WorldWideScience

Sample records for reported difficulties accessing

  1. Access to care for children with emotional/behavioral difficulties.

    Science.gov (United States)

    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.

  2. ACCESS Project: Final Report

    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

  3. DIFFICULTIeS OF TOTAL HIP REPLACEMENT IN PATIENTS WITH ANKYLOSING SPONDYLITIS (case report

    Directory of Open Access Journals (Sweden)

    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.

  4. Quality assurance issues in the teacher-based assessment of students with literacy difficulties for examination access arrangements.

    Science.gov (United States)

    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.

  5. The consequences of language proficiency and difficulty of lexical access for translation performance and priming.

    Science.gov (United States)

    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.

  6. 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.

  7. Prevalence and predictors of difficulty accessing the mouths of intubated critically ill adults to deliver oral care: An observational study.

    Science.gov (United States)

    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

  8. Do difficulties in accessing in-hours primary care predict higher use of out-of-hours GP services? Evidence from an English National Patient Survey.

    Science.gov (United States)

    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.

  9. Defective Number Sense or Impaired Access? Differential Impairments in Different Subgroups of Children with Mathematics Difficulties

    Science.gov (United States)

    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…

  10. People with Hemianopia Report Difficulty with TV, Computer, Cinema Use, and Photography.

    Science.gov (United States)

    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.

  11. Access 2007 forms and reports for dummies

    CERN Document Server

    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

  12. Patient-reported speech in noise difficulties and hyperacusis symptoms and correlation with test results.

    Science.gov (United States)

    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.

  13. Population Estimates, Health Care Characteristics, and Material Hardship Experiences of U.S. Children with Parent-Reported Speech-Language Difficulties: Evidence from Three Nationally Representative Surveys

    Science.gov (United States)

    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…

  14. Subject Access Project. Third Quarterly Report.

    Science.gov (United States)

    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…

  15. Self-reported learning difficulties and dietary intake in Norwegian adolescents.

    Science.gov (United States)

    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.

  16. Validity of a Protocol for Adult Self-Report of Dyslexia and Related Difficulties

    Science.gov (United States)

    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

  17. Self-reported difficulty in conceiving as a measure of infertility.

    Science.gov (United States)

    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.

  18. Surgical difficulties for Total Knee Replacement in Stickler syndrome: A case report

    Science.gov (United States)

    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

  19. Difficulties in daily life reported by patients with homonymous visual field defects

    NARCIS (Netherlands)

    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.

  20. Screening Bilingual Preschoolers for Language Difficulties: Utility of Teacher and Parent Reports

    Science.gov (United States)

    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…

  1. 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.

  2. Discrimination, other psychosocial stressors, and self-reported sleep duration and difficulties.

    Science.gov (United States)

    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.

  3. 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.

  4. Discrimination, Other Psychosocial Stressors, and Self-Reported Sleep Duration and Difficulties

    Science.gov (United States)

    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

  5. DIFFICULTIES RELATED TO THE FINANCIAL POSITION REPORTING INTO THE PUBLIC SECTOR IN ROMANIA

    OpenAIRE

    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...

  6. 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.

  7. Difficulties in accessing and availing of public health care systems among rural population in Chittoor District, Andhra Pradesh

    OpenAIRE

    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, ...

  8. Actigraphic and parental reports of sleep difficulties in children with attention-deficit/hyperactivity disorder

    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...

  9. 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.

  10. Strengths and difficulties in children with cochlear implants--comparing self-reports with reports from parents and teachers.

    Science.gov (United States)

    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.

  11. The Difficulties of Online Learning for Indigenous Australian Students Living in Remote Communities--It's an Issue of Access

    Science.gov (United States)

    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…

  12. Parent-reported indicators for detecting feeding and swallowing difficulties and undernutrition in preschool-aged children with cerebral palsy.

    Science.gov (United States)

    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.

  13. Dysfluencies in the speech of adults with intellectual disabilities and reported speech difficulties.

    Science.gov (United States)

    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

  14. Contributions of physical and cognitive impairments to self-reported driving difficulty in chronic whiplash-associated disorders.

    Science.gov (United States)

    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

  15. LTER network data access policy revision: report and recommendations.

    Science.gov (United States)

    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...

  16. 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...

  17. Attribution Style of Adolescents with School-Reported Social, Emotional and Behavioural Difficulties

    Science.gov (United States)

    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…

  18. Kinds of access: different methods for report reveal different kinds of metacognitive access

    Science.gov (United States)

    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

  19. Who walks? Factors associated with walking behavior in disabled older women with and without self-reported walking difficulty.

    Science.gov (United States)

    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.

  20. Self reported behavioral and emotional difficulties in relation to dentition status among school going children of Dilsukhnagar, Hyderabad, India

    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.

  1. Self reported behavioral and emotional difficulties in relation to dentition status among school going children of Dilsukhnagar, Hyderabad, India.

    Science.gov (United States)

    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.

  2. What can Parents' Self-report of Reading Difficulties Tell Us about Their Children's Emergent Literacy at School Entry?

    Science.gov (United States)

    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.

  3. Technical difficulties and its remedies in laparoscopic cholecystectomy in situs inversus totalis: A rare case report.

    Science.gov (United States)

    Arya, S V; Das, Anupam; Singh, Sunil; Kalwaniya, Dheer Singh; Sharma, Ashok; Thukral, B B

    2013-01-01

    Laparoscopic cholecystectomy is considered to be the gold standard surgical procedure for cholelithiasis and is one of the commonest surgical procedures in the world today. However, in rare cases of previously undiagnosed situs inversus totalis (with dextrocardia), the presentation of the cholecystitis, its diagnosis and the operative procedure can pose problems. We present here one such case and discuss how the diagnosis was made and difficulties encountered during surgery and how they were coped with. A 35 year old female presented with left hypochondrium pain and dyspepsia, for 2 years. A diagnosis of cholelithiasis with situs inversus was confirmed after thorough clinical examination, abdominal and chest X-rays and ultrasonography of the abdomen. Laparoscopic cholecystectomy, which is the standard treatment, was performed with numerous modifications in the positioning of the monitor, insufflator, ports and the position of the members of the surgical team and the laparoscopic instruments. The patient had an uneventful recovery. Situs inversus totalis is itself a rare condition and when associated with cholelithiasis poses a challenge in the management of the condition. We must appreciate the necessity of setting up the operating theatre, the positioning of the ports, the surgical team and the instruments. Therefore, it becomes important for the right handed surgeons to modify their techniques and establish a proper hand eye coordination to adapt to the mirror image anatomy of the Calot's triangle in a patient of situs inversus totalis. Copyright © 2013 Surgical Associates Ltd. Published by Elsevier Ltd. All rights reserved.

  4. OPTICA: Our Path Together Initiating Cultural Access. Final Report.

    Science.gov (United States)

    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…

  5. Families Affected by Huntington's Disease Report Difficulties in Communication, Emotional Involvement, and Problem Solving.

    Science.gov (United States)

    Jona, Celine M H; Labuschagne, Izelle; Mercieca, Emily-Clare; Fisher, Fiona; Gluyas, Cathy; Stout, Julie C; Andrews, Sophie C

    2017-01-01

    Family functioning in Huntington's disease (HD) is known from previous studies to be adversely affected. However, which aspects of family functioning are disrupted is unknown, limiting the empirical basis around which to create supportive interventions. The aim of the current study was to assess family functioning in HD families. We assessed family functioning in 61 participants (38 HD gene-expanded participants and 23 family members) using the McMaster Family Assessment Device (FAD; Epstein, Baldwin and Bishop, 1983), which provides scores for seven domains of functioning: Problem Solving; Communication; Affective Involvement; Affective Responsiveness; Behavior Control; Roles; and General Family Functioning. The most commonly reported disrupted domain for HD participants was Affective Involvement, which was reported by 39.5% of HD participants, followed closely by General Family Functioning (36.8%). For family members, the most commonly reported dysfunctional domains were Affective Involvement and Communication (both 52.2%). Furthermore, symptomatic HD participants reported more disruption to Problem Solving than pre-symptomatic HD participants. In terms of agreement between pre-symptomatic and symptomatic HD participants and their family members, all domains showed moderate to very good agreement. However, on average, family members rated Communication as more disrupted than their HD affected family member. These findings highlight the need to target areas of emotional engagement, communication skills and problem solving in family interventions in HD.

  6. Families Affected by Huntington’s Disease Report Difficulties in Communication, Emotional Involvement, and Problem Solving

    Science.gov (United States)

    Jona, Celine M.H.; Labuschagne, Izelle; Mercieca, Emily-Clare; Fisher, Fiona; Gluyas, Cathy; Stout, Julie C.; Andrews, Sophie C.

    2017-01-01

    Background: Family functioning in Huntington’s disease (HD) is known from previous studies to be adversely affected. However, which aspects of family functioning are disrupted is unknown, limiting the empirical basis around which to create supportive interventions. Objective: The aim of the current study was to assess family functioning in HD families. Methods: We assessed family functioning in 61 participants (38 HD gene-expanded participants and 23 family members) using the McMaster Family Assessment Device (FAD; Epstein, Baldwin and Bishop, 1983), which provides scores for seven domains of functioning: Problem Solving; Communication; Affective Involvement; Affective Responsiveness; Behavior Control; Roles; and General Family Functioning. Results: The most commonly reported disrupted domain for HD participants was Affective Involvement, which was reported by 39.5% of HD participants, followed closely by General Family Functioning (36.8%). For family members, the most commonly reported dysfunctional domains were Affective Involvement and Communication (both 52.2%). Furthermore, symptomatic HD participants reported more disruption to Problem Solving than pre-symptomatic HD participants. In terms of agreement between pre-symptomatic and symptomatic HD participants and their family members, all domains showed moderate to very good agreement. However, on average, family members rated Communication as more disrupted than their HD affected family member. Conclusion: These findings highlight the need to target areas of emotional engagement, communication skills and problem solving in family interventions in HD. PMID:28968240

  7. Biomedical research leaders: report on needs, opportunities, difficulties, education and training, and evaluation.

    Science.gov (United States)

    Wilson, S H; Merkle, S; Brown, D; Moskowitz, J; Hurley, D; Brown, D; Bailey, B J; McClain, M; Misenhimer, M; Buckalew, J; Burks, T

    2000-12-01

    The National Association of Physicians for the Environment (NAPE) has assumed a leadership role in protecting environmental health in recent years. The Committee of Biomedical Research Leaders was convened at the recent NAPE Leadership Conference: Biomedical Research and the Environment held on 1--2 November 1999, at the National Institutes of Health, Bethesda, Maryland. This report summarizes the discussion of the committee and its recommendations. The charge to the committee was to raise and address issues that will promote and sustain environmental health, safety, and energy efficiency within the biomedical community. Leaders from every important research sector (industry laboratories, academic health centers and institutes, hospitals and care facilities, Federal laboratories, and community-based research facilities) were gathered in this committee to discuss issues relevant to promoting environmental health. The conference and this report focus on the themes of environmental stewardship, sustainable development and "best greening practices." Environmental stewardship, an emerging theme within and outside the biomedical community, symbolizes the effort to provide an integrated, synthesized, and concerted effort to protect the health of the environment in both the present and the future. The primary goal established by the committee is to promote environmentally responsible leadership in the biomedical research community. Key outcomes of the committee's discussion and deliberation were a) the need for a central organization to evaluate, promote, and oversee efforts in environmental stewardship; and b) immediate need to facilitate efficient information transfer relevant to protecting the global environment through a database/clearinghouse. Means to fulfill these needs are discussed in this report.

  8. Diagnostic difficulties of Lactobacillus casei bacteraemia in immunocompetent patients: A case report

    Directory of Open Access Journals (Sweden)

    Tommasi Chiara

    2008-09-01

    Full Text Available Abstract Introduction Lactobacilli are currently proposed as probiotic agents in several dietary products. In blood cultures, they are usually considered as contaminants, but in recent years they have been recognized as causal infectious agents of endocarditis, urinary tract infections, meningitis, intra-abdominal infections and bacteraemia. Case presentation We report a case of Lactobacillus casei bacteraemia in a 66-year-old immunocompetent man with a history of fever of unknown origin. Leuconostoc bacteraemia was demonstrated by blood culture, but a later polymerase chain reaction analysis with sequencing of 16S ribosomal RNA identified Lactobacillus casei and a successful antibiotic therapy was performed. Conclusion Bacteraemia caused by probiotic organisms is rare but underestimated, since they are normally regarded as contaminants and their role as primary invaders is not always easily established. Although the consumption of probiotic products cannot be considered a risk factor in the development of diseases caused by usually non-pathogenic bacteria, specific individual clinical histories should be taken into account. This report should alert both clinicians and microbiologists to the possibility of unusual pathogens causing serious illnesses and to the use of 16S ribosomal RNA sequencing for molecular identification as a powerful tool in confirming the diagnosis of infrequent pathogens.

  9. The investor access to the presented financial reports

    OpenAIRE

    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...

  10. [Atypical subacute thyroiditis in combination with Grave's disease:Diagnostic difficulties in a case report].

    Science.gov (United States)

    Koutouridou, Emmanouela; Planck, Tereza; Uddman, Erik; Lantz, Mikael

    2018-04-13

    Subacute thyroiditis is a common inflammatory disorder of the thyroid gland, possibly of viral etiology, that typically presents with neck pain, fever and tenderness on palpation of the thyroid gland. Graves' disease is an autoimmune thyroid disorder caused by stimulation of the thyroid gland by thyrotropin receptor antibodies (TRAb). The development of Graves´ disease and subacute thyroiditis simultaneously is an uncommon condition and only a few cases have been reported. In this article we present a case of a 46-year old woman diagnosed with Graves´ disease who was started on thiamazole and weeks later developed high fever. Several differential diagnoses were considered such as infection, lymphoma and vasculitis due to thiamazole. Finally, the fine needle aspiration of the thyroid gland displayed histopathological features of subacute thyroiditis. Remarkably, our patient did not have neck pain or tenderness on palpation of the thyroid gland and overall the clinical presentation of subacute thyroiditis was atypical. Thus, subacute thyroiditis may be considered as a potential cause of fever of unknown origin.

  11. 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

  12. Report Focuses on Integrity and Accessibility of Research Data

    Science.gov (United States)

    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.

  13. Normative Data of the Self-Report Version of the German Strengths and Difficulties Questionnaire in an Epidemiological Setting.

    Science.gov (United States)

    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

  14. 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.

  15. 50 CFR 660.313 - Open access fishery-recordkeeping and reporting.

    Science.gov (United States)

    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...

  16. Asperger syndrome and nonverbal learning difficulties in adult males: self- and parent-reported autism, attention and executive problems.

    Science.gov (United States)

    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.

  17. Food label usage and reported difficulty with following a gluten-free diet among individuals in the USA with coeliac disease and those with noncoeliac gluten sensitivity.

    Science.gov (United States)

    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.

  18. Do older people with visual impairment and living alone in a rural developing country report greater difficulty in managing stairs?

    Science.gov (United States)

    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.

  19. Accessibility

    DEFF Research Database (Denmark)

    Brooks, Anthony Lewis

    2017-01-01

    This contribution is timely as it addresses accessibility in regards system hardware and software aligned with introduction of the Twenty-First Century Communications and Video Accessibility Act (CVAA) and adjoined game industry waiver that comes into force January 2017. This is an act created...... by the USA Federal Communications Commission (FCC) to increase the access of persons with disabilities to modern communications, and for other purposes. The act impacts advanced communications services and products including text messaging; e-mail; instant messaging; video communications; browsers; game...... platforms; and games software. However, the CVAA has no legal status in the EU. This text succinctly introduces and questions implications, impact, and wider adoption. By presenting the full CVAA and game industry waiver the text targets to motivate discussions and further publications on the subject...

  20. 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...

  1. Enhancing the Equating of Item Difficulty Metrics: Estimation of Reference Distribution. Research Report. ETS RR-14-07

    Science.gov (United States)

    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…

  2. Difficulties First-Year University Mathematics Students Have in Reading Their Mathematics Textbook. Technical Report. No. 2009-1

    Science.gov (United States)

    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 …

  3. 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...

  4. An Open Access future? Report from the eurocancercoms project

    Science.gov (United States)

    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

  5. Accession Medical Standards Analysis and Research Activity (AMSARA), 2016 Annual Report

    Science.gov (United States)

    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

  6. 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.

  7. 47 CFR 76.978 - Leased access annual reporting requirement.

    Science.gov (United States)

    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...

  8. 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.)

  9. Predictive value of health-related fitness tests for self-reported mobility difficulties among high-functioning elderly men and women.

    Science.gov (United States)

    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.

  10. Difficulties in emotion regulation and risky driving among Lithuanian drivers.

    Science.gov (United States)

    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.

  11. Accession Medical Standards Analysis & Research Activity 2012 Annual Report

    Science.gov (United States)

    2012-10-02

    junk food out of America’s schools. Mission: Readiness. Washington, DC. April 2010. 4. Niebuhr DW, Cavicchia MA, Bedno SA, et al. Accession...specified 464 1.8 322 1.8 99 1.9 41 1.3 Adverse food reactions, not elsewhere classified 437 1.7 402 2.2 94 1.8 68 2.2 Elevated blood pressure without...waivers for elevated blood pressure without a diagnosis of hypertension (88.4%) and toxic effect of noxious substances eaten as food (90.3%) had the

  12. 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...

  13. Accessing and Selecting Word Meaning in Autism Spectrum Disorder

    Science.gov (United States)

    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,…

  14. 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.

  15. Patient-reported access to primary care in Ontario: effect of organizational characteristics.

    Science.gov (United States)

    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

  16. Providers' Access of Imaging Versus Only Reports: A System Log File Analysis.

    Science.gov (United States)

    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.

  17. ARM User Survey Report: Data Access, Quality, and Delivery

    Energy Technology Data Exchange (ETDEWEB)

    Mather, JH; Roeder, LR; Sivaraman, C

    2012-06-28

    The objective of this survey was to obtain user feedback to determine how users of the Atmospheric Radiation Measurement (ARM) Climate Research Facility Data Archive interact with the more than 2000 available types of datastreams. The survey also gathered information about data discovery and data quality. The Market and Competitive Analysis group at Pacific Northwest National Laboratory worked with web administrators to develop a landing page from which users could access the survey. A survey invitation was sent by ARM via email to about 6100 users on February 22, 2012. The invitation was also posted on the ARM website and Facebook page. Reminders were sent via e-mail and posted on Facebook while the survey was open, February 22-March 23, 2012.

  18. Analysis of intraoperative difficulties and management of operative complications in revision anterior exposure of the lumbar spine: a report of 25 consecutive cases.

    Science.gov (United States)

    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.

  19. Pelvicalyceal system duplication with ectopic ureter – diagnostic difficulties associated with the imaging procedure. Two cases report

    Directory of Open Access Journals (Sweden)

    Agnieszka Pukajło-Marczyk

    2014-09-01

    Full Text Available Urinary tract abnormalities are the most frequently occurring developmental anomaly in children. Pelvicalyceal system duplication is one of them and signifies the existence of two urine diverting separate systems. This anomaly occurs in 10% of population, usually in girls, and is associated with complete or partial ureter duplication. The frequency of total ureter duplication, which in 20–40% of patients is found as bilateral, is 1:125 children (0.8% of the population. The most frequent malformation is asymptomatic, diagnosed coincidentally casually and does not require any treatment. In some patients with pelvicalyceal system duplication, vesicoureteral reflux (VUR and ectopic ureter may coexist. Malposition of ureter’s orifice into the bladder predispose to urinary retention, development of hydronephrosis and urinary tract infection (UTI. Ectopic ureterocele is recognized in 6–20% of children with recurrent UTI. The reason why children are referred to the hospital is UTI or hydronephrosis revealed by ultrasound imaging. When the ultrasound image of pelvicalyceal system duplication is ambiguous, micturating cystourethrography (MCU and scintigraphy become the primary diagnostic procedure, or urography – in more complicated cases. In the case of ectopic ureter, the danger of inappropriate catheterization, i.e. directly into its lumen, may occur. Though very rare, this may cause some diagnostic difficulties and lead to injury of the urinary tract. For this reason, we want to further discuss this complication following a diagnostic procedure on the example of two cases of pelvicalyceal system duplication with ectopic ureter.

  20. Effects of Psychological and Social Work Factors on Self-Reported Sleep Disturbance and Difficulties Initiating Sleep.

    Science.gov (United States)

    Vleeshouwers, Jolien; Knardahl, Stein; Christensen, Jan Olav

    2016-04-01

    This prospective cohort study examined previously underexplored relations between psychological/social work factors and troubled sleep in order to provide practical information about specific, modifiable factors at work. A comprehensive evaluation of a range of psychological/social work factors was obtained by several designs; i.e., cross-sectional analyses at baseline and follow-up, prospective analyses with baseline predictors (T1), prospective analyses with average exposure across waves as predictor ([T1 + T2] / 2), and prospective analyses with change in exposure from baseline to follow-up as predictor. Participants consisted of a sample of Norwegian employees from a broad spectrum of occupations, who completed a questionnaire at two points in time, approximately two years apart. Cross-sectional analyses at T1 comprised 7,459 participants, cross-sectional analyses at T2 included 6,688 participants. Prospective analyses comprised a sample 5,070 of participants who responded at both T1 and T2. Univariable and multivariable ordinal logistic regressions were performed. Thirteen psychological/social work factors and two aspects of troubled sleep, namely difficulties initiating sleep and disturbed sleep, were studied. Ordinal logistic regressions revealed statistically significant associations for all psychological and social work factors in at least one of the analyses. Psychological and social work factors predicted sleep problems in the short term as well as the long term. All work factors investigated showed statistically significant associations with both sleep items, however quantitative job demands, decision control, role conflict, and support from superior were the most robust predictors and may therefore be suitable targets of interventions aimed at improving employee sleep. © 2016 Associated Professional Sleep Societies, LLC.

  1. Molecular accessibility in solvent swelled coals. Final report

    Energy Technology Data Exchange (ETDEWEB)

    Kispert, L.D.

    1994-04-01

    The conversion of coal by an economically feasible catalytic method requires the catalyst to diffuse into the coal sample so that hydrogenation catalysis can occur from within as well as the normal surface catalysis. Thus an estimate of the size, shape, and reactivity, of the pores in the coal before and after the swelling with different solvents is needed so that an optimum sized catalyst will be used. This study characterizes the accessible area found in Argonne Premium Coal Samples (APCS) using a EPR spin probe technique. The properties deduced in this manner correlate well with the findings deduced from SANS, NMR, SEM, SAXS and light scattering measurements. The use of nitroxide spin probes with swelling solvents is a simple way in which to gain an understanding of the pore structure of coals, how it changes in the presence of swelling solvents and the chemistry that occurs at the pore wall. Hydrogen bonding sites occur primarily in low-rank coals and vary in reactive strength as rank is varied. Unswelled coals contain small, spherical pores which disappear when coal is swelled in the presence of polar solvents. Swelling studies of polystyrene-divinyl benzene copolymers implied that coal is polymeric, contains significant quantities of covalent cross-links and the covalent cross-link density increases with rank.

  2. Individual Public Transportation Accessibility is Positively Associated with Self-Reported Active Commuting.

    Science.gov (United States)

    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

  3. Relationship between self-reported cognitive difficulties, objective neuropsychological test performance and psychological distress in chronic pain.

    Science.gov (United States)

    Baker, K S; Gibson, S J; Georgiou-Karistianis, N; Giummarra, M J

    2018-03-01

    Persons with chronic pain often report problems with cognitive abilities, such as memory or attention. There is limited understanding of whether objective performance is consistent with subjective reports, and how psychological factors contribute. We aimed to investigate these relationships in a group of patients expressing cognitive concerns, and evaluate the utility of self-report tools for pain management settings. Participants with chronic pain (n = 41) completed standardized neuropsychological tests, and self-report measures of cognitive functioning, pain, mood and sleep, as part of a broader study investigating cognitive performance in pain. Average neuropsychological test performance was subtly below normative means (within one standard deviation). Twenty-five percent of the sample scored substantially below age-adjusted norms on one or more objective tests. There were moderate-to-large associations between objective performance (e.g. Trail-Making B) and subjective cognitive complaints (e.g. Everyday Memory Questionnaire - Revised), controlling for age and education level. This was moderated by anxiety, such that subjective-objective relationships were particularly strong in those with higher anxiety. Poorer test performance was associated with higher pain intensity and catastrophizing. Subjective-objective cognition relationships remained after controlling for catastrophizing. Patients' self-reported cognitive concerns concurred with objectively measured performance, independent of age, education and catastrophizing. Moreover, those with severe anxiety were more accurate in predicting their cognitive performance. The findings highlight some interesting cognition-mood relationships, and suggest that easy-to-administer questionnaires, such as the Everyday Memory Questionnaire - Revised and the Behavior Rating Inventory of Executive Function - Adult Version, may be useful to capture cognitive concerns in clinical settings. Cognitive concerns in chronic pain

  4. 75 FR 62514 - Notice of Availability of Report on Data Access and Privacy Issues Related to Smart Grid...

    Science.gov (United States)

    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...

  5. Report: Improvements Needed in CSB’s Identity and Access Management and Incident Response Security Functions

    Science.gov (United States)

    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.

  6. Do self-report measures of social anxiety reflect cultural bias or real difficulties for Asian American college students?

    Science.gov (United States)

    Ho, Lorinda Y; Lau, Anna S

    2011-01-01

    Construal of the self as independent or interdependent in relation to others has been found to correlate significantly with social anxiety symptom ratings, raising concerns about possible cultural bias in these measures for Asian Americans. To investigate the validity of self-reported social anxiety symptoms, we examined the role of ethnicity in the associations among social anxiety, self-construal, and adaptive social functioning in a sample of 229 Asian- and European American college students. Results revealed that ethnicity moderated the relationship between self-construal and social anxiety such that interdependent self-construal was associated with higher social anxiety only for first generation Asian Americans. However, there were no significant ethnic differences in the associations between social anxiety self-reports and several measures of social functioning.

  7. Researching Learning Difficulties: A Guide for Practitioners

    Science.gov (United States)

    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…

  8. 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.

  9. Swallowing difficulties with medication intake assessed with a novel self-report questionnaire in patients with systemic sclerosis – a cross-sectional population study

    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

  10. Hydrology under difficulties

    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.

  11. Self-reported difficulty and preferences of wheeled mobility device users for simulated low-floor bus boarding, interior circulation and disembarking.

    Science.gov (United States)

    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

  12. Students' Motivation to Access Academic Advising Services

    Science.gov (United States)

    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…

  13. Respiratory difficulty caused by an ectopic brain tissue mass in the neck of a two-month-old baby: a case report

    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.

  14. 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

  15. Modernisation of Higher Education in Europe 2014: Access, Retention and Employability. Eurydice Report

    Science.gov (United States)

    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…

  16. Pilot Test of the Online Public Access Catalog Project's User and Nonuser Questionnaires. Final Report.

    Science.gov (United States)

    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…

  17. 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

  18. The Situation of Open Access Institutional Repositories in Spain: 2009 Report

    Science.gov (United States)

    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…

  19. Individual public transportation accessibility is positively associated with self-reported active commuting

    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...

  20. The D-SDA Reporting System: Reporting and User Access at DLR-EOC

    OpenAIRE

    Senft, Johanna; Chereji, Cristian; Mario, Winkler; Katrin, Molch; Eberhard, Mikusch

    2015-01-01

    In recent years, Earth observation missions and projects have put ever-increasing emphasis on reporting. Detailed reports are being requested on system performance, user behaviour and processing workload. At the same time reporting is gaining significance for data centres’ internal purposes as well – for identifying bottlenecks and optimizing system performance and reliability. For future planning, Earth Observation data centres increasingly need information-based forecasts. Reliable reports ...

  1. The association between access to public transportation and self-reported active commuting.

    Science.gov (United States)

    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.

  2. 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.

  3. The validity, reliability and normative scores of the parent, teacher and self report versions of the Strengths and Difficulties Questionnaire in China

    Directory of Open Access Journals (Sweden)

    Coghill David

    2008-04-01

    Full Text Available Abstract Background The Strengths and Difficulties Questionnaire (SDQ has become one of the most widely used measurement tools in child and adolescent mental health work across the globe. The SDQ was originally developed and validated within the UK and whilst its reliability and validity have been replicated in several countries important cross cultural issues have been raised. We describe normative data, reliability and validity of the Chinese translation of the SDQ (parent, teacher and self report versions in a large group of children from Shanghai. Methods The SDQ was administered to the parents and teachers of students from 12 of Shanghai's 19 districts, aged between 3 and 17 years old, and to those young people aged between 11 and 17 years. Retest data was collected from parents and teachers for 45 students six weeks later. Data was analysed to describe normative scores, bandings and cut-offs for normal, borderline and abnormal scores. Reliability was assessed from analyses of internal consistency, inter-rater agreement, and temporal stability. Structural validity, convergent and discriminant validity were assessed. Results Full parent and teacher data was available for 1965 subjects and self report data for 690 subjects. Normative data for this Chinese urban population with bandings and cut-offs for borderline and abnormal scores are described. Principle components analysis indicates partial agreement with the original five factored subscale structure however this appears to hold more strongly for the Prosocial Behaviour, Hyperactivity – Inattention and Emotional Symptoms subscales than for Conduct Problems and Peer Problems. Internal consistency as measured by Cronbach's α coefficient were generally low ranging between 0.30 and 0.83 with only parent and teacher Hyperactivity – Inattention and teacher Prosocial Behaviour subscales having α > 0.7. Inter-rater correlations were similar to those reported previously (range 0.23 – 0

  4. Robotic single-access splenectomy using the Da Vinci Single-Site® platform: a case report.

    Science.gov (United States)

    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.

  5. Residents in difficulty

    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....

  6. 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...

  7. 37 CFR 201.29 - Access to, and confidentiality of, Statements of Account, Verification Auditor's Reports, and...

    Science.gov (United States)

    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...

  8. Policy principles for expanding financial access: report of the CGD task force on access to financial services

    NARCIS (Netherlands)

    Claessens, S.; Honohan, P.; Rojas-Suarez, L.

    2009-01-01

    Despite the rapid growth in finance worldwide over the past quarter-century — now interrupted by the global financial crisis — many low-income households and small firms remain excluded from access to many financial services, especially in developing countries. While traditionally seen by many

  9. Energy taxation difficulties

    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

  10. Male professional footballers' experiences of mental health difficulties and help-seeking.

    Science.gov (United States)

    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.

  11. Measuring adolescent mental health around the globe: psychometric properties of the self-report Strengths and Difficulties Questionnaire in South Africa, and comparison with UK, Australian and Chinese data

    NARCIS (Netherlands)

    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

  12. Cognitive function and the agreement between self-reported and accelerometer-accessed physical activity.

    Science.gov (United States)

    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.

  13. Water sanitation, access, use and self-reported diarrheal disease in rural Honduras.

    Science.gov (United States)

    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.

  14. A Field Study in the Application of CONSULT-I to the Problem of Inconsistency in Diagnosis and Treatment of Reading Difficulties. Proffitt Grant Final Report.

    Science.gov (United States)

    Newman, Anabel P.; Metz, Elizabeth

    A field study tested the application of the CONSULT-I (R) program, which uses artificial intelligence with statistical pattern recognition in constructing a diagnosis and recommending treatment of reading difficulties. Participants in the field study came from 10 southern and central Indiana school districts, both public and parochial, and one…

  15. An Evaluation of "Number Rockets": A Tier-2 Intervention for Grade 1 Students at Risk for Difficulties in Mathematics. Final Report. NCEE 2012-4007

    Science.gov (United States)

    Rolfhus, Eric; Gersten, Russell; Clarke, Ben; Decker, Lauren E.; Wilkins, Chuck; Dimino, Joseph

    2012-01-01

    The 2004 reauthorization of the Individuals with Disabilities Education Act (IDEA) approved schools' use of alternative methods for determining student eligibility for special education services. IDEA encourages schools to intervene as soon as there is a valid indication that a student might experience academic difficulties, rather than after…

  16. AMSARA: Accession Medical Standards Analysis and Research Activity. Report of 2007 Attrition and Morbidity Data for 2006 Accessions

    Science.gov (United States)

    2008-08-04

    cytological, histological , immunological and DNA test findings 796 Other nonspecific abnormal findings 995 Certain adverse effects not elsewhere classified...dissociative, or factititous disorder 795 Abnormal histological and 404 1.4 293 1.9 immunological findings 746 Congenital anomalies of heart and 368 1.3...several conditions for which a medical accession waiver was sought in 2006 had approval rates in excess of 90%. The highest were for chronic gastritis (100

  17. Difficulty scaling through incongruity

    NARCIS (Netherlands)

    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.

  18. Breathing difficulty - lying down

    Science.gov (United States)

    ... 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 ...

  19. 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.

  20. Associations between narcissism and emotion regulation difficulties: Respiratory sinus arrhythmia reactivity as a moderator.

    Science.gov (United States)

    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.

  1. Veganism: Motivations and Difficulties

    OpenAIRE

    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...

  2. 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)

  3. Ocean Surface Topography Mission (OSTM) /Jason-2: Near Real-Time Altimetry Validation System (NRTAVS) QA Reports (NODC Accession 0044984)

    Data.gov (United States)

    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...

  4. Comprehensive Dataset and Reports of the Mamala Bay Study during 1993-1995 on Oahu, Hawaii (NODC Accession 0000030)

    Data.gov (United States)

    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...

  5. Accession Medical Standards Analysis and Research Activity (AMSARA), 2014 Annual Report

    Science.gov (United States)

    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

  6. iC-ACCESS (Accessing Campscapes) HERA "Uses of the Past" : Progress Report 2 - as at 31st December 2017

    NARCIS (Netherlands)

    van der Laarse, Robert; Dolghin, Dana

    2018-01-01

    SECTION 1. PROGRESS REPORT 1.1PUBLISHABLE SUMMARY This section should be of suitable quality to enable direct publication by the HERA JRP Handling Agency. Please ensure that it is set out and formatted so that it can be printed as a stand-alone paper document not exceeding 500 words. It shall also

  7. A Longitudinal Study into Indicators of Mental Health, Strengths and Difficulties Reported by Boarding Students as They Transition from Primary School to Secondary Boarding Schools in Perth, Western Australia

    Science.gov (United States)

    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…

  8. Open access for freight railroads : worthwhile or wasteful disruption, final report.

    Science.gov (United States)

    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...

  9. Mathematics difficulties & classroom leadership

    DEFF Research Database (Denmark)

    Schmidt, Maria Christina Secher

    2016-01-01

    This article investigates possible links between inclusion, students, for whom mathematics is extensively difficult, and classroom leadership through a case study on teaching strategies and student participation in four classrooms at two different primary schools in Denmark. Three sets of results...... are presented: 1) descriptions of the teachers’ classroom leadership to include all their students in the learning community, 2) the learning community produced by stated and practiced rules for teaching and learning behavior, 3) the classroom behavior of students who experience difficulties with mathematics....... The findings suggest that the teachers’ pedagogical choices and actions support an active learning environment for students in diverse learning needs, and that the teachers practise dimensions of inclusive classroom leadership that are known to be successful for teaching mathematics to all students. Despite...

  10. Chiropractic management using a brain-based model of care for a 15-year-old adolescent boy with migraine headaches and behavioral and learning difficulties: a case report

    Science.gov (United States)

    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

  11. Repair of traumatic tricuspid insufficiency via minimally invasive port access.

    Science.gov (United States)

    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.

  12. Student difficulties with Gauss' law

    Science.gov (United States)

    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.

  13. [Difficulties in learning mathematics].

    Science.gov (United States)

    Rebollo, M A; Rodríguez, A L

    2006-02-13

    To discuss our concern for some aspects of mathematics learning disorders related to the nomenclature employed and their diagnosis; these aspects refer to the term 'dyscalculia' and to its diagnosis (especially syndromatic diagnosis). We also intend to propose a classification that could help to define the terminology. Lastly we are going to consider the different aspects of diagnosis and to determine which of them are indispensable in the diagnosis of primary and secondary disorders. As far as the nomenclature is concerned, we refer to the term 'dyscalculia'. The origins of the term are analysed along with the reasons why it should not be used in children with difficulties in learning mathematics. We propose a classification and denominations for the different types that should undoubtedly be discussed. With respect to the diagnosis, several problems related to the syndromatic diagnosis are considered, since in our country there are no standardised tests with which to study performance in arithmetic and geometry. This means that criterion reference tests are conducted to try to establish current and potential performance. At this stage of the diagnosis pedagogical and psychological studies must be conducted. The important factors with regard to the topographical and aetiological diagnoses are prior knowledge, results from the studies that have been carried out and findings from imaging studies. The importance of a genetic study must be defined in the aetiological diagnosis. We propose a nomenclature to replace the term 'dyscalculia'. Standardised tests are needed for the diagnosis. The need to establish current and potential performance is hierarchized. With regard to the topographical diagnosis, we highlight the need for more information about geometry, and in aetiological studies the analyses must be conducted with greater numbers of children.

  14. Tinnitus and Sleep Difficulties After Cochlear Implantation.

    Science.gov (United States)

    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

  15. Social and emotional loneliness and self-reported difficulty initiating and maintaining sleep (DIMS) in a sample of Norwegian university students.

    Science.gov (United States)

    Hayley, Amie C; Downey, Luke A; Stough, Con; Sivertsen, Børge; Knapstad, Marit; Øverland, Simon

    2017-02-01

    Social and emotional loneliness negatively impact several areas of health, including sleep. However, few comprehensive population-based studies have evaluated this relationship. Over 12,000 students aged 21-35 years who participated in the student survey for higher education in Norway (the SHoT study) were assessed. Loneliness was assessed using the Social and Emotional Loneliness Scale. Difficulty initiating and maintaining sleep (DIMS) was assessed by a single-item subjective response on the depression scale of the Hopkins Symptoms Checklist (HSCL-25). Social loneliness was associated with more serious DIMS (unadjusted proportional odds-ratio [OR] = 2.69, 95% CI = 2.46-2.95). This association was attenuated following adjustment for anxiety (adjusted OR = 1.92, 95% CI = 1.75-2.10) and depression (adjusted OR = 1.48, 95% CI = 1.34-1.63), however was not substantially altered when all demographics and psychological distress were accounted for (fully adjusted OR = 1.46, 95% CI = 1.30-1.63). Emotional loneliness was also associated with more serious DIMS (unadjusted proportional OR = 2.33, 95% CI = 2.12-2.57). Adjustment for anxiety (adjusted OR = 1.96, 95% CI = 1.78-2.15) and depression (adjusted OR = 1.64, 95% CI = 1.48-1.80) attenuated, but did not extinguish this relationship in the fully adjusted model (adjusted OR = 1.22, 95% CI = 1.09-1.31). Mediation analyses revealed that the social loneliness-DIMS association was fully attributed to psychological distress, while the emotional loneliness-DIMS association was only partially mediated, and a direct association was still observed. Associations between social and emotional loneliness and subjective DIMS were embedded in a larger pattern of psychological distress. Mitigating underlying feelings of loneliness may reduce potentially deleterious effects on sleep health and psychological wellbeing in young adults. © 2016 Scandinavian Psychological Associations and John Wiley & Sons Ltd.

  16. Evaluation on the Occupational Information Access System as Used at Churchill High School. A Project Report.

    Science.gov (United States)

    McKinlay, Bruce; Adams, Daniel

    The Occupational Information Access System (OIAS) improves the accessibility of occupational labor market information for career planning. Its operation at Churchill High School is evaluated from several angels: the likes and dislikes of users; the effect of OIAS on users' knowledge of occupational information and on their career plans; why other…

  17. Final Report: Advanced Methods for Accessing and Disseminating Nuclear Data, August 13, 1996 - March 15, 1999

    International Nuclear Information System (INIS)

    Stone, Craig A.

    1999-01-01

    Scientific Digital Visions, Inc. developed methods of accessing and dissemination nuclear data contained within the databases of the National Data Center (NNDC) at the Brookhaven National Laboratory supporting a long standing and important DOE Program to provide scientists access to NNDC Databases. The NNDC participated as a partner in this effort

  18. Where Are the Women? A Report into Issues Related to Women's Access to Workplace Literacy Programs.

    Science.gov (United States)

    Milton, Marion

    A study investigated provision of workplace literacy courses available for women in female-dominated industries and women's access to and participation in those courses. A literature review revealed very little research on the required increased literacy skills in Australia and no previous studies on women's access to workplace literacy courses in…

  19. Comparative Study of Periodical Literature Indexing: Print versus Electronic Access. Final Report.

    Science.gov (United States)

    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…

  20. Pectus patient information website has improved access to care and patient reported outcomes.

    Science.gov (United States)

    Tikka, Theofano; Webb, Joanne; Agostini, Paula; Kerr, Amy; Mannion, Glenn; Steyn, Richard S; Bishay, Ehab; Kalkat, Maninder S; Rajesh, Pala B; Naidu, Babu

    2016-04-26

    Pectus is the most common congenital disorder. Awareness amongst primary care physicians and the general public is poor. NHS commissioning bodies plan to withdraw funding for this surgery because they deem a lack of sufficient evidence of benefit. The purpose of this study is to assess the effects of introducing a patient information website on referral and activity patterns and on patients reported outcomes. We produced an innovative information website, www.pectus.co.uk , accessible to the general public, providing information about pectus deformities; management options and advice about surgery. Referral patterns and number of cases where studied before and after the introduction of the website in 2010. Patients' satisfaction post-op was assessed using the Brompton's single step questionnaire (SSQ). The website had considerable traffic with 2179 hits in 2012, 4983 in 2013 and 7416 in 2014. This has led to 1421 contacts and 372 email enquiries. These emails have resulted in an increased number of patients who have been assessed and go on to have surgery. We asked 59 pectus excavatum patients who were operated from 2008 to 2014 to complete the SSQ. We received 32 replies. Eighty-four percent (16/19) of patients who visited the website and then underwent surgery, found the website useful. All patients scored satisfactorily in SSQ. Even though those who visited the website tended to be more satisfied with the surgical outcomes this did not reach statistical significance. This group of patients said that would have the operation again given the option compared to 76.9 % of the group who did not visit the website before surgery (p=0.031). Despite the fact that patients who visited the website experienced more post-operative complications were equally or more satisfied with post-operative outcomes. The overall SSQ obtainable score was not different for the two subgroups, being more widespread in the group that did not visit the website. The introduction of a pectus

  1. Vulnerability to Bullying: Teacher-reported Conduct and Emotional Problems, Hyperactivity, Peer Relationship Difficulties, and Prosocial Behaviour in Primary School Children.

    Science.gov (United States)

    Johnson, Helen R.; Thompson, Margaret J. J.; Wilkinson, Suzanne; Walsh, Louise; Balding, Jonathon; Wright, Victoria

    2002-01-01

    Reports an investigation of whether certain behaviors in children resulted in bullying. Explains that teachers (n=25) completed an assessment for 523 children (ages 7-11) while children completed a questionnaire about school. Offers new evidence that teachers recognize social behavior and interactions that can significantly affect whether primary…

  2. A spatial analysis of variations in health access: linking geography, socio-economic status and access perceptions

    Science.gov (United States)

    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

  3. 15 CFR 8.7 - Cooperation, compliance reports and reviews and access to records.

    Science.gov (United States)

    2010-01-01

    .... In general, recipients should have available for the department racial and ethnic data showing the... part shall permit access by the responsible Department official or his designee during normal business...

  4. Accessible Transportation Technologies Research Initiative (ATTRI) : User Needs Assessment: Stakeholder Engagement Report.

    Science.gov (United States)

    2016-05-01

    The Accessible Transportation Technologies Research Initiative (ATTRI) is a joint U.S. Department of Transportation (U.S. DOT) initiative that is co-led by the Federal Highway Administration (FHWA) and the Federal Transit Administration (FTA). ATTRI ...

  5. SPECIAL REPORT - The KC EMPOWER Project: Designing More Accessible STEM Learning Activities

    OpenAIRE

    Bob Hirshon; Laureen Summers; Babette Moeller; Wendy Martin

    2016-01-01

    The overall purpose of the Kinetic City (KC) Empower project was to examine how informal science activities can be made accessible for students with disabilities. The premise of this project was that all students, including those with disabilities, are interested in and capable of engaging in science learning experiences, if these experiences are accessible to them. Drawing on resources from Kinetic City, a large collection of science experiments, games, and projects developed by the American...

  6. 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.

  7. Public access of environmental information. Report of an Interdepartmental Working Party on public access to information held by Pollution Control Authorities

    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)

  8. Infantile Feeding Difficulties

    Directory of Open Access Journals (Sweden)

    Laura C. McCarthy DO

    2014-10-01

    Full Text Available Background. Gastric volvulus refers to a torsion of all or part of the stomach that may cause an obstruction of the foregut. The clinical symptoms of gastric volvulus range from asymptomatic to life-threatening and thus must be rapidly diagnosed. However, the presenting symptoms of gastric volvulus vary widely, which may cause diagnosis to be delayed or missed. Objective. Describe varying presentations of gastric volvulus (including a case report of a rare presentation, pathophysiology of the entity, and how to diagnose/treat the phenomenon. Design/Method. Article review and case presentation. Results. Our patient was taken to the operating room for a gastropexy and G-tube placement. During surgery, the stomach was redundant and large, but not currently torsed, consistent with intermittent organoaxial volvulus. There are several approaches to classifying gastric volvulus as well as different theories on how to treat the volvulus based on type and degree of rotation that this article aims to detail more thoroughly. Conclusion. There are a growing number of case reports describing gastric volvulus, which had historically been viewed as a rare finding. The presenting symptoms of gastric volvulus commonly mimic other, more benign newborn diagnoses, and thus can be difficult to diagnose. We present our patient as well as an article review of other cases to highlight the diverse presentations of gastric volvulus so this potentially devastating disease can be diagnosed quickly with prompt treatment initiation.

  9. EXPANSION OF VISCERAL LEISHMANIASIS IN THE STATE OF RIO DE JANEIRO, BRAZIL: REPORT OF THE FIRST AUTOCHTHONOUS CASE IN THE MUNICIPALITY OF VOLTA REDONDA AND THE DIFFICULTY OF DIAGNOSIS

    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.

  10. Difficulties in Learning Inheritance and Polymorphism

    Science.gov (United States)

    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…

  11. Food Security and Women's Access to Natural Resources workshop; a brief report.

    Science.gov (United States)

    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.

  12. Report: EPA Could Improve Physical Access and Service Continuity/Contingency Controls for Financial and Mixed-Financial Systems Located at its Research Triangle Park Campus

    Science.gov (United States)

    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.

  13. Preliminary access routes and cost study analyses for seven potentially acceptable salt sites: Final report, October 1984

    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

  14. The difficulties of Biocommunication

    Directory of Open Access Journals (Sweden)

    Borrelli Eugenio

    2002-09-01

    Full Text Available Communicating modern biotechnologies is certainly no easy task. To tackle such a complex and future-oriented assignment, help may arrive, paradoxically, from the past, from ancient rhetorical tradition, and in particular from Aristotle, the most renowned rhetoric teacher of all time. In his Rhetoric, Aristotle suggested that to be persuasive speakers should make use of widely accepted opinions (endoxa, i.e. the common sense shared by all. Common sense is expressed in common truths and value-laden maxims. Common sense, however, is not flat but dialectical, in that it includes contrasting subjects. While reasoning, orators do not just passively report a conception of an unchanging world, but they reproduce the contrasting conceptions included in common sense. In the case of the debate about Biotechnologies, the contrasting conceptions can be found in the Natural/Artificial dualism, in the dichotomy between an attitude marked by obscurantism and suspicion of scientific and technological innovation and that of a scientistic attitude

  15. Characterizing Journal Access at a Canadian University Using the Journal Citation Reports Database

    Directory of Open Access Journals (Sweden)

    Alan Gale

    2011-07-01

    Full Text Available This article outlines a simple approach to characterizing the level of access to the scholarly journal literature in the physical sciences and engineering offered by a research library, particularly within the Canadian university system. The method utilizes the “Journal Citation Reports” (JCR database to produce lists of journals, ranked based on total citations, in the subject areas of interest. Details of the approach are illustrated using data from the University of Guelph. The examples cover chemistry, physics, mathematics and statistics, as well as engineering. In assessing the level of access both the Library’s current journal subscriptions and backfiles are considered. To gain greater perspective, data from both 2003 and 2008 is analyzed. In addition, the number of document delivery requests, received from University of Guelph Library users in recent years, are also reviewed. The approach taken in characterizing access to the journal literature is found to be simple and easy to implement, but time consuming. The University of Guelph Library is shown to provide excellent access to the current journal literature in the subject areas examined. Access to the historical literature in those areas is also strong. In making these assessments, a broad and comprehensive array of journals is considered in each case. Document delivery traffic (i.e. Guelph requests is found to have decreased markedly in recent years. This is attributed, at least in part, to improving access to the scholarly literature. For the University of Guelph, collection assessment is an ongoing process that must balance the needs of a diverse group of users. The results of analyses of the kind discussed in this article can be of practical significance and value to that process.

  16. Accession Medical Standards Analysis and Research Activity (AMSARA) 2014, Annual Report, and four Supplemental Applicants and Accessions Tables for: Army, Air Force, Marine, and Navy

    Science.gov (United States)

    2016-02-02

    active component accessions, between 2008 and 2013, 13% were accessed with a history of medical disqualification that was either remediated prior to...between 2008 and 2013, 15% accessed with a history of previous medical disqualification and 1% were hospitalized in the first year of service. About...include achievement, adjustment, attention-seeking, cooperation, dominance, even- temperedness, generosity, intellectual efficiency, non- delinquency

  17. SPECIAL REPORT - The KC EMPOWER Project: Designing More Accessible STEM Learning Activities

    Directory of Open Access Journals (Sweden)

    Bob Hirshon

    2016-01-01

    Full Text Available The overall purpose of the Kinetic City (KC Empower project was to examine how informal science activities can be made accessible for students with disabilities. The premise of this project was that all students, including those with disabilities, are interested in and capable of engaging in science learning experiences, if these experiences are accessible to them. Drawing on resources from Kinetic City, a large collection of science experiments, games, and projects developed by the American Association for the Advancement of Science (AAAS, the project researched and adapted five afterschool science activities guided by universal design for learning principles.

  18. Covering the screw-access holes of implant restorations in the esthetic zone: a clinical report.

    Directory of Open Access Journals (Sweden)

    Abolfazl Saboury

    2014-12-01

    Full Text Available Screw-retained implant restorations have an advantage of predictable retention as well as retrievability, and obviate the risk of excessive sub-gingival cement commonly associated with cement retained implant restorations. Screw-retained restorations generally have screw access holes, which can compromise esthetics and weaken the porcelain around the holes. The purpose of this study is to describe the use of a separate overcasting crown design to cover the screw access hole of implant screw-retained prosthesis for improved esthetics.

  19. Tricotilomania: dificuldades diagnósticas e relato de dois casos Trichotillomania: difficulties in diagnosis and report of two clinical cases

    Directory of Open Access Journals (Sweden)

    Maria Cristina P. Lima

    2010-03-01

    Full Text Available OBJETIVO: Relatar dois casos de tricotilomania, um transtorno psiquiátrico ainda subdiagnosticado e que pode estar associado a problemas sociais e clínicos relevantes. Pretende-se destacar as características clínicas, discutindo as implicações do diagnóstico precoce para a evolução dos pacientes. DESCRIÇÃO DO CASO: Uma adolescente com diagnóstico de tricotilomania "pura" e outra menina cujo quadro estava associado ao transtorno obsessivo-compulsivo. Embora com o tratamento, a evolução de ambas tenha sido favorável, houve demora significativa para estabelecer o diagnóstico e encaminhá-las a um serviço de saúde mental, com prejuízos escolares e sociais. COMENTÁRIOS: A tricotilomania difere dos quadros benignos e transitórios de arrancar cabelos observados nos primeiros anos de vida e ainda é subdiagnosticada. A vergonha dos sintomas observada nos portadores e o desconhecimento por parte dos profissionais de saúde contribuem para essa situação. O quadro pode ser grave, particularmente se acompanhado de tricofagia. Profissionais da saúde precisam identificar o transtorno precocemente e encaminhar as crianças para tratamento especializado antes das possíveis complicações clínicas e repercussões psicossociaisOBJECTIVE: To report two cases of trichotillomania, an underdiagnosed psychiatric disorder that may be associated with important social and clinical problems. The clinical features will be highlighted considering the implications of early diagnosis on patients' outcome. CASE DESCRIPTION: An adolescent with isolated trichotillomania and another girl whose symptoms were associated with obsessive-compulsive disorder are described. Although both patients presented a favorable outcome with treatment, there was a significant delay in establishing the diagnosis and in referring them to a mental health service, leading to negative impact in educational and social domains. COMMENTS: Trichotillomania differs from the benign

  20. Fulfillment Research Resources through Access Financial Report fo Go Public Company at Library STIE Perbanas Surabaya Perpustakaan STIE Perbanas Surabaya

    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.

  1. Fulfillment Research Resources through Access Financial Report fo Go Public Company at Library STIE Perbanas Surabaya Perpustakaan STIE Perbanas Surabaya

    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.

  2. Use of vascular access for haemodialysis in Europe: a report from the ERA-EDTA Registry

    NARCIS (Netherlands)

    Noordzij, Marlies; Jager, Kitty J.; van der Veer, Sabine N.; Kramar, Reinhard; Collart, Frederic; Heaf, James G.; Stojceva-Taneva, Olivera; Leivestad, Torbjørn; Buturovic-Ponikvar, Jadranka; Benítez Sánchez, Manuel; Moreso, Fransesc; Prütz, Karl G.; Severn, Alison; Wanner, Christoph; Vanholder, Raymond; Ravani, Pietro

    2014-01-01

    Although arteriovenous fistulas (AVFs) are actively promoted, their use at the start of haemodialysis (HD) seems to be decreasing worldwide. In this paper, we describe recent trends in incidence and prevalence of vascular access types in Europe from 2005 to 2009 and their relationship with patient

  3. 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)

  4. Vena cava filter placement via the antecubital access: a report of 6 cases

    International Nuclear Information System (INIS)

    Yu Bo; Shi Weihao; He Qing; Wang Tieping; Wang Wei

    2008-01-01

    Objective: To study the methods and skill of vena cava filter placement via the antecubital access. Methods: Six patients with DVT (4 males and 2 females, mean age of 62) underwent vena cava filter placement via the antecubital access in Huashan Hospital from Oct. 2004 to May. 2006. The right basilic vein was punctured with the use of micropuncture technique. SNF(Simon nitinol filter, Bard)was inserted through its carrier into the 90-cm-long sheath. The filter was then deployed with a standard fashion in the IVC, 5 cm inferior to the renal vein. Results: The filter was once placed successfully in all six patients within average time of 25 min without complications, but with good healing, exclusion of bleeding and no phlebitis. The position of filter was accurate without deviation and no occurrence of pulmonary embolism. Conclusions: vena cava filter placement via antecubital access is easy, minimal invasive, no need of lying in bed postoperatively. It is beneficial for DVT patients as an alternative for the contra-indication to femoral venous access. (authors)

  5. Annual Report to Parliament Access to Information Act - 2016-2017

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

    Isabelle

    ... the economic and social advancement of those regions.” ... Technology Division staff to ensure that access to Centre information in all forms respects the ... one came from a business, one came from academia and six came from the public. 4 ...

  6. Complication with Intraosseous Access: Scandinavian Users’ Experience

    Science.gov (United States)

    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

  7. 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.

  8. Jupiter data analysis program (JDAP) research grant on wave accessibility and attributes. Final report

    International Nuclear Information System (INIS)

    Calvert, W.

    1987-01-01

    For more than thirty years the intense decametric radio emissions from Jupiter (DAM) and the corresponding auroral kilometric radiation from the Earth (AKR) have remained major radio science mysteries. Part of the problem, aside from their inherent complexity, has been the difficulty of measuring their source location and emission properties from limited observations. Progress has been made on this problem by locating the source directly, i.e., by analysis of the faraday rotation observed with Voyager as the wave path crossed the Io plasma torus, and indirectly by comparing the peak frequencies of the decametric emission with that at the foot of the Io flux tube. Progress was also made on the general question of how the emissions originate by finding properties of both the AKR and DAM which would imply emission by natural radio lasing

  9. Difficulty Swallowing After Stroke (Dysphagia)

    Science.gov (United States)

    ... 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 ...

  10. 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...

  11. Blink activity and task difficulty.

    Science.gov (United States)

    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.

  12. Vehicle access and search training manual. Report for Oct 77-sep 79

    International Nuclear Information System (INIS)

    Obermiller, J.E.; Wait, H.J.

    1979-11-01

    This Vehicle Access and Search Training Manual is intended to assist NRC-licensed organizations and their security personnel in developing vehicle access, control and search operations necessary at nuclear fuel cycle facilities and at reactor facilities. The manual is based on security requirements prescribed by The Nuclear Regulatory Commission as contained in Title 10 of the Code of Federal Regulations, Part 73, 'Physical Protection of Plants and Materials.' As a condition of the licensing agreement, the licensee is required to maintain a physical protection system which includes a training program for security personnel. The manual includes lesson plans in (1) controlling vehicle entry and exit, (2) searching for contraband, and (3) protecting the facility from sabotage and/or theft of special nuclear materials. These training guidelines provide information and instruction for self-study, discussion and hands-on training. A job knowledge test reviews the entire training program

  13. Desirable difficulties in vocabulary learning

    OpenAIRE

    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...

  14. Difficulties encountered by black women entrepreneurs in accessing ...

    African Journals Online (AJOL)

    The long period of colonialism and apartheid, imposed oppression and exploitation on women especially black African women, meant that they could not own property in their own rights or enter into a contract. The dawn of democracy brought about changes in the role played by women. They have emerged significantly ...

  15. Chlorophyll fluorescence emission as a reporter on cold tolerance in Arabidopsis thaliana accessions

    Czech Academy of Sciences Publication Activity Database

    Mishra, Anamika; Mishra, Kumud; Höermiller, I. I.; Heyer, A. G.; Nedbal, Ladislav

    2011-01-01

    Roč. 6, č. 2 (2011), s. 301-310 ISSN 1559-2316 R&D Projects: GA MŠk(CZ) ED1.1.00/02.0073; GA MŠk OC08055; GA MŠk 2B06068 Institutional research plan: CEZ:AV0Z60870520 Keywords : chlorophyll fluorescence * cold acclimation * electrolyte leakage * high - throughput screening * natural accessions Subject RIV: EH - Ecology, Behaviour

  16. Molecular accessibility in solvent swelled coals. Quarterly report, [September--November, 1993

    Energy Technology Data Exchange (ETDEWEB)

    Kispert, L.D.

    1993-11-01

    This quarter, experiments were performed on the use of binary swelling solvents in molecular accessibility in coal conversion. These experiments consisted of accessibility measurements of spin probe VII (TEMPAMINE) in Toluene swelled Illinois No. 6 APCS coal. The toluene was spiked with amounts of pyridine which ranged in concentration from 500 ppm to 10%. The experiments were done in triplicate to gain information about the experimental error involved in the procedure. It was shown that oscillations occur in the concentration of spin probe retained as the amount of pyridine that is added to the swelling solvent is increased. These oscillations decrease in intensity as the concentration of pyridine in the solvent solution is increased up to 2% pyridine (0.2mLs pyridine in 10mLs toluene). From a 2% pyridine concentration to a 5% concentration, there is no significant change in the retention of spin probe VII. An increase in retention is observed when the concentration of pyridine is increased to 6% and 7% successively, followed by a large decrease at 8% and 9% pyridine. The largest changes in spin probe retention are observed for concentrations of pyridine less than 0.5%. A three fold increase in spin probe retention is observed upon the addition of 500 ppm pyridine in the toluene swelling solvent, which indicates that small amounts of a strong swelling solvent could be used to improve molecular accessibility 91% in coals swelled in an otherwise weak swelling solvent.

  17. Public access to classified reports at the Los Alamos Scientific Laboratory

    Energy Technology Data Exchange (ETDEWEB)

    None

    1980-03-26

    Circumstances surrounding the discovery of UCRL-4725, a nuclear weapons report, on the open shelves of a LASL public library are discussed. Instances of erroneous use of declassification marking are documented in the report series that included the above report. However, no staff person had checked for similar mistakes in declassification. Recommendations are presented to move this unclassified report to its vault for classified materials and that the person responsible for LASL's failure to report to DOE the security violations be disciplined. Comments to the draft report are appended. (PSB)

  18. Multimodal examination of emotion regulation difficulties as a function of co-occurring avoidant personality disorder among women with borderline personality disorder.

    Science.gov (United States)

    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.

  19. Difficulties in emotion regulation in patients with eating disorders.

    Science.gov (United States)

    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

  20. Single-port access laparoscopic abdominoperineal resection through the colostomy site: a case report

    DEFF Research Database (Denmark)

    Lauritsen, Morten; Bulut, O

    2012-01-01

    Single-port access (SPA) laparoscopic surgery is emerging as an alternative to conventional laparoscopic and open surgery, although its benefits still have to be determined. We present the case of a 87-year-old woman who underwent abdominoperineal resection (APR) with SPA. The abdominal part...... of the operation was performed with a SILS port inserted through the marked colostomy site, and the specimen was removed through the perineum after intersphincteric dissection. Operating time was 317 min. Bleeding was negligible. The specimen measured 26 cm in length. Thirteen lymph nodes were found, 2...

  1. Assessing the UN High-Level Panel on Access to Medicines Report in Light of the Right to Health

    Directory of Open Access Journals (Sweden)

    Lisa Forman

    2016-11-01

    Full Text Available Access to medicines is the lynchpin to realizing a range of human rights, public health and development imperatives. However, without strong policy action to increase access to affordable medicines, there is little hope of achieving the Sustainable Development Goals or of realizing the human right to health. Access to medicines is a fundamental element of the right to health, and the majority of states are bound by core obligations in this regard. Accordingly, states must ensure that this critical human rights, public health and development interest is appropriately prioritized against inadequate resource allocations and competing private or trade interests. This is an imperative which we have argued should have framed the deliberations of the UN High Level Panel on Access to Medicines, convened to propose solutions to the “policy incoherence” between international human rights, trade rules and public health that is impeding access to medicines and the right to health for millions. In this article we explore interpretations in international human rights law regarding state duties towards medicines that should have guided these deliberations, and which were presented by the first author in a submission to the panel. We argue that at least two clear right to health duties support the High Level Panel’s recommendations: (1 the duty to prevent unreasonably high costs for medicines from denying large segments of the population their rights to health; and (2 the core obligation to provide essential medicines. Consequently, we explore three areas of action implied by these duties: (1 consistent implementation of human rights impact assessment; (2 institutionalizing the Agreement on Trade-Related Intellectual Property Rights (TRIPS flexibilities in law and policy; (3 making permanent the waiver of TRIPS for least developed countries (LDC, and waiving the application of TRIPS to essential medicines in low and middle-income countries. Finally, we

  2. 12 CFR 715.10 - Audit report and working paper maintenance and access.

    Science.gov (United States)

    2010-01-01

    ... that the audit was performed and reported in accordance with the terms of the engagement letter... a summary of the results of the audit to the members of the credit union orally or in writing at the...”) so requests, the Supervisory Committee shall provide NCUA a copy of each of the audit reports it...

  3. Access to bank finance for Scottish SMEs.

    OpenAIRE

    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...

  4. Report on the access to the deposition areas of the repository. Shaft or Ramp?

    International Nuclear Information System (INIS)

    Baeckblom, Goeran; Christiansson, Rolf; Hedin, Allan; Norman, Fredrik; Lagerstedt, Leif

    2003-05-01

    During year 2002, SKB launched the site-specific engineering of the repository at the Oskarshamn and Oesthammar candidate sites. A part of the ongoing engineering work is to evaluate and possibly select type of access from surface to the underground deposition areas located at a depth of some 400 to 700 metres below the surface. The project objectives are to provide a basis for comparison and to compare generic options for access routes to the underground deposition areas, to formulate preliminary Design Justification Statements for the continued site-specific engineering of access routes to the underground repository and also to describe and exemplify methodology for optimisation of the repository engineering. In consideration of the requirements of SKB, several alternative access options are explored. The main alternatives are a ramp with one or two operational areas at the surface, a ramp with parallel excavation of a blind shaft and an alternative with shafts only. A suite of objective functions were employed in the evaluation of the main alternatives relating to long-term safety, occupational safety during construction and operation, environmental impact, sustainability of natural resources, total cost, schedules, flexibility and project risks. All alternatives studied are feasible and safe, but the alternative with a spiral ramp and a blind shaft is deemed to be the most favourable option. The alternative has the highest flexibility without any tangible disadvantages related neither to long-term safety, environmental impact nor to schedules. It is an advantage that ramp traffic is drastically reduced as rock and backfilling material is transported by the skip rather than by vehicles in the ramp, thereby reducing risks of accidents and fires in the ramp. The concurrent ramp and shaft excavation also shorten the construction period with 18 months for the underground excavations. The discounted total cost is however 100 million Swedish Kronor higher for this

  5. Learning Difficulty and Learner Identity: A Symbiotic Relationship

    Science.gov (United States)

    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,…

  6. The surgical management of male breast cancer: Time for an easy access national reporting database?

    Directory of Open Access Journals (Sweden)

    Robert M.T. Staruch

    2016-08-01

    Discussion: We report a series of seven cases of male breast cancer encountered over three years, evaluating patient demographics as well as treatment and outcomes. In our series patients were managed with mastectomy. New evidence is questioning the role of mastectomy against breast conserving surgery in male patients. Furthermore there is a lack of reporting infrastructure for national data capture of the benefits of surgical modalities. Literature review highlights the varied clinical experience between units that remains reported as podium presentation but not published. The establishment of an online international reporting registry would allow for efficient analysis of surgical outcomes to improve patient care from smaller single centres. This would facilitate large scale meta analysis by larger academic surgical centres.

  7. Annual Report to Parliament Access to Information Act - 2014-2015

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

    leonardi

    ... of requests. Of the six requests received in the reporting period, two came from private sector businesses; two came from media and two from academia. ..... the Statutory Deadline. Principal Reason. Workload. External. Consultation. Internal.

  8. Annual Report to Parliament Access to Information Act - 2012-2013

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

    leonardi

    The International Development Research Centre (IDRC) is pleased to table its. Annual Report to Parliament .... including human resources, finance and administration, grant administration, ... consultation at many libraries around the world. 3.

  9. University Students with Reading Difficulties: Do Perceived Supports and Comorbid Difficulties Predict Well-being and GPA?

    Science.gov (United States)

    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…

  10. Mental health insurance access and utilization among childhood cancer survivors: a report from the childhood cancer survivor study.

    Science.gov (United States)

    Perez, Giselle K; Kirchhoff, Anne C; Recklitis, Christopher; Krull, Kevin R; Kuhlthau, Karen A; Nathan, Paul C; Rabin, Julia; Armstrong, Gregory T; Leisenring, Wendy; Robison, Leslie L; Park, Elyse R

    2018-04-15

    To describe and compare the prevalence of mental health access, preference, and use among pediatric cancer survivors and their siblings. To identify factors associated with mental health access and use among survivors. Six hundred ninety-eight survivors in the Childhood Cancer Survivor Study (median age = 39.4; median years from diagnosis = 30.8) and 210 siblings (median age = 40.4) were surveyed. Outcomes included having mental health insurance coverage, delaying care due to cost, perceived value of mental health benefits, and visiting a mental health provider in the past year. There were no differences in mental health access, preferences, and use between survivors and siblings (p > 0.05). Among respondents with a history of distress, most reported not having seen a mental health provider in the past year (80.9% survivors vs. 77.1% siblings; p = 0.60). Uninsured survivors were more likely to defer mental health services due to cost (24.6 vs. 8.4%; p mental health coverage. Most childhood cancer survivors value having mental healthcare benefits; however, coverage and use of mental health services remain suboptimal. The most vulnerable of survivors, specifically the uninsured and those with a history of distress, are at risk of experiencing challenges accessing mental health care. Childhood cancer survivors are at risk for experiencing high levels of daily life stress that is compounded by treatment-related sequelae. Integrative, system-based approaches that incorporate financial programs with patient education about insurance benefits can help reduce some of the financial barriers survivors face.

  11. Molecular accessibility in solvent swelled coals. Quarterly report, [April--June 1993

    Energy Technology Data Exchange (ETDEWEB)

    Kispert, L.D.

    1993-08-01

    The effect of weathering (oxidation and dehydration upon exposure to air) on the molecular accessibility of potential catalysts was studied by the EPR spin probe technique. Fresh samples of all 8 APCS coals were exposed to air for periods up to 36 days. Weathering produced significant effects on the retention of spin probes in most of the APCS coals under 91 % carbon (dmmf). It was determined that the lower ranked coal (Beulah Zap and Wyodak) under went a structural collapse which precluded retention of even spin probe VIII. However, medium ranked coals exhibited improved retention upon weathering when swelled in toluene. Swelling with pyridine opened up small pores for 81--86% carbon which is not observed for swelling with toluene. Changes in coal structure were successfully followed by the EPR spin probe method. A detailed analysis of the data collected from the swelling of coals oxidized in a moisture free environment was completed to differentiate between weathering and oxidation. Eight vacuum dried APCS coals were oxidized in an enclosed, pure oxygen, moisture free environment, and the effects of oxidation alone on coal structure were studied by the intercalation of EPR spin probes. The data shows a factor of 5 increase in spin probe retention for some coals oxidized in O{sub 2} versus air., suggesting a large increase in oxidized material. Particular care was taken during the swelling procedures to avoid exposure of the coal samples to air or moisture. EPR spectra were then obtained for these 300 samples.

  12. [IgE myeloma. Laboratory typing difficulties].

    Science.gov (United States)

    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.

  13. Design for Accessibility

    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...

  14. 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....

  15. Translating Research Into Practice: Voluntary Reporting of Medication Errors in Critical Access Hospitals

    Science.gov (United States)

    Jones, Katherine J.; Cochran, Gary; Hicks, Rodney W.; Mueller, Keith J.

    2004-01-01

    Context:Low service volume, insufficient information technology, and limited human resources are barriers to learning about and correcting system failures in small rural hospitals. This paper describes the implementation of and initial findings from a voluntary medication error reporting program developed by the Nebraska Center for Rural Health…

  16. Access and management of HIV-related diseases in resource-constrained settings: a workshop report.

    Science.gov (United States)

    Dimba, Eao; Yengopal, V; Joshua, E; Thavarajah, R; Balasundaram, S

    2016-04-01

    With advancement of medical interventions, the lifespan of people living with HIV has increased globally. However, low- and middle-income countries (LMICs) which bear the greatest burden of the HIV pandemic face a constant challenge in addressing the treatment needs of immune-suppressed patients. An analysis of the current management protocols and access to medication in resource-poor settings was conducted at this workshop, with emphasis on the situation in resource-poor settings. The participants developed a consensus document based on the need to respond to the constantly changing HIV pandemic. Provision of oral health care must be guided by interconnecting principles based on population based strategies that address upstream determinants of health. Basic oral health coverage in developing countries can only be realized with a strong foundation at the primary health level. Early diagnosis of HIV-related comorbidities including the adverse effects of ARVs is essential for the improvement of treatment outcomes. Standardization of oral health care delivery mechanisms will facilitate evaluation at national and regional levels. Oral health care workers have a moral obligation to participate in sustained campaigns to reduce the social stigma associated with HIV/AIDS in their work places at every stage of the referral chain. Future research also needs to realign itself towards prevention using the common risk factor approach, which has a broader impact on non-communicable diseases, which are increasingly affecting patients with HIV/AIDS as their life expectancies increase. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  17. Accessing VA Healthcare During Large-Scale Natural Disasters.

    Science.gov (United States)

    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.

  18. Survey of International Rules and Practices Regarding Delineation of and Access to Regulated Areas for Radiation Protection - Final report

    International Nuclear Information System (INIS)

    Schieber, C.; Crouail, P.; Beltrami, L.-A.; Reaud, C.; Lehtinen, Maaret; Stritt, Nicolas; Thomas, Gareth

    2013-06-01

    European requirements for radiological protection, especially work on transposing the new EURATOM Directive on the basic radiological protection standards, are currently being revised. The Direction generale du travail (DGT - General Directorate of Labour) and the Autorite de Surete Nucleaire (ASN - Nuclear Safety Authority) therefore commissioned the Radiological Protection Standing Groups of experts (GPRAD and GPMED)1 to engage in a forward-looking debate on the delimitation of and access to regulated areas, within an ad hoc working group (called hereafter 'Classification of Area WG'). To fuel its debates, the 'Classification of Area WG' sought elements on international regulations and practices focusing on problem exposure situations in various areas of activity (nuclear, industrial, research, medical, transport and natural boosted). CEPN was entrusted with this study. This report presents a summary of rules applicable in seven countries in terms of delimitation of and access to regulated radiological protection areas. The countries are: Belgium, Spain, United States, Finland, United Kingdom, Sweden and Switzerland. Detailed sheets for each country can be found in the Annex. Based on these summaries, three countries have been selected to apply their rules and practices in force to a dozen or so particular cases put together by the 'Classification of Area WG' that are representative of exposure situations. The three countries are Finland, United Kingdom and Switzerland. The case studies applied to each country are presented in the second part of this report

  19. Inherited protein S deficiency due to a novel nonsense mutation in the PROS1 gene in the patient with recurrent vascular access thrombosis: A case report

    Directory of Open Access Journals (Sweden)

    Eun Jin Cho

    2012-03-01

    Full Text Available Vascular access thrombosis is one of the major causes of morbidity in patients maintained on chronic hemodialysis. Thrombophilia has been recognized as a risk factor of vascular access thrombosis. The authors report a case of inherited protein S deficiency associated with vascular access thrombotic events. DNA sequence analysis of the PROS1 gene identified a novel heterozygous nonsense mutation in exon 10 by transition of AAG (lysine to TAG (stop codon at codon 473 (c.1417A>T, p.K473X. Results from the study suggest that the inherited protein S deficiency due to a PROS1 gene mutation may cause vascular access thrombosis in hemodialysis patients.

  20. Towards Open Access Publishing in High Energy Physics Report of the SCOAP3 Working Party

    CERN Document Server

    Bianco, S; Ferreira, P; Friend, F; Gargiulo, P; Hanania, R; Henrot-Versillé, S; Holtkamp, A; Igo-Kemenes, P; Jarroux-Declais, D; Jordão, M; Kämper, B-C; Krause, J; Lagrange, T; Le Diberder, F R; Lemasurier, A; Lengenfelder, A; Lindqvist, C M; Mele, S; Plaszczynski, S; Schimmer, R; Vigen, Jens; Voss, R; Wilbers, M; Yeomans, J; Zioutas, K

    2007-01-01

    This Report concerns the implementation of a process today supported by leading actors from the particle physics community, and worked through in detail by members of an international Working Party. The initiative offers an opportunity for the cost-effective dissemination of high-quality research articles in particle physics, enabling use of the new technologies of e-Science across the literature of High Energy physics.

  1. Prosthetic rehabilitation of edentulous patient with limited oral access: A clinical report

    Directory of Open Access Journals (Sweden)

    Sandeep Kumar

    2012-01-01

    Full Text Available Microstomia may result from surgical treatment of orofacial neoplasms, cleft lips, maxillofacial trauma, burns, radiotherapy or scleroderma. A maximal oral opening that is smaller than the size of a complete denture can make prosthetic treatment challenging. This clinical report presents the prosthodontic management of a total edentulous patient with microstomia. Sectional mandibular and maxillary trays and foldable mandibular and maxillary denture were fabricated for the total edentulous patient.

  2. Parents' difficulties with decisions about childhood immunisation.

    Science.gov (United States)

    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.

  3. 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...

  4. Feeding Difficulties in Children with Esophageal Atresia.

    Science.gov (United States)

    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.

  5. Detecting Ebola with limited laboratory access in the Democratic Republic of Congo: evaluation of a clinical passive surveillance reporting system.

    Science.gov (United States)

    Ashbaugh, Hayley R; Kuang, Brandon; Gadoth, Adva; Alfonso, Vivian H; Mukadi, Patrick; Doshi, Reena H; Hoff, Nicole A; Sinai, Cyrus; Mossoko, Mathias; Kebela, Benoit Ilunga; Muyembe, Jean-Jacques; Wemakoy, Emile Okitolonda; Rimoin, Anne W

    2017-09-01

    Ebola virus disease (EVD) can be clinically severe and highly fatal, making surveillance efforts for early disease detection of paramount importance. In areas with limited access to laboratory testing, the Integrated Disease Surveillance and Response (IDSR) strategy in the Democratic Republic of Congo (DRC) may be a vital tool in improving outbreak response. Using DRC IDSR data from the nation's four EVD outbreak periods from 2007-2014, we assessed trends of Viral Hemorrhagic Fever (VHF) and EVD differential diagnoses reportable through IDSR. With official case counts from active surveillance of EVD outbreaks, we assessed accuracy of reporting through the IDSR passive surveillance system. Although the active and passive surveillance represent distinct sets of data, the two were correlated, suggesting that passive surveillance based only on clinical evaluation may be a useful predictor of true cases prior to laboratory confirmation. There were 438 suspect VHF cases reported through the IDSR system and 416 EVD cases officially recorded across the outbreaks examined. Although collected prior to official active surveillance cases, case reporting through the IDSR during the 2007, 2008 and 2012 outbreaks coincided with official EVD epidemic curves. Additionally, all outbreak areas experienced increases in suspected cases for both malaria and typhoid fever during EVD outbreaks, underscoring the importance of training health care workers in recognising EVD differential diagnoses and the potential for co-morbidities. © 2017 John Wiley & Sons Ltd.

  6. Desktop Access to Full-Text NACA and NASA Reports: Systems Developed by NASA Langley Technical Library

    Science.gov (United States)

    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.

  7. Rural mental health workforce difficulties: a management perspective.

    Science.gov (United States)

    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

  8. Study on the rules and practices in force abroad regarding the delimitation and access to regulated areas for radiation protection purposes. Final report - Appendices. Report no. 313

    International Nuclear Information System (INIS)

    Schieber, C.; Crouail, P.; Beltrami, L.A.; Reaud, C.

    2013-06-01

    Within the frame of a reviewing of European requirements in the field of radiation protection, this report presents a synthesis of rules which are applicable in seven countries (Belgium, Spain, United States, Finland, United-Kingdom, Sweden and Switzerland; a detailed report for each of these countries is provided in appendix) in the field of delimitation and access to regulated areas for radiation protection purposes. A synthesis is proposed for each country. Three countries are then selected (Finland, United Kingdom and Switzerland) and their rules and practices are applied to cases which correspond to representative exposure situations: a room with a glove box, a hall with hot spots, a parking of temporary warehousing (packages of used fuels), intermittent use of an X ray generator, use of an intense radiation beam, workshop being dismantled, laboratory in which radioactive iodine 131 is handled, and use of a mobile industrial radiography device

  9. INCREASE IN THE ROLE OF THE FINANCIAL SYNTHESIS REPORTS FOR ACCESSION OF THE EUROPEAN STRUCTURAL FUNDS

    Directory of Open Access Journals (Sweden)

    Droj Laurentiu

    2011-07-01

    Full Text Available European integration is supported through important financial resources in order to sustain the investment effort for aligning the business infrastructure and increase in the business competitiveness in order to fulfill the European Union standards. The financial management, a basic component of the general management, has as scope to realize complex financial analysis in order to substantiate the decisions for investments and financing which should ensure the maximization of results, ensuring also the elaboration of the project budget as an essential document in the identification of the needs for resources and for obtaining the non-reimbursable financial sources. An essential role in the investment decision making, having as support European funding, is realized by the financial-accounting reporting documents such as balance sheet, profit and loss account, table of the treasury flows, which together with a realistic established actualization rate ensures the relevance and efficiency of the financial indicators: Net present Value(NPV, Internal Rate of Return(IRR, the investment recovery period, the benefit/cost ratio. This study has as its goal to realize a critical analysis over the main simulation methods and techniques for forecasting annual return based on its growth rate, which should ensure the success of the implementation and operation of an investment realized through European structural funds respecting also the requirements for minimization of risks. In this research it is shown the importance of proper generation/modeling of the annual turnover in an investment project. Several methods were presented and case study was realized. Since the annual turnover constitutes the basis for the entire financial analysis it is very important that a realistic growth rate is used. Otherwise the provisions within the financial analysis of the investment (including CBA, the project implementation strategy and later the plan for the utilization of

  10. Experiment in data tagging in information-accessing services containing energy-related data. Final report 1975--78

    International Nuclear Information System (INIS)

    1978-08-01

    This report describes the results of an experiment conducted by Chemical Abstracts Service (CAS), on the use of 'data tags' in a machine-readable output file for incorporation into an on-line search service. 'Data tags' are codes which uniquely identify specific types of numerical data in the corresponding source documents referenced in the file. Editorial and processing procedures were established for the identification of data types; the recording, editing, verification, and correction of the data tags; and their compilation into a special version of ENERGY, a CAS computer-readable abstract text file. Possible data tagging plans are described and criteria for extended studies in data tagging and accessing are outlined

  11. Ghosts, Troubles, Difficulties, and Challenges

    DEFF Research Database (Denmark)

    Raahauge, Kirsten Marie

    2016-01-01

    not consider ‘ghosts’ or ‘haunting’ as a possible explanation. This causes difficulties when they narrate and contextualise their experience, and typically they present ambiguous narratives and stress their disbelief at and bewilderment with the experiences. Still, as I will try to show in my article......, their bewilderment and the way they use the notions ‘ghost’ and ‘haunting’ point to possible reinterpretations of these notions, so that the narrative mediation shapes not only the experience but also the ways that ‘ghosts’ and ‘haunting’ are reinterpreted in contemporary Denmark....

  12. Planning for Accessibility.

    Science.gov (United States)

    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…

  13. Managing social difficulties: roles and responsibilities of patients and staff.

    Science.gov (United States)

    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.

  14. Instruments and options for environmental policy during the accession process of EU associated countries in the area of environment and energy. Final report

    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.)

  15. Medication errors with the use of allopurinol and colchicine : A retrospective study of a national, anonymous Internet-accessible error reporting system

    NARCIS (Netherlands)

    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,

  16. Barriers to Maori sole mothers’ primary health care access

    Directory of Open Access Journals (Sweden)

    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.

  17. Difficulties faced by family physicians in primary health care centers in Jeddah, Saudi Arabia

    Directory of Open Access Journals (Sweden)

    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.

  18. Communication difficulties in children identified with psychiatric problems

    OpenAIRE

    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’...

  19. Difficulty buying food, BMI, and eating habits in young children.

    Science.gov (United States)

    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.

  20. Total On-line Access Data System (TOADS): Phase II Final Report for the Period August 2002 - August 2004

    Energy Technology Data Exchange (ETDEWEB)

    Yuracko, K. L. [YAHSGS LLC, Richland, WA (United States); Parang, M. [YAHSGS LLC, Richland, WA (United States); Landguth, D. C. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Coleman, R. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States)

    2004-09-13

    TOADS (Total On-line Access Data System) is a new generation of real-time monitoring and information management system developed to support unattended environmental monitoring and long-term stewardship of U.S. Department of Energy facilities and sites. TOADS enables project managers, regulators, and stakeholders to view environmental monitoring information in realtime over the Internet. Deployment of TOADS at government facilities and sites will reduce the cost of monitoring while increasing confidence and trust in cleanup and long term stewardship activities. TOADS: Reliably interfaces with and acquires data from a wide variety of external databases, remote systems, and sensors such as contaminant monitors, area monitors, atmospheric condition monitors, visual surveillance systems, intrusion devices, motion detectors, fire/heat detection devices, and gas/vapor detectors; Provides notification and triggers alarms as appropriate; Performs QA/QC on data inputs and logs the status of instruments/devices; Provides a fully functional data management system capable of storing, analyzing, and reporting on data; Provides an easy-to-use Internet-based user interface that provides visualization of the site, data, and events; and Enables the community to monitor local environmental conditions in real time. During this Phase II STTR project, TOADS has been developed and successfully deployed for unattended facility, environmental, and radiological monitoring at a Department of Energy facility.

  1. Four-Way Kidney Exchange Transplant With Desensitization Increases Access to Living-Donor Kidney Transplant: First Report From India.

    Science.gov (United States)

    Kute, Vivek B; Patel, Himanshu V; Shah, Pankaj R; Modi, Pranjal R; Shah, Veena R; Kasat, Govind S; Patil, Mayur V; Patel, Jaydeep C; Kumar, Deepak P; Trivedi, Hargovind L

    2017-09-26

    This study reports our experience of the first 4-way kidney exchange transplant combined with desensitization in India, which allows increased access to living-donor kidney transplant for sensitized patients. Four-way kidney exchange transplant procedures were approved by the ethics committee of our institution and the Organ Transplantation Authorization Committee of state governments of India (as per the Transplantation of Human Organs Act of India). The protocols conformed to Declaration of Istanbul principles and the ethical guidelines of the 1975 Helsinki Declaration. Written informed consent was obtained from patients, donors, and their guardians. In April 2016, our transplant team completed simultaneous 4-way kidney exchange transplant procedures without any medical (rejection and infections) or surgical complications. Reasons for being included for kidney exchange transplant were ABO incom-patible (2 recipients) and sensitization (2 recipients). All 4 recipients had stable graft function with no proteinuria and donor-specific antibody at 11-month follow-up on standard triple immunosup-pression. Patient and graft survival rates were both 100%. To the best of our knowledge, this is the first single-center report of 4-way kidney exchange transplant combined with desensitization from India. This procedure has the potential to expand living-donor kidney transplant in disadvantaged groups (eg, sensitized patients). Recipients who are hard to match due to high panel reactive antibody and difficult to desensitize due to strong donor-specific antibodies can receive a transplant with a combination of kidney exchange and desensitization. Our study suggests that 4-way kidney exchange transplant can be performed in developing countries (India) similar to that shown in programs in developed countries with team work, kidney exchange registry, and counseling.

  2. [Increasing difficulties for scientific publication in Venezuela].

    Science.gov (United States)

    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.

  3. Identifying and addressing student difficulties with the ideal gas law

    Science.gov (United States)

    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.

  4. [Central diabetes insipidus: diagnostic difficulties].

    Science.gov (United States)

    Matoussi, N; Aissa, K; Fitouri, Z; Hajji, M; Makni, S; Bellagha, I; Ben Becher, S

    2008-06-01

    Central diabetes insipidus is rare in children. Characteristic features include polyuria and polydipsia due to arginine vasopressin deficiency. The differential diagnosis of polyuric states may be difficult. Etiologic diagnosis of central diabetes insipidus may be an equally difficult task. To specify the difficulties encountered in the diagnosis of central diabetes insipidus and to point out features of the etiologic work-up and of long-term follow-up of children with idiopathic central diabetes insipidus. A retrospective study of 12 children admitted with a polyuria/polydipsia syndrome to the pediatric - consultation and emergency unit of the children's hospital of Tunis between 1988 and 2005. Children with acquired nephrogenic central diabetes insipidus were excluded. Fourteen-hour fluid restriction test and/or desmopressin test were used without plasma vasopressin measurement. Eight patients were classified as having central diabetes insipidus, which was severe in seven children and partial in one girl. One patient was classified as having primary polydipsia. The diagnosis remains unclear in three patients. The etiological work-up in eight patients with central diabetes insipidus enabled the identification of Langerhan's-cell histiocytosis in two patients and neurosurgical trauma in one. The cause was considered idiopathic in five patients. The median follow-up of the five patients with idiopathic central diabetes insipidus was five years two months plus or minus six years seven months (range five months, 14.5 years). During this follow-up, neither brain magnetic resonance imaging scans findings nor anterior pituitary function have changed. Fluid restriction and desmopressin tests did not enable an accurate distinction between partial diabetes insipidus and primary polydipsia. Regular surveillance is warranted in patients with idiopathic central diabetes insipidus to identify potential etiologies.

  5. Guided Endodontic Access in Maxillary Molars Using Cone-beam Computed Tomography and Computer-aided Design/Computer-aided Manufacturing System: A Case Report.

    Science.gov (United States)

    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.

  6. Sustainable energy for all. Technical report of task force 1 in support of the objective to achieve universal access to modern energy services by 2030

    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.

  7. Is Team-Based Primary Care Associated with Less Access Problems and Self-Reported Unmet Need in Canada?

    Science.gov (United States)

    Zygmunt, Austin; Asada, Yukiko; Burge, Frederick

    2017-10-01

    As in many jurisdictions, the delivery of primary care in Canada is being transformed from solo practice to team-based care. In Canada, team-based primary care involves general practitioners working with nurses or other health care providers, and it is expected to improve equity in access to care. This study examined whether team-based care is associated with fewer access problems and less unmet need and whether socioeconomic gradients in access problems and unmet need are smaller in team-based care than in non-team-based care. Data came from the 2008 Canadian Survey of Experiences with Primary Health Care (sample size: 10,858). We measured primary care type as team-based or non-team-based and socioeconomic status by income and education. We created four access problem variables and four unmet need variables (overall and three specific components). For each, we ran separate logistic regression models to examine their associations with primary care type. We examined socioeconomic gradients in access problems and unmet need stratified by primary care type. Primary care type had no statistically significant, independent associations with access problems or unmet need. Among those with non-team-based care, a statistically significant education gradient for overall access problems existed, whereas among those with team-based care, no statistically significant socioeconomic gradients existed.

  8. Progress Report Phase I: Use, access, and fire/fuels management attitudes and preferences of user groups concerning the Valles Caldera National Preserve (VCNP) and adjacent areas

    Science.gov (United States)

    Kurt F. Anschuetz; Carol B. Raish

    2010-01-01

    This document represents a progress report of activities completed during Phase I of the study titled, Use, Access, and Fire/Fuels Management Attitudes and Preferences of User Groups Concerning the Valles Caldera National Preserve (VCNP) and Adjacent Areas, and the preliminary findings of this work.

  9. Access Customized Forms

    OpenAIRE

    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.

  10. Respiratory difficulties and breathing disorders in achondroplasia.

    Science.gov (United States)

    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.

  11. Dificuldades de acesso a serviços de saúde para diagnóstico de tuberculose em municípios do Brasil Dificultades de acceso a servicios de salud para diagnóstico de tuberculosis en municipios de Brasil Difficulties in the accessibility to health services for tuberculosis diagnoses in Brazilian municipalities

    Directory of Open Access Journals (Sweden)

    Lúcia Marina Scatena

    2009-06-01

    , Itaboraí (sureste de Brasil; y Campina Grande y Feira de Santana (Noreste de Brasil. Se utilizó un instrumento "Primary Care Assessment Tool", adaptado para atención a la tuberculosis. El diagnóstico de tuberculosis en los servicios fue evaluado por medio del análisis factorial de correspondencia múltiple. RESULTADOS: El acceso al diagnóstico fue representado por las dimensiones "locomoción al servicio de salud" y "servicio de atención" en el plano factorial. Los pacientes de los municipios Ribeirao Preto e Itaboraí fueron asociados a las condiciones más favorables a la dimensión "locomoción" y los de Campina Grande y Feira de Santana a las menos favorables. Ribeirao Preto presentó condiciones más favorables para la dimensión "servicio de atención" seguido de los municipios Itaboraí, Feira de Santana y Campina Grande. Sao Jose do Río Preto presentó condiciones menos favorables que los otros municipios para las dimensiones "locomoción" y "servicio de atención". CONCLUSIONES: El análisis factorial permitió visualizar conjuntamente las características organizacionales de los servicios de atención a la tuberculosis. La descentralización de las acciones para el programa de salud de la familia y ambulatorio parece no presentar desempeño satisfactorio para el acceso al diagnóstico de tuberculosis, pues la forma de organización de los servicios no fue factor determinante para la garantía del acceso al diagnóstico precoz de la enfermedad.OBJECTIVE: To assess difficulties in the accessibility to tuberculosis diagnoses in the health services in Brazil. METHODS: The study was carried out in 2007 and surveyed tuberculosis patients treated in the primary care services in the cities of Ribeirão Preto, São José do Rio Preto, Itaboraí (these three in Southeastern Brazil, Campina Grande and Feira de Santana (these two in Northeastern Brazil. The instrument "Primary Care Assessment Tool" was used, adapted to assess tuberculosis care in Brazil

  12. Broadband Access

    Indian Academy of Sciences (India)

    First page Back Continue Last page Overview Graphics. Broadband Access. Worldwide market for broadband access $30 Billion! Over 200 million broadband subscribers worldwide! Various Competing Broadband access. Digital Subscriber line; Wireless; Optical Fiber.

  13. 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.

  14. 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.

  15. Guiding People to Interpret Their Experienced Difficulty as Importance Highlights Their Academic Possibilities and Improves Their Academic Performance

    Science.gov (United States)

    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

  16. Do People With Psychosis Have Specific Difficulties Regulating Emotions?

    Science.gov (United States)

    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

  17. Revocable Anonymous Access to the Internet?

    Science.gov (United States)

    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…

  18. [Value of preserved saphenous vein graft for the creation of access ports in hemodialyzed patients: report of 309 cases].

    Science.gov (United States)

    Schneider, Marc; Barrou, Benoît; Cluzel, Philippe; Hamani, Aziz; Bitker, Marc-Olivier; Richard, François

    2003-09-01

    Biological grafts are rarely used for the creation of vascular access, despite their many advantages. Our group prefers to use distal vascular accesses with interposition of a biological graft when direct access cannot be achieved. The objective of this study was to determine the long-term patency and the complication rate of a series of 309 vascular access procedures using a preserved saphenous (PS) vein homograft. 410 (27%) of the 1,500 vascular access procedures performed by our group required the use of a graft, including 376 PS vein homografts (25%). This retrospective study comprised complete data collection for 309 arteriovenous fistulas (AVF) using preserved saphenous (PS) vein graft in the forearm performed in 267 patients between 1985 and 2000. Primary patency was defined as the interval between creation of the vascular access and the first complication requiring surgical or radiological correction; secondary patency was defined as the interval between creation and loss of the graft, with or without revision of the fistula. Survival rates were calculated according to the Kaplan-Meier method. Inter-group comparison was performed by the Logrank test and analysis of variance was performed by logistic regression. Primary patency rates were 77%, 40% and 27% at 1,2 and 5 years, respectively. Secondary patency rates were 79% and 47% at 1 year and 5 years, respectively. The thrombosis rate was 42%. Two episodes of thrombosis occurred in 25% of grafts and 3 episodes were observed in 10% of cases. Infection rates were 1.9% postoperatively and 5% after dialysis, respectively. An aneurysm occurred on 10% of grafts. The operator's experience (RR = 1.58; p creation of vascular accesses with similar patency rates to those of prosthetic grafts. Vein grafts present a number of advantages, particularly a greater ease of use facilitating distal implantation of the graft and a low infection rate.

  19. Emotion Regulation Difficulties Moderate the Association Between Heavy Episodic Drinking and Dating Violence Perpetration Among College Men

    Science.gov (United States)

    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

  20. Patients report better satisfaction with part-time primary care physicians, despite less continuity of care and access.

    Science.gov (United States)

    Panattoni, Laura; Stone, Ashley; Chung, Sukyung; Tai-Seale, Ming

    2015-03-01

    The growing number of primary care physicians (PCPs) reducing their clinical work hours has raised concerns about meeting the future demand for services and fulfilling the continuity and access mandates for patient-centered care. However, the patient's experience of care with part-time physicians is relatively unknown, and may be mediated by continuity and access to care outcomes. We aimed to examine the relationships between a physicians' clinical full-time equivalent (FTE), continuity of care, access to care, and patient satisfaction with the physician. We used a multi-level structural equation estimation, with continuity and access modeled as mediators, for a cross-section in 2010. The study included family medicine (n = 104) and internal medicine (n = 101) physicians in a multi-specialty group practice, along with their patient satisfaction survey responses (n = 12,688). Physician level FTE, continuity of care received by patients, continuity of care provided by physician, and a Press Ganey patient satisfaction with the physician score, on a 0-100 % scale, were measured. Access to care was measured as days to the third next-available appointment. Physician FTE was directly associated with better continuity of care received (0.172% per FTE, p part-time PCPs in practice redesign efforts and initiatives to meet the demand for primary care services.

  1. Brain Regions Underlying Word Finding Difficulties in Temporal Lobe Epilepsy

    Science.gov (United States)

    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.…

  2. 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 ...

  3. Handwriting difficulties in juvenile idiopathic arthritis: a pilot study

    NARCIS (Netherlands)

    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

  4. Accessibility to health services by persons with disabilities.

    Science.gov (United States)

    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.

  5. 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.

  6. Students’ difficulties in probabilistic problem-solving

    Science.gov (United States)

    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.

  7. The association of sleep difficulties with health-related quality of life among patients with fibromyalgia.

    Science.gov (United States)

    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.

  8. Metastatic spread from squamous cell carcinoma of the hypopharynx to the totally implantable venous access port insertion site: Case report and review of literature.

    Science.gov (United States)

    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.

  9. 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...

  10. Report of the experts group on the taxation of the access to gas transport and distribution network

    International Nuclear Information System (INIS)

    2001-04-01

    In the framework of a new french gas industry organization (directive of the 22 june 1998), a concerting mission has been realized on prices taxation for the transport and distribution facilities. The following topics have been debated: the integration and competition of the european gas market, the gas market liberalization consistency and the taxation of transport and distribution network access. (A.L.B.)

  11. Barriers to accessing low vision services.

    Science.gov (United States)

    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.

  12. 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.

  13. [Access to care for vulnerable populations].

    Science.gov (United States)

    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.

  14. Computer skills and internet use in adults aged 50-74 years: influence of hearing difficulties.

    Science.gov (United States)

    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

  15. 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 ...

  16. 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.

  17. Motor and Coordination Difficulties in Children with Emotional and Behavioural Difficulties

    Science.gov (United States)

    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…

  18. RCRA Facility Investigation/Remedial Investigation Report for the Gunsite 113 Access Road Unit (631-24G) - March 1996

    Energy Technology Data Exchange (ETDEWEB)

    Palmer, E. [Westinghouse Savannah River Company, AIKEN, SC (United States)

    1996-03-01

    Gunsite 113 Access Road Unit is located in the northeast corner of SRS. In the mid 1980`s, sparse vegetation, dead trees, and small mounds of soil were discovered on a portion of the road leading to Gunsite 113. This area became the Gunsite 113 Access Road Unit (Gunsite 113). The unit appears to have been used as a spoil dirt and / or road construction debris disposal area. There is no documentation or record of any hazardous substance management, disposal, or any type of waste disposal at this unit. Based upon the available evidence, there are no potential contaminants of concern available for evaluation by a CERCLA baseline risk assessment. Therefore, there is no determinable health risk associated with Gunsite 113. In addition, it is also reasonable to conclude that, since contamination is below risk-based levels, the unit presents no significant ecological risk. It is recommended that no further remedial action be performed at this unit.

  19. RCRA Facility Investigation/Remedial Investigation Report for the Gunsite 113 Access Road Unit (631-24G) - March 1996

    International Nuclear Information System (INIS)

    Palmer, E.

    1996-03-01

    Gunsite 113 Access Road Unit is located in the northeast corner of SRS. In the mid 1980's, sparse vegetation, dead trees, and small mounds of soil were discovered on a portion of the road leading to Gunsite 113. This area became the Gunsite 113 Access Road Unit (Gunsite 113). The unit appears to have been used as a spoil dirt and / or road construction debris disposal area. There is no documentation or record of any hazardous substance management, disposal, or any type of waste disposal at this unit. Based upon the available evidence, there are no potential contaminants of concern available for evaluation by a CERCLA baseline risk assessment. Therefore, there is no determinable health risk associated with Gunsite 113. In addition, it is also reasonable to conclude that, since contamination is below risk-based levels, the unit presents no significant ecological risk. It is recommended that no further remedial action be performed at this unit

  20. A requirement for Australian research: access to 'big science' facilities, a report by the Australian National Committee for crystallography

    International Nuclear Information System (INIS)

    1989-03-01

    Two types of 'Big Science' research facility - synchrotron radiation sources and intense neutron beams - are now recognised as essential resources for a wide range of research activities in chemistry, physics and biology. The cost of such facilities and the lack of a sufficiently large user base will probably preclude their construction in Australia in the foreseeable future. The needs of Australian crystallographers for access to such facilities are assessed. In relation to synchrotron radiation sources, the Committee considered only the question of access to such facilities overseas. In relation to neutron beam sources, the Committee's inquiries included not only the question of access to powerful facilities overseas but also the special problems which confront Australian crystallographers as a result of the obsolescence of the HIFAR reactor. The arguments about, and options for, funding Australian use of facilities overseas are presented. The Committee concluded there is a strong case for the purchase of a beam-line at an overseas synchrotron radiation facility and a strong, though less urgent, case for substantial Australian involvement in an overseas neutron beam facility. The Committee recommended that the Australian HIFAR reactor be refurbished in its present shell, retaining the present flux and power levels, and that in the upgrading of the neutron scattering instrumentation at HIFAR special consideration be given to including items which are sufficiently specialised to attract the international neutron scattering community

  1. LEARNING DIFFICULTIES: AN ANALYSIS BASED ON VIGOTSKY

    Directory of Open Access Journals (Sweden)

    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.

  2. 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

  3. Wireless Access

    Indian Academy of Sciences (India)

    First page Back Continue Last page Overview Graphics. Wireless Access. Wireless connect to the Base station. Easy and Convenient access. Costlier as compared to the wired technology. Reliability challenges. We see it as a complementary technology to the DSL.

  4. Open access

    NARCIS (Netherlands)

    Valkenburg, P.M.

    2015-01-01

    Open access week Van 19 tot en met 25 oktober 2015 vond wereldwijd de Open Access Week plaats. Tijdens deze week werden er over de hele wereld evenementen georganiseerd waar open access een rol speelt. Ook in Nederland zijn er diverse symposia, workshops en debatten georganiseerd zoals het debat in

  5. Sleep difficulties and academic performance in Norwegian higher education students.

    Science.gov (United States)

    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.

  6. Handwriting difficulties in juvenile idiopathic arthritis: a pilot study.

    Science.gov (United States)

    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.

  7. Knowledge of disease and access to a specialist reported by Spanish patients with ulcerative colitis. UC-LIFE survey.

    Science.gov (United States)

    Argüelles-Arias, Federico; Carpio, Daniel; Calvet, Xavier; Romero, Cristina; Cea-Calvo, Luis; Juliá, Berta; López-Sanromán, Antonio

    2017-06-01

    Education of patients with ulcerative colitis (UC) about their disease and access to a specialist are important to improve health outcomes. Our objective was to determine, by collecting information directly from the patients, their information sources and knowledge of the disease, and the options for access to the gastroenterologist. The information was collected using a printed survey handed out by 39 gastroenterologists to 15 consecutive adult patients with UC. Patients answered anonymously from their home. The responses were stratified by hospital size (> 900; 500-900; < 500 beds). A total of 585 patients received the survey and 436 responded (74.5%; mean age of 46 years [13.5], 53% men). The main information source was the specialist physician (89.2%). Between 32% and 80% of patients had areas of improvement regarding knowledge of their disease. Knowledge of the disease was better in patients from small hospitals (< 500 beds). The frequency of routine visits was also higher in small hospitals. In case of a flare-up, 60% stated they were able to contact their doctor by phone and 37%, that they could get an appointment on the same day. The percentage stating that they had to ask for an appointment and wait until their physician was available was lower in small hospitals. There are areas of improvement with regard to knowledge of their disease in patients with UC followed in hospital clinics. Patients followed in small hospitals seem to know their disease better, are followed more frequently in the clinic, and have better access in case of a flare-up.

  8. Knowledge of disease and access to a specialist reported by Spanish patients with ulcerative colitis: UC-LIFE survey

    Directory of Open Access Journals (Sweden)

    Federico Argüelles-Arias

    Full Text Available Background and aim: Education of patients with ulcerative colitis (UC about their disease and access to a specialist are important to improve health outcomes. Our objective was to determine, by collecting information directly from the patients, their information sources and knowledge of the disease, and the options for access to the gastroenterologist. Methods: The information was collected using a printed survey handed out by 39 gastroenterologists to 15 consecutive adult patients with UC. Patients answered anonymously from their home. The responses were stratified by hospital size (> 900; 500-900; < 500 beds. Results: A total of 585 patients received the survey and 436 responded (74.5%; mean age of 46 years [13.5], 53% men. The main information source was the specialist physician (89.2%. Between 32% and 80% of patients had areas of improvement regarding knowledge of their disease. Knowledge of the disease was better in patients from small hospitals (< 500 beds. The frequency of routine visits was also higher in small hospitals. In case of a flare-up, 60% stated they were able to contact their doctor by phone and 37%, that they could get an appointment on the same day. The percentage stating that they had to ask for an appointment and wait until their physician was available was lower in small hospitals. Conclusions: There are areas of improvement with regard to knowledge of their disease in patients with UC followed in hospital clinics. Patients followed in small hospitals seem to know their disease better, are followed more frequently in the clinic, and have better access in case of a flare-up.

  9. Player Modeling for Intelligent Difficulty Adjustment

    Science.gov (United States)

    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.

  10. Workplace bullying and sleep difficulties: a 2-year follow-up study.

    Science.gov (United States)

    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.

  11. ACCOUNTABILITY INFLUENCE, TECHNICAL DIFFICULTY AND MEASUREMENT DIFFICULTY TOWARDS THE IMPLEMENTATION OF INDONESIAN STANDARD STATEMENT OF FINANCIAL ACCOUNTING (PSAK) NO. 27 (REVISED 1998) ABOUT COOPERATIVES ACCOUNTING IN EAST JAVA

    OpenAIRE

    ., 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 ...

  12. Accountability Influence, Technical Difficulty and Measurement Difficulty Towards the Implementation of Indonesian Standard Statement of Financial Accounting (PSAK) No. 27 (Revised 1998) About Cooperatives Accounting in East Java

    OpenAIRE

    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...

  13. Central intake to improve access to physiotherapy for children with complex needs: a mixed methods case report.

    Science.gov (United States)

    Wittmeier, Kristy D M; Restall, Gayle; Mulder, Kathy; Dufault, Brenden; Paterson, Marie; Thiessen, Matthew; Lix, Lisa M

    2016-08-31

    Children with complex needs can face barriers to system access and navigation related to their need for multiple services and healthcare providers. Central intake for pediatric rehabilitation was developed and implemented in 2008 in Winnipeg Manitoba Canada as a means to enhance service coordination and access for children and their families. This study evaluates the process and impact of implementing a central intake system, using pediatric physiotherapy as a case example. A mixed methods instrumental case study design was used. Interviews were completed with 9 individuals. Data was transcribed and analyzed for themes. Quantitative data (wait times, referral volume and caregiver satisfaction) was collected for children referred to physiotherapy with complex needs (n = 1399), and a comparison group of children referred for orthopedic concerns (n = 3901). Wait times were analyzed using the Kruskal-Wallis test, caregiver satisfaction was analyzed using Fisher exact test and change point modeling was applied to examine referral volume over the study period. Interview participants described central intake implementation as creating more streamlined processes. Factors that facilitated successful implementation included 1) agreement among stakeholders, 2) hiring of a central intake coordinator, 3) a financial commitment from the government and 4) leadership at the individual and organization level. Mean (sd) wait times improved for children with complex needs (12.3(13.1) to 8.0(6.9) days from referral to contact with family, p physiotherapy (i.e., decreasing wait times) for families of children with complex needs. Future research is needed to build on this single discipline case study approach to examine changes in wait times, therapy coordination and stakeholder satisfaction within the context of continuing improvements for pediatric therapy services within the province.

  14. Students’ difficulties in solving linear equation problems

    Science.gov (United States)

    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.

  15. Health Literacy and Access to Care

    Science.gov (United States)

    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

  16. Numerical Magnitude Representation in Children With Mathematical Difficulties With or Without Reading Difficulties.

    Science.gov (United States)

    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.

  17. Communication difficulties perceived by parents of children with developmental disorders.

    Science.gov (United States)

    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.

  18. 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

  19. The challenge of global water access monitoring: evaluating straight-line distance versus self-reported travel time among rural households in Mozambique.

    Science.gov (United States)

    Ho, Jeff C; Russel, Kory C; Davis, Jennifer

    2014-03-01

    Support is growing for the incorporation of fetching time and/or distance considerations in the definition of access to improved water supply used for global monitoring. Current efforts typically rely on self-reported distance and/or travel time data that have been shown to be unreliable. To date, however, there has been no head-to-head comparison of such indicators with other possible distance/time metrics. This study provides such a comparison. We examine the association between both straight-line distance and self-reported one-way travel time with measured route distances to water sources for 1,103 households in Nampula province, Mozambique. We find straight-line, or Euclidean, distance to be a good proxy for route distance (R(2) = 0.98), while self-reported travel time is a poor proxy (R(2) = 0.12). We also apply a variety of time- and distance-based indicators proposed in the literature to our sample data, finding that the share of households classified as having versus lacking access would differ by more than 70 percentage points depending on the particular indicator employed. This work highlights the importance of the ongoing debate regarding valid, reliable, and feasible strategies for monitoring progress in the provision of improved water supply services.

  20. Kinds of Access

    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...

  1. Percutaneous aortic valve implantation of the Medtronic CoreValve self-expanding valve prosthesis via left subclavian artery access: the first case report in Greece.

    Science.gov (United States)

    Karavolias, George K; Georgiadou, Panagiota; Houri, Mazen; Sbarouni, Eftihia; Thomopoulou, Sofia; Tsiapras, Dimitrios; Smirli, Anna; Balanika, Marina; Voudris, Vassilis

    2010-01-01

    This case report describes a percutaneous aortic valve implantation with the Medtronic CoreValve selfexpanding valve prosthesis in a patient with severe aortic stenosis. The approach was made via the left subclavian artery because of the lack of femoral vessel access. The patient was a 78-year-old female with breathlessness on minimal effort, a recent hospitalisation due to pulmonary oedema, and frequent episodes of pre-syncope; surgical valve replacement had been ruled out. The prosthetic valve was successfully implanted with mild paravalvular aortic regurgitation. At 30 days, the patient's clinical condition had significantly improved, with excellent functioning of the aortic valve prosthesis.

  2. Working Memory in Students with Mathematical Difficulties

    Science.gov (United States)

    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.

  3. Barriers to accessing and using health insurance cards among methadone maintenance treatment patients in northern Vietnam.

    Science.gov (United States)

    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

  4. NEW CONTRIBUTIONS TO READING DIFFICULTIES INTERVENTION

    Directory of Open Access Journals (Sweden)

    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.

  5. Discriminating Between Legitimate and Predatory Open Access Journals: Report from the International Federation for Emergency Medicine Research Committee

    Directory of Open Access Journals (Sweden)

    Bhakti Hansoti

    2016-09-01

    Full Text Available Introduction: Open access (OA medical publishing is growing rapidly. While subscription-based publishing does not charge the author, OA does. This opens the door for “predatory” publishers who take authors’ money but provide no substantial peer review or indexing to truly disseminate research findings. Discriminating between predatory and legitimate OA publishers is difficult. Methods: We searched a number of library indexing databases that were available to us through the University of California, Irvine Libraries for journals in the field of emergency medicine (EM. Using criteria from Jeffrey Beall, University of Colorado librarian and an expert on predatory publishing, and the Research Committee of the International Federation for EM, we categorized EM journals as legitimate or likely predatory. Results: We identified 150 journal titles related to EM from all sources, 55 of which met our criteria for OA (37%, the rest subscription based. Of these 55, 25 (45% were likely to be predatory. We present lists of clearly legitimate OA journals, and, conversely, likely predatory ones. We present criteria a researcher can use to discriminate between the two. We present the indexing profiles of legitimate EM OA journals, to inform the researcher about degree of dissemination of research findings by journal. Conclusion: OA journals are proliferating rapidly. About half in EM are legitimate. The rest take substantial money from unsuspecting, usually junior, researchers and provide no value for true dissemination of findings. Researchers should be educated and aware of scam journals.

  6. Occipital transtentorial/falcine approach, a "cross-court" trajectory to accessing contralateral posterior thalamic lesions: case report.

    Science.gov (United States)

    Iwami, Kenichiro; Fujii, Masazumi; Saito, Kiyoshi

    2017-07-01

    Surgical treatment of lesions in the posterior thalamus, especially those extending laterally, is technically challenging because of a deep surgical field, narrow operative corridor, and the surrounding critical neurovascular structures. The authors describe an occipital transtentorial/falcine approach (OTFA) that was successfully used in the treatment of a cavernous malformation (CM) extending laterally from thalamus to midbrain. A 40-year-old man complained of progressive right hemiparesis and numbness. Radiological evaluation revealed a large CM in the left thalamus, surfacing on the pulvinar thalami, and extending 4 cm laterally from the midline. In addition to the usual procedures of a right-sided occipital transtentorial approach, the authors incised the falx cerebri to expand the operative corridor to the left thalamus. They achieved generous exposure of the left thalamus through a "cross-court" oblique trajectory while avoiding excessive retraction on the occipital lobe. The CM was completely removed, and no newly developed or worsening deficits were detected postoperatively. To better understand the OTFA and its application, the authors performed a cadaveric dissection. The OTFA provides increased exposure of the posterior thalamus without cortical incision and facilitates lateral access to this area through the "cross-court" operative corridor. This approach adds to the armamentarium for neurosurgeons treating thalamic lesions.

  7. Working Memory Deficits in Children with Reading Difficulties: Memory Span and Dual Task Coordination

    Science.gov (United States)

    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…

  8. Children's History of Speech-Language Difficulties: Genetic Influences and Associations with Reading-Related Measures

    Science.gov (United States)

    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…

  9. Cognitive and affective dimensions of difficulties in emotional functioning in somatoform disorders and borderline personality disorder.

    Science.gov (United States)

    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.

  10. Design of a Computer-Controlled, Random-Access Slide Projector Interface. Final Report (April 1974 - November 1974).

    Science.gov (United States)

    Kirby, Paul J.; And Others

    The design, development, test, and evaluation of an electronic hardware device interfacing a commercially available slide projector with a plasma panel computer terminal is reported. The interface device allows an instructional computer program to select slides for viewing based upon the lesson student situation parameters of the instructional…

  11. Open Access

    Science.gov (United States)

    Suber, Peter

    2012-01-01

    The Internet lets us share perfect copies of our work with a worldwide audience at virtually no cost. We take advantage of this revolutionary opportunity when we make our work "open access": digital, online, free of charge, and free of most copyright and licensing restrictions. Open access is made possible by the Internet and copyright-holder…

  12. Open access

    African Journals Online (AJOL)

    Prof. Dennis Ocholla

    The argument that access to information is an instrumental and individual as well as ... and Dean School of Information Studies, University of Wisconsin, Milwaukee, USA. ... to scholarly publications and can be in any digital format, including text, movies and ... language barriers, censorship, lack of access to the Internet and ...

  13. UK Renal Registry 13th Annual Report (December 2010): Chapter 14: enhancing access to UK Renal Registry data through innovative online data visualisations.

    Science.gov (United States)

    Chaudhry, Afzal; Feest, Terry

    2011-01-01

    As the volume of data and analyses grows with time, so does the need to present this increasingly complex information in an accessible and clinically informative manner which is responsive to, and reflects the nature of, the enquiries made by those seeking to access the data. The UK Renal Registry (UKRR) now has a bespoke interactive data portal which provides a focussed point of access to a variety of graphical display formats and analyses of UKRR data including: · Centre-specific reports--a distillation of annual UKRR data including a colour-coded dashboard summary as well as both funnel plots and longitudinal statistical process control charts for a range of clinical parameters. · Interactive flash-based longitudinal Statistical Process Control charts on a per-centre and per-parameter basis allowing for a more detailed review of performance over time. These charts are the interactive correlates of those available in the centre-specific reports. · Rosling/Gapminder-style motion charts on a perparameter basis simultaneously detailing performance and activity data from multiple centres interactively over time (more details below). · An interactive graphical pivot chart solution using OLAP technology allowing users to design and export their own charts/analyses in real-time using UKRR data. This work builds strongly on the wealth of information arising from the high-quality validated UKRR datasets. The portal will empower and engage the UK renal community in the comparative analysis of delivered renal care ultimately leading to enhanced quality improvement over time. Copyright © 2011 S. Karger AG, Basel.

  14. A review of existing studies reporting the negative effects of alcohol access and positive effects of alcohol control policies on interpersonal violence

    Directory of Open Access Journals (Sweden)

    Jessica Laura Fitterer

    2015-11-01

    Full Text Available Alcohol consumption often leads to elevated rates of violence yet alcohol access policies continue to relax across the globe. Our review establishes the extent alcohol policy can moderate violent crime through alcohol availability restrictions. Results were informed from comprehensive selection of peer-reviewed journals from 1950 to October 2015. Our search identified 88 relevant studies on alcohol access and violence conducted across 12 countries. Seventeen studies included quasi-control design, and 23 conducted intervention analysis. Seventy-two (82% reported a significant relationship between alcohol access and violent offences. Alcohol outlet studies reported the greatest percentage of significant results (93%, with trading hours (63%, and alcohol price following (58%. Results from baseline studies indicated the effectiveness of increasing the price of commonly consumed alcohol, restricting the hours of alcohol trading, and limiting the number of alcohol outlets per region to prevent violent offences. Unclear are the effects of tax reductions, restriction of on-premises re-entry, and different outlet types on violent crime. Further, the generalization of statistics over broad areas and the low number of control/intervention studies poses some concern for confounding or correlated effects on study results, and amount of information for local level prevention of interpersonal violence. Future studies should focus on gathering longitudinal data, validating models, limiting crime data to peak drinking days and times, and wherever possible collecting the joint distribution between violent crime, intoxication, and place. A greater up take of local level analysis will benefit studies comparing the influence of multiple alcohol establishment types by relating the location of a crime to establishment proximity. Despite, some uncertainties particular studies showed that even modest policy changes such as 1% increases in alcohol price, one hour changes

  15. UK Renal Registry 16th annual report: chapter 14 2012 multisite dialysis access audit in England, Northern Ireland and Wales and 2011 PD one year follow-up: national and centre-specific analyses.

    Science.gov (United States)

    Briggs, Victoria; Pitcher, David; Shaw, Catriona; Fluck, Richard; Wilkie, Martin

    2013-01-01

    Dialysis access should be timely, minimise complications and maintain functionality. Good functional access is required for renal replacement therapy (RRT) to be successful. The aim of the combined vascular and peritoneal dialysis access audit was to examine practice patterns with respect to dialysis access and highlight variations in practice between renal centres. The UK Renal Registry collected centre-specific information on vascular and peritoneal access outcome measures including patient demographics, dialysis access type (at start of dialysis and three months after start of dialysis), surgical assessment and access functionality. The combined access audit covered incident haemodialysis (HD) and peritoneal dialysis (PD) patients in 2012 from England, Northern Ireland and Wales. Centres who had reported data on incident PD patients for the previous audit in 2011 were additionally asked to provide one year follow up data for this group. Fifty-one centres in England, Wales and Northern Ireland (representing 82% of all centres) returned data on first access from 3,720 incident HD patients and 1,018 incident PD patients. A strong relationship was seen between surgical assessment and the likelihood of starting HD with an arteriovenous fistula (AVF). Type of first access was related to the length of time known to renal services with higher numbers of AVFs and PD catheters used in patients known to renal services for at least one year. Three month and one year outcomes of HD and PD access were poorly reported. This audit provides information on important patient related outcome measures with the potential to lead to an improvement in access provision. This represents an important advance, however data collection remains suboptimal. There is wide practice variation across the England, Wales and Northern Ireland in provision of both HD and PD access which requires further exploration. © 2014 S. Karger AG, Basel.

  16. Difficulties in Initial Algebra Learning in Indonesia

    Science.gov (United States)

    Jupri, Al; Drijvers, Paul; van den Heuvel-Panhuizen, Marja

    2014-01-01

    Within mathematics curricula, algebra has been widely recognized as one of the most difficult topics, which leads to learning difficulties worldwide. In Indonesia, algebra performance is an important issue. In the Trends in International Mathematics and Science Study (TIMSS) 2007, Indonesian students' achievement in the algebra domain was…

  17. 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)

  18. Fractions Learning in Children with Mathematics Difficulties

    Science.gov (United States)

    Tian, Jing; Siegler, Robert S.

    2017-01-01

    Learning fractions is difficult for children in general and especially difficult for children with mathematics difficulties (MD). Recent research on developmental and individual differences in fraction knowledge of children with MD and typically achieving (TA) children has demonstrated that U.S. children with MD start middle school behind their TA…

  19. Difficulties in initial algebra learning in Indonesia

    NARCIS (Netherlands)

    Jupri, Al; Drijvers, Paulus; van den Heuvel - Panhuizen, Marja

    2014-01-01

    Within mathematics curricula, algebra has been widely recognized as one of the most difficult topics, which leads to learning difficulties worldwide. In Indonesia, algebra performance is an important issue. In the Trends in International Mathematics and Science Study (TIMSS) 2007, Indonesian

  20. Infrared difficulties with thermal quantum field theories

    International Nuclear Information System (INIS)

    Grandou, T.

    1997-01-01

    Reviewing briefly the two main difficulties encountered in thermal quantum field theories at finite temperature when dealing with the Braaten-Pisarski (BP) resummation program, the motivation is introduced of an analysis relying on the bare perturbation theory, right from the onset. (author)

  1. Binomial test models and item difficulty

    NARCIS (Netherlands)

    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

  2. Time Estimation Deficits in Childhood Mathematics Difficulties

    Science.gov (United States)

    Hurks, Petra P. M.; van Loosbroek, Erik

    2014-01-01

    Time perception has not been comprehensively examined in mathematics difficulties (MD). Therefore, verbal time estimation, production, and reproduction were tested in 13 individuals with MD and 16 healthy controls, matched for age, sex, and intellectual skills. Individuals with MD performed comparably to controls in time reproduction, but showed a…

  3. Students' Difficulties with Vector Calculus in Electrodynamics

    Science.gov (United States)

    Bollen, Laurens; van Kampen, Paul; De Cock, Mieke

    2015-01-01

    Understanding Maxwell's equations in differential form is of great importance when studying the electrodynamic phenomena discussed in advanced electromagnetism courses. It is therefore necessary that students master the use of vector calculus in physical situations. In this light we investigated the difficulties second year students at KU Leuven…

  4. Learning Difficulties and Nutrition: Pills or Pedagogy?

    Science.gov (United States)

    Evans, Roy

    1999-01-01

    Examines the efforts to find effective ameliorative measures for literacy difficulties such as dyslexia and dyspraxia, focusing on noneducational techniques found in holistic medicine, complementary therapies, and nutritional supplements. Maintains that dyslexia has become big business for drug companies and that the appropriate research regarding…

  5. Mathematics Difficulties: Does One Approach Fit All?

    Science.gov (United States)

    Gifford, Sue; Rockliffe, Freda

    2012-01-01

    This article reviews the nature of learning difficulties in mathematics and, in particular, the nature and prevalence of dyscalculia, a condition that affects the acquisition of arithmetical skills. The evidence reviewed suggests that younger children (under the age of 10) often display a combination of problems, including minor physical…

  6. Quantization and hall effect: necessities and difficulties

    International Nuclear Information System (INIS)

    Ahmed Bouketir; Hishamuddin Zainuddin

    1999-01-01

    The quantization procedure is a necessary tool for a proper understanding of many interesting quantum phenomena in modern physics. In this note, we focus on geometrical framework for such procedures, particularly the group-theoretic approach and their difficulties. Finally we look through the example of Hall effect as a quantized macroscopic phenomenon with group-theoretic quantization approach. (author)

  7. Pupils' Difficulties: What Can the Teacher Do?

    Science.gov (United States)

    Dawson, C. J.

    1978-01-01

    Discusses how the teacher can deal with difficulties pupils of varying ages have in understanding certain chemical ideas. The article does not support using a Piagetian model for science courses in secondary schools. It suggests that Ausubel's learning theory is of much more use to the practicing teacher. (HM)

  8. Older Adults Have Difficulty in Decoding Sarcasm

    Science.gov (United States)

    Phillips, Louise H.; Allen, Roy; Bull, Rebecca; Hering, Alexandra; Kliegel, Matthias; Channon, Shelley

    2015-01-01

    Younger and older adults differ in performance on a range of social-cognitive skills, with older adults having difficulties in decoding nonverbal cues to emotion and intentions. Such skills are likely to be important when deciding whether someone is being sarcastic. In the current study we investigated in a life span sample whether there are…

  9. Early Identification of Reading Comprehension Difficulties

    Science.gov (United States)

    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…

  10. Measuring Difficulty in English-Chinese Translation: Towards a General Model of Translation Difficulty

    Science.gov (United States)

    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…

  11. Memory Abilities in Children with Mathematical Difficulties: Comorbid Language Difficulties Matter

    Science.gov (United States)

    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,…

  12. Comparison between publicly accessible publications, registries, and protocols of phase III trials indicated persistence of selective outcome reporting.

    Science.gov (United States)

    Zhang, Sheng; Liang, Fei; Li, Wenfeng

    2017-11-01

    The decision to make protocols of phase III randomized controlled trials (RCTs) publicly accessible by leading journals was a landmark event in clinical trial reporting. Here, we compared primary outcomes defined in protocols with those in publications describing the trials and in trial registration. We identified phase III RCTs published between January 1, 2012, and June 30, 2015, in The New England Journal of Medicine, The Lancet, The Journal of the American Medical Association, and The BMJ with available protocols. Consistency in primary outcomes between protocols and registries (articles) was evaluated. We identified 299 phase III RCTs with available protocols in this analysis. Out of them, 25 trials (8.4%) had some discrepancy for primary outcomes between publications and protocols. Types of discrepancies included protocol-defined primary outcome reported as nonprimary outcome in publication (11 trials, 3.7%), protocol-defined primary outcome omitted in publication (10 trials, 3.3%), new primary outcome introduced in publication (8 trials, 2.7%), protocol-defined nonprimary outcome reported as primary outcome in publication (4 trials, 1.3%), and different timing of assessment of primary outcome (4 trials, 1.3%). Out of trials with discrepancies in primary outcome, 15 trials (60.0%) had discrepancies that favored statistically significant results. Registration could be seen as a valid surrogate of protocol in 237 of 299 trials (79.3%) with regard to primary outcome. Despite unrestricted public access to protocols, selective outcome reporting persists in a small fraction of phase III RCTs. Only studies from four leading journals were included, which may cause selection bias and limit the generalizability of this finding. Copyright © 2017 Elsevier Inc. All rights reserved.

  13. 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.

  14. Falls and Hospitalizations Among Persons With Dementia and Associated Caregiver Emotional Difficulties.

    Science.gov (United States)

    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.

  15. Responding to the Needs of Students with Mental Health Difficulties in Higher Education: An Irish Perspective

    Science.gov (United States)

    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…

  16. Facilities for external radiation accessible for investigation on biological studies - progress report may 2004; Les installations d'irradiation externe accessibles aux etudes de biologie - etat d'avancement mai 2004

    Energy Technology Data Exchange (ETDEWEB)

    Gaillard-Lecanu, E. [CEA Fontenay aux Roses (DSV/Carmin), 92 (France); Authier, N.; Verrey, B. [CEA Valduc, Dept. Recherche sur les Materiaux Nucleaires, 21 - Is-sur-Tille (France); Bailly, I. [CEA Bruyeres le Chatel, 91 (France). Dept. de Physique Theorique et Appliquee; Baldacchino, G.; Pin, S.; Pommeret, S.; Renault, J.Ph. [CEA Saclay, Dept. de Recherche sur Etat Condense, les Atomes et les Molecules, 91 - Gif sur Yvette (France); Bordy, J.M. [CEA Saclay, Dir. de la Recherche Technologique (DRT/DETECS/LNHB/LMD), 91 - Gif sur Yvette (France); Coffigny, H. [CEA Fontenay aux Roses, Dept. de Radiobiologie et de Radiopathologie, 92 (France); Cortela, L. [CEA Grenoble, ARC-Nucleart, 38 (France); Duval, D. [CEA Saclay, Schering - CIS bio International, 91 - Gif sur Yvette (France); Leplat, J.J. [CEA Saclay (DSV/DRR/LREG), 91 - Gif sur Yvette (France); Poncy, J.L. [CEA Fontenay aux Roses (DSV/DRR/SRCA), 92 (France); Testard, I. [CEA Caen (DSV/DRR/LRO-LARIA), 14 - Caen (France); Thuret, J.Y. [CEA Saclay (DSV/DBJC/SBGM), 91 - Gif sur Yvette (France)

    2004-07-01

    The Life Science Division of the Atomic Energy Commission is making an inventory of the various radiation sources accessible for investigation on the biological effects of ionizing radiation. In this field, a wide range of studies is being carried out at the Life Science Division, attempting to characterize the kind of lesions with their early biological consequences (on the various cell compartments) and their late biological consequences (deterministic or stochastic effects), in relation to the radiation type and dose, especially at low doses. Several experimental models are available: plants, bacteria, eukaryotic cells from yeast up to mammalian cells and in vivo studies, mostly on rodents, in order to characterize the somatic late effects and the hereditary effects. Due to the significant cost of these facilities, also to their specific properties (nature of the radiation, dose and dose rate, possible accuracy of the irradiation at the molecular level), the closeness is no longer the only criteria for biologists to make a choice. The current evolution is to set up irradiation infrastructures combining ionizing radiation sources themselves and specific tools dedicated to biological studies: cell or molecular biology laboratories, animal facilities. The purpose, in this new frame, is to provide biologists with the most suitable facilities, and, if possible, to change these facilities according to requirements in radiobiology. In this report, the basics of interactions of ionizing radiation with biological tissues are briefly introduced, followed by a presentation of some of the facilities available at the CEA for radiobiological studies. This panorama is not a comprehensive one, new data will be included as they advance, whether reporting existing facilities or if a new one is developed. (authors)

  17. Adding Data Accessibility and Rule-Based Targeted Data Collection to the California Cancer Reporting System for Breast Cases.

    Science.gov (United States)

    1998-03-01

    findings contained in this report are those of the author(s) and should not be construed as an official Department of the Army position, policy or...to policies of appT i rrnhle Federal Law 45 CFE. 46. In conducting research utilizing recombinant DNA technology, the investigator {a) adhered...34-r— ■«-r-mooaimco-q-r-Tj-comcoTi- SCOrCOCVOlCOCMCMt CM CM oocNcooo->*-i-~T-T- cNCD -ɝ’in’<rooco oococO’inT-ot-~CNvrt^M-mcO’-cn CnOl-r-r

  18. 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.

  19. Insurance + Access ≠ Health Care: Typology of Barriers to Health Care Access for Low-Income Families

    Science.gov (United States)

    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

  20. Insurance + access not equal to health care: typology of barriers to health care access for low-income families.

    Science.gov (United States)

    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.

  1. Access Contested

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

    Transforming Global Information and Communication Markets: The Political Economy of ... 8 Control and Resistance: Attacks on Burmese Opposition Media 153 ...... “Reluctant Gatekeepers: Corporate Ethics on a Filtered Internet,” in Access ...

  2. Accessing memory

    Science.gov (United States)

    Yoon, Doe Hyun; Muralimanohar, Naveen; Chang, Jichuan; Ranganthan, Parthasarathy

    2017-09-26

    A disclosed example method involves performing simultaneous data accesses on at least first and second independently selectable logical sub-ranks to access first data via a wide internal data bus in a memory device. The memory device includes a translation buffer chip, memory chips in independently selectable logical sub-ranks, a narrow external data bus to connect the translation buffer chip to a memory controller, and the wide internal data bus between the translation buffer chip and the memory chips. A data access is performed on only the first independently selectable logical sub-rank to access second data via the wide internal data bus. The example method also involves locating a first portion of the first data, a second portion of the first data, and the second data on the narrow external data bus during separate data transfers.

  3. 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

  4. The association between self-reported grocery store access, fruit and vegetable intake, sugar-sweetened beverage consumption, and obesity in a racially diverse, low-income population

    Directory of Open Access Journals (Sweden)

    Lauren Nichol Gase

    2014-11-01

    Full Text Available This study sought to examine the relationship between self-reported time and distance to the nearest retail grocery store, healthy and unhealthy food consumption, and objectively measured body mass index. We conducted a survey with 1,503 racially diverse, low-income residents at five public health centers in Los Angeles County. Most participants reported shopping at a supermarket (86.7% and driving (59.9% to their usual source for groceries. Over half reported living less than a mile from (58.9% and traveling five minutes or less to reach (50.3% the nearest grocery store. In the multivariable regression models, neither self-reported distance nor time to the nearest grocery store was consistently associated with fruit and vegetable intake, sugar-sweetened beverage consumption, or body mass index. Results suggest the need to consider access and quality as well as urban planning and transportation, when examining the relationship between the retail food environment and health outcomes.

  5. The Association between Self-Reported Grocery Store Access, Fruit and Vegetable Intake, Sugar-Sweetened Beverage Consumption, and Obesity in a Racially Diverse, Low-Income Population.

    Science.gov (United States)

    Gase, Lauren Nichol; DeFosset, Amelia Rose; Smith, Lisa V; Kuo, Tony

    2014-01-01

    This study sought to examine the relationship between self-reported time and distance to the nearest retail grocery store, healthy and unhealthy food consumption, and objectively measured body mass index (BMI). We conducted a survey with 1,503 racially diverse, low-income residents at five public health centers in Los Angeles County. Most participants reported shopping at a supermarket (86.7%) and driving (59.9%) to their usual source for groceries. Over half reported living less than a mile from (58.9%) and traveling 5 min or less to reach (50.3%) the nearest grocery store. In the multivariable regression models, neither self-reported distance nor time to the nearest grocery store was consistently associated with fruit and vegetable intake, sugar-sweetened beverage consumption, or BMI. Results suggest that the need to consider access and quality as well as urban planning and transportation, when examining the relationship between the retail food environment and health outcomes.

  6. Interoperative fundus image and report sharing in compliance with integrating the healthcare enterprise conformance and web access todigital imaging and communication in medicinepersistent object protocol

    Directory of Open Access Journals (Sweden)

    Hui-Qun Wu

    2013-12-01

    Full Text Available AIM:To address issues in interoperability between different fundus image systems, we proposed a web eye-picture archiving and communication system (PACS framework in conformance with digital imaging and communication in medicine (DICOM and health level 7 (HL7 protocol to realize fundus images and reports sharing and communication through internet.METHODS: Firstly, a telemedicine-based eye care work flow was established based on integrating the healthcare enterprise (IHE Eye Care technical framework. Then, a browser/server architecture eye-PACS system was established in conformance with the web access to DICOM persistent object (WADO protocol, which contains three tiers.RESULTS:In any client system installed with web browser, clinicians could log in the eye-PACS to observe fundus images and reports. Multipurpose internet mail extensions (MIME type of a structured report is saved as pdf/html with reference link to relevant fundus image using the WADO syntax could provide enough information for clinicians. Some functions provided by open-source Oviyam could be used to query, zoom, move, measure, view DICOM fundus images.CONCLUSION:Such web eye-PACS in compliance to WADO protocol could be used to store and communicate fundus images and reports, therefore is of great significance for teleophthalmology.

  7. A comparative study of financial data sources for critical access hospitals: audited financial statements, the Medicare cost report, and the Internal Revenue Service form 990.

    Science.gov (United States)

    Ozmeral, Alisha Bhadelia; Reiter, Kristin L; Holmes, George M; Pink, George H

    2012-01-01

    Medicare cost reports (MCR), Internal Revenue Service form 990s (IRS 990), and audited financial statements (AFS) vary in their content, detail, purpose, timeliness, and certification. The purpose of this study was to compare selected financial data elements and characterize the extent of differences in financial data and ratios across the MCR, IRS 990, and AFS for a sample of nonprofit critical access hospitals (CAHs). Line items from AFS of 47 CAHs were compared to data reported in the hospitals' MCR and IRS 990s. Line items were based on 9 financial indicators commonly used to assess hospital financial performance. Of the indicators examined, the equity financing ratio most frequently matched between the 3 reports, while salaries and benefits to total expenses and debt service coverage were often different. Variances were driven by differences in individual account balances used to construct the ratios. Relative to AFS, cash was frequently lower on the IRS 990 while marketable securities and unrestricted investments were often higher. Other revenue and net income were consistently lower on the MCR and IRS 990, and depreciation was often higher on the MCR. The majority of total assets and fund balance (equity) values matched across the 3 reports, suggesting differences in classification among detailed accounts were more common than variances between the component totals (total assets, total liabilities, and fund balance). Health policy researchers should consider the impact of these variances on study results and consider ways to improve the availability and quality of financial accounting information. © 2012 National Rural Health Association.

  8. Interoperative fundus image and report sharing in compliance with integrating the healthcare enterprise conformance and web access to digital imaging and communication in medicine persistent object protocol.

    Science.gov (United States)

    Wu, Hui-Qun; Lv, Zheng-Min; Geng, Xing-Yun; Jiang, Kui; Tang, Le-Min; Zhou, Guo-Min; Dong, Jian-Cheng

    2013-01-01

    To address issues in interoperability between different fundus image systems, we proposed a web eye-picture archiving and communication system (PACS) framework in conformance with digital imaging and communication in medicine (DICOM) and health level 7 (HL7) protocol to realize fundus images and reports sharing and communication through internet. Firstly, a telemedicine-based eye care work flow was established based on integrating the healthcare enterprise (IHE) Eye Care technical framework. Then, a browser/server architecture eye-PACS system was established in conformance with the web access to DICOM persistent object (WADO) protocol, which contains three tiers. In any client system installed with web browser, clinicians could log in the eye-PACS to observe fundus images and reports. Multipurpose internet mail extensions (MIME) type of a structured report is saved as pdf/html with reference link to relevant fundus image using the WADO syntax could provide enough information for clinicians. Some functions provided by open-source Oviyam could be used to query, zoom, move, measure, view DICOM fundus images. Such web eye-PACS in compliance to WADO protocol could be used to store and communicate fundus images and reports, therefore is of great significance for teleophthalmology.

  9. Forbidden Access

    CERN Multimedia

    C. Colloca TS/FM

    2004-01-01

    TS/FM group informs you that, for the replacement of the door of the main entrance at bldg. 500, the access will be closed to the public between 19 and 30 July 2004. Access to the Main Building complex will be assured at any time through both of the side doors and from bldg. 64. For more information, please contact 73273. C. Colloca TS/FM

  10. Open Access von A bis Z

    OpenAIRE

    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,...

  11. Impact of Psychosocial Environment on Young Children's Emotional and Behavioral Difficulties.

    Science.gov (United States)

    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.

  12. 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.

  13. 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.

  14. Hearing loss and speech perception in noise difficulties in Fanconi anemia

    NARCIS (Netherlands)

    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

  15. Difficulties in radiodiagnosis of children's tumors

    International Nuclear Information System (INIS)

    Kolinova, E.; Zitkova, M.; Suchmova, M.; Jirasek, M.

    1984-01-01

    Some problems of current radiodiagnosis in pediatric oncology are discussed. The main cause of errors in diagnosis and of difficulties barring timely correct diagnosis is the relatively small number of tumors in children and the ensuing lack of knowledge and experience in diagnosis. The situation can only be improved by the disciplined observance of purposeful diagnostic procedures and the centralization of these procedures at specialized departments. (author)

  16. Access 2010 for dummies

    CERN Document Server

    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

  17. 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.

  18. 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.

  19. Direct pelvic access percutaneous nephrolithotomy in management of ectopic kidney stone: a case report and literature review.

    Science.gov (United States)

    Mehmet, Rifaioglu Murat; Rustu, Yalcinkaya Fatih; Hanefi, Bayarogullari; Mursel, Davarci; Fusun, Aydogan; Mehmet, Inci

    2013-01-01

    Percutaneous nephrolithotomy (PNL) is an effective procedure for the treatment of patients with large or complex stones. PNL is challenging in anomalous kidneys, certain patients, such as those with renal ectopia. It is unable to undergo PNL in conventional technique safely in these cases. We presented a case report of laparoscopic-assisted PNL via direct pelvic puncture in a pelvic kidney stone and discussed previous published literature. A 49-year-old man presented with right lower quadrant pain and hematuria. Intravenous pyelography and three-dimensional computerized tomography revealed an opaque 2.7 × 1.7 cm pelvis renalis stone in a right side ectopic pelvic kidney with grade III hydronephrosis. Laparoscopic-assisted tubeless PNL was performed to remove the calculus. Laparoscopic-assisted PNL as a minimally invasive therapy in ectopic kidney has many advantages. Our case showed that, in pelvic ectopic kidney with pelvic stones greater than 1.5 cm in size, laparoscopic-assisted PNL via direct pelvis puncture is a safe and effective technique.

  20. Prevalence of functioning difficulties and disability in Mexican adolescent women and their populational characteristics

    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.

  1. Process measures or patient reported experience measures (PREMs) for comparing performance across providers? A study of measures related to access and continuity in Swedish primary care.

    Science.gov (United States)

    Glenngård, Anna H; Anell, Anders

    2018-01-01

    Aim To study (a) the covariation between patient reported experience measures (PREMs) and registered process measures of access and continuity when ranking providers in a primary care setting, and (b) whether registered process measures or PREMs provided more or less information about potential linkages between levels of access and continuity and explaining variables. Access and continuity are important objectives in primary care. They can be measured through registered process measures or PREMs. These measures do not necessarily converge in terms of outcomes. Patient views are affected by factors not necessarily reflecting quality of services. Results from surveys are often uncertain due to low response rates, particularly in vulnerable groups. The quality of process measures, on the other hand, may be influenced by registration practices and are often more easy to manipulate. With increased transparency and use of quality measures for management and governance purposes, knowledge about the pros and cons of using different measures to assess the performance across providers are important. Four regression models were developed with registered process measures and PREMs of access and continuity as dependent variables. Independent variables were characteristics of providers as well as geographical location and degree of competition facing providers. Data were taken from two large Swedish county councils. Findings Although ranking of providers is sensitive to the measure used, the results suggest that providers performing well with respect to one measure also tended to perform well with respect to the other. As process measures are easier and quicker to collect they may be looked upon as the preferred option. PREMs were better than process measures when exploring factors that contributed to variation in performance across providers in our study; however, if the purpose of comparison is continuous learning and development of services, a combination of PREMs and

  2. Multisensory perceptual learning is dependent upon task difficulty.

    Science.gov (United States)

    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.

  3. Difficulties in Balint groups: a qualitative study of leaders' experiences.

    Science.gov (United States)

    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.

  4. Accessible Knowledge - Knowledge on Accessibility

    DEFF Research Database (Denmark)

    Kirkeby, Inge Mette

    2015-01-01

    Although serious efforts are made internationally and nationally, it is a slow process to make our physical environment accessible. In the actual design process, architects play a major role. But what kinds of knowledge, including research-based knowledge, do practicing architects make use of when...... designing accessible environments? The answer to the question is crucially important since it affects how knowledge is distributed and how accessibility can be ensured. In order to get first-hand knowledge about the design process and the sources from which they gain knowledge, 11 qualitative interviews...... were conducted with architects with experience of designing for accessibility. The analysis draws on two theoretical distinctions. The first is research-based knowledge versus knowledge used by architects. The second is context-independent knowledge versus context-dependent knowledge. The practitioners...

  5. Increasing access to kidney transplantation for sensitized recipient through three-way kidney paired donation with desensitization: The first Indian report

    Science.gov (United States)

    Kute, Vivek B; Patel, Himanshu V; Shah, Pankaj R; Modi, Pranjal R; Shah, Veena R; Rizvi, Sayyed J; Pal, Bipin C; Modi, Manisha P; Shah, Priya S; Varyani, Umesh T; Wakhare, Pavan S; Shinde, Saiprasad G; Ghodela, Viajay A; Patel, Minaxi H; Trivedi, Varsha B; Trivedi, Hargovind L

    2016-01-01

    The combination of kidney paired donation (KPD) with desensitization represents a promising method of increasing the rate of living donor kidney transplantation (LDKT) in immunologically challenging patients. Patients who are difficult to match and desensitize due to strong donor specific antibody are may be transplanted by a combination of desensitization and KPD protocol with more immunologically favorable donor. We present our experience of combination of desensitization protocol with three-way KPD which contributed to successful LDKT in highly sensitized end stage renal disease patient. All recipients were discharged with normal and stable allograft function at 24 mo follow up. We believe that this is first report from India where three-way KPD exchange was performed with the combination of KPD and desensitization. The combination of desensitization protocol with KPD improves access and outcomes of LDKT. PMID:27803919

  6. UK Renal Registry 17th Annual Report: Chapter 10 2013 Multisite Dialysis Access Audit in England, Northern Ireland and Wales and 2012 PD One Year Follow-up: National and Centre-specific Analyses.

    Science.gov (United States)

    Rao, Anirudh; Pitcher, David; Fluck, Richard; Kumwenda, Mick

    2015-01-01

    Dialysis access should be timely, minimize complications and maintain functionality. The aim of the second combined vascular and peritoneal dialysis access audit was to examine practice patterns with respect to dialysis access and highlight variations in practice between renal centres. The UK Renal Registry collected centre-specific information on incident vascular and peritoneal dialysis access outcome measures in patients from England, Wales and Northern Ireland (EW&NI), including patient demographics, dialysis access type (at start of dialysis and three months after start of dialysis), surgical assessment and access functionality. Centres who had reported data on incident PD patients for the previous 2012 audit were additionally asked to provide one year follow up data for this group. The findings were compared to the audit measures stated in Renal Association clinical practice guidelines for dialysis access. Fifty-seven centres in EW&NI (representing 92% of all centres) returned data on first access from 3,663 incident HD patients and 1,022 incident PD patients. A strong relationship was seen between surgical assessment and the likelihood of starting HD with an arteriovenous fistula (AVF). Twenty-four centres were at least two standard deviations below the 65% target for incident patients starting haemodialysis on AVF and only eight centres (14%) were within two standard deviations of the 85% target for prevalent haemodialysis patients on AVF. There was wide practice variation across the UK in provision of both HD and PD access which requires further exploration.

  7. 14 CFR 121.703 - Service difficulty reports.

    Science.gov (United States)

    2010-01-01

    ... that affects fuel flow or causes hazardous leakage during flight; (12) An unwanted landing gear extension or retraction, or an unwanted opening or closing of landing gear doors during flight; (13) Brake... means the period from the moment the aircraft leaves the surface of the earth on takeoff until it...

  8. 14 CFR 135.415 - Service difficulty reports.

    Science.gov (United States)

    2010-01-01

    ... leaves the surface of the earth on takeoff until it touches down on landing. (c) In addition to the... fuel flow or causes hazardous leakage during flight; (12) An unwanted landing gear extension or retraction or opening or closing of landing gear doors during flight; (13) Brake system components that...

  9. Small Business: HUBZone Program Suffers From Reporting and Implementation Difficulties

    National Research Council Canada - National Science Library

    2001-01-01

    .... Also, all federally-recognized Indian reservations are HUBZones. The purpose of the HUBZone program is to increase employment opportunities, investment, and economic development in these areas...

  10. Diagnostic difficulties with intraorbital foreign bogies: A case report

    International Nuclear Information System (INIS)

    Czarnowska, M.; Studniarek, D.; Socha-Korybalska, D.; Raczynska, K.

    2005-01-01

    As a result of trauma, a foreign body can enter the orbit and, via the orbital fissures, the cranial cavity. The most common are metallic, which are easily seen in X-rays, while low-density foreign bodies cause diagnostics problems. A 27-year old patient underwent trauma of the left orbit when walking in a forest. Twenty-four hours after the trauma the patient came to the ophthalmology outpatient clinic with complaints of inability to move the upper eyelid. The cause of the complaint was a 6-cm-long piece of wood within the orbit which was penetrating the middle cranial fossa via the upper orbital fissure. X-rays are the bases of diagnosing orbito-cranial injures and are a sufficient radiological method when the foreign body is metallic. CT is indispensable for the precise localization of low-density foreign bodies, the estimation of injury, and for diagnosis. CT scans are not typical for each foreign body. In this case, the hypo density of the wood was initially misinterpreted as an intra orbital air edema. (author)

  11. [Diagnostic difficulties in Grave's orbitopathy--case report].

    Science.gov (United States)

    Jedrzejowski, Maciej; Grzesiuk, Wiesław; Szwejda, Elzbieta; Bar-Andziak, Ewa

    2004-03-01

    Graves' orbitopathy is caused by intraorbital inflammatory reaction due to autoimmune thyroid disease. In most cases the diagnosis is based on the coexistence of typical eye signs and hyperthyroidism symptoms. In presented case, the absence of thyroid dysfunction implicated performance of differential diagnosis. Among many available diagnostic tools nuclear magnetic resonance seems to be the most accurate in confirmation of diagnosis of Graves' orbitopathy.

  12. Open access

    CERN Document Server

    Suber, Peter

    2012-01-01

    The Internet lets us share perfect copies of our work with a worldwide audience at virtually no cost. We take advantage of this revolutionary opportunity when we make our work "open access": digital, online, free of charge, and free of most copyright and licensing restrictions. Open access is made possible by the Internet and copyright-holder consent, and many authors, musicians, filmmakers, and other creators who depend on royalties are understandably unwilling to give their consent. But for 350 years, scholars have written peer-reviewed journal articles for impact, not for money, and are free to consent to open access without losing revenue. In this concise introduction, Peter Suber tells us what open access is and isn't, how it benefits authors and readers of research, how we pay for it, how it avoids copyright problems, how it has moved from the periphery to the mainstream, and what its future may hold. Distilling a decade of Suber's influential writing and thinking about open access, this is the indispe...

  13. Medication errors with the use of allopurinol and colchicine: a retrospective study of a national, anonymous Internet-accessible error reporting system.

    Science.gov (United States)

    Mikuls, Ted R; Curtis, Jeffrey R; Allison, Jeroan J; Hicks, Rodney W; Saag, Kenneth G

    2006-03-01

    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. We examined data from the MEDMARX database, covering the period from January 1, 1999 through December 31, 2003. For allopurinol and colchicine, we examined error severity, source, type, contributing factors, and healthcare personnel involved in errors, and we detailed errors resulting in patient harm. Causes of error and the frequency of other error characteristics were compared for gout medications versus other musculoskeletal treatments using the chi-square statistic. Gout medication errors occurred in 39% (n = 273) of facilities participating in the MEDMARX program. Reported errors were predominantly from the inpatient hospital setting and related to the use of allopurinol (n = 524), followed by colchicine (n = 315), probenecid (n = 50), and sulfinpyrazone (n = 2). Compared to errors involving other musculoskeletal treatments, allopurinol and colchicine errors were more often ascribed to problems with physician prescribing (7% for other therapies versus 23-39% for allopurinol and colchicine, p < 0.0001) and less often due to problems with drug administration or nursing error (50% vs 23-27%, p < 0.0001). Our results suggest that inappropriate prescribing practices are characteristic of errors occurring with the use of allopurinol and colchicine. Physician prescribing practices are a potential target for quality improvement interventions in gout care.

  14. Information Access for Disabled Students

    OpenAIRE

    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...

  15. Accessibility-based evaluation of transportation and land-use planning : from laboratory to practice : USDOT Region V Regional University Transportation Center final report.

    Science.gov (United States)

    2016-12-16

    The concept of accessibility has made inroads into planning practice, largely at the system level. That is, accessibility is measured or modeled for current or future regional transportation and land-use scenarios for evaluation or broad policy guida...

  16. Modelling Question Difficulty in an A Level Physics Examination

    Science.gov (United States)

    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…

  17. Access French

    CERN Document Server

    Grosz, Bernard

    2014-01-01

    Access is the major new language series designed with the needs of today's generation of students firmly in mind. Whether learning for leisure or business purposes or working towards a curriculum qualification, Access French is specially designed for adults of all ages and gives students a thorough grounding in all the skills required to understand, speak, read and write contemporary French from scratch. The coursebook consists of 10 units covering different topic areas, each of which includes Language Focus panels explaining the structures covered and a comprehensive glossary. Learning tips

  18. Victimisation and psychosocial difficulties associated with sexual orientation concerns: a school-based study of adolescents.

    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.

  19. Military children's difficulty with reintegration after deployment: A relational turbulence model perspective.

    Science.gov (United States)

    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).

  20. [Double localization of pancreatic insulinoma. Diagnostic and therapeutic difficulties].

    Science.gov (United States)

    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.

  1. On the study and difficulties of mathematics

    CERN Document Server

    De Morgan, Augustus

    2005-01-01

    One of the twentieth century's most eminent mathematical writers, Augustus De Morgan enriched his expositions with insights from history and psychology. On the Study and Difficulties of Mathematics represents some of his best work, containing points usually overlooked by elementary treatises, and written in a fresh and natural tone that provides a refreshing contrast to the mechanical character of common textbooks.Presuming only a knowledge of the rules of algebra and Euclidean theorems, De Morgan begins with some introductory remarks on the nature and objects of mathematics. He discusses the

  2. NECCESITY AND DIFFICULTY OF R D PERFORMANCEMEASUREMENT

    Directory of Open Access Journals (Sweden)

    MariaFekete-Farkas

    2012-07-01

    Full Text Available We are living in a globalized world with increasing population which is facingsevere global economic and financial crises as well as serious environmentalproblems. The possibilities to overcome these difficulties can be interpreted asthe need for sustainable development calling for innovation, increased R Dspending with increased R D effectiveness and efficiency. Besides greaterattentionforthe need of deeper understanding of the innovation process and therole of R D in it, this paper has discussed the many analytical problems thatconfront a researcher in this area, and additionally calls for research oncollaboration between universities and industry. Among other conclusions thispaper also provides a new way of thinking for policy makers and performancemonitoring committees.

  3. Factors protecting against the development of adjustment difficulties in young adults exposed to childhood sexual abuse.

    Science.gov (United States)

    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.

  4. Gaining Access.

    Science.gov (United States)

    Wand, Sean; Thermos, Adam C.

    1998-01-01

    Explains the issues to consider before a college decides to purchase a card-access system. The benefits of automation, questions involving implementation, the criteria for technology selection, what typical card technology involves, privacy concerns, and the placement of card readers are discussed. (GR)

  5. Sectoral Plan 'Deep Geological Disposal', Stage 2. Proposed site areas for the surface facilities of the deep geological repositories as well as for their access infrastructure. General report

    International Nuclear Information System (INIS)

    2011-12-01

    In line with the provisions of the nuclear energy legislation, the sites for deep geological disposal of Swiss radioactive waste are selected in a three-stage Sectoral Plan process (Sectoral Plan for Deep Geological Disposal). The disposal sites are specified in Stage 3 of the selection process with the granting of a general licence in accordance with the Nuclear Energy Act. The first stage of the process was completed on 30 th November 2011, with the decision of the Federal Council to incorporate the six geological siting regions proposed by the National Cooperative for the Disposal of Radioactive Waste (NAGRA) into the Sectoral Plan for Deep Geological Disposal, for further evaluation in Stage 2. The decision also specifies the planning perimeters within which the surface facilities and shaft locations for the repositories will be constructed. In the second stage of the process, at least two geological siting regions each will be specified for the repository for low- and intermediate-level waste (L/ILW) and for the high-level waste (HLW) repository and these will undergo detailed geological investigation in Stage 3. For each of these potential siting regions, at least one location for the surface facility and a corridor for the access infrastructure will also be specified. NAGRA is responsible, at the beginning of Stage 2, for submitting proposals for potential locations for the surface facilities and their access infrastructure to the Federal Office of Energy (SFOE); these are then considered by the regional participation bodies in the siting regions. The present report and its annexes volume document these proposals. In Stage 2, under the lead of the SFOE, socio-economic-ecological studies will also be carried out to investigate the impact of a repository project on the environment, economy and society. The present reports also contain the input data to be provided by NAGRA for the generic (site-independent) part of these impact studies. A meaningful discussion

  6. Perceived difficulties using everyday technology after acquired brain injury: influence on activity and participation.

    Science.gov (United States)

    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.

  7. 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.

  8. Mining for Murder-Suicide: An Approach to Identifying Cases of Murder-Suicide in the National Violent Death Reporting System Restricted Access Database.

    Science.gov (United States)

    McNally, Matthew R; Patton, Christina L; Fremouw, William J

    2016-01-01

    The National Violent Death Reporting System (NVDRS) is a United States Centers for Disease Control and Prevention (CDC) database of violent deaths from 2003 to the present. The NVDRS collects information from 32 states on several types of violent deaths, including suicides, homicides, homicides followed by suicides, and deaths resulting from child maltreatment or intimate partner violence, as well as legal intervention and accidental firearm deaths. Despite the availability of data from police narratives, medical examiner reports, and other sources, reliably finding the cases of murder-suicide in the NVDRS has proven problematic due to the lack of a unique code for murder-suicide incidents and outdated descriptions of case-finding procedures from previous researchers. By providing a description of the methods used to access to the NVDRS and coding procedures used to decipher these data, the authors seek to assist future researchers in correctly identifying cases of murder-suicide deaths while avoiding false positives. © 2015 American Academy of Forensic Sciences.

  9. Intervention program efficacy for spelling difficulties.

    Science.gov (United States)

    Sampaio, Maria Nobre; Capellini, Simone Aparecida

    2014-01-01

    To develop an intervention procedure for spelling difficulties and to verify the effectiveness of the intervention program in students with lower spelling performance. We developed an intervention program for spelling difficulties, according to the semiology of the errors. The program consisted of three modules totaling 16 sessions. The study included 40 students of the third to fifth grade of public elementary education of the city of Marilia (SP), of both genders, in aged of eight to 12 years old, being distributed in the following groups: GI (20 students with lower spelling performance) and GII (20 students with higher spelling performance). In situation of pre and post-testing, all groups were submitted to the Pro-Orthography. The results statistically analyzed showed that, in general, all groups had average of right that has higher in post-testing, reducing the types of errors second semiologycal classification, mainly related to natural spelling errors. However, the results also showed that the groups submitted to the intervention program showed better performance on spelling tests in relation to not submitted. The intervention program developed was effective once the groups submitted showed better performance on spelling tests in relation to not submitted. Therefore, the intervention program can help professionals in the Health and Education to minimize the problems related to spelling, giving students an intervention that is effective for the development of the spelling knowledge.

  10. Determinants of footwear difficulties in people with plantar heel pain.

    Science.gov (United States)

    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.

  11. Emotional regulation difficulties and premenstrual symptoms among Israeli students.

    Science.gov (United States)

    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.

  12. Student Difficulties in Learning Density: A Distributed Cognition Perspective

    Science.gov (United States)

    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.

  13. 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

  14. Regulatory difficulties in a developing country

    International Nuclear Information System (INIS)

    Jacobs, W.R. Jr.

    1978-01-01

    The regulatory agency assigned the task of regulating the initial entry into the field of nuclear power generation by a developing country has a very difficult job. Based on the authors' experience during the start-up and initial operation of Ko-Ri Unit I, the first power reactor in the Republic of Korea, observations on regulatory difficulties and recommendations for improved regulatory effectiveness are offered. The problem areas can be loosely grouped into three general categories: (1) Lack of adequate technical knowledge which is the basis for all effective regulation; (2) Difficulties with understanding and utilization of the required regulatory documentation; (3) Failure to establish the proper regulatory environment. Examples are cited from actual experience during the Ko-Ri Unit I start-up to demonstrate the impact that regulatory activities can have on a plant construction and testing programme. The problems encountered are not unique to developing countries but also exist in the United States of America. Recommendations are offered which should be beneficial to either newly formed regulatory agencies or agencies wishing to improve their abilities and effectiveness. These include: (1) Additional training of regulatory inspectors in plant operations; (2) Additional experience gained by participation in regulatory activities in other countries; (3) Increased attention given to regulatory documents, especially plant technical specifications; (4) Establishment of formal lines of communication between the utility and the regulatory agency; (5) Clear definition of regulatory responsibilities to avoid areas of overlapping jurisdiction; (6) Active participation by the regulatory staff very early in the project. It is hoped that these and other recommendations offered will greatly improve regulatory effectiveness and at the same time demonstrate that when the decision is made to 'go nuclear', a strong commitment must be made to develop and support a technically

  15. College Access Marketing

    Science.gov (United States)

    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…

  16. Difficulties of diabetic patients in the illness control: feelings and behaviors

    OpenAIRE

    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...

  17. The role of materialism on social, emotional and behavioural difficulties for British adolescents

    OpenAIRE

    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...

  18. The conceptualization of emotion regulation difficulties, and its association with posttraumatic stress symptoms in traumatized refugees.

    Science.gov (United States)

    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.

  19. Cyber bullying and internalizing difficulties: above and beyond the impact of traditional forms of bullying.

    Science.gov (United States)

    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.

  20. Access to knowledge difficulties in developing countries : a balanced access to copyrighted works in the digital environment / Thipsurang Vathitphund

    Index Scriptorium Estoniae

    Vathitphund, Thipsurang

    2010-01-01

    Terve ajakiri on pühendatud materjalide kättesaamisele Internetist, juurdepääsule autoriõigusega kaitstud töödele, andmekaitsele, Googlèi teenuste kasutamisele akadeemilistes institutsioonides, videokonverentsile ning digitaalallkirjale

  1. Validating office-based screening for psychosocial strengths and difficulties among youths in foster care.

    Science.gov (United States)

    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.

  2. Staff Report on the Hispanic Access to Higher Education of the Committee on Education and Labor. House of Representatives, Ninety-Ninth Congress, First Session.

    Science.gov (United States)

    Congress of the U.S., Washington, DC. House Committee on Education and Labor.

    Key issues affecting Hispanic participation in higher education are evaluated, with attention to access, retention, and transfer. Societal factors influencing access are also covered: migration, technology, employment and income levels, and secondary schooling. In addition, postsecondary education in Puerto Rico is addressed. Hispanics constitute…

  3. Alone? Perceived social support and chronic interpersonal difficulties in suicidal elders.

    Science.gov (United States)

    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.

  4. Associations between sports participation and psychological difficulties during childhood: a two-year follow up.

    Science.gov (United States)

    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.

  5. Social communication difficulties and autism in previously institutionalized children.

    Science.gov (United States)

    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.

  6. Status of Muslim Immigrants' Children with Learning Difficulties in Vienna

    Science.gov (United States)

    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…

  7. FAMILY BUSINESSES AND THE DIFFICULTIES ENCOUNTERED BY

    Directory of Open Access Journals (Sweden)

    Alessandra Martins

    2009-05-01

    Full Text Available There are few family owned businesses that survive to the next generation. In general, 30% of these businesses are passed on to second generation families and less than 15% survive to third generation families. There has been little research done on third generation family businesses. Therefore the main purpose of this paper is to identify the principal difficulties of passing on managerial skills to the third generation owners. This study uses a case study of a Brazilian family organization composed of twelve enterprises. The instrument to collect data was an individually guided recorded interview with all of the family managers (1ª, 2ª e 3ª generation. The technique applied, was suggested for Miles & Huberman (1994 to group the data in analytical categories to facilitate the analyzed speeches contained in the 49 blocks of responses. As a result, the transition the business to the third generation owners has been strongly associated with the relation between family and business by the following factors: a the succession process influenced by emotional and family values; b conflicts, rivalries and divergences of strategic visions and business goals between the family generations; c lack of professional criteria to hire relatives; and d fragility of communication and consequent asymmetry of information among the family members.

  8. Fractions Learning in Children With Mathematics Difficulties.

    Science.gov (United States)

    Tian, Jing; Siegler, Robert S

    Learning fractions is difficult for children in general and especially difficult for children with mathematics difficulties (MD). Recent research on developmental and individual differences in fraction knowledge of children with MD and typically achieving (TA) children has demonstrated that U.S. children with MD start middle school behind their TA peers in fraction understanding and fall further behind during middle school. In contrast, Chinese children, who like the MD children in the United States score in the bottom one third of the distribution in their country, possess reasonably good fraction understanding. We interpret these findings within the framework of the integrated theory of numerical development. By emphasizing the importance of fraction magnitude knowledge for numerical understanding in general, the theory proved useful for understanding differences in fraction knowledge between MD and TA children and for understanding how knowledge can be improved. Several interventions demonstrated the possibility of improving fraction magnitude knowledge and producing benefits that generalize to fraction arithmetic learning among children with MD. The reasonably good fraction understanding of Chinese children with MD and several successful interventions with U.S. students provide hope for the improvement of fraction knowledge among American children with MD.

  9. Multidisciplinary intervention for childhood feeding difficulties.

    Science.gov (United States)

    Marshall, Jeanne; Hill, Rebecca J; Ware, Robert S; Ziviani, Jenny; Dodrill, Pamela

    2015-05-01

    The aim of the study was to determine whether operant conditioning (OC) or systematic desensitization (SysD) intervention resulted in more improvements in dietary variety/intake, and more reductions in difficult mealtime behaviors. Children 2 to 6 years with autism spectrum disorder or with a nonmedically complex history were recruited. Feeding difficulties were confirmed based on clinical assessment. Participants were randomized to receive 10 OC or SysD sessions (parents could opt for intervention once per week, or intensively within a week). Immersive parent education was delivered across both arms. A 3-month review was provided to measure outcomes postintervention. In total, 68 participants (87%) completed the study. There were no significant differences in outcome measures between the OC and SysD intervention groups from baseline to 3-month review. When the data were combined across both groups, however, significant improvements in primary outcome measures were observed (P education, these 2 intervention approaches are effective. Further research is required in exploring these interventions across other subgroups, and examining outcomes for longer periods.

  10. [Difficulties in psychology and sexual behavior].

    Science.gov (United States)

    1973-01-01

    After an introduction by S. Kepes (Fertilite Orthogenie 4(4): 174-177,1972) the participants and audience discussed general topics such as the physician-patient relationship, unconscious motives, attitudes of male partners and physicians, and treatment of minors. Resistance by male partners toward contraception was considered due to fear of inadequacy in the face of female sexuality or to adherence to a double moral standard for wives. A gynecologist claimed that high school students are more likely to request contraception and use it effectively than they were 5 years ago; a midwife said that less privileged adolescents frequently become pregnant. Opinions were expressed that it is inappropriate to consider contraception from a psychological viewpoint, since it is part of a revolution toward a better life; that some psychological difficulties come from the doctor having preferences for certain methods; that the pill does not cause frigidity but is often blamed for preexisting problems; that the press frightens women away from taking the pill; that physicians should prescribe contraception to minors without seeking parental consent (unlawful in France).

  11. Enabling Pupils with Learning Difficulties to Reflect on Their Own Thinking.

    Science.gov (United States)

    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)

  12. "I Want to Feel Like a Full Man": Conceptualizing Gay, Bisexual, and Heterosexual Men's Sexual Difficulties.

    Science.gov (United States)

    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.

  13. 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...

  14. Intercity passenger rail : Amtrak will continue to have difficulty controlling its costs and meeting capital needs

    Science.gov (United States)

    2000-05-01

    This report responds to the request to review Amtrak's costs and capital investment needs. In particular, this report discusses changes since 1995 in Amtrak's operating costs, including labor costs, payments to freight railroads to access their track...

  15. Young people with features of gender dysphoria: Demographics and associated difficulties.

    Science.gov (United States)

    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.

  16. Decrease in Self-Reported Tanning Frequency among Utah Teens following the Passage of Utah Senate Bill 41: An Analysis of the Effects of Youth-Access Restriction Laws on Tanning Behaviors

    OpenAIRE

    Simmons, Rebecca G.; Smith, Kristi; Balough, Meghan; Friedrichs, Michael

    2014-01-01

    Introduction. Adolescent use of indoor tanning facilities is associated with an increased risk in later development of melanoma skin cancers. States that have imposed age restrictions on access to indoor tanning generally show lower self-reported rates of indoor tanning than states with no restrictions, but currently no studies have assessed indoor tanning use before and after such restrictions. Methods. In 2013, we compared self-reported indoor tanning data collected in the Prevention Needs ...

  17. Health Professions' Retention-Accession Incentives Study Report to Congress (Phase 1: Compensation Comparison of Selected Uniformed and Private-Sector Health Care Professionals)

    National Research Council Canada - National Science Library

    Brannman, Shayne

    2001-01-01

    .... The Department of Defense (DOD) is competing against private sector employees who are offering accession bonuses, flexible work schedules, portable retirement plans, continuing educational opportunities, employee-tailored benefits...

  18. Addison's disease - the difficulty of diagnosis

    OpenAIRE

    Preto, Clara; Correia, Joana; Pinheiro, Marina; Barroso, Fábio; Leite, Sara; Fernandes, Alexandre; Cardoso, Helena; Borges, Teresa

    2018-01-01

    Introduction: Primary adrenal insufficiency is a rare disease, especially in pediatric age. Case report: We report the case of a teenager with astenia with four months’ evolution, causing repeated visits to the emergency department during the previous month due gastrointestinal symptoms and a ten kilograms weight loss. In admission the patient had a reasonable general condition, hydrated and without cutaneous hyperpigmentation. Laboratory results showed hyponatremia, increased levels of corti...

  19. Transcatheter closure of a large patent ductus arteriosus using jugular access in an infant.

    Science.gov (United States)

    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.

  20. Measurement of functional task difficulty during motor learning: What level of difficulty corresponds to the optimal challenge point?

    Science.gov (United States)

    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.

  1. Difficulties related to compliance with gluten-free diet by patients with coeliac disease living in Upper Silesia

    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.

  2. Feeding difficulties in children with food protein-induced gastrointestinal allergies.

    Science.gov (United States)

    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.

  3. 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.

  4. Proband Mental Health Difficulties and Parental Stress Predict Mental Health in Toddlers at High-Risk for Autism Spectrum Disorders.

    Science.gov (United States)

    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.

  5. Change in economic difficulties and physical and mental functioning: Evidence from British and Finnish employee cohorts.

    Science.gov (United States)

    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.

  6. Can Excess Bilirubin Levels Cause Learning Difficulties?

    Science.gov (United States)

    Pretorius, E.; Naude, H.; Becker, P. J.

    2002-01-01

    Examined learning problems in South African sample of 7- to 14-year-olds whose mothers reported excessively high infant bilirubin shortly after the child's birth. Found that this sample had lowered verbal ability with the majority also showing impaired short-term and long-term memory. Findings suggested that impaired formation of astrocytes…

  7. Creating a supportive learning environment for students with learning difficulties

    OpenAIRE

    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...

  8. Prediction and Stability of Mathematics Skill and Difficulty

    OpenAIRE

    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...

  9. Grammatical Templates: Improving Text Difficulty Evaluation for Language Learners

    OpenAIRE

    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...

  10. Late Emerging Reading Difficulties in English Language Learners

    OpenAIRE

    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...

  11. Restitution report of the working group called 'access to the information' implemented in the framework of the public debate EPR ''head of series'' at Flamanville

    International Nuclear Information System (INIS)

    2005-10-01

    The works realized by this working group show some strong conclusions. The citizen confidence in the information access availability must be reinforced. The existence of secrets protecting the industrialists and the Nation interests seems all the more legitimate since they are well limited.The respect of the industrial and commercial secret is not an opposition to a better access to the nuclear safety documents. The defense secret is an indispensable element of the nuclear safety but its role and limits must be debated. (A.L.B.)

  12. INTOR critical issue D: maintainability. Tritium containment and personnel access vs remote maintenance, Chapter VI of the US INTOR report for Phase Two A, Part 2

    International Nuclear Information System (INIS)

    Spampinato, P.T.; Finn, P.A.; Gohar, Y.

    1984-01-01

    The purpose of this study is to compare the benefits and costs associated with personnel access mmaintenance procedures compared to those of all-remote maintenance procedures. The INTOR Phase Two A, Part I configuration was used to make this comparison. For both approaches, capital and operating costs were considered to first order, maintenance equipment requirements were investigated, maintenance requirements common to both approaches and unique to each were identified, tritium handling requirements were outlined, and maintenance scenarios and device downtime were developed for both. In addition, estimates of person-rem exposure were made for the personnel access approach

  13. Addison's disease - the difficulty of diagnosis

    Directory of Open Access Journals (Sweden)

    Clara Preto

    2018-04-01

    Full Text Available Introduction: Primary adrenal insufficiency is a rare disease, especially in pediatric age. Case report: We report the case of a teenager with astenia with four months’ evolution, causing repeated visits to the emergency department during the previous month due gastrointestinal symptoms and a ten kilograms weight loss. In admission the patient had a reasonable general condition, hydrated and without cutaneous hyperpigmentation. Laboratory results showed hyponatremia, increased levels of corticotropin with normal cortisol levels, increased levels of renin with decreased aldosterone levels and presence of antissuprarrenal antibodies, allowing the diagnosis of autoimmune primary adrenal insufficiency. The boy started treatment with hydrocortisone and fludrocortisone with favorable response. Discussion/conclusions: The diagnosis of Addison’s disease requires a high degree of suspicion due its unspecific symptomatology. This disease often presents gastrointestinal symptoms. Thus, towards a patient with hyponatremia accompanied by constitutional and gastrointestinal symptoms, we must always consider this diagnosis.

  14. Difficulties with True Interoperability in Modeling & Simulation

    Science.gov (United States)

    2011-12-01

    Standards in M&S cover multiple layers of technical abstraction. There are middleware specifica- tions, such as the High Level Architecture (HLA) ( IEEE Xplore ... IEEE Xplore Digital Library. 2010. 1516-2010 IEEE Standard for Modeling and Simulation (M&S) High Level Architecture (HLA) – Framework and Rules...using different communication protocols being able to allow da- 2642978-1-4577-2109-0/11/$26.00 ©2011 IEEE Report Documentation Page Form ApprovedOMB No

  15. Medicaid: State and Federal Actions Have Been Taken to Improve Children's Access to Dental Services, but Gaps Remain. Report to Congressional Requesters. GAO-09-723

    Science.gov (United States)

    US Government Accountability Office, 2009

    2009-01-01

    Children's access to Medicaid dental services is a long-standing concern. The tragic case of a 12-year-old boy who died from an untreated infected tooth that led to a fatal brain infection renewed attention to this issue. He was enrolled in Medicaid--a joint federal and state program that provides health care coverage, including dental care, for…

  16. Case Report: Access to Personal Data and the Right to Good Governance during Asylum Procedures after the CJEU’s YS. and M. and S. judgment

    NARCIS (Netherlands)

    Brouwer, E.R.; Zuiderveen Borgesius, F.J.

    2015-01-01

    In the YS. and M. and S. judgment, the Court of Justice of the European Union ruled on three procedures in which Dutch judges asked for clarification on the right of asylum seekers to have access to the documents regarding the decision on asylum applications. The judgment is relevant for

  17. The Strengths and Difficulties Questionnaire in the Nordic countries.

    Science.gov (United States)

    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.

  18. Lexical Difficulty--Using Elicited Imitation to Study Child L2

    Science.gov (United States)

    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…

  19. Separation-Individuation Difficulties and Cognitive-Behavioral Indicators of Eating Disorders among College Women.

    Science.gov (United States)

    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…

  20. Identifying Student Difficulties with Entropy, Heat Engines, and the Carnot Cycle

    Science.gov (United States)

    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…

  1. The Differential Effects of Labelling: How Do "Dyslexia" and "Reading Difficulties" Affect Teachers' Beliefs

    Science.gov (United States)

    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…

  2. How University Students with Reading Difficulties Are Supported in Achieving Their Goals

    Science.gov (United States)

    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…

  3. Readability Formulas and User Perceptions of Electronic Health Records Difficulty: A Corpus Study.

    Science.gov (United States)

    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

  4. Emotional Intelligence, Personality Traits and Career Decision Difficulties

    Science.gov (United States)

    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…

  5. Learner's Learning Experiences & Difficulties towards (ESL) among UKM Undergraduates

    Science.gov (United States)

    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…

  6. Common Factors Among Family Medicine Residents Who Encounter Difficulty.

    Science.gov (United States)

    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.

  7. 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.

  8. Assessment of Pragmatic Difficulties and Socioemotional Adjustment in Practice

    Science.gov (United States)

    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.…

  9. A Theoretical Framework towards Understanding of Emotional and Behavioural Difficulties

    Science.gov (United States)

    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'…

  10. 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 ...

  11. Early Writing Deficits in Preschoolers with Oral Language Difficulties

    Science.gov (United States)

    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…

  12. School Success for Kids with Dyslexia and Other Reading Difficulties

    Science.gov (United States)

    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…

  13. Perceived importance and difficulty of online activities among visually impaired persons in Nigeria.

    Science.gov (United States)

    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.

  14. Workplace-based assessments of junior doctors: do scores predict training difficulties?

    Science.gov (United States)

    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

  15. Project Access: Strategies to improve care for children and youth with epilepsy: illustrations of recommendations in the IOM report on the epilepsies.

    Science.gov (United States)

    Wagner, Janelle L; Levisohn, Paul M; Onufer, Charles N; Uchegbu, Gloria C; Fletcher, Linda; Zupanc, Mary; Browne, Mimi

    2013-10-01

    Project Access (PA), funded by the Maternal and Child Health Bureau (MCHB) of the Health Resources and Services Administration (HRSA), provided grants to state and local agencies to improve awareness, provide education, design, test, pilot and evaluate system changes, and improve quality of services and access to early diagnosis and comprehensive, coordinated health care and related services for children and youth with epilepsy residing in rural and medically underserved areas. In 2011, the Institute of Medicine of the National Academies (IOM) published a series of 13 recommendations addressing unmet psychosocial, medical, and public health needs of individuals with epilepsy, including children and youth. This paper examines the synergy between these two projects showing how the strategies utilized in the PA demonstration projects can address the IOM recommendations and how these recommendations can inform future initiatives for improving care for children and youth with epilepsy. © 2013.

  16. 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.

  17. Patients' perceptions on losing access to FPs: qualitative study.

    Science.gov (United States)

    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.

  18. Frameless Stereotactic Insertion of Viewsite Brain Access System with Microscope-Mounted Tracking Device for Resection of Deep Brain Lesions: Technical Report

    OpenAIRE

    White, Tim; Chakraborty, Shamik; Lall, Rohan; Fanous, Andrew A; Boockvar, John; Langer, David J

    2017-01-01

    The surgical management of deep brain tumors is often challenging due to the limitations of stereotactic needle biopsies and the morbidity associated with transcortical approaches. We present a novel microscopic navigational technique utilizing the Viewsite Brain Access System (VBAS) (Vycor Medical, Boca Raton, FL, USA) for resection of a deep parietal periventricular high-grade glioma as well as another glioma and a cavernoma with no related morbidity. The approach utilized a navigational tr...

  19. Granulomatous lobular mastitis: difficulty of diagnosis.

    Science.gov (United States)

    Kanazawa, S; Nagae, T; Fukuda, K; Katsu, I; Mukai, N; Sugihara, Y; Otani, H; Higami, Y; Tsunoda, T

    2000-02-01

    We report a case of a rare inflammatory disease, granulomatous lobular mastitis. Two weeks prior to admission the patient, a 43 year-old woman, (gravida 1, para 1) had noticed a left breast mass associated with tenderness. Palpation, gross inspection, and clinical examination, as well as the rapid growth of the mass lesion led us to believe that it was highly suspicious of malignant neoplasm. Mammography, ultrasonography, and computed tomography did not differentiate it from a malignant neoplasm. Aspiration cytology revealed an inflammatory lesion with a few clusters of epithelial cells it was diagnosed as borderline malignancy(class III) by a prudent pathologist, and thus mastectomy was performed. However, the final histologi-cal diagnosis was granulomatous lobular mastitis with no evidence of malignancy. As the clinical manifestations of granulomatous mastitis are similar to those of mammary carcinoma and, as it is an inflammatory lesion of uncertain etiology and pathogenesis, it has often been mistaken clinically for carcinoma and treated as such. Our review of the literature indicated that granulomatous mastitis most often occurs in young patients with a history of childbirth or oral contraceptive usage. Recurrence was documented in 38% of patients, and, accordingly long-term follow-up by aspiration cytology, complete resection, and adequate drug treatment with corticosteroids are recommended.

  20. 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...

  1. Posttraumatic stress, difficulties in emotion regulation, and coping-oriented marijuana use.

    Science.gov (United States)

    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.

  2. 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...

  3. Determining Which Introductory Physics Topics Pre-Service Physics Teachers Have Difficulty Understanding and What Accounts for These Difficulties

    Science.gov (United States)

    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…

  4. 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.

  5. Progress report from Duke University - Cooperative Research and Training Program in Biological Oceanography from 01 July 1965 to 30 June 1966 (NODC Accession 7200405)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The progress report covers the period from 01 July 1965 to 30 June 1966. The main purpose of the report is to provide cooperating investigators with field and cruise...

  6. Cross-cultural acceptability and utility of the strengths and difficulties questionnaire: views of families

    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.

  7. Cross-cultural acceptability and utility of the strengths and difficulties questionnaire: views of families.

    Science.gov (United States)

    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.

  8. 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.

  9. Difficulties faced by family physicians in primary health care centers in Jeddah, Saudi Arabia.

    Science.gov (United States)

    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.

  10. Evaluation of ultrasound-guided vascular access in dogs.

    Science.gov (United States)

    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.

  11. Access to destinations : annual accessibility measure for the Twin Cities Metropolitan Region.

    Science.gov (United States)

    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...

  12. [Measurement of carotenoids by high pressure liquid chromatography: from difficulties to solutions].

    Science.gov (United States)

    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.

  13. Sexual touching and difficulties with sexual arousal and orgasm among U.S. older adults.

    Science.gov (United States)

    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.

  14. Sexual Touching and Difficulties with Sexual Arousal and Orgasm Among U.S. Older Adults

    Science.gov (United States)

    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

  15. Alcohol and Difficulty Conceiving in the SUN Cohort: A Nested Case-Control Study.

    Science.gov (United States)

    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.

  16. 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.

  17. Special needs children with speech and hearing difficulties: prevalence and unmet needs.

    Science.gov (United States)

    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.

  18. Central coordination difficulty and brain CT in infancy

    International Nuclear Information System (INIS)

    Hiraiwa, Mikio; Nonaka, Chizuru; Abe, Toshiaki; Ohmi, Kazuhiko; Togo, Tomoko

    1980-01-01

    Brain CT (Computed Tomography) was performed in eighteen infants, eight males and ten females, one-month-old to twelve-month-old with central coordination difficulty (CCD) in General Electrics (U.S.A.) model CT/T-8800. Analyses of CT findings were enforced with two dimensional measurement which we previously reported. We measured intracranial area, brain area, ventricular area, and bifrontal fluid collection (low density area between skull and anterior side of the frontal lobe). Each slices we measured were through foramen of Monro by fifteen-degree declined from cantho-meatal line. Patients with CCD had higher amount of accumulated bifrontal fluid collection on the CT compared with those without CCD. Brain area index (brain area x100/intracranial area) also showed diagnostic value for CCD. Patients with CCD had lower brain area index than those without CCD. Ventricular area index (ventricular area x100/intracranial area) was less appropriate index for CCD than accumulated bifrontal fluid collection and brain area index. We thought that CT findings of the patients with CCD in infancy were characteristic in accumulated bifrontal fluid collection and reduced brain area index. (author)

  19. Visual search in barn owls: Task difficulty and saccadic behavior.

    Science.gov (United States)

    Orlowski, Julius; Ben-Shahar, Ohad; Wagner, Hermann

    2018-01-01

    How do we find what we are looking for? A target can be in plain view, but it may be detected only after extensive search. During a search we make directed attentional deployments like saccades to segment the scene until we detect the target. Depending on difficulty, the search may be fast with few attentional deployments or slow with many, shorter deployments. Here we study visual search in barn owls by tracking their overt attentional deployments-that is, their head movements-with a camera. We conducted a low-contrast feature search, a high-contrast orientation conjunction search, and a low-contrast orientation conjunction search, each with set sizes varying from 16 to 64 items. The barn owls were able to learn all of these tasks and showed serial search behavior. In a subsequent step, we analyzed how search behavior of owls changes with search complexity. We compared the search mechanisms in these three serial searches with results from pop-out searches our group had reported earlier. Saccade amplitude shortened and fixation duration increased in difficult searches. Also, in conjunction search saccades were guided toward items with shared target features. These data suggest that during visual search, barn owls utilize mechanisms similar to those that humans use.

  20. Difficulties in fumonisin determination: the issue of hidden fumonisins.

    Science.gov (United States)

    Dall'Asta, Chiara; Mangia, Mattia; Berthiller, Franz; Molinelli, Alexandra; Sulyok, Michael; Schuhmacher, Rainer; Krska, Rudolf; Galaverna, Gianni; Dossena, Arnaldo; Marchelli, Rosangela

    2009-11-01

    In this paper, the results obtained by five independent methods for the quantification of fumonisins B(1), B(2), and B(3) in raw maize are reported. Five naturally contaminated maize samples and a reference material were analyzed in three different laboratories. Although each method was validated and common calibrants were used, a poor agreement about fumonisin contamination levels was obtained. In order to investigate the interactions among analyte and matrix leading to this lack of consistency, the occurrence of fumonisin derivatives was checked. Significant amounts of hidden fumonisins were detected for all the considered samples. Furthermore, the application of an in vitro digestion protocol to raw maize allowed for a higher recovery of native fumonisins, suggesting that the interaction occurring among analytes and matrix macromolecules is associative rather than covalent. Depending on the analytical method as well as the maize sample, only 37-68% of the total fumonisin concentrations were found to be extractable from the samples. These results are particularly impressive and significant in the case of the certified reference material, underlying the actual difficulties in ascertaining the trueness of a method for fumonisin determination, opening thus an important issue for risk assessment.

  1. Swallowing difficulties for cerebellar stroke may recover beyond three years.

    Science.gov (United States)

    Périé, S; Wajeman, S; Vivant, R; St Guily, J L

    1999-01-01

    Swallowing disorders after stroke or skull base surgery can be life threatening. Although late recovery can occur, it remains poorly documented. We report a case of a 54-year-old woman with dysphagia resulting from a cerebellar stroke with hemorrhage that was evacuated through craniotomy. Swallowing difficulties were assessed by a videoendoscopic swallowing study. She presented with disruption of swallow initiation and impairment of the pharyngeal stage, resulting in hypopharyngeal stasis and penetration with aspiration. Supportive swallowing therapy was conducted with careful reeducation to assist initiation of the pharyngeal stage as well as development of compensatory postural technique. Initial improvement was very slow but became rapidly progressive from the 31st month after the stroke. By the 34th month, oral feeding was possible without aspiration. This case demonstrates that improvement in swallowing function can be expected even 3 years after stroke or skull base surgery. Determination of predictive factors for late functional recovery is of great importance and should be the focus of further investigation.

  2. 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.

  3. Exploring communication difficulties in pediatric hematology: oncology nurses.

    Science.gov (United States)

    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.

  4. 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

  5. Subjective Word-Finding Difficulty Reduces Engagement in Social Leisure Activities in Alzheimer’s Disease

    Science.gov (United States)

    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

  6. UK Renal Registry 15th annual report: Chapter 8 UK multisite peritoneal dialysis access catheter audit for first PD catheters 2011.

    Science.gov (United States)

    Briggs, Victoria; Pitcher, David; Braddon, Fiona; Fogarty, Damian; Wilkie, Martin

    2013-01-01

    The central paradigm of effective peritoneal dialysis (PD) is an appropriate standard of PD catheter function. The aim of the project was to develop an effective national PD access audit which would identify an 'appropriate standard' of PD catheter function. The UK Renal Registry collected centre specific information on various PD access outcome measures including catheter functionality and post-insertion complications. The first PD access audit covering England, Northern Ireland and Wales was conducted during April to June 2012 looking at incident dialysis patients in 2011. Forty three data collection spreadsheets were returned from a total of 65 centres describing 917 PD catheter placements. The median age of PD patients was 61 years and 61.5% were male. The proportion of patients initiated on PD in comparison to HD was lower in socially deprived areas. There was a relationship between the timing of nephrology referral and the likelihood of surgical assessment regarding PD catheter placement. Patients with diabetes did not have higher rates of PD catheter failure or of early peritonitis. A comparative PD catheter audit has the potential to provide valuable information on an important patient related outcome measure and lead to an improvement in patient experience. There was wide variation between centres of PD catheter use for late presenting patients. Overall patients were more likely to get a PD catheter if they had been known to the service for more than 1 year. The percutaneous insertion technique was associated with a higher early (less than 2 week) peritonitis rate and more catheter flow problems. Copyright © 2013 S. Karger AG, Basel.

  7. On the golden road : Open access publishing in particle physics

    CERN Multimedia

    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...

  8. On the golden road Open access publishing in particle physics

    CERN Document Server

    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...

  9. Mobility Modification Alleviates Environmental Influence on Incident Mobility Difficulty among Community-Dwelling Older People: A Two-Year Follow-Up Study

    Science.gov (United States)

    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

  10. [Pain control by continuous infusion of morphine using subarachnoid catheter access to the port--a report of a home death case].

    Science.gov (United States)

    Kawagoe, Koh; Matsuura, Shinobu

    2008-12-01

    This is a case of a 50s male with cecal cancer suffering from severe pain caused by osteolytic metastasis to the lumbar vertebra, right iliac bone, and the head of the right femur. The pain was palliated by continuous infusion of morphine using a subarachnoid catheter that had access to the subcutaneous "Port". The maximum dose of morphine used a day was 384 mg, which corresponded to 57,600 mg/day of oral morphine. Sixty eight days after the start of home hospice care, the patient died at home because of diffuse peritonitis caused by intestinal rupture.

  11. Access to care and use of the Internet to search for health information: results from the US National Health Interview Survey.

    Science.gov (United States)

    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

  12. The behaviour and self-esteem of children with specific speech and language difficulties.

    Science.gov (United States)

    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

  13. Women's experiences of using vaginal trainers (dilators) to treat vaginal penetration difficulties diagnosed as vaginismus: a qualitative interview study.

    Science.gov (United States)

    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

  14. 2005 annual report of MEXT specially promoted research, 'Development of the 4D Space Access Neutron Spectrometer (4SEASONS) and elucidation of the Mechanism of Oxide High-Tc superconductivity'

    International Nuclear Information System (INIS)

    Arai, Masatoshi; Kajimoto, Ryoichi; Nakajima, Kenji; Shamoto, Shin'ichi; Soyama, Kazuhiko; Nakamura, Mitsutaka; Aizawa, Kazuya; Asaoka, Hidehito; Kodama, Katsuaki; Inamura, Yasuhiro; Imai, Yoshinori; Yokoo, Tetsuya; Ino, Takashi; Yamada, Kazuyoshi; Fujita, Masaki; Ohoyama, Kenji; Hiraka, Haruhiro

    2006-11-01

    A research project entitled 'Development of the 4D Space Access Neutron Spectrometer (4SEASONS) and Elucidation of the Mechanism of Oxide High-T c Superconductivity' has started in 2005 (repr. by M. Arai). It is supported by MEXT, Grant-in-Aid for Specially Promoted Research and is going to last until fiscal 2009. The goal of the project is to elucidate the mechanism of oxide high-T c superconductivity by neutron scattering technique. For this purpose, we will develop an inelastic neutron scattering instrument 4SEASONS (4d SpacE AccesS neutrON Spectrometer) for the spallation neutron source in Japan Proton Accelerator Research Complex (J-PARC). The instrument will have 100 times higher performance than existing world-class instruments, and will enable detailed observation of anomalous magnetic excitations and phonons in a four-dimensional momentum-energy space. This report summarizes the progress in the research project in fiscal 2005. (author)

  15. 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)

  16. Fishing Access Areas

    Data.gov (United States)

    Vermont Center for Geographic Information — The Vermont Fish & Wildlife Department maintains developed fishing access areas. These sites provide public access to waters in Vermont for shore fishing...

  17. Accessibility and sensory experiences

    DEFF Research Database (Denmark)

    Ryhl, Camilla

    2010-01-01

    and accessibility. Sensory accessibility accommodates aspects of a sensory disability and describes architectural design requirements needed to ensure access to architectural experiences. In the context of architecture accessibility has become a design concept of its own. It is generally described as ensuring...... physical access to the built environment by accommodating physical disabilities. While the existing concept of accessibility ensures the physical access of everyone to a given space, sensory accessibility ensures the choice of everyone to stay and be able to participate and experience....

  18. Task Number and Cognitive Complexity as Determinants of Difficulty ...

    African Journals Online (AJOL)

    PROF. O. E. OSUAGWU

    2013-09-01

    Sep 1, 2013 ... amenable to item analysis and are sample- ... as item difficulty, item discrimination, and .... The aim of this study is to determine: ... and then evaluators will have to pay significant ... calculated and the test statistics were used to.

  19. Teaching chemistry to students with learning difficulties: exemplary ...

    African Journals Online (AJOL)

    Teaching chemistry to students with learning difficulties: exemplary adaptive instructional practices of experienced teachers. ... Arguably, today's science classrooms are witnessing a situation in which students experience a special learning ...

  20. 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....

  1. Individual difficulties faced by persons with mobility impairments

    CSIR Research Space (South Africa)

    Greeff, M

    2007-07-01

    Full Text Available Disabled persons are experiencing additional difficulties when interacting with systems, applications or devices and also have their own unique requirements that enable them to use a system. If the design of the system does not support...

  2. Reading Comprehension Difficulties among French Students of the ...

    African Journals Online (AJOL)

    Reading Comprehension Difficulties among French Students of the University of Education, Winneba: ... The quality of work done depends so much on the level of understanding of the reading text by students. ... AJOL African Journals Online.

  3. The effectiveness of anger management's training on difficulty of ...

    African Journals Online (AJOL)

    Journal of Fundamental and Applied Sciences ... The purpose of this research is the effect of anger management training on adolescents' emotional regulation. ... Keywords: Anger management, Difficulty in emotion regulation, Adolescent ...

  4. From bureaucratic tot post-bureaucratic: the difficulties of transition

    NARCIS (Netherlands)

    Josserand, E.; Teo, S.; Clegg, S.R.

    2006-01-01

    Purpose - Modern bureaucracies are under reconstruction, bureaucracy being no longer "modern"; they are becoming "post" bureaucratic. Defining the post-bureaucratic organization as a hybrid form provides insight into the intrinsic difficulties involved in the refurbishment of large complex

  5. 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...

  6. Older Adults' Experiences of Sexual Difficulties: Qualitative Findings From the English Longitudinal Study on Ageing (ELSA).

    Science.gov (United States)

    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.

  7. Retrospective Basic Parent-Child Communication Difficulties and Risk of Depression in Deaf Adults.

    Science.gov (United States)

    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.

  8. Difficulties in emotion regulation in patients with eating disorders

    OpenAIRE

    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...

  9. 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.

  10. The Relationships between Indonesian Fourth Graders’ Difficulties in Fractions and the Opportunity to Learn Fractions: A Snapshot of TIMSS Results

    OpenAIRE

    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...

  11. Eating difficulties among stroke patients in the acute state: a descriptive, cross-sectional, comparative study.

    Science.gov (United States)

    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.

  12. Does spinal excitability scale to the difficulty of the dual-task?

    Science.gov (United States)

    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.

  13. 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

  14. Adolescents with a history of specific language impairment (SLI): strengths and difficulties in social, emotional and behavioral functioning.

    Science.gov (United States)

    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.

  15. Report on the access to the deposition areas of the repository. Shaft or Ramp?; Utredning roerande tilltraedesvaegar till djupfoervarets deponeringsomraaden. Schakt eller ramp?

    Energy Technology Data Exchange (ETDEWEB)

    Baeckblom, Goeran [Conrox (Sweden); Christiansson, Rolf; Hedin, Allan; Norman, Fredrik [Swedish Nuclear Fuel and Waste Management Co., Stockholm (Sweden); Lagerstedt, Leif [SwedPower AB, Stockholm (Sweden)

    2003-05-01

    During year 2002, SKB launched the site-specific engineering of the repository at the Oskarshamn and Oesthammar candidate sites. A part of the ongoing engineering work is to evaluate and possibly select type of access from surface to the underground deposition areas located at a depth of some 400 to 700 metres below the surface. The project objectives are to provide a basis for comparison and to compare generic options for access routes to the underground deposition areas, to formulate preliminary Design Justification Statements for the continued site-specific engineering of access routes to the underground repository and also to describe and exemplify methodology for optimisation of the repository engineering. In consideration of the requirements of SKB, several alternative access options are explored. The main alternatives are a ramp with one or two operational areas at the surface, a ramp with parallel excavation of a blind shaft and an alternative with shafts only. A suite of objective functions were employed in the evaluation of the main alternatives relating to long-term safety, occupational safety during construction and operation, environmental impact, sustainability of natural resources, total cost, schedules, flexibility and project risks. All alternatives studied are feasible and safe, but the alternative with a spiral ramp and a blind shaft is deemed to be the most favourable option. The alternative has the highest flexibility without any tangible disadvantages related neither to long-term safety, environmental impact nor to schedules. It is an advantage that ramp traffic is drastically reduced as rock and backfilling material is transported by the skip rather than by vehicles in the ramp, thereby reducing risks of accidents and fires in the ramp. The concurrent ramp and shaft excavation also shorten the construction period with 18 months for the underground excavations. The discounted total cost is however 100 million Swedish Kronor higher for this

  16. Use of computer access technology as an alternative to writing for a pre-school child with athetoid cerebral palsy--a case report.

    Science.gov (United States)

    Dhas, Brightlin Nithis; Samuel, Preethy Sarah; Manigandan, C

    2014-07-01

    The purpose of this study was to demonstrate the use of an outcome-driven model of decision-making in the implementation of computer access technology (CAT) for a pre-school child with athetoid cerebral palsy. The child did not have the fine motor skills required to hold a pencil but had the cognitive abilities to learn to write; therefore, we explored the use of a CAT device to enable written communication. Case study methodology was used to describe the selection process, child-level outcomes, and clinical challenges faced by the therapist in the use of a consortium model that was designed for an outcome-driven model of decision-making. The critical role of an occupational therapist in this process using a family-centered approach is discussed.

  17. Frameless Stereotactic Insertion of Viewsite Brain Access System with Microscope-Mounted Tracking Device for Resection of Deep Brain Lesions: Technical Report.

    Science.gov (United States)

    White, Tim; Chakraborty, Shamik; Lall, Rohan; Fanous, Andrew A; Boockvar, John; Langer, David J

    2017-02-04

    The surgical management of deep brain tumors is often challenging due to the limitations of stereotactic needle biopsies and the morbidity associated with transcortical approaches. We present a novel microscopic navigational technique utilizing the Viewsite Brain Access System (VBAS) (Vycor Medical, Boca Raton, FL, USA) for resection of a deep parietal periventricular high-grade glioma as well as another glioma and a cavernoma with no related morbidity. The approach utilized a navigational tracker mounted on a microscope, which was set to the desired trajectory and depth. It allowed gentle continuous insertion of the VBAS directly to a deep lesion under continuous microscopic visualization, increasing safety by obviating the need to look up from the microscope and thus avoiding loss of trajectory. This technique has broad value for the resection of a variety of deep brain lesions.

  18. Users’ Perception And Reported Effects Of Long-term Access To In-Vehicle Traffic Information Services Mediated Through Nomadic Devices

    Directory of Open Access Journals (Sweden)

    Skoglund Tor

    2015-09-01

    Full Text Available ICT-mediated traffic information has been argued to contribute to a more sustainable transport system through affecting drivers. Nevertheless, long-term effects of travellers having access to nomadic in-vehicle systems for traveller information are not well known. This study presents the results from a multi-national large-scale field operational test (FOT. The results show that the users in general were positive to the tested systems and that there were several effects on their driving behaviour but in many cases the effects were limited. Moreover the effects varied between system types. Positive effects were related to comfort, as well as individual and system efficiency. One could also notice that perceived effects were not as high as the participants had expected, leading to some disappointment. Most of the times this was due to the tested systems functioning in a less than optimal way.

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

    Directory of Open Access Journals (Sweden)

    Lisabeth D Finn

    2008-01-01

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

  20. JISC Open Access Briefing Paper

    OpenAIRE

    Swan, Alma

    2005-01-01

    What Open Access is. What Open Access is not. How is Open Access provided? Open Access archives or repositories. Open Access journals. Why should authors provide Open Access to their work? Further information and resources