However these techniques still require much time and skills, and direct application of published methods is rarely satisfying. We report here the difficulties that we met to transfer some HPLC methods described in the literature to our laboratories. We propose some solution to overcome the problems that we have encountered, our experience will perhaps help out other biologists. We reported also some results obtained in healthy populations.
International Nuclear Information System (INIS)
1986-01-01
The working party was set up to report to the Government ways of implementing the recommendations of the Royal Commission on Environmental Pollution that 'there should be a presumption in favour of unrestricted public access to the information which the pollution control authorities obtain or receive by virtue of their statutory powers'. Chapter 6 deals with Radioactive wastes. The present situation (eg on how the information is gathered, which department or bodies are involved etc) and the current state of the law are discussed. Licensed nuclear sites, sea disposal, inspections and defence wastes are all considered briefly. The case for improving public access to information and, recommendations on how to achieve this made, and the resource implications considered. On control of radioactive wastes there is currently no power for the responsible Government Departments to make information public. It is recommended that new legislation should confer powers to make information available, including a power to require public registers to be kept at prescribed places giving information related to certificates issued under the Radioactive Substances Act 1960. (UK)
Health Websites: Accessibility and Usability for American Sign Language Users
Kushalnagar, Poorna; Naturale, Joan; Paludneviciene, Raylene; Smith, Scott R.; Werfel, Emily; Doolittle, Richard; Jacobs, Stephen; DeCaro, James
2015-01-01
To date, there have been efforts towards creating better health information access for Deaf American Sign Language (ASL) users. However, the usability of websites with access to health information in ASL has not been evaluated. Our paper focuses on the usability of four health websites that include ASL videos. We seek to obtain ASL users’ perspectives on the navigation of these ASL-accessible websites, finding the health information that they needed, and perceived ease of understanding ASL video content. ASL users (N=32) were instructed to find specific information on four ASL-accessible websites, and answered questions related to: 1) navigation to find the task, 2) website usability, and 3) ease of understanding ASL video content for each of the four websites. Participants also gave feedback on what they would like to see in an ASL health library website, including the benefit of added captioning and/or signer model to medical illustration of health videos. Participants who had lower health literacy had greater difficulty in finding information on ASL-accessible health websites. This paper also describes the participants’ preferences for an ideal ASL-accessible health website, and concludes with a discussion on the role of accessible websites in promoting health literacy in ASL users. PMID:24901350
Common Factors Among Family Medicine Residents Who Encounter Difficulty.
Binczyk, Natalia M; Babenko, Oksana; Schipper, Shirley; Ross, Shelley
2018-04-01
Residents in difficulty are costly to programs in both time and resources, and encountering difficulty can be emotionally harmful to residents. Approximately 10% of residents will encounter difficulty at some point in training. While there have been several studies looking at common factors among residents who encounter difficulty, some of the findings are inconsistent. The objective of this study was to determine whether there are common factors among the residents who encounter difficulty during training in a large Canadian family medicine residency program. Secondary data analysis was performed on archived resident files from a Canadian family medicine residency program. Residents who commenced an urban family medicine residency program between the years of 2006 and 2014 were included in the study. Five hundred nine family medicine residents were included in data analysis. Residents older than 30 years were 2.33 times (95% CI: 1.27-4.26) more likely to encounter difficulty than residents aged 30 years or younger. Nontransfer residents were 8.85 times (95% CI: 1.17-66.67) more likely to encounter difficulty than transfer residents. The effects of sex, training site, international medical graduate status, and rotation order on the likelihood of encountering difficulty were nonsignificant. Older and nontransfer residents may be facing unique circumstances and may benefit from additional support from the program.
Prediction and Stability of Mathematics Skill and Difficulty
Martin, Rebecca B.; Cirino, Paul T.; Barnes, Marcia A.; Ewing-Cobbs, Linda; Fuchs, Lynn S.; Stuebing, Karla K.; Fletcher, Jack M.
2012-01-01
The present study evaluated the stability of math learning difficulties over a 2-year period and investigated several factors that might influence this stability (categorical vs. continuous change, liberal vs. conservative cut point, broad vs. specific math assessment); the prediction of math performance over time and by performance level was also evaluated. Participants were 144 students initially identified as having a math difficulty (MD) or no learning difficulty according to low achievem...
Difficulties and practices regarding information provision among Korean and Italian nurses.
Ingravallo, F; Kim, K H; Han, Y H; Volta, A; Chiari, P; Taddia, P; Kim, J S
2017-12-01
To investigate nurses' opinions and practices of providing information in a global context through cultural comparison. Providing sufficient information to patients about nursing interventions and plans is essential for patient-centred care. While many countries have specific legislation making information delivery to patients a legal duty of nurses, no such legislation exists in both the Republic of Korea and Italy; nurses' only guidance is the deontological code. This was a cross-sectional survey study involving a convenience sample of 174 Korean nurses and 121 Italian nurses working in internal medicine and surgery at university hospitals. Data were collected using a self-administered questionnaire between February and November 2014. The questionnaire assessed demographic and professional characteristics, and difficulties and practices regarding information provision. Korean and Italian nurses significantly differed in all demographic and professional characteristics. More Korean than Italian participants reported that their role in providing information was well explained within their teams, but both groups reported the same level and type of difficulties in delivering information. Nurses in both countries regularly informed patients about medications and nursing procedures, but provided information about nursing care plans less frequently. Few nurses frequently provided information to relatives instead of patients. Despite cultural, demographic and professional differences between Korean and Italian nurses, their difficulties and practices in information delivery to patient were similar. Hospital managers and policymakers should be aware that nurse-patient communication can be impaired by organizational factors, patient characteristics or the interaction among providers. Educational interventions and strategies are needed to increase information provision to patients about nursing care plans. © 2017 International Council of Nurses.
Investigating student difficulties on integral calculus based on critical thinking aspects
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Farida Nursyahidah
2017-11-01
Full Text Available Students of Mathematics education often struggle with integration problem, but yet the root of the problem related to critical thinking is rarely investigated. This article reports research where the first-year students of Mathematics Education of PGRI University Semarang were given an integral problem, then individually they were interviewed related to the answer they have made. The findings of students' difficulties in working on integration problem were confirmed through several questions in the interview which aimed to uncover their critical thinking process related to concepts, procedures, and problem solving. This study shows that student difficulties in Integration by disc method such as failure in identifying radius of a rotary object, specify partition, and integration bounds are closely related to their failure to think critically related to concept, skills, and problem solving aspects of critical thinking.
Coppens-Hofman, Marjolein C; Terband, Hayo R; Maassen, Ben A M; van Schrojenstein Lantman-De Valk, Henny M J; van Zaalen-op't Hof, Yvonne; Snik, Ad F M
2013-01-01
In individuals with an intellectual disability, speech dysfluencies are more common than in the general population. In clinical practice, these fluency disorders are generally diagnosed and treated as stuttering rather than cluttering. To characterise the type of dysfluencies in adults with intellectual disabilities and reported speech difficulties with an emphasis on manifestations of stuttering and cluttering, which distinction is to help optimise treatment aimed at improving fluency and intelligibility. The dysfluencies in the spontaneous speech of 28 adults (18-40 years; 16 men) with mild and moderate intellectual disabilities (IQs 40-70), who were characterised as poorly intelligible by their caregivers, were analysed using the speech norms for typically developing adults and children. The speakers were subsequently assigned to different diagnostic categories by relating their resulting dysfluency profiles to mean articulatory rate and articulatory rate variability. Twenty-two (75%) of the participants showed clinically significant dysfluencies, of which 21% were classified as cluttering, 29% as cluttering-stuttering and 25% as clear cluttering at normal articulatory rate. The characteristic pattern of stuttering did not occur. The dysfluencies in the speech of adults with intellectual disabilities and poor intelligibility show patterns that are specific for this population. Together, the results suggest that in this specific group of dysfluent speakers interventions should be aimed at cluttering rather than stuttering. The reader will be able to (1) describe patterns of dysfluencies in the speech of adults with intellectual disabilities that are specific for this group of people, (2) explain that a high rate of dysfluencies in speech is potentially a major determiner of poor intelligibility in adults with ID and (3) describe suggestions for intervention focusing on cluttering rather than stuttering in dysfluent speakers with ID. Copyright © 2013 Elsevier Inc
Access to patient-centered medical home among Ohio's Children with Special Health Care Needs.
Conrey, Elizabeth J; Seidu, Dazar; Ryan, Norma J; Chapman, Dj Sam
2013-06-01
Medical homes deliver primary care that is accessible, continuous, comprehensive, family centered, coordinated, compassionate and culturally effective. Children with special health care needs (CSHCN) require a wide range of support to maintain health, making medical home access particularly important. We sought to understand independent risk factors for lacking access. We analyzed Ohio, USA data from the National Survey of Children with Special Health Care Needs (2005-2006). Among CSHCN, 55.6% had medical home access. The proportion achieving each medical home component was highest for having a personal doctor/nurse and lowest for receiving coordinated care, family-centered care and referrals. Specific subsets of CSHCN were significantly and independently more likely to lack medical home access: Hispanic (AOR=3.08), moderate/high severity of difficulty (AOR=2.84), and any public insurance (AOR=1.60). Efforts to advance medical home access must give special attention to these CSHCN populations and improvements must be made to referral access, family-centered care, and care coordination.
National Oceanic and Atmospheric Administration, Department of Commerce — This accession contains comprehensive dataset and reports collected in support of the Mamala Bay Study during 1993-1995. Physical, chemical, biological, and...
International Nuclear Information System (INIS)
1987-02-01
This report analyzes highway and railroad access to seven potentially acceptable salt repository sites: Richton Dome and Cypress Creek Dome in Mississippi, Vacherie Dome in Louisiana, Swisher County and Deaf Smith County in Texas, and Davis Canyon and Lavender Canyon in utah. The objectives of the study were to investigate the routing of reasonable access corridors to the sites, describe major characteristics of each route, and estimate the costs for constructing or upgrading highways and railroads. The routes used in the analysis are not necessarily recommended or preferred over other routes, nor do they represent an implied final selection. Detailed engineering studies must be performed for the Davis Canyon and Lavender Canyon highway access before the analyzed routes can be considered to be viable. 20 refs., 7 figs., 3 tabs
Educator perspectives on the postsecondary transition difficulties of students with autism.
Elias, Rebecca; Muskett, Ashley E; White, Susan W
2017-10-01
Addressing the challenges of adolescents and emerging adults with autism spectrum disorder is crucial to improving the outcomes of these students in the postsecondary setting. Although secondary and postsecondary educators and staff are critical to helping these students access services, there has been little investigation into the perspectives of this stakeholder group, with respect to the needs of postsecondary students with autism spectrum disorder. A series of focus groups was conducted with secondary and postsecondary educators to understand educator perspectives related to the challenges faced by postsecondary students with autism spectrum disorder. Competence, autonomy and independence, and the development and sustainment of interpersonal relationships emerged as primary areas of difficulty and corresponding need. Results suggest that targeted interventions addressing these areas should be implemented, prior to and during enrollment in a postsecondary setting, to facilitate transition in a comprehensive manner.
Difficulty scaling through incongruity
Lankveld, van G.; Spronck, P.; Rauterberg, G.W.M.; Mateas, M.; Darken, C.
2008-01-01
In this paper we discuss our work on using the incongruity measure from psychological literature to scale the difficulty level of a game online to the capabilities of the human player. Our approach has been implemented in a small game called Glove.
A three-stage heuristic for harvest scheduling with access road network development
Mark M. Clark; Russell D. Meller; Timothy P. McDonald
2000-01-01
In this article we present a new model for the scheduling of forest harvesting with spatial and temporal constraints. Our approach is unique in that we incorporate access road network development into the harvest scheduling selection process. Due to the difficulty of solving the problem optimally, we develop a heuristic that consists of a solution construction stage...
Reading comprehension difficulties in children with rolandic epilepsy.
Currie, Nicola K; Lew, Adina R; Palmer, Tom M; Basu, Helen; De Goede, Christian; Iyer, Anand; Cain, Kate
2018-03-01
Difficulties in reading comprehension can arise from either word reading or listening comprehension difficulties, or a combination of the two. We sought to determine whether children with rolandic epilepsy had poor reading comprehension relative to typically developing comparison children, and whether such difficulties were associated with word reading and/or general language comprehension difficulties. In this cross-sectional study, children with rolandic epilepsy (n=25; 16 males, 9 females; mean age 9y 1mo, SD 1y 7mo) and a comparison group (n=39; 25 males, 14 females; mean age 9y 1mo, SD 1y 3mo) completed assessments of reading comprehension, listening comprehension, word/non-word reading, speech articulation, and Non-verbal IQ. Reading comprehension and word reading were worse in children with rolandic epilepsy (F 1,61 =6.89, p=0.011, ηp2=0.10 and F 1,61 =6.84, p=0.011, ηp2=0.10 respectively), with listening comprehension being marginal (F 1,61 =3.81, p=0.055, ηp2=0.06). Word reading and listening comprehension made large and independent contributions to reading comprehension, explaining 70% of the variance. Children with rolandic epilepsy may be at risk of reading comprehension difficulties. Thorough assessment of individual children is required to ascertain whether the difficulties lie with decoding text, or with general comprehension skills, or both. Children with rolandic epilepsy may be at risk of poor reading comprehension. This was related to poor word reading, poor listening comprehension, or both. Reading comprehension interventions should be tailored to the profile of difficulties. © 2017 Mac Keith Press.
LEARNING DIFFICULTIES: AN ANALYSIS BASED ON VIGOTSKY
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Adriane Cenci
2010-06-01
Full Text Available We aimed, along the text, to bring a reflection upon learning difficulties based on Socio-Historical Theory, relating what is observed in schools to what has been discussed about learning difficulties and the theory proposed by Vygotsky in the early XX century. We understand that children enter school carrying experiences and knowledge from their cultural group and that school ignores such knowledge very often. Then, it is in such disengagement that emerges what we started to call learning difficulties. One cannot forget to see a child as a whole – a student is a social being constituted by culture, language and specific values to which one must be attentive.
Hearing difficulties and feelings of social isolation among Canadians aged 45 or older.
Ramage-Morin, Pamela L
2016-11-16
Social isolation is associated with reduced health-related quality of life, increased morbidity, and mortality. Social isolation can be a concern for older Canadians, especially those with conditions that interfere with making and maintaining social connections. The 2008/2009 Canadian Community Health Survey-Healthy Aging (CCHS-HA) collected data from a population-based sample of Canadians aged 45 or older living in private households. Frequencies, cross-tabulations and logistic regression were used to examine the prevalence of hearing difficulties and social isolation, and associations between them when controlling for sociodemographic characteristics, other functional limitations (for example, vision, mobility, and cognition), incontinence, and fear of falling. Social isolation was more common among 45- to 59-year-olds than among people aged 60 or older. Women were more likely than men to be socially isolated (16% versus 12%), but they were less likely to report hearing difficulties (5% versus 7%). Hearing difficulties were more prevalent at older ages: 25% of men and 18% of women at age 75 or older. When sociodemographic factors (age, education, living arrangements, regular driver, workforce participation), incontinence, fear of falling, and functional limitations were taken into account, the odds of being socially isolated increased with the severity of the hearing impairment among women but not among men (OR: 1.04, 95% CI: 1.00, 1.09). Hearing difficulties are associated with age, and therefore, a growing public health concern as Canada's population ages. For women, hearing difficulties were found to be associated with social isolation.
Euros vs. yuan: comparing European and Chinese fishing access in West Africa.
Directory of Open Access Journals (Sweden)
Dyhia Belhabib
Full Text Available We compare the performance of European Union (EU and Chinese fisheries access agreements with West African countries in terms of illegal and unreported fishing, economic equity, and patterns of exploitation. Bottom-up re-estimations of catch reveal that the EU (1.6 million t•year(-1 and China (2.3 million t•year(-1 report only 29% and 8%, respectively, of their estimated total catches (including estimated discards whenever possible from West African countries between 2000 and 2010. EU catches are declining, while Chinese catches are increasing and are yet to reach the historic maximum level of EU catches (3 million t•year(-1 on average in the 1970s-1980s. The monetary value of EU fishing agreements, correlated in theory with reported catches, is straightforward to access, in contrast to Chinese agreements. However, once quantified, the value of Chinese agreements is readily traceable within the African economy through the different projects they directly cover, in contrast to the funds disbursed [to host governments] by the EU. Overall, China provides resources equivalent to about 4% of the ex-vessel value [value at landing] of the catch taken by Chinese distant-water fleets from West African waters, while the EU pays 8%. We address the difficulties of separating fees directly related to fishing from other economic or political motivations for Chinese fees, which could introduce a bias to the present findings as this operation is not performed for EU access fees officially related to fishing. Our study reveals that the EU and China perform similarly in terms of illegal fishing, patterns of exploitation and sustainability of resource use, while under-reporting by the EU increases and that by China decreases. The EU agreements provide, in theory, room for improving scientific research, monitoring and surveillance, suggesting a better performance than for Chinese agreements, but the end-use of the EU funds are more difficult, and sometime
Difficulty Swallowing After Stroke (Dysphagia)
... Stroke Heroes Among Us Difficulty Swallowing After Stroke (Dysphagia) Updated:Nov 15,2016 Excerpted and adapted from "Swallowing Disorders After a Stroke," Stroke Connection Magazine July/August ...
Mander, David J.; Lester, Leanne
2017-01-01
This study examined indicators of mental health, as well as strengths and difficulties, as reported by same-age boarding and non-boarding students spanning four time points over a 2-year period as they transitioned from primary to boarding school in Western Australia (i.e., at the end of Grade 7, beginning of Grade 8, end of Grade 8, and end of…
Breathing difficulty - lying down
... other conditions that lead to it) Panic disorder Sleep apnea Snoring Home Care Your health care provider may recommend self-care measures. For example, weight loss may be suggested if you are obese. When to Contact a Medical Professional If you have any unexplained difficulty in breathing ...
Accessibility of hypertensive users to health units and treatment adherence
Directory of Open Access Journals (Sweden)
Natasha Marques Frota
2013-09-01
Full Text Available We aimed to analyze the accessibility of hypertensive users to the health system with focus on treatment adherence. A cross-sectional study with quantitative approach was conducted in four Family Health Basic Units of Fortaleza-CE, Brazil. The sample consisted of 400 users. Data collection happened through a form applied from May to August 2011. About 97.5% of users were older than 40 years, and 67.2% were female. The accessibility to the referral service occurred in 47.2% of users to secondary care, of which 101 (25.2% were referred to Emergency Units, and 88 (22.0% were admitted to Inpatient Units. Most hypertensive patients adhered to healthy habits, except the use of dietetic sweeteners (36.0% and physical exercise (35.0%. The hypertensive patients had good treatment adherence and difficulty in accessibility regarding counter-referral services to secondary and tertiary care services.
Subjective difficulties in young people related to extensive loud music listening
Directory of Open Access Journals (Sweden)
Budimčić Milenko
2010-01-01
Full Text Available Introduction. For human ear, noise represents every undesirable and valueless sound. In disco clubs, as in some other places with loud music mostly attended by young people, the level of noise sometimes attains over 100 dB. As reported by numerous studies, a high noise level could induce subjective difficulties (ear buzzing, audition loss, vertigo and palpitations, anxiety, high blood pressure, decreased concentration, lowered memory storing. Objective. Assessment of subjective difficulties occurring in young people when staying in places with a high noise level (cafes, disco clubs, rock concerts, which can produce health problems, due to loud music, in association with demographic data, addictions and personal life style data. One of the goals is to find factors leading to subjective difficulties, which would be objectively studied in the second stage of the research and marked as early predictors of possible health problems. Methods. The study was conducted among 780 students of the Higher Healthcare School of Professional Studied in Belgrade. We used a questionnaire with 20 questions, divided into four categories: demographic data, case-history data, subjective problems and addictions of the subjects. In the statistical data processing we used the methods of descriptive and exploratory analysis, chi-square tests, correlation tests and Mantel-Haenszel odds ratio. Results. After listening loud music, 54.0% of examined subjects felt ear buzzing, and 4.6% had hearing damage. The habit of visiting places with loud music, mostly once a week in duration of 2-3 hours per visit had 80.4% of subjects. The presence of subjective complaints after listening of loud music was in association with loud music listening and disco clubs visits. The major reasons of the present subjective difficulties could be predicated by listening of loud music and club visits (r=0.918 and r=0.857. A relative risk for subjective difficulties presentation was 1.599. Conclusion
[Subjective difficulties in young people related to extensive loud music listening].
Budimcić, Milenko; Ignatović, Snezana; Zivić, Ljubica
2010-01-01
For human ear, noise represents every undesirable and valueless sound. In disco clubs, as in some other places with loud music mostly attended by young people, the level of noise sometimes attains over 100 dB. As reported by numerous studies, a high noise level could induce subjective difficulties (ear buzzing, audition loss, vertigo and palpitations, anxiety, high blood pressure, decreased concentration, lowered memory storing). Assessment of subjective difficulties occurring in young people when staying in places with a high noise level (cafes, disco clubs, rock concerts), which can produce health problems, due to loud music, in association with demographic data, addictions and personal life style data. One of the goals is to find factors leading to subjective difficulties, which would be objectively studied in the second stage of the research and marked as early predictors of possible health problems. The study was conducted among 780 students of the Higher Healthcare School of Professional Studied in Belgrade. We used a questionnaire with 20 questions, divided into four categories: demographic data, case-history data, subjective problems and addictions of the subjects. In the statistical data processing we used the methods of descriptive and exploratory analysis, chi-square tests, correlation tests and Mantel-Haenszel odds ratio. After listening loud music, 54.0% of examined subjects felt ear buzzing, and 4.6% had hearing damage. The habit of visiting places with loud music, mostly once a week in duration of 2-3 hours per visit had 80.4% of subjects. The presence of subjective complaints after listening of loud music was in association with loud music listening and disco clubs visits.The major reasons of the present subjective difficulties could be predicated by listening of loud music and club visits (r = 0.918 and r = 0.857). A relative risk for subjective difficulties presentation was 1.599. According to the results of our study, over half of children
Unexpected online gambling disorder in late-life:A case report
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Anne eSauvaget
2015-05-01
Full Text Available Background.The lifetime prevalence of problem or Gambling disorder (GD in the elderly (i.e., those over 60 years old is reported to range from 0.01% to 10.9%. Research has identified several specific risk factors and vulnerabilities in the elderly. Since the late 1990s, an increase in online GD has been observed in the youth population, whereas casinos, slot machines, and bingo seem to be the activities of choice among the elderly. Interestingly, online GD has not been described in the elderly to date.Case Description.We report an 83-year-old man who started online casino gambling from the age of 80 years, leading to debts that exceeded €30,000. He underwent a full clinical and neuropsychological assessment, without any evidence of cognitive impairment or any associated neurodegenerative disease. However, he had risk factors for GD, including adjustment disorder, stressful life events, previous offline casino GD when 50 years old, and dysfunctional personality traits. The change to online GD may have been due to his isolation, movement difficulties, and his high level of education, which facilitated his access to the Internet. Care management focused on individual cognitive-behavioral therapy.Conclusion.The prevalence of online GD may be underestimated among the elderly, and may increase among isolated old people with movement difficulties and ready access to the Internet. However, late-life GD should be considered a diagnosis of elimination, requiring a full medical, psychiatric (including suicide risk, and cognitive assessment. Specific therapeutic approaches need to be proposed and developed.
International Nuclear Information System (INIS)
Şahin, Esin; Yağbasan, Rahmi
2012-01-01
This study aims at diagnosing which subjects pre-service physics teachers have difficulty understanding in introductory physics courses and what accounts for these difficulties. A questionnaire consisting of two qualitative questions was used to collect data for this study. The questionnaire was administered to 101 pre-service physics teachers who have completed the courses Physics 1 (Mechanics 1), Physics 2 (Mechanics 2), Physics 3 (Electricity) and Physics 4 (Magnetism). Of the pre-service physics teachers 28 were second year, 26 were third year, 27 were fourth year and 20 were fifth year students. The results of the data analysis indicated that the percentage of students who think that Magnetism has the most difficult subjects is the highest compared to the others. The reasons why the pre-service physics teachers experience difficulty in understanding the subjects have been grouped into four categories. (paper)
NEW CONTRIBUTIONS TO READING DIFFICULTIES INTERVENTION
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VÍCTOR SANTIUSTE BERMEJO
2005-01-01
Full Text Available This article presents a synthesis of the intervention programs and strategies to treat reading difficulties. The synthesisincludes a review of the last published articles on the issue, both in Spanish and English. It also presents the visits todifferent Language Rehabilitation Centers in the Community of Madrid including the approaches applied in thesecenters. Besides the description of the general intervention strategies applied to reading problems, some of theprograms to treat specific difficulties of words decoding and recognizing are explained, and the programs to treatreading comprehension and fluidity.
Vigen, Jens
2007-01-01
The High Energy Physics community over the last 15 years has achieved so-called full green Open Access through the wide dissemination of preprints via arXiv, a central subject repository managed by Cornell University. However, green Open Access does not alleviate the economic difficulties of libraries as they are still expected to offer access to versions of record of the peer-reviewed literature. For this reason the particle physics community is now addressing the issue of gold Open Access by converting a set of the existing core journals to Open Access. A Working Party has been established to bring together funding agencies, laboratories and libraries into a single consortium, called SCOAP3 (Sponsoring Consortium for Open Access Publishing in Particle Physics). This consortium will engage with publishers to build a sustainable model for Open Access publishing. In this model, subscription fees from multiple institutions are replaced by contracts with publishers of Open Access journals, where the SCOAP3 conso...
Communication difficulties in teenagers with health impairments
Directory of Open Access Journals (Sweden)
Samokhvalova, Anna G.
2016-09-01
Full Text Available Contemporary psychological and pedagogical studies pay special attention to the socialization of physically impaired children, inclusive education and methods of providing such children with a safe environment to assist in their development. However, difficulties in interpersonal communication experienced by children with health impairments have remained beyond the research scope. The authors conducted a comparative analysis of communication difficulties in typically developed teenagers aged 12-13 years (n = 100 and the problems faced by their peers with visual (n = 30, auditory (n = 30, speech (n = 25 and motor (n = 15 impairments. Actual communication difficulties in teenagers were studied in two ways: the subjective component of impaired communication was registered through a content analysis of a sentence completion test and the objective manifestations of impaired communication were identified through expert evaluation of children’s communicative behavior (educators and psychologists who had been in close contact with the teenagers acted as experts. First, the authors identified typical standard communication problems that were characteristic of teenagers aged 12-13 years, that is, problems with aggression, tolerance, the ability to admit wrongdoing and make concessions, empathy, self-control, self-analysis and self-expression in communication. Second, typical communication difficulties characteristic of physically impaired children were revealed: failure to understand meaning; feelings of awkwardness and shame of oneself; expectations of a negative attitude toward oneself; gelotophobia; and manifestations of despotism, petulance and egotism as defensive reactions in situations of impaired communication. Third, the authors described specific communication difficulties in teenagers with auditory, visual, speech and motor impairments.
[Public health infrastructure investment difficulties in Chile: concessions and public tenders].
Goyenechea, Matías
2016-05-12
This paper seeks to highlight the problems of gaps in health infrastructure in Chile, and to analyze the mechanisms by which it is provided. In Chile this is done in two ways: the first is through competitive bidding or sector-wide modality. The second way is through hospital concessions. Both mechanisms have had difficulties in recent years, which are reported. Finally, we propose ways to improve the provision of health infrastructure in Chile.
Wijaya, Ariyadi
2017-01-01
This paper reports an exploration into Indonesian fourth graders' difficulties in fractions and their relation to the opportunity to learn fractions students got at schools. The concept of "opportunity to learn" is often considered as a framework to investigate possible reasons for students' difficulties. The data for this study was…
A PRELIMINARY STUDY FOR DEVELOPING ACCESSIBLE MOOC SERVICES
Directory of Open Access Journals (Sweden)
Francisco Iniesto
2016-11-01
Full Text Available The flexibility of the MOOC service allows students to learn at their own time, place and pace, enhancing continuous communication and interaction between all participants in knowledge and community building. This model especially benefits people with disabilities, which can improve therefore their level of employability and social inclusion, reaching a better quality of life. Unfortunately the access to MOOC platforms present severe barriers: there is a lack of accessibility on the learning resources, the communicating tools and personalized user interfaces. All these issues add extra difficulties such as the need to develop specific digital or even social skills for students with functional diversity. In this context, MOOCs are leading a revolutionary computer and mobile-based scenario along with social technologies that will emerge new kinds of learning applications that enhance communication and collaboration processes. For that reason, this paper describes the need for designing an information model and related specifications to support a new strategy for delivering accessible MOOC courses to learners with special needs, in terms of their preferences and context of use based on a particular application profile. This user profile’s design is based on standard metadata schemas, data that provides information about other data, regarding the achievement of accessibility from content to user preferences.
Shepherd, Mary D.; Selden, Annie; Selden, John
2009-01-01
This exploratory study examined the experiences and difficulties certain first-year university students displayed in reading new passages from their mathematics textbooks. We interviewed eleven precalculus and calculus students who were considered to be good at mathematics, as indicated by high ACT mathematics scores. These students were also …
Potts, Tiffany M; Nguyen, Jacqueline L; Ghai, Kanika; Li, Kathy; Perlmuter, Lawrence
2015-04-15
To investigate whether perceptions of task difficulty on neuropsychological tests predicted academic achievement after controlling for glucose levels and depression. Participants were type 1 diabetic adolescents, with a mean age = 12.5 years (23 females and 16 males), seen at a northwest suburban Chicago hospital. The sample population was free of co-morbid clinical health conditions. Subjects completed a three-part neuropsychological battery including the Digit Symbol Task, Trail Making Test, and Controlled Oral Word Association test. Following each task, individuals rated task difficulty and then completed a depression inventory. Performance on these three tests is reflective of neuropsychological status in relation to glucose control. Blood glucose levels were measured immediately prior to and after completing the neuropsychological battery using a glucose meter. HbA1c levels were obtained from medical records. Academic performance was based on self-reported grades in Math, Science, and English. Data was analyzed using multiple regression models to evaluate the associations between academic performance, perception of task difficulty, and glucose control. Perceptions of difficulty on a neuropsychological battery significantly predicted academic performance after accounting for glucose control and depression. Perceptions of difficulty on the neuropsychological tests were inversely correlated with academic performance (r = -0.48), while acute (blood glucose) and long-term glucose levels increased along with perceptions of task difficulty (r = 0.47). Additionally, higher depression scores were associated with poorer academic performance (r = -0.43). With the first regression analysis, perception of difficulty on the neuropsychological tasks contributed to 8% of the variance in academic performance after controlling for peripheral blood glucose and depression. In the second regression analysis, perception of difficulty accounted for 11% of the variance after
Smoke-Free Medical Facility Campus Legislation: Support, Resistance, Difficulties and Cost
Directory of Open Access Journals (Sweden)
J. Gary Wheeler
2009-01-01
Full Text Available Although medical facilities restrict smoking inside, many people continue to smoke outside, creating problems with second-hand smoke, litter, fire risks, and negative role modeling. In 2005, Arkansas passed legislation prohibiting smoking on medical facility campuses. Hospital administrators (N=113 were surveyed pre- and post-implementation. Administrators reported more support and less difficulty than anticipated. Actual cost was 10-50% of anticipated cost. Few negative effects and numerous positive effects on employee performance and retention were reported. The results may be of interest to hospital administrators and demonstrate that state legislation can play a positive role in facilitating broad health-related policy change.
[Double localization of pancreatic insulinoma. Diagnostic and therapeutic difficulties].
Ungureanu, C D; David, L; Braşoveanu, V; Herlea, V; Coculescu, M; Popescu, I
2005-01-01
Insulinomas are the most common cause of hypoglycemia resulting from endogenous hyperinsulinism. Because most of insulinomas are less than 2 cm in size and rarely they not may be visible by CT scan or transabdominal ultrasonography. Intraoperative ultrasonography may be a solution. Although as surgical method is preferred enucleation because operative time is shorter and easier and the low frequency postoperative complications, pancreaticoduodenectomy Whipple is indicated in selected cases. We report a case of double insulinoma located in the head of the pancreas in which the diagnosis and surgical treatment presented difficulties which determined a particular clinical evolution.
Lallukka, Tea; Ferrie, Jane E; Rahkonen, Ossi; Shipley, Martin J; Pietiläinen, Olli; Kivimäki, Mika; Marmot, Michael G; Lahelma, Eero
2013-09-01
The main aims of this longitudinal study were to (i) examine associations between changes in economic difficulties and health functioning among middle-aged employees and (ii) assess whether the associations remained after considering conventional domains of socioeconomic position. The associations were tested in two European welfare state occupational cohorts to strengthen the evidence base and improve generalizability. Data came from two cohorts: the Finnish Helsinki Health Study (baseline 2000-2002, follow-up 2007, N = 6328) and the British Whitehall II Study (baseline 1997-1999, follow-up 2003-2004, N = 4350). Responses to the survey item "finding it hard to afford adequate food and clothes and pay bills" repeated at baseline and follow-up were used to examine persistent, increasing, and decreasing economic difficulties. Poor physical and mental health functioning were denoted as being in the lowest quartile of the Short Form 36 physical and mental component summary. Logistic regression analyses were adjusted for sex, age, childhood economic difficulties, household income at baseline and follow-up, employment status at follow-up, and baseline health functioning. We observed strong sex- and age-adjusted associations between increasing [odds ratio (OR) range 1.69-2.96] and persistent (OR range 2.54-3.21) economic difficulties and poorer physical and mental health functioning in both British and Finnish occupational cohorts. These associations remained after full adjustments. Those reporting decreasing difficulties over follow-up also had poorer functioning (OR range 1.30-1.61) compared to those who did not have difficulties at baseline, possibly reflecting residual effects of economic difficulties at baseline. Changes in economic difficulties are associated with poorer physical and mental health functioning independent of income, employment status, and baseline health functioning.
DIFFICULTY OF AMENDMENT AND INTERPRETATIVE CHOICE
Directory of Open Access Journals (Sweden)
Andrew Coan
2016-01-01
Full Text Available The extreme difficulty of amending the U.S. Constitution plays a central but largely unexamined role in theoretical debates over interpretive choice. In particular, conventional wisdom assumes that the extreme difficulty of Article V amendment weakens the case for originalism. This view might ultimately be correct, but it is not the freestanding argument against originalism it is often presumed to be. Rather, it depends on contestable normative and empirical premises that require defense. If those premises are wrong, the stringency of Article V might actually strengthen the case for originalism. Or Article V might have no impact on that case one way or another. This “complexity thesis” highlights and clarifies the role that difficulty of amendment plays across a range of significant interpretive debates, including those surrounding writtenness, John Hart Ely’s representation-reinforcement theory, interpretive pluralism, and originalism as a theory of positive law. It also has important implications for the under-studied relations between statutory and constitutional interpretation and federal and state constitutional interpretation.
Gibbs, Simon; Elliott, Julian
2015-01-01
This paper reports a survey of primary school teachers' beliefs about working with poor readers. The primary research question was "does the way difficulties with reading are labelled affect the teachers' beliefs about their ability to intervene effectively?" An opportunity sample of teachers was surveyed using 2 questionnaires. One…
Creating Access to Opportunities for Youth in Transition from Foster Care. An AYPF Policy Brief
Russ, Erin; Fryar, Garet
2014-01-01
What happens to youth in foster care when they turn 18? Many face unprecedented challenges like homelessness, lack of financial resources, difficulty accessing educational opportunities, and unemployment. In this issue brief, The American Youth Policy Forum (AYPF) document these challenges and opportunities in three distinct yet overlapping areas…
Rights of Women and Access to Land in Sénégal : a Citizenship to ...
International Development Research Centre (IDRC) Digital Library (Canada)
The feminization of poverty in Sénégal seems largely related to women's difficulty in accessing resources, notably land. Patrilinear modes of social organization persist despite the existence of laws protecting the rights of women. Several research works have attempted to explain the persistence of gender-based injustice.
The Prevalence of Reading Difficulties among Children in Scholar Age
Directory of Open Access Journals (Sweden)
Maria Rosita Cecilia
2014-10-01
Full Text Available The study investigates the prevalence of reading difficulties among children in scholar age and analyses the socio-demographic characteristics of learners who presented reading difficulties in central Italy. A sample of 623 students 7-11 aged, was assessed with the Italian MT standardized tests. Information on gender, age, handedness, and other socio-demographic variables were also gathered. The study showed that 11% of learners presented poor comprehension skills. The reading speed difficulties were more common than the reading correctness problems: about 7% of children vs 1% were dyslexics due to slow reading. There were no significant differences regarding gender, age. However, dominant hand and the school location seemed to affect the speed difficulties and the comprehension problems. The analyses showed that attending a school located in a rural area was statistically associated with the reading difficulties. Left-handed children were more likely to be slow decoders and/or poor comprehenders. These findings may be used in the early diagnosis of poor readers. These difficulties often have a chronic progression with substantial psychosocial limitations and psychological stress, so children with reading difficulties should be identified as early as possible.
Language and Text-to-Speech Technologies for Highly Accessible Language & Culture Learning
Directory of Open Access Journals (Sweden)
Anouk Gelan
2011-06-01
Full Text Available This contribution presents the results of the “Speech technology integrated learning modules for Intercultural Dialogue” project. The project objective was to increase the availability and quality of e-learning opportunities for less widely-used and less taught European languages using a user-friendly and highly accessible learning environment. The integration of new Text-to-Speech developments into web-based authoring software for tutorial CALL had a double goal: on the one hand increase the accessibility of e-learning packages, also for learners having difficulty reading (e.g. dyslexic learners or preferring auditory learning; on the other hand exploiting some didactic possibilities of this technology.
Brain injury and severe eating difficulties at admission
DEFF Research Database (Denmark)
Kjærsgaard, Annette; Kaae Kristensen, Hanne
Objective: The objective of this pilot study was to explore and interpret the way that individuals with acquired brain injury, admitted to inpatient neurorehabilitation with severe eating difficulties, experienced eating nine to fifteen months after discharge. Methods: Four individuals with acqui......Objective: The objective of this pilot study was to explore and interpret the way that individuals with acquired brain injury, admitted to inpatient neurorehabilitation with severe eating difficulties, experienced eating nine to fifteen months after discharge. Methods: Four individuals...... with acquired brain injury were interviewed via qualitative semi-structured interviews. An explorative study was conducted to study eating difficulties. Qualitative content analysis was used. Results: Four main themes emerged from the analysis: personal values related to eating, swallowing difficulties, eating......-of-life. The preliminary findings provide knowledge regarding the patient perspective of adapting to and developing new strategies for activities related to eating, however, further prospective, longitudinal research in a larger scale and with repeated interviews is needed....
Status of Muslim Immigrants' Children with Learning Difficulties in Vienna
Mohsin, M. Naeem; Shabbir, Muhammad; Saeed, Wizra; Mohsin, M. Saleem
2013-01-01
The study was conducted to know the status of Muslim immigrants' children with learning difficulties and importance of parents' involvement for the education whose children are with learning difficulties, and the factors responsible for the learning difficulties among immigrants' children. There were 81 immigrant children with learning…
Early Identification of Reading Difficulties
DEFF Research Database (Denmark)
Poulsen, Mads; Nielsen, Anne-Mette Veber; Juul, Holger
2017-01-01
Early screening for reading difficulties before the onset of instruction is desirable because it allows intervention that is targeted at prevention rather than remediation of reading difficulties. However, early screening may be too inaccurate to effectively allocate resources to those who need...... them. The present study compared the accuracy of early screening before the onset of formal reading instruction with late screening six months into the first year of instruction. The study followed 164 Danish students from the end of Grade 0 to the end of Grade 2. Early screening included measures...... of phonemic awareness, rapid naming, letter knowledge, paired associate learning, and reading. Late screening included only reading. Results indicated that reading measures improved substantially as predictors over the first six months of Grade 1, to the point where late reading measures alone provided...
31 CFR 103.61 - Access to records.
2010-07-01
... REPORTING OF CURRENCY AND FOREIGN TRANSACTIONS General Provisions § 103.61 Access to records. Except as... with the recordkeeping and reporting requirements of this part, this part does not authorize the... this part. Other inspection, review or access to such records is governed by other applicable law. [50...
Ali, Usama S.; Walker, Michael E.
2014-01-01
Two methods are currently in use at Educational Testing Service (ETS) for equating observed item difficulty statistics. The first method involves the linear equating of item statistics in an observed sample to reference statistics on the same items. The second method, or the item response curve (IRC) method, involves the summation of conditional…
Grammatical Templates: Improving Text Difficulty Evaluation for Language Learners
Wang, Shuhan; Andersen, Erik
2016-01-01
Language students are most engaged while reading texts at an appropriate difficulty level. However, existing methods of evaluating text difficulty focus mainly on vocabulary and do not prioritize grammatical features, hence they do not work well for language learners with limited knowledge of grammar. In this paper, we introduce grammatical templates, the expert-identified units of grammar that students learn from class, as an important feature of text difficulty evaluation. Experimental clas...
Ulrich Fuller, Laurie
2010-01-01
A friendly, step-by-step guide to the Microsoft Office database application Access may be the least understood and most challenging application in the Microsoft Office suite. This guide is designed to help anyone who lacks experience in creating and managing a database learn to use Access 2010 quickly and easily. In the classic For Dummies tradition, the book provides an education in Access, the interface, and the architecture of a database. It explains the process of building a database, linking information, sharing data, generating reports, and much more.As the Micr
Working Memory in Students with Mathematical Difficulties
Nur, I. R. D.; Herman, T.; Ningsih, S.
2018-04-01
Learning process is the activities that has important role because this process is one of the all factors that establish students success in learning. oftentimes we find so many students get the difficulties when they study mathematics. This condition is not only because of the outside factor but also it comes from the inside. The purpose of this research is to analyze and give the representation how students working memory happened in physical education students for basic statistics subjects which have mathematical difficulties. The subjects are 4 students which have a mathematical difficulties. The research method is case study and when the describe about students working memory are explanated deeply with naturalistic observation. Based on this research, it was founded that 4 students have a working memory deficit in three components. The components are phonological loop, visuospatial sketchpad, dan episodic buffer.
Kane, Steven T.; Walker, John H.; Schmidt, George R.
2011-01-01
This article describes the development and validation of the "Learning Difficulties Assessment" (LDA), a normed and web-based survey that assesses perceived difficulties with reading, writing, spelling, mathematics, listening, concentration, memory, organizational skills, sense of control, and anxiety in college students. The LDA is designed to…
National Oceanic and Atmospheric Administration, Department of Commerce — This accession contains the descriptions for the OSTM/Jason-2 Near Real-Time Altimetry Validation System Quality Reports, which are served through the NOAA/NESDIS...
Directory of Open Access Journals (Sweden)
Aboud Mohammed J
2011-06-01
Full Text Available Abstract Introduction Neuroglial heterotopia, heterotopic brain tissue, or differentiated neural tissue outside the cranial vault is uncommon, and these anomalies most commonly occur in the nasal cavity. Case presentation We report a case of rare pure cystic heterotopic brain tissue in a two-month-old Caucasian baby girl that presented as a large cystic neck mass and was confused with a cystic hygroma. Her mother reported a progressive increase in the size of this swelling and mild respiratory difficulty when the girl was sleeping. A computed tomography scan of the brain and neck showed a large heterogeneous mass extending from the base of the skull to the left submandibular region; a cystic component was also noted. Our patient under went total excision of the cystic mass and prevention of airway obstruction by a left submandibular approach. The final gross pathology diagnosis was heterotopic brain tissue. Conclusions Pure cystic neck heterotopic brain tissue lesions are very uncommon, and a preoperative diagnosis of this lesion is difficult. Brain heterotopia is a rare, benign condition that should be considered in the differential diagnosis of the neonatal head and neck mass.
Secure, web-accessible call rosters for academic radiology departments.
Nguyen, A V; Tellis, W M; Avrin, D E
2000-05-01
Traditionally, radiology department call rosters have been posted via paper and bulletin boards. Frequently, changes to these lists are made by multiple people independently, but often not synchronized, resulting in confusion among the house staff and technical staff as to who is on call and when. In addition, multiple and disparate copies exist in different sections of the department, and changes made would not be propagated to all the schedules. To eliminate such difficulties, a paperless call scheduling application was developed. Our call scheduling program allowed Java-enabled web access to a database by designated personnel from each radiology section who have privileges to make the necessary changes. Once a person made a change, everyone accessing the database would see the modification. This eliminates the chaos resulting from people swapping shifts at the last minute and not having the time to record or broadcast the change. Furthermore, all changes to the database were logged. Users are given a log-in name and password and can only edit their section; however, all personnel have access to all sections' schedules. Our applet was written in Java 2 using the latest technology in database access. We access our Interbase database through the DataExpress and DB Swing (Borland, Scotts Valley, CA) components. The result is secure access to the call rosters via the web. There are many advantages to the web-enabled access, mainly the ability for people to make changes and have the changes recorded and propagated in a single virtual location and available to all who need to know.
Channel access: A software bus for the LAACS
International Nuclear Information System (INIS)
Hill, J.O.
1990-01-01
The host processor for a code running within a distributed process control system is often predetermined by constraints built into the software architecture of the control system. Input/output (I/O) channels directly connected to the host processors are usually easier to access in software than channels on remote processors. It is often difficult to modernize selective parts of a control system's software while leaving the other parts unchanged. Likewise, software developed at one laboratory is often difficult to integrate into a control system developed at another laboratory. Software that runs in one machine or operating-system architecture is often unable to communicate with control-system software running on a different platform. For the Los Alamos Accelerator Control System (LAACS) we have attempted to address the above difficulties with a software communication facility which we call Channel Access. Channel Access provides a 'software bus' that allows programs to be connected through a network to I/O channels on real-time processors in a manner similar to the way in which hardware modules are integrated within a standardized hardware bus such as CAMAC or VME. We have already placed an operator interface on Channel Access and we are currently designing alarm, archiving and sequencing tools as well. Numerous application-specific programs use Channel Access. This paper describes the unique feature of this approach and its performance as an integral part of the Los Alamos Accelerator Control System. (orig.)
Case studies in rural recycling. Public service report series
Energy Technology Data Exchange (ETDEWEB)
Cosper, S.D.; Hallenbeck, W.H.; Brenniman, G.R.
1994-02-01
Due to state planning requirements and federal landfill regulations, solid waste management in rural areas (particularly recycling) has received much attention in recent years. The growth of recycling during the 1980s occurred mainly in urban and suburban areas. Therefore, rural recycling is still a relatively new enterprise. This report presents several rural recycling case studies from Colorado, Illinois, Indiana, Iowa, Minnesota, Tennessee, and Ontario, Canada to provide examples of successes and problems. This report also discusses the current issues of cooperative marketing of recyclables and municipal solid waste flow control. With respect to recycling, a rural region does not have ready access to markets for collected materials and has difficulty in generating easily marketable quantities of recyclables. (Copyright (c) 1994 The Board of Trustees of the University of Illinois.)
Performance monitoring in obsessive-compulsive undergraduates: Effects of task difficulty.
Riesel, Anja; Richter, Anika; Kaufmann, Christian; Kathmann, Norbert; Endrass, Tanja
2015-08-01
Both obsessive-compulsive disorder and subclinical obsessive-compulsive (OC) symptoms seem to be associated with hyperactive error-related brain activity. The current study examined performance monitoring in subjects with subclinical OC symptoms using a new task with different levels of difficulty. Nineteen subjects with high and 18 subjects with low OC characteristics performed a random dot cinematogram (RDC) task with three levels of difficulty. The high and low OC groups did not differ in error-related negativity (ERN), correct-related negativity (CRN) and performance irrespective of task difficulty. The amplitude of the ERN decreased with increasing difficulty whereas the magnitude of CRN did not vary. ERN and CRN approached in size and topography with increasing difficulty, which suggests that errors and correct responses are processed more similarly. These results add to a growing number of studies that fail to replicate hyperactive performance monitoring in individuals with OC symptoms in task with higher difficulty or requiring learning. Together with these findings our results suggest that the relationship between OC symptoms and performance monitoring may be sensitive to type of task and task characteristics and cannot be observed in a RDC that differs from typically used tasks in difficulty and the amount of response-conflict. Copyright © 2015 Elsevier Inc. All rights reserved.
Peters Jean; Grimsley Michael; Dibben Chris; Goyder Elizabeth; Blank Lindsay; Ellis Elizabeth
2006-01-01
Abstract Background There are large variations in mental health prescribing in UK populations. However the underlying reasons for these differences, which may be related to differences in prevalence, cultural expectations or practical difficulties in access to treatment, remain uncertain. Methods Linear modelling was used to investigate whether population characteristics or access to primary care account for variations in mental health prescribing across 39 deprived neighbourhoods. Results Th...
Perceived Difficulties in e-Learning During the First Term at University
Directory of Open Access Journals (Sweden)
Galina Kavaliauskienė
2013-08-01
Full Text Available Purpose—the focus of this article is to explore difficulties that are encountered by students during the first term at university. It is well known that students can have various problems in learning English and make mistakes in grammar, vocabulary, and pronunciation. The native language of a learner affects learning and using English. Speaking and e-listening are the skills that are more common on an everyday basis than reading and writing. Moreover, these skills are more difficult to master. English vocabulary presents another problem for language learners. Albeit, at the university level students study English for Specific Purposes (ESP, in other words, the foreign language for their future profession, and they might face particular difficulties in their studies of ESP. Design/methodology/approach—the research paper adopts the qualitative research approach. The questionnaire on learner perceptions of difficulties in e-learning was administered to students of three different specializations. Students’ self-assessments of achievements or failures were analysed. Findings. The results indicated that perceptions of difficulties to adapting to university studies depended on their chosen specialization. The findings show that undergraduates of all three investigated specializations encounter the same difficulties, but to a different degree. In other words, there are no significantly specific difficulties due to the complexity of the professional vocabulary that students must learn. The ratings of Psychology, Social Work and Public Policy and Management students reveal higher mean values and wider range of Standard Deviations than reported by other researchers (Berman, Cheng, 2001. The results obtained imply that Lithuanian learners are more positive than their foreign counterparts. Computations of Pearson’s correlations coefficients demonstrate that there are some good correlational relationships within each specialization. Research
Open access for freight railroads : worthwhile or wasteful disruption, final report.
2009-01-01
This study compares the experience of the freight railroads in North America, Europe and : Australia with required access. Europe and Australia have pursued very different network access : strategies than the United States and Canada. Both the Europe...
Toward Improved Market Access for ASEAN Agricultural Commodities
International Development Research Centre (IDRC) Digital Library (Canada)
... technical report, November 2009 - May 2013. Études. Towards improved market access for ASEAN agricultural commodities : donor partnerships strategy and plan. Rapports. Towards improved market access for ASEAN agricultural commodities : project inception meeting report, Palm Garden Hotel, Putrajaya, Malaysia, ...
Emotional Intelligence, Personality Traits and Career Decision Difficulties
Di Fabio, Annamaria; Palazzeschi, Letizia
2009-01-01
This study aims to take an in-depth look at the role of emotional intelligence and personality traits in relation to career decision difficulties. The Italian version of the Career Decision Difficulties Questionnaire (CDDQ), the Bar-On Emotional Quotient Inventory: Short (Bar-On EQ-i: S), and the Big Five Questionnaire (BFQ) were administered to…
Anthony, Sarah G.; Keating, Michael S.
2013-01-01
Online learning and new technologies are driving a trend in worldwide education that is not only gaining momentum, it is becoming a juggernaut. While the positives for online learning are clear and are often being touted by Universities and Vocational Education and Training providers as a panacea for educational access, what is not clear is the…
Directory of Open Access Journals (Sweden)
Patel D
2017-12-01
Full Text Available Drasti Patel,1 Christine Koehmstedt,1 Rebecca Jones,1 Nathan T Coffey,1 Xinsheng Cai,2 Steven Garfinkel,2 Dahlia M Shaewitz,2 Ali A Weinstein1 1Center for Study of Chronic Illness and Disability, College of Health and Human Services, George Mason University, Fairfax, VA, 2American Institutes for Research, Washington, DC, USA Purpose: Research examining the utilization of evidence-based practice (EBP specifically among rehabilitation clinicians is limited. The objective of this study was to examine how various rehabilitative clinicians including physical therapists, occupational therapists, rehabilitation counselors, and physiatrists are gaining access to literature and whether they are able to implement the available research into practice.Methods: A total of 21 total clinicians were interviewed via telephone. Using NVivo, a qualitative analysis of the responses was performed.Results: There were similarities found with respect to the information-seeking behaviors and translation of research across the different clinician types. Lack of time was reported to be a barrier for both access to literature and implementation of research across all clinician types. The majority of clinicians who reported having difficulty with utilizing the published literature indicated that the literature was not applicable to their practice, the research was not specific enough to be put into practice, or the research found was too outdated to be relevant. In addition, having a supportive work environment aided in the search and utilization of research through providing resources central to assisting clinicians in gaining access to health information.Conclusion: Our study identified several barriers that affect EBP for rehabilitation clinicians. The findings suggest the need for researchers to ensure that their work is applicable and specific to clinical practice for implementation to occur. Keywords: health information, information behavior, knowledge utilization
Motion perception tasks as potential correlates to driving difficulty in the elderly
Raghuram, A.; Lakshminarayanan, V.
2006-09-01
Changes in the demographics indicates that the population older than 65 is on the rise because of the aging of the ‘baby boom’ generation. This aging trend and driving related accident statistics reveal the need for procedures and tests that would assess the driving ability of older adults and predict whether they would be safe or unsafe drivers. Literature shows that an attention based test called the useful field of view (UFOV) was a significant predictor of accident rates compared to any other visual function tests. The present study evaluates a qualitative trend on using motion perception tasks as a potential visual perceptual correlates in screening elderly drivers who might have difficulty in driving. Data was collected from 15 older subjects with a mean age of 71. Motion perception tasks included—speed discrimination with radial and lamellar motion, time to collision using prediction motion and estimating direction of heading. A motion index score was calculated which was indicative of performance on all of the above-mentioned motion tasks. Scores on visual attention was assessed using UFOV. A driving habit questionnaire was also administered for a self report on the driving difficulties and accident rates. A qualitative trend based on frequency distributions show that thresholds on the motion perception tasks are successful in identifying subjects who reported to have had difficulty in certain aspects of driving and had accidents. Correlation between UFOV and motion index scores was not significant indicating that probably different aspects of visual information processing that are crucial to driving behaviour are being tapped by these two paradigms. UFOV and motion perception tasks together can be a better predictor for identifying at risk or safe drivers than just using either one of them.
Architectures for a quantum random access memory
Giovannetti, Vittorio; Lloyd, Seth; Maccone, Lorenzo
2008-11-01
A random access memory, or RAM, is a device that, when interrogated, returns the content of a memory location in a memory array. A quantum RAM, or qRAM, allows one to access superpositions of memory sites, which may contain either quantum or classical information. RAMs and qRAMs with n -bit addresses can access 2n memory sites. Any design for a RAM or qRAM then requires O(2n) two-bit logic gates. At first sight this requirement might seem to make large scale quantum versions of such devices impractical, due to the difficulty of constructing and operating coherent devices with large numbers of quantum logic gates. Here we analyze two different RAM architectures (the conventional fanout and the “bucket brigade”) and propose some proof-of-principle implementations, which show that, in principle, only O(n) two-qubit physical interactions need take place during each qRAM call. That is, although a qRAM needs O(2n) quantum logic gates, only O(n) need to be activated during a memory call. The resulting decrease in resources could give rise to the construction of large qRAMs that could operate without the need for extensive quantum error correction.
Directory of Open Access Journals (Sweden)
Classi Peter
2012-10-01
Full Text Available Abstract Background The objective of this study was to examine the impact of co-occurring social and emotional difficulties on missed school days and healthcare utilization among children with attention deficit/hyperactivity disorder (ADHD. Methods Data were from the 2007 U.S. National Health Interview Survey (NHIS and were based on parental proxy responses to questions in the Sample Child Core, which includes questions on demographics, health, healthcare treatment, and social and emotional status as measured by questions about depression, anxiety, and phobias, as well as items from the brief version of the Strength and Difficulties Questionnaire (SDQ. Logistic regression was used to assess the association between co-occurring social and emotional difficulties with missed school days and healthcare utilization, adjusting for demographics. Results Of the 5896 children aged 6–17 years in the 2007 NHIS, 432 (7.3% had ADHD, based on parental report. Children with ADHD and comorbid depression, anxiety, or phobias had significantly greater odds of experiencing > 2 weeks of missed school days, ≥ 6 visits to a healthcare provider (HCP, and ≥ 2 visits to the ER, compared with ADHD children without those comorbidities (OR range: 2.1 to 10.4. Significantly greater odds of missed school days, HCP visits, and ER visits were also experienced by children with ADHD who were worried, unhappy/depressed, or having emotional difficulties as assessed by the SDQ, compared with ADHD children without those difficulties (OR range: 2.2 to 4.4. Conclusions In children with ADHD, the presence of social and emotional problems resulted in greater odds of missed school days and healthcare utilization. These findings should be viewed in light of the limited nature of the parent-report measures used to assess social and emotional problems.
Respiratory difficulties and breathing disorders in achondroplasia.
Afsharpaiman, S; Saburi, A; Waters, Karen A
2013-12-01
Respiratory difficulties and breathing disorders in achondroplasia are thought to underlie the increased risk for sudden infant death and neuropsychological deficits seen in this condition. This review evaluates literature regarding respiratory dysfunctions and their sequelae in patients with achondroplasia. The limited number of prospective studies of respiratory disease in achondroplasia means that observational studies and case series provide a large proportion of the data regarding the spectrum of respiratory diseases in achondroplasia and their treatments. Amongst clinical respiratory problems described, snoring is the commonest observed abnormality, but the reported incidence of obstructive sleep apnoea (OSA) shows wide variance (10% to 75%). Reported treatments of OSA include adenotonsillectomy, the use of CPAP, and surgical improvement of the airway, including mid-face advancement. Otolaryngologic manifestations are also common. Respiratory failure due to small thoracic volumes is reported, but uncommon. Mortality rate at all ages was 2.27 (CI: 1.7-3.0) with age-specific mortality increased at all ages. Sudden death was most common in infants and children. Cardiovascular events are the main cause of mortality in adults. Despite earlier recognition and treatment of respiratory complications of achondroplasia, increased mortality rates and other complications remain high. Future and ongoing evaluation of the prevalence and impact of respiratory disorders, particularly OSA, in achondroplasia is recommended. Crown Copyright © 2013. Published by Elsevier Ltd. All rights reserved.
Mikuls, TR; Curtis, [No Value; Allison, JJ; Hicks, RW; Saag, KG
Objectives. To more closely assess medication errors in gout care, we examined data from a national, Internet-accessible error reporting program over a 5-year reporting period. Methods. We examined data from the MEDMARX (TM) database, covering the period from January 1, 1999 through December 31,
Directory of Open Access Journals (Sweden)
Jens Vigen
2008-01-01
Full Text Available The High Energy Physics community over the last 15 years has achieved so-called full green Open Access through the wide dissemination of preprints via arXiv, a central subject repository managed by Cornell University. However, green Open Access does not alleviate the economic difficulties of libraries as they are still expected to offer access to versions of record of the peer-reviewed literature. For this reason the particle physics community is now addressing the issue of gold Open Access by converting a set of the existing core journals to Open Access. A Working Party has been established to bring together funding agencies, laboratories and libraries into a single consortium, called SCOAP3 (Sponsoring Consortium for Open Access Publishing in Particle Physics. This consortium will engage with publishers to build a sustainable model for Open Access publishing. In this model, subscription fees from multiple institutions are replaced by contracts with publishers of Open Access journals, where the SCOAP3 consortium is a single financial partner.
Accessibility of antiretroviral therapy in Ghana: convenience of access.
Addo-Atuah, Joyce; Gourley, Dick; Gourley, Greta; White-Means, Shelley I; Womeodu, Robin J; Faris, Richard J; Addo, Nii Akwei
2012-01-01
The convenience of accessing antiretroviral therapy (ART) is important for initial access to care and subsequent adherence to ART. We conducted a qualitative study of people living with HIV/AIDS (PLWHA) and ART healthcare providers in Ghana in 2005. The objective of this study was to explore the participants' perceived convenience of accessing ART by PLWHA in Ghana. The convenience of accessing ART was evaluated from the reported travel and waiting times to receive care, the availability, or otherwise, of special considerations, with respect to the waiting time to receive care, for those PLWHA who were in active employment in the formal sector, the frequency of clinic visits before and after initiating ART, and whether the PLWHA saw the same or different providers at each clinic visit (continuity of care). This qualitative study used in-depth interviews based on Yin's case-study research design to collect data from 20 PLWHA and 24 ART healthcare providers as study participants. • Reported travel time to receive ART services ranged from 2 to 12 h for 30% of the PLWHA. • Waiting time to receive care was from 4 to 9 h. • While known government workers, such as teachers, were attended to earlier in some of the centres, this was not a consistent practice in all the four ART centres studied. • The PLWHA corroborated the providers' description of the procedure for initiating and monitoring ART in Ghana. • PLWHA did not see the same provider every time, but they were assured that this did not compromise the continuity of their care. Our study suggests that convenience of accessing ART is important to both PLWHA and ART healthcare providers, but the participants alluded to other factors, including open provider-patient communication, which might explain the PLWHA's understanding of the constraints under which they were receiving care. The current nation-wide coverage of the ART programme in Ghana, however, calls for the replication of this study to identify
Visual difficulty and employment status in the world.
Directory of Open Access Journals (Sweden)
Hanen Harrabi
Full Text Available PURPOSE: Using a world-wide, population-based dataset, we sought to examine the relationship between visual difficulty and employment status. METHODS: The World Health Survey was conducted in 70 countries throughout the world in 2003 using a random, multi-stage, stratified, cluster sampling design. Far vision was assessed by asking about the level of difficulty in seeing and recognizing a person you know across the road (i.e. from a distance of about 20 meters. Responses included none, mild, moderate, severe, or extreme/unable. Participants were asked about their current job, and if they were not working, the reason why (unable to find job, ill health, homemaker, studies, unpaid work, other. The occupation in the last 12 months was obtained. Multinomial regression was used accounting for the complex survey design. RESULTS: Of those who wanted to work, 79% of those with severe visual difficulty and 64% of those with extreme visual difficulty were actually working. People who had moderate, severe, or extreme visual difficulty had a higher odds of not working due to an inability to find a job and of not working due to ill health after adjusting for demographic and health factors (P<0.05. CONCLUSIONS: As the major causes of visual impairment in the world are uncorrected refractive error and cataract, countries are losing a great deal of labor productivity by failing to provide for the vision health needs of their citizens and failing to help them integrate into the workforce.
Visual difficulty and employment status in the world.
Harrabi, Hanen; Aubin, Marie-Josee; Zunzunegui, Maria Victoria; Haddad, Slim; Freeman, Ellen E
2014-01-01
Using a world-wide, population-based dataset, we sought to examine the relationship between visual difficulty and employment status. The World Health Survey was conducted in 70 countries throughout the world in 2003 using a random, multi-stage, stratified, cluster sampling design. Far vision was assessed by asking about the level of difficulty in seeing and recognizing a person you know across the road (i.e. from a distance of about 20 meters). Responses included none, mild, moderate, severe, or extreme/unable. Participants were asked about their current job, and if they were not working, the reason why (unable to find job, ill health, homemaker, studies, unpaid work, other). The occupation in the last 12 months was obtained. Multinomial regression was used accounting for the complex survey design. Of those who wanted to work, 79% of those with severe visual difficulty and 64% of those with extreme visual difficulty were actually working. People who had moderate, severe, or extreme visual difficulty had a higher odds of not working due to an inability to find a job and of not working due to ill health after adjusting for demographic and health factors (P<0.05). As the major causes of visual impairment in the world are uncorrected refractive error and cataract, countries are losing a great deal of labor productivity by failing to provide for the vision health needs of their citizens and failing to help them integrate into the workforce.
Access to safe legal abortion in Malaysia: women's insights and health sector response.
Low, Wah-Yun; Tong, Wen-Ting; Wong, Yut-Lin; Jegasothy, Ravindran; Choong, Sim-Poey
2015-01-01
Malaysia has an abortion law, which permits termination of pregnancy to save a woman's life and to preserve her physical and mental health (Penal Code Section 312, amended in 1989). However, lack of clear interpretation and understanding of the law results in women facing difficulties in accessing abortion information and services. Some health care providers were unaware of the legalities of abortion in Malaysia and influenced by their personal beliefs with regard to provision of abortion services. Accessibility to safer abortion techniques is also an issue. The development of the 2012 Guidelines on Termination of Pregnancy and Guidelines for Management of Sexual and Reproductive Health among Adolescents in Health Clinics by the Ministry of Health, Malaysia, is a step forward toward increasing women's accessibility to safe abortion services in Malaysia. This article provides an account of women's accessibility to abortion in Malaysia and the health sector response in addressing the barriers. © 2014 APJPH.
Review of student difficulties in upper-level quantum mechanics
Directory of Open Access Journals (Sweden)
Chandralekha Singh
2015-09-01
Full Text Available [This paper is part of the Focused Collection on Upper Division Physics Courses.] Learning advanced physics, in general, is challenging not only due to the increased mathematical sophistication but also because one must continue to build on all of the prior knowledge acquired at the introductory and intermediate levels. In addition, learning quantum mechanics can be especially challenging because the paradigms of classical mechanics and quantum mechanics are very different. Here, we review research on student reasoning difficulties in learning upper-level quantum mechanics and research on students’ problem-solving and metacognitive skills in these courses. Some of these studies were multiuniversity investigations. The investigations suggest that there is large diversity in student performance in upper-level quantum mechanics regardless of the university, textbook, or instructor, and many students in these courses have not acquired a functional understanding of the fundamental concepts. The nature of reasoning difficulties in learning quantum mechanics is analogous to reasoning difficulties found via research in introductory physics courses. The reasoning difficulties were often due to overgeneralizations of concepts learned in one context to another context where they are not directly applicable. Reasoning difficulties in distinguishing between closely related concepts and in making sense of the formalism of quantum mechanics were common. We conclude with a brief summary of the research-based approaches that take advantage of research on student difficulties in order to improve teaching and learning of quantum mechanics.
Dutcher, Christina D; Vujanovic, Anka A; Paulus, Daniel J; Bartlett, Brooke A
2017-09-01
Emotion regulation difficulties are a potentially key mechanism underlying the association between childhood maltreatment and alcohol use in adulthood. The current study examined the mediating role of emotion regulation difficulties in the association between childhood maltreatment severity (i.e., Childhood Trauma Questionnaire total score) and past-month alcohol use severity, including alcohol consumption frequency and alcohol-related problems (i.e., number of days of alcohol problems, ratings of "bother" caused by alcohol problems, ratings of treatment importance for alcohol problems). Participants included 111 acute-care psychiatric inpatients (45.0% female; Mage=33.5, SD=10.6), who reported at least one DSM-5 posttraumatic stress disorder Criterion A traumatic event, indexed via the Life Events Checklist for DSM-5. Participants completed questionnaires regarding childhood maltreatment, emotion regulation difficulties, and alcohol use. A significant indirect effect of childhood maltreatment severity via emotion regulation difficulties in relation to alcohol use severity (β=0.07, SE=0.04, 99% CI [0.01, 0.21]) was documented. Specifically, significant indirect effects were found for childhood maltreatment severity via emotion regulation difficulties in relation to alcohol problems (β's between 0.05 and 0.12; all 99% bootstrapped CIs with 10,000 resamples did not include 0) but not alcohol consumption. Emotion regulation difficulties may play a significant role in the association between childhood maltreatment severity and alcohol outcomes. Clinical implications are discussed. Copyright © 2017 Elsevier Inc. All rights reserved.
Magluta, Cynthia; Gomes, Maria A de Sousa Mendes; Wuillaume, Susana M
2011-08-01
Clinical guidelines are tools that systematize scientific evidence and help to achieve proper care. Several difficulties are reported regarding the effective use, such as the shortcomings in the level of knowledge and attitudes by the professionals, the service structure and the preferences appointed by patients. An analysis of these difficulties was the objective of this study in the context of government Neonatal Intensive Care Units (NICU) in Brazil. A semi-structured survey was carried out with 53 managers (medical and nursing) of the 15 NICU in a convenient sample of two groups of government units in Brazil. The managers chose their answers from a list of difficulties to implement the guidelines based on the analytical model of Cabana and graded the difficulties found on a 5-point scale with no reference to quality. Respondents have reported several difficulties with the following priority: lack of professionals to provide care, being perceived as more critical within the nursing and physiotherapy crews, minor participation of professionals in the discussion process and inadequate infrastructure. The lack of acquaintance with the guidelines by the professionals has been reported by few of the surveyed. These findings show some common ground to literature pointing the importance of adequate infrastructure. Managers showed a low valuation of both the level of knowledge and the professionals' adhesion to the guidelines. © 2011 Blackwell Publishing Ltd.
Conlon, Elizabeth G; Rahaley, Nicole; Davis, Jessica
2017-05-01
Our study aimed to determine how age- and disease-related difficulties were associated with attitudes and beliefs about driving self-regulation in men and women in the baby boomer and older generations. Three hundred and ninety-nine men (n=204) and women (n=195) aged between 48 and 91 years participated in a cross-sectional study of Australian drivers. Demographic characteristics and measures of driving confidence, driving difficulty and driving self-regulation; perceptions of visual, physical and cognitive capacity; and attitudes and beliefs about driving were obtained. Driving self-regulation in men and women was explained by different mechanisms. For men, self-report of visual and cognitive difficulties and poor driving confidence predicted driving self-regulation. For women, negative attitudes toward driving mediated the associations found between health-related difficulties and driving self-regulation. Barriers to driving self-regulation were not associated with the driving self-regulatory practices of men or women. Regardless of generation, women reported poorer driving confidence, greater driving difficulty and more driving self-regulation than men. We concluded that age- and disease-related difficulties are related to increasing driving self-regulation in mature men and women. These results indicate that different pathways are needed in models of driving self-regulation for men and women regardless of generational cohort. Copyright © 2017 Elsevier Ltd. All rights reserved.
Directory of Open Access Journals (Sweden)
Dianne Goeman
2016-01-01
Full Text Available Background. Health literacy is the ability to access, understand, and use information and services for good health. Among people with chronic conditions, health literacy requirements for effective self-management are high. The Optimising Health Literacy and Access (Ophelia study engaged diverse organisations in the codesign of interventions involving the Health Literacy Questionnaire (HLQ needs assessment, followed by development and evaluation of interventions addressing identified needs. This study reports the process and outcomes of one of the nine organisations, the Royal District Nursing Service (RDNS. Methods. Participants were home nursing clients with diabetes. The intervention included tailored diabetes self-management education according to preferred learning style, a standardised diabetes education tool, resources, and teach-back method. Results. Needs analysis of 113 quota-sampled clients showed difficulties managing health and finding and appraising health information. The service-wide diabetes education intervention was applied to 24 clients. The intervention was well received by clients and nurses. Positive impacts on clients’ diabetes knowledge and behaviour were seen and nurses reported clear benefits to their practice. Conclusion. A structured method that supports healthcare services to codesign interventions that respond to the health literacy needs of their clients can lead to evidence-informed, sustainable practice changes that support clients to better understand effective diabetes self-management.
Prottengeier, Johannes; Albermann, Matthias; Heinrich, Sebastian; Birkholz, Torsten; Gall, Christine; Schmidt, Joachim
2016-12-01
Intravenous access in prehospital emergency care allows for early administration of medication and extended measures such as anaesthesia. Cannulation may, however, be difficult, and failure and resulting delay in treatment and transport may have negative effects on the patient. Therefore, our study aims to perform a concise assessment of the difficulties of prehospital venous cannulation. We analysed 23 candidate predictor variables on peripheral venous cannulations in terms of cannulation failure and exceedance of a 2 min time threshold. Multivariate logistic regression models were fitted for variables of predictive value (P0.6) of their respective receiver operating characteristic curve. A total of 762 intravenous cannulations were enroled. In all, 22% of punctures failed on the first attempt and 13% of punctures exceeded 2 min. Model selection yielded a three-factor model (vein visibility without tourniquet, vein palpability with tourniquet and insufficient ambient lighting) of fair accuracy for the prediction of puncture failure (AUC=0.76) and a structurally congruent model of four factors (failure model factors plus vein visibility with tourniquet) for the exceedance of the 2 min threshold (AUC=0.80). Our study offers a simple assessment to identify cases of difficult intravenous access in prehospital emergency care. Of the numerous factors subjectively perceived as possibly exerting influences on cannulation, only the universal - not exclusive to emergency care - factors of lighting, vein visibility and palpability proved to be valid predictors of cannulation failure and exceedance of a 2 min threshold.
Directory of Open Access Journals (Sweden)
Salomi Papadima-Sophocleous
2013-12-01
Full Text Available In a university setting, self-access language learning centres (SALLCs are generally created out of the need to support students and other members of the university and extra-mural community to explore and expand their language learning horizons. The nature of SALLCs depends on the needs of each institution and its community. They range from fully self-directed to semi-guided, from virtual online-self-access centres (OSACs to real centres, with traditional print, and more contemporary electronic and digital materials. While much of the research so far has dealt with different aspects of SALLCs, particularly of prominent ones, this article reports on the case of a small-scale SALLC, which was designed and developed, and which has operated, during difficult circumstances. This report describes how despite the administrative and financial constraints faced during the establishment of the host university and language centre, current theories and practices in SALLC were still taken into account. Also, despite these difficulties and the economic constraints being endured by the country as a whole, a number of strategies were implemented enabling the SALLC to be accessible to all students, with a view to promoting both autonomy and lifelong learning. The data used consisted of field notes collected during the period of operation as well as results from an evaluation of the use of different learning pathways on offer. Finally, the challenges still being faced as the SALLC enters a new period in its development are outlined.
DIFABLE PERCEPTION FOR ACCESSIBILITY AND INFORMATION OF PUBLIC TRANSPORT IN JAKARTA
Directory of Open Access Journals (Sweden)
Mochdiana Hernawan
2015-02-01
Full Text Available Every human being has equal right for accessing to the transportation. Difable persons that have different ability also have the same right. The provision of the accessibility and information facility in public transport is not fully meet difable need and therefore difable persons have difficulties in accessibility and information while using public transports. This research will investigate the difable perceptions about accessibility and traveler information for the public transport in Jakarta. Questionnaire method will be used for this purpose and then analyzed by Importance Performance Analysis. The improvement for the transport infrastructure and information system will be elaborated. The findings of the research could be used as input for the local authority while planning or re-construction public transport infrastructure and information system so that difable persons become more accessible and convenience. The study results show that the average value of the perceived performance for the accessibility is 2.78 from 5 scales. This means the performance of the accessibility in overall is fairly. For the information facility, the average performance is 3.11 that meaning the performance in overall is good. The respondents required the provision of waiting room for difable persons as a priority. The information about the departure of the vehicle should been improved as priority to be increased. Furthermore, it is obtained that the Customer Satisfaction Index (CSI value for accessibility is 56%. This indicates the entire respondents satisfied sufficiently with the accessibility facility. Also, 62% of the CSI value shows that the respondents satisfied sufficiently with the provided information.
Medin, Jörgen; Windahl, Jenny; von Arbin, Magnus; Tham, Kerstin; Wredling, Regina
2011-09-01
To examine eating difficulties among stroke patients - a comparison between women and men. Gender differences have been reported in studies of stroke, but the findings are inconclusive and few of these studies have specifically focused on gender differences in eating difficulties. This study was a descriptive, cross-sectional, comparative study. Patients with stroke were recruited at a general hospital in Sweden. To detect eating difficulties, individual observations of the patients were made during one meal using a structured observation protocol. Assessment also included measurements of nutritional and oral status, degree of independence, stroke severity, neglect and well-being. One hundred and four patients (53·8% women) were included in the study. The proportion of stroke patients with one or more eating difficulties was 81·7%. The most common eating difficulties were 'managing food on the plate' (66·3%), 'food consumption' (54·8%) and 'sitting position' (45·2%). Women had lower 'food consumption', more severe stroke (p = 0·003), worse functional status (p = 0·001) and lower quality of life (QoL) (p=0·038) than men. More women than men were malnourished and living alone. After adjustment for functional status and motor arm, the odds ratio of having difficulties with food consumption was four times higher among women than men (1·7-9·4, confidence interval 95%). More women than men with stroke suffered from inadequate food consumption. The women had more severe strokes, experienced poorer QoL and showed lower functional status than the men. In the rehabilitation process of women with stroke, these factors should be taken into consideration. Structured observation of meals, including assessment of food consumption, might be necessary in acute stroke care to detect patients, especially women, who might need closer supervision and nutritional intervention. © 2011 Blackwell Publishing Ltd.
Graphical modeling for item difficulty in medical faculty exams
African Journals Online (AJOL)
. Conclusion: The ... difficulty criteria. Key words: Item difficulty, quality control, statistical process control, variable control charts ..... assumed that 68% of the values fall in the interval ± 1.S; .... The balance of the construction of items of exam has ...
Speech and Communication Changes Reported by People with Parkinson's Disease.
Schalling, Ellika; Johansson, Kerstin; Hartelius, Lena
2017-01-01
Changes in communicative functions are common in Parkinson's disease (PD), but there are only limited data provided by individuals with PD on how these changes are perceived, what their consequences are, and what type of intervention is provided. To present self-reported information about speech and communication, the impact on communicative participation, and the amount and type of speech-language pathology services received by people with PD. Respondents with PD recruited via the Swedish Parkinson's Disease Society filled out a questionnaire accessed via a Web link or provided in a paper version. Of 188 respondents, 92.5% reported at least one symptom related to communication; the most common symptoms were weak voice, word-finding difficulties, imprecise articulation, and getting off topic in conversation. The speech and communication problems resulted in restricted communicative participation for between a quarter and a third of the respondents, and their speech caused embarrassment sometimes or more often to more than half. Forty-five percent of the respondents had received speech-language pathology services. Most respondents reported both speech and language symptoms, and many experienced restricted communicative participation. Access to speech-language pathology services is still inadequate. Services should also address cognitive/linguistic aspects to meet the needs of people with PD. © 2018 S. Karger AG, Basel.
SODA-IIoT4ConnectedCars: Spread updates between cars with limited Internet access
Boudguiga , Aymen; Quesnel , Flavien; Bouzerna , Nabil
2017-01-01
International audience; A blockchain infrastructure, combined with cryptographic signatures, can improve availability and accountability for the deployment of IoT updates.However, cars with limited or intermittent Internet access may have difficulties in downloading full updates fromthe blockchain. Therefore, we allow cars that successfully downloaded updates to share them with other cars by means of a Peer-to-Peer (P2P) mechanism.
Energy Technology Data Exchange (ETDEWEB)
Walters, Terri [National Renewable Energy Lab. (NREL), Golden, CO (United States); Rai, Neha [International Institute for Environment and Development (IIED), London (England); Esterly, Sean [National Renewable Energy Lab. (NREL), Golden, CO (United States); Cox, Sadie [National Renewable Energy Lab. (NREL), Golden, CO (United States); Reber, Tim [National Renewable Energy Lab. (NREL), Golden, CO (United States); Muzammil, Maliha [Univ. of Oxford (United Kingdom); Mahmood, Tasfiq [International Center for Climate Change and Development, Baridhara (Bangladesh); Kaur, Nanki [International Institute for Environment and Development (IIED), London (England); Tesfaye, Lidya [Echnoserve Consulting (Ethiopia); Mamuye, Simret [Echnoserve Consulting (Ethiopia); Knuckles, James [Univ. of London (England). Cass Business School; Morris, Ellen [Columbia Univ., New York, NY (United States); de Been, Merijn [Delft Univ. of Technology (Netherlands); Steinbach, Dave [International Institute for Environment and Development (IIED), London (England); Acharya, Sunil [Digo Bikas Inst. (Nepal); Chhetri, Raju Pandit [National Renewable Energy Lab. (NREL), Golden, CO (United States); Bhushal, Ramesh [National Renewable Energy Lab. (NREL), Golden, CO (United States)
2015-09-01
Government policy is one of the most important factors in engaging the private sector in providing universal access to electricity. In particular, the private sector is well positioned to provide decentralized electricity products and services. While policy uncertainty and regulatory barriers can keep enterprises and investors from engaging in the market, targeted policies can create opportunities to leverage private investment and skills to expand electricity access. However, creating a sustainable market requires policies beyond traditional electricity regulation. The report reviews the range of policy issues that impact the development and expansion of a market for decentralized electricity services from establishing an enabling policy environment to catalyzing finance, building human capacity, and integrating energy access with development programs. The case studies in this report show that robust policy frameworks--addressing a wide range of market issues--can lead to rapid transformation in energy access. The report highlights examples of these policies in action Bangladesh, Ethiopia, Mali, Mexico, and Nepal.
Evidence-based interventions for reading and language difficulties: creating a virtuous circle.
Snowling, Margaret J; Hulme, Charles
2011-03-01
BACKGROUND. Children may experience two very different forms of reading problem: decoding difficulties (dyslexia) and reading comprehension difficulties. Decoding difficulties appear to be caused by problems with phonological (speech sound) processing. Reading comprehension difficulties in contrast appear to be caused by problems with 'higher level' language difficulties including problems with semantics (including deficient knowledge of word meanings) and grammar (knowledge of morphology and syntax). AIMS. We review evidence concerning the nature, causes of, and treatments for children's reading difficulties. We argue that any well-founded educational intervention must be based on a sound theory of the causes of a particular form of learning difficulty, which in turn must be based on an understanding of how a given skill is learned by typically developing children. Such theoretically motivated interventions should in turn be evaluated in randomized controlled trials (RCTs) to establish whether they are effective, and for whom. RESULTS. There is now considerable evidence showing that phonologically based interventions are effective in ameliorating children's word level decoding difficulties, and a smaller evidence base showing that reading and oral language (OL) comprehension difficulties can be ameliorated by suitable interventions to boost vocabulary and broader OL skills. CONCLUSIONS. The process of developing theories about the origins of children's educational difficulties and evaluating theoretically motivated treatments in RCTs, produces a 'virtuous circle' whereby theory informs practice, and the evaluation of effective interventions in turn feeds back to inform and refine theories about the nature and causes of children's reading and language difficulties. ©2010 The British Psychological Society.
Costa, Hugo Câmara; Perdry, Hervé; Soria, Carmen; Pulgar, Salomé; Cusin, Françoise; Dellatolas, Georges
2013-03-01
This study examined the relation between emergent literacy skills, teachers' reports of behavioral problems, and word reading achievement in a community sample of French students. Family background was investigated and included familial antecedents of reading difficulties (Fa/Rd) and parents' educational level. The analyses explored the pattern of concurrent relations between behavioral, familial and emergent literacy measures in a sample of 812 preschoolers, and their predictive power in explaining word reading achievement in a sub-sample of 150 children followed from kindergarten to fifth grade. Word reading at fifth grade was predicted by kindergarten measures of phonological awareness and letter knowledge. Teachers' reports of inattention symptoms at each grade level were associated with early reading skills and with subsequent word reading. Fa/Rd were concurrently and longitudinally associated with emergent literacy skills, teachers' reported inattention and word reading. These results indicate that children with a family history of reading difficulties are at increased risk for the co-occurrence of reading difficulties and attention problems from kindergarten onward. These findings confirm the shared influence of Fa/Rd on the comorbidity between inattention symptoms and reading difficulties in a non-diagnosed community sample of preschool children followed through late elementary school. Copyright © 2012 Elsevier Ltd. All rights reserved.
Emotional and Personality-Related Aspects of Persistent Career Decision-Making Difficulties
Saka, Noa; Gati, Itamar
2007-01-01
This study focused on examining the persistent aspects of career decision-making difficulties, using the Emotional and Personality-related Career decision-making Difficulties scale ("EPCD"; [Saka, N., Gati, I., & Kelly, K.R. (in press). Emotional and personality-related aspects of career decision-making difficulties. "Journal of Career…
Tulsky, David S; Kisala, Pamela A; Tate, Denise G; Spungen, Ann M; Kirshblum, Steven C
2015-05-01
To describe the development and psychometric properties of the Spinal Cord Injury--Quality of Life (SCI-QOL) Bladder Management Difficulties and Bowel Management Difficulties item banks and Bladder Complications scale. Using a mixed-methods design, a pool of items assessing bladder and bowel-related concerns were developed using focus groups with individuals with spinal cord injury (SCI) and SCI clinicians, cognitive interviews, and item response theory (IRT) analytic approaches, including tests of model fit and differential item functioning. Thirty-eight bladder items and 52 bowel items were tested at the University of Michigan, Kessler Foundation Research Center, the Rehabilitation Institute of Chicago, the University of Washington, Craig Hospital, and the James J. Peters VA Medical Center, Bronx, NY. Seven hundred fifty-seven adults with traumatic SCI. The final item banks demonstrated unidimensionality (Bladder Management Difficulties CFI=0.965; RMSEA=0.093; Bowel Management Difficulties CFI=0.955; RMSEA=0.078) and acceptable fit to a graded response IRT model. The final calibrated Bladder Management Difficulties bank includes 15 items, and the final Bowel Management Difficulties item bank consists of 26 items. Additionally, 5 items related to urinary tract infections (UTI) did not fit with the larger Bladder Management Difficulties item bank but performed relatively well independently (CFI=0.992, RMSEA=0.050) and were thus retained as a separate scale. The SCI-QOL Bladder Management Difficulties and Bowel Management Difficulties item banks are psychometrically robust and are available as computer adaptive tests or short forms. The SCI-QOL Bladder Complications scale is a brief, fixed-length outcomes instrument for individuals with a UTI.
Directory of Open Access Journals (Sweden)
Catherine O'Leary
2018-02-01
Full Text Available Irish and international legal reform resulting from the Convention on the Rights of Persons with Disabilities [CRPD] has primarily focussed on Article 12, the right to exercise legal capacity. Article 13, which declares the right to access justice and the right to access procedural accommodations for all with disabilities, is often neglected. Specifically, research has not sufficiently explored the accommodations needed by witnesses with communication difficulties to testify in the courtroom. This study brings this aspect of Article 13 into focus by exploring the views of Irish legal professionals and disability advocates regarding existing and potential further accommodations for witnesses with communication diffiuclties in Irish criminal proceedings. By comparing and contrasting contributions, a series of conflicting perspectives between the legal profession and disability community are revealed. As successful implementation of Article 13 requires collaboration between both groups, this study concludes that these conflicts will need to be acknowledged and addressed in order for reform of courtroom accommodations to succeed.
The Strengths and Difficulties Questionnaire in the Nordic countries.
Obel, Carsten; Heiervang, Einar; Rodriguez, Alina; Heyerdahl, Sonja; Smedje, Hans; Sourander, André; Guethmundsson, Olafur O; Clench-Aas, Jocelyne; Christensen, Else; Heian, Frode; Mathiesen, Kristin S; Magnússon, Páll; Njarethvík, Urethur; Koskelainen, Merja; Rønning, John A; Stormark, Kjell Morten; Olsen, Jørn
2004-01-01
The Strengths and Difficulties Questionnaire (SDQ) has been translated into the different Nordic languages between 1996 and 2003. During the past few years, SDQs have been completed for nearly 100,000 children and adolescents in population-based studies as well as in clinical samples. The largest studies have been performed in Norway and Denmark, and in these countries the diagnostic interview DAWBA has also been used in conjunction with the SDQ. In addition to a brief overview of past and ongoing SDQ work in Sweden, Finland, Norway, Denmark, and Iceland, we present scale means and standard deviations from selected community studies with comparable age groups, including parental reports for 7, 9 and 11 year-old children and self-reports of 13 and 15 year-olds. The descriptive statistics suggest that the distributions of SDQ scores are very similar across the Nordic countries. Further collaborative efforts in establishing norms and evaluating the validity of the SDQ as a screening instrument are encouraged.
[Increasing difficulties for scientific publication in Venezuela].
Ryder, Elena
2014-03-01
A very important increase in the costs of the edition of scientific journals has taken place in Venezuela, due to difficulties in obtaining imported free acid paper and other materials used for handling documents. Like other journals, Investigaci6n Clinica has been considering switching completely to a digital publication format; however there are several reasons that prevent us to doing it at this time: the journal is distributed in printed form to many national institutions, which do not have immediate access to digital information. In addition, there exists a commitment of shipment of printed issues for some international indices and in exchange with other national and foreign journals, whose printed format we receive. Another important aspect is that our University maintains a weak technological platform that makes difficult the immediacy required for the interchange with authors and consulted referees of received papers; and there is a latent danger of limitations in the use of digital technologies, due to current national politic problems. Consequently, we need to continue with the printed format, but must reduce the amount of printed issues, so as not to limit the number of papers published in each edition. Nevertheless, there is an ever increasing number of contributions from foreign researches and Investigaci6n Clinica has been recently included in two new international indices, the SEIIC from Argentina and the Infobase Index from India, reasons that obligate us to maintain our levels of excellence and commitment to our authors and readers.
Ariyadi Wijaya
2017-01-01
This paper reports an exploration into Indonesian fourth graders’ difficulties in fractions and their relation to the opportunity to learn fractions students got at schools. The concept of ‘opportunity to learn’ is often considered as a framework to investigate possible reasons for students’ difficulties. The data for this study was drawn from TIMSS 2015 that comprised test results and teachers’ responses to TIMSS Teacher Questionnaire. The test and questionnaire data were anal...
Uniform access to clinical data in a distributed environment. Radiology
International Nuclear Information System (INIS)
Adelhard, K.; Swoboda, N.; Nissen-Meyer, S.; Reiser, M.
1999-01-01
Purpose: Providing medical reports on wards and ambulatory settings in electronic form can improve the quality of health care delivery. Radiology was chosen as an example to demonstrate how to implement uniform access to clinical data in a hospital. Method: Medical professionals at the university hospital in Munich, Grosshadern, have access to all radiological reports of their patients. Web browsers are used as a front end. A centralized administration of users and patients is in place. Results: Centralized access control and patient selection guarantee uniform access to all applicable data via intranet and controls access rights. The high acceptance of this service is reflected by the high number of 150 requests per day. Discussion: Access to radiological reports within the Grosshadern University Clinics was enabled via web browsers in a short time. The high acceptance of the system also proves its easy use. Integration of the system in a centralized user and patient identification system supports the unified access to clinical data. (orig.) [de
Gündogmus, Hatice Degirmenci
2018-01-01
The purpose of the current research is to identify the difficulties that primary school teachers experience in the primary reading and writing instruction, and to find out their solution offers for eliminating these difficulties. The study group of the research is composed of 51 primary school teachers selected by criterion sampling as a type of…
Pisani, Anthony R.; Wyman, Peter A.; Petrova, Mariya; Schmeelk-Cone, Karen; Goldston, David B.; Xia, Yinglin; Gould, Madelyn S.
2013-01-01
To develop and refine interventions to prevent youth suicide, knowledge is needed about specific processes that reduce risk at a population level. Using a cross-sectional design, the present study tested hypotheses regarding associations between self-reported suicide attempts, emotion regulation difficulties, and positive youth-adult relationships…
van Steenbergen, Henk; Band, Guido P H; Hommel, Bernhard
2015-01-01
Sequential modulation of congruency effects in conflict tasks indicates that cognitive control quickly adapts to changing task demands. We investigated in four experiments how this behavioral congruency-sequence effect relates to different levels of perceived task difficulty in a flanker and a Stroop task. In addition, online measures of pupil diameter were used as a physiological index of effort mobilization. Consistent with motivational accounts predicting that increased levels of perceived task difficulty will increase effort mobilization only up to a certain limit, reliable dynamic conflict-driven adjustment in cognitive control was only observed when task difficulty was relatively low. Instead, tasks tentatively associated with high levels of difficulty showed no or reversed conflict adaptation. Although the effects could not be linked consistently to effects in self-reported task difficulty in all experiments, regression analyses showed associations between perceived task difficulty and conflict adaptation in some of the experiments, which provides some initial evidence for an inverted U-shape relationship between perceived difficulty and adaptations in cognitive control. Furthermore, high levels of task difficulty were associated with a conflict-driven reduction in pupil dilation, suggesting that pupil dilation can be used as a physiological marker of mental overload. Our findings underscore the importance of developing models that are grounded in motivational accounts of cognitive control.
Directory of Open Access Journals (Sweden)
Pierre Mounier
2013-03-01
Full Text Available Between the two paths of open access – green and gold – the latter is the harder to develop and has less support from the research community. The main difficulty lies in finding a sound economic model. Open Access journals usually depend on two funding sources: subsidies and/or donations from institutions and publication fees from research units in the author-pay model. These two ways of funding Open Access journals and books have proved effective in some cases (Plos, but are not flawless. The Center for Open Electronic Publishing, a French initiative for Open Access publishing in humanities and social sciences, has recently developed a new economic model based on “Freemium” for its full Open Access journal and book series, in order to address two issues: improve their economic soundness and give them more visibility in libraries. Freemium, a blend of “free” and “premium”, preserves the information side of Open Access as well as premium service marketing.
Social communication difficulties and autism in previously institutionalized children.
Levin, April R; Fox, Nathan A; Zeanah, Charles H; Nelson, Charles A
2015-02-01
To determine the risk of difficulties with social communication and restricted/repetitive behaviors as well as the rate of autism in children institutionalized in early infancy and to assess the impact of a foster care intervention on ameliorating this risk. Children abandoned at birth and raised in institutions in Bucharest, Romania were randomly assigned to a care-as-usual group (institutional care, CAUG), or placed in family-centered foster care (FCG) as part of the Bucharest Early Intervention Project (BEIP). At approximately 10 years of age, the Social Communication Questionnaire (SCQ) was administered to caregivers of children in both groups as well as to parents of a typically developing community sample (Never-Institutionalized group [NIG]) residing in Bucharest, Romania. Children scoring ≥12 on the SCQ underwent clinical evaluation for autism spectrum disorder (ASD). Caregivers of children with a history of institutionalization reported that these children had significantly more deviant behavior than never-institutionalized children on all subdomains of the SCQ (all p communication. Three of 60 CAUG children, 2 of 57 FCG children, and none of the NIG children received a formal ASD diagnosis. Early institutional rearing was associated with an increased risk of social communication difficulties and ASD. A family-centered foster care intervention improved social communication skills. Copyright © 2015 American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved.
Assessment of Pragmatic Difficulties and Socioemotional Adjustment in Practice
Farmer, Marion; Oliver, Alice
2005-01-01
Background: In professional practice, psychologists and other professionals such as therapists and teachers receive referrals of many children who present with social, emotional and behavioural difficulties that are difficult to understand and assess. The problems of some of these children may stem from pragmatic difficulties in communication.…
Increasing Access to Special Collections
Directory of Open Access Journals (Sweden)
Ricky Erway
2012-01-01
Full Text Available In an environment where we increasingly have access to a collective collection of digitized books, special collections will become increasingly invisible if they are not accessible online. In an era of increasing expectations and decreasing budgets, finding ways to streamline some of our processes is the best way to enable us to do more with less. This report details a number of investigations into how access to special collections can be increased. It includes guidance running the gamut from digitization and rights management to policies and procedures.
Deaf and hard of hearing social workers accessing their profession: a call to action.
Sheridan, Martha A; White, Barbara J; Mounty, Judith L
2010-01-01
This article aims to familiarize the social work profession with a paradox in its midst. Culturally sensitive and accessible services for deaf and hard of hearing people can often best be provided by social workers who are themselves deaf and hard of hearing, who have specialized language and communication skills, as well as unique cultural knowledge of this population at risk. Yet, deaf and hard of hearing graduates of social work education programs routinely experience difficulties accessing the profession. Addressing this paradox calls for creative collaborations among professional social work organizations, social work education programs, policymakers, and deaf and hard of hearing social workers.
Free open access medical education can help rural clinicians deliver 'quality care, out there'.
Leeuwenburg, Tim J; Parker, Casey
2015-01-01
Rural clinicians require expertise across a broad range of specialties, presenting difficulty in maintaining currency of knowledge and application of best practice. Free open access medical education is a new paradigm in continuing professional education. Use of the internet and social media allows a globally accessible crowd-sourced adjunct, providing inline (contextual) and offline (asynchronous) content to augment traditional educational principles and the availability of relevant resources for life-long learning. This markedly reduces knowledge translation (the delay from inception of a new idea to bedside implementation) and allows rural clinicians to further expertise by engaging in discussion of cutting edge concepts with peers worldwide.
Elias, Cindy V; Power, Thomas G; Beck, Ashley E; Goodell, L Suzanne; Johnson, Susan L; Papaioannou, Maria A; Hughes, Sheryl O
2016-12-01
Maternal depressive symptoms and perceptions of child difficulty are associated with negative effects on general development and cognitive functioning in children. The study examined associations between maternal depressive symptoms, perceptions of child difficulty, and maternal feeding behaviors in a population at elevated risk for childhood obesity. Participants were 138 low-income black and Hispanic mothers and their children (ages 3-5) participating in an observational study of mealtimes among Head Start families. Three dinnertime observations were conducted over 2 weeks on each family and audio/videotaped for coding. Coding included eating influence attempts and other food- and nonfood-related interactions exhibited by the mother during dinner. Mothers completed questionnaires on depressive symptoms and perceptions of child difficulty. Linear regressions were conducted, examining associations between maternal depressive symptoms, perceptions of child difficulty, and coded parent feeding behaviors. Mothers reporting higher levels of depressive symptoms used more verbal pressure to get their child to eat during meals, were more likely to discourage child independence, and less likely to enforce table manners. Mothers reporting higher perceptions of child difficulty were less likely to have nonfood-related discussions during meals and to try to get the child to eat a different food. This study is one of the first to investigate associations between maternal depression, perceptions of child difficulty, and mother's feeding behaviors during meals using observational methodology. These results may help researchers identify specific parental characteristics and feeding practices on which to intervene when developing tailored intervention programs for reducing childhood obesity.
Creating a supportive learning environment for students with learning difficulties
Grah, Jana
2013-01-01
Co-building of supporting learning environment for the learners with learning difficulties is one of the 21st century inclusive school’s elements. Since the physical presence of learners with learning difficulties in the classroom does not self-evidently lead to an effective co-operation and implementation of 21st century inclusive school, I have dedicated my doctor thesis to the establishment of supporting learning environment for the learners with learning difficulties in primary school wit...
Vermette, David; Shetgiri, Rashmi; Al Zuheiri, Haidar; Flores, Glenn
2015-10-01
To identify access barriers to healthcare and potential interventions to improve access for Iraqi refugee children. Four focus groups were conducted using consecutive sampling of Iraqi refugee parents residing in the US for 8 months to 5 years. Eight key-informant interviews also were conducted with employees of organizations serving Iraqi refugee families, recruited using snowball sampling. Focus groups and interviews were audiotaped, transcribed, and analyzed using margin coding and grounded theory. Iraqi refugees identified provider availability, Medicaid maintenance and renewal, language issues, and inadequate recognition of post-traumatic stress disorder as barriers to care for their children. Interviewees cited loss of case-management services and difficulties in understanding the Medicaid renewal process as barriers. Potential interventions to improve access include community-oriented efforts to educate parents on Medicaid renewal, obtaining services, and accessing specialists. Given the enduring nature of language and Medicaid renewal barriers, policies addressing eligibility alone are insufficient.
DIFFICULTIES TO LEARN AND TO TEACH MODERN PHYSICS.
Directory of Open Access Journals (Sweden)
R. Antonowiski
2017-08-01
Full Text Available Physics is engaged in scientific and technological development in several areas, however, its learning in high school has high failure rates that demonstrate a low level of use. It is a science that allows us to understand the nature of the macroscopic and atomic matter, but it is taught in a disjointed manner, upon presentation of concepts, laws and mathematical sentences, repetitive exercises that have taken the preparatory character for college entrance. Thus, the student gets stuck sentences featuring a partial knowledge and disposable. This study aimed to analyze the main difficulties that undergraduate students in Physics have in Modern Physics learning. Point out the difficulties in teaching and learning Physics is not an easy task and to identify them comes the difficulty of how to solve them. After analysis of several hypotheses we can conclude that there is no single factor responsible for the difficulty of the teaching and learning of Modern Physics. The lack of time to work and developed since middle school, stimulating the curiosity of students, adequately trained teachers, lack of structure offered by the government, parents' responsibilities and students in learning, among others, constitute a major challenge for successful teaching and learning of Modern Physics
Analysis of junior high school students' difficulty in resolving rectangular conceptual problems
Utami, Aliksia Kristiana Dwi; Mardiyana, Pramudya, Ikrar
2017-08-01
Geometry is one part of the mathematics that must be learned in school and it has important effects on the development of creative thinking skills of learners, but in fact, there are some difficulties experienced by the students. This research focuses on analysis difficulty in resolving rectangular conceptual problems among junior high school students in every creative thinking skills level. This research used a descriptive method aimed to identify the difficulties and cause of the difficulties experienced by five students. The difficulties are associated with rectangular shapes and related problems. Data collection was done based on students' work through test, interview, and observations. The result revealed that student' difficulties in understanding the rectangular concept can be found at every creative thinking skills level. The difficulties are identifying the objects rectangular in the daily life except for a rectangle and square, analyzing the properties of rectangular shapes, and seeing the interrelationships between figures.
Macey, Kat; Gregory, Angela; Nunns, David; das Nair, Roshan
2015-06-20
Recent research has highlighted controversies in the conceptualisation, diagnosis and treatment of vaginismus. Vaginal trainers are currently the most widely used treatment. Critiques have highlighted concerns that the evidence-base of its effectiveness is limited, with controlled trials reporting disappointing results, and its prescription promotes 'performance-based' sexuality which may be detrimental. Despite this, little has been done to seek women's views about their treatment. This study set out to explore women's experiences of vaginismus treatment with vaginal trainers, and to use their voices to propose guidelines for improving treatment. 13 women who had used vaginal trainers for vaginal penetration difficulties diagnosed as vaginismus were recruited through a specialist clinic, university campuses, and online forums. The women took part in semi-structured individual interviews (face-to-face/telephone/Skype), which were audio-recorded, transcribed verbatim and analysed using Thematic Analysis. Four superordinate themes were elicited and used to draft 'better treatment' guidelines. Themes were: (1) Lack of knowledge, (2) Invalidation of suffering by professionals, (3) Difficult journey, and (4) Making the journey easier. This paper describes themes (3) and (4). Difficult Journey describes the long and arduous 'Journey into treatment', including difficulties asking for help, undergoing physical investigations and negotiating 'the system' of medical referrals. It also describes the sometimes demoralising process of 'being in treatment', which includes emotional and practical demands of treatment. Making the journey easier highlights the importance of and limits to 'partner support'. 'Professional support' comprises personal qualities of professionals/therapeutic relationship, the value of specialist skills and knowledge and the need for facilitating couple communication about vaginismus. 'Peer support/helping each other' describes the importance of
Food Security and Women's Access to Natural Resources workshop; a brief report.
1997-01-01
This article describes the workshop on Food Security and Women's Access to Natural Resources, held in January 1997 in Mumbai, India. The workshop was organized jointly by the Tata Institute of Social Sciences and the Indian Association of Women's Studies. The aim was to examine the food security situation in Maharashtra and Gujarat states in the west, the initiative to build alternative institutions, legal changes augmenting industrialization, and how traditional rights to common property resources can be legalized and how the poor can have access to new resources. The workshop organizers were unable to obtain experts on some topics. Core discussion centered on changes in industrialization, natural resources, gender and food security; access to natural resources and poverty alleviation programs; initiatives to create food security; and laws related to access to land and water. Discussions revealed the alienation of small and marginal farmers, landless laborers, and artisans from their livelihoods and survival strategies for these disenfranchised groups. The design of drought eradication and water conservation programs did not permit women and men working at construction sites to have access to the program assets. Case studies revealed situations in which women won the right of access to community water and then negotiated for land in lease. The women used landowners to negotiate credit and access development program assets, but normal channels of the National Bank of Agricultural Research and Development could have provided these benefits. Participants discussed how governments can be held accountable and how public funds could be used to revamp poverty alleviation and asset creation programs. All agreed that macrolevel development should give priority to agricultural development and legal constraints or problems. Five follow-up activities are identified.
Learner's Learning Experiences & Difficulties towards (ESL) among UKM Undergraduates
Maarof, Nooreiny; Munusamy, Indira Malani A/P
2015-01-01
This paper aims to investigate the learners learning experiences and difficulties of ESL among the UKM undergraduates. This study will be focusing on identifying the factors behind Malaysian undergraduate's experiences and also their difficulties in the English as Second Language (ESL) classroom. This paper discusses some of the issues of English…
Early Writing Deficits in Preschoolers with Oral Language Difficulties
Puranik, Cynthia S.; Lonigan, Christopher J.
2012-01-01
The purpose of this study was to investigate whether preschool children with language impairments (LI), a group with documented reading difficulties, also experience writing difficulties. In addition, a purpose was to examine if the writing outcomes differed when children had concomitant cognitive deficits in addition to oral language problems. A…
Directory of Open Access Journals (Sweden)
Luiz Henrique Conde Sangenis
2014-06-01
Full Text Available Visceral Leishmaniasis has been showing remarkable epidemiological changes in recent decades, with marked expansion and an emergence of cases in urban areas of the North, Southeast and Midwest regions of Brazil. The Kala-azar cases reported here, despite being very characteristic, presented a great difficulty of diagnosis, because the disease is not endemic in Volta Redonda. The child underwent two hospitalizations in different hospitals, but got the correct diagnosis only after 11 months of symptom onset. In this report we discuss the main differential diagnoses and call attention to the suspected symptoms of visceral leishmaniasis in patients with prolonged fever, hepatosplenomegaly and pancytopenia, even in areas not traditionally endemic for the disease.
Landripet, Ivan; Štulhofer, Aleksandar
2015-05-01
Recent epidemiological studies reported high prevalence rates of erectile dysfunction (ED) among younger heterosexual men (≤40). It has been suggested that this "epidemic" of ED is related to increased pornography use. However, empirical evidence for such association is currently lacking. This study analyzes associations between pornography use and sexual health disturbances among younger heterosexual men using four large-scale online samples from three European countries. The analyses were carried out using a 2011 cross-sectional online study of Croatian, Norwegian, and Portuguese men (Study 1; N = 2,737) and a 2014 cross-sectional online study of Croatian men (Study 2; N = 1,211). Chi-square test and multivariate logistic regression were used to explore the associations between pornography use and sexual difficulties. In Study 1, erectile difficulties, inability to reach orgasm, and a lack of sexual desire were measured using the Global Study of Sexual Attitudes and Behavior indicators. In Study 2, ED was measured with the abridged International Index of Erectile Function (IIEF-5). Delayed ejaculation and a decrease of sexual desire were assessed with one-item indicators. In Study 1, only the relationship between pornography use and ED among Croatian men was statistically significant (χ(2) [2] = 18.76, P pornography, moderate but not high frequency of pornography use increased the odds of reporting ED (adjusted odds ratio = 0.53, P pornography use and male sexual dysfunctions were observed. We found little evidence of the association between pornography use and male sexual health disturbances. Contrary to raising public concerns, pornography does not seem to be a significant risk factor for younger men's desire, erectile, or orgasmic difficulties. © 2015 International Society for Sexual Medicine.
Adapting Building Design to Access by Individuals with Intellectual Disability
Directory of Open Access Journals (Sweden)
L Castell
2012-11-01
Full Text Available Over the last 15 years, since introductionof the Disability Discrimination Act (DDA(Commonwealth Government of Australia,1992, there has been much discussionabout the extent and nature of buildingaccess for the disabled, particularly inresponse to proposed revisions to theBuilding Code of Australia (BCA and theintroduction of a Premises Standardcovering building access. Much of theargument which contributed to the twoyear delay in submitting a final version ofthese documents for government approvalrelated to the extent of access provisionsand the burden of cost. The final versionsubmitted to government by the AustralianBuilding Codes Board (ABCB (notreleased publicly appears to still containinconsistencies between the DDA and theBCA in several areas such as wayfindingand egress.In the debate preceding submission of thefinal version there appears to have beenlittle reference to access requirements forindividuals with intellectual disability (ID.This may be due to a general lack ofresearch on the topic. Consequently, thispaper uses a combination of theknowledge gained from a limited numberof previous wayfinding studies, literaturedescribing general problems faced bythose with ID and the author’s personalexperience observing others with ID tocreate a list of probable difficulties andsuggested solutions. The paperconcludes with a discussion about theassociated cost implications and benefitsin providing the required access.
Access to Finance of the Macedonian Companies in the Post-Crisis period
Directory of Open Access Journals (Sweden)
Meri Boshkoska
2016-08-01
Full Text Available In this paper we analyzed the liquidity of the companies, the plans for the future cash flows and questions related to the new law regarding the financial discipline. Main questions addressed here are the number of difficulties related to the sources of financing the current and the developing activities of the companies in Macedonia. The analysis is undertaken by using statistical techniques and models. The results suggest that in the post-crisis period the companies are facing with number of difficulties of providing financial resources for the current and the developing activities where the most significant source of finance are the bank credits. Also, the results suggest that delayed payment of claims, the legislative and the high level of interest rate are the most common factors that restrict the access to finance of the Macedonian companies.
Orthogonally Evolved AI to Improve Difficulty Adjustment in Video Games
DEFF Research Database (Denmark)
Hintze, Arend; Olson, Randal; Lehman, Joel Anthony
2016-01-01
Computer games are most engaging when their difficulty is well matched to the player's ability, thereby providing an experience in which the player is neither overwhelmed nor bored. In games where the player interacts with computer-controlled opponents, the difficulty of the game can be adjusted...... not only by changing the distribution of opponents or game resources, but also through modifying the skill of the opponents. Applying evolutionary algorithms to evolve the artificial intelligence that controls opponent agents is one established method for adjusting opponent difficulty. Less-evolved agents...... (i.e. agents subject to fewer generations of evolution) make for easier opponents, while highly-evolved agents are more challenging to overcome. In this publication we test a new approach for difficulty adjustment in games: orthogonally evolved AI, where the player receives support from collaborating...
Williams, Natalie A.; Fournier, Jennifer; Coday, Mace; Richey, Phyllis A.; Tylavsky, Frances A.; Hare, Marion E.
2012-01-01
Objective To determine whether there is an association between body mass index (BMI) and body esteem in young overweight and obese urban children, and to test peer relationship difficulties and perceived physical health as mediators of this relationship. Methods Child self-reported body esteem, and parent-reported child peer relationship difficulties (being bullied by peers and peer rejection) and physical health perceptions were obtained from 218 overweight and obese children ages 5–7 years (81% racial/ethnic minority, M BMI = 25.3) and their primary caregivers. Results Higher BMI was associated with lower body esteem for both girls and boys. This relation was mediated by poor physical health for boys but not for girls. Peer relationship difficulties did not mediate the observed association between BMI and body esteem in either group; however, girls with higher BMI experienced more bullying and being bullied by peers was associated with lower body esteem in girls. Conclusions Intervening with perceptions of physical health may buffer overweight and obese boys from developing low body esteem in early childhood. PMID:22882115
Energy Technology Data Exchange (ETDEWEB)
Cames, M.; Matthes, F.C.; Baer, S.; Oberthuer, S.; Krug, M.; Mez, L.; Tempel, S.
2001-07-01
With regard to the leading role of the EU in climate protection policies, it is important to consider the impact of the accession process on EU climate policy. This study includes the analysis of the most important issues related to environment and energy within the accession process, namely: 1) status quo and development of the energy sector and structural CO{sub 2} mitigation options; 2) legal gap assessment and analysis of performance in the accession process; 3) identification of implementation patterns through detailed policy analysis; 4) evaluation of co-operation projects in the field of environment and energy in order to develop new projects that promote the accession process. This volume includes comparative analysis of the five Accession Countries. The detailed analysis of each country is documented in five country reports, each in a separate volume available only on the attached CD. (orig.)
Energy Technology Data Exchange (ETDEWEB)
Birol, Fatih [International Energy Agency, Paris (France); Brew-Hammond, Abeeku [University of Science and Technology (Ghana
2012-04-15
The UN Secretary General established the Sustainable Energy for All initiative in order to guide and support efforts to achieve universal access to modern energy, rapidly increase energy efficiency, and expand the use of renewable energies. Task forces were formed involving prominent energy leaders and experts from business, government, academia and civil society worldwide. The goal of the Task Forces is to inform the implementation of the initiative by identifying challenges and opportunities for achieving its objectives. This report contains the findings of Task Force One which is dedicated to the objective of achieving universal access to modern energy services by 2030. The report shows that universal energy access can be realized by 2030 with strong, focused actions set within a coordinated framework.
How does the legal system respond when children with learning difficulties are victimized?
Cederborg, Ann-Christin; Lamb, Michael E
2006-05-01
To understand how the Swedish legal system perceives and handles mentally handicapped children who may have been victimized. Twenty-two judicial districts in Sweden provided complete files on 39 District Court cases (including the Appeals Court files on 17 of these cases) involving children with learning difficulties or other handicaps as alleged victims of abuse, threat and neglect. The children (25 girls and 14 boys) averaged 11.8 years of age when first allegedly victimized. Sexual abuse was the most frequently alleged crime (33 cases). Court transcripts, court files and expert assessments of the alleged victims' handicaps and their possible consequences were examined to elucidate the ways in which courts evaluated the credibility of the alleged victims. The children's reports of their victimization were expected to have the characteristics emphasized by proponents of Statement Reality Analysis (SRA) and Criterion Based Content Analysis (CBCA) in order to be deemed credible. Expert reports were seldom available or adequate. Because many reports were poorly written or prepared by experts who lacked the necessary skills, courts were left to rely on their own assumptions and knowledge when evaluating children's capacities and credibility. Children with learning difficulties or other handicaps were expected to provide the same sort of reports as other children. To minimize the risk that judgments may be based on inaccurate assumptions courts need to require more thorough assessments of children's limitations and their implications. Assessments by competent mental health professionals could inform and strengthen legal decision-making. A standardized procedure that included psycho-diagnostic instruments would allow courts to understand better the abilities, capacities, and behavior of specific handicapped children.
Sakai, Christina; Mackie, Thomas I; Shetgiri, Rashmi; Franzen, Sara; Partap, Anu; Flores, Glenn; Leslie, Laurel K
2014-01-01
To examine the perspectives of youth on factors that influence mental health service use after aging out of foster care. Focus groups were conducted with youth with a history of mental health needs and previous service use who had aged out of foster care. Questions were informed by the Health Belief Model and addressed 4 domains: youth perceptions of the "threat of mental health problems," treatment benefits versus barriers to accessing mental health services, self-efficacy, and "cues to action." Data were analyzed using a modified grounded-theory approach. Youth (N = 28) reported ongoing mental health problems affecting their functioning; however, they articulated variable levels of reliance on formal mental health treatment versus their own ability to resolve these problems without treatment. Past mental health service experiences influenced whether youth viewed treatment options as beneficial. Youth identified limited self-efficacy and insufficient psychosocial supports "cueing action" during their transition out of foster care. Barriers to accessing mental health services included difficulties obtaining health insurance, finding a mental health provider, scheduling appointments, and transportation. Youths' perceptions of their mental health needs, self-efficacy, psychosocial supports during transition, and access barriers influence mental health service use after aging out of foster care. Results suggest that strategies are needed to 1) help youth and clinicians negotiate shared understanding of mental health treatment needs and options, 2) incorporate mental health into transition planning, and 3) address insurance and other systemic barriers to accessing mental health services after aging out of foster care. Copyright © 2014 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.
Access to health care and community social capital.
Hendryx, Michael S; Ahern, Melissa M; Lovrich, Nicholas P; McCurdy, Arthur H
2002-02-01
To test the hypothesis that variation in reported access to health care is positively related to the level of social capital present in a community. The 1996 Household Survey of the Community Tracking Study, drawn from 22 metropolitan statistical areas across the United States (n = 19,672). Additional data for the 22 communities are from a 1996 multicity broadcast media marketing database, including key social capital indicators, the 1997 National Profile of Local Health Departments survey, and Interstudy, American Hospital Association, and American Medical Association sources. The design is cross-sectional. Self-reported access to care problems is the dependent variable. Independent variables include individual sociodemographic variables, community-level health sector variables, and social capital variables. Data are merged from the various sources and weighted to be population representative and are analyzed using hierarchical categorical modeling. Persons who live in metropolitan statistical areas featuring higher levels of social capital report fewer problems accessing health care. A higher HMO penetration rate in a metropolitan statistical area was also associated with fewer access problems. Other health sector variables were not related to health care access. The results observed for 22 major U.S. cities are consistent with the hypothesis that community social capital enables better access to care, perhaps through improving community accountability mechanisms.
Directory of Open Access Journals (Sweden)
Fridman M
2017-03-01
Full Text Available Moshe Fridman,1 Tobias Banaschewski,2 Vanja Sikirica,3 Javier Quintero,4 Kristina S Chen5 1AMF Consulting, Inc., Los Angeles, CA, USA; 2Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim of the University of Heidelberg, Mannheim, Germany; 3Global Health Economics Outcomes Research and Epidemiology, Shire, Wayne, PA, USA; 4Psychiatry Department, Hospital Universitario Infanta Leonor, Complutense University, Madrid, Spain; 5Global Health Economics Outcomes Research and Epidemiology, Shire, Lexington, MA, USA Background: Attention-deficit/hyperactivity disorder (ADHD is one of the most common childhood psychiatric disorders and negatively impacts caregivers’ lives. Factors including barriers to accessing care, dissatisfaction with support services, and lack of caregiver resources may contribute to this.Objectives: To report caregivers’ experiences of ADHD diagnosis, behavioral therapy (BT, and supportive care for children/adolescents with ADHD.Methods: The Caregiver Perspective on Pediatric ADHD (CAPPA survey included caregivers of children/adolescents (6–17 years from ten European countries who were currently receiving/had received ADHD pharmacotherapy in the previous 6 months. Caregivers reported experiences of obtaining an ADHD diagnosis, access to BT, availability of caregiver resources, and level of health care/school support. Pan-EU and country-specific descriptive statistics are reported; responses were compared across countries.Results: Of 3,616 caregivers, 66% were female. Mean age of children/adolescents was 11.5 years; 80% were male. Mean time from the first doctor visit to diagnosis was 10.8 (95% confidence interval 10.2, 11.3 months; 31% of caregivers reported the greatest degrees of difficulty in obtaining an ADHD diagnosis; 44% of children/adolescents did not receive BT. Forty-seven percent of caregivers reported that sufficient resources were available
Tibiopedal access for lower extremity arterial intervention: when to use and how to perform.
Wiechmann, Bret N
2014-09-01
Tibiopedal artery access is being used with increasing frequency as an alternative access to facilitate procedural success in lower extremity arterial intervention. This technique is usually employed in the setting of critical limb ischemia and tibial artery intervention, but it may offer potential practical advantages for popliteal artery and even superficial femoral artery intervention in unique situations. As in all cases of lower extremity arterial intervention, consideration of access is important not only for initial approach to any obstructing lesion but also for exit strategy. The dorsalis pedis artery and posterior tibial artery can be readily accessed if necessary owing to their relatively superficial position in the foot or the ankle, yet their normal diameter and the presence of significant calcification (a common finding in patients with tibial occlusive disease and critical limb ischemia) can pose difficulties as well. In addition, the peroneal artery in the lower leg can be accessed percutaneously; however, its size and depth may present additional challenges. Meticulous attention to detail is paramount in avoiding complications in what may be the only distal vessel supplying the foot. This article describes common techniques in using tibiopedal artery access as a means of alternative access for successful infrainguinal intervention. Copyright © 2014 Elsevier Inc. All rights reserved.
Healthcare Needs of and Access Barriers for Brazilian Transgender and Gender Diverse People.
Costa, Angelo Brandelli; da Rosa Filho, Heitor Tome; Pase, Paola Fagundes; Fontanari, Anna Martha Vaitses; Catelan, Ramiro Figueiredo; Mueller, Andressa; Cardoso, Dhiordan; Soll, Bianca; Schwarz, Karine; Schneider, Maiko Abel; Gagliotti, Daniel Augusto Mori; Saadeh, Alexandre; Lobato, Maria Inês Rodrigues; Nardi, Henrique Caetano; Koller, Silvia Helena
2018-02-01
Transgender and gender diverse people (TGD) have specific healthcare needs and struggles with access barriers that should be addressed by public health systems. Our study aimed to address this topic in the Brazilian context. A hospital and web-based cross-sectional survey built with input from the medical and transgender communities was developed to assess TGD healthcare needs of and access barriers in two Brazilian states. Although services that assist this population have existed in Brazil since the 1990s, TGD have difficulty accessing these services due to discrimination, lack of information and a policy design that does not meet the needs of TGD. A history of discrimination was associated with a 6.72-fold increase in the frequency of health service avoidance [95% CI (4.5, 10.1)]. This article discusses the urgent necessity for adequate health policies and for the training of professionals regarding the needs of Brazilian TGD.
Mangla, Ankit; Agarwal, Nikki; Mullane, Michael Russell
2017-12-01
The totally implantable venous access port plays a crucial role in delivering chemotherapy in the outpatient setting. Here, we report the first case of a patient with hypopharyngeal tumor who developed chest wall metastasis over the totally implantable venous access port inserted in the internal jugular vein. Our patient, a 58-year-old man with a hypopharyngeal tumor presented with a lump over the totally implantable venous access port site. The port was removed and the lump was biopsied. The CT studies showed that the tumor had spread along the catheter from the hypopharynx to the chest wall. The pathology from the biopsy showed squamous cell carcinoma (SCC). The patient had poor performance status and opted for hospice care. We present a novel case of metastasis over the totally implantable venous access port implanted in a patient with a hypopharyngeal tumor. We also reviewed relevant literature comparing the data from percutaneous endoscopic gastrostomy (PEG) tube site metastasis with our patient and other similar case reports. © 2017 Wiley Periodicals, Inc.
Divided attention: an undesirable difficulty in memory retention.
Gaspelin, Nicholas; Ruthruff, Eric; Pashler, Harold
2013-10-01
How can we improve memory retention? A large body of research has suggested that difficulty encountered during learning, such as when practice sessions are distributed rather than massed, can enhance later memory performance (see R. A. Bjork & E. L. Bjork, 1992). Here, we investigated whether divided attention during retrieval practice can also constitute a desirable difficulty. Following two initial study phases and one test phase with Swahili-English word pairs (e.g., vuvi-snake), we manipulated whether items were tested again under full or divided attention. Two days later, participants were brought back for a final cued-recall test (e.g., vuvi-?). Across three experiments (combined N = 122), we found no evidence that dividing attention while practicing retrieval enhances memory retention. This finding raises the question of why many types of difficulty during practice do improve long-term retention, but dividing attention does not.
McKeague, L.; Morant, N.; Blackshaw, E.; Brown, J. S. L.
2017-01-01
BACKGROUND: Adolescents with emotional difficulties need accessible, acceptable and evidence-based mental health interventions. Self-referral workshops (DISCOVER workshops) were offered to stressed 16- to 19-year olds in 10 Inner London schools. METHOD: Semistructured interviews were conducted with three groups of participants: students who attended a 1-day workshop (n = 15); students who initially showed interest in the DISCOVER workshop programme, but decided not to take part (n...
Difficulties in using everyday technology after acquired brain injury: a qualitative analysis.
Engström, Ann-Louice Lövgreen; Lexell, Jan; Lund, Maria Larsson
2010-09-01
The aim of this study was to identify and describe the characteristics of the difficulties using everyday technology in persons with an aquired brain injury (ABI), and their experiences of how these difficulties influenced their life. Thirteen persons with an ABI were interviewed about their difficulties in using everyday technology and were observed in their use of technology. Data were analysed qualitatively with a constant comparative method. The results showed that the persons' experiences formed two categories: “A variety of combinations of difficulties in the use of everyday technology” and “Restrictions in life”. The difficulties identified were related not only to everyday technology itself but also to the interaction between the technology, the task, the person, and the environment. These difficulties influenced their experiences of restrictions in occupational performance, personal identification, and participation in society. The results emphasize that occupational therapists who design interventions for people with an ABI need to accommodate both the technology and other interacting aspects in order to overcome difficulties in using everyday technology.
Directory of Open Access Journals (Sweden)
Henk eVan Steenbergen
2015-07-01
Full Text Available Sequential modulation of congruency effects in conflict tasks indicates that cognitive control quickly adapts to changing task demands. We investigated in four experiments how this behavioral congruency-sequence effect relates to different levels of perceived task difficulty in a flanker and a Stroop task. In addition, online measures of pupil diameter were used as a physiological index of effort mobilization. Consistent with motivational accounts predicting that increased levels of perceived task difficulty will increase effort mobilization only up to a certain limit, reliable dynamic conflict-driven adjustment in cognitive control was only observed when task difficulty was relatively low. Instead, tasks tentatively associated with high levels of difficulty showed no or reversed conflict adaptation. Although the effects could not be linked consistently to effects in self-reported task difficulty in all experiments, regression analyses showed associations between perceived task difficulty and conflict adaptation in some of the experiments, which provides some initial evidence for an inverted U-shape relationship between perceived difficulty and adaptations in cognitive control. Furthermore, high levels of task difficulty were associated with a conflict-driven reduction in pupil dilation, suggesting that pupil dilation can be used as a physiological marker of mental overload. Our findings underscore the importance of developing models that are grounded in motivational accounts of cognitive control.
Section 508 Electronic Information Accessibility Requirements for Software Development
Ellis, Rebecca
2014-01-01
Section 508 Subpart B 1194.21 outlines requirements for operating system and software development in order to create a product that is accessible to users with various disabilities. This portion of Section 508 contains a variety of standards to enable those using assistive technology and with visual, hearing, cognitive and motor difficulties to access all information provided in software. The focus on requirements was limited to the Microsoft Windows® operating system as it is the predominant operating system used at this center. Compliance with this portion of the requirements can be obtained by integrating the requirements into the software development cycle early and by remediating issues in legacy software if possible. There are certain circumstances with software that may arise necessitating an exemption from these requirements, such as design or engineering software using dynamically changing graphics or numbers to convey information. These exceptions can be discussed with the Section 508 Coordinator and another method of accommodation used.
Disk access controller for Multi 8 computer
International Nuclear Information System (INIS)
Segalard, Jean
1970-01-01
After having presented the initial characteristics and weaknesses of the software provided for the control of a memory disk coupled with a Multi 8 computer, the author reports the development and improvement of this controller software. He presents the different constitutive parts of the computer and the operation of the disk coupling and of the direct access to memory. He reports the development of the disk access controller: software organisation, loader, subprograms and statements
Directory of Open Access Journals (Sweden)
McCann Terence V
2012-08-01
Full Text Available Abstract Background Despite the emergence of mental health problems during adolescence and early adulthood, many young people encounter difficulties accessing appropriate services. In response to this gap, the Australian Government recently established new enhanced primary care services (headspace that target young people with emerging mental health problems. In this study, we examine the experience of young people with depression accessing one of these services, with a focus on understanding how they access the service and the difficulties they encounter in the process. Method Individual, in-depth, audio-recorded interviews were used to collect data. Twenty-six young people with depression were recruited from a headspace site in Melbourne, Australia. Interpretative phenomenological analysis was used to analyse the data. Results Four overlapping themes were identified in the data. First, school counsellors as access mediators, highlights the prominent role school counsellors have in facilitating student access to the service. Second, location as an access facilitator and inhibitor. Although the service is accessible by public transport, it is less so to those who do not live near public transport. Third, encountering barriers accessing the service initially. Two main service access barriers were experienced: unfamiliarity with the service, and delays in obtaining initial appointments for ongoing therapy. Finally, the service’s funding model acts as an access facilitator and barrier. While the model provides a low or no cost services initially, it limits the number of funded sessions, and this can be problematic. Conclusions Young people have contrasting experiences accessing the service. School counsellors have an influential role in facilitating access, and its close proximity to public transport enhances access. The service needs to become more prominent in young people’s consciousness, while the appointment system would benefit from
McCann, Terence V; Lubman, Dan I
2012-08-01
Despite the emergence of mental health problems during adolescence and early adulthood, many young people encounter difficulties accessing appropriate services. In response to this gap, the Australian Government recently established new enhanced primary care services (headspace) that target young people with emerging mental health problems. In this study, we examine the experience of young people with depression accessing one of these services, with a focus on understanding how they access the service and the difficulties they encounter in the process. Individual, in-depth, audio-recorded interviews were used to collect data. Twenty-six young people with depression were recruited from a headspace site in Melbourne, Australia. Interpretative phenomenological analysis was used to analyse the data. Four overlapping themes were identified in the data. First, school counsellors as access mediators, highlights the prominent role school counsellors have in facilitating student access to the service. Second, location as an access facilitator and inhibitor. Although the service is accessible by public transport, it is less so to those who do not live near public transport. Third, encountering barriers accessing the service initially. Two main service access barriers were experienced: unfamiliarity with the service, and delays in obtaining initial appointments for ongoing therapy. Finally, the service's funding model acts as an access facilitator and barrier. While the model provides a low or no cost services initially, it limits the number of funded sessions, and this can be problematic. Young people have contrasting experiences accessing the service. School counsellors have an influential role in facilitating access, and its close proximity to public transport enhances access. The service needs to become more prominent in young people's consciousness, while the appointment system would benefit from providing more timely appointments with therapists. The service's funding
Masculine Discrepancy Stress, Emotion-Regulation Difficulties, and Intimate Partner Violence.
Berke, Danielle S; Reidy, Dennis E; Gentile, Brittany; Zeichner, Amos
2016-05-24
Research suggests that masculine socialization processes contribute to the perpetration of intimate partner violence (IPV) by men. Although this research has traditionally focused on men who strongly adhere to traditional gender norms, men who negatively evaluate themselves as falling short of these norms (a construct termed masculine discrepancy stress) have proven to be at increased risk of IPV perpetration. Likewise, men experiencing problems with emotion regulation, a multidimensional construct reflecting difficulties in effectively experiencing and responding to emotional states, are also at risk of IPV perpetration. In the present research, we tested the hypothesis that the link between discrepancy stress and IPV perpetration is mediated via difficulties in emotion regulation. Three hundred fifty-seven men completed online surveys assessing their experience of discrepancy stress, emotion-regulation difficulties, and history of IPV perpetration. Results indicated that discrepancy-stressed men's use of physical IPV was fully mediated by emotion-regulation difficulties. In addition, emotion-regulation difficulties partially mediated the association between discrepancy stress and sexual IPV. Findings are discussed in terms of the potential utility of emotion-focused interventions for modifying men's experience and expression of discrepancy stress and reducing perpetration of IPV. © The Author(s) 2016.
Masculine Discrepancy Stress, Emotion-Regulation Difficulties, and Intimate Partner Violence
Berke, Danielle S.; Reidy, Dennis E.; Gentile, Brittany; Zeichner, Amos
2018-01-01
Research suggests that masculine socialization processes contribute to the perpetration of intimate partner violence (IPV) by men. Although this research has traditionally focused on men who strongly adhere to traditional gender norms, men who negatively evaluate themselves as falling short of these norms (a construct termed masculine discrepancy stress) have proven to be at increased risk of IPV perpetration. Likewise, men experiencing problems with emotion regulation, a multidimensional construct reflecting difficulties in effectively experiencing and responding to emotional states, are also at risk of IPV perpetration. In the present research, we tested the hypothesis that the link between discrepancy stress and IPV perpetration is mediated via difficulties in emotion regulation. Three hundred fifty-seven men completed online surveys assessing their experience of discrepancy stress, emotion-regulation difficulties, and history of IPV perpetration. Results indicated that discrepancy-stressed men's use of physical IPV was fully mediated by emotion-regulation difficulties. In addition, emotion-regulation difficulties partially mediated the association between discrepancy stress and sexual IPV. Findings are discussed in terms of the potential utility of emotion-focused interventions for modifying men's experience and expression of discrepancy stress and reducing perpetration of IPV. PMID:27226013
Undergraduate Students’ Difficulties in Reading and Constructing Phylogenetic Tree
Sa'adah, S.; Tapilouw, F. S.; Hidayat, T.
2017-02-01
Representation is a very important communication tool to communicate scientific concepts. Biologists produce phylogenetic representation to express their understanding of evolutionary relationships. The phylogenetic tree is visual representation depict a hypothesis about the evolutionary relationship and widely used in the biological sciences. Phylogenetic tree currently growing for many disciplines in biology. Consequently, learning about phylogenetic tree become an important part of biological education and an interesting area for biology education research. However, research showed many students often struggle with interpreting the information that phylogenetic trees depict. The purpose of this study was to investigate undergraduate students’ difficulties in reading and constructing a phylogenetic tree. The method of this study is a descriptive method. In this study, we used questionnaires, interviews, multiple choice and open-ended questions, reflective journals and observations. The findings showed students experiencing difficulties, especially in constructing a phylogenetic tree. The students’ responds indicated that main reasons for difficulties in constructing a phylogenetic tree are difficult to placing taxa in a phylogenetic tree based on the data provided so that the phylogenetic tree constructed does not describe the actual evolutionary relationship (incorrect relatedness). Students also have difficulties in determining the sister group, character synapomorphy, autapomorphy from data provided (character table) and comparing among phylogenetic tree. According to them building the phylogenetic tree is more difficult than reading the phylogenetic tree. Finding this studies provide information to undergraduate instructor and students to overcome learning difficulties of reading and constructing phylogenetic tree.
Geurs KT; Ritsema van Eck JR; Universiteit Utrecht-URU; LAE
2001-01-01
This report describes an extensive literature study and three case studies aimed at reviewing accessibility measures for their ability to evaluate the accessibility impacts of national land-use and transport scenarios, and related social and economic impacts. Several activity- and utility-based accessibility measures were computed to analyse job accessibility by car and public transport in the Netherlands for: (1) the (base) year 1995, (2) a Trend, or business-as-usual, scenario, representing...
Examining the model structure of the strengths and difficulties questionnaire (SDQ)
Azzopardi, Lara Marie; Camilleri, Liberato; Sammut, Fiona; Cefai, Carmel
2016-01-01
The Strengths and Difficulties questionnaire (SDQ), proposed by Goodman 1997, has been used by researchers to measure social, emotional and behaviour difficulties in children. The SDQ includes four difficulty subscales, measuring emotional, conduct, hyperactivity and peer problems. It also includes a fifth subscale, measuring prosocial behaviour. Dickey 2004 suggested that the SDQ factor structure can be reduced to three dimensions comprising the prosocial, externalisation and internalisation...
CO2 angiography of vascular access in hemodialysis: a preliminary report
International Nuclear Information System (INIS)
Li Huimin; Xiao Xiangsheng; Yan Bing; Dong Sheng; Li Wentao; Dong Yonghua; Ye Chaoyang; Rong Shu
2005-01-01
Objective: To explore the technique and value of CO 2 angiography in surveillance of vascular access in hemodialysis. Methods: CO 2 angiography was undertaken in 10 chronic renal failure (CRF) patients with native arteriovenous fistulas for hemodialysis. The injection sites were the vein dorsale manus (n=7) and the fistula (n=3). The whole draining veins were obtained using a Toshiba DSA unit, when 40-60 ml gas were injected by hands every time. The compression on elbow and image stacking technique were used. Results: All patients had a safe examination, and the vessels on the CO 2 venogram were tubular or bubble-flow. A significant draining vein was revealed in 4 cases (3 of them injection from fistula). The elbow compression had the effect on venogram in 2 cases. All of the draining veins above the elbow were clearly visualized, and the stacking technique imp roved the display of veins. Conclusion: Internal fistula CO 2 angiography is safe, cheap, and efficacy for dialysis access surveillance. The draining veins of vascular access in CRF patients have their own characteristics, and can be best revealed by direct internal fistula CO 2 venography. CO 2 angiogram of the vascular access can be improved with various kinds of skills. (authors)
Fang, Mei Lan; Sixsmith, Judith; Lawthom, Rebecca; Mountian, Ilana; Shahrin, Afifa
2015-09-19
Asylum seekers, refugees and persons without legal status have been reported to experience a range of difficulties when accessing public services and supports in the UK. While research has identified health care barriers to equitable access such as language difficulties, it has not considered the broader social contexts of marginalization experienced through the dynamics of 'othering'. The current study explores health and health care experiences of Somali and Iraqi asylum seekers, refugees and persons without legal status, highlighting 'minoritization' processes and the 'pathologization' of difference as analytical lenses to understand the multiple layers of oppression that contribute to health inequities. For the study, qualitative methods were used to document the lived experiences of asylum seekers, refugees and persons without legal status. Thirty-five in-depth interviews and five focus groups were used to explore personal accounts, reveal shared understandings and enable social, cognitive and emotional understandings of on-going health problems and challenges when seeking treatment and care. A participatory framework was undertaken which inspired collaborative workings with local organizations that worked directly with asylum seekers, refugees and persons without legal status. The analysis revealed four key themes: 1) pre-departure histories and post-arrival challenges; 2) legal status; 3) health knowledges and procedural barriers as well as 4) language and cultural competence. Confidentiality, trust, wait times and short doctor-patient consultations were emphasized as being insufficient for culturally specific communications and often translating into inadequate treatment and care. Barriers to accessing health care was associated with social disadvantage and restrictions of the broader welfare system suggesting that a re-evaluation of the asylum seeking process is required to improve the situation. Macro- and micro-level intersections of accustomed societal
Veganism: Motivations and Difficulties
Beck, Mathilde Therese Claudine; Harvey, John Carr; Trauth, Christina
2017-01-01
An increasing number of people are adopting a vegan lifestyle, which means to stop consuming products, that are made from or based on animals, like meat, dairy or eggs. However, the number of research concerning veganism is limited. As the existing research is mainly concentrating on the process of adopting a vegan lifestyle and the view of vegans, these findings shall be examined further with the question, What are the motivation and difficulties about adopting a plant based vegan diet in We...
Directory of Open Access Journals (Sweden)
Guibo Sun
2015-05-01
Full Text Available The influence of hilliness on walking behavior could be a consequence of the real effect of the local topography, but individual perception of the difficulties associated with walking in a hilly environment may also be important. Previous studies have found that people’s perceptions do not necessarily match well with the realities of walking in hilly environments. There are a few methods that can be used to visualize the geography of that difference for use by urban planners and public health practitioners. A walking accessibility measure that allows comparison of perception and reality is proposed and implemented in this study. We note that difficulties in calculating accessibility measures in the present context arise primarily from problems with data quality, three-dimensional pedestrian network modelling and the adequacy of accessibility methods for describing and predicting walking behavior. We present practical strategies for addressing these issues using geographic information systems. Our method is illustrated by calculating accessibility for a hilly university campus in Hong Kong. Walking behaviors on, and people’s perceptions of, this hilly environment were obtained through walking diaries and a survey. The article concludes with suggested directions for the future development of walking accessibility measures along with some ideas about their applicability to the practice of planning and designing a walkable environment.
Single-port access laparoscopic hysterectomy: a new dimension of minimally invasive surgery.
Liliana, Mereu; Alessandro, Pontis; Giada, Carri; Luca, Mencaglia
2011-01-01
The fundamental idea is to have all of the laparoscopic working ports entering the abdominal wall through the same incision. Single-incision laparoscopic surgery is an alternative to conventional multiport laparoscopy. Single-access laparoscopy using a transumbilical port affords maximum cosmetic benefits because the surgical incision is hidden in the umbilicus and reduces morbidity of minimally invasive surgery. The advantages of single-access laparoscopic surgery may include less bleeding, infection, and hernia formation and better cosmetic outcome and less pain. The disadvantages and limitations include longer surgery time, difficulty in learning the technique, and the need for specialized instruments. This review summarizes the history of SPAL hysterectomy (single-port access laparoscopy), and emphasizes nomenclature, surgical technique, instrumentation, and perioperative outcomes. Specific gynecological applications of single-port hysterectomy to date are summarized. Using the PubMed database, the English-language literature was reviewed for the past 40 years. Keyword searches included scarless, scar free, single-port/trocar/incision, single-port access laparoscopic hysterectomy. Within the bibliography of selected references, additional sources were retrieved. The purpose of the present article was to review the development and current status of SPAL hysterectomy and highlight important advances associated with this innovative approach.
The Frequency of Rapid Pupil Dilations as a Measure of Linguistic Processing Difficulty.
Directory of Open Access Journals (Sweden)
Vera Demberg
Full Text Available While it has long been known that the pupil reacts to cognitive load, pupil size has received little attention in cognitive research because of its long latency and the difficulty of separating effects of cognitive load from the light reflex or effects due to eye movements. A novel measure, the Index of Cognitive Activity (ICA, relates cognitive effort to the frequency of small rapid dilations of the pupil. We report here on a total of seven experiments which test whether the ICA reliably indexes linguistically induced cognitive load: three experiments in reading (a manipulation of grammatical gender match/mismatch, an experiment of semantic fit, and an experiment comparing locally ambiguous subject versus object relative clauses, all in German, three dual-task experiments with simultaneous driving and spoken language comprehension (using the same manipulations as in the single-task reading experiments, and a visual world experiment comparing the processing of causal versus concessive discourse markers. These experiments are the first to investigate the effect and time course of the ICA in language processing. All of our experiments support the idea that the ICA indexes linguistic processing difficulty. The effects of our linguistic manipulations on the ICA are consistent for reading and auditory presentation. Furthermore, our experiments show that the ICA allows for usage within a multi-task paradigm. Its robustness with respect to eye movements means that it is a valid measure of processing difficulty for usage within the visual world paradigm, which will allow researchers to assess both visual attention and processing difficulty at the same time, using an eye-tracker. We argue that the ICA is indicative of activity in the locus caeruleus area of the brain stem, which has recently also been linked to P600 effects observed in psycholinguistic EEG experiments.
Attitude towards Innovation and Barriers in Capital Access
Directory of Open Access Journals (Sweden)
Katarzyna Prędkiewicz
2017-06-01
Full Text Available The goal of the study is to verify whether there is a relation between a company’s declared innovation strategy and declared problems with access to capital. The research is based on a survey that covers more than 400 companies operating in Poland. Beside the self-assessment approach to evaluation of financial constraints and level of innovativeness of the company, an analysis of financial data was employed in the study. Chi-squared, Welch’s t-test, ANOVA and the ordered logit model were used to test the hypotheses. It was proved that there is relation between innovation strategy and financial constraints. The firms that are moderate innovators are financially constrained more than strong innovators, which can be linked with their better financial condition. Research confirms also that SMEs are still in a worse position compared to large enterprises in the area of access to different sources of capital. Secondly, innovative companies are exposed to additional difficulties in raising funds successfully, which confirms the validity of the used dedicated tools as a subsidy by authorities.
Online access to doctors' notes: patient concerns about privacy.
Vodicka, Elisabeth; Mejilla, Roanne; Leveille, Suzanne G; Ralston, James D; Darer, Jonathan D; Delbanco, Tom; Walker, Jan; Elmore, Joann G
2013-09-26
Offering patients online access to medical records, including doctors' visit notes, holds considerable potential to improve care. However, patients may worry about loss of privacy when accessing personal health information through Internet-based patient portals. The OpenNotes study provided patients at three US health care institutions with online access to their primary care doctors' notes and then collected survey data about their experiences, including their concerns about privacy before and after participation in the intervention. To identify patients' attitudes toward privacy when given electronic access to their medical records, including visit notes. The design used a nested cohort study of patients surveyed at baseline and after a 1-year period during which they were invited to read their visit notes through secure patient portals. Participants consisted of 3874 primary care patients from Beth Israel Deaconess Medical Center (Boston, MA), Geisinger Health System (Danville, PA), and Harborview Medical Center (Seattle, WA) who completed surveys before and after the OpenNotes intervention. The measures were patient-reported levels of concern regarding privacy associated with online access to visit notes. 32.91% of patients (1275/3874 respondents) reported concerns about privacy at baseline versus 36.63% (1419/3874 respondents) post-intervention. Baseline concerns were associated with non-white race/ethnicity and lower confidence in communicating with doctors, but were not associated with choosing to read notes or desire for continued online access post-intervention (nearly all patients with notes available chose to read them and wanted continued access). While the level of concern among most participants did not change during the intervention, 15.54% (602/3874 respondents, excluding participants who responded "don't know") reported more concern post-intervention, and 12.73% (493/3874 respondents, excluding participants who responded "don't know") reported less
Annual Report to Parliament Access to Information Act International ...
International Development Research Centre (IDRC) Digital Library (Canada)
leonardi
Part 6: Completion time of consultations on Cabinet confidences . ... The Act gives Canadian citizens and permanent residents the right to have access to federal government ... The ATIP Coordinator works with IDRC's Information Management .... to its employees on the Act. However, a training program was developed and.
EXPLORING STUDENTS‟ DIFFICULTIES IN READING ACADEMIC TEXTS
Directory of Open Access Journals (Sweden)
Ira Ernawati
2017-04-01
Full Text Available Academic texts play an important role for university students. However, those texts are considered difficult. This study is intended to investigate students‘ difficulties in reading academic texts. The qualitative approach was employed in this study. The design was a case study. The participants were ten students from fifth semester of CLS: EE (Classroom Language and Strategy: Explaining and Exemplifying class who were selected by using purposive sampling. The data were gathered from students‘ journal reflections, observation, and interview. The finding shows that the students encountered reading difficulties in area of textual factors, namely vocabulary, comprehending specific information, text organization, and grammar and human factors including background knowledge, mood, laziness, and time constraint.
McKeague, Lynn; Morant, Nicola; Blackshaw, Emily; Brown, June
2017-01-01
Background: Adolescents with emotional difficulties need accessible, acceptable and evidence-based mental health interventions. Self-referral workshops (DISCOVER workshops) were offered to stressed 16- to 19-year olds in 10 Inner London schools. Method: Semistructured interviews were conducted with three groups of par- ticipants: students who attended a 1-day workshop (n = 15); students who initially showed interest in the DIS- COVER workshop programme, but decided not to take part (n = 9); a...
Gender and access to education in Asia
Jayaweera, Swarna
1987-12-01
Attention has been focused in recent years by international agencies and national governments in Asia on the need to extend educational opportunity and to universalize at least the first level of education. The resource constraints of economically developing societies have militated against reaching these goals. Statistics of gender-based enrolment at all three levels of education show that equal access of women to education even at the first level is an almost illusory goal for six countries in South Asia. Gender disparities in educational participation are seen to be minimal in other countries except in vocational education. It is argued that while economic difficulties are a major constraint to educational opportunity, patriarchal social structures have also operated as a significant barrier in economically disadvantaged countries.
Ambur, Manjula Y.; Adams, David L.; Trinidad, P. Paul
1997-01-01
NASA Langley Technical Library has been involved in developing systems for full-text information delivery of NACA/NASA technical reports since 1991. This paper will describe the two prototypes it has developed and the present production system configuration. The prototype systems are a NACA CD-ROM of thirty-three classic paper NACA reports and a network-based Full-text Electronic Reports Documents System (FEDS) constructed from both paper and electronic formats of NACA and NASA reports. The production system is the DigiDoc System (DIGItal Documents) presently being developed based on the experiences gained from the two prototypes. DigiDoc configuration integrates the on-line catalog database World Wide Web interface and PDF technology to provide a powerful and flexible search and retrieval system. It describes in detail significant achievements and lessons learned in terms of data conversion, storage technologies, full-text searching and retrieval, and image databases. The conclusions from the experiences of digitization and full- text access and future plans for DigiDoc system implementation are discussed.
STRATEGIES OF COPING WITH DIFFICULTIES DURING RESEARCH PERFORMED BY YOUNG SCIENTISTS
Directory of Open Access Journals (Sweden)
Tatiana G. Bokhan
2017-03-01
Full Text Available Introduction: young scientists engaged in creative activities face difficulties during scientific research, implementation and commercialisation of the results. The impossibility of coping with obstacles leads to the impairment of motivational and creative activity. The problem of studying the main semantic contents of difficult situations and strategies to cope with them becomes relevant as it is conducive to the process of personal development of young scientists. Materials and Methods: the authors used a questionnaire with open-ended questions for revealing the main difficulties and coping strategies in the process of research activity; COPE questionnaire adapted by E. Rasskazova, T. Gordeyeva, E. Osin; Style of Self-Regulation of Behaviour technique by V. I. Morosanova. Statistical data processing was carried out with descriptive statistics methods, analysis of frequencies, factor analysis (Varimax rotation with Kaiser normalisation, cluster analysis (furthest neighbour method and Ward’s method. Results: eight main semantic categories related to difficulties experienced in the process of performing the research work have been detected. The main ways of coping with arising difficulties have been identified. Types of respondents different in terms of coping strategies and regulatory-behavioural characteristics have been distinguished. Discussion and Conclusions: difficulties of self-organisation in time for realisation of new meanings, difficulties in structuring the research work and search for information act as psychological barriers provoking mental stress. The most efficient coping strategies in respondents are strategies Active coping and search for positive meaning and personal development. The inefficient coping strategy with difficulties complicating the process of self-development is Avoiding problems strategies.
ERRORS AND DIFFICULTIES IN TRANSLATING LEGAL TEXTS
Directory of Open Access Journals (Sweden)
Camelia, CHIRILA
2014-11-01
Full Text Available Nowadays the accurate translation of legal texts has become highly important as the mistranslation of a passage in a contract, for example, could lead to lawsuits and loss of money. Consequently, the translation of legal texts to other languages faces many difficulties and only professional translators specialised in legal translation should deal with the translation of legal documents and scholarly writings. The purpose of this paper is to analyze translation from three perspectives: translation quality, errors and difficulties encountered in translating legal texts and consequences of such errors in professional translation. First of all, the paper points out the importance of performing a good and correct translation, which is one of the most important elements to be considered when discussing translation. Furthermore, the paper presents an overview of the errors and difficulties in translating texts and of the consequences of errors in professional translation, with applications to the field of law. The paper is also an approach to the differences between languages (English and Romanian that can hinder comprehension for those who have embarked upon the difficult task of translation. The research method that I have used to achieve the objectives of the paper was the content analysis of various Romanian and foreign authors' works.
Tremblay, Christopher W.
2011-01-01
College Access Marketing (CAM) is a relatively new phenomenon that seeks to positively influence the college-going rate. This report defines CAM, describes CAM examples, and discusses how CAM seeks to counter barriers to college. It explores four main elements of CAM: information, marketing, advocacy, and social mobilization. Further, it…
Directory of Open Access Journals (Sweden)
Chen-Wei Pan
Full Text Available Managing stairs is a challenging aspect of daily activities of living for older people. We assessed whether older adults with visual impairment (VI have greater difficulties of managing stairs in daily lives.The study was designed as a community-based cross-sectional study based on a Chinese cohort aged 60 years and older in rural China. Visual acuity (VA was measured in both eyes using a retro-illuminated Snellen chart with tumbling-E optotypes. VI (including blindness was defined as presenting VA of worse than 20/60 in either eye. Having any difficulties in managing stairs was self-reported based on a question drawn from the Barthel Index. Information on participants' socioeconomic status, lifestyle-related factors, diseases histories and medication intake was collected using a questionnaire.The Barthel Index, Activities of Daily Living questionnaire was completed by 4597 (99.7% participants including 2218 men and 2379 women. The age of the participants ranged from 60 to 93 years with a mean of 67.6 ± 6.3 years. In age and gender adjusted models, adults with VI had a higher likelihood of having difficulties in managing stairs (odds ratio [OR] = 2.7; 95% confidence interval [CI] 2.0, 3.7 compared with those without. The association of VI with the likelihood of having difficulties in managing stairs was stronger in older adults who lived alone (OR = 3.2; 95%CI 1.8, 4.5 compared with those who lived with other family members (OR = 2.0; 95%CI 1.3, 4.3. Compared with hypertension, diabetes, obesity and cognitive dysfunction, VI had the greatest impact on people's abilities of managing stairs.VI was associated with an increased likelihood of having difficulties in managing stairs, especially in those who lived alone. However, whether the finding could be extrapolated to other populations warrants further studies as different environmental exposures such as illumination and types of stairs may alter the association observed in this study.
A Theoretical Framework towards Understanding of Emotional and Behavioural Difficulties
Poulou, Maria S.
2014-01-01
Children's emotional and behavioural difficulties are the result of multiple individual, social and contextual factors working in concert. The current paper proposes a theoretical framework to interpret students' emotional and behavioural difficulties in schools, by taking into consideration teacher-student relationships, students'…
47 CFR 76.978 - Leased access annual reporting requirement.
2010-10-01
... against the cable system with the Commission or a Federal district court regarding a commercial leased..., which provides the following information for the calendar year: (1) The number of commercial leased... commercial leased access channel. (3) The rates the cable system charges for full-time and part-time leased...
Rural providers' access to online resources: a randomized controlled trial
Hall, Laura J.; McElfresh, Karen R.; Warner, Teddy D.; Stromberg, Tiffany L.; Trost, Jaren; Jelinek, Devin A.
2016-01-01
Objective The research determined the usage and satisfaction levels with one of two point-of-care (PoC) resources among health care providers in a rural state. Methods In this randomized controlled trial, twenty-eight health care providers in rural areas were stratified by occupation and region, then randomized into either the DynaMed or the AccessMedicine study arm. Study participants were physicians, physician assistants, and nurses. A pre- and post-study survey measured participants' attitudes toward different information resources and their information-seeking activities. Medical student investigators provided training and technical support for participants. Data analyses consisted of analysis of variance (ANOVA), paired t tests, and Cohen's d statistic to compare pre- and post-study effects sizes. Results Participants in both the DynaMed and the AccessMedicine arms of the study reported increased satisfaction with their respective PoC resource, as expected. Participants in both arms also reported that they saved time in finding needed information. At baseline, both arms reported too little information available, which increased to “about right amounts of information” at the completion of the study. DynaMed users reported a Cohen's d increase of +1.50 compared to AccessMedicine users' reported use of 0.82. DynaMed users reported d2 satisfaction increases of 9.48 versus AccessMedicine satisfaction increases of 0.59 using a Cohen's d. Conclusion Participants in the DynaMed arm of the study used this clinically oriented PoC more heavily than the users of the textbook-based AccessMedicine. In terms of user satisfaction, DynaMed users reported higher levels of satisfaction than the users of AccessMedicine. PMID:26807050
Observations on Student Difficulties with Mathematics in Upper-Division Electricity and Magnetism
Pepper, Rachel E.; Chasteen, Stephanie V.; Pollock, Steven J.; Perkins, Katherine K.
2012-01-01
We discuss common difficulties in upper-division electricity and magnetism (E&M) in the areas of Gauss's law, vector calculus, and electric potential using both quantitative and qualitative evidence. We also show that many of these topical difficulties may be tied to student difficulties with mathematics. At the junior level, some students…
Identifying predictors of physics item difficulty: A linear regression approach
Mesic, Vanes; Muratovic, Hasnija
2011-06-01
Large-scale assessments of student achievement in physics are often approached with an intention to discriminate students based on the attained level of their physics competencies. Therefore, for purposes of test design, it is important that items display an acceptable discriminatory behavior. To that end, it is recommended to avoid extraordinary difficult and very easy items. Knowing the factors that influence physics item difficulty makes it possible to model the item difficulty even before the first pilot study is conducted. Thus, by identifying predictors of physics item difficulty, we can improve the test-design process. Furthermore, we get additional qualitative feedback regarding the basic aspects of student cognitive achievement in physics that are directly responsible for the obtained, quantitative test results. In this study, we conducted a secondary analysis of data that came from two large-scale assessments of student physics achievement at the end of compulsory education in Bosnia and Herzegovina. Foremost, we explored the concept of “physics competence” and performed a content analysis of 123 physics items that were included within the above-mentioned assessments. Thereafter, an item database was created. Items were described by variables which reflect some basic cognitive aspects of physics competence. For each of the assessments, Rasch item difficulties were calculated in separate analyses. In order to make the item difficulties from different assessments comparable, a virtual test equating procedure had to be implemented. Finally, a regression model of physics item difficulty was created. It has been shown that 61.2% of item difficulty variance can be explained by factors which reflect the automaticity, complexity, and modality of the knowledge structure that is relevant for generating the most probable correct solution, as well as by the divergence of required thinking and interference effects between intuitive and formal physics knowledge
Identifying predictors of physics item difficulty: A linear regression approach
Directory of Open Access Journals (Sweden)
Hasnija Muratovic
2011-06-01
Full Text Available Large-scale assessments of student achievement in physics are often approached with an intention to discriminate students based on the attained level of their physics competencies. Therefore, for purposes of test design, it is important that items display an acceptable discriminatory behavior. To that end, it is recommended to avoid extraordinary difficult and very easy items. Knowing the factors that influence physics item difficulty makes it possible to model the item difficulty even before the first pilot study is conducted. Thus, by identifying predictors of physics item difficulty, we can improve the test-design process. Furthermore, we get additional qualitative feedback regarding the basic aspects of student cognitive achievement in physics that are directly responsible for the obtained, quantitative test results. In this study, we conducted a secondary analysis of data that came from two large-scale assessments of student physics achievement at the end of compulsory education in Bosnia and Herzegovina. Foremost, we explored the concept of “physics competence” and performed a content analysis of 123 physics items that were included within the above-mentioned assessments. Thereafter, an item database was created. Items were described by variables which reflect some basic cognitive aspects of physics competence. For each of the assessments, Rasch item difficulties were calculated in separate analyses. In order to make the item difficulties from different assessments comparable, a virtual test equating procedure had to be implemented. Finally, a regression model of physics item difficulty was created. It has been shown that 61.2% of item difficulty variance can be explained by factors which reflect the automaticity, complexity, and modality of the knowledge structure that is relevant for generating the most probable correct solution, as well as by the divergence of required thinking and interference effects between intuitive and formal
Employment status, difficulties at work and quality of life in inflammatory bowel disease patients.
De Boer, Angela G E M; Bennebroek Evertsz', Floor; Stokkers, Pieter C; Bockting, Claudia L; Sanderman, Robert; Hommes, Daniel W; Sprangers, Mirjam A G; Frings-Dresen, Monique H W
2016-10-01
To assess employment status, difficulties at work and sick leave in inflammatory bowel disease (IBD) patients and their relation with sociodemographic and clinical factors, quality of life (QoL), and anxiety and depression. IBD patients attending an IBD outpatients' clinic received self-report questionnaires on employment status, IBD-related difficulties at work and sick leave (Trimbos/iMTA questionnaire for Costs associated with Psychiatric Illness), sociodemographic factors, QoL (Inflammatory Bowel Disease Questionnaire and 12-item Short-form Health Survey) and anxiety and depression (Hospital Anxiety and Depression Scale). Disease activity was assessed by their gastroenterologist. Associations between paid employment and sick leave with sociodemographic and clinical factors, QoL and anxiety and depression were assessed by regression analyses. In total, 202 IBD patients of working age, with a mean age of 41 years, participated; 63% had Crohn's disease and 37% had ulcerative colitis, and 57% were women and 19% had active disease. In all, 123 (61%) patients were in paid employment, of whom 31 (25%) were on sick leave, whereas 46 (23%) received a disability pension. Concentration problems (72%), low working pace (78%) and delayed work production (50%) were the most prevalent IBD-related work difficulties. IBD patients without paid employment were older and more often women, with active disease, lower QoL and higher anxiety and depression rates. Sick leave was associated with lower QoL and higher anxiety and depression rates. More than half of IBD patients were in paid employment, whereas almost a quarter was receiving a disability pension. A large majority experienced work difficulties. Having no paid employment was associated with poorer QoL and more anxiety and depression symptomatology.
Disability in post-earthquake Haiti: prevalence and inequality in access to services.
Danquah, Lisa; Polack, Sarah; Brus, Aude; Mactaggart, Islay; Houdon, Claire Perrin; Senia, Patrick; Gallien, Pierre; Kuper, Hannah
2015-01-01
To assess the prevalence of disability and service needs in post-earthquake Haiti, and to compare the inclusion and living conditions of people with disabilities to those without disabilities. A population-based prevalence survey of disability was undertaken in 2012 in Port-au-Prince region, which was at the centre of the earthquake in 2010. Sixty clusters of 50 people aged 5 + years were selected with probability proportionate to size sampling and screened for disability (Washington Group short set questionnaire). A case-control study was undertaken, nested within the survey, matching cases to controls by age, gender and cluster. There was additional case finding to identify further children with disabilities. Information was collected on: socioeconomic status, education, livelihood, health, activities, participation and barriers. The prevalence of disability was 4.1% (3.4-4.7%) across 3132 eligible individuals. The earthquake was the second leading cause of disability. Disability was more common with increasing age, but unrelated to poverty. Large gaps existed in access of services for people with disabilities. Adults with disabilities were less likely to be literate or work and more likely to visit health services than adults without disabilities. Children with disabilities were less likely to be currently enrolled at school compared to controls. Children and adults with disabilities reported more activity limitations and participation restriction. Further focus is needed to improve inclusion of people with disabilities in post-earthquake Haiti to ensure that their rights are fulfilled. Almost one in six households in this region of Haiti included a person with a disability, and the earthquake was the second leading cause of disability. Fewer than half of people who reported needing medical rehabilitation had received this service. The leading reported barriers to the uptake of health services included financial constraints (50%) and difficulties with
Newton, Caroline
2012-01-01
There are some children with speech and/or language difficulties who are significantly more difficult to understand in connected speech than in single words. The study reported here explores the between-word behaviours of three such children, aged 11;8, 12;2 and 12;10. It focuses on whether these patterns could be accounted for by lenition, as…
Comparative Study of Periodical Literature Indexing: Print versus Electronic Access. Final Report.
Lowry, Charles B.
This 2-year project at the University of Texas at Arlington (UTA) was conducted to determine the feasibility of providing online periodical indexing to the journal holdings of the UTA libraries by demonstrating an extended use of the libraries' NOTIS Online Public Access Catalog (OPAC) to provide better access to local resources. Three approaches…
Emotional and Personality-Related Aspects of Career-Decision-Making Difficulties
Saka, Noa; Gati, Itamar; Kelly, Kevin R.
2008-01-01
This research focuses on developing a theoretical framework for analyzing the emotional and personality-related aspects of career-decision-making difficulties. The proposed model is comprised of three major clusters: pessimistic views, anxiety, and self-concept and identity. In Study 1, the Emotional and Personality Career Difficulties Scale…
School Success for Kids with Dyslexia and Other Reading Difficulties
Dunson, Walter E.
2012-01-01
"School Success for Kids With Dyslexia and Other Reading Difficulties" provides parents and teachers with goals that will meet the needs of students who are struggling with reading, leading them to work through their difficulties and enjoy reading. It includes information, assessments, and techniques that parents, teachers, and school…
HIV/AIDS programmes should focus on improved access.
Manning, A
2000-10-14
This paper discusses the need for HIV/AIDS programs in sub-Saharan countries to focus more on improved access to information to empower poor people living in remote areas. It is noted that despite Glaxo Wellcome's move to reduce the cost of antiretroviral therapy, it is unlikely to have an impact on most of those infected with or affected by HIV/AIDS, since concerns regarding lack of sustainability, bureaucratic administration, and communication difficulties predominate in the country. In this regard, it is therefore recommended that national HIV/AIDS programs be balanced with the needs of both the community and the individual and in prevention and care. Health workers should be explicit in confronting traditional beliefs, such as those about gender roles and traditional medicine, in prevention campaigns. Moreover, there is also an urgent need to improve access to condoms; strengthen health programs such as directly observed treatment short-term (DOTS) courses for tuberculosis and the syndromic approach to sexually transmitted disease treatment; and improve practical support to communities caring for those who are sick and the orphans. Lastly, all partners working with prevention programs should use the more positive community attitudes towards HIV/AIDS issues seen in many sub-Saharan countries to develop evidence-based programs that focus more on improved access and less on sustainability.
Difficulties in emotion regulation in patients with eating disorders
Ruscitti, Catherine; Rufino, Katrina; Goodwin, Natalie; Wagner, Rebecca
2016-01-01
Background A defining characteristic of eating disorders (EDs) is difficulty with emotion regulation (ER). Previous research indicates that ED subtypes demonstrate differing ER difficulties. Specifically, individuals with Anorexia Nervosa (AN) or Bulimia Nervosa (BN) show greater impairment in their ability to regulate emotions in areas such as achieving goals while upset, reacting impulsively to distress, and effectively using coping strategies, as compared to those with Binge Eating Disorde...
Paz-Bailey, Gabriela; Isern Fernandez, Virginia; Morales Miranda, Sonia; Jacobson, Jerry O; Mendoza, Suyapa; Paredes, Mayte A; Danaval, Damien C; Mabey, David; Monterroso, Edgar
2012-01-01
We conducted a study among HIV-positive men and women in Honduras to describe demographics, HIV risk behaviors and sexually transmitted infection prevalence, and identify correlates of unsafe sex. Participants were recruited from HIV clinics and nongovernmental organizations in Tegucigalpa and San Pedro Sula, Honduras in a cross-sectional study in 2006. We used audio-assisted computer interviews on demographics; behaviors in the past 12 months, 6 months, and 30 days; and access to care. Assays performed included herpes (HSV-2 Herpes Select), syphilis (rapid plasma reagin [RPR] and Treponema pallidum particle agglutination assay [TPPA]) serology, and other sexually transmitted infections by polymerase chain reaction (PCR). Bivariate and multivariate analyses were conducted to assess variables associated with unprotected sex across all partner types in the past 12 months. Of 810 participants, 400 were from Tegucigalpa and 410 from San Pedro Sula; 367 (45%) were men. Mean age was 37 years (interquartile range: 31-43). Consistent condom use for men and women was below 60% for all partner types. In multivariate analysis, unprotected sex was more likely among women (odds ratio [OR]: 1.9, 95% confidence interval [CI]: 1.2-3.1, P = 0.007), those with HIV diagnoses within the past year (OR: 2.0, 95% CI: 1.1-3.7, P = 0.016), those reporting difficulty accessing condoms (OR: 2.6, 95% CI: 1.4-4.7, P = 0.003), and those reporting discrimination (OR: 1.8, 95% CI: 1.1-3.0, P = 0.016). Programs targeting HIV-positive patients need to address gender-based disparities, improve condom access and use, and help establish a protective legal and policy environment free of stigma and discrimination.
Psychosocial difficulties from the perspective of persons with neuropsychiatric disorders.
Coenen, Michaela; Cabello, Maria; Umlauf, Silvia; Ayuso-Mateos, José Luis; Anczewska, Marta; Tourunen, Jouni; Leonardi, Matilde; Cieza, Alarcos
2016-01-01
The objective of this study is to determine whether persons with neuropsychiatric disorders experience a common set of psychosocial difficulties using qualitative data from focus groups and individual interviews. The study was performed in five European countries (Finland, Italy, Germany, Poland and Spain) using the focus groups and individual interviews with persons with nine neuropsychiatric disorders (dementia, depression, epilepsy, migraine, multiple sclerosis, Parkinson's disease, schizophrenia, stroke and substance dependence). Digitally recorded sessions were analysed using a step-by-step qualitative and quantitative methodology resulting in the compilation of a common set of psychosocial difficulties using the International Classification of Functioning, Disability and Health (ICF) as a framework. Sixty-seven persons participated in the study. Most persons with neuropsychiatric disorders experience difficulties in emotional functions, sleeping, carrying out daily routine, working and interpersonal relationships in common. Sixteen out of 33 psychosocial difficulties made up the common set. This set includes mental functions, pain and issues addressing activities and participation and provides first evidence for the hypothesis of horizontal epidemiology of psychosocial difficulties in neuropsychiatric disorders. This study provides information about psychosocial difficulties that should be covered in the treatment and rehabilitation of persons with neuropsychiatric disorders regardless of clinical diagnoses. Emotional problems, work and sleep problems should be addressed in all the treatments of neuropsychiatric disorders regardless of their specific diagnosis, etiology and severity. Personality issues should be targeted in the treatment for neurological disorders, whereas communication skill training may also be useful for mental disorders. The effects of medication and social environment on patient's daily life should be considered in all the
Summary Report of the Consultant's Meeting on Further Development of EXFOR
International Nuclear Information System (INIS)
Brown, D.; Simakov, S.
2012-04-01
The Meeting was convened to assess needs and ways for improvement and development of the EXFOR formats to meet future requirements. Participants reported the difficulties of coding complex nuclear reaction and supplemental experimental information in the present EXFOR exchange format, shared their experiences from work with other databases and formats (ENDF/GND, NRDF, ROOT, XSAMS). The general consensus was achieved on the necessity to explore further extensions of the exchange format to facilitate the coding of experimental results, continue development of EXFOR/XML output for easier access and intercommunication with other databases, further development of editors and other software for compilers, establish integrated EXFOR documentation and knowledge database to aid compilers and general users. (author)
Experiences in accessing the U.S. equity markets
International Nuclear Information System (INIS)
Gosbee, G. F. J.
1998-01-01
This paper was designed to deal with three issues: (1) reasons for the difficulty of attracting U.S. capital into Canada; (2) Canadian companies' need for U.S. capital, and (3) how to successfully attract U.S. capital. As far as the reasons for the difficulties of attracting U.S. capital are concerned, intense world-wide competition for U.S. capital, the relatively small capital needs in Canada, the relatively poorly developed reporting practices, passive management and shareholders, and Canada's more stringent regulatory practices were highlighted as being most responsible. As to whether Canadian companies need U.S. capital, the answer was in the affirmative, citing multiple expansion, shareholder base diversification and the large equity raising power of the U.S. market as contributing factors. With regard to attracting U.S. capital into Canada, the advice given included differentiating the company, adopting U.S. reporting practices, addressing regulatory concerns, obtaining U.S.listings, and outperforming competitors
Communication difficulties between radiobiologists and radiotherapists
International Nuclear Information System (INIS)
Revesz, L.
1977-01-01
The communication difficulties between radiobiologists and radiotherapists are attributable to the existence of two cultures in radiology, separated by different philosophies, values, standards and attitudes. Integrated education in the separate branches of science and joint experimental ventures are proposed in order to develop unifying concepts. (author)
Binomial test models and item difficulty
van der Linden, Willem J.
1979-01-01
In choosing a binomial test model, it is important to know exactly what conditions are imposed on item difficulty. In this paper these conditions are examined for both a deterministic and a stochastic conception of item responses. It appears that they are more restrictive than is generally
Early Identification of Reading Comprehension Difficulties
Catts, Hugh W.; Nielsen, Diane Corcoran; Bridges, Mindy Sittner; Liu, Yi-Syuan
2016-01-01
Most research on early identification of reading disabilities has focused on word reading problems and little attention has been given to reading comprehension difficulties. In this study, we investigated whether measures of language ability and/or response to language intervention in kindergarten uniquely predicted reading comprehension…
Applying a Systemic Procedure to Locate Career Decision-Making Difficulties
Gati, Itamar; Amir, Tamar
2010-01-01
Locating clients' career decision-making difficulties is one of the first steps in career counseling. The authors demonstrate the feasibility and utility of a systematic 4-stage procedure for locating and interpreting career decision-making difficulties by analyzing responses of 626 college students (collected by Tai, 2007) to the Career…
FEEDING DIFFICULTIES IN PRESCHOOL CHILDREN, PREVIOUS FEEDING PRACTICES, AND NUTRITIONAL STATUS.
Maranhão, Hélcio de Sousa; Aguiar, Renata Cunha de; Lira, Débora Teixeira Jales de; Sales, Mônica Úrsula Figuerêdo; Nóbrega, Nathalia Ávila do Nascimento
2018-01-01
To identify the prevalence of feeding difficulties in preschoolers, its association with epidemiological factors and previous eating habits, and repercussion on nutritional status. Cross-sectional study with a questionnaire given to the mothers of 301 children aged 2-6 years enrolled in public and private kindergartens in Natal, Northeast Brazil, conducted in 2014-2015. Feeding difficulty was assessed according to Kerzner's criteria, resulting in the profiles "highly selective intake", "active child with small appetite", "fear of feeding", and "child with psychological disorder or neglected". Association with the following independent variables was analyzed by logistic regression: breastfeeding time, age of cows' milk and complementary feeding introduction, age range, family income, type of school, mothers' profile (responsive or nonresponsive), and body mass index (BMI). Feeding difficulty was found in 37.2% of cases, with predominance of "highly selective intake" (25.4%). It was not associated with infancy feeding practices, family income or type of school. There were no differences between the BMI Z score means for the groups with and without feeding difficulty (1.0±1.5 SD and 1.1±1.4 SD, respectively). The five-to-six age range had more occurrences (OR 1.8; 95%CI 1.1-2.9). Children of responsive mothers were less likely to have feeding difficulties (OR 0.4; 95%CI 0.2-0.8). Feeding difficulties were very frequent. Nutritional status was not impacted by it, and infancy eating habits were not associated with it. Responsive mothers' profile is a protective factor against eating difficulties and reinforces the importance of behavioral factors and mother-child interaction.
Molecular accessibility in solvent swelled coals. Quarterly report
Energy Technology Data Exchange (ETDEWEB)
Kispert, L.D.
1993-02-01
An EPR technique developed in this lab is being used to determine the pore size and number distribution changes after swelling the coal samples with various solvents. Stable nitroxide radical spin probes of different sizes, shapes and reactivity are dissolved in an appropriate solvent, the coal sample is added to the resulting solution, stirred over night at elevated temperature, filtered, washed with a non swelling solvent to eliminate any spin probes that are not trapped in the pores and the spin concentration is measured. Comparing these spin probe measurements to DRIFT data have shown that the relative number distribution of acidic functionalities can be accurately predicted by the spin probe method. The spin probe method had also been used to predict the increase in elongated voids in Pittsburgh No. 8 (APCS No. 4) upon swelling with pyridine in agreement with independent SANS data. NMR relaxation data show that it is possible to deduce the pore (accessibility) distribution as a function of size (up to 6 mn). It has also been possible by variable temperature and ENDOR measurements to determine the presence of hydrogen bonding as a function of pore shape and size. The advantage of the EPR method is that it permits molecules of selected shape and size to be used as probes of accessible regions of coal, thus providing information on the importance of molecular shape.
Schneider, Marguerite
2009-01-01
This article discusses the current efforts to measure disability in a comparable manner internationally, the effects of using different types of wording in questions, and the implications of the approach of asking about 'difficulties' rather than 'disability' on the use of disability statistics. The study design was qualitative. Twenty-one focus groups were run with adults responding for themselves. Nine groups were classified a priori by the author as 'disabled', six as 'unsure', and the last six as 'non-disabled'. The participants completed a questionnaire using the Washington Group on Disability Statistics (WG) Short Set, the South African Census 2001 question, and the question 'Are you disabled?'. This was followed by group discussion on these questions and on how the concept of disability is understood by group participants. Participants understand disability as being a permanent, unchangeable state, mostly physical, and where a person is unable to do anything. The participants in the three groups of allocated disability status (disabled, unsure and non-disabled) provided quite different responses on the three questions. All participants in the 'disabled' and 'unsure' groups reported having 'difficulty' on the WG questions, but the 'unsure' groups did not identify as being 'disabled' on either of the two other questions. Using questions that ask about 'difficulty' rather than 'disability' provides a more comprehensive and inclusive measure of disability with a clearer understanding of what is being measured. Asking about 'difficulty' provides an improved measure of disability status for effective data collection and analysis to promote development, implementation and monitoring of disability-inclusive policies.
O'Hare, Anne; Khalid, Shabana
2002-01-01
Children with developmental coordination disorder/dyspraxia (DCD) are at high risk of reading and writing delay. The difficulties with motor skills are heterogeneous and many children have features of poor cerebellar function, reflected in problems with posture, balance and fast accurate control of movement. This study confirmed a high level of parental reporting of reading and writing delay in a clinical group of 23 children with DCD, defined on the basis of both clinical examination and standardized testing of motor function. Direct measurement of reading delay, identified still further children in the group. Those children with reading delay had associated findings typical of phonological awareness difficulties. The children also underwent a standardized test of neurological function and although they all had difficulties with cerebellar function, no distinctive pattern emerged for those whose presentation was complicated by delayed reading and writing. Both the children with DCD and 136 typically developing children, completed the pilot parental questionnaire on gross motor skills. The three skills of catching a ball, jumping on a moving playground roundabout and handwriting, distinguished the children with DCD. This study therefore confirms that children with DCD should be assessed for difficulties in phonological awareness. Additionally, children aged between 7 and 12 years are on the whole, highly competent in a range of gross motor skills and further study might determine whether a simple parental questionnaire might detect children who would benefit from further assessment. The study also suggests that all the children with DCD have cerebellar dysfunction and further work with a larger group might determine particular patterns associated with reading delay.