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Sample records for reported greater difficulty

  1. 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.

  2. Conservatives report, but liberals display, greater happiness.

    Science.gov (United States)

    Wojcik, Sean P; Hovasapian, Arpine; Graham, Jesse; Motyl, Matt; Ditto, Peter H

    2015-03-13

    Research suggesting that political conservatives are happier than political liberals has relied exclusively on self-report measures of subjective well-being. We show that this finding is fully mediated by conservatives' self-enhancing style of self-report (study 1; N = 1433) and then describe three studies drawing from "big data" sources to assess liberal-conservative differences in happiness-related behavior (studies 2 to 4; N = 4936). Relative to conservatives, liberals more frequently used positive emotional language in their speech and smiled more intensely and genuinely in photographs. Our results were consistent across large samples of online survey takers, U.S. politicians, Twitter users, and LinkedIn users. Our findings illustrate the nuanced relationship between political ideology, self-enhancement, and happiness and illuminate the contradictory ways that happiness differences can manifest across behavior and self-reports. Copyright © 2015, American Association for the Advancement of Science.

  3. Promoting greater Federal energy productivity [Final report

    Energy Technology Data Exchange (ETDEWEB)

    Hopkins, Mark; Dudich, Luther

    2003-03-05

    This document is a close-out report describing the work done under this DOE grant to improve Federal Energy Productivity. Over the four years covered in this document, the Alliance To Save Energy conducted liaison with the private sector through our Federal Energy Productivity Task Force. In this time, the Alliance held several successful workshops on the uses of metering in Federal facilities and other meetings. We also conducted significant research on energy efficiency, financing, facilitated studies of potential energy savings in energy intensive agencies, and undertook other tasks outlined in this report.

  4. 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.

  5. 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.

  6. 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

  7. Individuals with chronic low back pain have greater difficulty in engaging in positive lifestyle behaviours than those without back pain: An assessment of health literacy

    Directory of Open Access Journals (Sweden)

    Burnett Angus F

    2011-07-01

    Full Text Available Abstract Background Despite the large volume of research dedicated to understanding chronic low back pain (CLBP, patient outcomes remain modest while healthcare costs continue to rise, creating a major public health burden. Health literacy - the ability to seek, understand and utilise health information - has been identified as an important factor in the course of other chronic conditions and may be important in the aetiology of CLBP. Many of the currently available health literacy measurement tools are limited since they measure narrow aspects of health literacy. The Health Literacy Measurement Scale (HeLMS was developed recently to measure broader elements of health literacy. The aim of this study was to measure broad elements of health literacy among individuals with CLBP and without LBP using the HeLMS. Methods Thirty-six community-dwelling adults with CLBP and 44 with no history of LBP responded to the HeLMS. Individuals were recruited as part of a larger community-based spinal health study in Western Australia. Scores for the eight domains of the HeLMS as well as individual item responses were compared between the groups. Results HeLMS scores were similar between individuals with and without CLBP for seven of the eight health literacy domains (p > 0.05. However, compared to individuals with no history of LBP, those with CLBP had a significantly lower score in the domain 'Patient attitudes towards their health' (mean difference [95% CI]: 0.46 [0.11-0.82] and significantly lower scores for each of the individual items within this domain (p d = 0.47-0.65. Conclusions Although no differences were identified in HeLMS scores between the groups for seven of the health literacy domains, adults with CLBP reported greater difficulty in engaging in general positive health behaviours. This aspect of health literacy suggests that self-management support initiatives may benefit individuals with CLBP.

  8. 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.

  9. 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.

  10. Greater repertoire and temporal variability of cross-frequency coupling (CFC modes in resting-state neuromagnetic recordings among children with reading difficulties

    Directory of Open Access Journals (Sweden)

    Stavros I Dimitriadis

    2016-04-01

    Full Text Available AbstractCross-frequency, phase-to-amplitude coupling (PAC between neuronal oscillations at rest may serve as the substrate that supports information exchange between functionally specialized neuronal populations both within and between cortical regions. The study utilizes novel algorithms to identify prominent instantaneous modes of cross-frequency coupling and their temporal stability in resting state magnetoencephalography (MEG data from 23 students experiencing severe reading difficulties (RD and 27 age-matched non-impaired readers (NI.Phase coherence estimates were computed in order to identify the prominent mode of PAC interaction for each sensor, sensor pair, and pair of frequency bands (from δ to γ at successive temporal segments of the continuous MEG record. The degree of variability in the characteristic frequency-pair PACf1-f2 modes over time was also estimated. Results revealed a wider repertoire of prominent PAC interactions in RD as compared to NI students, suggesting an altered functional substrate for information exchange between neuronal assemblies in the former group. Moreover, RD students showed significant variability in PAC modes over time. This temporal instability of PAC values was particularly prominent: (a within and between right hemisphere temporal and occipitotemporal sensors and, (b between left hemisphere frontal, temporal, and occipitotemporal sensors and corresponding right hemisphere sites. Altered modes of neuronal population coupling may help account for extant data revealing reduced, task-related neurophysiological and hemodynamic activation in left hemisphere regions involved in the reading network in RD. Moreover, the spatial distribution of pronounced instability of cross-frequency coupling modes in this group may provide an explanation for previous reports suggesting the presence of inefficient compensatory mechanisms to support reading.

  11. 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.

  12. Familial History of Reading Difficulty Is Associated with Diffused Bilateral Brain Activation during Reading and Greater Association with Visual Attention Abilities

    Science.gov (United States)

    Horowitz-Kraus, Tzipi

    2017-01-01

    Reading difficulty (RD; or dyslexia) is a heritable condition characterized by slow, inaccurate reading accompanied by executive dysfunction, specifically with respect to visual attention. The current study was designed to examine the effect of familial history of RD on the relationship between reading and visual attention abilities in children…

  13. 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.

  14. 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

  15. 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.

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

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    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

  17. 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.

  18. 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…

  19. 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.

  20. Diagnosing companies in financial difficulty based on the auditor’s report

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    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.

  1. 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...

  2. Greater Occipital Nerve Treatment in the Management of Spontaneous Intracranial Hypotension Headache: A Case Report.

    Science.gov (United States)

    Niraj, G; Critchley, Peter; Kodivalasa, Mahesh; Dorgham, Mohammed

    2017-06-01

    Clinical presentation of spontaneous intracranial hypotension headache (SIHH) has similarities with postdural puncture headache (PDPH). Recommended treatment for both conditions is an epidural blood patch. Successful outcomes following greater occipital nerve blocks have been reported in the management of PDPH. We present the first report of greater occipital nerve treatment in SIHH. A 40-year-old male presented with a 2-year history of daily postural headaches having a significant impact on quality of life. Magnetic resonance imaging revealed bilateral convexity subdural collections. Post gadolinium scan revealed pachymeningeal enhancement with reduced pontomesencephalic angle below 50 degrees. The patient was offered an epidural blood patch and greater occipital nerve block with corticosteroids. The patient chose occipital nerve block. The patient reported significant short-term benefit lasting 4 months. Thereafter, the patient underwent pulsed radiofrequency treatment to bilateral greater occipital nerves. He reported significant benefit lasting 10 months. Greater occipital nerve treatment may have a role in management of SIHH. © 2017 American Headache Society.

  3. Undergraduate ESL Students’ Difficulties in Writing the Introduction for Research Reports

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    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.

  4. Greater Pupil Size in Response to Emotional Faces as an Early Marker of Social-Communicative Difficulties in Infants at High Risk for Autism.

    Science.gov (United States)

    Wagner, Jennifer B; Luyster, Rhiannon J; Tager-Flusberg, Helen; Nelson, Charles A

    2016-01-01

    When scanning faces, individuals with autism spectrum disorder (ASD) have shown reduced visual attention (e.g., less time on eyes) and atypical autonomic responses (e.g., heightened arousal). To understand how these differences might explain sub-clinical variability in social functioning, 9-month-olds, with or without a family history of ASD, viewed emotionally-expressive faces, and gaze and pupil diameter (a measure of autonomic activation) were recorded using eye-tracking. Infants at high-risk for ASD with no subsequent clinical diagnosis (HRA-) and low-risk controls (LRC) showed similar face scanning and attention to eyes and mouth. Attention was overall greater to eyes than mouth, but this varied as a function of the emotion presented. HRA- showed significantly larger pupil size than LRC. Correlations between scanning at 9 months, pupil size at 9 months, and 18-month social-communicative behavior, revealed positive associations between pupil size and attention to both face and eyes at 9 months in LRC, and a negative association between 9-month pupil size and 18-month social-communicative behavior in HRA-. The present findings point to heightened autonomic arousal in HRA-. Further, with greater arousal relating to worse social-communicative functioning at 18 months, this work points to a mechanism by which unaffected siblings might develop atypical social behavior.

  5. 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...

  6. 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.

  7. College students who have an eveningness preference report lower self-control and greater procrastination.

    Science.gov (United States)

    Digdon, Nancy L; Howell, Andrew J

    2008-11-01

    Previous research suggests a possible link between eveningness and general difficulties with self-regulation (e.g., evening types are more likely than other chronotypes to have irregular sleep schedules and social rhythms and use substances). Our study investigated the relationship between eveningness and self-regulation by using two standardized measures of self-regulation: the Self-Control Scale and the Procrastination Scale. We predicted that an eveningness preference would be associated with poorer self-control and greater procrastination than would an intermediate or morningness preference. Participants were 308 psychology students (mean age=19.92 yrs) at a small Canadian college. Students completed the self-regulation questionnaires and Morningness/Eveningness Questionnaire (MEQ) online. The mean MEQ score was 46.69 (SD=8.20), which is intermediate between morningness and eveningness. MEQ scores ranged from definite morningness to definite eveningness, but the dispersion of scores was skewed toward more eveningness. Pearson and partial correlations (controlling for age) were used to assess the relationship between MEQ score and the Self-Control Scale (global score and 5 subscale scores) and Procrastination Scale (global score). All correlations were significant. The magnitude of the effects was medium for all measures except one of the Self-Control subscales, which was small. A multiple regression analysis to predict MEQ score using the Self-Control Scale (global score), Procrastination Scale, and age as predictors indicated the Self-Control Scale was a significant predictor (accounting for 20% of the variance). A multiple regression analysis to predict MEQ scores using the five subscales of the Self-Control Scale and age as predictors showed the subscales for reliability and work ethic were significant predictors (accounting for 33% of the variance). Our study showed a relationship between eveningness and low self-control, but it did not address whether the

  8. Torsion of the Greater Omentum Secondary to Omental Lymphangioma in a Child: A Case Report

    International Nuclear Information System (INIS)

    Mistry, Kewal Arunkumar; Iyer, Dayashankar

    2015-01-01

    Omental cyst and omental torsion both are uncommon but important causes of acute abdomen with a difficult clinical diagnosis due to nonspecific features. Here we report a case of an eight year old child with acute abdominal pain referred for USG and CT scan which revealed two cysts in greater omentum leading to secondary omental torsion. An eight year old male child presented to casualty with severe pain abdomen since 1 day. There was no history of vomiting or altered bowel habits. The patient was febrile with tachycardia on arrival. On examination rigidity and tenderness all over abdomen were present. Serum amylase was within normal range. USG and CECT abdomen were done subsequently. USG showed two well defined cystic lesions in lower abdomen with presence of some internal echogenic debris and calcified foci in their dependent part. There was also presence of omentum with a whirl of blood vessels seen along anterior abdominal wall leading to these lesions suggesting torsion. On colour Doppler the presence of blood flow within the whirl of vessels was seen. Mild amount of free fluid was also seen in the peritoneal cavity. On CECT abdomen the findings of omental cysts and torsion of greater omentum with free fluid in abdomen were confirmed. The cysts measured 60×55 and 65×55mm on CT. The patient was taken for an emergency laparotomy for indication of acute generalized peritonitis. Two large omental cysts were found in the pelvic cavity along with torsed greater omentum along with 150 ml of hemorrhagic fluid in peritoneal cavity. The cysts and twisted necrotic part of the greater omentum were excised at surgery. No postoperative complications were observed. Histopathologic examination was suggestive of lymphangioma of omentum. Lymphangioma of the omentum is an not very uncommon however acute presentation with omental torsion and infarction is an unusual entity. Optimal utilization of preoperative imaging with USG, Doppler and contrast enhanced CT scan can provide

  9. 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.

  10. 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

  11. 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

  12. 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…

  13. 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.

  14. 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.

  15. 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.

  16. How report cards on physicians, physician groups, and hospitals can have greater impact on consumer choices.

    Science.gov (United States)

    Sinaiko, Anna D; Eastman, Diana; Rosenthal, Meredith B

    2012-03-01

    Public report cards with quality and cost information on physicians, physician groups, and hospital providers have proliferated in recent years. However, many of these report cards are difficult for consumers to interpret and have had little impact on the provider choices consumers are making. To gain a more focused understanding of why these reports cards have not been more successful and what improvements could be made, we interviewed experts and surveyed registrants at the March 2011 AHRQ National Summit on Public Reporting for Consumers in Health Care. We found broad agreement that public reporting has been disconnected from consumer decisions about providers because of weaknesses in report card content, design, and accessibility. Policy makers have an opportunity to change the landscape of public reporting by taking advantage of advances in measurement, data collection, and information technology to deliver a more consumer-centered report card. Overcoming the constraint of limited public funding, and achieving the acceptance of providers, is critical to realizing future success.

  17. Greater-Than-Class C Low-Level Radioactive Waste Transportation Strategy report and institutional plan

    Energy Technology Data Exchange (ETDEWEB)

    Schmitt, R.C.; Tyacke, M.J.

    1995-01-01

    This document contains two parts. Part I, Greater-Than-Class-C Low-Level Radioactive Waste Transportation Strategy, addresses the requirements, responsibilities, and strategy to transport and receive these wastes. The strategy covers (a) transportation packaging, which includes shipping casks and waste containers; (b) transportation operations relating to the five facilities involved in transportation, i.e., waste originator, interim storage, dedicated storage, treatment, and disposal; (c) system safety and risk analysis; (d) routes; (e) emergency preparedness and response; and (o safeguards and security. A summary of strategic actions is provided at the conclusion of Part 1. Part II, Institutional Plan for Greater-Than-Class C Low-Level Radioactive Waste Packaging and Transportation, addresses the assumptions, requirements, and institutional plan elements and actions. As documented in the Strategy and Institutional Plan, the most challenging issues facing the GTCC LLW Program shipping campaign are institutional issues closely related to the strategy. How the Program addresses those issues and demonstrates to the states, local governments, and private citizens that the shipments can and will be made safely will strongly affect the success or failure of the campaign.

  18. Greater-Than-Class C Low-Level Radioactive Waste Transportation Strategy report and institutional plan

    International Nuclear Information System (INIS)

    Schmitt, R.C.; Tyacke, M.J.

    1995-01-01

    This document contains two parts. Part I, Greater-Than-Class-C Low-Level Radioactive Waste Transportation Strategy, addresses the requirements, responsibilities, and strategy to transport and receive these wastes. The strategy covers (a) transportation packaging, which includes shipping casks and waste containers; (b) transportation operations relating to the five facilities involved in transportation, i.e., waste originator, interim storage, dedicated storage, treatment, and disposal; (c) system safety and risk analysis; (d) routes; (e) emergency preparedness and response; and (o safeguards and security. A summary of strategic actions is provided at the conclusion of Part 1. Part II, Institutional Plan for Greater-Than-Class C Low-Level Radioactive Waste Packaging and Transportation, addresses the assumptions, requirements, and institutional plan elements and actions. As documented in the Strategy and Institutional Plan, the most challenging issues facing the GTCC LLW Program shipping campaign are institutional issues closely related to the strategy. How the Program addresses those issues and demonstrates to the states, local governments, and private citizens that the shipments can and will be made safely will strongly affect the success or failure of the campaign

  19. 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.

  20. 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.

  1. Greater Vancouver regional district air quality management plan : implementation status report

    International Nuclear Information System (INIS)

    2001-03-01

    In December 1994, an Air Quality Management Plan (AQMP) was adopted by the Greater Vancouver Regional District. The AQMP included ways to improve air quality in the region, leading to reduced emissions from commercial and industrial operations. This Plan encourages cooperation with the various communities affected to achieve clean air lifestyles and manage emissions from human activity to enhance human health and the integrity of the environment. The reduction of total emissions of the common air contaminants sulphur and nitrogen oxides, particulate matter, carbon monoxide and volatile organic compounds by 38 per cent is the stated aim of the AQMP. Five years of planning resulted in the formulation of the AQMP. The issues addressed were assigned one of four priorities as follows: priority 1 deals with ground level ozone and fine particulate, priority 2 looks at visibility, hazardous air pollutants, and global climate change, priority 3 concerns odour, carbon monoxide, sulphur dioxide, acidic deposition, and nitrogen dioxide, and priority 4 contains total suspended particulate matter and volatile organic compounds. A total of 54 Emission Reduction Measures were established, and the document reviewed them. Progress is being made in all areas. 2 tabs., 3 figs

  2. 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.

  3. 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

  4. Combined impairments in vision, hearing and cognition are associated with greater levels of functional and communication difficulties than cognitive impairment alone: Analysis of interRAI data for home care and long-term care recipients in Ontario.

    Directory of Open Access Journals (Sweden)

    Dawn M Guthrie

    Full Text Available The objective of the current study was to understand the added effects of having a sensory impairment (vision and/or hearing impairment in combination with cognitive impairment with respect to health-related outcomes among older adults (65+ years old receiving home care or residing in a long-term care (LTC facility in Ontario, Canada.Cross-sectional analyses were conducted using existing data collected with one of two interRAI assessments, one for home care (n = 291,824 and one for LTC (n = 110,578. Items in the assessments were used to identify clients with single sensory impairments (e.g., vision only [VI], hearing only [HI], dual sensory impairment (DSI; i.e., vision and hearing and those with cognitive impairment (CI. We defined seven mutually exclusive groups based on the presence of single or combined impairments.The rate of people having all three impairments (i.e., CI+DSI was 21.3% in home care and 29.2% in LTC. Across the seven groups, individuals with all three impairments were the most likely to report loneliness, to have a reduction in social engagement, and to experience reduced independence in their activities of daily living (ADLs and instrumental ADLs (IADLs. Communication challenges were highly prevalent in this group, at 38.0% in home care and 49.2% in LTC. In both care settings, communication difficulties were more common in the CI+DSI group versus the CI-alone group.The presence of combined sensory and cognitive impairments is high among older adults in these two care settings and having all three impairments is associated with higher rates of negative outcomes than the rates for those having CI alone. There is a rising imperative for all health care professionals to recognize the potential presence of hearing, vision and cognitive impairments in those for whom they provide care, to ensure that basic screening occurs and to use those results to inform care plans.

  5. 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.

  6. 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.

  7. [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.

  8. 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

  9. Social and institutional evaluation report for Greater-Than-Class C Low-Level Radioactive Waste Disposal

    International Nuclear Information System (INIS)

    Anderson, T.L.; Lewis, B.E.; Turner, K.H.; Rozelle, M.A.

    1993-10-01

    This report identifies and characterizes social and institutional issues that would be relevant to the siting, licensing, construction, closure, and postclosure of a Greater-Than-Class-C low-level radioactive waste (GTCC LLW) disposal facility. A historical perspective of high-level radioactive waste (HLW) and LLW disposal programs is provided as an overview of radioactive waste disposal and to support the recommendations and conclusions in the report. A characterization of each issue is provided to establish the basis for further evaluations. Where applicable, the regulatory requirements of 10 CFR 60 and 61 are incorporated in the issue characterizations. The issues are used to compare surface, intermediate depth, and deep geologic disposal alternatives. The evaluation establishes that social and institutional issues do not significantly discriminate among the disposal alternatives. Recommendations are provided for methods by which the issues could be considered throughout the lifecycle of a GTCC LLW disposal program

  10. Social and institutional evaluation report for Greater-Than-Class C Low-Level Radioactive Waste Disposal

    Energy Technology Data Exchange (ETDEWEB)

    Anderson, T.L.; Lewis, B.E.; Turner, K.H.; Rozelle, M.A. [Dames and Moore, Denver, CO (United States)

    1993-10-01

    This report identifies and characterizes social and institutional issues that would be relevant to the siting, licensing, construction, closure, and postclosure of a Greater-Than-Class-C low-level radioactive waste (GTCC LLW) disposal facility. A historical perspective of high-level radioactive waste (HLW) and LLW disposal programs is provided as an overview of radioactive waste disposal and to support the recommendations and conclusions in the report. A characterization of each issue is provided to establish the basis for further evaluations. Where applicable, the regulatory requirements of 10 CFR 60 and 61 are incorporated in the issue characterizations. The issues are used to compare surface, intermediate depth, and deep geologic disposal alternatives. The evaluation establishes that social and institutional issues do not significantly discriminate among the disposal alternatives. Recommendations are provided for methods by which the issues could be considered throughout the lifecycle of a GTCC LLW disposal program.

  11. Waste Management Facilities Cost Information report for Greater-Than-Class C and DOE equivalent special case waste

    Energy Technology Data Exchange (ETDEWEB)

    Feizollahi, F.; Shropshire, D.

    1993-07-01

    This Waste Management Facility Cost Information (WMFCI) report for Greater-Than-Class C low-level waste (GTCC LLW) and DOE equivalent special case waste contains preconceptual designs and planning level life-cycle cost (PLCC) estimates for treatment, storage, and disposal facilities needed for management of GTCC LLW and DOE equivalent waste. The report contains information on 16 facilities (referred to as cost modules). These facilities are treatment facility front-end and back-end support functions (administration support, and receiving, preparation, and shipping cost modules); seven treatment concepts (incineration, metal melting, shredding/compaction, solidification, vitrification, metal sizing and decontamination, and wet/air oxidation cost modules); two storage concepts (enclosed vault and silo); disposal facility front-end functions (disposal receiving and inspection cost module); and four disposal concepts (shallow-land, engineered shallow-land, intermediate depth, and deep geological cost modules). Data in this report allow the user to develop PLCC estimates for various waste management options. A procedure to guide the U.S. Department of Energy (DOE) and its contractor personnel in the use of estimating data is also included in this report.

  12. Preventive maintenance basis: Volume 10 -- High voltage electric motors (5 kV and greater). Final report

    International Nuclear Information System (INIS)

    Worledge, D.; Hinchcliffe, G.

    1997-07-01

    US nuclear plants are implementing preventive maintenance (PM) tasks with little documented basis beyond fundamental vendor information to support the tasks or their intervals. The Preventive Maintenance Basis project provides utilities with the technical basis for PM tasks and task intervals associated with 40 specific components such as valves, electric motors, pumps, and HVAC equipment. This report provides an overview of the PM Basis project and describes use of the PM Basis database. Volume 10 of the report provides a program of PM tasks suitable for application to high voltage (5kV and greater) electric motors in nuclear power plants. The PM tasks that are recommended provide a cost-effective way to intercept the causes and mechanisms that lead to degradation and failure. They can be used, in conjunction with material from other sources, to develop a complete PM program or to improve an existing program. Users of this information will be utility managers, supervisors, craft technicians, and training instructors responsible for developing, optimizing, or fine-tuning PM programs. Reactor Coolant Pumps motors (RCP's) are not excluded from this report in so far as good PM practices for motors of the appropriate class are concerned. However, the special auxiliary equipment normally associated with RCP's has not been included. Consequently, this report does not provide a complete PM program for RCP's. Industry and vendor programs for RCP's should be consulted for complete definition of RCP motor PM programs

  13. Waste Management Facilities Cost Information report for Greater-Than-Class C and DOE equivalent special case waste

    International Nuclear Information System (INIS)

    Feizollahi, F.; Shropshire, D.

    1993-07-01

    This Waste Management Facility Cost Information (WMFCI) report for Greater-Than-Class C low-level waste (GTCC LLW) and DOE equivalent special case waste contains preconceptual designs and planning level life-cycle cost (PLCC) estimates for treatment, storage, and disposal facilities needed for management of GTCC LLW and DOE equivalent waste. The report contains information on 16 facilities (referred to as cost modules). These facilities are treatment facility front-end and back-end support functions (administration support, and receiving, preparation, and shipping cost modules); seven treatment concepts (incineration, metal melting, shredding/compaction, solidification, vitrification, metal sizing and decontamination, and wet/air oxidation cost modules); two storage concepts (enclosed vault and silo); disposal facility front-end functions (disposal receiving and inspection cost module); and four disposal concepts (shallow-land, engineered shallow-land, intermediate depth, and deep geological cost modules). Data in this report allow the user to develop PLCC estimates for various waste management options. A procedure to guide the U.S. Department of Energy (DOE) and its contractor personnel in the use of estimating data is also included in this report

  14. 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.

  15. Adults with Greater Weight Satisfaction Report More Positive Health Behaviors and Have Better Health Status Regardless of BMI

    Directory of Open Access Journals (Sweden)

    Christine E. Blake

    2013-01-01

    Full Text Available Background. Prior studies suggest that weight satisfaction may preclude changes in behavior that lead to healthier weight among individuals who are overweight or obese. Objective. To gain a better understanding of complex relationships between weight satisfaction, weight-related health behaviors, and health outcomes. Design. Cross-sectional analysis of data from the Aerobics Center Longitudinal Study (ACLS. Participants. Large mixed-gender cohort of primarily white, middle-to-upper socioeconomic status (SES adults with baseline examination between 1987 and 2002 (n=19,003. Main Outcome Variables. Weight satisfaction, weight-related health behaviors, chronic health conditions, and clinical health indicators. Statistical Analyses Performed. Chi-square test, t-tests, and linear and multivariate logistic regression. Results. Compared to men, women were more likely to be dieting (32% women; 18% men and had higher weight dissatisfaction. Men and women with greater weight dissatisfaction reported more dieting, yo-yo dieting, and snacking and consuming fewer meals, being less active, and having to eat either more or less than desired to maintain weight regardless of weight status. Those who were overweight or obese and dissatisfied with their weight had the poorest health. Conclusion. Greater satisfaction with one’s weight was associated with positive health behaviors and health outcomes in both men and women and across weight status groups.

  16. 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.

  17. Ecology of Greater Sage-Grouse in the Bi-State Planning Area Final Report, September 2007

    Science.gov (United States)

    Casazza, Michael L.; Overton, Cory T.; Farinha, Melissa A.; Torregrosa, Alicia; Fleskes, Joseph P.; Miller, Michael R.; Sedinger, James S.; Kolada, Eric J.

    2009-01-01

    Conservation efforts for greater sage-grouse (Centrocercus urophasianus), hereafter sage-grouse, are underway across the range of this species. Over 70 local working groups have been established and are implementing on-the-ground sage-grouse oriented conservation projects. Early on in this process, the California Department of Fish and Game (CDFG) recognized the need to join in these efforts and received funding from the U.S. Fish and Wildlife Service (USFWS) under the Candidate Species Conservation Program to help develop a species conservation plan for sage-grouse in the Mono County area. This conservation plan covers portions of Alpine, Mono, and Inyo counties in California and Douglas, Esmeralda, Lyon, and Mineral counties in Nevada. A concurrent effort underway through the Nevada Governor's Sage-grouse Conservation Team established Local Area Working Groups across Nevada and eastern California. The Mono County populations of sage-grouse were encompassed by the Bi-State Local Planning Area, which was comprised of six population management units (PMUs). The state agencies from California (CDFG) and Nevada (Nevada Department of Wildlife; NDOW) responsible for the management of sage-grouse agreed to utilize the process that had begun with the Nevada Governor's Team in order to develop local plans for conservation planning and implementation. Resources from the USFWS were applied to several objectives in support of the development of the Bi-State Local Area Sage-grouse Conservation Plan through a grant to the U.S. Geological Survey (USGS). Objectives included: (1) participate in the development of the Bi-State Conservation Plan, (2) compile and synthesize existing sage-grouse data, (3) document seasonal movements of sage-grouse, (4) identify habitats critical to sage-grouse, (5) determine survival rates and identify causal factors of mortality, (6) determine nest success and brood success of sage-grouse, and (7) identify sage-grouse lek sites. Progress reports

  18. Towards a greater understanding of the illicit tobacco trade in Europe: a review of the PMI funded 'Project Star' report.

    Science.gov (United States)

    Gilmore, Anna B; Rowell, Andy; Gallus, Silvano; Lugo, Alessandra; Joossens, Luk; Sims, Michelle

    2014-05-01

    Following a legal agreement with the European Union (EU), Philip Morris International (PMI) commissions a yearly report ('Project Star', PS) on the European illicit cigarette trade from KPMG, the global accountancy firm. Review of PS 2010 report. Comparison with data from independent sources including a 2010 pan-European survey (N=18,056). Within PS, data covering all 27 EU countries are entered into a model. While the model itself seems appropriate, concerns are identified with the methodologies underlying the data inputs and thus their quality: there is little transparency over methodologies; interview data underestimate legal non-domestic product partly by failing to account for legal cross-border sales; illicit cigarette estimates rely on tobacco industry empty pack surveys which may overestimate illicit; and there is an over-reliance on data supplied by PMI with inadequate external validation. Thus, PMI sales data are validated using PMI smoking prevalence estimates, yet PMI is unable to provide sales (shipment) data for the Greek islands and its prevalence estimates differ grossly from independent data. Consequently, comparisons with independent data suggest PS will tend to overestimate illicit cigarette levels particularly where cross-border shopping is frequent (Austria, Finland, France) and in Western compared with Eastern European countries. The model also provides data on the nature of the illicit cigarette market independent of seizure data suggesting that almost a quarter of the illicit cigarette market in 2010 comprised PMI's own brands compared with just 5% counterfeited PMI brands; a finding hidden in PMI's public representation of the data. PS overestimates illicit cigarette levels in some European countries and suggests PMI's supply chain control is inadequate. Its publication serves the interests of PMI over those of the EU and its member states. PS requires greater transparency, external scrutiny and use of independent data. Published by the BMJ

  19. 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…

  20. 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…

  1. 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 …

  2. Case Report: Anteromedial temporosphenoidal encephalocele with a clinically silent lateral bony defect in the greater wing of the sphenoid

    International Nuclear Information System (INIS)

    Pandey, Anoop Kumar

    2009-01-01

    Anteromedial temporosphenoidal encephalocele is the least common type of temporal encephalocele. It commonly presents with spontaneous cerebrospinal fluid rhinorrhea in adults. This article presents the CT cisternography and MRI findings of one such case, which also had an associated clinically silent defect in the greater wing of the sphenoid on the same side

  3. Case Report: Anteromedial temporosphenoidal encephalocele with a clinically silent lateral bony defect in the greater wing of the sphenoid

    Directory of Open Access Journals (Sweden)

    Pandey Anoop

    2009-01-01

    Full Text Available Anteromedial temporosphenoidal encephalocele is the least common type of temporal encephalocele. It commonly presents with spontaneous cerebrospinal fluid rhinorrhea in adults. This article presents the CT cisternography and MRI findings of one such case, which also had an associated clinically silent defect in the greater wing of the sphenoid on the same side.

  4. 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.)

  5. 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.

  6. EnergyWorks Final Report: A Better Buildings Neighborhood Program in the Five-County Greater Philadelphia Region

    Energy Technology Data Exchange (ETDEWEB)

    Gajewski, Katherine [City of Philadelphia

    2014-03-05

    This report covers the grant performance period of July 1, 2010-September 30, 2013 and discusses of the program design, outcomes and best practices as they relate to the following six areas: 1. Institutional Design and Business Model; 2. Program Design and Customer Experience; 3. Driving Demand; 4. Workforce Development; 5. Financing and Incentives; 6. Data and Evaluation.

  7. Greater autonomy at work

    NARCIS (Netherlands)

    Houtman, I.L.D.

    2004-01-01

    In the past 10 years, workers in the Netherlands increasingly report more decision-making power in their work. This is important for an economy in recession and where workers face greater work demands. It makes work more interesting, creates a healthier work environment, and provides opportunities

  8. 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.

  9. 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.

  10. Petro-Canada 2004 strategic overview report : building our portfolio assets for greater profitability today and tomorrow

    International Nuclear Information System (INIS)

    2004-01-01

    Financial information from Petro-Canada was presented and a review of their 2004 operations was made available for the benefit of shareholders. Petro-Canada is focused on 5 core businesses that include: North American gas; east coast oil; oil sands development; international business; and downstream operations. Highlights from 2004 for each of these core business areas were presented. In 2003, record earnings from operations and cash flows were reported at more than $1.9 billion. Upstream production of 451,100 barrels of oil equivalent per day was reported in 2004. This surpassed planned production volumes in 2004 and more than replaced reserves. Refined petroleum product sales were 56,600 cubic metres per day. Highlights for the company for 2004 include the purchase of a coalbed methane and tight bas business in the U.S. Rockies, the acquisition of unconventional land positions in Western Canada and plans to jointly develop a liquefied natural gas re-gasification terminal in Quebec. This report summarized the company's energy resource activities and presented an operations review as well as consolidated financial statements, and common share information including the accounts of Petro-Canada and its subsidiaries and the company's proportionate share of assets, liabilities, revenues, expenses and cash flows of joint ventures. Revenue and expenditure statements were summarized by source. tabs., figs

  11. Natural Recharge to the Unconfined Aquifer System on the Hanford Site from the Greater Cold Creek Watershed: Progress Report 2004

    Energy Technology Data Exchange (ETDEWEB)

    Waichler, Scott R.; Wigmosta, Mark S.; Coleman, Andre M.

    2004-09-14

    Movement of contaminants in groundwater at the Hanford Site is heavily dependent on recharge to the unconfined aquifer. As the effects of past artificial discharges dissipate, the water table is expected to return to more natural conditions, and natural recharge will become the driving force when evaluating future groundwater flow conditions and related contaminant transport. Previous work on the relationship of natural recharge to groundwater movement at the Hanford Site has focused on direct recharge from infiltrating rainfall and snowmelt within the area represented by the Sitewide Groundwater Model (SGM) domain. However, part of the groundwater recharge at Hanford is provided by flow from Greater Cold Creek watershed (GCC), a large drainage area on the western boundary of the Hanford Site that includes Cold Creek Valley, Dry Creek Valley, and the Hanford side of Rattlesnake Mountain. This study was undertaken to estimate the recharge from GCC, which is believed to enter the unconfined aquifer as both infiltrating streamflow and shallow subsurface flow. To estimate recharge, the Distributed Hydrology-Soil-Vegetation Model (DHSVM) was used to simulate a detailed water balance of GCC from 1956 to 2001 at a spatial resolution of 200~m and a temporal resolution of one hour. For estimating natural recharge to Hanford from watersheds along its western and southwestern boundaries, the most important aspects that need to be considered are 1)~distribution and relative magnitude of precipitation and evapotranspiration over the watershed, 2)~streamflow generation at upper elevations and infiltration at lower elevations during rare runoff events, and 3)~permeability of the basalt bedrock surface underlying the soil mantle.

  12. Out of sight, but not out of mind? Greater reported pain in patients who spontaneously look away during venepuncture.

    Science.gov (United States)

    Vijayan, R; Scott, G; Brownlie, W

    2015-01-01

    Various external factors can influence patients' experiences of noxious stimuli, but little is known of how patients' natural behaviour may be relevant. We ascertained how often patients spontaneously look or look away during venepuncture and associated reports of pain during a previously reported experimental randomized study. The study was conducted in the outpatient department of a U.K. district general hospital. Patients were randomized to hearing 'sharp scratch' or the verbal cue 'ready?' immediately before venepuncture. Whether patients looked or looked away during needle insertion was recorded. Patients were asked to rate their pain using a verbal numerical rating score (VNRS) and verbal response scale (VRS). One hundred ninety-two patients were included; mean age 51.7 years, 55% male. During needle insertion, 73% spontaneously looked away, whereas 27% looked. There was no significant difference in the proportion of these patients assigned to the 'sharp scratch' or 'ready?' groups, nor was there any difference in mean age or gender. For the group that looked, mean VNRS was 0.48 and VRS was 1.27, significantly less than the group that looked away (mean VNRS 0.94, p = 0.014; VRS 1.61, p = 0.002). As previously reported, pain ratings between 'sharp scratch' and 'ready?' groups were not significantly different. Almost three quarters of patients spontaneously look away during venepuncture, but their pain ratings are almost twice that of the quarter of patients who look. It is unclear why this may be, but previous experimental studies indicate that observing the body when a noxious stimulus is applied can have an analgesic effect. © 2014 European Pain Federation - EFIC®

  13. 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

  14. 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.

  15. 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.

  16. 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.

  17. 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

  18. Yoga Meditation Practitioners Exhibit Greater Gray Matter Volume and Fewer Reported Cognitive Failures: Results of a Preliminary Voxel-Based Morphometric Analysis

    Directory of Open Access Journals (Sweden)

    Brett Froeliger

    2012-01-01

    Full Text Available Hatha yoga techniques, including physical postures (asanas, breathing exercises (pranayama, and meditation, involve the practice of mindfulness. In turn, yoga meditation practices may induce the state of mindfulness, which, when evoked recurrently through repeated practice, may accrue into trait or dispositional mindfulness. Putatively, these changes may be mediated by experience-dependent neuroplastic changes. Though prior studies have identified differences in gray matter volume (GMV between long-term mindfulness practitioners and controls, no studies to date have reported on whether yoga meditation is associated with GMV differences. The present study investigated GMV differences between yoga meditation practitioners (YMP and a matched control group (CG. The YMP group exhibited greater GM volume in frontal, limbic, temporal, occipital, and cerebellar regions; whereas the CG had no greater regional greater GMV. In addition, the YMP group reported significantly fewer cognitive failures on the Cognitive Failures Questionnaire (CFQ, the magnitude of which was positively correlated with GMV in numerous regions identified in the primary analysis. Lastly, GMV was positively correlated with the duration of yoga practice. Results from this preliminary study suggest that hatha yoga practice may be associated with the promotion of neuroplastic changes in executive brain systems, which may confer therapeutic benefits that accrue with repeated practice.

  19. 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

  20. 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.

  1. [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.

  2. 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

  3. 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....

  4. 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.

  5. Towards a greater understanding of the illicit tobacco trade in Europe: a review of the PMI funded ‘Project Star’ report

    Science.gov (United States)

    Gilmore, Anna B; Rowell, Andy; Gallus, Silvano; Lugo, Alessandra; Joossens, Luk; Sims, Michelle

    2014-01-01

    Background Following a legal agreement with the European Union (EU), Philip Morris International (PMI) commissions a yearly report (‘Project Star’, PS) on the European illicit cigarette trade from KPMG, the global accountancy firm. Methods Review of PS 2010 report. Comparison with data from independent sources including a 2010 pan-European survey (N=18 056). Findings Within PS, data covering all 27 EU countries are entered into a model. While the model itself seems appropriate, concerns are identified with the methodologies underlying the data inputs and thus their quality: there is little transparency over methodologies; interview data underestimate legal non-domestic product partly by failing to account for legal cross-border sales; illicit cigarette estimates rely on tobacco industry empty pack surveys which may overestimate illicit; and there is an over-reliance on data supplied by PMI with inadequate external validation. Thus, PMI sales data are validated using PMI smoking prevalence estimates, yet PMI is unable to provide sales (shipment) data for the Greek islands and its prevalence estimates differ grossly from independent data. Consequently, comparisons with independent data suggest PS will tend to overestimate illicit cigarette levels particularly where cross-border shopping is frequent (Austria, Finland, France) and in Western compared with Eastern European countries. The model also provides data on the nature of the illicit cigarette market independent of seizure data suggesting that almost a quarter of the illicit cigarette market in 2010 comprised PMI's own brands compared with just 5% counterfeited PMI brands; a finding hidden in PMI's public representation of the data. Conclusions PS overestimates illicit cigarette levels in some European countries and suggests PMI's supply chain control is inadequate. Its publication serves the interests of PMI over those of the EU and its member states. PS requires greater transparency, external scrutiny and

  6. 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

  7. 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

  8. 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…

  9. 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…

  10. 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.

  11. 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 ...

  12. Negative mood-induced alcohol-seeking is greater in young adults who report depression symptoms, drinking to cope, and subjective reactivity.

    Science.gov (United States)

    Hogarth, Lee; Hardy, Lorna; Mathew, Amanda R; Hitsman, Brian

    2018-04-01

    Acute negative mood powerfully motivates alcohol-seeking behavior, but it remains unclear whether sensitivity to this effect is greater in drinkers who report depression symptoms, drinking to cope, and subjective reactivity. To examine these questions, 128 young adult alcohol drinkers (ages 18-25) completed questionnaires of alcohol use disorder symptoms, depression symptoms, and drinking to cope with negative affect. Baseline alcohol choice was measured by preference to enlarge alcohol versus food thumbnail images in two-alternative forced-choice trials. Negative mood was then induced by depressive statements and music, before alcohol choice was tested. Subjective reactivity was indexed by increased sadness pre- to post-mood induction. Baseline alcohol choice correlated with alcohol dependence symptoms (p = .001), and drinking coping motives (ps ≤ .01). Mood induction increased alcohol choice and subjective sadness overall (ps choice was associated with depression symptoms (p = .007), drinking to cope (ps ≤ .03), and subjective reactivity (p = .007). The relationship between mood-induced alcohol choice and drinking to cope remained significant after covarying for other drinking motives. Furthermore, the three predictors (depression, drinking to cope, and subjective reactivity) accounted for unique variance in mood-induced alcohol choice (ps ≥ .03), and collectively accounted for 18% of the variance (p choice task as sensitive to the relative value of alcohol and acute negative mood. The findings also accord with the core prediction of negative reinforcement theory that sensitivity to the motivational impact of negative mood on alcohol-seeking behavior may be an important mechanism that links depression and alcohol dependence. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

  13. 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...

  14. 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.

  15. 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.

  16. 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…

  17. 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.

  18. 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...

  19. Greater-confinement disposal

    International Nuclear Information System (INIS)

    Trevorrow, L.E.; Schubert, J.P.

    1989-01-01

    Greater-confinement disposal (GCD) is a general term for low-level waste (LLW) disposal technologies that employ natural and/or engineered barriers and provide a degree of confinement greater than that of shallow-land burial (SLB) but possibly less than that of a geologic repository. Thus GCD is associated with lower risk/hazard ratios than SLB. Although any number of disposal technologies might satisfy the definition of GCD, eight have been selected for consideration in this discussion. These technologies include: (1) earth-covered tumuli, (2) concrete structures, both above and below grade, (3) deep trenches, (4) augered shafts, (5) rock cavities, (6) abandoned mines, (7) high-integrity containers, and (8) hydrofracture. Each of these technologies employ several operations that are mature,however, some are at more advanced stages of development and demonstration than others. Each is defined and further described by information on design, advantages and disadvantages, special equipment requirements, and characteristic operations such as construction, waste emplacement, and closure

  20. Evaluation and review of planning for greater-confinement disposal by the Independent Peer Review Committee, July 9-10, 1985. Final report

    International Nuclear Information System (INIS)

    1985-07-01

    This evaluation and review was performed under contract by Argonne National Laboratory in support of their role for developing the ''Planning for Greater Confinement Disposal'' Document for the Low-Level Waste Management Program Office for the Department of Energy, Office of Defense Waste and Byproducts Management. The Independent Peer Review Committee was composed of 13 well-qualified and recognized experts in their fields and pertinent disciplines, collectively representing considerable expertise and experience in waste disposal operations, waste management, environmental assessment and impact analysis, and other aspects of radioactive waste disposal. The members of the Peer Review Committee, their organizations, and thier area of expertise are given in Appendix 1. The general consensus of the Independent Review Committee was that the ''Planning for Greater-Confinement Disposal'' document was reasonably comprehensive, covering nearly all topics necessary to provide a good planning guide. There is, however, a definite need to reorganize the document into two volumes with appendices and the relationship of the GCD document to other LLWMP documents needs to be clarified in the introductory volume. Specific recommendations made by the committee on the DCD document are given in Section 3.2. Recommendations by the committee that have a somewhat broader scope than just the GCD document are given in Section 3.3

  1. 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

  2. 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.

  3. More features, greater connectivity.

    Science.gov (United States)

    Hunt, Sarah

    2015-09-01

    Changes in our political infrastructure, the continuing frailties of our economy, and a stark growth in population, have greatly impacted upon the perceived stability of the NHS. Healthcare teams have had to adapt to these changes, and so too have the technologies upon which they rely to deliver first-class patient care. Here Sarah Hunt, marketing co-ordinator at Aid Call, assesses how the changing healthcare environment has affected one of its fundamental technologies - the nurse call system, argues the case for wireless such systems in terms of what the company claims is greater adaptability to changing needs, and considers the ever-wider range of features and functions available from today's nurse call equipment, particularly via connectivity with both mobile devices, and ancillaries ranging from enuresis sensors to staff attack alert 'badges'.

  4. Greater oil investment opportunities

    International Nuclear Information System (INIS)

    Arenas, Ismael Enrique

    1997-01-01

    Geologically speaking, Colombia is a very attractive country for the world oil community. According to this philosophy new and important steps are being taken to reinforce the oil sector: Expansion of the exploratory frontier by including a larger number of sedimentary areas, and the adoption of innovative contracting instruments. Colombia has to offer, Greater economic incentives for the exploration of new areas to expand the exploratory frontier, stimulation of exploration in areas with prospectivity for small fields. Companies may offer Ecopetrol a participation in production over and above royalties, without it's participating in the investments and costs of these fields, more favorable conditions for natural gas seeking projects, in comparison with those governing the terms for oil

  5. 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.

  6. 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.

  7. Public acceptance of management actions and judgments of responsibility for the wolves of the southern Greater Yellowstone Area: Report to Grand Teton National Park

    Science.gov (United States)

    Taylor, Jonathan G.; Johnson, S. Shea; Shelby, Lori B.

    2005-01-01

    Introduction Wolves of Grand Teton National Park and the Greater Yellowstone Area Gray wolves (Canis lupus) appeared in Grand Teton National Park (GRTE) in October of 1998, two years after being reintroduced to Yellowstone National Park (YNP). Since that time, five packs have been within the GRTE borders - Gros Ventre Pack, Nez Perce Pack, Yellowstone Delta Pack, Teton Pack, and Green River Pack (Table 1). Wolves in the Greater Yellowstone Area are increasing and spreading out geographically (USFWS and others, 2004). This dispersion was demonstrated recently by the death of a 2-year-old female wolf from the Swan Lake pack on I-70 in Colorado (June 7, 2004; http://mountain-prairie.USFWS.gov/pressrel /04-43.htm). The organization of wolf packs in the GYA is dynamic and highly structured. In 2003, for example, a wolf from the Teton Pack joined with the Green River Pack, and several young wolves left the Teton Pack and moved south (USFWS and others, 2004). Pack size (averaging five to ten members) is dependent on hunting efficiency, which depends on prey size, type, and density. Each pack defends home ranges of several hundred square miles. The social structure of the pack is based on a breeding pair (an alpha male and female). Other wolves in the pack can be categorized as betas (males and/or females second in rank to the alphas), subordinates, pups, and occasional omegas (outcasts). Because generally only the alpha pair breeds, subordinate wolves of reproductive age must disperse from their packs and form new associations in order to breed. (http://www.nps.gov/grte/wolf/biolo.htm). The reintroduced wolves are classified by the U.S. Fish and Wildlife Service (USFWS) as "nonessential experimental" under section 10(j) of the Endangered Species Act. The recovery criteria for the GYA wolves were met in 2002 for removing the wolves from the Endangered Species List (30 or more breeding pairs). Currently, the USFWS manages wolf populations in the GYA until delisting occurs

  8. 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

  9. 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.

  10. 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…

  11. 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

  12. Planning for greater confinement disposal

    International Nuclear Information System (INIS)

    Gilbert, T.L.; Luner, C.; Meshkov, N.K.; Trevorrow, L.E.; Yu, C.

    1985-01-01

    A report that provides guidance for planning for greater-confinement disposal (GCD) of low-level radioactive waste is being prepared. The report addresses procedures for selecting a GCD technology and provides information for implementing these procedures. The focus is on GCD; planning aspects common to GCD and shallow-land burial are covered by reference. Planning procedure topics covered include regulatory requirements, waste characterization, benefit-cost-risk assessment and pathway analysis methodologies, determination of need, waste-acceptance criteria, performance objectives, and comparative assessment of attributes that support these objectives. The major technologies covered include augered shafts, deep trenches, engineered structures, hydrofracture, improved waste forms, and high-integrity containers. Descriptive information is provided, and attributes that are relevant for risk assessment and operational requirements are given. 10 refs., 3 figs., 2 tabs

  13. 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.

  14. 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.

  15. 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…

  16. 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

  17. 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

  18. 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 ...

  19. 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...

  20. 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.

  1. 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.

  2. 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...

  3. 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...

  4. Hearing acuity as a predictor of walking difficulties in older women.

    Science.gov (United States)

    Viljanen, Anne; Kaprio, Jaakko; Pyykkö, Ilmari; Sorri, Martti; Koskenvuo, Markku; Rantanen, Taina

    2009-12-01

    To examine whether hearing acuity correlates with walking ability and whether impaired hearing at baseline predicts new self-reported walking difficulties after 3 years. Prospective follow-up. Research laboratory and community. Four hundred thirty-four women aged 63 to 76. Hearing was measured using clinical audiometry. A person was defined as having a hearing impairment if a pure-tone average of thresholds at 0.5 to 4 kHz in the better ear was 21 dB or greater. Maximal walking speed was measured over 10 m (m/s), walking endurance as the distance (m), covered in 6 minutes and difficulties in walking 2 km according to self-report. At baseline, women with hearing impairment (n=179) had slower maximal walking speed (1.7 +/- 0.3 m/s vs 1.8 +/- 0.3 m/s, P=.007), lower walking endurance (520 +/- 75 m vs 536 +/- 75 m, P=.08), and more selfreported major difficulties in walking 2 km (12.8% vs 5.5%, P=.02) than those without hearing impairment. During follow-up, major walking difficulties developed for 33 participants. Women with hearing impairment at baseline had a twice the age-adjusted risk for new walking difficulties as those without hearing impairment (odds ratio=2.04, 95% confidence interval=0.96-4.33). Hearing acuity correlated with mobility, which may be explained by the association between impaired hearing and poor balance and greater risk for falls, both of which underlie decline in mobility. Prevention of hearing loss is not only important for the ability to communicate, but may also have more wide-ranging influences on functional ability.

  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. 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.

  7. 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

  8. 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.

  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. [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.

  11. 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....

  12. 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...

  13. 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.

  14. 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.

  15. Who helps the leaders? Difficulties experienced by cancer support group leaders.

    Science.gov (United States)

    Kirsten, Laura; Butow, Phyllis; Price, Melanie; Hobbs, Kim; Sunquist, Kendra

    2006-07-01

    Cancer support groups are an important source of support for cancer patients, yet little is known about the challenges and training needs of both professionally trained and untrained leaders. The aim of this study was to discover the difficulties experienced and training desired by cancer support group leaders. Twenty-seven leaders of 34 cancer support groups participated in focus groups or individual interviews. Groups were purposively selected as representative of 173 support groups identified in New South Wales which were for adults with cancer and/or their adult carers and were not therapeutic or education-only groups. Difficulties identified included dealing with people's different communication styles and needs; dealing with recurrence, metastases and death; practical issues, including resources, setting the programme and funding security; maintaining personal balance and preventing burn out; establishing group credibility; dealing with group cycles; and leading groups in rural areas. Leaders also identified benefits and rewards from group leadership such as contributing to others' well-being, self-development and insight into others' lives. Non-professionally trained leaders experienced more difficulties, particularly in dealing with group process and practical issues. Difficulties identified were related both to working with a cancer population specifically and to working with groups in general. While some issues were common to both health professionals and non-health professionals, non-health professionals reported greater supportive needs. Clear guidelines, targeted training and development of better methods of support to reduce the stress and burn out experienced by group leaders are needed.

  16. 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....

  17. Fear of moving outdoors and development of outdoor walking difficulty in older people.

    Science.gov (United States)

    Rantakokko, Merja; Mänty, Minna; Iwarsson, Susanne; Törmäkangas, Timo; Leinonen, Raija; Heikkinen, Eino; Rantanen, Taina

    2009-04-01

    To study which individual characteristics and environmental factors correlate with fear of moving outdoors and whether fear of moving outdoors predicts development of mobility limitation. Observational prospective cohort study and cross-sectional analyses. Community and research center. Seven hundred twenty-seven community-living people aged 75 to 81 were interviewed at baseline, of whom 314 took part in a 3.5-year follow-up. Fear of moving outdoors and its potential individual and environmental correlates were assessed at baseline. Perceived difficulties in walking 0.5 km and 2 km were assessed twice a year over a 3.5-year period. At baseline, 65% of the women and 29% of the men reported fear of moving outdoors. Poor socioeconomic status; musculoskeletal diseases; slow walking speed; and the presence of poor street conditions, hills in the nearby environment, and noisy traffic correlated with fear of moving outdoors. At the first 6-month follow-up, participants with fear of moving outdoors had more than four times the adjusted risk (odds ratio (OR)=4.6, 95% confidence interval (CI)=1.92-11.00) of developing difficulties in walking 0.5 km and a three times greater adjusted risk (OR=3.10, 95% CI=1.49-6.46) for developing difficulty in walking 2 km compared with those without fear. The difference in the prevalence of walking difficulties remained statistically significant over the 3.5-year follow-up (P=.02 and P=.009, respectively). Fear of moving outdoors is common in older adults and increases the risk of developing self-reported difficulties in walking 0.5 km and 2 km. Knowledge about individual and environmental factors underlying fear of moving outdoors and finding ways to alleviate fear of moving outdoors are important for community planning and prevention of disability.

  18. Social and emotional difficulties in children with ADHD and the impact on school attendance and healthcare utilization

    Directory of Open Access Journals (Sweden)

    Classi Peter

    2012-10-01

    Full Text Available Abstract Background The objective of this study was to examine the impact of co-occurring social and emotional difficulties on missed school days and healthcare utilization among children with attention deficit/hyperactivity disorder (ADHD. Methods Data were from the 2007 U.S. National Health Interview Survey (NHIS and were based on parental proxy responses to questions in the Sample Child Core, which includes questions on demographics, health, healthcare treatment, and social and emotional status as measured by questions about depression, anxiety, and phobias, as well as items from the brief version of the Strength and Difficulties Questionnaire (SDQ. Logistic regression was used to assess the association between co-occurring social and emotional difficulties with missed school days and healthcare utilization, adjusting for demographics. Results Of the 5896 children aged 6–17 years in the 2007 NHIS, 432 (7.3% had ADHD, based on parental report. Children with ADHD and comorbid depression, anxiety, or phobias had significantly greater odds of experiencing > 2 weeks of missed school days, ≥ 6 visits to a healthcare provider (HCP, and ≥ 2 visits to the ER, compared with ADHD children without those comorbidities (OR range: 2.1 to 10.4. Significantly greater odds of missed school days, HCP visits, and ER visits were also experienced by children with ADHD who were worried, unhappy/depressed, or having emotional difficulties as assessed by the SDQ, compared with ADHD children without those difficulties (OR range: 2.2 to 4.4. Conclusions In children with ADHD, the presence of social and emotional problems resulted in greater odds of missed school days and healthcare utilization. These findings should be viewed in light of the limited nature of the parent-report measures used to assess social and emotional problems.

  19. Simultaneous bilateral isolated greater trochanter fracture

    Directory of Open Access Journals (Sweden)

    Maruti Kambali

    2013-01-01

    Full Text Available A 48-year-old woman sustained simultaneous isolated bilateral greater trochanteric fracture, following a road traffic accident. The patient presented to us 1 month after the injury. She presented with complaints of pain in the left hip and inability to walk. Roentgenograms revealed displaced comminuted bilateral greater trochanter fractures. The fracture of the left greater trochanter was reduced and fixed internally using the tension band wiring technique. The greater trochanter fracture on the right side was asymptomatic and was managed conservatively. The patient regained full range of motion and use of her hips after a postoperative follow-up of 6 months. Isolated fractures of the greater trochanter are unusual injuries. Because of their relative rarity and the unsettled controversy regarding their etiology and pathogenesis, several methods of treatment have been advocated. Furthermore, the reports of this particular type of injury are not plentiful and the average textbook coverage afforded to this entity is limited. In our study we discuss the mechanism of injury and the various treatment options available.

  20. 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’...

  1. 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.

  2. [Autoerotic fatalities in Greater Dusseldorf].

    Science.gov (United States)

    Hartung, Benno; Hellen, Florence; Borchard, Nora; Huckenbeck, Wolfgang

    2011-01-01

    Autoerotic fatalities in the Greater Dusseldorf area correspond to the relevant medicolegal literature. Our results included exclusively young to middle-aged, usually single men who were found dead in their city apartments. Clothing and devices used showed a great variety. Women's or fetish clothing and complex shackling or hanging devices were disproportionately frequent. In most cases, death occurred due to hanging or ligature strangulation. There was no increased incidence of underlying psychiatric disorders. In most of the deceased no or at least no remarkable alcohol intoxication was found. Occasionally, it may be difficult to reliably differentiate autoerotic accidents, accidents occurring in connection with practices of bondage & discipline, dominance & submission (BDSM) from natural death, suicide or homicide.

  3. 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

    difficulties (odds ratio [OR]=1.57, 95% confidence interval [CI] 1.06-2.30, P=.02). Those with moderate+ hearing difficulties had lower odds of PC use compared with those with no hearing difficulties, both overall (OR=0.58, 95% CI 0.39-0.87, P=.008) and in the younger group (OR=0.49, 95% CI 0.26-0.86, P=.008). Similar results were demonstrated for Internet use by age group (older: OR=1.57, 95% CI 0.99-2.47, P=.05; younger: OR=0.32, 95% CI 0.16-0.62, P=.001). Hearing health care is of particular relevance to older adults because of the prevalence of age-related hearing loss. Our data show that older adults experiencing slight hearing difficulty have increased odds of greater PC skill and Internet use than those reporting no difficulty. These findings suggest that PC and Internet delivery of hearing screening, information, and intervention is feasible for people between 50-74 years who have hearing loss, but who would not typically present to an audiologist.

  4. 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.

  5. Romantic Ideals, Mate Preferences, and Anticipation of Future Difficulties in Marital Life: A comparative study of young adults in India and America

    Directory of Open Access Journals (Sweden)

    Kathrine eBejanyan

    2014-12-01

    Full Text Available Previous studies have established that Indians tend to be greater in collectivism and gender role traditionalism than Americans. The purpose of the present study was to examine whether these differences explained further cultural differences in romantic beliefs, traditional mate preferences, and anticipation of future difficulties in marital life. Results revealed that Indians reported greater collectivism than Americans and, in turn, held stronger romantic beliefs. Additionally, Indians’ greater collectivism and endorsement of more traditional gender roles in part predicted their preferences for a marital partner possessing traditional characteristics, and fully accounted for their heightened concerns about encountering future difficulties in marital life. These results shed light on the processes underlying cultural differences in relationship attitudes and preferences, and point to culture-specific therapies to enhance marital functioning.

  6. Romantic ideals, mate preferences, and anticipation of future difficulties in marital life: a comparative study of young adults in India and America

    Science.gov (United States)

    Bejanyan, Kathrine; Marshall, Tara C.; Ferenczi, Nelli

    2014-01-01

    Previous studies have established that Indians tend to be greater in collectivism and gender role traditionalism than Americans. The purpose of the present study was to examine whether these differences explained further cultural differences in romantic beliefs, traditional mate preferences, and anticipation of future difficulties in marital life. Results revealed that Indians reported greater collectivism than Americans and, in turn, held stronger romantic beliefs. Additionally, Indians' greater collectivism and endorsement of more traditional gender roles in part predicted their preferences for a marital partner possessing traditional characteristics, and fully accounted for their heightened concerns about encountering future difficulties in marital life. These results shed light on the processes underlying cultural differences in relationship attitudes and preferences, and point to culture-specific therapies to enhance marital functioning. PMID:25520681

  7. The influence of age-related health difficulties and attitudes toward driving on driving self-regulation in the baby boomer and older adult generations.

    Science.gov (United States)

    Conlon, Elizabeth G; Rahaley, Nicole; Davis, Jessica

    2017-05-01

    Our study aimed to determine how age- and disease-related difficulties were associated with attitudes and beliefs about driving self-regulation in men and women in the baby boomer and older generations. Three hundred and ninety-nine men (n=204) and women (n=195) aged between 48 and 91 years participated in a cross-sectional study of Australian drivers. Demographic characteristics and measures of driving confidence, driving difficulty and driving self-regulation; perceptions of visual, physical and cognitive capacity; and attitudes and beliefs about driving were obtained. Driving self-regulation in men and women was explained by different mechanisms. For men, self-report of visual and cognitive difficulties and poor driving confidence predicted driving self-regulation. For women, negative attitudes toward driving mediated the associations found between health-related difficulties and driving self-regulation. Barriers to driving self-regulation were not associated with the driving self-regulatory practices of men or women. Regardless of generation, women reported poorer driving confidence, greater driving difficulty and more driving self-regulation than men. We concluded that age- and disease-related difficulties are related to increasing driving self-regulation in mature men and women. These results indicate that different pathways are needed in models of driving self-regulation for men and women regardless of generational cohort. Copyright © 2017 Elsevier Ltd. All rights reserved.

  8. A Review of the Approaches Investigating the Post-16 Transition of Young Adults with Learning Difficulties

    Science.gov (United States)

    Carroll, Catherine

    2015-01-01

    Investigations into the lives and transition from compulsory schooling of young adults with a disability, including a learning difficulty (LD), are increasing. The emerging consensus is one which points to this group of young people experiencing greater difficulties and poorer outcomes compared to the general population. How these investigations…

  9. [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.

  10. Waste management in Greater Vancouver

    Energy Technology Data Exchange (ETDEWEB)

    Carrusca, K. [Greater Vancouver Regional District, Burnaby, BC (Canada); Richter, R. [Montenay Inc., Vancouver, BC (Canada)]|[Veolia Environmental Services, Vancouver, BC (Canada)

    2006-07-01

    An outline of the Greater Vancouver Regional District (GVRD) waste-to-energy program was presented. The GVRD has an annual budget for solid waste management of $90 million. Energy recovery revenues from solid waste currently exceed $10 million. Over 1,660,00 tonnes of GVRD waste is recycled, and another 280,000 tonnes is converted from waste to energy. The GVRD waste-to-energy facility combines state-of-the-art combustion and air pollution control, and has processed over 5 million tonnes of municipal solid waste since it opened in 1988. Its central location minimizes haul distance, and it was originally sited to utilize steam through sales to a recycle paper mill. The facility has won several awards, including the Solid Waste Association of North America award for best facility in 1990. The facility focuses on continual improvement, and has installed a carbon injection system; an ammonia injection system; a flyash stabilization system; and heat capacity upgrades in addition to conducting continuous waste composition studies. Continuous air emissions monitoring is also conducted at the plant, which produces a very small percentage of the total air emissions in metropolitan Vancouver. The GVRD is now seeking options for the management of a further 500,000 tonnes per year of solid waste, and has received 23 submissions from a range of waste energy technologies which are now being evaluated. It was concluded that waste-to-energy plants can be located in densely populated metropolitan areas and provide a local disposal solution as well as a source of renewable energy. Other GVRD waste reduction policies were also reviewed. refs., tabs., figs.

  11. Visual performance on detection tasks with double-targets of the same and different difficulty.

    Science.gov (United States)

    Chan, Alan H S; Courtney, Alan J; Ma, C W

    2002-10-20

    This paper reports a study of measurement of horizontal visual sensitivity limits for 16 subjects in single-target and double-targets detection tasks. Two phases of tests were conducted in the double-targets task; targets of the same difficulty were tested in phase one while targets of different difficulty were tested in phase two. The range of sensitivity for the double-targets test was found to be smaller than that for single-target in both the same and different target difficulty cases. The presence of another target was found to affect performance to a marked degree. Interference effect of the difficult target on detection of the easy one was greater than that of the easy one on the detection of the difficult one. Performance decrement was noted when correct percentage detection was plotted against eccentricity of target in both the single-target and double-targets tests. Nevertheless, the non-significant correlation found between the performance for the two tasks demonstrated that it was impossible to predict quantitatively ability for detection of double targets from the data for single targets. This indicated probable problems in generalizing data for single target visual lobes to those for multiple targets. Also lobe area values obtained from measurements using a single-target task cannot be applied in a mathematical model for situations with multiple occurrences of targets.

  12. 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.

  13. 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.

  14. 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

  15. Planning for greater-confinement disposal

    International Nuclear Information System (INIS)

    Gilbert, T.L.; Luner, C.; Meshkov, N.K.; Trevorrow, L.E.; Yu, C.

    1984-01-01

    This contribution is a progress report for preparation of a document that will summarize procedures and technical information needed to plan for and implement greater-confinement disposal (GCD) of low-level radioactive waste. Selection of a site and a facility design (Phase I), and construction, operation, and extended care (Phase II) will be covered in the document. This progress report is limited to Phase I. Phase I includes determination of the need for GCD, design alternatives, and selection of a site and facility design. Alternative designs considered are augered shafts, deep trenches, engineered structures, high-integrity containers, hydrofracture, and improved waste form. Design considerations and specifications, performance elements, cost elements, and comparative advantages and disadvantages of the different designs are covered. Procedures are discussed for establishing overall performance objectives and waste-acceptance criteria, and for comparative assessment of the performance and cost of the different alternatives. 16 references

  16. Planning for greater-confinement disposal

    International Nuclear Information System (INIS)

    Gilbert, T.L.; Luner, C.; Meshkov, N.K.; Trevorrow, L.E.; Yu, C.

    1984-01-01

    This contribution is a progress report for preparation of a document that will summarize procedures and technical information needed to plan for and implement greater-confinement disposal (GCD) of low-level radioactive waste. Selection of a site and a facility design (Phase I), and construction, operation, and extended care (Phase II) will be covered in the document. This progress report is limited to Phase I. Phase I includes determination of the need for GCD, design alternatives, and selection of a site and facility design. Alternative designs considered are augered shafts, deep trenches, engineered structures, high-integrity containers, hydrofracture, and improved waste form. Design considerations and specifications, performance elements, cost elements, and comparative advantages and disadvantages of the different designs are covered. Procedures are discussed for establishing overall performance objecties and waste-acceptance criteria, and for comparative assessment of the performance and cost of the different alternatives. 16 refs

  17. Interatrial septum thickness and difficulty with transseptal puncture during redo catheter ablation of atrial fibrillation.

    Science.gov (United States)

    Tomlinson, David R; Sabharwal, Nikant; Bashir, Yaver; Betts, Timothy R

    2008-12-01

    Patients undergoing catheter ablation for atrial fibrillation (AF) frequently require redo procedures, but there are no data reporting interatrial septum thickness (IAS) and difficulty during repeat transseptal puncture (TSP). Patients undergoing two separate AF ablation procedures had preprocedural fossa ovalis (FO) thickness measured using transesophageal echocardiography (TEE). "Difficult" TSP was defined by two observers as requiring excessive force, or conversion to TEE guidance. The study comprised 42 patients (37 male) with mean+/-SD age 55+/-9 years. Mean FO thickness was significantly greater at the time of redo TSP (2.2+/-1.6 mm vs 2.6+/-1.5 mm at redo, P=0.03); however, this finding was limited to those who underwent initial dual transseptal sheath procedures, FO thickness 2.0+/-1.5 mm and 2.5+/-1.4 mm for TEE 1 and 2, respectively (P=0.048). There was a trend for more frequent difficult redo TSP procedures, 7/42 (17%; 95% confidence interval [CI] 8-31) redo, versus 4/42 (10%; 95% CI 3-23) first TSP. On univariate analysis, FO thickness was not predictive of TSP difficulty; the only predictor of difficult redo TSP was diabetes. IAS thickness at the FO increased following catheter ablation of AF, yet on subgroup analysis this was limited to initial procedures utilizing dual transseptal sheaths. There was a trend toward more frequent difficulty during redo TSP, yet this was not associated with FO thickening. Diabetes may predispose to difficulty during redo TSP; this finding requires confirmation in a larger study population.

  18. Greater Caregiving Risk, Better Infant Memory Performance?

    Science.gov (United States)

    Rifkin-Graboi, Anne; Quan, Jeffry; Richmond, Jenny; Goh, Shaun Kok Yew; Sim, Lit Wee; Chong, Yap Seng; Francois-Bureau, Jean; Chen, Helen; Qiu, Anqi

    2018-04-16

    Poor early life care often relates to cognitive difficulties. However, newer work suggests that in early-life, adversity may associate with enhanced or accelerated neurodevelopment. We examine associations between postnatal caregiving risks (i.e., higher self-reported postnatal-anxiety and lower observed maternal sensitivity) and infant relational memory (i.e. via deferred imitation and relational binding). Using subsamples of 67-181 infants (aged 433-477 post-conceptual days, or roughly five to seven months since birth) taking part in the GUSTO study, we found such postnatal caregiving risk significantly predictive of "better" performance on a relational binding task following a brief delay, after Bonferroni adjustments. Subsequent analyses suggest that the association between memory and these risks may specifically be apparent amongst infants spending at least 50% of their waking hours in the presence of their mothers. Our findings echo neuroimaging research concerning similar risk exposure and larger infant hippocampal volume, and likewise underscore the importance of considering developmental context in understanding early life experience. With this in mind, these findings caution against the use of cognitive outcomes as indices of experienced risk. This article is protected by copyright. All rights reserved. © 2018 Wiley Periodicals, Inc.

  19. 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.…

  20. 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 ...

  1. 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

  2. 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.

  3. 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.

  4. 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…

  5. Commercial Integrated Heat Pump with Thermal Storage --Demonstrate Greater than 50% Average Annual Energy Savings, Compared with Baseline Heat Pump and Water Heater (Go/No-Go) FY16 4th Quarter Milestone Report

    Energy Technology Data Exchange (ETDEWEB)

    Shen, Bo [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Baxter, Van D. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Rice, C. Keith [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Abu-Heiba, Ahmad [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States)

    2017-03-01

    For this study, we authored a new air source integrated heat pump (AS-IHP) model in EnergyPlus, and conducted building energy simulations to demonstrate greater than 50% average energy savings, in comparison to a baseline heat pump with electric water heater, over 10 US cities, based on the EnergyPlus quick-service restaurant template building. We also assessed water heating energy saving potentials using ASIHP versus gas heating, and pointed out climate zones where AS-IHPs are promising.

  6. 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...

  7. 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

  8. Kauffman Teen Survey. An Annual Report on Teen Health Behaviors: Use of Alcohol, Tobacco, and Other Drugs among 8th-, 10th-, and 12th-Grade Students in Greater Kansas City, 1991-92 to 2000-01.

    Science.gov (United States)

    Ewing Marion Kauffman Foundation, Kansas City, MO.

    The Ewing Marion Kauffman Foundation began surveying Kansas City area teens during the 1984-85 school year. The Kauffman Teen Survey now addresses two sets of issues for teens. Teen Health Behaviors, addressed in this report, have been a focus of the survey since its inception. The report focuses on teen use of alcohol, tobacco, and other drugs in…

  9. 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.

  10. 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.

  11. 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…

  12. 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.

  13. Monitoring and research on the Bi-State Distinct Population Segment of greater sage-grouse (Centrocercus urophasianus) in the Pine Nut Mountains, California and Nevada—Study progress report, 2011–15

    Science.gov (United States)

    Coates, Peter S.; Andrle, Katie M.; Ziegler, Pilar T.; Casazza, Michael L.

    2016-09-29

    The Bi-State distinct population segment (DPS) of greater sage-grouse (Centrocercus urophasianus) that occurs along the Nevada–California border was proposed for listing as threatened under the Endangered Species Act (ESA) by the U.S. Fish and Wildlife Service (FWS) in October 2013. However, in April 2015, the FWS determined that the Bi-State DPS no longer required protection under the ESA and withdrew the proposed rule to list the Bi-State DPS (U.S. Fish and Wildlife Service, 2015). The Bi-State DPS occupies portions of Alpine, Mono, and Inyo Counties in California, and Douglas, Esmeralda, Lyon, Carson City, and Mineral Counties in Nevada. Unique threats facing this population include geographic isolation, expansion of single-leaf pinyon (Pinus monophylla) and Utah juniper (Juniperus osteosperma), anthropogenic activities, and recent changes in predator communities. Estimating population vital rates, identifying seasonal habitat, quantifying threats, and identifying movement patterns are important first steps in developing effective sage-grouse management and conservation plans. During 2011–15, we radio- and Global Positioning System (GPS)-marked (2012–14 only) 44, 47, 17, 9, and 3 sage-grouse, respectively, for a total of 120, in the Pine Nut Mountains Population Management Unit (PMU). No change in lek attendance was detected at Mill Canyon (maximum=18 males) between 2011 and 2012; however, 1 male was observed in 2014 and no males were observed in 2013 and 2015. Males were observed near Bald Mountain in 2013, making it the first year this lek was observed to be active during the study period. Males were observed at a new site in the Buckskin Range in 2014 during trapping efforts and again observed during surveys in 2015. Findings indicate that pinyon-juniper is avoided by sage-grouse during every life stage. Nesting females selected increased sagebrush cover, sagebrush height, and understory horizontal cover, and brood-rearing females selected similar areas

  14. Greater saphenous vein anomaly and aneurysm with subsequent pulmonary embolism

    OpenAIRE

    Ma, Truong; Kornbau, Craig

    2017-01-01

    Abstract Venous aneurysms often present as painful masses. They can present either in the deep or superficial venous system. Deep venous system aneurysms have a greater risk of thromboembolism. Though rare, there have been case reports of superficial aneurysms and thrombus causing significant morbidity such as pulmonary embolism. We present a case of an anomalous greater saphenous vein connection with an aneurysm and thrombus resulting in a pulmonary embolism. This is the only reported case o...

  15. 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.

  16. 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.

  17. 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.

  18. 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.

  19. Dyslexia and English: Degree of Difficulties Faced by the Students with Dyslexia while Learning English

    Directory of Open Access Journals (Sweden)

    Paraskevi Kaperoni

    2016-12-01

    Full Text Available This research aims to investigate the hypothesis that students diagnosed with dyslexia face a greater amount of difficulty when they attempt to learn a foreign language and especially English. On a survey carried out in the form of a questionnaire, two groups of students completed the same questionnaire regarding their difficulty to learn the basic skills such as reading, writing, listening, and speaking. The questions mostly focused on the difficulty they may face in spelling, reading, and listening which are the main aspects of the language dyslexic students’ score lower than students without dyslexia. The answers were evaluated with the use of the statistical method of t-test. The findings of the survey displayed a great difference on the score chosen by the two teams, which indicates the greater degree of difficulty the dyslexic students face confirming the original hypothesis.

  20. Increased Difficulties in Managing Stairs in Visually Impaired Older Adults: A Community-Based Survey.

    Directory of Open Access Journals (Sweden)

    Chen-Wei Pan

    Full Text Available Managing stairs is a challenging aspect of daily activities of living for older people. We assessed whether older adults with visual impairment (VI have greater difficulties of managing stairs in daily lives.The study was designed as a community-based cross-sectional study based on a Chinese cohort aged 60 years and older in rural China. Visual acuity (VA was measured in both eyes using a retro-illuminated Snellen chart with tumbling-E optotypes. VI (including blindness was defined as presenting VA of worse than 20/60 in either eye. Having any difficulties in managing stairs was self-reported based on a question drawn from the Barthel Index. Information on participants' socioeconomic status, lifestyle-related factors, diseases histories and medication intake was collected using a questionnaire.The Barthel Index, Activities of Daily Living questionnaire was completed by 4597 (99.7% participants including 2218 men and 2379 women. The age of the participants ranged from 60 to 93 years with a mean of 67.6 ± 6.3 years. In age and gender adjusted models, adults with VI had a higher likelihood of having difficulties in managing stairs (odds ratio [OR] = 2.7; 95% confidence interval [CI] 2.0, 3.7 compared with those without. The association of VI with the likelihood of having difficulties in managing stairs was stronger in older adults who lived alone (OR = 3.2; 95%CI 1.8, 4.5 compared with those who lived with other family members (OR = 2.0; 95%CI 1.3, 4.3. Compared with hypertension, diabetes, obesity and cognitive dysfunction, VI had the greatest impact on people's abilities of managing stairs.VI was associated with an increased likelihood of having difficulties in managing stairs, especially in those who lived alone. However, whether the finding could be extrapolated to other populations warrants further studies as different environmental exposures such as illumination and types of stairs may alter the association observed in this study.

  1. Challenges and Difficulties to Teaching Engineering to Generation Z: a case research

    OpenAIRE

    Barreiro, Suamit Correia; Bozutti, Daniel Fernando

    2017-01-01

    Many people from generation Z are at the beginning of their academic activities. This generation has peculiar characteristics that might be a challenge in the labor market. Thus, instructors have a great role in their preparation. However, professors might face difficulties dealing with their specific characteristics. The research aims to carry out a general survey to enable an understanding of the greater challenges and difficulties in teaching the subject of engineering to the students of G...

  2. 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 ...

  3. 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...

  4. The psychosocial burden of childhood overweight and obesity: evidence for persisting difficulties in boys and girls.

    Science.gov (United States)

    Gibson, Lisa Y; Allen, Karina L; Davis, Elizabeth; Blair, Eve; Zubrick, Stephen R; Byrne, Susan M

    2017-07-01

    There is evidence that overweight and obese children tend to remain overweight or obese into adolescence and adulthood. However, little is known about the long-term psychosocial outcomes of childhood overweight and obesity. This study aimed to investigate the course of psychosocial difficulties over a 2-year period for children who were overweight or obese at baseline, and a sample of children who were a healthy weight at baseline. Participants were 212 children aged 8 to 13 years at baseline, who were participating in the Childhood Growth and Development (GAD) Study. Questionnaire and interview measures were used to assess children's self-esteem, depressive symptoms, body image, eating disorder symptoms, experiences with bullying, family satisfaction and quality of life. Linear mixed models were used to consider longitudinal changes in psychosocial variables. Overweight and obese children reported greater psychosocial distress than healthy weight children, and these differences were more pronounced for girls than boys. Weight and psychosocial impairment showed stability from baseline to 2-year follow-up. The results of this study suggest that psychosocial difficulties show considerable stability in childhood, for overweight/obese and healthy weight children. What is Known: • Childhood obesity tracks into adolescence and adulthood. • Physical health problems associated with childhood obesity also persist to adulthood. What is New: • Overweight and obese children are at risk of ongoing psychosocial distress from childhood into early adolescence.

  5. 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.

  6. 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.

  7. 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.

  8. 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

  9. 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.

  10. G132 Which cut off should we choose? Is severity of motor coordination difficulties related to co-morbidity in children at risk for DCD?

    NARCIS (Netherlands)

    Lingam, R; Schoemaker, M; Jongmans, M; van Heuvelena, M; Emond, A

    2014-01-01

    Aim of the study was to investigate whether children aged 7–9 year old with severe motor difficulties had a greater risk of additional difficulties in activities in daily living (ADL), academic skills, attention and social skills than children with moderate motor difficulties. Methods Children

  11. A review of factors associated with greater likelihood of suicide attempts and suicide deaths in bipolar disorder: Part II of a report of the International Society for Bipolar Disorders Task Force on Suicide in Bipolar Disorder.

    Science.gov (United States)

    Schaffer, Ayal; Isometsä, Erkki T; Azorin, Jean-Michel; Cassidy, Frederick; Goldstein, Tina; Rihmer, Zoltán; Sinyor, Mark; Tondo, Leonardo; Moreno, Doris H; Turecki, Gustavo; Reis, Catherine; Kessing, Lars Vedel; Ha, Kyooseob; Weizman, Abraham; Beautrais, Annette; Chou, Yuan-Hwa; Diazgranados, Nancy; Levitt, Anthony J; Zarate, Carlos A; Yatham, Lakshmi

    2015-11-01

    Many factors influence the likelihood of suicide attempts or deaths in persons with bipolar disorder. One key aim of the International Society for Bipolar Disorders Task Force on Suicide was to summarize the available literature on the presence and magnitude of effect of these factors. A systematic review of studies published from 1 January 1980 to 30 May 2014 identified using keywords 'bipolar disorder' and 'suicide attempts or suicide'. This specific paper examined all reports on factors putatively associated with suicide attempts or suicide deaths in bipolar disorder samples. Factors were subcategorized into: (1) sociodemographics, (2) clinical characteristics of bipolar disorder, (3) comorbidities, and (4) other clinical variables. We identified 141 studies that examined how 20 specific factors influenced the likelihood of suicide attempts or deaths. While the level of evidence and degree of confluence varied across factors, there was at least one study that found an effect for each of the following factors: sex, age, race, marital status, religious affiliation, age of illness onset, duration of illness, bipolar disorder subtype, polarity of first episode, polarity of current/recent episode, predominant polarity, mood episode characteristics, psychosis, psychiatric comorbidity, personality characteristics, sexual dysfunction, first-degree family history of suicide or mood disorders, past suicide attempts, early life trauma, and psychosocial precipitants. There is a wealth of data on factors that influence the likelihood of suicide attempts and suicide deaths in people with bipolar disorder. Given the heterogeneity of study samples and designs, further research is needed to replicate and determine the magnitude of effect of most of these factors. This approach can ultimately lead to enhanced risk stratification for patients with bipolar disorder. © The Royal Australian and New Zealand College of Psychiatrists 2015.

  12. A review of factors associated with greater likelihood of suicide attempts and suicide deaths in bipolar disorder: Part II of a report of the International Society for Bipolar Disorders Task Force on Suicide in Bipolar Disorder

    Science.gov (United States)

    Schaffer, Ayal; Isometsä, Erkki T; Azorin, Jean-Michel; Cassidy, Frederick; Goldstein, Tina; Rihmer, Zoltán; Sinyor, Mark; Tondo, Leonardo; Moreno, Doris H; Turecki, Gustavo; Reis, Catherine; Kessing, Lars Vedel; Ha, Kyooseob; Weizman, Abraham; Beautrais, Annette; Chou, Yuan-Hwa; Diazgranados, Nancy; Levitt, Anthony J; Zarate, Carlos A; Yatham, Lakshmi

    2018-01-01

    Objectives Many factors influence the likelihood of suicide attempts or deaths in persons with bipolar disorder. One key aim of the International Society for Bipolar Disorders Task Force on Suicide was to summarize the available literature on the presence and magnitude of effect of these factors. Methods A systematic review of studies published from 1 January 1980 to 30 May 2014 identified using keywords ‘bipolar disorder’ and ‘suicide attempts or suicide’. This specific paper examined all reports on factors putatively associated with suicide attempts or suicide deaths in bipolar disorder samples. Factors were subcategorized into: (1) sociodemographics, (2) clinical characteristics of bipolar disorder, (3) comorbidities, and (4) other clinical variables. Results We identified 141 studies that examined how 20 specific factors influenced the likelihood of suicide attempts or deaths. While the level of evidence and degree of confluence varied across factors, there was at least one study that found an effect for each of the following factors: sex, age, race, marital status, religious affiliation, age of illness onset, duration of illness, bipolar disorder subtype, polarity of first episode, polarity of current/recent episode, predominant polarity, mood episode characteristics, psychosis, psychiatric comorbidity, personality characteristics, sexual dysfunction, first-degree family history of suicide or mood disorders, past suicide attempts, early life trauma, and psychosocial precipitants. Conclusion There is a wealth of data on factors that influence the likelihood of suicide attempts and suicide deaths in people with bipolar disorder. Given the heterogeneity of study samples and designs, further research is needed to replicate and determine the magnitude of effect of most of these factors. This approach can ultimately lead to enhanced risk stratification for patients with bipolar disorder. PMID:26175498

  13. 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.

  14. 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…

  15. 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…

  16. 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.

  17. Greater trochanteric pain syndrome diagnosis and treatment.

    Science.gov (United States)

    Mallow, Michael; Nazarian, Levon N

    2014-05-01

    Lateral hip pain, or greater trochanteric pain syndrome, is a commonly seen condition; in this article, the relevant anatomy, epidemiology, and evaluation strategies of greater trochanteric pain syndrome are reviewed. Specific attention is focused on imaging of this syndrome and treatment techniques, including ultrasound-guided interventions. Copyright © 2014 Elsevier Inc. All rights reserved.

  18. 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…

  19. 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)

  20. 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…

  1. 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

  2. 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)

  3. 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

  4. 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…

  5. 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…

  6. 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…

  7. 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…

  8. 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)

  9. 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)

  10. 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…

  11. 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…

  12. 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…

  13. 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,…

  14. Difficulties in getting treatment for injuries in rural Vietnam.

    Science.gov (United States)

    Hang, H M; Byass, P

    2009-01-01

    Knowledge about the health-seeking behaviour of injury patients is important for the improvement of community health services. The aims of this study were: (1) to describe the healthcare-seeking behaviour of injury patients; (2) to examine factors associated with injury patients seeking care at health facilities; and (3) to describe the costs of health care for injury patients. This study took place in Bavi District, northern Vietnam within a longitudinal community surveillance site (FilaBavi). All non-fatal unintentional injuries occurring in a sample of 24,776 people during 2000 were recorded. The injury questionnaire included information on care-seeking behaviour, severity and consequences of injury. Both univariate and multivariate logistic regression models were used to find associations between sociodemographic factors and utilization of any health services, as well as for each type of health service used, compared with the group who did not use any health services. Of 24,776 persons living in the study area, 1917 reported 2079 new non-fatal debilitating injuries during the four 3-month periods of observation. Health-seeking behaviour relating to the first 1917 injuries was analysed. Self-treatment was most common (51.7%), even in cases of severe injury. There was low usage of public health services (23.2%) among injury patients. Long distances, poor economic status and residence in difficult geographic areas such as highlands and mountains were barriers for seeking health services. A large proportion of household income was spent on treating injury patients. Poor people spent a greater proportion of their income on health care than the rich, and often used less qualified or untrained private providers. These results demonstrate the logistical and financial difficulties associated with the treatment of injuries in rural Vietnam. This suggests the need to make public health subsidies available more efficiently and equitably. Whilst this study looked at the

  15. 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.

  16. 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

  17. 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.

  18. Ectopic decidua of the greater omentum: a case report

    Directory of Open Access Journals (Sweden)

    Biserka Pigac

    2016-04-01

    Full Text Available Ectopic decidua is defined as extrauterine deposits of decidual stromal cells. It occurs in 85-100% of pregnancies. Focal sites can be present in various locations, yet a peritoneal location is rare. A 24- year- old woman underwent a cesarean section in 39th week of her first pregnancy, during which adhesions of the omentum to the fundus, entire left side of the uterus, and a part of the right front abdominal wall were found. An operative specimen was taken for a pathohistological analysis under the assumption of being fibrous adhesive tissue. The analysis revealed ectopic decidual tissue composed of large, polygonal cells with eosinophilic cytoplasm, and large nuclei with conspicuous nucleoli infiltrated with mature fatty cells and lymphocytes. Strong staining for vimentin was observed in the decidual cell cytoplasm and for a progesterone- receptor in the cell nuclei, medium staining was detected for S-100, and negative staining for CK 5/ 6, HMB-45, desmin, smooth muscle actin, estrogen and androgen- receptors. We present this case in order to educate clinicians and pathologists about the phenomenon of ectopic deciduosis. Although it can exist as asymptomatic condition, we point out the importance of considering this condition since it can result in serious pathology, like intraperitoneal hemorrhage and labour obstruction, if remains unrecognized. Another pitfall is possible confusion of this entity with other conditions. A resemblance to adhesions of the omentum and malignant neoplastic lesions, like squamous cell and metastatic carcinoma, metastatic melanoma, malignant decidual mesothelioma, metastatic mucin -producing adenocarcinoma, can be deceiving. These obstacles may present a pitfall to clinicians and pathologists, with a negative impact on patient treatment and outcome.

  19. 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.

  20. 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.

  1. 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.

  2. 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

  3. 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.

  4. 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)

  5. 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.

  6. 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.

  7. Do age-related word retrieval difficulties appear (or disappear) in connected speech?

    Science.gov (United States)

    Kavé, Gitit; Goral, Mira

    2017-09-01

    We conducted a comprehensive literature review of studies of word retrieval in connected speech in healthy aging and reviewed relevant aphasia research that could shed light on the aging literature. Four main hypotheses guided the review: (1) Significant retrieval difficulties would lead to reduced output in connected speech. (2) Significant retrieval difficulties would lead to a more limited lexical variety in connected speech. (3) Significant retrieval difficulties would lead to an increase in word substitution errors and in pronoun use as well as to greater dysfluency and hesitation in connected speech. (4) Retrieval difficulties on tests of single-word production would be associated with measures of word retrieval in connected speech. Studies on aging did not confirm these four hypotheses, unlike studies on aphasia that generally did. The review suggests that future research should investigate how context facilitates word production in old age.

  8. 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.

  9. 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.

  10. 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.

  11. 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...

  12. 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...

  13. 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...

  14. 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)

  15. [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.

  16. Perceptual discrimination difficulty and familiarity in the Uncanny Valley: more like a "Happy Valley".

    Science.gov (United States)

    Cheetham, Marcus; Suter, Pascal; Jancke, Lutz

    2014-01-01

    The Uncanny Valley Hypothesis (UVH) predicts that greater difficulty perceptually discriminating between categorically ambiguous human and humanlike characters (e.g., highly realistic robot) evokes negatively valenced (i.e., uncanny) affect. An ABX perceptual discrimination task and signal detection analysis was used to examine the profile of perceptual discrimination (PD) difficulty along the UVH' dimension of human likeness (DHL). This was represented using avatar-to-human morph continua. Rejecting the implicitly assumed profile of PD difficulty underlying the UVH' prediction, Experiment 1 showed that PD difficulty was reduced for categorically ambiguous faces but, notably, enhanced for human faces. Rejecting the UVH' predicted relationship between PD difficulty and negative affect (assessed in terms of the UVH' familiarity dimension), Experiment 2 demonstrated that greater PD difficulty correlates with more positively valenced affect. Critically, this effect was strongest for the ambiguous faces, suggesting a correlative relationship between PD difficulty and feelings of familiarity more consistent with the metaphor happy valley. This relationship is also consistent with a fluency amplification instead of the hitherto proposed hedonic fluency account of affect along the DHL. Experiment 3 found no evidence that the asymmetry in the profile of PD along the DHL is attributable to a differential processing bias (cf. other-race effect), i.e., processing avatars at a category level but human faces at an individual level. In conclusion, the present data for static faces show clear effects that, however, strongly challenge the UVH' implicitly assumed profile of PD difficulty along the DHL and the predicted relationship between this and feelings of familiarity.

  17. Eating difficulties in relation to gender, length of stay, and discharge to institutional care, among patients in stroke rehabilitation.

    Science.gov (United States)

    Westergren, A; Ohlsson, O; Hallberg, I R

    2002-07-10

    To describe and compare eating difficulties from admission to discharge, with regard to length of stay (LOS) and discharge to institutional care, as well as in relation to gender. Patients, aged 65 or above, admitted for stroke rehabilitation, having at least one eating difficulty were observed (n =108) as regards to eating on admission and at discharge. Analysis followed earlier findings in which eating difficulties had been found to have three components, i.e. ingestion, deglutition and energy. Of the components, ingestion difficulties were the most common, followed by low energy. The most common single difficulties were low food consumption, difficulties in manipulating food on the plate and transporting it to the mouth. Ingestion difficulties especially decreased during the rehabilitation period. Women were older and ate less on admission and at discharge than men, improved less than men, and also a higher proportion had a low food intake at the time of discharge if having longer LOS and/or being discharged to institutional care. Patients with longer LOS and those discharged to institutional care had more eating difficulties on admission and were more dependent in activities of daily living (ADL) than those with shorter LOS and those who returned home. LOS was mainly explained by ingestion difficulties on admission and low age. Discharge to institutional care was explained by living alone before admission, ingestion difficulties at discharge, male gender and high age. Ingestion difficulties on admission indicate a longer in-hospital stay and decrease to a greater extent than other types of eating difficulties. If these difficulties persist at the time of discharge the patients are more likely to need institutional care. It is important to assess and take systematic measures for each of the three variants of eating difficulties, i.e. ingestion, deglutition, and energy, to improve eating abilities. Women in particular need attention with regard to low food intake.

  18. 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…

  19. 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.

  20. 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).

  1. [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.

  2. A web-based endodontic case difficulty assessment tool.

    Science.gov (United States)

    Shah, P K; Chong, B S

    2018-01-25

    To develop a web-based tool to facilitate identification, evaluation and management of teeth requiring endodontic treatment. Following a literature search and thorough analysis of existing case difficulty assessment forms, the web-based tool was developed using an online survey builder (Qualtrics, Qualtrics Lab, UT, USA). Following feedback from a pilot study, it was refined and improved. A study was performed, using the updated version (EndoApp) on a cohort (n = 53) of dental professionals and dental students. The participants were e-mailed instructions detailing the assessment of five test cases using EndoApp, followed by completion of a structured feedback form. Analysis of the EndoApp responses was used to evaluate usage times, whereas the results of the feedback forms were used to assess user experience and relevance, other potential applications and comments on further improvement/s. The average usage time was 2 min 7 s; the average times needed for the last three (Cases 3-5) were significantly less than the preceding two (Cases 1 & 2) test cases. An overwhelming majority of participants expressed favourable views on user experience and relevance of the web-based case difficulty assessment tool. Only two participants (4%) were unlikely or very unlikely to use EndoApp again. The potential application of EndoApp as an 'educational tool' and for 'primary care triage' was deemed the most popular features and of greater importance than the secondary options of 'fee setting' and as a 'dento-legal justification tool'. Within the study limitations, owing to its ability to quantify the level of difficulty and provide guidance, EndoApp was considered user-friendly and helped facilitate endodontic case difficulty assessment. From the feedback, further improvements and the development of a Smartphone App version are in progress. EndoApp may facilitate treatment planning, improve treatment cost-effectiveness and reduce frequency of procedural errors by providing

  3. Greater trochanteric fracture with occult intertrochanteric extension.

    Science.gov (United States)

    Reiter, Michael; O'Brien, Seth D; Bui-Mansfield, Liem T; Alderete, Joseph

    2013-10-01

    Proximal femoral fractures are frequently encountered in the emergency department (ED). Prompt diagnosis is paramount as delay will exacerbate the already poor outcomes associated with these injuries. In cases where radiography is negative but clinical suspicion remains high, magnetic resonance imaging (MRI) is the study of choice as it has the capability to depict fractures which are occult on other imaging modalities. Awareness of a particular subset of proximal femoral fractures, namely greater trochanteric fractures, is vital for both radiologists and clinicians since it has been well documented that they invariably have an intertrochanteric component which may require surgical management. The detection of intertrochanteric or cervical extension of greater trochanteric fractures has been described utilizing MRI but is underestimated with both computed tomography (CT) and bone scan. Therefore, if MRI is unavailable or contraindicated, the diagnosis of an isolated greater trochanteric fracture should be met with caution. The importance of avoiding this potential pitfall is demonstrated in the following case of an elderly woman with hip pain and CT demonstrating an isolated greater trochanteric fracture who subsequently returned to the ED with a displaced intertrochanteric fracture.

  4. Butterfly valves: greater use in power plants

    International Nuclear Information System (INIS)

    McCoy, M.

    1975-01-01

    Improvements in butterfly valves, particularly in the areas of automatic control and leak tightness are described. The use of butterfly valves in nuclear power plants is discussed. These uses include service in component cooling, containment cooling, and containment isolation. The outlook for further improvements and greater uses is examined. (U.S.)

  5. Greater Somalia, the never-ending dream?

    DEFF Research Database (Denmark)

    Zoppi, Marco

    2015-01-01

    This paper provides an historical analysis of the concept of Greater Somalia, the nationalist project that advocates the political union of all Somali-speaking people, including those inhabiting areas in current Djibouti, Ethiopia and Kenya. The Somali territorial unification project of “lost...

  6. 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

  7. 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.

  8. 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.

  9. 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.

  10. 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.

  11. 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.

  12. Utilization of wind energy in greater Hanover

    International Nuclear Information System (INIS)

    Sahling, U.

    1993-01-01

    Since the beginning of the Eighties, the association of communities of Greater Hanover has dealt intensively with energy and ecopolitical questions in the scope of regional planning. Renewable energy sources play a dominant role in this context. This brochure is the third contribution to the subject ''Energy policy and environmental protection''. Experts as well as possibly interested parties are addressed especially. For all 8 contributions contained, separate entries have been recorded in this database. (BWI) [de

  13. Small cities face greater impact from automation

    OpenAIRE

    Frank, Morgan R.; Sun, Lijun; Cebrian, Manuel; Youn, Hyejin; Rahwan, Iyad

    2017-01-01

    The city has proven to be the most successful form of human agglomeration and provides wide employment opportunities for its dwellers. As advances in robotics and artificial intelligence revive concerns about the impact of automation on jobs, a question looms: How will automation affect employment in cities? Here, we provide a comparative picture of the impact of automation across U.S. urban areas. Small cities will undertake greater adjustments, such as worker displacement and job content su...

  14. The Greater Sekhukhune-CAPABILITY outreach project.

    Science.gov (United States)

    Gregersen, Nerine; Lampret, Julie; Lane, Tony; Christianson, Arnold

    2013-07-01

    The Greater Sekhukhune-CAPABILITY Outreach Project was undertaken in a rural district in Limpopo, South Africa, as part of the European Union-funded CAPABILITY programme to investigate approaches for capacity building for the translation of genetic knowledge into care and prevention of congenital disorders. Based on previous experience of a clinical genetic outreach programme in Limpopo, it aimed to initiate a district clinical genetic service in Greater Sekhukhune to gain knowledge and experience to assist in the implementation and development of medical genetic services in South Africa. Implementing the service in Greater Sekhukhune was impeded by a developing staff shortage in the province and pressure on the health service from the existing HIV/AIDS and TB epidemics. This situation underscores the need for health needs assessment for developing services for the care and prevention of congenital disorders in middle- and low-income countries. However, these impediments stimulated the pioneering of innovate ways to offer medical genetic services in these circumstances, including tele-teaching of nurses and doctors, using cellular phones to enhance clinical care and adapting and assessing the clinical utility of a laboratory test, QF-PCR, for use in the local circumstances.

  15. Operational technology for greater confinement disposal

    International Nuclear Information System (INIS)

    Dickman, P.T.; Vollmer, A.T.; Hunter, P.H.

    1984-12-01

    Procedures and methods for the design and operation of a greater confinement disposal facility using large-diameter boreholes are discussed. It is assumed that the facility would be located at an operating low-level waste disposal site and that only a small portion of the wastes received at the site would require greater confinement disposal. The document is organized into sections addressing: facility planning process; facility construction; waste loading and handling; radiological safety planning; operations procedures; and engineering cost studies. While primarily written for low-level waste management site operators and managers, a detailed economic assessment section is included that should assist planners in performing cost analyses. Economic assessments for both commercial and US government greater confinement disposal facilities are included. The estimated disposal costs range from $27 to $104 per cubic foot for a commercial facility and from $17 to $60 per cubic foot for a government facility. These costs are based on average site preparation, construction, and waste loading costs for both contact- and remote-handled wastes. 14 figures, 22 tables

  16. 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.

  17. 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.

  18. 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.

  19. 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.

  20. 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

  1. 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...

  2. 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...

  3. Greater happiness for a greater number: Is that possible in Austria?

    NARCIS (Netherlands)

    R. Veenhoven (Ruut)

    2011-01-01

    textabstractWhat is the final goal of public policy? Jeremy Bentham (1789) would say: greater happiness for a greater number. He thought of happiness as subjective enjoyment of life; in his words as “the sum of pleasures and pains”. In his time the happiness of the great number could not be measured

  4. Greater happiness for a greater number: Is that possible? If so how? (Arabic)

    NARCIS (Netherlands)

    R. Veenhoven (Ruut); E. Samuel (Emad)

    2012-01-01

    textabstractWhat is the final goal of public policy? Jeremy Bentham (1789) would say: greater happiness for a greater number. He thought of happiness as subjective enjoyment of life; in his words as “the sum of pleasures and pains”. In his time, the happiness of the great number could not be

  5. Greater happiness for a greater number: Is that possible in Germany?

    NARCIS (Netherlands)

    R. Veenhoven (Ruut)

    2009-01-01

    textabstractWhat is the final goal of public policy? Jeremy Bentham (1789) would say: greater happiness for a greater number. He thought of happiness as subjective enjoyment of life; in his words as “the sum of pleasures and pains”. In his time the Happiness of the great number could not be measured

  6. Honing in on the Social Difficulties Associated With Sluggish Cognitive Tempo in Children: Withdrawal, Peer Ignoring, and Low Engagement.

    Science.gov (United States)

    Becker, Stephen P; Garner, Annie A; Tamm, Leanne; Antonini, Tanya N; Epstein, Jeffery N

    2017-03-13

    Sluggish cognitive tempo (SCT) symptoms are associated with social difficulties in children, though findings are mixed and many studies have used global measures of social impairment. The present study tested the hypothesis that SCT would be uniquely associated with aspects of social functioning characterized by withdrawal and isolation, whereas attention deficit/hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD) symptoms would be uniquely associated with aspects of social functioning characterized by inappropriate responding in social situations and active peer exclusion. Participants were 158 children (70% boys) between 7-12 years of age being evaluated for possible ADHD. Both parents and teachers completed measures of SCT, ADHD, ODD, and internalizing (anxiety/depression) symptoms. Parents also completed ratings of social engagement and self-control. Teachers also completed measures assessing asociality and exclusion, as well as peer ignoring and dislike. In regression analyses controlling for demographic characteristics and other psychopathology symptoms, parent-reported SCT symptoms were significantly associated with lower social engagement (e.g., starting conversations, joining activities). Teacher-reported SCT symptoms were significantly associated with greater asociality/withdrawal and ratings of more frequent ignoring by peers, as well as greater exclusion. ODD symptoms and ADHD hyperactive-impulsive symptoms were more consistently associated with other aspects of social behavior, including peer exclusion, being disliked by peers, and poorer self-control during social situations. Findings provide the clearest evidence to date that the social difficulties associated with SCT are primarily due to withdrawal, isolation, and low initiative in social situations. Social skills training interventions may be effective for children displaying elevated SCT symptomatology.

  7. 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.

  8. Search for greater stability in nuclear regulation

    International Nuclear Information System (INIS)

    Asselstine, J.K.

    1985-01-01

    The need for greater stability in nuclear regulation is discussed. Two possible approaches for dealing with the problems of new and rapidly changing regulatory requirements are discussed. The first approach relies on the more traditional licensing reform initiatives that have been considered off and on for the past decade. The second approach considers a new regulator philosophy aimed at the root causes of the proliferation of new safety requirements that have been imposed in recent years. For the past few years, the concepts of deregulation and regulatory reform have been in fashion in Washington, and the commercial nuclear power program has not remained unaffected. Many look to these concepts to provide greater stability in the regulatory program. The NRC, the nuclear industry and the administration have all been avidly pursuing regulatory reform initiatives, which take the form of both legislative and administrative proposals. Many of these proposals look to the future, and, if adopted, would have little impact on currently operating nuclear power plants or plants now under construction

  9. Greater Sudbury fuel efficient driving handbook

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2009-12-15

    Reducing the amount of fuel that people use for personal driving saves money, improves local air quality, and reduces personal contributions to climate change. This handbook was developed to be used as a tool for a fuel efficient driving pilot program in Greater Sudbury in 2009-2010. Specifically, the purpose of the handbook was to provide greater Sudbury drivers with information on how to drive and maintain their personal vehicles in order to maximize fuel efficiency. The handbook also provides tips for purchasing fuel efficient vehicles. It outlines the benefits of fuel maximization, with particular reference to reducing contributions to climate change; reducing emissions of air pollutants; safe driving; and money savings. Some tips for efficient driving are to avoid aggressive driving; use cruise control; plan trips; and remove excess weight. Tips for efficient winter driving are to avoid idling to warm up the engine; use a block heater; remove snow and ice; use snow tires; and check tire pressure. The importance of car maintenance and tire pressure was emphasized. The handbook also explains how fuel consumption ratings are developed by vehicle manufacturers. refs., figs.

  10. Women at greater risk of HIV infection.

    Science.gov (United States)

    Mahathir, M

    1997-04-01

    Although many people believe that mainly men get infected with HIV/AIDS, women are actually getting infected at a faster rate than men, especially in developing countries, and suffer more from the adverse impact of AIDS. As of mid-1996, the Joint UN Program on AIDS estimated that more than 10 million of the 25 million adults infected with HIV since the beginning of the epidemic are women. The proportion of HIV-positive women is growing, with almost half of the 7500 new infections daily occurring among women. 90% of HIV-positive women live in a developing country. In Asia-Pacific, 1.4 million women have been infected with HIV out of an estimated total 3.08 million adults from the late 1970s until late 1994. Biologically, women are more vulnerable than men to infection because of the greater mucus area exposed to HIV during penile penetration. Women under age 17 years are at even greater risk because they have an underdeveloped cervix and low vaginal mucus production. Concurrent sexually transmitted diseases increase the risk of HIV transmission. Women's risk is also related to their exposure to gender inequalities in society. The social and economic pressures of poverty exacerbate women's risk. Prevention programs are discussed.

  11. Mood Sensitivity to Seasonal Changes in African College Students Living in the Greater Washington D.C. Metropolitan Area

    Directory of Open Access Journals (Sweden)

    Alvaro Guzman

    2007-01-01

    Full Text Available The purpose of this study was to estimate the degree of seasonality and prevalence of winter- and summer-type seasonal affective disorder (SAD in African immigrant college students in comparison with African American peers. A convenience sample of 246 African immigrants and 599 African Americans studying in Washington, D.C. completed the Seasonal Pattern Assessment Questionnaire (SPAQ, which was used to calculate a global seasonality score (GSS and to estimate the prevalence of winter- and summer-type SAD. Degree of seasonality was related to a complex interaction between having general awareness of SAD, ethnicity, and gender. A greater percentage of African students reported experiencing a problem with seasonal changes relative to African American students, and had summer SAD, but the groups did not differ on GSS and winter SAD. African students reported more difficulties with seasonal changes than their African American peers, which could represent a manifestation of incomplete acclimatization to a higher latitude and temperate climate. As Africans also had a greater rate of summer SAD, this argues against acclimatization to heat.

  12. Torsion of the greater omentum: A rare preoperative diagnosis

    International Nuclear Information System (INIS)

    Tandon, Ankit Anil; Lim, Kian Soon

    2010-01-01

    Torsion of the greater omentum is a rare acute abdominal condition that is seldom diagnosed preoperatively. We report the characteristic computed tomography (CT) scan findings and the clinical implications of this unusual diagnosis in a 41-year-old man, who also had longstanding right inguinal hernia. Awareness of omental torsion as a differential diagnosis in the acute abdomen setting is necessary for correct patient management

  13. Towards Greater Harmonisation of Decommissioning Cost Estimates

    International Nuclear Information System (INIS)

    O'Sullivan, Patrick; ); Laraia, Michele; ); LaGuardia, Thomas S.

    2010-01-01

    The NEA Decommissioning Cost Estimation Group (DCEG), in collaboration with the IAEA Waste Technology Section and the EC Directorate-General for Energy and Transport, has recently studied cost estimation practices in 12 countries - Belgium, Canada, France, Germany, Italy, Japan, the Netherlands, Slovakia, Spain, Sweden, the United Kingdom and the United States. Its findings are to be published in an OECD/NEA report entitled Cost Estimation for Decommissioning: An International Overview of Cost Elements, Estimation Practices and Reporting Requirements. This booklet highlights the findings contained in the full report. (authors)

  14. 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.

  15. Functional visual fields: a cross-sectional UK study to determine which visual field paradigms best reflect difficulty with mobility function.

    Science.gov (United States)

    Subhi, Hikmat; Latham, Keziah; Myint, Joy; Crossland, Michael

    2017-11-20

    To develop an appropriate method of assessing visual field (VF) loss which reflects its functional consequences, this study aims to determine which method(s) of assessing VF best reflect mobility difficulty. This cross-sectional observational study took place within a single primary care setting. Participants attended a single session at a University Eye Clinic, Cambridge, UK, with data collected by a single researcher (HS), a qualified optometrist. 50 adult participants with peripheral field impairment were recruited for this study. Individuals with conditions not primarily affecting peripheral visual function, such as macular degeneration, were excluded from the study. Participants undertook three custom and one standard binocular VF tests assessing VF to 60°, and also integrated monocular threshold 24-2 visual fields (IVF). Primary VF outcomes were average mean threshold, percentage of stimuli seen and VF area. VF outcomes were compared with self-reported mobility function assessed with the Independent Mobility Questionnaire, and time taken and patient acceptability were also considered. Receiver operating characteristic (ROC) curves determined which tests best predicted difficulty with mobility tasks. Greater VF loss was associated with greater self-reported mobility difficulty with all field paradigms (R 2 0.38-0.48, all Pmobility tasks in ROC analysis. Mean duration of the tests ranged from 1 min 26 s (±9 s) for kinetic assessment to 9 min 23 s (±24 s) for IVF. The binocular VF tests extending to 60° eccentricity all relate similarly to self-reported mobility function, and slightly better than integrated monocular VFs. A kinetic assessment of VF area is quicker than and as effective at predicting mobility function as static threshold assessment. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  16. 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.

  17. Small cities face greater impact from automation.

    Science.gov (United States)

    Frank, Morgan R; Sun, Lijun; Cebrian, Manuel; Youn, Hyejin; Rahwan, Iyad

    2018-02-01

    The city has proved to be the most successful form of human agglomeration and provides wide employment opportunities for its dwellers. As advances in robotics and artificial intelligence revive concerns about the impact of automation on jobs, a question looms: how will automation affect employment in cities? Here, we provide a comparative picture of the impact of automation across US urban areas. Small cities will undertake greater adjustments, such as worker displacement and job content substitutions. We demonstrate that large cities exhibit increased occupational and skill specialization due to increased abundance of managerial and technical professions. These occupations are not easily automatable, and, thus, reduce the potential impact of automation in large cities. Our results pass several robustness checks including potential errors in the estimation of occupational automation and subsampling of occupations. Our study provides the first empirical law connecting two societal forces: urban agglomeration and automation's impact on employment. © 2018 The Authors.

  18. Small cities face greater impact from automation

    Science.gov (United States)

    Sun, Lijun; Cebrian, Manuel; Rahwan, Iyad

    2018-01-01

    The city has proved to be the most successful form of human agglomeration and provides wide employment opportunities for its dwellers. As advances in robotics and artificial intelligence revive concerns about the impact of automation on jobs, a question looms: how will automation affect employment in cities? Here, we provide a comparative picture of the impact of automation across US urban areas. Small cities will undertake greater adjustments, such as worker displacement and job content substitutions. We demonstrate that large cities exhibit increased occupational and skill specialization due to increased abundance of managerial and technical professions. These occupations are not easily automatable, and, thus, reduce the potential impact of automation in large cities. Our results pass several robustness checks including potential errors in the estimation of occupational automation and subsampling of occupations. Our study provides the first empirical law connecting two societal forces: urban agglomeration and automation's impact on employment. PMID:29436514

  19. Greater confinement disposal of radioactive wastes

    International Nuclear Information System (INIS)

    Trevorrow, L.E.; Gilbert, T.L.; Luner, C.; Merry-Libby, P.A.; Meshkov, N.K.; Yu, C.

    1985-01-01

    Low-level radioactive waste (LLW) includes a broad spectrum of different radionuclide concentrations, half-lives, and hazards. Standard shallow-land burial practice can provide adequate protection of public health and safety for most LLW. A small volume fraction (approx. 1%) containing most of the activity inventory (approx. 90%) requires specific measures known as greater-confinement disposal (GCD). Different site characteristics and different waste characteristics - such as high radionuclide concentrations, long radionuclide half-lives, high radionuclide mobility, and physical or chemical characteristics that present exceptional hazards - lead to different GCD facility design requirements. Facility design alternatives considered for GCD include the augered shaft, deep trench, engineered structure, hydrofracture, improved waste form, and high-integrity container. Selection of an appropriate design must also consider the interplay between basic risk limits for protection of public health and safety, performance characteristics and objectives, costs, waste-acceptance criteria, waste characteristics, and site characteristics

  20. The post-orgasmic prolactin increase following intercourse is greater than following masturbation and suggests greater satiety.

    Science.gov (United States)

    Brody, Stuart; Krüger, Tillmann H C

    2006-03-01

    Research indicates that prolactin increases following orgasm are involved in a feedback loop that serves to decrease arousal through inhibitory central dopaminergic and probably peripheral processes. The magnitude of post-orgasmic prolactin increase is thus a neurohormonal index of sexual satiety. Using data from three studies of men and women engaging in masturbation or penile-vaginal intercourse to orgasm in the laboratory, we report that for both sexes (adjusted for prolactin changes in a non-sexual control condition), the magnitude of prolactin increase following intercourse is 400% greater than that following masturbation. The results are interpreted as an indication of intercourse being more physiologically satisfying than masturbation, and discussed in light of prior research reporting greater physiological and psychological benefits associated with coitus than with any other sexual activities.

  1. 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

  2. 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…

  3. 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.

  4. 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.

  5. 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.

  6. [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).

  7. [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.

  8. Increased Resting-State Functional Connectivity in the Cingulo-Opercular Cognitive-Control Network after Intervention in Children with Reading Difficulties.

    Directory of Open Access Journals (Sweden)

    Tzipi Horowitz-Kraus

    Full Text Available Dyslexia, or reading difficulty, is characterized by slow, inaccurate reading accompanied by executive dysfunction. Reading training using the Reading Acceleration Program improves reading and executive functions in both children with dyslexia and typical readers. This improvement is associated with increased activation in and functional connectivity between the anterior cingulate cortex, part of the cingulo-opercular cognitive-control network, and the fusiform gyrus during a reading task after training. The objective of the current study was to determine whether the training also has an effect on functional connectivity of the cingulo-opercular and fronto-parietal cognitive-control networks during rest in children with dyslexia and typical readers. Fifteen children with reading difficulty and 17 typical readers (8-12 years old were included in the study. Reading and executive functions behavioral measures and resting-state functional magnetic resonance imaging data were collected before and after reading training. Imaging data were analyzed using a graphical network-modeling tool. Both reading groups had increased reading and executive-functions scores after training, with greater gains among the dyslexia group. Training may have less effect on cognitive control in typical readers and a more direct effect on the visual area, as previously reported. Statistical analysis revealed that compared to typical readers, children with reading difficulty had significantly greater functional connectivity in the cingulo-opercular network after training, which may demonstrate the importance of cognitive control during reading in this population. These results support previous findings of increased error-monitoring activation after reading training in children with dyslexia and confirm greater gains with training in this group.

  9. 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)

  10. "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.

  11. 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...

  12. 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.

  13. Setting the Greater Mekong Subregion - Development Analysis ...

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

    The funding will support the first stage of a two-stage research program in ... Inclusive development in basic education and health in Cambodia : final report ... New website will help record vital life events to improve access to services for all.

  14. Moderate Baseline Vagal Tone Predicts Greater Prosociality in Children

    Science.gov (United States)

    Miller, Jonas G.; Kahle, Sarah; Hastings, Paul D.

    2016-01-01

    Vagal tone is widely believed to be an important physiological aspect of emotion regulation and associated positive behaviors. However, there is inconsistent evidence for relations between children’s baseline vagal tone and their helpful or prosocial responses to others (Hastings & Miller, 2014). Recent work in adults suggests a quadratic association (inverted U-shape curve) between baseline vagal tone and prosociality (Kogan et al., 2014). The present research examined whether this nonlinear association was evident in children. We found consistent evidence for a quadratic relation between vagal tone and prosociality across 3 samples of children using 6 different measures. Compared to low and high vagal tone, moderate vagal tone in early childhood concurrently predicted greater self-reported prosociality (Study 1), observed empathic concern in response to the distress of others and greater generosity toward less fortunate peers (Study 2), and longitudinally predicted greater self-, mother-, and teacher-reported prosociality 5.5 years later in middle childhood (Study 3). Taken together, our findings suggest that moderate vagal tone at rest represents a physiological preparedness or tendency to engage in different forms of prosociality across different contexts. Early moderate vagal tone may reflect an optimal balance of regulation and arousal that helps prepare children to sympathize, comfort, and share with others. PMID:27819463

  15. Urban acid deposition in Greater Manchester

    Energy Technology Data Exchange (ETDEWEB)

    Lee, D.S.; Longhurst, J.W.S.; Gee, D.R.; Hare, S.E. (Manchester Polytechnic, Manchester (UK). Acid Rain Information Centre)

    1989-08-01

    Data are presented from a monitoring network of 18 bulk precipitation collectors and one wet-only collector in the urban area of Greater Manchester, in the north west of England. Weekly samples were analysed for all the major ions in precipitation along with gaseous nitrogen dioxide concentrations from diffusion tubes. Statistical analysis of the data shows significant spatial variation of non marine sulphate, nitrate, ammonium, acidity and calcium concentrations, and nitrogen dioxide concentrations. Calcium is thought to be responsible for the buffering of acidity and is of local origin. Wet deposition is the likely removal process for calcium in the atmosphere and probably by below cloud scavenging. Nitrate and ammonium concentrations and depositions show close spatial, temporal and statistical association. Examination of high simultaneous episodes of nitrate and ammonium deposition shows that these depositions cannot be explained in terms of trajectories and it is suggested that UK emissions of ammonia may be important. Statistical analysis of the relationships between nitrate and ammonium depositions, concentrations and precipitation amount suggest that ammonia from mesoscale sources reacts reversibly with nitric acid aerosol and is removed by below cloud scavenging. High episodes of the deposition of non marine sulphate are difficult to explain by trajectory analysis alone, perhaps suggesting local sources. In a comparison between wet deposition and bulk deposition, it was shown that only 15.2% of the non marine sulphur was dry deposited to the bulk precipitation collector. 63 refs., 86 figs., 31 tabs.

  16. Form cues and content difficulty as determinants of children's cognitive processing of televised educational messages.

    Science.gov (United States)

    Campbell, T A; Wright, J C; Huston, A C

    1987-06-01

    An experiment was designed to assess the effects of formal production features and content difficulty on children's processing of televised messages about nutrition. Messages with identical content (the same script and visual shot sequence) were made in two forms: child program forms (animated film, second-person address, and character voice narration with sprightly music) and adult program forms (live photography, third-person address, and adult male narration with sedate background music). For each form, messages were made at three levels of content difficulty. Easier versions were longer, more redundant, and used simpler language; difficult versions presented information more quickly with less redundancy and more abstract language. Regardless of form or difficulty level, each set of bits presented the same basic information. Kindergarten children (N = 120) were assigned to view three different bits of the same form type and difficulty embedded in a miniprogram. Visual attention to child forms was significantly greater than to adult forms; free and cued recall scores were also higher for child than for adult forms. Although all recall and recognition scores were best for easy versions and worst for difficult versions, attention showed only minor variation as a function of content difficulty. Results are interpreted to indicate that formal production features, independently of content, influence the effort and level of processing that children use to understand televised educational messages.

  17. Impaired fertility and perceived difficulties conceiving in Ghana : measurement problems and prospects

    OpenAIRE

    Fledderjohann, Jasmine; Johnson, David R.

    2016-01-01

    What is the most appropriate measure of impaired fertility for understanding its social consequences in sub-Saharan Africa? The dearth of subjective measures in surveys in the region has prevented comparisons of subjective and objective measures. Perceived difficulties conceiving may have a greater impact than objective measures for social outcomes such as divorce, stigmatization and distress. This study compares 12- (clinical) and 24- (epidemiological) month measures from biomedicine and 5- ...

  18. Patient expectations predict greater pain relief with joint arthroplasty.

    Science.gov (United States)

    Gandhi, Rajiv; Davey, John Roderick; Mahomed, Nizar

    2009-08-01

    We examined the relationship between patient expectations of total joint arthroplasty and functional outcomes. We surveyed 1799 patients undergoing primary hip or knee arthroplasty for demographic data and Western Ontario McMaster University Osteoarthritis Index scores at baseline, 3 months, and 1 year of follow-up. Patient expectations were determined with 3 survey questions. The patients with the greatest expectations of surgery were younger, male, and had a lower body mass index. Linear regression modeling showed that a greater expectation of pain relief with surgery independently predicted greater reported pain relief at 1 year of follow-up, adjusted for all relevant covariates (P relief after joint arthroplasty is an important predictor of outcomes at 1 year.

  19. Understanding the mediating role of corporal punishment in the association between maternal stress, efficacy, co-parenting and children's adjustment difficulties among Arab mothers.

    Science.gov (United States)

    Khoury-Kassabri, Mona; Attar-Schwartz, Shalhevet; Zur, Hana

    2014-06-01

    This study, guided by the Family Systems Theory, examines the direct effect of maternal use of corporal punishment on children's adjustment difficulties. Also, it explores whether corporal punishment serves as a mediating factor in the relationship between several maternal characteristics, marital relationships, and children's adjustment difficulties. A total of 2,447 Arab mothers completed anonymous, structured, self-report questionnaires. The use of corporal punishment was generally strongly supported by the Arab mothers in our sample. A greater likelihood of using corporal punishment was found among mothers of boys rather than girls, among mothers with lower perceived self-efficacy to discipline children, and among mothers with a lower perception of their husbands' participation in child-related labor. In addition, the higher a mother's reports on disagreement with her husband about discipline methods and the stronger her level of maternal stress, the more likely she was to use corporal punishment. Corporal punishment also mediated the association between the above mentioned factors and child adjustment difficulties. Furthermore, a husband's emotional support and family socioeconomic status were directly associated to children's adjustment difficulties. The results of the current study emphasize the need to observe children's development within the context of their family systems and to consider the mutual influences of different subsystems such as marital relationships and mother-child interactions. Prevention and intervention programs should raise parents' awareness concerning the harmful effects of corporal punishment and take into account the impact of dynamic transactions of parental conflicts and disagreements regarding discipline methods on child outcomes. Copyright © 2014 Elsevier Ltd. All rights reserved.

  20. 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...

  1. 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.

  2. 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.

  3. Appeal for legislation on greater safety.

    Science.gov (United States)

    Baillie, Jonathan

    2011-10-01

    An Essex-headquartered company which claims to manufacture the world's leading "brand" of glass vision panel, is calling for legislation to regulate the quality and design of such products. With no statutory governance currently in place, it is concerned that a rash of badly-designed, poorer quality variants, that it says have emerged in recent years, pose a significant self-harm and ligature risk to mentally unwell patients in hospitals, and a potential danger to staff when components like internal fittings and the glass itself, especially should the latter be too thin and thus easy to break, are used as "weapons". HEJ editor Jonathan Baillie reports.

  4. Garnet peridotite found in the Greater Antilles

    Science.gov (United States)

    Abbott, Richard N., Jr.; Draper, Grenville; Keshav, Shantanu

    Although Alpine peridotites are relatively common in collisional orogenic zones, garnet-bearing peridotites are rare and only associated with high pressure/ultra-high pressure or temperature (HP/UHP or T) terranes [Brueckner and Medaris, 2000; Medaris, 1999]. Until recently all reported occurrences of Alpine-type garnet peridotites and HP/UHP terranes were in Eurasia and Africa, with one occurrence in the Seward Peninsula, Alaska [Till, 1981;Lieberman and Till, 1987]. Now a new Alpine-type garnet peridotite locality has been discovered in the Caribbean island of Hispaniola. This discovery is the second of its kind in the Americas.

  5. 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.

  6. 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.

  7. 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.

  8. 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…

  9. Deviance and resistance: Malaria elimination in the greater Mekong subregion.

    Science.gov (United States)

    Lyttleton, Chris

    2016-02-01

    Malaria elimination rather than control is increasingly globally endorsed, requiring new approaches wherein success is not measured by timely treatment of presenting cases but eradicating all presence of infection. This shift has gained urgency as resistance to artemisinin-combination therapies spreads in the Greater Mekong Sub-region (GMS) posing a threat to global health security. In the GMS, endemic malaria persists in forested border areas and elimination will require calibrated approaches to remove remaining pockets of residual infection. A new public health strategy called 'positive deviance' is being used to improve health promotion and community outreach in some of these zones. However, outbreaks sparked by alternative understandings of appropriate behaviour expose the unpredictable nature of 'border malaria' and difficulties eradication faces. Using a recent spike in infections allegedly linked to luxury timber trade in Thai borderlands, this article suggests that opportunities for market engagement can cause people to see 'deviance' as a means to material advancement in ways that increase disease vulnerability. A malaria outbreak in Ubon Ratchathani was investigated during two-week field-visit in November 2014 as part of longer project researching border malaria in Thai provinces. Qualitative data were collected in four villages in Ubon's three most-affected districts. Discussions with villagers focused primarily on changing livelihoods, experience with malaria, and rosewood cutting. Informants included ten men and two women who had recently overnighted in the nearby forest. Data from health officials and villagers are used to frame Ubon's rise in malaria transmission within moral and behavioural responses to expanding commodity supply-chains. The article argues that elimination strategies in the GMS must contend with volatile outbreaks among border populations wherein 'infectiousness' and 'resistance' are not simply pathogen characteristics but also

  10. Rural New Zealand health professionals' perceived barriers to greater use of the internet for learning.

    Science.gov (United States)

    Janes, Ron; Arroll, Bruce; Buetow, Stephen; Coster, Gregor; McCormick, Ross; Hague, Iain

    2005-01-01

    The purpose of this research was to investigate rural North Island (New Zealand) health professionals' attitudes and perceived barriers to using the internet for ongoing professional learning. A cross-sectional postal survey of all rural North Island GPs, practice nurses and pharmacists was conducted in mid-2003. The questionnaire contained both quantitative and qualitative questions. The transcripts from two open questions requiring written answers were analysed for emergent themes, which are reported here. The first open question asked: 'Do you have any comments on the questionnaire, learning, computers or the Internet?' The second open question asked those who had taken a distance-learning course using the internet to list positive and negative aspects of their course, and suggest improvements. Out of 735 rural North Island health professionals surveyed, 430 returned useable questionnaires (a response rate of 59%). Of these, 137 answered the question asking for comments on learning, computers and the internet. Twenty-eight individuals who had completed a distance-learning course using the internet, provided written responses to the second question. Multiple barriers to greater use of the internet were identified. They included lack of access to computers, poor availability of broadband (fast) internet access, lack of IT skills/knowledge, lack of time, concerns about IT costs and database security, difficulty finding quality information, lack of time, energy or motivation to learn new skills, competing priorities (eg family), and a preference for learning modalities which include more social interaction. Individuals also stated that rural health professionals needed to engage the technology, because it provided rapid, flexible access from home or work to a significant health information resource, and would save money and travelling time to urban-based education. In mid-2003, there were multiple barriers to rural North Island health professionals making greater

  11. 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...

  12. 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...

  13. 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...

  14. 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...

  15. 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.

  16. 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

  17. Practicing more retrieval routes leads to greater memory retention.

    Science.gov (United States)

    Zheng, Jun; Zhang, Wei; Li, Tongtong; Liu, Zhaomin; Luo, Liang

    2016-09-01

    A wealth of research has shown that retrieval practice plays a significant role in improving memory retention. The current study focused on one simple yet rarely examined question: would repeated retrieval using two different retrieval routes or using the same retrieval route twice lead to greater long-term memory retention? Participants elaborately learned 22 Japanese-Chinese translation word pairs using two different mediators. Half an hour after the initial study phase, the participants completed two retrieval sessions using either one mediator (Tm1Tm1) or two different mediators (Tm1Tm2). On the final test, which was performed 1week after the retrieval practice phase, the participants received only the cue with a request to report the mediator (M1 or M2) followed by the target (Experiment 1) or only the mediator (M1 or M2) with a request to report the target (Experiment 2). The results of Experiment 1 indicated that the participants who practiced under the Tm1Tm2 condition exhibited greater target retention than those who practiced under the Tm1Tm1 condition. This difference in performance was due to the significant disadvantage in mediator retrieval and decoding of the unpracticed mediator under the Tm1Tm1 condition. Although mediators were provided to participants on the final test in Experiment 2, decoding of the unpracticed mediators remained less effective than decoding of the practiced mediators. We conclude that practicing multiple retrieval routes leads to greater memory retention than focusing on a single retrieval route. Thus, increasing retrieval variability during repeated retrieval practice indeed significantly improves long-term retention in a delay test. Copyright © 2016 Elsevier B.V. All rights reserved.

  18. 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.

  19. A case-control study of the difficulties in daily functioning experienced by children with depressive disorder.

    Science.gov (United States)

    Usami, Masahide; Iwadare, Yoshitaka; Watanabe, Kyota; Ushijima, Hirokage; Kodaira, Masaki; Okada, Takashi; Sasayama, Daimei; Sugiyama, Nobuhiro; Saito, Kazuhiko

    2015-07-01

    The parent-assessed children-with-difficulties questionnaire (Questionnaire-Children with Difficulties; QCD) is designed to evaluate a child׳s difficulties in functioning during specific periods of the day. This study aimed to use the QCD to evaluate the difficulties in daily functioning experienced by children with depressive disorders. A case-control design was used. The cases comprised 90 junior high school students with depressive disorder, whereas a community sample of 363 junior high school students was enrolled as controls. Behaviors were assessed using the QCD, Depression Self-Rating Scale (DSRS), Tokyo Autistic Behavior Scale (TABS), attention deficit hyperactivity disorder-rating scale (ADHD-RS), and Oppositional Defiant Behavior Inventory (ODBI). We then analyzed the effects of sex and diagnosis on the QCD scores as well as the correlation coefficients between the QCD and the other questionnaires. We included 90 cases (33 boys, 57 girls) with depressive disorders and 363 controls (180 boys, 183 girls). The QCD scores for the children with depressive disorders were significantly lower compared with those from the community sample (Pdepressive disorders and truancy problems than for those with depressive disorders alone (Pdepressive disorders experienced greater difficulties in completing basic daily activities compared with community controls. These difficulties were dependent on sex, symptoms, and the time of day. The use of QCD to assess children with depressive disorders enables clinicians to clarify the time periods at which the children face difficulties. Copyright © 2015 Elsevier B.V. All rights reserved.

  20. Adjustment Difficulties and Caregiving Burdens Faced by College Students with a Parent with Bipolar or Depressive Disorders

    Science.gov (United States)

    Crandall, Erin K.; Ruggero, Camilo J.; Bain, Kathleen; Kilmer, Jared

    2014-01-01

    College campuses often host students who come from families where one or more parent has been affected by a bipolar or depressive disorder. The present study sought to determine whether these students face unique challenges in college, including increased adjustment difficulties as well as greater caregiving burden associated with their…

  1. 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…

  2. 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…

  3. 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…

  4. 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…

  5. 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…

  6. Hypertensive diabetic patients: guidelines for conduct and their difficulties

    Directory of Open Access Journals (Sweden)

    Weimar K. S. Barroso

    2003-08-01

    Full Text Available OBJECTIVE: To assess the effect of blood pressure (BP control and other cardiovascular risk factors in patients with diabetes mellitus in a referral service for the treatment of hypertension. METHODS: A retrospective study where diabetic patients (at least 2 fasting glucose levels above 126 mg/dL, use of hypoglycemic agents or insulin, or both of these were included. They were evaluated at the first appointment (M1 and at the last appointment (M2, regarding blood pressure, body mass index (BMI, use of hypertensive drugs, glycemia, total cholesterol (TC, creatinine, and potassium. RESULTS: Of 1,032 patients studied, 146 patients with a mean age of 61.6 years had diabetes, and 27 were men (18.5%. Mean follow-up was 5.5 years. BP values were 161.6 x 99.9 mmHg in M1 and 146.3 x 89.5 mmHg in M2. In M1, 10.4% of the patients did not use medications, 50.6% used just 1 drug, 30.8% used 2 drugs, and 8.2% used 3 or more drugs. In M2, these values were 10.9%, 39%, 39.7%, and 10.4%, respectively. Diuretics were the most commonly used medication, whereas angiotensin-converting enzyme inhibitors (ACE inhibitors were those drugs which presented greater increase when comparing M1 to M2 (24.6% and 41.7%, respectively. Only 17,1% reached the recommended goal (BP<130x85 mmhg. The other cardiovascular risk factors did not change significantly. CONCLUSION: Our data reinforce the necessity of a more aggressive approach in the treatment of these patients, despite the social and economic difficulties in adhering to treatment.

  7. Radiation monitoring: Quarterly report for the Greater Manchester Fire and Civil Defence Authority and the Manchester Area Pollution Advisory Council. Manchester Area Gamma Radiation Air Monitoring System (MANAGRAMS): report covering period of 3 months 01/07/1996 to 30/09/1996

    International Nuclear Information System (INIS)

    1996-01-01

    Gamma radiation monitoring data from ten outstations in the Manchester area for the period 01/07/1996 to 30/09/1996 are presented. For each station there is a summary table, a background radiation graph showing 6 hour mean levels and a wind rose graph showing the direction of the wind as a percentage of the total. A line graph comparison between stations is provided for the background 6 hour mean levels and a bar chart comparison of total dose during the reporting period. Graphs of barometric pressure and temperature taken from extra sensors at the Trafford station are also presented. (UK)

  8. Is effect of transcranial direct current stimulation on visuomotor coordination dependent on task difficulty?

    Directory of Open Access Journals (Sweden)

    Yong Hyun Kwon

    2015-01-01

    Full Text Available Transcranial direct current stimulation (tDCS, an emerging technique for non-invasive brain stimulation, is increasingly used to induce changes in cortical excitability and modulate motor behavior, especially for upper limbs. The purpose of this study was to investigate the effects of tDCS of the primary motor cortex on visuomotor coordination based on three levels of task difficulty in healthy subjects. Thirty-eight healthy participants underwent real tDCS or sham tDCS. Using a single-blind, sham-controlled crossover design, tDCS was applied to the primary motor cortex. For real tDCS conditions, tDCS intensity was 1 mA while stimulation was applied for 15 minutes. For the sham tDCS, electrodes were placed in the same position, but the stimulator was turned off after 5 seconds. Visuomotor tracking task, consisting of three levels (levels 1, 2, 3 of difficulty with higher level indicating greater difficulty, was performed before and after tDCS application. At level 2, real tDCS of the primary motor cortex improved the accurate index compared to the sham tDCS. However, at levels 1 and 3, the accurate index was not significantly increased after real tDCS compared to the sham tDCS. These findings suggest that tasks of moderate difficulty may improve visuomotor coordination in healthy subjects when tDCS is applied compared with easier or more difficult tasks.

  9. 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…

  10. 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…

  11. 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.

  12. 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.

  13. 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.…

  14. 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'…

  15. 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 ...

  16. 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…

  17. 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…

  18. 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

  19. 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.

  20. 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.

  1. 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...

  2. 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.

  3. 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...

  4. 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…

  5. 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.

  6. 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.

  7. Taino and African maternal heritage in the Greater Antilles.

    Science.gov (United States)

    Bukhari, Areej; Luis, Javier Rodriguez; Alfonso-Sanchez, Miguel A; Garcia-Bertrand, Ralph; Herrera, Rene J

    2017-12-30

    Notwithstanding the general interest and the geopolitical importance of the island countries in the Greater Antilles, little is known about the specific ancestral Native American and African populations that settled them. In an effort to alleviate this lacuna of information on the genetic constituents of the Greater Antilles, we comprehensively compared the mtDNA compositions of Cuba, Dominican Republic, Haiti, Jamaica and Puerto Rico. To accomplish this, the mtDNA HVRI and HVRII regions, as well as coding diagnostic sites, were assessed in the Haitian general population and compared to data from reference populations. The Taino maternal DNA is prominent in the ex-Spanish colonies (61.3%-22.0%) while it is basically non-existent in the ex-French and ex-English colonies of Haiti (0.0%) and Jamaica (0.5%), respectively. The most abundant Native American mtDNA haplogroups in the Greater Antilles are A2, B2 and C1. The African mtDNA component is almost fixed in Haiti (98.2%) and Jamaica (98.5%), and the frequencies of specific African haplogroups vary considerably among the five island nations. The strong persistence of Taino mtDNA in the ex-Spanish colonies (and especially in Puerto Rico), and its absence in the French and English excolonies is likely the result of different social norms regarding mixed marriages with Taino women during the early years after the first contact with Europeans. In addition, this article reports on the results of an integrative approach based on mtDNA analysis and demographic data that tests the hypothesis of a southward shift in raiding zones along the African west coast during the period encompassing the Transatlantic Slave Trade. Copyright © 2017 Elsevier B.V. All rights reserved.

  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. Challenges and Difficulties to Teaching Engineering to Generation Z: a case research

    Directory of Open Access Journals (Sweden)

    Suamit Correia Barreiro

    2017-08-01

    Full Text Available Many people from generation Z are at the beginning of their academic activities. This generation has peculiar characteristics that might be a challenge in the labor market. Thus, instructors have a great role in their preparation. However, professors might face difficulties dealing with their specific characteristics. The research aims to carry out a general survey to enable an understanding of the greater challenges and difficulties in teaching the subject of engineering to the students of Generation Z. The research method used was a case study at a University with 20 instructors from the Faculty of Engineering. The analysis revealed a great challenge in relating theoretical concepts with practical concepts. The research also showed a probable tendency of using more exhibition methods, and the low knowledge about generation Z by most instructors. This study seeks to contribute to the teaching-learning process of engineering.

  11. [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.

  12. 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.

  13. 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.

  14. 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.

  15. Malaria in the Greater Mekong Subregion: Heterogeneity and Complexity

    Science.gov (United States)

    Cui, Liwang; Yan, Guiyun; Sattabongkot, Jetsumon; Cao, Yaming; Chen, Bin; Chen, Xiaoguang; Fan, Qi; Fang, Qiang; Jongwutiwes, Somchai; Parker, Daniel; Sirichaisinthop, Jeeraphat; Kyaw, Myat Phone; Su, Xin-zhuan; Yang, Henglin; Yang, Zhaoqing; Wang, Baomin; Xu, Jianwei; Zheng, Bin; Zhong, Daibin; Zhou, Guofa

    2011-01-01

    The Greater Mekong Subregion (GMS), comprised of six countries including Cambodia, China's Yunnan Province, Lao PDR, Myanmar (Burma), Thailand and Vietnam, is one of the most threatening foci of malaria. Since the initiation of the WHO's Mekong Malaria Program a decade ago, malaria situation in the GMS has greatly improved, reflected in the continuous decline in annual malaria incidence and deaths. However, as many nations are moving towards malaria elimination, the GMS nations still face great challenges. Malaria epidemiology in this region exhibits enormous geographical heterogeneity with Myanmar and Cambodia remaining high-burden countries. Within each country, malaria distribution is also patchy, exemplified by ‘border malaria’ and ‘forest malaria’ with high transmission occurring along international borders and in forests or forest fringes, respectively. ‘Border malaria’ is extremely difficult to monitor, and frequent malaria introductions by migratory human populations constitute a major threat to neighboring, malaria-eliminating countries. Therefore, coordination between neighboring countries is essential for malaria elimination from the entire region. In addition to these operational difficulties, malaria control in the GMS also encounters several technological challenges. Contemporary malaria control measures rely heavily on effective chemotherapy and insecticide control of vector mosquitoes. However, the spread of multidrug resistance and potential emergence of artemisinin resistance in Plasmodium falciparum make resistance management a high priority in the GMS. This situation is further worsened by the circulation of counterfeit and substandard artemisinin-related drugs. In most endemic areas of the GMS, P. falciparum and P. vivax coexist, and in recent malaria control history, P. vivax has demonstrated remarkable resilience to control measures. Deployment of the only registered drug (primaquine) for the radical cure of vivax malaria is

  16. 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)

  17. 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.

  18. 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.

  19. 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.

  20. 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.

  1. 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.

  2. 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

  3. Strontium isotopic geochemistry of intrusive rocks, Puerto Rico, Greater Antilles

    International Nuclear Information System (INIS)

    Jones, L.M.; Kesler, S.E.

    1980-01-01

    The strontium isotope geochemistry is given for three Puerto Rican intrusive rocks: the granodioritic Morovis and San Lorenzo plutons and the Rio Blanco stock of quartz dioritic composition. The average calculated initial 87 Sr/ 86 Sr ratios are 0.70370, 0.70355 and 0.70408, respectively. In addition, the San Lorenzo data establish a whole-rock isochron of 71 +- 2 m.y., which agrees with the previously reported K-Ar age of 73 m.y. Similarity of most of the intrusive rocks in the Greater Antilles with respect to their strontium isotopic geochemistry regardless of their major element composition indicates that intrusive magmas with a wide range of composition can be derived from a single source material. The most likely source material, in view of the available isotopic data, is the mantle wedge overlying the subduction zone. (orig.)

  4. Comparing statistical tests for detecting soil contamination greater than background

    International Nuclear Information System (INIS)

    Hardin, J.W.; Gilbert, R.O.

    1993-12-01

    The Washington State Department of Ecology (WSDE) recently issued a report that provides guidance on statistical issues regarding investigation and cleanup of soil and groundwater contamination under the Model Toxics Control Act Cleanup Regulation. Included in the report are procedures for determining a background-based cleanup standard and for conducting a 3-step statistical test procedure to decide if a site is contaminated greater than the background standard. The guidance specifies that the State test should only be used if the background and site data are lognormally distributed. The guidance in WSDE allows for using alternative tests on a site-specific basis if prior approval is obtained from WSDE. This report presents the results of a Monte Carlo computer simulation study conducted to evaluate the performance of the State test and several alternative tests for various contamination scenarios (background and site data distributions). The primary test performance criteria are (1) the probability the test will indicate that a contaminated site is indeed contaminated, and (2) the probability that the test will indicate an uncontaminated site is contaminated. The simulation study was conducted assuming the background concentrations were from lognormal or Weibull distributions. The site data were drawn from distributions selected to represent various contamination scenarios. The statistical tests studied are the State test, t test, Satterthwaite's t test, five distribution-free tests, and several tandem tests (wherein two or more tests are conducted using the same data set)

  5. 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

  6. Coralistas amadores: auto-imagem, dificuldades e sintomas na voz cantada Amateur choir singers: self-image, difficulties and symptoms of the singing voice

    Directory of Open Access Journals (Sweden)

    Ana Cristina de Castro Coelho

    2013-04-01

    containing identification data, information about self-perception of the singing voice, difficulties with singing and negative symptoms after singing. RESULTS: the comparison considering vocal classification evidenced greater difficulties with high notes for altos and basses, greater difficulty regarding the transition to high notes for basses and greater vocal fatigue for altos. Comparing the singers by age, both adults and young adults referred more breathiness than the elderly. The adults referred better vocal intensity than the young adults. The young adults referred better timbre than adults. Regarding the experience, the less experienced singers reported self-perception of hoarseness and presence of hoarseness after singing in greater number than the experienced singers. CONCLUSION: the difficulties with singing are connected to the vocal classification and do not depend on age or experience. Vocal symptoms are related to the vocal classification and to the experience with singing. Negative self-perception is also related the vocal classification and to the experience with singing, and positive self-perception was more reported by experienced singers.

  7. Greater general startle reflex is associated with greater anxiety levels: a correlational study on 111 young women

    Directory of Open Access Journals (Sweden)

    Eleonora ePoli

    2015-02-01

    Full Text Available Startle eyeblink reflex is a valid non-invasive tool for studying attention, emotion and psychiatric disorders. In the absence of any experimental manipulation, the general (or baseline startle reflex shows a high inter-individual variability, which is often considered task-irrelevant and therefore normalized across participants. Unlike the above view, we hypothesized that greater general startle magnitude is related to participants’ higher anxiety level. 111 healthy young women, after completing the State-Trait Anxiety Inventory, were randomly administered 10 acoustic white noise probes (50 ms, 100 dBA acoustic level while integrated EMG from left and right orbicularis oculi was recorded. Results showed that participants with greater state anxiety levels exhibited larger startle reflex magnitude from the left eye (r109=0.23, p<0.05. Furthermore, individuals who perceived the acoustic probe as more aversive reported the largest anxiety scores (r109=0.28, p<0.05 and had the largest eyeblinks, especially in the left eye (r109 = 0.34, p<0.001. Results suggest that general startle may represent a valid tool for studying the neural excitability underlying anxiety and emotional dysfunction in neurological and mental disorders.

  8. Haemangiopericytoma of greater omentum. A rare cause of acute abdominal pain.

    Science.gov (United States)

    Bovino, A; Basso, L; Di Giacomo, G; Codacci Pisanelli, M; Basile, U; De Toma, G

    2003-12-01

    Haemangiopericytoma (HPT) is a rare neoplasm that can occur in any part of the human body. In this report, we describe the case of a patient with sudden severe upper abdominal pain caused by primary HPT in the greater omentum.

  9. 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.

  10. 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 ...

  11. 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....

  12. 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...

  13. 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.

  14. 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 ...

  15. 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

  16. 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...

  17. Feasibility of a UK community-based, eTherapy mental health service in Greater Manchester: repeated-measures and between-groups study of 'Living Life to the Full Interactive', 'Sleepio' and 'Breaking Free Online' at 'Self Help Services'.

    Science.gov (United States)

    Elison, Sarah; Ward, Jonathan; Williams, Chris; Espie, Colin; Davies, Glyn; Dugdale, Stephanie; Ragan, Kathryn; Chisnall, Leanne; Lidbetter, Nicky; Smith, Keith

    2017-07-20

    There is increasing evidence to support the effectiveness of eTherapies for mental health, although limited data have been reported from community-based services. Therefore, this service evaluation reports on feasibility and outcomes from an eTherapy mental health service. 'Self Help Services', an Increasing Access to Psychological Therapies (IAPT) eTherapy service in Greater Manchester. 1068 service users referred to the service for secondary care for their mental health difficulties. Participants were triaged into one of three eTherapy programmes: 'Living Life to the Full Interactive' for low mood, stress and anxiety; 'Sleepio' for insomnia; and 'Breaking Free Online' for substance misuse, depending on clinical need. Standardised psychometric assessments of depression, anxiety and social functioning, collected as part of the IAPT Minimum Data Set, were conducted at baseline and post-treatment. Data indicated baseline differences, with the Breaking Free Online group having higher scores for depression and anxiety than the Living Life to the Full Interactive (depression CI 1.27 to 3.21, pmental health scores were found within all three groups (all pmental health difficulties (pmental health difficulties and suggest that eTherapies may be a useful addition to treatment offering in community-based services. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  18. 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.

  19. 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.

  20. 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.

  1. 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...

  2. 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.

  3. 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.

  4. 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

  5. 'Female condoms give women greater control': a qualitative assessment of the experiences of commercial sex workers in Swaziland.

    Science.gov (United States)

    Mathenjwa, Thulile; Maharaj, Pranitha

    2012-10-01

    To explore commercial sex workers' experiences with the female condom in Swaziland. This is a qualitative study that draws on two focus group discussions and ten individual in-depth interviews with female commercial sex workers in Lavumisa, Swaziland. The findings suggest that the majority of female sex workers prefer to use the female condom with their clients because it offers them greater control over the sexual encounter. Other factors that facilitate its use include the absence of side effects, the enhancement of sexual pleasure and protection against the risk of STIs (including HIV). In addition, the women reported that the female condom is stronger and more resistant to breakage than the male condom. Moreover, the female condoms can be inserted well in advance of sexual intercourse. Difficulties of insertion, partner objection and limited product availability were some of the barriers to the use of the device. There was also a tendency to reuse the female condoms because of lack of product availability and privacy to insert it. Although female condom use involves negotiation with clients, the fact that it offers sex workers an independent method of protection gives them more power and also, increases their ability to control their sexual and reproductive health.

  6. Myiasis in Dogs in the Greater Accra Region of Ghana.

    Science.gov (United States)

    Johnson, Sherry A M; Gakuya, Daniel W; Mbuthia, Paul G; Mande, John D; Afakye, Kofi; Maingi, Ndichu

    2016-01-01

    Myiasis is the infestation of tissues of live vertebrate animals and humans with dipterous larvae. In sub-Saharan Africa, Cordylobia anthropohaga and Cordylobia rodhaini are known to be responsible for cutaneous myiasis in animals and humans. Human cases of myiasis, purportedly acquired in Ghana but diagnosed in other countries, have been reported; however, published data on its occurrence in animals in Ghana is unavailable. This study assessed the prevalence of canine myiasis among owned dogs in the Greater Accra region (GAR) of Ghana. A cross-sectional study was conducted in the Greater Accra region of Ghana, selected for being the region with the highest estimated population density of owned dogs. Physical examination and demographic characteristics of the study dogs were assessed. Management of the dogs was assessed through a questionnaire administered to the dog owners. A total of 392 owned dogs were sampled. Twenty-nine (7.4%) had cutaneous myiasis caused by C. rodhaini. In addition, one (0.2%) of the dogs had intestinal myiasis, with Dermatobia hominis as the offending larvae. Among the breeds of dogs with myiasis, the mongrel was most affected, with 24 (82.8%) out of the 29 cases. The mongrels, majority of which (24; 82.8%) were males, were left to roam freely in the community. Results from this study demonstrate that C. rodhaini and D. hominis are important causes of myiasis in owned dogs in the GAR of Ghana. Dogs could play a role in the spread of myiasis to humans, with its attendant public health implications.

  7. Maternal worries, home safety behaviors, and perceived difficulties.

    Science.gov (United States)

    Hendrickson, Sherry Garrett

    2008-01-01

    The aim of the study was to explore the worries, safety behaviors, and perceived difficulties in keeping children safe at home in a purposive sample of low-income, predominantly non-English speaking mothers as a foundation for later nursing interventions. This study was a qualitative, descriptive design with content analysis to identify maternal concerns, behaviors, and perceptions of home safety as part of a larger study. Eighty-two mothers, 64% of whom were monolingual Spanish-speakers, responded in writing to three semistructured interview questions. When mothers were unable to read and write the researcher wrote the responses, then read the content aloud for verification. A standardized probe for each question was posed to obtain richer responses. Data management included use of the software program NUD*IST and coding analyses following the Miles and Huberman guidelines (1994). Interpretations were translated into English for this report. The major worries were falling, health, kidnapping, and being hit by a car. The leading maternal behaviors were coded as being physically, verbally, and environmentally preventive. Mothers said that it was their role to provide safety, and that this role could be wearisome, such that constant supervision was difficult. Low-income mothers described their worries for their 1 to 4 year-old children, explored their behaviors for preventing injury, and discussed what made keeping children from harm difficult. Understanding how mothers keep children safe, the barriers to home safety, and effective safety behaviors are important to the health of children. The clinical relevance of this study includes building trust as clinicians plan assessment, intervention and evaluation of home safety to encourage dialog about concerns, safety behaviors, and barriers to keeping children from injury.

  8. Reading comprehension difficulties in children with rolandic epilepsy.

    Science.gov (United States)

    Currie, Nicola K; Lew, Adina R; Palmer, Tom M; Basu, Helen; De Goede, Christian; Iyer, Anand; Cain, Kate

    2018-03-01

    Difficulties in reading comprehension can arise from either word reading or listening comprehension difficulties, or a combination of the two. We sought to determine whether children with rolandic epilepsy had poor reading comprehension relative to typically developing comparison children, and whether such difficulties were associated with word reading and/or general language comprehension difficulties. In this cross-sectional study, children with rolandic epilepsy (n=25; 16 males, 9 females; mean age 9y 1mo, SD 1y 7mo) and a comparison group (n=39; 25 males, 14 females; mean age 9y 1mo, SD 1y 3mo) completed assessments of reading comprehension, listening comprehension, word/non-word reading, speech articulation, and Non-verbal IQ. Reading comprehension and word reading were worse in children with rolandic epilepsy (F 1,61 =6.89, p=0.011, ηp2=0.10 and F 1,61 =6.84, p=0.011, ηp2=0.10 respectively), with listening comprehension being marginal (F 1,61 =3.81, p=0.055, ηp2=0.06). Word reading and listening comprehension made large and independent contributions to reading comprehension, explaining 70% of the variance. Children with rolandic epilepsy may be at risk of reading comprehension difficulties. Thorough assessment of individual children is required to ascertain whether the difficulties lie with decoding text, or with general comprehension skills, or both. Children with rolandic epilepsy may be at risk of poor reading comprehension. This was related to poor word reading, poor listening comprehension, or both. Reading comprehension interventions should be tailored to the profile of difficulties. © 2017 Mac Keith Press.

  9. Parental depressive symptoms and childhood cancer: the importance of financial difficulties.

    Science.gov (United States)

    Creswell, Paul D; Wisk, Lauren E; Litzelman, Kristin; Allchin, Adelyn; Witt, Whitney P

    2014-02-01

    Research suggests a relationship between caring for a child with cancer and psychological distress in caregivers. Less evident is the role which financial difficulties might play in this relationship. We sought to determine if caring for a child with cancer was related to clinically relevant depressive symptoms among parents, whether or not financial difficulties mediated this relationship, and if financial difficulties were independently associated with symptoms of depression among parents of children with cancer. Data are from 215 parents of children diagnosed with cancer or brain tumors (n = 75) and a comparison group of parents of healthy children (n = 140). Multiple logistic regression analyses were used to assess the factors associated with reporting clinically relevant depressive symptoms. Caring for a child with cancer was associated with increased odds of clinically relevant depressive symptoms in parents (OR = 4.93; 95 % CI 1.97-12.30), controlling for covariates. The mediating effect of financial burden on this relationship was not statistically significant. However, among parents of children with cancer, negative financial life events increased the likelihood of reporting symptoms of depression (OR = 4.89; 95 % CI 1.26-18.96). Caring for a child with cancer was associated with depressive symptoms for parents. Financial difficulties were the strongest correlate of these symptoms among parents of children with cancer. Our results suggest that it may not only be the burden of caring for the child with cancer but also the associated financial difficulties that contribute to a higher likelihood of depressive symptoms in parents.

  10. Diagnosis of Spasmodic Dysphonia Manifested by Swallowing Difficulty in Videofluoroscopic Swallowing Study

    Science.gov (United States)

    Yeo, Han Gyeol; Lee, Seong Jae; Hyun, Jung Keun

    2015-01-01

    Spasmodic dysphonia is defined as a focal laryngeal disorder characterized by dystonic spasms of the vocal cord during speech. We described a case of a 22-year-old male patient who presented complaining of idiopathic difficulty swallowing that suddenly developed 6 months ago. The patient also reported pharyngolaryngeal pain, throat discomfort, dyspnea, and voice change. Because laryngoscopy found no specific problems, an electrodiagnostic study and videofluoroscopic swallowing study (VFSS) were performed to find the cause of dysphagia. The VFSS revealed continuous twitch-like involuntary movement of the laryngeal muscle around the vocal folds. Then, he was diagnosed with spasmodic dysphonia by VFSS, auditory-perceptual voice analysis, and physical examination. So, we report the first case of spasmodic dysphonia accompanied with difficulty swallowing that was confirmed by VFSS. PMID:25932430

  11. Undergraduate Students’ Difficulties in Reading and Constructing Phylogenetic Tree

    Science.gov (United States)

    Sa'adah, S.; Tapilouw, F. S.; Hidayat, T.

    2017-02-01

    Representation is a very important communication tool to communicate scientific concepts. Biologists produce phylogenetic representation to express their understanding of evolutionary relationships. The phylogenetic tree is visual representation depict a hypothesis about the evolutionary relationship and widely used in the biological sciences. Phylogenetic tree currently growing for many disciplines in biology. Consequently, learning about phylogenetic tree become an important part of biological education and an interesting area for biology education research. However, research showed many students often struggle with interpreting the information that phylogenetic trees depict. The purpose of this study was to investigate undergraduate students’ difficulties in reading and constructing a phylogenetic tree. The method of this study is a descriptive method. In this study, we used questionnaires, interviews, multiple choice and open-ended questions, reflective journals and observations. The findings showed students experiencing difficulties, especially in constructing a phylogenetic tree. The students’ responds indicated that main reasons for difficulties in constructing a phylogenetic tree are difficult to placing taxa in a phylogenetic tree based on the data provided so that the phylogenetic tree constructed does not describe the actual evolutionary relationship (incorrect relatedness). Students also have difficulties in determining the sister group, character synapomorphy, autapomorphy from data provided (character table) and comparing among phylogenetic tree. According to them building the phylogenetic tree is more difficult than reading the phylogenetic tree. Finding this studies provide information to undergraduate instructor and students to overcome learning difficulties of reading and constructing phylogenetic tree.

  12. Visual difficulty and employment status in the world.

    Directory of Open Access Journals (Sweden)

    Hanen Harrabi

    Full Text Available PURPOSE: Using a world-wide, population-based dataset, we sought to examine the relationship between visual difficulty and employment status. METHODS: The World Health Survey was conducted in 70 countries throughout the world in 2003 using a random, multi-stage, stratified, cluster sampling design. Far vision was assessed by asking about the level of difficulty in seeing and recognizing a person you know across the road (i.e. from a distance of about 20 meters. Responses included none, mild, moderate, severe, or extreme/unable. Participants were asked about their current job, and if they were not working, the reason why (unable to find job, ill health, homemaker, studies, unpaid work, other. The occupation in the last 12 months was obtained. Multinomial regression was used accounting for the complex survey design. RESULTS: Of those who wanted to work, 79% of those with severe visual difficulty and 64% of those with extreme visual difficulty were actually working. People who had moderate, severe, or extreme visual difficulty had a higher odds of not working due to an inability to find a job and of not working due to ill health after adjusting for demographic and health factors (P<0.05. CONCLUSIONS: As the major causes of visual impairment in the world are uncorrected refractive error and cataract, countries are losing a great deal of labor productivity by failing to provide for the vision health needs of their citizens and failing to help them integrate into the workforce.

  13. Visual difficulty and employment status in the world.

    Science.gov (United States)

    Harrabi, Hanen; Aubin, Marie-Josee; Zunzunegui, Maria Victoria; Haddad, Slim; Freeman, Ellen E

    2014-01-01

    Using a world-wide, population-based dataset, we sought to examine the relationship between visual difficulty and employment status. The World Health Survey was conducted in 70 countries throughout the world in 2003 using a random, multi-stage, stratified, cluster sampling design. Far vision was assessed by asking about the level of difficulty in seeing and recognizing a person you know across the road (i.e. from a distance of about 20 meters). Responses included none, mild, moderate, severe, or extreme/unable. Participants were asked about their current job, and if they were not working, the reason why (unable to find job, ill health, homemaker, studies, unpaid work, other). The occupation in the last 12 months was obtained. Multinomial regression was used accounting for the complex survey design. Of those who wanted to work, 79% of those with severe visual difficulty and 64% of those with extreme visual difficulty were actually working. People who had moderate, severe, or extreme visual difficulty had a higher odds of not working due to an inability to find a job and of not working due to ill health after adjusting for demographic and health factors (P<0.05). As the major causes of visual impairment in the world are uncorrected refractive error and cataract, countries are losing a great deal of labor productivity by failing to provide for the vision health needs of their citizens and failing to help them integrate into the workforce.

  14. The effect of preinjury sleep difficulties on neurocognitive impairment and symptoms after sport-related concussion.

    Science.gov (United States)

    Sufrinko, Alicia; Pearce, Kelly; Elbin, R J; Covassin, Tracey; Johnson, Eric; Collins, Michael; Kontos, Anthony P

    2015-04-01

    Researchers have reported that sleep duration is positively related to baseline neurocognitive performance. However, researchers have yet to examine the effect of preinjury sleep difficulties on postconcussion impairments. To compare neurocognitive impairment and symptoms of athletes with preinjury sleep difficulties to those without after a sport-related concussion (SRC). Cohort study; Level of evidence, 3. The sample included 348 adolescent and adult athletes (age, mean ± SD, 17.43 ± 2.34 years) with a diagnosed SRC. The sample was divided into 2 groups: (1) 34 (10%) participants with preinjury sleep difficulties (sleeping less as well as having trouble falling asleep; SLEEP SX) and (2) 231 (66%) participants without preinjury sleep difficulties (CONTROL). The remaining 84 (24%) participants with minimal sleep difficulties (1 symptom) were excluded. Participants completed the Immediate Postconcussion Assessment and Cognitive Test (ImPACT) and Postconcussion Symptom Scale (PCSS) at baseline and 3 postinjury intervals (2, 5-7, and 10-14 days after injury). A series of repeated-measures analyses of covariance with Bonferroni correction, controlling for baseline non-sleep-related symptoms, were conducted to compare postinjury neurocognitive performance between groups. Follow-up exploratory t tests examined between-group differences at each time interval. A series of analyses of variance were used to examine total PCSS score, sleep-related, and non-sleep-related symptoms across time intervals between groups. Groups differed significantly in PCSS scores across postinjury intervals for reaction time (P SLEEP SX group performing worse than controls at 5-7 days (mean ± SD, 0.70 ± 0.32 [SLEEP SX], 0.60 ± 0.14 [CONTROL]) and 10-14 days (0.61 ± 0.17 [SLEEP SX]; 0.57 ± 0.10 [CONTROL]) after injury. Groups also differed significantly on verbal memory performance (P = .04), with the SLEEP SX (68.21 ± 18.64) group performing worse than the CONTROL group (76.76 ± 14

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

    Science.gov (United States)

    Verheij, Emmy; Oomen, Karin P Q; Smetsers, Stephanie E; van Zanten, Gijsbert A; Speleman, Lucienne

    2017-10-01

    Fanconi anemia is a hereditary chromosomal instability disorder. Hearing loss and ear abnormalities are among the many manifestations reported in this disorder. In addition, Fanconi anemia patients often complain about hearing difficulties in situations with background noise (speech perception in noise difficulties). Our study aimed to describe the prevalence of hearing loss and speech perception in noise difficulties in Dutch Fanconi anemia patients. Retrospective chart review. A retrospective chart review was conducted at a Dutch tertiary care center. All patients with Fanconi anemia at clinical follow-up in our hospital were included. Medical files were reviewed to collect data on hearing loss and speech perception in noise difficulties. In total, 49 Fanconi anemia patients were included. Audiograms were available in 29 patients and showed hearing loss in 16 patients (55%). Conductive hearing loss was present in 24.1%, sensorineural in 20.7%, and mixed in 10.3%. A speech in noise test was performed in 17 patients; speech perception in noise was subnormal in nine patients (52.9%) and abnormal in two patients (11.7%). Hearing loss and speech perception in noise abnormalities are common in Fanconi anemia. Therefore, pure tone audiograms and speech in noise tests should be performed, preferably already at a young age, because hearing aids or assistive listening devices could be very valuable in developing language and communication skills. 4. Laryngoscope, 127:2358-2361, 2017. © 2016 The American Laryngological, Rhinological and Otological Society, Inc.

  16. Walking modality, but not task difficulty, influences the control of dual-task walking.

    Science.gov (United States)

    Wrightson, J G; Smeeton, N J

    2017-10-01

    During dual-task gait, changes in the stride-to-stride variability of stride time (STV) are suggested to represent the allocation of cognitive control to walking [1]. However, contrasting effects have been reported for overground and treadmill walking, which may be due to differences in the relative difficulty of the dual task. Here we compared the effect of overground and treadmill dual-task walking on STV in 18 healthy adults. Participants walked overground and on a treadmill for 120s during single-task (walking only) and dual-task (walking whilst performing serial subtractions in sevens) conditions. Dual-task effects on STV, cognitive task (serial subtraction) performance and perceived task difficulty were compared between walking modalities. STV was increased during overground dual-task walking, but was unchanged during treadmill dual-task walking. There were no differences in cognitive task performance or perceived task difficulty. These results show that gait is controlled differently during overground and treadmill dual-task walking. However, these differences are not solely due to differences in task difficulty, and may instead represent modality dependent control strategies. Copyright © 2017 Elsevier B.V. All rights reserved.

  17. Hearing difficulty and tinnitus among U.S. workers and non-workers in 2007.

    Science.gov (United States)

    Masterson, Elizabeth A; Themann, Christa L; Luckhaupt, Sara E; Li, Jia; Calvert, Geoffrey M

    2016-04-01

    Hearing loss and tinnitus are two potentially debilitating physical conditions affecting many people in the United States. The purpose of this study was to estimate the prevalence of hearing difficulty, tinnitus, and their co-occurrence within U.S. Data from the 2007 National Health Interview Survey (NHIS) were examined. Weighted prevalence and adjusted prevalence ratios for self-reported hearing difficulty, tinnitus, and their co-occurrence were estimated and compared by demographic, among workers with and without occupational noise exposure, and across industries and occupations. Seven percent of U.S. workers never exposed to occupational noise had hearing difficulty, 5% had tinnitus and 2% had both conditions. However, among workers who had ever been exposed to occupational noise, the prevalence was 23%, 15%, and 9%, respectively (P Hearing difficulty and tinnitus are prevalent in the U.S.; especially among noise-exposed workers. Improved strategies for hearing conservation or better implementation are needed. Published 2016. This article is a U.S. Government work and is in the public domain in the USA.

  18. Health worry, physical activity participation, and walking difficulty among older adults: a mediation analysis.

    Science.gov (United States)

    Li, Kin-Kit; Cardinal, Bradley J; Vuchinich, Samuel

    2009-03-01

    This study examined the effect of health worry (i.e., cognitive aspect of anxiety resulting from concern for health) on walking difficulty in a nationally representative sample (N = 7,527) of older adults (M age = 76.83 years). The study further tested whether physical activity mediates the effect of health worry on walking difficulty in a 6-year follow-up design. Results of a mediation analysis using structural equation modeling showed that people with a high degree of health worry engaged in less physical activity (beta = -.24, p < .001), and people who participated in less physical activity were more likely to report walking difficulty at the 6-year follow-up (beta = -.22, p < .001). There was a significant indirect effect from health worry to walking difficulty through physical activity (beta = .05, p < .001), controlling for demographic, psychosocial, and health related factors. Results suggested that inducing threat and worry may not be effective for physical activity promotion in the older population. More promising coping and regulation strategies are discussed.

  19. Cardiovascular conditions, hearing difficulty, and occupational noise exposure within US industries and occupations.

    Science.gov (United States)

    Kerns, Ellen; Masterson, Elizabeth A; Themann, Christa L; Calvert, Geoffrey M

    2018-03-14

    The purpose of this study was to estimate the prevalence of occupational noise exposure, hearing difficulty and cardiovascular conditions within US industries and occupations, and to examine any associations of these outcomes with occupational noise exposure. National Health Interview Survey data from 2014 were examined. Weighted prevalence and adjusted prevalence ratios of self-reported hearing difficulty, hypertension, elevated cholesterol, and coronary heart disease or stroke were estimated by level of occupational noise exposure, industry, and occupation. Twenty-five percent of current workers had a history of occupational noise exposure (14% exposed in the last year), 12% had hearing difficulty, 24% had hypertension, 28% had elevated cholesterol; 58%, 14%, and 9% of these cases can be attributed to occupational noise exposure, respectively. Hypertension, elevated cholesterol, and hearing difficulty are more prevalent among noise-exposed workers. Reducing workplace noise levels is critical. Workplace-based health and wellness programs should also be considered. Published 2018. This article is a U.S. Government work and is in the public domain in the USA.

  20. [Public health infrastructure investment difficulties in Chile: concessions and public tenders].

    Science.gov (United States)

    Goyenechea, Matías

    2016-05-12

    This paper seeks to highlight the problems of gaps in health infrastructure in Chile, and to analyze the mechanisms by which it is provided. In Chile this is done in two ways: the first is through competitive bidding or sector-wide modality. The second way is through hospital concessions. Both mechanisms have had difficulties in recent years, which are reported. Finally, we propose ways to improve the provision of health infrastructure in Chile.

  1. Spanish researchers’ perceived difficulty writing research articles for English-medium journals: the impact of proficiency in English versus publication experience

    Directory of Open Access Journals (Sweden)

    Ana I. Moreno

    2012-10-01

    Full Text Available Previous quantitative studies suggest that the burden researchers who use English as an additional language perceive when writing research articles (RAs for publication in English (as L2 is 24% greater than the burden they perceive when they write RAs for publication in their L1. It remains unclear precisely which aspects of research article (RA writing in English present these writers with the greatest challenge and just why they perceive this increase in difficulty. A structured questionnaire comprising thirty-seven questions about researchers’ publication experiences in scientific journals in English and in Spanish was designed and sent out to all (n = 8,794 Spanish postdoctoral researchers at one research-only institution and four universities in Spain, yielding responses from 1,717 researchers. Our first results show that the discussion is the section that is perceived as more difficult to write for English-medium journals, across the four broad knowledge areas in a way that cannot be fully explained by their lower level of proficiency in English (as L2. This article proposes the rhetorical transfer hypothesis as a possible explanation for their additional difficulty. Our results also reveal that their increased perceived difficulty writing RA discussions in English (as L2 does not decrease noticeably until Spanish researchers report high or very high levels of proficiency in English (as L2 for academic or general purposes or have published on average at least 37 RAs as corresponding author in English-medium journals over the last ten years. Implications for English for Academic Purposes (EAP research and pedagogy are discussed.

  2. Divided attention: an undesirable difficulty in memory retention.

    Science.gov (United States)

    Gaspelin, Nicholas; Ruthruff, Eric; Pashler, Harold

    2013-10-01

    How can we improve memory retention? A large body of research has suggested that difficulty encountered during learning, such as when practice sessions are distributed rather than massed, can enhance later memory performance (see R. A. Bjork & E. L. Bjork, 1992). Here, we investigated whether divided attention during retrieval practice can also constitute a desirable difficulty. Following two initial study phases and one test phase with Swahili-English word pairs (e.g., vuvi-snake), we manipulated whether items were tested again under full or divided attention. Two days later, participants were brought back for a final cued-recall test (e.g., vuvi-?). Across three experiments (combined N = 122), we found no evidence that dividing attention while practicing retrieval enhances memory retention. This finding raises the question of why many types of difficulty during practice do improve long-term retention, but dividing attention does not.

  3. Differences in Emotion Regulation Difficulties Across Types of Eating Disorders During Adolescence.

    Science.gov (United States)

    Weinbach, Noam; Sher, Helene; Bohon, Cara

    2017-11-04

    Emotion regulation appears to play a key role in eating disorders. However, prior attempts to associate specific emotion regulation abilities with specific types of eating disorders resulted in inconsistent findings. Moreover, far less is known about emotion regulation in eating disorders during adolescence, a critical period of emotional development. The current study addresses this gap, comparing emotion regulation characteristics between adolescents with restrictive types of eating disorders and those with binge eating or purging types of eating disorders. Ninety-eight adolescents with eating disorders (49 with restrictive and 49 with binge eating/purging eating disorders) completed a set of questionnaires including the Difficulties in Emotion Regulation Scale (DERS). The results revealed that binge eating/purging types of eating disorders were associated with greater difficulties in a variety of emotion regulation dimensions including impulse control, goal-directed behavior and access to effective emotion regulation strategies. Awareness and clarity of emotions were also worse in the binge eating/purging types of eating disorders, but this difference did not remain when comorbid psychopathology measures were controlled for. Moreover, the emotion regulation profile of adolescents with anorexia nervosa-binging/purging type was more similar to that of adolescents with bulimia nervosa than to that of adolescents with anorexia nervosa-restrictive type. While both restrictive and binge eating/purging eating disorders have been associated with emotion regulation difficulties, the current study shows that the presence of binge eating or purging episodes is linked with greater severity of emotion regulation deficits among adolescents with eating disorders.

  4. The factor structure of the Strengths and Difficulties Questionnaire (SDQ in Greek adolescents

    Directory of Open Access Journals (Sweden)

    Rotsika Vasiliki

    2009-08-01

    Full Text Available Abstract Background The Strengths and Difficulties Questionnaire (SDQ is a practical, economic and user-friendly screening instrument of emotional and behavioural problems in children and adolescents. This study was aimed primarily at evaluating the factor structure of the Greek version of the SDQ. Methods A representative nationwide sample of 1,194 adolescents (11 to 17 years old completed the questionnaire. Confirmatory factor analysis (CFA was conducted to assess the factor structure of the SDQ. Results CFA supported the original five-factor structure. The modification of the model provided some improvements. Internal consistency was acceptable for total difficulties, emotional symptoms and prosocial behaviour scale, moderate for hyperactivity/inattention scale and inadequate for peer and conduct problems scale. Older adolescents (aged 15 to 17 years reported more hyperactivity/inattention and conduct problems than younger ones (aged 11 to 14 years and girls reported more emotional symptoms and less prosocial behaviour problems than boys. Adolescents of low socioeconomic status (SES reported more difficulties than those of medium and high SES. Conclusion The Greek SDQ could be potentially considered as a community-wide screening instrument for adolescents' emotional and behavioural problems.

  5. Psychosocial difficulties from the perspective of persons with neuropsychiatric disorders.

    Science.gov (United States)

    Coenen, Michaela; Cabello, Maria; Umlauf, Silvia; Ayuso-Mateos, José Luis; Anczewska, Marta; Tourunen, Jouni; Leonardi, Matilde; Cieza, Alarcos

    2016-01-01

    The objective of this study is to determine whether persons with neuropsychiatric disorders experience a common set of psychosocial difficulties using qualitative data from focus groups and individual interviews. The study was performed in five European countries (Finland, Italy, Germany, Poland and Spain) using the focus groups and individual interviews with persons with nine neuropsychiatric disorders (dementia, depression, epilepsy, migraine, multiple sclerosis, Parkinson's disease, schizophrenia, stroke and substance dependence). Digitally recorded sessions were analysed using a step-by-step qualitative and quantitative methodology resulting in the compilation of a common set of psychosocial difficulties using the International Classification of Functioning, Disability and Health (ICF) as a framework. Sixty-seven persons participated in the study. Most persons with neuropsychiatric disorders experience difficulties in emotional functions, sleeping, carrying out daily routine, working and interpersonal relationships in common. Sixteen out of 33 psychosocial difficulties made up the common set. This set includes mental functions, pain and issues addressing activities and participation and provides first evidence for the hypothesis of horizontal epidemiology of psychosocial difficulties in neuropsychiatric disorders. This study provides information about psychosocial difficulties that should be covered in the treatment and rehabilitation of persons with neuropsychiatric disorders regardless of clinical diagnoses. Emotional problems, work and sleep problems should be addressed in all the treatments of neuropsychiatric disorders regardless of their specific diagnosis, etiology and severity. Personality issues should be targeted in the treatment for neurological disorders, whereas communication skill training may also be useful for mental disorders. The effects of medication and social environment on patient's daily life should be considered in all the

  6. Greater future global warming inferred from Earth's recent energy budget.

    Science.gov (United States)

    Brown, Patrick T; Caldeira, Ken

    2017-12-06

    Climate models provide the principal means of projecting global warming over the remainder of the twenty-first century but modelled estimates of warming vary by a factor of approximately two even under the same radiative forcing scenarios. Across-model relationships between currently observable attributes of the climate system and the simulated magnitude of future warming have the potential to inform projections. Here we show that robust across-model relationships exist between the global spatial patterns of several fundamental attributes of Earth's top-of-atmosphere energy budget and the magnitude of projected global warming. When we constrain the model projections with observations, we obtain greater means and narrower ranges of future global warming across the major radiative forcing scenarios, in general. In particular, we find that the observationally informed warming projection for the end of the twenty-first century for the steepest radiative forcing scenario is about 15 per cent warmer (+0.5 degrees Celsius) with a reduction of about a third in the two-standard-deviation spread (-1.2 degrees Celsius) relative to the raw model projections reported by the Intergovernmental Panel on Climate Change. Our results suggest that achieving any given global temperature stabilization target will require steeper greenhouse gas emissions reductions than previously calculated.

  7. Vapour cloud explosion hazard greater with light feedstocks

    Energy Technology Data Exchange (ETDEWEB)

    Windebank, C.S.

    1980-03-03

    Because lighter chemical feedstocks such as propylene and butylenes are more reactive than LPG's they pose a greater risk of vapor cloud explosion, particularly during their transport. According to C.S. Windebank (Insurance Tech. Bur.), percussive unconfined vapor cloud explosions (PUVCE's) do not usually occur below the ten-ton threshold for saturated hydrocarbons but can occur well below this threshold in the case of unsaturated hydrocarbons such as propylene and butylenes. Boiling liquid expanding vapor explosions (BLEVE's) are more likely to be ''hot'' (i.e., the original explosion is associated with fire) than ''cold'' in the case of unsaturated hydrocarbons. No PUVCE or BLEVE incident has been reported in the UK. In the US, 16 out of 20 incidents recorded between 1970 and 1975 were related to chemical feedstocks, including propylene and butylenes, and only 4 were LPG-related. The average losses were $20 million per explosion. Between 1968 and 1978, 8% of LPG pipeline spillages led to explosions.

  8. Technical concept for a greater-confinement-disposal test facility

    International Nuclear Information System (INIS)

    Hunter, P.H.

    1982-01-01

    Greater confinement disposal (GCO) has been defined by the National Low-Level Waste Program as the disposal of low-level waste in such a manner as to provide greater containment of radiation, reduce potential for migration or dispersion or radionuclides, and provide greater protection from inadvertent human and biological intrusions in order to protect the public health and safety. This paper discusses: the need for GCD; definition of GCD; advantages and disadvantages of GCD; relative dose impacts of GCD versus shallow land disposal; types of waste compatible with GCD; objectives of GCD borehole demonstration test; engineering and technical issues; and factors affecting performance of the greater confinement disposal facility

  9. DOD Financial Management: Greater Visibility Needed to Better Assess Audit Readiness for Property, Plant, and Equipment

    Science.gov (United States)

    2016-05-01

    with U.S. generally accepted accounting principles and establish and maintain effective internal control over financial reporting and compliance with... Accountability Office Highlights of GAO-16-383, a report to congressional committees May 2016 DOD FINANCIAL MANAGEMENT Greater Visibility... Accounting Standards Advisory Board FIAR Financial Improvement and Audit Readiness IUS internal-use software NDAA National Defense Authorization Act

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

    Science.gov (United States)

    Wijaya, Ariyadi

    2017-01-01

    This paper reports an exploration into Indonesian fourth graders' difficulties in fractions and their relation to the opportunity to learn fractions students got at schools. The concept of "opportunity to learn" is often considered as a framework to investigate possible reasons for students' difficulties. The data for this study was…

  11. Relationship between gender and tactile-kinesthetic sensitivity and the quality of writing among students with and without writing difficulties

    Directory of Open Access Journals (Sweden)

    Vujanović Marina M.

    2017-01-01

    Full Text Available Writing, a skill that students practice as soon as they start primary school, requires coordination between motor, perceptual and cognitive abilities. In order to determine the effect of gender on writing difficulties and the possible differences in the relationship between tactile-kinesthetic perception and writing skills of boys and girls with and without writing difficulties, a study was conducted in 2016 on a sample of 1,156 fifth to eighth grade students of eight Belgrade primary schools. Although the results obtained suggest that girls write faster than boys, difficulties with writing fast were equally present in both groups of students. However, difficulties with writing quality occurred with statistically significantly greater frequency among boys. Pencil grip, kinesthetic sensibility test results and consistency of pressure were not unrelated to students' gender, with girls achieving better results. Moreover, boys had significantly lower scores than girls on tactile function tests. The obtained results indicate that gender is a determinant of writing difficulties as measured through speed of writing and legibility. Also, girls have more developed kinesthetic-tactile functions, which are correlated with writing quality.

  12. Moderating effect of communication difficulty on the relationship between depression and pain: a study on community-dwelling older adults in Hong Kong.

    Science.gov (United States)

    Chan, Wallace Chi Ho; Kwan, Chi Wai; Chi, Iris

    2015-01-01

    This study examined the relationship between depression and pain, and the moderating effect of communication difficulty on this relationship, among community-dwelling older adults in Hong Kong. We used logistic regression to analyze secondary data regarding 12,402 Chinese older adults applying for long-term care service in Hong Kong in 2012. Approximately 30% of participants were depressed and 37% experienced communication difficulty. Depression was associated with increased pain. Communication difficulty was found to moderate the relationship between depression and pain. Pain scores increased more when individuals who experienced communication difficulty reported being depressed, compared to those who did not experience communication difficulty. The moderating effect of communication difficulty may be explained by the interaction between depression and communication difficulty. Participants who were depressed and concurrently experienced communication difficulty may be more likely to catastrophize their pain and may tend to report or experience more pain. Health care professionals need to be aware of the different effects of communication difficulty on the pain experiences of older adults. Psychosocial intervention may be provided to minimize older adults' communication barriers to pain management.

  13. Heterogeneity of emotional and interpersonal difficulties in alcohol-dependence: A cluster analytic approach.

    Science.gov (United States)

    Maurage, Pierre; Timary, Philippe de; D'Hondt, Fabien

    2017-08-01

    Emotional and interpersonal impairments have been largely reported in alcohol-dependence, and their role in its development and maintenance is widely established. However, earlier studies have exclusively focused on group comparisons between healthy controls and alcohol-dependent individuals, considering them as a homogeneous population. The variability of socio-emotional profiles in this disorder thus remains totally unexplored. The present study used a cluster analytic approach to explore the heterogeneity of affective and social disorders in alcohol-dependent individuals. 296 recently-detoxified alcohol-dependent patients were first compared with 246 matched healthy controls regarding self-reported emotional (i.e. alexithymia) and social (i.e. interpersonal problems) difficulties. Then, a cluster analysis was performed, focusing on the alcohol-dependent sample, to explore the presence of differential patterns of socio-emotional deficits and their links with demographic, psychopathological and alcohol-related variables. The group comparison between alcohol-dependent individuals and controls clearly confirmed that emotional and interpersonal difficulties constitute a key factor in alcohol-dependence. However, the cluster analysis identified five subgroups of alcohol-dependent individuals, presenting distinct combinations of alexithymia and interpersonal problems ranging from a total absence of reported impairment to generalized socio-emotional difficulties. Alcohol-dependent individuals should no more be considered as constituting a unitary group regarding their affective and interpersonal difficulties, but rather as a population encompassing a wide variety of socio-emotional profiles. Future experimental studies on emotional and social variables should thus go beyond mere group comparisons to explore this heterogeneity, and prevention programs proposing an individualized evaluation and rehabilitation of these deficits should be promoted. Copyright © 2017

  14. Hearing difficulties and feelings of social isolation among Canadians aged 45 or older.

    Science.gov (United States)

    Ramage-Morin, Pamela L

    2016-11-16

    Social isolation is associated with reduced health-related quality of life, increased morbidity, and mortality. Social isolation can be a concern for older Canadians, especially those with conditions that interfere with making and maintaining social connections. The 2008/2009 Canadian Community Health Survey-Healthy Aging (CCHS-HA) collected data from a population-based sample of Canadians aged 45 or older living in private households. Frequencies, cross-tabulations and logistic regression were used to examine the prevalence of hearing difficulties and social isolation, and associations between them when controlling for sociodemographic characteristics, other functional limitations (for example, vision, mobility, and cognition), incontinence, and fear of falling. Social isolation was more common among 45- to 59-year-olds than among people aged 60 or older. Women were more likely than men to be socially isolated (16% versus 12%), but they were less likely to report hearing difficulties (5% versus 7%). Hearing difficulties were more prevalent at older ages: 25% of men and 18% of women at age 75 or older. When sociodemographic factors (age, education, living arrangements, regular driver, workforce participation), incontinence, fear of falling, and functional limitations were taken into account, the odds of being socially isolated increased with the severity of the hearing impairment among women but not among men (OR: 1.04, 95% CI: 1.00, 1.09). Hearing difficulties are associated with age, and therefore, a growing public health concern as Canada's population ages. For women, hearing difficulties were found to be associated with social isolation.

  15. 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.

  16. Determining which introductory physics topics pre-service physics teachers have difficulty understanding and what accounts for these difficulties

    International Nuclear Information System (INIS)

    Şahin, Esin; Yağbasan, Rahmi

    2012-01-01

    This study aims at diagnosing which subjects pre-service physics teachers have difficulty understanding in introductory physics courses and what accounts for these difficulties. A questionnaire consisting of two qualitative questions was used to collect data for this study. The questionnaire was administered to 101 pre-service physics teachers who have completed the courses Physics 1 (Mechanics 1), Physics 2 (Mechanics 2), Physics 3 (Electricity) and Physics 4 (Magnetism). Of the pre-service physics teachers 28 were second year, 26 were third year, 27 were fourth year and 20 were fifth year students. The results of the data analysis indicated that the percentage of students who think that Magnetism has the most difficult subjects is the highest compared to the others. The reasons why the pre-service physics teachers experience difficulty in understanding the subjects have been grouped into four categories. (paper)

  17. Perceived Difficulties in e-Learning During the First Term at University

    Directory of Open Access Journals (Sweden)

    Galina Kavaliauskienė

    2013-08-01

    Full Text Available Purpose—the focus of this article is to explore difficulties that are encountered by students during the first term at university. It is well known that students can have various problems in learning English and make mistakes in grammar, vocabulary, and pronunciation. The native language of a learner affects learning and using English. Speaking and e-listening are the skills that are more common on an everyday basis than reading and writing. Moreover, these skills are more difficult to master. English vocabulary presents another problem for language learners. Albeit, at the university level students study English for Specific Purposes (ESP, in other words, the foreign language for their future profession, and they might face particular difficulties in their studies of ESP. Design/methodology/approach—the research paper adopts the qualitative research approach. The questionnaire on learner perceptions of difficulties in e-learning was administered to students of three different specializations. Students’ self-assessments of achievements or failures were analysed. Findings. The results indicated that perceptions of difficulties to adapting to university studies depended on their chosen specialization. The findings show that undergraduates of all three investigated specializations encounter the same difficulties, but to a different degree. In other words, there are no significantly specific difficulties due to the complexity of the professional vocabulary that students must learn. The ratings of Psychology, Social Work and Public Policy and Management students reveal higher mean values and wider range of Standard Deviations than reported by other researchers (Berman, Cheng, 2001. The results obtained imply that Lithuanian learners are more positive than their foreign counterparts. Computations of Pearson’s correlations coefficients demonstrate that there are some good correlational relationships within each specialization. Research

  18. Delayed Self-Recognition in Autism: A Unique Difficulty?

    Science.gov (United States)

    Dunphy-Lelii, Sarah; Wellman, Henry M.

    2012-01-01

    Achieving a sense of self is a crucial task of ordinary development. With which aspects of self do children with autism have particular difficulty? Two prior studies concluded that children with autism are unimpaired in delayed self-recognition; we confirm and clarify this conclusion by examining it in conjunction with another key aspect of self…

  19. Students' Conceptual Difficulties in Quantum Mechanics: Potential Well Problems

    Science.gov (United States)

    Ozcan, Ozgur; Didis, Nilufer; Tasar, Mehmet Fatih

    2009-01-01

    In this study, students' conceptual difficulties about some basic concepts in quantum mechanics like one-dimensional potential well problems and probability density of tunneling particles were identified. For this aim, a multiple choice instrument named Quantum Mechanics Conceptual Test has been developed by one of the researchers of this study…

  20. Linear Algebra Revisited: An Attempt to Understand Students' Conceptual Difficulties

    Science.gov (United States)

    Britton, Sandra; Henderson, Jenny

    2009-01-01

    This article looks at some of the conceptual difficulties that students have in a linear algebra course. An overview of previous research in this area is given, and the various theories that have been espoused regarding the reasons that students find linear algebra so difficult are discussed. Student responses to two questions testing the ability…

  1. On the difficulties of acquiring mathematical experience: Case rural education

    DEFF Research Database (Denmark)

    Booss-Bavnbek, Bernhelm

    2014-01-01

    Based on a variety of philosophical approaches and my own work for decades in pure and applied mathematics teaching and research, I explain my view upon the basic difficulties of acquiring the “Mathematical Experience” (in the sense of P.J. Davis and R. Hersh 1981) and submit a list of claims how...

  2. Magnetic order in graphite: Experimental evidence, intrinsic and extrinsic difficulties

    International Nuclear Information System (INIS)

    Esquinazi, P.; Barzola-Quiquia, J.; Spemann, D.; Rothermel, M.; Ohldag, H.; Garcia, N.; Setzer, A.; Butz, T.

    2010-01-01

    We discuss recently obtained data using different experimental methods including magnetoresistance measurements that indicate the existence of metal-free high-temperature magnetic order in graphite. Intrinsic as well as extrinsic difficulties to trigger magnetic order by irradiation of graphite are discussed in view of recently published theoretical work.

  3. Determining Difficulty of Questions in Intelligent Tutoring Systems

    Science.gov (United States)

    Gunel, Korhan; Asliyan, Rifat

    2009-01-01

    The object of this study is to model the level of a question difficulty by a differential equation at a pre-specified domain knowledge, to be used in an educational support system. For this purpose, we have developed an intelligent tutoring system for mathematics education. Intelligent Tutoring Systems are computer systems designed for improvement…

  4. The Strengths and Difficulties Questionnaire in the Nordic countries

    DEFF Research Database (Denmark)

    Obel, Carsten; Heiervang, Einar; Rodriguez, Alina

    2004-01-01

    BACKGROUND: 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...

  5. Beyond Stigmatization of Children with Difficulties in Learning

    Science.gov (United States)

    Hido, Margarita; Shehu, Irena

    2010-01-01

    In the Albanian schools settings does not exist religious discrimination, neither gender discrimination, but there exists a discrimination, as unfair against children called "difficulty". The children who drop out of school are by far less numerous compared with those who start school, but who are not properly treated, so that they can…

  6. DYSPNEA ASSOCIATED WITH ANXIETY: MISTAKES AND DIFFICULTIES IN THE DIAGNOSIS

    Directory of Open Access Journals (Sweden)

    L. I. Tyukalova

    2013-01-01

    Full Text Available Two clinical cases that demonstrate the difficulties diagnosing the causes of shortness of breath, coupled with anxiety, are analyzed. From the standpoint of modern neurophysiology it explains the relationship of these conditions. There were revealed typical diagnostic mistakes: «the effect of precocious focusing", "the negative effect of the narrow specialization

  7. Eye Movements Reveal How Task Difficulty Moulds Visual Search

    Science.gov (United States)

    Young, Angela H.; Hulleman, Johan

    2013-01-01

    In two experiments we investigated the relationship between eye movements and performance in visual search tasks of varying difficulty. Experiment 1 provided evidence that a single process is used for search among static and moving items. Moreover, we estimated the functional visual field (FVF) from the gaze coordinates and found that its size…

  8. Common difficulties experienced by grade 12 students in learning ...

    African Journals Online (AJOL)

    The objective of this study was to examine the nature and causes of common difficulties experienced by grade twelve students in learning chemistry in Ebinat preparatory school. A qualitative method was employed to investigate the questions, which used interviews and questionnaires with students and teachers. The key ...

  9. Student Difficulties Regarding Symbolic and Graphical Representations of Vector Fields

    Science.gov (United States)

    Bollen, Laurens; van Kampen, Paul; Baily, Charles; Kelly, Mossy; De Cock, Mieke

    2017-01-01

    The ability to switch between various representations is an invaluable problem-solving skill in physics. In addition, research has shown that using multiple representations can greatly enhance a person's understanding of mathematical and physical concepts. This paper describes a study of student difficulties regarding interpreting, constructing,…

  10. Are Difficulties Balancing Work and Family Associated with Subsequent Fertility?

    Science.gov (United States)

    Liu, Siwei; Hynes, Kathryn

    2012-01-01

    Despite considerable interest in the causes and consequences of work-family conflict, and the frequent suggestion in fertility research that difficulty in balancing work and family is one of the factors leading to low fertility rates in several developed countries, little research uses longitudinal data to examine whether women who report…

  11. Difficulties on the road to a liberalized energy market

    International Nuclear Information System (INIS)

    Koevoet, H.

    2001-01-01

    Starting January 1, 2002 about 55,000 consumers of electricity and 2,100 consumers of natural gas (small and medium-sized businesses) in the Netherlands can choose their own supplier. Some of the constraints and difficulties with respect to the liberalized energy market in the Netherlands are discussed

  12. Interdisciplinary collaboration and conflict about inclusion and children in difficulties

    DEFF Research Database (Denmark)

    Røn Larsen, Maja

    My paper builds on the “sub-project C” concerned with: Legislation and administration as institutional conditions for interdisciplinary collaboration about children in difficulties in school. I have been doing the research together within, Stine Jørgensen, who is a researcher at the faculty of law...

  13. Preoperative ultrasonography and prediction of technical difficulties during laparoscopic cholecystectomy.

    Science.gov (United States)

    Daradkeh, S S; Suwan, Z; Abu-Khalaf, M

    1998-01-01

    A prospective study was carried out to investigate the value of preoperative ultrasound findings for predicting difficulties encountered during laparoscopic cholecystectomy (LC). Altogether 160 consecutive patients with symptomatic gallbladder (GB) disease (130 females, 30 males) referred to the Jordan University Hospital were recruited for the purpose of this study. All patients underwent detailed ultrasound examination 24 hours prior to LC. The overall difficulty score (ODS), as a dependent variable, was based on the following operative parameters: duration of surgery, bleeding, dissection of Calot's triangle, dissection of gallbladder wall, adhesions, spillage of bile, spillage of stone, and difficulty of gallbladder extraction. Multiple regression analysis was used to assess the significance of the following preoperative ultrasound variables (independent) for predicting the variation in the ODS: size of the GB, number of GB stones, size of stones, location of GB stones, thickness of GB wall, common bile duct (CBD) diameter, and liver size. Only thickness of GB wall and CBD diameter were found to be significant predictors of the variation in the ODS (adjusted R2 = 0.25). We conclude that the preoperative ultrasound examination is of value for predicting difficulties encountered during LC, but it is not the sole predictor.

  14. Financial difficulties lead OPEC countries on the prices correction way

    International Nuclear Information System (INIS)

    Anon.

    1994-01-01

    The financial difficulties of OPEC countries are going to lead them to correct the petroleum prices. In front of a decreasing since 1992, it is necessary to make them grow of about $1 the barrel. It is the principal conclusion of Bali meeting for next months even perhaps for next years

  15. 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

    2017-01-01

    Background: 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.…

  16. Tracking Change in Children with Severe and Persisting Speech Difficulties

    Science.gov (United States)

    Newbold, Elisabeth Joy; Stackhouse, Joy; Wells, Bill

    2013-01-01

    Standardised tests of whole-word accuracy are popular in the speech pathology and developmental psychology literature as measures of children's speech performance. However, they may not be sensitive enough to measure changes in speech output in children with severe and persisting speech difficulties (SPSD). To identify the best ways of doing this,…

  17. Career Decision-Making Difficulties of Turkish Adolescents

    Science.gov (United States)

    Bacanli, Feride

    2016-01-01

    The purposes of this study are (1) to adapt the Career Decision-Making Difficulties Questionnaire (CDDQ) to Turkish high school students and (2) to examine gender differences, grade differences, and differences between "decided" and "undecided" students. The sample consisted of 2509 adolescent students. The results showed that…

  18. Fast and Efficient Discrimination of Traveling Salesperson Problem Stimulus Difficulty

    Science.gov (United States)

    Dry, Matthew J.; Fontaine, Elizabeth L.

    2014-01-01

    The Traveling Salesperson Problem (TSP) is a computationally difficult combinatorial optimization problem. In spite of its relative difficulty, human solvers are able to generate close-to-optimal solutions in a close-to-linear time frame, and it has been suggested that this is due to the visual system's inherent sensitivity to certain geometric…

  19. Using Student Performance to Judge the Difficulty of Examinations

    Science.gov (United States)

    Roegner, Katherine

    2015-01-01

    This contribution focuses on a scheme developed to characterize the level of difficulty of an examination in the course "Linear Algebra for Engineers" and on the transfer of the underlying idea to a similar scheme for examinations in the course "Analysis I for Engineers". Using these schemes, it is possible to define standards…

  20. Difficulties in Learning and Teaching Statistics: Teacher Views

    Science.gov (United States)

    Koparan, Timur

    2015-01-01

    The purpose of this study is to define teacher views about the difficulties in learning and teaching middle school statistics subjects. To serve this aim, a number of interviews were conducted with 10 middle school maths teachers in 2011-2012 school year in the province of Trabzon. Of the qualitative descriptive research methods, the…

  1. Specific Learning Difficulties--What Teachers Need to Know

    Science.gov (United States)

    Hudson, Diana

    2015-01-01

    This book clearly explains what Specific Learning Difficulties (SpLD) are, and describes the symptoms of conditions most commonly encountered in the mainstream classroom: dyslexia, dyspraxia, dyscalculia, dysgraphia, Autism Spectrum Disorder, ADHD, and OCD. The author provides an overview of the strengths and weaknesses commonly associated with…

  2. Investigating Difficulties of Learning Computer Programming in Saudi Arabia

    Science.gov (United States)

    Alakeel, Ali M.

    2015-01-01

    Learning computer programming is one of the main requirements of many educational study plans in higher education. Research has shown that many students face difficulties acquiring reasonable programming skills during their first year of college. In Saudi Arabia, there are twenty-three state-owned universities scattered around the country that…

  3. Could Specific Braille Reading Difficulties Result from Developmental Dyslexia?

    Science.gov (United States)

    Veispak, Anneli; Ghesquiere, Pol

    2010-01-01

    A proportion of children with visual impairments have specific reading difficulties that cannot be easily explained. This article reviews the data on problems with braille reading and interprets them from the framework of the temporal-processing deficit theory of developmental dyslexia.

  4. DIFFICULTIES TO LEARN AND TO TEACH MODERN PHYSICS.

    Directory of Open Access Journals (Sweden)

    R. Antonowiski

    2017-08-01

    Full Text Available Physics is engaged in scientific and technological development in several areas, however, its learning in high school has high failure rates that demonstrate a low level of use. It is a science that allows us to understand the nature of the macroscopic and atomic matter, but it is taught in a disjointed manner, upon presentation of concepts, laws and mathematical sentences, repetitive exercises that have taken the preparatory character for college entrance. Thus, the student gets stuck sentences featuring a partial knowledge and disposable. This study aimed to analyze the main difficulties that undergraduate students in Physics have in Modern Physics learning. Point out the difficulties in teaching and learning Physics is not an easy task and to identify them comes the difficulty of how to solve them. After analysis of several hypotheses we can conclude that there is no single factor responsible for the difficulty of the teaching and learning of Modern Physics. The lack of time to work and developed since middle school, stimulating the curiosity of students, adequately trained teachers, lack of structure offered by the government, parents' responsibilities and students in learning, among others, constitute a major challenge for successful teaching and learning of Modern Physics

  5. Assessing Human Impacts on the Greater Akaki River, Ethiopia ...

    African Journals Online (AJOL)

    We assessed the impacts of human activities on the Greater Akaki River using physicochemical parameters and macroinvertebrate metrics. Physicochemical samples and macroinvertebrates were collected bimonthly from eight sites established on the Greater Akaki River from February 2006 to April 2006. Eleven metrics ...

  6. Comparative Education in Greater China: Contexts, Characteristics, Contrasts and Contributions.

    Science.gov (United States)

    Bray, Mark; Qin, Gui

    2001-01-01

    The evolution of comparative education in Greater China (mainland China, Taiwan, Hong Kong, and Macau) has been influenced by size, culture, political ideologies, standard of living, and colonialism. Similarities and differences in conceptions of comparative education are identified among the four components and between Greater China and other…

  7. Greater temperature sensitivity of plant phenology at colder sites

    DEFF Research Database (Denmark)

    Prevey, Janet; Vellend, Mark; Ruger, Nadja

    2017-01-01

    Warmer temperatures are accelerating the phenology of organisms around the world. Temperature sensitivity of phenology might be greater in colder, higher latitude sites than in warmer regions, in part because small changes in temperature constitute greater relative changes in thermal balance...

  8. Breeding of Greater and Lesser Flamingos at Sua Pan, Botswana ...

    African Journals Online (AJOL)

    to fledging was unknown owing to the rapid drying of the pan in late March 1999. No Greater Flamingo breeding was seen that season. Exceptional flooding during 1999–2000 produced highly favourable breeding conditions, with numbers of Greater and Lesser Flamingos breeding estimated to be 23 869 and 64 287 pairs, ...

  9. Surgical anatomy of greater occipital nerve and its relation to ...

    African Journals Online (AJOL)

    Introduction: The knowledge of the anatomy of greater occipital nerve and its relation to occipital artery is important for the surgeon. Blockage or surgical release of greater occipital nerve is clinically effective in reducing or eliminating chronic migraine symptoms. Aim: The aim of this research was to study the anatomy of ...

  10. Surgical anatomy of greater occipital nerve and its relation to ...

    African Journals Online (AJOL)

    Nancy Mohamed El Sekily

    2014-08-19

    Aug 19, 2014 ... Abstract Introduction: The knowledge of the anatomy of greater occipital nerve and its relation to occipital artery is important for the surgeon. Blockage or surgical release of greater occipital nerve is clinically effective in reducing or eliminating chronic migraine symptoms. Aim: The aim of this research was to ...

  11. INDUSTRIAL LAND DEVELOPMENT AND MANUFACTURING DECONCENTRATION IN GREATER JAKARTA

    NARCIS (Netherlands)

    Hudalah, Delik; Viantari, Dimitra; Firman, Tommy; Woltjer, Johan

    2013-01-01

    Industrial land development has become a key feature of urbanization in Greater Jakarta, one of the largest metropolitan areas in Southeast Asia. Following Suharto's market-oriented policy measures in the late 1980s, private developers have dominated the land development projects in Greater Jakarta.

  12. Strategies for Talent Management: Greater Philadelphia Companies in Action

    Science.gov (United States)

    Council for Adult and Experiential Learning (NJ1), 2008

    2008-01-01

    Human capital is one of the critical issues that impacts the Greater Philadelphia region's ability to grow and prosper. The CEO Council for Growth (CEO Council) is committed to ensuring a steady and talented supply of quality workers for this region. "Strategies for Talent Management: Greater Philadelphia Companies in Action" provides…

  13. Identifying predictors of physics item difficulty: A linear regression approach

    Science.gov (United States)

    Mesic, Vanes; Muratovic, Hasnija

    2011-06-01

    Large-scale assessments of student achievement in physics are often approached with an intention to discriminate students based on the attained level of their physics competencies. Therefore, for purposes of test design, it is important that items display an acceptable discriminatory behavior. To that end, it is recommended to avoid extraordinary difficult and very easy items. Knowing the factors that influence physics item difficulty makes it possible to model the item difficulty even before the first pilot study is conducted. Thus, by identifying predictors of physics item difficulty, we can improve the test-design process. Furthermore, we get additional qualitative feedback regarding the basic aspects of student cognitive achievement in physics that are directly responsible for the obtained, quantitative test results. In this study, we conducted a secondary analysis of data that came from two large-scale assessments of student physics achievement at the end of compulsory education in Bosnia and Herzegovina. Foremost, we explored the concept of “physics competence” and performed a content analysis of 123 physics items that were included within the above-mentioned assessments. Thereafter, an item database was created. Items were described by variables which reflect some basic cognitive aspects of physics competence. For each of the assessments, Rasch item difficulties were calculated in separate analyses. In order to make the item difficulties from different assessments comparable, a virtual test equating procedure had to be implemented. Finally, a regression model of physics item difficulty was created. It has been shown that 61.2% of item difficulty variance can be explained by factors which reflect the automaticity, complexity, and modality of the knowledge structure that is relevant for generating the most probable correct solution, as well as by the divergence of required thinking and interference effects between intuitive and formal physics knowledge

  14. Identifying predictors of physics item difficulty: A linear regression approach

    Directory of Open Access Journals (Sweden)

    Hasnija Muratovic

    2011-06-01

    Full Text Available Large-scale assessments of student achievement in physics are often approached with an intention to discriminate students based on the attained level of their physics competencies. Therefore, for purposes of test design, it is important that items display an acceptable discriminatory behavior. To that end, it is recommended to avoid extraordinary difficult and very easy items. Knowing the factors that influence physics item difficulty makes it possible to model the item difficulty even before the first pilot study is conducted. Thus, by identifying predictors of physics item difficulty, we can improve the test-design process. Furthermore, we get additional qualitative feedback regarding the basic aspects of student cognitive achievement in physics that are directly responsible for the obtained, quantitative test results. In this study, we conducted a secondary analysis of data that came from two large-scale assessments of student physics achievement at the end of compulsory education in Bosnia and Herzegovina. Foremost, we explored the concept of “physics competence” and performed a content analysis of 123 physics items that were included within the above-mentioned assessments. Thereafter, an item database was created. Items were described by variables which reflect some basic cognitive aspects of physics competence. For each of the assessments, Rasch item difficulties were calculated in separate analyses. In order to make the item difficulties from different assessments comparable, a virtual test equating procedure had to be implemented. Finally, a regression model of physics item difficulty was created. It has been shown that 61.2% of item difficulty variance can be explained by factors which reflect the automaticity, complexity, and modality of the knowledge structure that is relevant for generating the most probable correct solution, as well as by the divergence of required thinking and interference effects between intuitive and formal

  15. Managing PBL difficulties in an industrial engineering and management program

    Directory of Open Access Journals (Sweden)

    Anabela Alves

    2016-08-01

    Full Text Available Purpose: Project-Based Learning (PBL is considered to be an active learning methodology which can be used to develop both technical and transversal competences in engineering programs. This methodology demands a great deal of work effort from the students and also from the teachers and it requires a meticulous plan and a well-managed project as well. These activities go far beyond the normal activities in traditional lectures, enabling to outpace the difficulties that spur along the way that may be both complex and demotivating. This methodology has been implemented in the Integrated Master Degree on Industrial Engineering and Management (IEM, at one public university in Portugal, since the 2004/2005 academic year. The aim of this paper is to identify and discuss the main difficulties of the implementation of PBL, mainly from the teachers’ perspectives. Additionally, some effective strategies will be recommended to overcome such difficulties. Design/methodology/approach: The perceptions of the teachers were collected through a survey based on six main themes. The participants in the study include eight teachers from the five courses of the first semester of the first year of the IEM program involved in the 2012/2013 and 2013/2014 editions. Findings: Integration of courses in the project; student assessment; growing number of students in each team and the need of physical spaces for them; and compartmentalized knowledge has emerged as the main difficulties. To overcome these difficulties some key strategies were recommended. Originality/value: A new perspective based on course teachers' views and experiences will deepen the understanding of the problems and provide inputs for the development of strategies that may improve the effectiveness of PBL and introduce changes for its successful implementation. These strategies are intended to be transferable to other contexts, as most of the problems and constraints are common to other active learning

  16. Managing PBL difficulties in an industrial engineering and management program

    International Nuclear Information System (INIS)

    Alves, A.; Sousa, R.; Moreira, F.; Carvalho, M.A.; Cardoso, E.; Pimenta, P.; Malheiro, T.; Brito, I.; Fernandes, S.; Mesquita, D.

    2016-01-01

    Project-Based Learning (PBL) is considered to be an active learning methodology which can be used to develop both technical and transversal competences in engineering programs. This methodology demands a great deal of work effort from the students and also from the teachers and it requires a meticulous plan and a well-managed project as well. These activities go far beyond the normal activities in traditional lectures, enabling to outpace the difficulties that spur along the way that may be both complex and demotivating. This methodology has been implemented in the Integrated Master Degree on Industrial Engineering and Management (IEM), at one public university in Portugal, since the 2004/2005 academic year. The aim of this paper is to identify and discuss the main difficulties of the implementation of PBL, mainly from the teachers’ perspectives. Additionally, some effective strategies will be recommended to overcome such difficulties. Design/methodology/approach: The perceptions of the teachers were collected through a survey based on six main themes. The participants in the study include eight teachers from the five courses of the first semester of the first year of the IEM program involved in the 2012/2013 and 2013/2014 editions. Findings: Integration of courses in the project; student assessment; growing number of students in each team and the need of physical spaces for them; and compartmentalized knowledge has emerged as the main difficulties. To overcome these difficulties some key strategies were recommended. Originality/value: A new perspective based on course teachers' views and experiences will deepen the understanding of the problems and provide inputs for the development of strategies that may improve the effectiveness of PBL and introduce changes for its successful implementation. These strategies are intended to be transferable to other contexts, as most of the problems and constraints are common to other active learning approaches. (Author)

  17. Managing PBL difficulties in an industrial engineering and management program

    Energy Technology Data Exchange (ETDEWEB)

    Alves, A.; Sousa, R.; Moreira, F.; Carvalho, M.A.; Cardoso, E.; Pimenta, P.; Malheiro, T.; Brito, I.; Fernandes, S.; Mesquita, D.

    2016-07-01

    Project-Based Learning (PBL) is considered to be an active learning methodology which can be used to develop both technical and transversal competences in engineering programs. This methodology demands a great deal of work effort from the students and also from the teachers and it requires a meticulous plan and a well-managed project as well. These activities go far beyond the normal activities in traditional lectures, enabling to outpace the difficulties that spur along the way that may be both complex and demotivating. This methodology has been implemented in the Integrated Master Degree on Industrial Engineering and Management (IEM), at one public university in Portugal, since the 2004/2005 academic year. The aim of this paper is to identify and discuss the main difficulties of the implementation of PBL, mainly from the teachers’ perspectives. Additionally, some effective strategies will be recommended to overcome such difficulties. Design/methodology/approach: The perceptions of the teachers were collected through a survey based on six main themes. The participants in the study include eight teachers from the five courses of the first semester of the first year of the IEM program involved in the 2012/2013 and 2013/2014 editions. Findings: Integration of courses in the project; student assessment; growing number of students in each team and the need of physical spaces for them; and compartmentalized knowledge has emerged as the main difficulties. To overcome these difficulties some key strategies were recommended. Originality/value: A new perspective based on course teachers' views and experiences will deepen the understanding of the problems and provide inputs for the development of strategies that may improve the effectiveness of PBL and introduce changes for its successful implementation. These strategies are intended to be transferable to other contexts, as most of the problems and constraints are common to other active learning approaches. (Author)

  18. Smoke-Free Medical Facility Campus Legislation: Support, Resistance, Difficulties and Cost

    Directory of Open Access Journals (Sweden)

    J. Gary Wheeler

    2009-01-01

    Full Text Available Although medical facilities restrict smoking inside, many people continue to smoke outside, creating problems with second-hand smoke, litter, fire risks, and negative role modeling. In 2005, Arkansas passed legislation prohibiting smoking on medical facility campuses. Hospital administrators (N=113 were surveyed pre- and post-implementation. Administrators reported more support and less difficulty than anticipated. Actual cost was 10-50% of anticipated cost. Few negative effects and numerous positive effects on employee performance and retention were reported. The results may be of interest to hospital administrators and demonstrate that state legislation can play a positive role in facilitating broad health-related policy change.

  19. Speech comprehension difficulties in chronic tinnitus and its relation to hyperacusis

    Directory of Open Access Journals (Sweden)

    Veronika Vielsmeier

    2016-12-01

    Full Text Available AbstractObjectiveMany tinnitus patients complain about difficulties regarding speech comprehension. In spite of the high clinical relevance little is known about underlying mechanisms and predisposing factors. Here, we performed an exploratory investigation in a large sample of tinnitus patients to (1 estimate the prevalence of speech comprehension difficulties among tinnitus patients, to (2 compare subjective reports of speech comprehension difficulties with objective measurements in a standardized speech comprehension test and to (3 explore underlying mechanisms by analyzing the relationship between speech comprehension difficulties and peripheral hearing function (pure tone audiogram, as well as with co-morbid hyperacusis as a central auditory processing disorder. Subjects and MethodsSpeech comprehension was assessed in 361 tinnitus patients presenting between 07/2012 and 08/2014 at the Interdisciplinary Tinnitus Clinic at the University of Regensburg. The assessment included standard audiological assessment (pure tone audiometry, tinnitus pitch and loudness matching, the Goettingen sentence test (in quiet for speech audiometric evaluation, two questions about hyperacusis, and two questions about speech comprehension in quiet and noisy environments (How would you rate your ability to understand speech?; How would you rate your ability to follow a conversation when multiple people are speaking simultaneously?. Results Subjectively reported speech comprehension deficits are frequent among tinnitus patients, especially in noisy environments (cocktail party situation. 74.2% of all investigated patients showed disturbed speech comprehension (indicated by values above 21.5 dB SPL in the Goettingen sentence test. Subjective speech comprehension complaints (both in general and in noisy environment were correlated with hearing level and with audiologically-assessed speech comprehension ability. In contrast, co-morbid hyperacusis was only correlated

  20. Investigating student difficulties on integral calculus based on critical thinking aspects

    Directory of Open Access Journals (Sweden)

    Farida Nursyahidah

    2017-11-01

    Full Text Available Students of Mathematics education often struggle with integration problem, but yet the root of the problem related to critical thinking is rarely investigated. This article reports research where the first-year students of Mathematics Education of PGRI University Semarang were given an integral problem, then individually they were interviewed related to the answer they have made. The findings of students' difficulties in working on integration problem were confirmed through several questions in the interview which aimed to uncover their critical thinking process related to concepts, procedures, and problem solving. This study shows that student difficulties in Integration by disc method such as failure in identifying radius of a rotary object, specify partition, and integration bounds are closely related to their failure to think critically related to concept, skills, and problem solving aspects of critical thinking.

  1. The influence of multiple sensory impairments on functional balance and difficulty with falls among U.S. adults.

    Science.gov (United States)

    Wilson, Samuel J; Garner, John C; Loprinzi, Paul D

    2016-06-01

    Studies have looked at the individual associations of sensory impairment on balance, but no population-based studies have examined their combined association on balance and difficulty with falls. Thus, the purpose of this study was to examine both the independent associations and combined associations of visual impairment, peripheral neuropathy, and self-reported hearing loss with the odds of reporting difficulty with falls and functional balance. Data from the 2003-2004 National Health and Nutrition Examination Survey were used. Vision and peripheral neuropathy were objectively measured, and hearing was self-reported. Balance testing consisted of a modified Romberg test. After exclusions, 1662 (40-85years of age) participants provided complete data on the study variables. Sensory impairment was associated with perceived difficulty of falls and functional balance. Participants who presented a single sensory impairment had 29% reduced odds of having functional balance (95% CI=0.54-0.93, p=0.01) and increased odds of reporting difficulty with falls by 61% (95% CI=0.99-2.60, p=0.05). Moreover, our multisensory models showed some evidence of a dose-response relationship, in that sensory impairment of multiple sensory systems was associated with worse balance (OR =0.59, CI=0.35-1.00, p=0.05) and perceived difficulty of falls (OR =5.02, 95% CI=1.99-12.66, p=0.002) when compared to those with less sensory impairment. Multiple sensory impairment is associated with significantly higher odds of both reporting difficulty with falls and balance dysfunction, which may lead to a subsequent fall, ultimately compromising the individual's health. Copyright © 2016 Elsevier Inc. All rights reserved.

  2. Association Between Chewing Difficulty and Symptoms of Depression in Adults: Results from the Korea National Health and Nutrition Examination Survey.

    Science.gov (United States)

    Shin, Hye-Sun; Ahn, Yong-Soon; Lim, Do-Seon

    2016-12-01

    To assess the association between chewing difficulty and symptoms of depression in a representative sample of the Korean population. Cross-sectional. Korea National Health and Nutrition Examination Survey (KNHANES). KNHANES participants (N = 5,158). Chewing difficulty was assessed according to the self-reported presence of chewing problems using a structured questionnaire. Symptoms of depression were defined as having feelings of sadness or depression consecutively over 2 weeks during the last 12 months. Multivariable logistic regression analysis was used to determine the adjusted odds ratios (AORs) and 95% confidence intervals (CIs) of the associations between chewing difficulty and symptoms of depression, adjusted for age; sex; monthly household income; education; number of teeth; number of decayed, missing, or filled permanent teeth; periodontitis; state of dentition; tooth brushing frequency; regular dental visits; smoking status; alcohol consumption; hypertension; diabetes mellitus; and obesity. The interaction effects between chewing difficulty and confounders were evaluated, and age- and sex-stratified analyses were performed. There was a significant positive association between chewing difficulty and symptoms of depression in the fully adjusted model (AOR = 1.86, 95% CI = 1.48-2.33). The strength of the association was highest in men aged 60 and older (AOR = 3.28, 95% CI = 1.54-7.00). Chewing difficulty was independently associated with symptoms of depression in a representative sample of Korean adults. © 2016, Copyright the Authors Journal compilation © 2016, The American Geriatrics Society.

  3. Childhood maltreatment severity and alcohol use in adult psychiatric inpatients: The mediating role of emotion regulation difficulties.

    Science.gov (United States)

    Dutcher, Christina D; Vujanovic, Anka A; Paulus, Daniel J; Bartlett, Brooke A

    2017-09-01

    Emotion regulation difficulties are a potentially key mechanism underlying the association between childhood maltreatment and alcohol use in adulthood. The current study examined the mediating role of emotion regulation difficulties in the association between childhood maltreatment severity (i.e., Childhood Trauma Questionnaire total score) and past-month alcohol use severity, including alcohol consumption frequency and alcohol-related problems (i.e., number of days of alcohol problems, ratings of "bother" caused by alcohol problems, ratings of treatment importance for alcohol problems). Participants included 111 acute-care psychiatric inpatients (45.0% female; Mage=33.5, SD=10.6), who reported at least one DSM-5 posttraumatic stress disorder Criterion A traumatic event, indexed via the Life Events Checklist for DSM-5. Participants completed questionnaires regarding childhood maltreatment, emotion regulation difficulties, and alcohol use. A significant indirect effect of childhood maltreatment severity via emotion regulation difficulties in relation to alcohol use severity (β=0.07, SE=0.04, 99% CI [0.01, 0.21]) was documented. Specifically, significant indirect effects were found for childhood maltreatment severity via emotion regulation difficulties in relation to alcohol problems (β's between 0.05 and 0.12; all 99% bootstrapped CIs with 10,000 resamples did not include 0) but not alcohol consumption. Emotion regulation difficulties may play a significant role in the association between childhood maltreatment severity and alcohol outcomes. Clinical implications are discussed. Copyright © 2017 Elsevier Inc. All rights reserved.

  4. Modular to Monoblock: Difficulties of Detaching the M(2)a-Magnum(TM) Head Are Common in Metal-on-metal Revisions.

    Science.gov (United States)

    Mäntymäki, Heikki; Mäkelä, Keijo T; Vahlberg, Tero; Hirviniemi, Joni; Niinimäki, Tuukka

    2016-09-01

    Modern hip implants typically feature modular heads, which allow for easy exchange and removal from the femoral stem at the time of revision. However, owing to fretting, corrosion, or cold welding, the modular head may be difficult or impossible to separate from the underlying trunnion, especially if the implant has titanium interfaces between the head and the stem. We have repeatedly encountered difficulty removing the titanium sleeve adapter in the M(2)a-Magnum(TM) implant. Although the manufacturer warns about this complication and cases with these difficulties have been reported to the United States FDA, we believed this topic is important to study, because the frequency of difficulties in head removal is unknown and the complications related to this event have not been characterized. We asked: (1) Do revisions of M(2)a-Magnum(TM) implants differ from those of M(2)a-38(TM) implants in terms of ease of removal of the femoral head? (2) In cases where difficulty with M(2)a-Magnum(TM) head removal occurred, was the operative time, bleeding, risk of periprosthetic fracture, or joint infection increased compared with cases where the M(2)a-Magnum(TM) head was removed without difficulties? Between 2004 and 2014, we revised 296 THAs with metal-on-metal implants that involved M(2)a-Magnum(TM) (123) or M(2)a-38(TM) heads (88); of those, 84 were planned to include a femoral stem revision and insufficient data were available for three operations, so they were excluded from this analysis, leaving 124 THAs in the current retrospective study (70 THAs with M(2)a-Magnum(TM) and 54 THAs with M(2)a-38(TM) heads).The method of modular head removal, any difficulties removing the femoral head from the trunnion, operation time, and complications were recorded based on chart review. All the observed problems of detaching the head or taper adapter were among M(2)a-Magnum(TM) heads; there were no problems detaching the head in revisions of the M(2)a-38(TM) implant. In 29% (20 of 70) of

  5. Interspecific nest parasitism by chukar on greater sage-grouse

    Science.gov (United States)

    Fearon, Michelle L.; Coates, Peter S.

    2014-01-01

    Nest parasitism occurs when a female bird lays eggs in the nest of another and the host incubates the eggs and may provide some form of parental care for the offspring (Lyon and Eadie 1991). Precocial birds (e.g., Galliformes and Anseriformes) are typically facultative nest parasites of both their own and other species (Lyon and Eadie 1991). This behavior increases a female’s reproductive success when she parasitizes other nests while simultaneously raising her own offspring. Both interspecific and conspecific nest parasitism have been well documented in several families of the order Galliformes, particularly the Phasianidae (Lyon and Eadie 1991, Geffen and Yom-Tov 2001, Krakauer and Kimball 2009). The Chukar (Alectoris chukar) has been widely introduced as a game bird to western North America from Eurasia and is now well established within the Great Basin from northeastern California east to Utah and north to Idaho and Oregon (Christensen 1996). Over much of this range the Chukar occurs with other phasianids, including the native Greater Sage-Grouse (Centrocercus urophasianus), within sagebrush (Artemisia spp.) steppe (Christensen 1996, Schroeder et al. 1999, Connelly et al. 2000). Chukar typically exploit a broader range of habitats than do sage-grouse, but both species use the same species of sagebrush and other shrubs for nesting cover (Christensen 1996, Schroeder et al. 1999). Chukar are known to parasitize nests of other individuals of their own species (Geffen and Yom-Tov 2001), but we are unaware of reported evidence that Chukar may parasitize nests of sage-grouse. Here we describe a case of a Chukar parasitizing a sage-grouse nest in the sagebrush steppe of western Nevada.

  6. Fractures of the greater trochanter following total hip replacement.

    Science.gov (United States)

    Brun, Ole-Christian L; Maansson, Lukas

    2013-01-01

    We studied the incidence of greater trochanteric fractures at our department following THR. In all we examined 911 patients retrospectively and found the occurance of a greater trochanteric fracture to be 3%. Patients with fractures had significantly poorer outcome on Oxford Hip score, Pain VAS, Satisfaction VAS and EQ-5D compared to THR without fractures. Greater trochanteric fracture following THR is one of the most common complications following THR. It has previously been thought to have little impact on the overall outcome following THR, but our study suggests otherwise.

  7. The outcome of endoscopy for recalcitrant greater trochanteric pain syndrome.

    Science.gov (United States)

    Drummond, James; Fary, Camdon; Tran, Phong

    2016-11-01

    Greater trochanteric pain syndrome (GTPS), previously referred as trochanteric bursitis, is a debilitating condition characterised by chronic lateral hip pain. The syndrome is thought to relate to gluteal tendinopathy, with most cases responding to non-operative treatment. A number of open and endoscopic surgical techniques targeting the iliotibial band, trochanteric bursa and gluteal tendons have, however, been described for severe recalcitrant cases. We report the outcomes of one such endoscopic approach here. We retrospectively reviewed 49 patients (57 operations) who had undergone endoscopic longitudinal vertical iliotibial band release and trochanteric bursectomy. Inclusion criteria included diagnosed GTPS with a minimum of six months of non-operative treatment. Exclusion criteria included concomitant intra- or extra-articular hip pathology and previous hip surgery including total hip arthroplasty. Outcomes were assessed using the Visual Analogue Scale, Oxford hip Score and International Hip Outcome Tool (iHOT-33). The series included 42 females and 7 males with a mean age of 65.0 years (26.7-88.6). Mean follow-up time was 20.7 months (5.3-41.2). Eight patients had full thickness gluteal tendon tears, of which 7 were repaired. Adjuvant PRP was injected intraoperatively in 38 of 57 operations (67.2 %). At follow-up, overall mean Visual Analogue Scale values had decreased from 7.8 to 2.8 (p < 0.001), Oxford hip Scores had increased from 20.4 to 37.3 (p < 0.001) and iHOT-33 scores had increased from 23.8 to 70.2 (p < 0.001). Of the 57 operations performed, patients reported feeling very satisfied with the surgical outcome in 28 operations (49.1 %), satisfied in 17 operations (29.8 %) and less than satisfied in 12 operations (21.1 %). While the majority of patients with GTPS will improve with non-operative management, endoscopic iliotibial band release, trochanteric bursectomy and gluteal tendon repair is a safe and effective treatment for severe

  8. Perception of difficulty and glucose control: Effects on academic performance in youth with type I diabetes.

    Science.gov (United States)

    Potts, Tiffany M; Nguyen, Jacqueline L; Ghai, Kanika; Li, Kathy; Perlmuter, Lawrence

    2015-04-15

    To investigate whether perceptions of task difficulty on neuropsychological tests predicted academic achievement after controlling for glucose levels and depression. Participants were type 1 diabetic adolescents, with a mean age = 12.5 years (23 females and 16 males), seen at a northwest suburban Chicago hospital. The sample population was free of co-morbid clinical health conditions. Subjects completed a three-part neuropsychological battery including the Digit Symbol Task, Trail Making Test, and Controlled Oral Word Association test. Following each task, individuals rated task difficulty and then completed a depression inventory. Performance on these three tests is reflective of neuropsychological status in relation to glucose control. Blood glucose levels were measured immediately prior to and after completing the neuropsychological battery using a glucose meter. HbA1c levels were obtained from medical records. Academic performance was based on self-reported grades in Math, Science, and English. Data was analyzed using multiple regression models to evaluate the associations between academic performance, perception of task difficulty, and glucose control. Perceptions of difficulty on a neuropsychological battery significantly predicted academic performance after accounting for glucose control and depression. Perceptions of difficulty on the neuropsychological tests were inversely correlated with academic performance (r = -0.48), while acute (blood glucose) and long-term glucose levels increased along with perceptions of task difficulty (r = 0.47). Additionally, higher depression scores were associated with poorer academic performance (r = -0.43). With the first regression analysis, perception of difficulty on the neuropsychological tasks contributed to 8% of the variance in academic performance after controlling for peripheral blood glucose and depression. In the second regression analysis, perception of difficulty accounted for 11% of the variance after

  9. Prey selection by a reintroduced lion population in the Greater ...

    African Journals Online (AJOL)

    Prey selection by a reintroduced lion population in the Greater Makalali Conservancy, South Africa. Dave Druce, Heleen Genis, Jonathan Braak, Sophie Greatwood, Audrey Delsink, Ross Kettles, Luke Hunter, Rob Slotow ...

  10. LiveDiverse: Case study area, Greater Kruger South Africa

    CSIR Research Space (South Africa)

    Nortje, Karen

    2011-01-01

    Full Text Available Livelihoods and Biodiversity in Developing Countries Case study area: Greater Kruger, South Africa January 2011 Kolhapur, India Where are we? HARDSHIP LIVELIHOODS NATURE & BIODIVERSITY BELIEFS & CULTURAL PRACTISE threesansinv foursansinv onesansinv...

  11. Exploration of the Energy Efficiency of the Greater London Authority ...

    African Journals Online (AJOL)

    GLA Building/City Hall) ... Journal Home > Vol 11, No 2 (2007) > ... The Greater London Authority building was acclaimed as being energy efficient, with claims of 75 % reduction in its annual energy consumption compared to a high specification ...

  12. Molecular insights into the biology of Greater Sage-Grouse

    Science.gov (United States)

    Oyler-McCance, Sara J.; Quinn, Thomas W.

    2011-01-01

    Recent research on Greater Sage-Grouse (Centrocercus urophasianus) genetics has revealed some important findings. First, multiple paternity in broods is more prevalent than previously thought, and leks do not comprise kin groups. Second, the Greater Sage-Grouse is genetically distinct from the congeneric Gunnison sage-grouse (C. minimus). Third, the Lyon-Mono population in the Mono Basin, spanning the border between Nevada and California, has unique genetic characteristics. Fourth, the previous delineation of western (C. u. phaios) and eastern Greater Sage-Grouse (C. u. urophasianus) is not supported genetically. Fifth, two isolated populations in Washington show indications that genetic diversity has been lost due to population declines and isolation. This chapter examines the use of molecular genetics to understand the biology of Greater Sage-Grouse for the conservation and management of this species and put it into the context of avian ecology based on selected molecular studies.

  13. GREATER OMENTUM: MORPHOFUNCTIONAL CHARACTERISTICS AND CLINICAL SIGNIFICANCE IN PEDIATRICS

    Directory of Open Access Journals (Sweden)

    A.V. Nekrutov

    2007-01-01

    Full Text Available The review analyzes the structure organization and pathophysiological age specificities of the greater omentum, which determine its uniqueness and functional diversity in a child's organism. the article discusses protective functions of the organ, its role in the development of post operative complications of children, and the usage in children's reconstructive plastic surgery.Key words: greater omentum, omentitis, of post operative complications, children.

  14. Working memory resources in young children with mathematical difficulties.

    Science.gov (United States)

    Kyttälä, Minna; Aunio, Pirjo; Hautamäki, Jarkko

    2010-02-01

    Working memory (WM) (Baddeley, 1986, 1997) is argued to be one of the most important cognitive resources underlying mathematical competence (Geary, 2004). Research has established close links between WM deficits and mathematical difficulties. This study investigated the possible deficits in WM, language and fluid intelligence that seem to characterize 4- to 6-year-old children with poor early mathematical skills before formal mathematics education. Children with early mathematical difficulties showed poor performance in both verbal and visuospatial WM tasks as well as on language tests and a fluid intelligence test indicating a thoroughly lower cognitive base. Poor WM performance was not moderated by fluid intelligence, but the extent of WM deficits was related to language skills. The educational implications are discussed.

  15. Research on Difficulty in Indonesia Students Learning Chinese Language

    Directory of Open Access Journals (Sweden)

    Lydia Anggreani

    2013-05-01

    Full Text Available Chinese has become the world’s second language. Each language has its own law, as is the Chinese. Indonesian students have difficulty in learning Chinese which are are not surprising. Every language has various characteristics, so do Chinese and Bahasa Indonesia. Article analyzes difficulties to learn Chinese, especially for Indonesian students, those are tone, grammar, sounds of “er hua” such as Alice retroflex. The respondents are 100 Indonesian students who are randomly selected for testing samples analyzed. Since there is no tone in Bahasa Indonesia, it makes a lot of Indonesian students in the learning process often appear in Chinese foreign accent phenomenon. This article expects to explore the problem by studying the formation of the causes and solutions. Indonesian students learning Chinese was designed to provide some teaching and learning strategies.

  16. The Affective Dimensions of Mathematical Difficulties in Schoolchildren

    Directory of Open Access Journals (Sweden)

    Morena Lebens

    2011-01-01

    Full Text Available Mathematical difficulties (MDs are frequently characterised by cognitive deficits such as ineffective problem solving strategies and a lack of computational fluency. The established literature indicates that mathematical achievement is not only a function of cognitive factors but it also points to the importance of affective factors for the development of mathematical achievement. In the light of this evidence, the exploration of children's affective responses towards mathematics becomes a central issue. Whereas previous studies tended to research affective motivational constructs such as self-efficacy in isolation from other related constructs, the literature suffers from a shortage of research on the relationship between different affective motivational variables and their impact on mathematical achievement in different age and achievement bands. The present paper aims to address this aim by employing a newly developed instrument to measure affective motivational variables. Overall, the present findings support the assumption that children of average ability are less influenced by affective factors than children with mathematical difficulties.

  17. Identification of children with reading difficulties: Cheap can be adequate

    DEFF Research Database (Denmark)

    Poulsen, Mads; Nielsen, Anne-Mette Veber

    Classification of reading difficulties: Cheap screening can be accurate Purpose: Three factors are important for identification of students in need of remedial instruction: accuracy, timeliness, and cost. The identification has to be accurate to be of any use, the identification has to be timely......, inexpensive testing. The present study investigated the classification accuracy of three screening models varying in timeliness and cost. Method: We compared the ROC statistics of three logistic models for predicting end of Grade 2 reading difficulties in a sample of 164 students: 1) an early, comprehensive...... model using a battery of Grade 0 tests, including phoneme awareness, rapid naming, and paired associate learning, 2) a late, comprehensive model adding reading measures from January of Grade 1, and 3) a late, inexpensive model using only group-administered reading measures from January of Grade 1...

  18. [Efficacy of decoding training for children with difficulty reading hiragana].

    Science.gov (United States)

    Uchiyama, Hitoshi; Tanaka, Daisuke; Seki, Ayumi; Wakamiya, Eiji; Hirasawa, Noriko; Iketani, Naotake; Kato, Ken; Koeda, Tatsuya

    2013-05-01

    The present study aimed to clarify the efficacy of decoding training focusing on the correspondence between written symbols and their readings for children with difficulty reading hiragana (Japanese syllabary). Thirty-five children with difficulty reading hiragana were selected from among 367 first-grade elementary school students using a reading aloud test and were then divided into intervention (n=15) and control (n=20) groups. The intervention comprised 5 minutes of decoding training each day for a period of 3 weeks using an original program on a personal computer. Reading time and number of reading errors in the reading aloud test were compared between the groups. The intervention group showed a significant shortening of reading time (F(1,33)=5.40, phiragana.

  19. Socio-economic considerations of cleaning Greater Vancouver's air

    International Nuclear Information System (INIS)

    2005-08-01

    Socio-economic considerations of better air quality on the Greater Vancouver population and economy were discussed. The purpose of the study was to provide socio-economic information to staff and stakeholders of the Greater Vancouver Regional District (GVRD) who are participating in an Air Quality Management Plan (AQMP) development process and the Sustainable Region Initiative (SRI) process. The study incorporated the following methodologies: identification and review of Canadian, American, and European quantitative socio-economic, cost-benefit, cost effectiveness, competitiveness and health analyses of changes in air quality and measures to improve air quality; interviews with industry representatives in Greater Vancouver on competitiveness impacts of air quality changes and ways to improve air quality; and a qualitative analysis and discussion of secondary quantitative information that identifies and evaluates socio-economic impacts arising from changes in Greater Vancouver air quality. The study concluded that for the Greater Vancouver area, the qualitative analysis of an improvement in Greater Vancouver air quality shows positive socio-economic outcomes, as high positive economic efficiency impacts are expected along with good social quality of life impacts. 149 refs., 30 tabs., 6 appendices

  20. Luck is Hard to Beat: The Difficulty of Sports Prediction

    OpenAIRE

    Aoki, Raquel YS; Assuncao, Renato M; de Melo, Pedro OS Vaz

    2017-01-01

    Predicting the outcome of sports events is a hard task. We quantify this difficulty with a coefficient that measures the distance between the observed final results of sports leagues and idealized perfectly balanced competitions in terms of skill. This indicates the relative presence of luck and skill. We collected and analyzed all games from 198 sports leagues comprising 1503 seasons from 84 countries of 4 different sports: basketball, soccer, volleyball and handball. We measured the competi...

  1. Player Modeling Using HOSVD towards Dynamic Difficulty Adjustment in Videogames

    OpenAIRE

    Anagnostou , Kostas; Maragoudakis , Manolis

    2012-01-01

    Part 3: Second International Workshop on Computational Intelligence in Software Engineering (CISE 2012); International audience; In this work, we propose and evaluate a Higher Order Singular Value Decomposition (HOSVD) of a tensor as a means to classify player behavior and adjust game difficulty dynamically. Applying this method to player data collected during a plethora of game sessions resulted in a reduction of the dimensionality of the classification problem and a robust classification of...

  2. An Educational Application of Online Games for Learning Difficulties

    OpenAIRE

    M. Margoudi; Z. Smyrnaiou

    2015-01-01

    The current paper presents the results of a conducted case study. During the past few years the number of children diagnosed with Learning Difficulties has drastically augmented and especially the cases of ADHD (Attention Deficit Hyperactivity Disorder). One of the core characteristics of ADHD is a deficit in working memory functions. The review of the literature indicates a plethora of educational software that aim at training and enhancing the working memory. Neverthele...

  3. Trajectories of older adults' hearing difficulties: examining the influence of health behaviors and social activity over 10 years.

    Science.gov (United States)

    Heine, Chyrisse; Browning, Colette; Cowlishaw, Sean; Kendig, Hal

    2013-10-01

    The aims of the present study were to describe the trajectories of self-reported hearing difficulties over time, and evaluate the impacts of age, sex, lifestyle factors and social activity, in explaining individual differences in patterns of change over time. As part of the Melbourne Longitudinal Studies on Healthy Aging (MELSHA) Program, the hearing status of 947 adults aged 65 years and older, across five measurement periods (over 10 years), were analyzed using Latent Growth Curve Modeling analysis. A multidimensional survey was also administered, which included questions relating to sociodemographic variables, self-reported hearing difficulties, nutrition, smoking habits and level of social activity. Although there was a general increase in hearing difficulties over time, older age, poor nutrition, a lifetime of smoking and increased social activity predicted more rapid increases in hearing difficulty over time. Findings support the importance of lifestyle factors in reducing the rate of perceived hearing difficulties in older people, and provide further evidence of the links between lifestyle and sensory loss in older people. Poor nutrition and smoking are areas that both clinicians and public health professionals should address in their work with older people. © 2013 Japan Geriatrics Society.

  4. Maternal abuse history and self-regulation difficulties in preadolescence.

    Science.gov (United States)

    Delker, Brianna C; Noll, Laura K; Kim, Hyoun K; Fisher, Philip A

    2014-12-01

    Although poor parenting is known to be closely linked to self-regulation difficulties in early childhood, comparatively little is understood about the role of other risk factors in the early caregiving environment (such as a parent's own experiences of childhood abuse) in developmental pathways of self-regulation into adolescence. Using a longitudinal design, this study aimed to examine how a mother's history of abuse in childhood relates to her offspring's self-regulation difficulties in preadolescence. Maternal controlling parenting and exposure to intimate partner aggression in the child's first 24-36 months were examined as important early social and environmental influences that may explain the proposed connection between maternal abuse history and preadolescent self-regulation. An ethnically diverse sample of mothers (N=488) who were identified as at-risk for child maltreatment was recruited at the time of their children's birth. Mothers and their children were assessed annually from the child's birth through 36 months, and at age 9-11 years. Structural equation modeling and bootstrap tests of indirect effects were conducted to address the study aims. Findings indicated that maternal abuse history indirectly predicted their children's self-regulation difficulties in preadolescence mainly through maternal controlling parenting in early childhood, but not through maternal exposure to aggression by an intimate partner. Maternal history of childhood abuse and maternal controlling parenting in her child's early life may have long-term developmental implications for child self-regulation. Copyright © 2014 Elsevier Ltd. All rights reserved.

  5. Reading Comprehension Difficulties in Chinese-English Bilingual Children.

    Science.gov (United States)

    Tong, Xiuhong; McBride, Catherine; Shu, Hua; Ho, Connie Suk-Han

    2018-02-01

    The co-occurrence of reading comprehension difficulties for first language (L1) Chinese and second language (L2) English and associated longitudinal cognitive-linguistic correlates in each language were investigated. Sixteen poor comprehenders in English and 16 poor comprehenders in Chinese, 18 poor readers in both, and 18 children with normal performance in both were identified at age 10. The prevalence rate for being poor in both was 52.94%, suggesting that approximately half of children who are at risk for Chinese reading comprehension difficulty are also at risk for English reading comprehension difficulty. Chinese word reading, phonological, and morphological awareness were longitudinal correlates of poor comprehension in Chinese. English word reading and vocabulary were longitudinal correlates of poor comprehension in English. Chinese phonological awareness was an additional correlate of poor comprehension in English. Moreover, poor comprehenders in both Chinese and English showed slower rapid automatized naming scores than the other groups. Findings highlight some factors that might be critical for reading comprehension in L1 Chinese and L2 English; fluency is likely to be a critical part of reading comprehension across languages. Copyright © 2017 John Wiley & Sons, Ltd. Copyright © 2017 John Wiley & Sons, Ltd.

  6. Upper-division student difficulties with the Dirac delta function

    Directory of Open Access Journals (Sweden)

    Bethany R. Wilcox

    2015-03-01

    Full Text Available The Dirac delta function is a standard mathematical tool that appears repeatedly in the undergraduate physics curriculum in multiple topical areas including electrostatics, and quantum mechanics. While Dirac delta functions are often introduced in order to simplify a problem mathematically, students still struggle to manipulate and interpret them. To characterize student difficulties with the delta function at the upper-division level, we examined students’ responses to traditional exam questions and a standardized conceptual assessment, and conducted think-aloud interviews. Our analysis was guided by an analytical framework that focuses on how students activate, construct, execute, and reflect on the Dirac delta function in the context of problem solving in physics. Here, we focus on student difficulties using the delta function to express charge distributions in the context of junior-level electrostatics. Common challenges included invoking the delta function spontaneously, translating a description of a charge distribution into a mathematical expression using delta functions, integrating 3D or non-Cartesian delta function expressions, and recognizing that the delta function can have units. We also briefly discuss implications of these difficulties for instruction.

  7. 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.

  8. The curation of genetic variants: difficulties and possible solutions.

    Science.gov (United States)

    Pandey, Kapil Raj; Maden, Narendra; Poudel, Barsha; Pradhananga, Sailendra; Sharma, Amit Kumar

    2012-12-01

    The curation of genetic variants from biomedical articles is required for various clinical and research purposes. Nowadays, establishment of variant databases that include overall information about variants is becoming quite popular. These databases have immense utility, serving as a user-friendly information storehouse of variants for information seekers. While manual curation is the gold standard method for curation of variants, it can turn out to be time-consuming on a large scale thus necessitating the need for automation. Curation of variants described in biomedical literature may not be straightforward mainly due to various nomenclature and expression issues. Though current trends in paper writing on variants is inclined to the standard nomenclature such that variants can easily be retrieved, we have a massive store of variants in the literature that are present as non-standard names and the online search engines that are predominantly used may not be capable of finding them. For effective curation of variants, knowledge about the overall process of curation, nature and types of difficulties in curation, and ways to tackle the difficulties during the task are crucial. Only by effective curation, can variants be correctly interpreted. This paper presents the process and difficulties of curation of genetic variants with possible solutions and suggestions from our work experience in the field including literature support. The paper also highlights aspects of interpretation of genetic variants and the importance of writing papers on variants following standard and retrievable methods. Copyright © 2012. Published by Elsevier Ltd.

  9. 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.

  10. Effects of Stress and Task Difficulty on Working Memory and Cortical Networking.

    Science.gov (United States)

    Kim, Yujin; Woo, Jihwan; Woo, Minjung

    2017-12-01

    This study investigated interactive effects of stress and task difficulty on working memory and cortico-cortical communication during memory encoding. Thirty-eight adolescent participants (mean age of 15.7 ± 1.5 years) completed easy and hard working memory tasks under low- and high-stress conditions. We analyzed the accuracy and reaction time (RT) of working memory performance and inter- and intrahemispheric electroencephalogram coherences during memory encoding. Working memory accuracy was higher, and RT shorter, in the easy versus the hard task. RT was shorter under the high-stress (TENS) versus low-stress (no-TENS) condition, while there was no difference in memory accuracy between the two stress conditions. For electroencephalogram coherence, we found higher interhemispheric coherence in all bands but only at frontal electrode sites in the easy versus the hard task. On the other hand, intrahemispheric coherence was higher in the left hemisphere in the easy (versus hard task) and higher in the right hemisphere (with one exception) in the hard (versus easy task). Inter- and intracoherences were higher in the low- versus high-stress condition. Significant interactions between task difficulty and stress condition were observed in coherences of the beta frequency band. The difference in coherence between low- and high-stress conditions was greater in the hard compared with the easy task, with lower coherence under the high-stress condition relative to the low-stress condition. Stress seemed to cause a decrease in cortical network communications between memory-relevant cortical areas as task difficulty increased.

  11. The Relationship between Older Adults' Risk for a Future Fall and Difficulty Performing Activities of Daily Living.

    Science.gov (United States)

    Mamikonian-Zarpas, Ani; Laganá, Luciana

    2015-12-01

    Functional status is often defined by cumulative scores across indices of independence in performing basic and instrumental activities of daily living (ADL/IADL), but little is known about the unique relationship of each daily activity item with the fall outcome. The purpose of this retrospective study was to examine the level of relative risk for a future fall associated with difficulty with performing various tasks of normal daily functioning among older adults who had fallen at least once in the past 12 months. The sample was comprised of community-dwelling individuals 70 years and older from the 1984-1990 Longitudinal Study of Aging by Kovar, Fitti, and Chyba (1992). Risk analysis was performed on individual items quantifying 6 ADLs and 7 IADLs, as well as 10 items related to mobility limitations. Within a subsample of 1,675 older adults with a history of at least one fall within the past year, the responses of individuals who reported multiple falls were compared to the responses of participants who had a single fall and reported 1) difficulty with walking and/or balance (FRAIL group, n = 413) vs. 2) no difficulty with walking or dizziness (NDW+ND group, n = 415). The items that had the strongest relationships and highest risk ratios for the FRAIL group (which had the highest probabilities for a future fall) included difficulty with: eating (73%); managing money (70%); biting or chewing food (66%); walking a quarter of a mile (65%); using fingers to grasp (65%); and dressing without help (65%). For the NDW+ND group, the most noteworthy items included difficulty with: bathing or showering (79%); managing money (77%); shopping for personal items (75%); walking up 10 steps without rest (72%); difficulty with walking a quarter of a mile (72%); and stooping/crouching/kneeling (70%). These findings suggest that individual items quantifying specific ADLs and IADLs have substantive relationships with the fall outcome among older adults who have difficulty with walking

  12. The Relationship between Older Adults’ Risk for a Future Fall and Difficulty Performing Activities of Daily Living

    Science.gov (United States)

    Mamikonian-Zarpas, Ani; Laganá, Luciana

    2016-01-01

    Functional status is often defined by cumulative scores across indices of independence in performing basic and instrumental activities of daily living (ADL/IADL), but little is known about the unique relationship of each daily activity item with the fall outcome. The purpose of this retrospective study was to examine the level of relative risk for a future fall associated with difficulty with performing various tasks of normal daily functioning among older adults who had fallen at least once in the past 12 months. The sample was comprised of community-dwelling individuals 70 years and older from the 1984–1990 Longitudinal Study of Aging by Kovar, Fitti, and Chyba (1992). Risk analysis was performed on individual items quantifying 6 ADLs and 7 IADLs, as well as 10 items related to mobility limitations. Within a subsample of 1,675 older adults with a history of at least one fall within the past year, the responses of individuals who reported multiple falls were compared to the responses of participants who had a single fall and reported 1) difficulty with walking and/or balance (FRAIL group, n = 413) vs. 2) no difficulty with walking or dizziness (NDW+ND group, n = 415). The items that had the strongest relationships and highest risk ratios for the FRAIL group (which had the highest probabilities for a future fall) included difficulty with: eating (73%); managing money (70%); biting or chewing food (66%); walking a quarter of a mile (65%); using fingers to grasp (65%); and dressing without help (65%). For the NDW+ND group, the most noteworthy items included difficulty with: bathing or showering (79%); managing money (77%); shopping for personal items (75%); walking up 10 steps without rest (72%); difficulty with walking a quarter of a mile (72%); and stooping/crouching/kneeling (70%). These findings suggest that individual items quantifying specific ADLs and IADLs have substantive relationships with the fall outcome among older adults who have difficulty with

  13. Criteria and technical concept for demonstrating greater confinement disposal of radioactive wastes at Arid Western Sites

    International Nuclear Information System (INIS)

    Hunter, P.H.

    1981-01-01

    This report summarizes the work of two documents; the Criteria for Greater Confinement of Radioactive Wastes at Arid Western Sites, NVO-234, March 1981, (within this report, referred to as the GCDF Criteria Document); and the Draft Technical Concept for a Test of Greater Confinement Disposal of Radioactive Waste in Unsaturated Media at the Nevada Test Site, FBDU-343-004, June 1981, (referred within this report as the Technical Concept for the GCDF). For the past two years, Ford, Bacon and Davis has been performing technical services for the Department of Energy at the Nevada Test Site in development of defense low-level waste management concepts, including the greater confinement disposal concept with particular application to arid sites. The investigations have included the development of Criteria for Greater Confinement Disposal, NVO-234, which we published in May of this year; then the draft for the technical concept for greater confinement disposal, published in June; leading up to the point where we are now. The final technical concept and design specifications should be published imminently. The document is prerequisite to the actual construction and implementation of the demonstration facility this fiscal year

  14. 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.

  15. Identifying and addressing specific student difficulties in advanced thermal physics

    Science.gov (United States)

    Smith, Trevor I.

    As part of an ongoing multi-university research study on student understanding of concepts in thermal physics at the upper division, I identified several student difficulties with topics related to heat engines (especially the Carnot cycle), as well as difficulties related to the Boltzmann factor. In an effort to address these difficulties, I developed two guided-inquiry worksheet activities (a.k.a. tutorials) for use in advanced undergraduate thermal physics courses. Both tutorials seek to improve student understanding of the utility and physical background of a particular mathematical expression. One tutorial focuses on a derivation of Carnot's theorem regarding the limit on thermodynamic efficiency, starting from the Second Law of Thermodynamics. The other tutorial helps students gain an appreciation for the origin of the Boltzmann factor and when it is applicable; focusing on the physical justification of its mathematical derivation, with emphasis on the connections between probability, multiplicity, entropy, and energy. Student understanding of the use and physical implications of Carnot's theorem and the Boltzmann factor was assessed using written surveys both before and after tutorial instruction within the advanced thermal physics courses at the University of Maine and at other institutions. Classroom tutorial sessions at the University of Maine were videotaped to allow in-depth scrutiny of student successes and failures following tutorial prompts. I also interviewed students on various topics related to the Boltzmann factor to gain a more complete picture of their understanding and inform tutorial revisions. Results from several implementations of my tutorials at the University of Maine indicate that students did not have a robust understanding of these physical principles after lectures alone, and that they gain a better understanding of relevant topics after tutorial instruction; Fisher's exact tests yield statistically significant improvement at the

  16. Improving greater trochanteric reattachment with a novel cable plate system.

    Science.gov (United States)

    Baril, Yannick; Bourgeois, Yan; Brailovski, Vladimir; Duke, Kajsa; Laflamme, G Yves; Petit, Yvan

    2013-03-01

    Cable-grip systems are commonly used for greater trochanteric reattachment because they have provided the best fixation performance to date, even though they have a rather high complication rate. A novel reattachment system is proposed with the aim of improving fixation stability. It consists of a Y-shaped fixation plate combined with locking screws and superelastic cables to reduce cable loosening and limit greater trochanter movement. The novel system is compared with a commercially available reattachment system in terms of greater trochanter movement and cable tensions under different greater trochanteric abductor application angles. A factorial design of experiments was used including four independent variables: plate system, cable type, abductor application angle, and femur model. The test procedure included 50 cycles of simultaneous application of an abductor force on the greater trochanter and a hip force on the femoral head. The novel plate reduces the movements of a greater trochanter fragment within a single loading cycle up to 26%. Permanent degradation of the fixation (accumulated movement based on 50-cycle testing) is reduced up to 46%. The use of superelastic cables reduces tension loosening up to 24%. However this last improvement did not result in a significant reduction of the grater trochanter movement. The novel plate and cables present advantages over the commercially available greater trochanter reattachment system. The plate reduces movements generated by the hip abductor. The superelastic cables reduce cable loosening during cycling. Both of these positive effects could decrease the risks related to grater trochanter non-union. Copyright © 2012 IPEM. Published by Elsevier Ltd. All rights reserved.

  17. IMPAIRED FERTILITY AND PERCEIVED DIFFICULTIES CONCEIVING IN GHANA: MEASUREMENT PROBLEMS AND PROSPECTS.

    Science.gov (United States)

    Fledderjohann, Jasmine; Johnson, David R

    2016-08-01

    What is the most appropriate measure of impaired fertility for understanding its social consequences in sub-Saharan Africa? The dearth of subjective measures in surveys in the region has prevented comparisons of subjective and objective measures. Perceived difficulties conceiving may have a greater impact than objective measures for social outcomes such as divorce, stigmatization and distress. This study compares 12- (clinical) and 24- (epidemiological) month measures from biomedicine and 5- and 7-year measures from demography with a subjective measure of impaired fertility using correlations, random effects models and test-retest models to assess relationships between measures, their association with sociodemographic characteristics and the stability of measures across time. Secondary panel data (1998-2004) from 1350 Ghanaian women aged 15-49 of all marital statuses are used. Longer waiting times to identification of impaired fertility required by demographic measures result in more stable measures, but perceived difficulties conceiving are most closely aligned with clinical infertility (r=0.61; pconceiving and self-identified infertility to assess which is most valid; in order to accomplish this, it is imperative that subjective measures of infertility be included in social surveys in sub-Saharan Africa.

  18. Difficulty identifying feelings and automatic activation in the fusiform gyrus in response to facial emotion.

    Science.gov (United States)

    Eichmann, Mischa; Kugel, Harald; Suslow, Thomas

    2008-12-01

    Difficulties in identifying and differentiating one's emotions are a central characteristic of alexithymia. In the present study, automatic activation of the fusiform gyrus to facial emotion was investigated as a function of alexithymia as assessed by the 20-item Toronto Alexithymia Scale. During 3 Tesla fMRI scanning, pictures of faces bearing sad, happy, and neutral expressions masked by neutral faces were presented to 22 healthy adults who also responded to the Toronto Alexithymia Scale. The fusiform gyrus was selected as the region of interest, and voxel values of this region were extracted, summarized as means, and tested among the different conditions (sad, happy, and neutral faces). Masked sad facial emotions were associated with greater bilateral activation of the fusiform gyrus than masked neutral faces. The subscale, Difficulty Identifying Feelings, was negatively correlated with the neural response of the fusiform gyrus to masked sad faces. The correlation results suggest that automatic hyporesponsiveness of the fusiform gyrus to negative emotion stimuli may reflect problems in recognizing one's emotions in everyday life.

  19. The Effects of a Social and Talent Development Intervention for High Ability Youth with Social Skill Difficulties

    Science.gov (United States)

    Foley-Nicpon, Megan; Assouline, Susan G.; Kivlighan, D. Martin; Fosenburg, Staci; Cederberg, Charles; Nanji, Michelle

    2017-01-01

    Contemporary models highlight the need to cultivate cognitive and psychosocial factors in developing domain-specific talent. This model was the basis for the current study where high ability youth with self-reported social difficulties (n = 28, 12 with a coexisting disability) participated in a social skills and talent development intervention…

  20. Between-Word Processes in Children with Speech Difficulties: Insights from a Usage-Based Approach to Phonology

    Science.gov (United States)

    Newton, Caroline

    2012-01-01

    There are some children with speech and/or language difficulties who are significantly more difficult to understand in connected speech than in single words. The study reported here explores the between-word behaviours of three such children, aged 11;8, 12;2 and 12;10. It focuses on whether these patterns could be accounted for by lenition, as…