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Sample records for strengthen quality early

  1. Strengthening Parents and Families during the Early Childhood Years.

    Science.gov (United States)

    Swick, Kevin J.

    This book provides early childhood educators with perspectives and tools that will enable them to strengthen parents and families during the child's earliest year of development. The 25 chapters are divided into 6 parts or themes. Part one focuses on understanding families as learners from an ecological and empathetic perspective, with the premise…

  2. Impact of a quality improvement project to strengthen infection ...

    African Journals Online (AJOL)

    Impact of a quality improvement project to strengthen infection prevention and control training at rural healthcare facilities. ... African Journal of Health Professions Education. Journal Home · ABOUT THIS JOURNAL · Advanced Search ...

  3. Correspondence: Strengthening capacity, collaboration and quality ...

    African Journals Online (AJOL)

    Developing countries bear 90% of the global disease burden, but only access about 10% of globally available health research funding. Weak south–south networking hampers effective use of limited resources, production of critical mass of quality scientists, career opportunities and incentives to retain the few available ...

  4. The Strengthening Families Initiative and Child Care Quality Improvement: How Strengthening Families Influenced Change in Child Care Programs in One State

    Science.gov (United States)

    Douglass, Anne; Klerman, Lorraine

    2012-01-01

    Research Findings: This study investigated how the Strengthening Families through Early Care and Education initiative in Illinois (SFI) influenced change in 4 child care programs. Findings indicate that SFI influenced quality improvements through 4 primary pathways: (a) Learning Networks, (b) the quality of training, (c) the engagement of program…

  5. Strengthening systems for integrated early childhood development services: a cross-national analysis of governance.

    Science.gov (United States)

    Britto, Pia Rebello; Yoshikawa, Hirokazu; van Ravens, Jan; Ponguta, Liliana Angelica; Reyes, Maria; Oh, Soojin; Dimaya, Roland; Nieto, Ana María; Seder, Richard

    2014-01-01

    While there has been substantial growth in early childhood development (ECD) services in low- and middle-income countries (LMICs), there is considerable inequity in their distribution and quality. Evidence-based governance strategies are necessary, but currently they are insufficient for widespread, quality implementation. In particular, there is a limited understanding of the use of systems approaches for the analysis of ECD services as they go to scale. The aim of this paper is to present findings from four countries, using a cross-national case study approach to explore governance mechanisms required to strengthen national systems of ECD services. While different sets of governance strategies and challenges were identified in each country, overarching themes also emerged with implications for systems strengthening. Study results focus on local, mid-level and central governance, with recommendations for effective coordination and the integration of ECD services in LMICs. © 2014 New York Academy of Sciences.

  6. Laboratory system strengthening and quality improvement in Ethiopia

    Directory of Open Access Journals (Sweden)

    Tilahun M. Hiwotu

    2014-11-01

    Full Text Available Background: In 2010, a National Laboratory Strategic Plan was set forth in Ethiopia to strengthen laboratory quality systems and set the stage for laboratory accreditation. As a result, the Strengthening Laboratory Management Toward Accreditation (SLMTA programme was initiated in 45 Ethiopian laboratories. Objectives: This article discusses the implementation of the programme, the findings from the evaluation process and key challenges. Methods: The 45 laboratories were divided into two consecutive cohorts and staff from each laboratory participated in SLMTA training and improvement projects. The average amount of supportive supervision conducted in the laboratories was 68 hours for cohort I and two hoursfor cohort II. Baseline and exit audits were conducted in 44 of the laboratories and percent compliance was determined using a checklist with scores divided into zero- to five-star ratinglevels. Results: Improvements, ranging from < 1 to 51 percentage points, were noted in 42 laboratories, whilst decreases were recorded in two. The average scores at the baseline and exit audits were 40% and 58% for cohort I (p < 0.01; and 42% and 53% for cohort II (p < 0.01,respectively. The p-value for difference between cohorts was 0.07. At the exit audit, 61% ofthe first and 48% of the second cohort laboratories achieved an increase in star rating. Poor awareness, lack of harmonisation with other facility activities and the absence of a quality manual were challenges identified. Conclusion: Improvements resulting from SLMTA implementation are encouraging. Continuous advocacy at all levels of the health system is needed to ensure involvement of stakeholders and integration with other improvement initiatives and routine activities.

  7. Strengthening the regulatory system through the implementation and use of a quality management system

    Directory of Open Access Journals (Sweden)

    Reinhold Eisner

    2017-04-01

    Full Text Available ABSTRACT Quality management systems (QMS, based on ISO 9001 requirements, are applicable to government service organizations such as Health Canada’s Biologics and Genetic Therapies Directorate (BGTD. This communication presents the process that the BGTD followed since the early 2000s to implement a quality management system and describes how the regulatory system was improved as a result of this project. BGTD undertook the implementation of a quality management system based on ISO 9001 and containing aspects of ISO 17025 with the goal of strengthening the regulatory system through improvements in the people, processes, and services of the organization. We discuss the strategy used by BGTD to implement the QMS and the benefits that were realized from the various stages of implementation. The eight quality principals upon which the QMS standards of the ISO 9000 series are based were used by senior management as a framework to guide QMS implementation.

  8. Developing a customised approach for strengthening tuberculosis laboratory quality management systems toward accreditation

    Directory of Open Access Journals (Sweden)

    Heidi Albert

    2017-03-01

    Full Text Available Background: Quality-assured tuberculosis laboratory services are critical to achieve global and national goals for tuberculosis prevention and care. Implementation of a quality management system (QMS in laboratories leads to improved quality of diagnostic tests and better patient care. The Strengthening Laboratory Management Toward Accreditation (SLMTA programme has led to measurable improvements in the QMS of clinical laboratories. However, progress in tuberculosis laboratories has been slower, which may be attributed to the need for a structured tuberculosis-specific approach to implementing QMS. We describe the development and early implementation of the Strengthening Tuberculosis Laboratory Management Toward Accreditation (TB SLMTA programme. Development: The TB SLMTA curriculum was developed by customizing the SLMTA curriculum to include specific tools, job aids and supplementary materials specific to the tuberculosis laboratory. The TB SLMTA Harmonized Checklist was developed from the World Health Organisation Regional Office for Africa Stepwise Laboratory Quality Improvement Process Towards Accreditation checklist, and incorporated tuberculosis-specific requirements from the Global Laboratory Initiative Stepwise Process Towards Tuberculosis Laboratory Accreditation online tool. Implementation: Four regional training-of-trainers workshops have been conducted since 2013. The TB SLMTA programme has been rolled out in 37 tuberculosis laboratories in 10 countries using the Workshop approach in 32 laboratories in five countries and the Facility based approach in five tuberculosis laboratories in five countries. Conclusion: Lessons learnt from early implementation of TB SLMTA suggest that a structured training and mentoring programme can build a foundation towards further quality improvement in tuberculosis laboratories. Structured mentoring, and institutionalisation of QMS into country programmes, is needed to support tuberculosis laboratories

  9. Quality practice and customer value:strengthening the ideal linkage

    OpenAIRE

    Lilja, Johan

    2005-01-01

    Quality management is continuously evolving and the progression so far is frequently described in terms of four stages. According to these descriptions, Total Quality Management (TQM) constitutes the currently highest level, or fourth stage, of quality management. Despite the divergence of views on what constitutes TQM, it is commonly described as a number of diverse activities, here designated as quality practice, performed to display and embody a certain set of values. One of these values, ...

  10. Strengthening Laboratory Capacity for Early Warning Alert and Response System (EWARS) in Indonesia

    OpenAIRE

    Kandel, Nirmal; Hapsari, Ratna Budi; Riana, Dyah Armi; Setiawaty, Vivi; Larasati, Wita; Wulandari, Endang; Purwanto, Edy

    2017-01-01

    Background: Establishment of Early Warning Alert and Response System (EWARS) in Indonesia was initiated since 2009 in few selected provinces and government was planning to roll out in other provinces. Before initiating this roll out the assessment of performance of EWARS in 2012 was conducted. The aim of the assessment is to strengthen laboratory for supporting to EWARS for alerts testing. Methods: Laboratory capacity mapping tool and laboratory algorithm for twenty two priority diseases of ...

  11. Exercise and Quality of Life: Strengthening the Connections

    OpenAIRE

    Hacker, Eileen

    2009-01-01

    Exercise improves quality of life (QOL) in people with cancer. Most oncology healthcare providers recognize the statement to be true because the research literature provides strong support for the physical and psychological benefits of exercise. Because the terms exercise, QOL, and people with cancer have different meanings, the contextual connections in which they are used are important to understanding the relationship between exercise and QOL in people with cancer. This article explores th...

  12. Exercise and quality of life: strengthening the connections.

    Science.gov (United States)

    Hacker, Eileen

    2009-02-01

    Exercise improves quality of life (QOL) in people with cancer. Most oncology healthcare providers recognize the statement to be true because the research literature provides strong support for the physical and psychological benefits of exercise. Because the terms exercise, QOL, and people with cancer have different meanings, the contextual connections in which they are used are important to understanding the relationship between exercise and QOL in people with cancer. This article explores the links between exercise and QOL in people with cancer and examines issues that impact the development, implementation, and evaluation of exercise programs for people with cancer. Issues related to exercise goal development, exercise prescription, exercise testing, exercise adherence, and methods to evaluate the efficacy of exercise in relation to QOL are discussed.

  13. Effects of the bilateral isokinetic strengthening training on functional parameters, gait, and the quality of life in patients with stroke

    OpenAIRE

    Büyükvural Şen, Sıdıka; Özbudak Demir, Sibel; Ekiz, Timur; Özgirgin, Neşe

    2015-01-01

    Objective: To evaluate the effects of the bilateral isokinetic strengthening training applied to knee and ankle muscles on balance, functional parameters, gait, and the quality of in stroke patients. Methods: Fifty patients (33 M, 17 F) with subacute-chronic stroke and 30 healthy subjects were included. Stroke patients were allocated into isokinetic and control groups. Conventional rehabilitation program was applied to all cases; additionally maximal concentric isokinetic strengthening traini...

  14. The economic impact of strengthening fuel quality regulation-reducing sulfur content in diesel fuel

    International Nuclear Information System (INIS)

    Chang, H.J.; Cho, G.L.; Kim, Y.D.

    2006-01-01

    This paper investigates the impact of strengthening vehicle emission regulation on economic activities. The government attempts to use three regulation measures to protect air quality from transportation emission. The measures include the aggregate limit (bubbles), the vehicle emission standard, and the fuel quality standard. Especially, we focus on the economic impact of reducing sulfur content in diesel fuel quality standard. Sulfur content in diesel fuel is one of the main factors in worsening local air quality. The emission from diesel vehicle accounts for 51.8% of total vehicle emission in Korea. If sulfur content reduction regulation is implemented, then the petroleum industry should build more facility to produce low sulfur content diesel, leading to additional production costs and increasing prices and decreasing outputs. We use computable general equilibrium model to analyze how the sulfur reduction regulation affects economic activities and trace out local emission reduction cost and GDP loss. And we suggest the tax-recycling mechanism to mitigate the negative economic costs due to the sulfur reduction regulation

  15. Antenatal care strengthening for improved quality of care in Jimma, Ethiopia: an effectiveness study.

    Science.gov (United States)

    Villadsen, Sarah Fredsted; Negussie, Dereje; GebreMariam, Abebe; Tilahun, Abebech; Friis, Henrik; Rasch, Vibeke

    2015-04-11

    Interventions for curing most diseases and save lives of pregnant and delivering women exist, yet the power of health systems to deliver them to those in most need is not sufficient. The aims of this study were to design a participatory antenatal care (ANC) strengthening intervention and assess the implementation process and effectiveness on quality of ANC in Jimma, Ethiopia. The intervention comprised trainings, supervisions, equipment, development of health education material, and adaption of guidelines. It was implemented at public facilities and control sites were included in the evaluation. Improved content of care (physical examinations, laboratory testing, tetanus toxoid (TT)-immunization, health education, conduct of health professionals, and waiting time) were defined as proximal project outcomes and increased quality of care (better identification of health problems and increased overall user satisfaction with ANC) were distal project outcomes. The process of implementation was documented in monthly supervision reports. Household surveys, before (2008) and after (2010) intervention, were conducted amongst all women who had given birth within the previous 12 months. The effect of the intervention was assessed by comparing the change in quality of care from before to after the intervention period at intervention sites, relative to control sites, using logistic mixed effect regression. The continued attention to the ANC provision during implementation stimulated increased priority of ANC among health care providers. The organizational structure of the facilities and lack of continuity in care provision turned out to be a major challenge for implementation. There was a positive effect of the intervention on health education on danger signs during pregnancy (OR: 3.9, 95% CI: 2.6;5.7), laboratory testing (OR for blood tests other than HIV 2.9, 95% CI: 1.9;4.5), health problem identification (OR 1.8, 95% CI: 1.1;3.1), and satisfaction with the service (OR: 0

  16. Effects of the bilateral isokinetic strengthening training on functional parameters, gait, and the quality of life in patients with stroke.

    Science.gov (United States)

    Büyükvural Şen, Sıdıka; Özbudak Demir, Sibel; Ekiz, Timur; Özgirgin, Neşe

    2015-01-01

    To evaluate the effects of the bilateral isokinetic strengthening training applied to knee and ankle muscles on balance, functional parameters, gait, and the quality of in stroke patients. Fifty patients (33 M, 17 F) with subacute-chronic stroke and 30 healthy subjects were included. Stroke patients were allocated into isokinetic and control groups. Conventional rehabilitation program was applied to all cases; additionally maximal concentric isokinetic strengthening training was applied to the knee-ankle muscles bilaterally to the isokinetic group 5 days a week for 3 weeks. Biodex System 3 Pro Multijoint System isokinetic dynamometer was used for isokinetic evaluation. The groups were assessed by Functional Independence Measure, Stroke Specific Quality of Life Scale, Timed 10-Meter Walk Test, Six-Minute Walk Test, Stair-Climbing Test, Timed up&go Test, Berg Balance Scale, and Rivermead Mobility Index. Compared with baseline, the isokinetic PT values of the knee and ankle on both sides significantly increased in all cases. PT change values were significantly higher in the isokinetic group than the control group (Pisokinetic group (Pisokinetic strengthening training in addition to conventional rehabilitation program after stroke seems to be effective on strengthening muscles on both sides, improving functional parameters, gait, balance and life quality.

  17. Strengthening Mathematics And Science Education (SMASE) For Improving The Quality Of Teachers in Nigeria

    Science.gov (United States)

    Shuaibu, Zainab Muhammad

    2016-04-01

    The education system in Nigeria, especially at the basic education level, teachers who teach mathematics and science need to be confident with what they are teaching, they need to have appropriate techniques and strategies of motivating the pupils. If these subjects are not taught well at the basic education level its extraordinarily hard to get them (pupils/students) back to track, no matter what will be done in the secondary and tertiary level. Teachers as the driving force behind improvements in the education system are in the best position to understand and propose solutions to problems faced by students. Teachers must have access to sustainable, high quality professional development in order to improve teaching and student learning. Teachers' professional development in Nigeria, however, has long been criticized for its lack of sustainability and ability to produce effective change in teaching and students achievement. Education theorists today believe that a critical component of educational reform lies in providing teachers with various opportunities and supports structures that encourage ongoing improvement in teachers' pedagogy and discipline-specific content knowledge. However, the ongoing reforms in education sector and the need to refocus the Nigeria education system towards the goal of the National Economical Empowerment and Development Strategies (NEEDS) demand that the existing In-service and Education Training (INSET) in Nigeria be refocused. It is against this premise that an INSET programme aimed at Strengthening Mathematics And Science Education (SMASE) for primary and secondary school teachers was conceived. The relevance of the SMASE INSET according to the Project Design Matrix (PDM) was derived from an In-service aimed at enhancing the quality of teachers in terms of positive attitude, teaching methodology, mastery of content, resource mobilization and utilization of locally available teaching and learning materials. The intervention of

  18. National Quality Improvement Center on Early Childhood

    Science.gov (United States)

    Browne, Charlyn Harper

    2014-01-01

    The national Quality Improvement Center on early Childhood (QIC-eC) funded four research and demonstration projects that tested child maltreatment prevention approaches. The projects were guided by several key perspectives: the importance of increasing protective factors in addition to decreasing risk factors in child maltreatment prevention…

  19. Strengthening exercises improve symptoms and quality of life but do not change autonomic modulation in fibromyalgia: a randomized clinical trial.

    Directory of Open Access Journals (Sweden)

    Maria Bernadete Renoldi Oliveira Gavi

    Full Text Available OBJECTIVE: Autonomic dysfunction is an important mechanism that could explain many symptoms observed in fibromyalgia (FM. Exercise is an effective treatment, with benefits potentially mediated through changes in autonomic modulation. Strengthening is one of the less studied exercises in FM, and the acute and chronic effects of strengthening on the autonomic system remain unknown. The objective of this study was to assess the chronic effects of strengthening exercises (STRE on autonomic modulation, pain perception and the quality of life (QOL of FM patients. METHODS: Eighty sedentary women with FM (ACR 1990 were randomly selected to participate in STRE or flexibility (FLEX exercises in a blinded controlled trial. The intensity of STRE was set at 45% of the estimated load of 1 Repetition Maximum (RM in 12 different exercises. Outcomes were Visual Analog Scale (VAS for pain, Heart Rate Variability (HRV analysis, treadmill test, the sit and reach test (Wells and Dillon's Bench, maximal repetitions test and handgrip dynamometry; and quality of life by the Fibromyalgia Impact Questionnaire (FIQ, the Beck and Idate Trait-State Inventory (IDATE, a short-form health survey (SF-36. RESULTS: The STRE group was more effective to strength gain for all muscles and pain control after 4 and 16 weeks (p<0.05. The FLEX group showed higher improvements in anxiety (p<0.05. Both groups showed improvements in the QOL, and there was no significant difference observed between the groups. There was no change in the HRV of the STRE and FLEX groups. CONCLUSIONS: Strengthening exercises show greater and more rapid improvements in pain and strength than flexibility exercises. Despite the benefits in fitness, pain, depression, anxiety and quality of life, no effect was observed on the autonomic modulation in both groups. This observation suggests that changes in autonomic modulation are not a target tobe clinically achieved in fibromyalgia. TRIAL REGISTRATION: Clinical

  20. Strengthening exercises improve symptoms and quality of life but do not change autonomic modulation in fibromyalgia: a randomized clinical trial.

    Science.gov (United States)

    Gavi, Maria Bernadete Renoldi Oliveira; Vassalo, Dalton Valentin; Amaral, Fabian Tadeu; Macedo, Danielle Constância Felício; Gava, Pablo Lúcio; Dantas, Eduardo Miranda; Valim, Valéria

    2014-01-01

    Autonomic dysfunction is an important mechanism that could explain many symptoms observed in fibromyalgia (FM). Exercise is an effective treatment, with benefits potentially mediated through changes in autonomic modulation. Strengthening is one of the less studied exercises in FM, and the acute and chronic effects of strengthening on the autonomic system remain unknown. The objective of this study was to assess the chronic effects of strengthening exercises (STRE) on autonomic modulation, pain perception and the quality of life (QOL) of FM patients. Eighty sedentary women with FM (ACR 1990) were randomly selected to participate in STRE or flexibility (FLEX) exercises in a blinded controlled trial. The intensity of STRE was set at 45% of the estimated load of 1 Repetition Maximum (RM) in 12 different exercises. Outcomes were Visual Analog Scale (VAS) for pain, Heart Rate Variability (HRV) analysis, treadmill test, the sit and reach test (Wells and Dillon's Bench), maximal repetitions test and handgrip dynamometry; and quality of life by the Fibromyalgia Impact Questionnaire (FIQ), the Beck and Idate Trait-State Inventory (IDATE), a short-form health survey (SF-36). The STRE group was more effective to strength gain for all muscles and pain control after 4 and 16 weeks (pquality of life, no effect was observed on the autonomic modulation in both groups. This observation suggests that changes in autonomic modulation are not a target tobe clinically achieved in fibromyalgia. ClinicalTrials.gov NCT02004405.

  1. Early interglacial carbonate-dilution events in the South China Sea: Implications for strengthened typhoon activities over subtropical East Asia

    Science.gov (United States)

    Huang, Enqing; Tian, Jun; Qiao, Peijun; Wan, Sui; Xie, Xin; Yang, Wenguang

    2015-10-01

    A compilation of many late Quaternary marine sediment records from the northern South China Sea (SCS) continental slope confirms 15-50% reductions in sedimentary calcium carbonate concentrations between 11.0 and 8.5 ka BP in the early Holocene. This low carbonate% event occurred at a time when the regional sea level rose from -50 m to -10 m, which drowned large areas of continental shelves especially those near and within the Taiwan Strait. This event is associated with a significant increase in bulk sedimentation rates on the upper continental slope and the relative abundance of fine-grained detritus. Sediment provenance analyses suggest a dominant terrigenous input from Taiwan and a minor contribution from Luzon during the low carbonate% event, similar to the background terrigenous deposition in other periods of the Holocene. Two comparable low carbonate% events, respectively from the beginning of marine isotope stages 5.5 and 7.3, have also been recognized, pointing to similar causal factors. While carbonate dissolution and carbonate accumulation rate should not have been responsible, increased terrigenous input and dilution is considered as the main cause for the recurrent low carbonate% events in early interglacials. We further hypothesize that, during early interglacials, fluvial sediment discharge from Taiwan and Luzon intensified due to stronger typhoon activities, and massive fine-grained sediments from these two end members may have been transported to the northern SCS continental slope via surface and deep ocean currents. The conjecture of strengthened typhoon activities over East Asia during the early Holocene is supported by high ocean heat contents in the West Pacific Warm Pool area with the prevailing La Niña-like conditions.

  2. Strengthening Agricultural Decisions in Countries at Risk of Food Insecurity: The GEOGLAM Crop Monitor for Early Warning

    Science.gov (United States)

    Becker-Reshef, I.; Barker, B.; McGaughey, K.; Humber, M. L.; Sanchez, A.; Justice, C. O.; Rembold, F.; Verdin, J. P.

    2016-12-01

    Timely, reliable information on crop conditions, and prospects at the subnational scale, is critical for making informed policy and agricultural decisions for ensuring food security, particularly for the most vulnerable countries. However, such information is often incomplete or lacking. As such, the Crop Monitor for Early Warning (CM for EW) was developed with the goal to reduce uncertainty and strengthen decision support by providing actionable information on a monthly basis to national, regional and global food security agencies through timely consensus assessments of crop conditions. This information is especially critical in recent years, given the extreme weather conditions impacting food supplies including the most recent El Nino event. This initiative brings together the main international food security monitoring agencies and organizations to develop monthly crop assessments based on satellite observations, meteorological information, field observations and ground reports, which reflect an international consensus. This activity grew out of the successful Crop Monitor for the G20 Agricultural Market Information System (AMIS), which provides operational monthly crop assessments of the main producing countries of the world. The CM for EW was launched in February 2016 and has already become a trusted source of information internationally and regionally. Its assessments have been featured in a large number of news articles, reports, and press releases, including a joint statement by the USAID's FEWS NET, UN World Food Program, European Commission Joint Research Center, and the UN Food and Agriculture Organziation, on the devastating impacts of the southern African drought due to El Nino. One of the main priorities for this activity going forward is to expand its partnership with regional and national monitoring agencies, and strengthen capacity for national crop condition assessments.

  3. An “All Teach, All Learn” Approach to Research Capacity Strengthening in Indigenous Primary Health Care Continuous Quality Improvement

    Science.gov (United States)

    McPhail-Bell, Karen; Matthews, Veronica; Bainbridge, Roxanne; Redman-MacLaren, Michelle Louise; Askew, Deborah; Ramanathan, Shanthi; Bailie, Jodie; Bailie, Ross; Matthews, Veronica

    2018-01-01

    In Australia, Indigenous people experience poor access to health care and the highest rates of morbidity and mortality of any population group. Despite modest improvements in recent years, concerns remains that Indigenous people have been over-researched without corresponding health improvements. Embedding Indigenous leadership, participation, and priorities in health research is an essential strategy for meaningful change for Indigenous people. To centralize Indigenous perspectives in research processes, a transformative shift away from traditional approaches that have benefited researchers and non-Indigenous agendas is required. This shift must involve concomitant strengthening of the research capacity of Indigenous and non-Indigenous researchers and research translators—all must teach and all must learn. However, there is limited evidence about how to strengthen systems and stakeholder capacity to participate in and lead continuous quality improvement (CQI) research in Indigenous primary health care, to the benefit of Indigenous people. This paper describes the collaborative development of, and principles underpinning, a research capacity strengthening (RCS) model in a national Indigenous primary health care CQI research network. The development process identified the need to address power imbalances, cultural contexts, relationships, systems requirements and existing knowledge, skills, and experience of all parties. Taking a strengths-based perspective, we harnessed existing knowledge, skills and experiences; hence our emphasis on capacity “strengthening”. New insights are provided into the complex processes of RCS within the context of CQI in Indigenous primary health care. PMID:29761095

  4. Assessing the quality of service of village malaria workers to strengthen community-based malaria control in Cambodia

    Directory of Open Access Journals (Sweden)

    Ly Po

    2010-04-01

    Full Text Available Abstract Background Malaria continues to be a major public health problem in remote forested areas in Cambodia. As a national strategy to strengthen community-based malaria control, the Cambodian government has been running the Village Malaria Worker (VMW project since 2001. This study sought to examine the nature and quality of the VMWs' services. Methods Data collection was carried out in February and March 2008 through interviews with one of the two VMWs who takes the lead in malaria control activities in each of the 315 VMW villages (n = 251. The questionnaire addressed 1 the sociodemographic characteristics of VMWs, 2 service quality, 3 actions for malaria prevention and vector control, and 4 knowledge of malaria epidemiology and vector ecology. Results VMWs were effective in conducting diagnosis with Rapid Diagnostic Tests (RDTs and prescribing anti-malarials to those who had positive RDT results, skills that they had acquired through their training programmes. However, most other services, such as active detection, explanations about compliance, and follow-up of patients, were carried out by only a small proportion of VMWs. The variety of actions that VMWs took for malaria prevention and vector control was small (average action index score 12.8/23, and their knowledge was very limited with less than 20% of the VMWs giving correct answers to six out of seven questions on malaria epidemiology and vector ecology. Knowledge of vector breeding places and malaria transmission were significant determinants of both the quality of VMWs' services and the variety of their actions for malaria prevention and vector control. Conclusions VMWs' services focused primarily on diagnosis and treatment. Their focus needs to be broadened to cover other aspects of malaria control in order to further strengthen community-based malaria control. VMWs' actions and knowledge also need substantial improvement. Strengthening training programmes can help achieve better

  5. The health benefits of attaining and strengthening air quality standards in Cape Town

    Directory of Open Access Journals (Sweden)

    Samantha Keen

    2016-12-01

    Full Text Available The link between pollution and poor health and mortality has been established globally. Developing countries carry most of the burden of ill health from air pollution, and urban centres like the City of Cape Town even more so. Effective air quality management to protect human health relies on the attainment of air quality standards. This study uses the Benefits Mapping and Analysis Program (BenMAP along with a locally derived exposure-response function and air quality monitor data to investigate whether the consistent attainment of current or more stringent air quality standards would avoid loss of life. The results show that attaining the PM10 24-hour mean South Africa National Standard limit and the PM10 and SO2 24-hour mean World Health Organisation guidelines in Cape Town reduces levels of pollutants and does reduce excess risk of mortality in Cape Town.

  6. Antenatal care strengthening for improved quality of care in Jimma, Ethiopia

    DEFF Research Database (Denmark)

    Villadsen, Sarah Fredsted; Negussie, Dereje; GebreMariam, Abebe

    2015-01-01

    and assess the implementation process and effectiveness on quality of ANC in Jimma, Ethiopia. METHODS: The intervention comprised trainings, supervisions, equipment, development of health education material, and adaption of guidelines. It was implemented at public facilities and control sites were included...... in the evaluation. Improved content of care (physical examinations, laboratory testing, tetanus toxoid (TT)-immunization, health education, conduct of health professionals, and waiting time) were defined as proximal project outcomes and increased quality of care (better identification of health problems....... The effect of the intervention was assessed by comparing the change in quality of care from before to after the intervention period at intervention sites, relative to control sites, using logistic mixed effect regression. RESULTS: The continued attention to the ANC provision during implementation stimulated...

  7. Evaluation of a policy to strengthen case management and quality of diabetes care in general practice in Denmark

    DEFF Research Database (Denmark)

    Rudkjøbing, Andreas; Vrangbaek, Karsten; Birk, Hans Okkels

    2015-01-01

    OBJECTIVES: To evaluate the utilization of a policy for strengthening general practitioner's case management and quality of care of diabetes patients in Denmark incentivized by a novel payment mode. We also want to elucidate any geographical variation or variation on the basis of practice features...... of the GP were are able to determine differences in use of the policy in relation to the practice-specific information. RESULTS: At the end of the study period (2007-2012) approximately 30% of practices have enrolled extending services to approximately 10% of the diabetes population. There is regional...... structure defined in the policy not strong enough to move the majority of GPs to change their way of delivering and financing care for patients with diabetes within a period of more than 5 years....

  8. Strengthening Internal Quality Assurance Processes: Facilitating Student Evaluation Committees to Contribute

    Science.gov (United States)

    Stalmeijer, Renée; Whittingham, Jill; de Grave, Willem; Dolmans, Diana

    2016-01-01

    Student evaluation committees play a crucial role in internal quality assurance processes as representatives of the student body. However, the students on these committees sometimes experience difficulty in providing constructive and structured feedback to faculty in an environment characterised by a strong power differential between student and…

  9. QUALITY MANAGEMENT IN TERMS OF STRENGTHENING THE "THREE LINES OF DEFENCE" IN RISK MANAGEMENT - PROCESS APPROACH

    OpenAIRE

    Radoica Luburic; Milan Perovic; Rajko Sekulovic

    2015-01-01

    The authors of the paper analyze risk management processes contained in the model considering its longstanding application in many European organisations. The paper also analyses quality management system (QMS) standards and risk management (RM) standards. It particularly addresses the process approach to QMS which, when coupled with active involvement of employees and constant improvements, makes this approach interesting as the topic of this paper. The analyses herein resulted in integratin...

  10. Strengthening of national capacity in implementation of antimalarial drug quality assurance in Thailand.

    Science.gov (United States)

    Vijaykadga, Saowanit; Cholpol, Sawat; Sitthimongkol, Saipin; Pawaphutanan, Anusorn; Pinyoratanachot, Arunya; Rojanawatsirivet, Chaiporn; Kovithvattanapong, Rojana; Thimasarn, Krongthong

    2006-01-01

    Substandard and counterfeit pharmaceutical products, including antimalarial drugs, appear to be widespread internationally and affect both the developing and developed countries. The aim of the study was to investigate the quality of antimalarial drugs, ie, artesunate (ART), chloroquine (CHL), mefloquine (MEF), quinine (QUI), sulfadoxine/pyrimethamine (S/P) and tetracycline (TT) obtained from the government sector and private pharmacies in 4 Thai provinces: Mae Hong Son, Kanchanaburi, Ranong, and Chanthaburi. Three hundred sixty-nine samples of 6 antimalarial drugs from 27 government hospitals, 27 malaria clinics, and 53 drugstores, were collected. Drug quality was assessed by simple disintegration test and semi-quantitative thin-layer chromatography in each province; 10% passed, 100% failed and doubtful samples were sent to be verified by high performance liquid chromatography (HPLC) at the Thai National Drug Analysis Laboratory, (NL). Fifteen point four percent of ART, 11.1% of CHL and 29.4% of QUI were substandard. Based on the finding, drug regulatory authorities in the country took appropriate action against violators to ensure that antimalarial drugs consumed by malaria patients are of good quality.

  11. The Investigation on Strain Strengthening Induced Martensitic Phase Transformation of Austenitic Stainless Steel: A Fundamental Research for the Quality Evaluation of Strain Strengthened Pressure Vessel

    Science.gov (United States)

    Li, Bo; Cai Ren, Fa; Tang, Xiao Ying

    2018-03-01

    The manufacture of pressure vessels with austenitic stainless steel strain strengthening technology has become an important technical means for the light weight of cryogenic pressure vessels. In the process of increasing the strength of austenitic stainless steel, strain can induce the martensitic phase transformation in austenite phase. There is a quantitative relationship between the transformation quantity of martensitic phase and the basic mechanical properties. Then, the martensitic phase variables can be obtained by means of detection, and the mechanical properties and safety performance are evaluated and calculated. Based on this, the quantitative relationship between strain hardening and deformation induced martensite phase content is studied in this paper, and the mechanism of deformation induced martensitic transformation of austenitic stainless steel is detailed.

  12. Strengthening the Network for Monitoring Air Quality in the Valle de Aburra with Passive Meters

    International Nuclear Information System (INIS)

    Zapata S, Carmen; Quijano, Ricardo; Vasquez Eliana

    2008-01-01

    This investigation was made by the National University of Colombia in agreement with the Metropolitan Area of the Aburra Valley. The principal objective was to enforcing the monitoring of the quality of the air of the Aburra valley by means of the passive testers of sulfur dioxide, nitrogen dioxide, ozone, volatile organic compounds (BTX) and the rate of particle sedimentation in main road routes. Testers were settled in 15 Stations of the Metropolitan Area for a year. In gas measurement passive tubes of diffusion were used. Settle able particle measurement uses the principle of the gravity and the samples are analyzed by means of total solids. The results of sulfur dioxide and nitrogen do not exceed the Annual Colombian Norm, but in 12 stations of testing the value is surpassed guides of the WHO for nitrogen dioxide. The ozone levels show formation of this one polluting agent in the zones of slope. In 9 stations the Annual Colombian Norm for benzene is exceeded and all the stations the WHO Norm was not fulfilled. The greater rates of particle sedimentation are obtained in the sites of testing influenced by activities of construction and maintenance of ways. The use of passive measurers allows to identify critic zones and to evaluate of simple way the tendencies of atmospheric contamination. We suggest that in Colombia this technique for the measurement of the quality of the air is approved.

  13. Famine Early Warning Systems Network (FEWS NET) Contributions to Strengthening Resilience and Sustainability for the East African Community

    Science.gov (United States)

    Budde, M. E.; Galu, G.; Funk, C. C.; Verdin, J. P.; Rowland, J.

    2014-12-01

    The Planning for Resilience in East Africa through Policy, Adaptation, Research, and Economic Development (PREPARED) is a multi-organizational project aimed at mainstreaming climate-resilient development planning and program implementation into the East African Community (EAC). The Famine Early Warning Systems Network (FEWS NET) has partnered with the PREPARED project to address three key development challenges for the EAC; 1) increasing resiliency to climate change, 2) managing trans-boundary freshwater biodiversity and conservation and 3) improving access to drinking water supply and sanitation services. USGS FEWS NET has been instrumental in the development of gridded climate data sets that are the fundamental building blocks for climate change adaptation studies in the region. Tools such as the Geospatial Climate Tool (GeoCLIM) have been developed to interpolate time-series grids of precipitation and temperature values from station observations and associated satellite imagery, elevation data, and other spatially continuous fields. The GeoCLIM tool also allows the identification of anomalies and assessments of both their frequency of occurrence and directional trends. A major effort has been put forth to build the capacities of local and regional institutions to use GeoCLIM to integrate their station data (which is not typically available to the public) into improved national and regional gridded climate data sets. In addition to the improvements and capacity building activities related to geospatial analysis tools, FEWS NET will assist in two other areas; 1) downscaling of climate change scenarios and 2) vulnerability impact assessments. FEWS NET will provide expertise in statistical downscaling of Global Climate Model output fields and work with regional institutions to assess results of other downscaling methods. Completion of a vulnerability impact assessment (VIA) involves the examination of sectoral consequences in identified climate "hot spots". FEWS NET

  14. Continuity and Respect for Diversity: Strengthening Early Transitions in Peru. Working Papers in Early Childhood Development, No. 56. Studies in Early Childhood Transitions

    Science.gov (United States)

    Ames, Patricia; Rojas, Vanessa; Portugal, Tamia

    2010-01-01

    This working paper is part of a series on early transitions from "Young Lives," a 15-year longitudinal study of childhood poverty in Ethiopia, India, Peru and Vietnam. It explores the diverse experiences of 28 children from four contrasting communities in Peru as they start school. These detailed case studies highlight common problems:…

  15. The Role of Staff in Quality Improvement in Early Childhood

    Science.gov (United States)

    Sims, Margaret; Waniganayake, Manjula

    2015-01-01

    There is international recognition of the importance of high quality services for young children with a consensus that three pillars contribute to quality improvement: adult: child ratios, staff qualifications and group size. In Australia over the past 5 years, early childhood policy has attempted to drive improvements in early childhood service…

  16. Five-Star Schools: Defining Quality in Early Childhood Programs

    Science.gov (United States)

    Hertzog, Nancy B.

    2012-01-01

    Hakeem, Emily, Jose, and Latisha are all entering preschool in the fall. Their mothers are looking for the highest quality early childhood program they can find. Is there a guide for them to find a five-star program? Are all certified or accredited programs of equal quality? How do these parents and guardians know what defines quality in early…

  17. Improving child survival through a district management strengthening and community empowerment intervention: early implementation experiences from Uganda.

    Science.gov (United States)

    Katahoire, Anne Ruhweza; Henriksson, Dorcus Kiwanuka; Ssegujja, Eric; Waiswa, Peter; Ayebare, Florence; Bagenda, Danstan; Mbonye, Anthony K; Peterson, Stefan Swartling

    2015-08-19

    The Community and District Empowerment for Scale-up (CODES) project pioneered the implementation of a comprehensive district management and community empowerment intervention in five districts in Uganda. In order to improve effective coverage and quality of child survival interventions CODES combines UNICEF tools designed to systematize priority setting, allocation of resources and problem solving with Community dialogues based on Citizen Report Cards and U-Reports used to engage and empower communities in monitoring health service provision and to demand for quality services. This paper presents early implementation experiences in five pilot districts and lessons learnt during the first 2 years of implementation. This qualitative study was comprised of 38 in-depth interviews with members of the District Health Teams (DHTs) and two implementing partners. These were supplemented by observations during implementation and documents review. Thematic analysis was used to distill early implementation experiences and lessons learnt from the process. All five districts health teams with support from the implementing partners were able to adopt the UNICEF tools and to develop district health operational work plans that were evidence-based. Members of the DHTs described the approach introduced by the CODES project as a more systematic planning process and very much appreciated it. Districts were also able to implement some of the priority activities included in their work plans but limited financial resources and fiscal decision space constrained the implementation of some activities that were prioritized. Community dialogues based on Citizen Report Cards (CRC) increased community awareness of available health care services, their utilization and led to discussions on service delivery, barriers to service utilization and processes for improvement. Community dialogues were also instrumental in bringing together service users, providers and leaders to discuss problems and

  18. Quality Early Education and Child Care From Birth to Kindergarten.

    Science.gov (United States)

    Donoghue, Elaine A

    2017-08-01

    High-quality early education and child care for young children improves physical and cognitive outcomes for the children and can result in enhanced school readiness. Preschool education can be viewed as an investment (especially for at-risk children), and studies show a positive return on that investment. Barriers to high-quality early childhood education include inadequate funding and staff education as well as variable regulation and enforcement. Steps that have been taken to improve the quality of early education and child care include creating multidisciplinary, evidence-based child care practice standards; establishing state quality rating and improvement systems; improving federal and state regulations; providing child care health consultation; as well as initiating other innovative partnerships. Pediatricians have a role in promoting quality early education and child care for all children not only in the medical home but also at the community, state, and national levels. Copyright © 2017 by the American Academy of Pediatrics.

  19. Approaches to ensuring and improving quality in the context of health system strengthening: a cross-site analysis of the five African Health Initiative Partnership programs.

    Science.gov (United States)

    Hirschhorn, Lisa R; Baynes, Colin; Sherr, Kenneth; Chintu, Namwinga; Awoonor-Williams, John Koku; Finnegan, Karen; Philips, James F; Anatole, Manzi; Bawah, Ayaga A; Basinga, Paulin

    2013-01-01

    Integrated into the work in health systems strengthening (HSS) is a growing focus on the importance of ensuring quality of the services delivered and systems which support them. Understanding how to define and measure quality in the different key World Health Organization building blocks is critical to providing the information needed to address gaps and identify models for replication. We describe the approaches to defining and improving quality across the five country programs funded through the Doris Duke Charitable Foundation African Health Initiative. While each program has independently developed and implemented country-specific approaches to strengthening health systems, they all included quality of services and systems as a core principle. We describe the differences and similarities across the programs in defining and improving quality as an embedded process essential for HSS to achieve the goal of improved population health. The programs measured quality across most or all of the six WHO building blocks, with specific areas of overlap in improving quality falling into four main categories: 1) defining and measuring quality; 2) ensuring data quality, and building capacity for data use for decision making and response to quality measurements; 3) strengthened supportive supervision and/or mentoring; and 4) operational research to understand the factors associated with observed variation in quality. Learning the value and challenges of these approaches to measuring and improving quality across the key components of HSS as the projects continue their work will help inform similar efforts both now and in the future to ensure quality across the critical components of a health system and the impact on population health.

  20. Developing the quality of early childhood mentoring institutions

    Directory of Open Access Journals (Sweden)

    Sri Hartini

    2017-09-01

    Full Text Available The study was to uncover the concept of quality improvement, the supporting and the inhibiting factors within the quality improve and the quality improvement in the early childhood mentoring institutions/kindergarten. The study was a qualitative research. The subjects in the study were kindergarten principals, kindergarten teachers and parents. The data were gathered by means of observation, interview and documentation. For the data analysis, the researcher selected the qualitative descriptive data analysis method. The results of the study were as follows. First, the concept of educational quality improvement in the early childhood mentoring institutions/ kindergarten has been improveed from the vision, the mission and the objectives and the concept includes the aspects of planning, process and output which has synergy from one to another. The planning has been formulated in the curriculum, the syllabus and the daily activity plan. Second, the approach, the strategy and the technique of quality improvement has maximized the well-qualified schools’ resources, have been supported by the sufficient facilities and have been funded by the sufficient budget. Third, the supporting factors within the quality improvement of early childhood mentoring institutions/kindergarten have been the increasing awareness within the society toward the significance of early childhood mentoring institutions, the massive socialization conducted by the Office of Education through the provision of training programs in relation to the early childhood mentoring institution/kindergarten management and the human resources empowerment toward developing the quality of early childhood mentoring institutions. Fourth, the inhibiting factors within the quality improvement of early childhood mentoring institutions have been the lack of society care and participation, the less quality human resources that early childhood mentoring institutions have, the fund limitation, the

  1. Effects of Pilates and trunk strengthening exercises on health-related quality of life in women with chronic low back pain.

    Science.gov (United States)

    Kofotolis, Nikolaos; Kellis, Eleftherios; Vlachopoulos, Symeon P; Gouitas, Iraklis; Theodorakis, Yannis

    2016-11-21

    Pilates programs are widely used as a form of regular exercise in a broad range of populations investigating their effectiveness for chronic low back pain (CLBP) treatment. The aim of this study was to compare the effects of a Pilates program and a trunk strengthening exercise program on functional disability and health-related quality of life (HRQOL) in women with nonspecific CLBP. A total of 101 volunteer women with CLBP provided data with a 3-month follow-up. They were randomized to either a Pilates (n= 37), trunk strengthening exercise (n= 36) or a control group (n= 28), exercising for a period of 8 weeks, three times a week. Data were collected on HRQOL using the Short-Form 36 Health Survey (SF-36v2), and functional disability using the Roland Morris Disability Questionnaire prior to program initiation, mid-intervention, immediately after program termination, and three months post-intervention. The Pilates participants reported greater improvements on self-reported functional disability and HRQOL compared with participants in the trunk strengthening exercise and control groups (p Pilates group and to a lesser extent for the trunk strengthening exercise group. An 8-week Pilates program improved HRQOL and reduced functional disability more than either a trunk strengthening exercise program or controls among women with CLBP.

  2. Deconstructing Teacher Quality in Urban Early Childhood Education

    Science.gov (United States)

    Young, Jemimah L.; Butler, Bettie Ray; Dolzhenko, Inna N.; Ardrey, Tameka N.

    2018-01-01

    Purpose: The purpose of this paper is to deconstruct the extant scholarship on quality in early childhood education and to emphasize the importance of extending the literature to explore the potential influence that a teachers' educational background may have on kindergarten readiness for African American children in urban early learning settings.…

  3. Qualities of Early Childhood Teachers: Reflections from Teachers and Administrators.

    Science.gov (United States)

    Weitman, Catheryn J.; Humphries, Janie H.

    Data were collected from elementary school principals and kindergarten teachers in Texas and Louisiana in an effort to identify qualities that are thought to be important for kindergarten teachers. A questionnaire listing 462 qualities of early childhood teachers was compiled from literature reviews. Subjects were asked to check a maximum of 50…

  4. Assessing Quality in Early Childhood Education and Care

    Science.gov (United States)

    Ishimine, Karin; Tayler, Collette

    2014-01-01

    Evaluating quality in early childhood education and care (ECEC) service internationally is increasingly important. Research to date indicates that it is "high-quality" programmes that boost and sustain children's achievement outcomes over time. There is also growing interest in the accountability of public funds used for ECEC…

  5. Dyadic Processes in Early Marriage: Attributions, Behavior, and Marital Quality

    Science.gov (United States)

    Durtschi, Jared A.; Fincham, Frank D.; Cui, Ming; Lorenz, Frederick O.; Conger, Rand D.

    2011-01-01

    Marital processes in early marriage are important for understanding couples' future marital quality. Spouses' attributions about a partner's behavior have been linked to marital quality, yet the mechanisms underlying this association remain largely unknown. When we used couple data from the Family Transitions Project (N = 280 couples) across the…

  6. Variations in Chinese Parental Perceptions of Early Childhood Education Quality

    Science.gov (United States)

    Hu, Bi Ying; Zhou, Yisu; Li, Kejian

    2017-01-01

    As consumers of Early Childhood Education and Care (ECEC), Chinese parents play a crucial role in the ongoing process of monitoring, evaluating, and improving the quality of ECEC in China. This study used questionnaires to solicit parental feedback on the importance of, and their quality ratings for, aspects of ECEC. The researchers used a random…

  7. Developing Leadership for Early Childhood Professionals through Oral Inquiry: Strengthening Equity through Making Particulars Visible in Dilemmas of Practice

    Science.gov (United States)

    Nicholson, Julie Marie; Kroll, Linda

    2015-01-01

    Developing leadership among early childhood professionals has become increasingly important as investing in children's early years has been championed as a public and private national and international priority. Two case studies present how oral inquiry and specifically, the Prospect Center's Descriptive Review of a Professional Dilemma of…

  8. Associations between structural quality aspects and process quality in Dutch early childhood education and care settings

    NARCIS (Netherlands)

    Slot, P.L.; Leseman, P.P.M.; Verhagen, J.; Mulder, H.

    2015-01-01

    The relationship between structural quality and process quality in early childhood education and care (ECEC) has been addressed in several studies. However, the findings are not conclusive. The present study was conducted in the Netherlands, which has a strongly regulated mid-quality ECEC system

  9. Whose Quality? The (Mis)Uses of Quality Reform in Early Childhood and Education Policy

    Science.gov (United States)

    Hunkin, Elise

    2018-01-01

    This paper reports on the findings of an in-depth genealogical study of the discourse of quality in Australian Early Childhood Education and Care (ECEC) policy. Quality reform has become the foremost global policy agenda for ECEC due to assumptions about the economic potentials of quality services. In Australia, the recent National Quality…

  10. Early Relationship Quality from Home to School: A Longitudinal Study.

    Science.gov (United States)

    Vondra, Joan I.; Shaw, Daniel S.; Swearingen, Laure; Owens, Elizabeth B.; Cohen, Meredith

    1999-01-01

    Examined role of home social relationships as predictors of social functioning in first years of school. Found that the quality of different family relationships provided relatively independent and complementary information about early social functioning in school, with more limited evidence for compensatory or protective processes at work.…

  11. Polycrystalline strengthening

    DEFF Research Database (Denmark)

    Hansen, Niels

    1985-01-01

    for the understanding of polycrystalline strengthening is obtained mainly from surface relief patterns and from bulk structures observed by transmission electron microscopy of thin foils. The results obtained by these methods are discussed and correlations are proposed. A number of features characterizing the deformed...... structure are summarized and the behavior of a number of metals and alloys is reviewed with emphasis on the structural changes in the interior of the grains and in the vicinity of the grain boundaries. The models for strain accommodation during deformation are discussed on the basis of the microstructures...

  12. UN Women’s experience with strengthening evaluation systems in Africa: Enhancing quantity, quality and use of evaluations

    Directory of Open Access Journals (Sweden)

    Caspar Merkle

    2016-12-01

    Full Text Available Background: Following the adoption of the Women Evaluation Policy in 2012, a series of systems and mechanisms were introduced in the organisation to strengthen the evaluation function at both central and decentralised levels. They were based on a systemic approach and a Theory of Change for building an enabling environment for evaluation in UN Women. Objectives: The purpose of this article was to analyse progress made and challenges with respect to establishing evaluation systems and institutionalising an evaluation culture in the UN Women Africa region. Method: The article draws on UN Women evaluation performance data collected over the past five years, discussions and practical experience by the author of working on evaluation with UN Women since 2009. It also analyses UN Women documents and the broader literature on the topic. Results: The findings illustrate that the different mechanisms to strengthen the evaluation function in UN Women show progress in the Africa region on four out of the five selected evaluation performance indicators. The Theory of Change to strengthen the UN Women evaluation function is largely validated by the wider literature on evaluation use. External assessments confirm that the UN Women evaluation function is sound overall. Conclusion: The article concludes that evaluation performance indicators only provide a partial snapshot of the many different factors that help or undermine evaluative thinking and a learning culture within an organisation. Institutional systems and mechanisms are necessary but not sufficient for nurturing an evaluation culture and ensuring utilisation of evaluation for better development effectiveness.

  13. Dispersion strengthening

    International Nuclear Information System (INIS)

    Scattergood, R.O.; Das, E.S.P.

    1976-01-01

    Using digital computer-based methods, models for dispersion strengthening can now be developed which take into account many of the important effects that have been neglected in the past. In particular, the self interaction of a dislocation can be treated, and a computer simulation method was developed to determine the flow stress of a random distribution of circular, impenetrable obstacles, taking into account all such interactions. The flow stress values depended on the obstacle sizes and spacings, over and above the usual 1/L dependence where L is the average obstacle spacing. From an analysis of the results, it was found that the main effects of the self interactions can be captured in a line tension analogue in which the obstacles appear to be penetrable

  14. Using adapted quality-improvement approaches to strengthen community-based health systems and improve care in high HIV-burden sub-Saharan African countries.

    Science.gov (United States)

    Horwood, Christiane M; Youngleson, Michele S; Moses, Edward; Stern, Amy F; Barker, Pierre M

    2015-07-01

    Achieving long-term retention in HIV care is an important challenge for HIV management and achieving elimination of mother-to-child transmission. Sustainable, affordable strategies are required to achieve this, including strengthening of community-based interventions. Deployment of community-based health workers (CHWs) can improve health outcomes but there is a need to identify systems to support and maintain high-quality performance. Quality-improvement strategies have been successfully implemented to improve quality and coverage of healthcare in facilities and could provide a framework to support community-based interventions. Four community-based quality-improvement projects from South Africa, Malawi and Mozambique are described. Community-based improvement teams linked to the facility-based health system participated in learning networks (modified Breakthrough Series), and used quality-improvement methods to improve process performance. Teams were guided by trained quality mentors who used local data to help nurses and CHWs identify gaps in service provision and test solutions. Learning network participants gathered at intervals to share progress and identify successful strategies for improvement. CHWs demonstrated understanding of quality-improvement concepts, tools and methods, and implemented quality-improvement projects successfully. Challenges of using quality-improvement approaches in community settings included adapting processes, particularly data reporting, to the education level and first language of community members. Quality-improvement techniques can be implemented by CHWs to improve outcomes in community settings but these approaches require adaptation and additional mentoring support to be successful. More research is required to establish the effectiveness of this approach on processes and outcomes of care.

  15. Contributions of a Strengthened Early Holocene Monsoon and Sediment Loading to Present-Day Subsidence of the Ganges-Brahmaputra Delta

    Science.gov (United States)

    Karpytchev, M.; Ballu, V.; Krien, Y.; Becker, M.; Goodbred, S.; Spada, G.; Calmant, S.; Shum, C. K.; Khan, Z.

    2018-02-01

    The contribution of subsidence to relative sea level rise in the Ganges-Brahmaputra delta (GBD) is largely unknown and may considerably enhance exposure of the Bengal Basin populations to sea level rise and storm surges. This paper focuses on estimating the present-day subsidence induced by Holocene sediment in the Bengal Basin and by oceanic loading due to eustatic sea level rise over the past 18 kyr. Using a viscoelastic Earth model and sediment deposition history based on in situ measurements, results suggest that massive sediment influx initiated in the early Holocene under a strengthened South Asian monsoon may have contributed significantly to the present-day subsidence of the GBD. We estimate that the Holocene loading generates up to 1.6 mm/yr of the present-day subsidence along the GBD coast, depending on the rheological model of the Earth. This rate is close to the twentieth century global mean sea level rise (1.1-1.7 mm/yr). Thus, past climate change, by way of enhanced sedimentation, is impacting vulnerability of the GBD populations.

  16. Early experiences building a software quality prediction model

    Science.gov (United States)

    Agresti, W. W.; Evanco, W. M.; Smith, M. C.

    1990-01-01

    Early experiences building a software quality prediction model are discussed. The overall research objective is to establish a capability to project a software system's quality from an analysis of its design. The technical approach is to build multivariate models for estimating reliability and maintainability. Data from 21 Ada subsystems were analyzed to test hypotheses about various design structures leading to failure-prone or unmaintainable systems. Current design variables highlight the interconnectivity and visibility of compilation units. Other model variables provide for the effects of reusability and software changes. Reported results are preliminary because additional project data is being obtained and new hypotheses are being developed and tested. Current multivariate regression models are encouraging, explaining 60 to 80 percent of the variation in error density of the subsystems.

  17. [Suggestions to strengthen quality management of herbal decoction pieces--based on production chain of herbal decoction pieces].

    Science.gov (United States)

    Liu, Yan; Nie, Qing; Chen, Jing

    2015-08-01

    With the development of society and the improvement of people's living standards, the effect of Chinese medicine in treatment and health care is more and more prominent. The herbal decoction pieces are the important part of Chinese medicine,it can be applied directly to clinical treatment and it's also the raw material of Chinese patent medicine. Therefore, the quality of herbal decoction pieces is quite important. The parts of the production of herbal decoction pieces are numerous, and there are possibilities of adverse effects on the quality of the herbal decoction pieces in every part. In this paper, we based on the production chain of herbal decoction pieces, analyzed the main problem that affect the quality of herbal decoction pieces in the part of selection of Chinese herbal medicines, planting, purchasing, processing, packaging, storage and transport, such as the poor quality of seed and seedlings of plant-based Chinese medicines, some plants left their place of origin and have been introduced in the place that is not suitable for this kind of plant, the insufficient growth time and the excessive harmful substances. The purchasers and the accepters lack of professional knowledge and professional ethics. The mechanism of processing is not clear, the standards can not be uniformed, and lack of qualified person in processing, etc. So we suggest: intensify the basic research of key scientific issues. Improve the quality of persons who work in herbal decoction pieces; Establish an "integration" mode of operation in herbal decoction pieces enterprise; Breeding high quality plant resources, establish the large-scale planting basement; Make the packing of herbal decoction pieces standard; Establish the modernization traditional Chinese medicine logistics enterprise.

  18. Analyzing Process Quality of Early Childhood Education with Many Facet Rash Measurement Model

    Science.gov (United States)

    Basturk, Ramazan; Isikoglu, Nesrin

    2008-01-01

    Quality of early childhood education institutions specifically, dimensions of process quality should be evaluated. Purpose of this study is to analyze process quality of early childhood education by using many-facet Rasch measurement model (MFRM). In this study, data were collected from twelve early childhood education institutions by four…

  19. Towards a chain coordination model for quality management strategies to strengthen the competition of European pork producers

    NARCIS (Netherlands)

    Brinkmann, D.; Lang, J.; Petersen, B.; Wognum, P.M.; Trienekens, J.H.

    2011-01-01

    This paper presents a new chain coordination model for quality management strategies of European pork supply chains. It is a result of qualitative research into intensive and extensive pork production in seven selected countries consisting of a literature review, country-specific expert interviews

  20. Pump Early, Pump Often: A Continuous Quality Improvement Project.

    Science.gov (United States)

    Spatz, Diane L; Froh, Elizabeth B; Schwarz, Jessica; Houng, Kathy; Brewster, Isabel; Myers, Carey; Prince, Judy; Olkkola, Michelle

    2015-01-01

    Research demonstrates that although many mothers initiate pumping for their critically ill children, few women are successful at maintaining milk supply throughout their infants' entire hospital stay. At the Garbose Family Special Delivery Unit (SDU) at the Children's Hospital of Philadelphia, we care for mothers who have critically ill infants born with complex cardiac and congenital anomalies. Human milk is viewed as a medical intervention at our institution. Therefore, nurses on the SDU wanted to ensure best practice in terms of pumping initiation. This article describes a continuous quality improvement project that ensured mothers pumped early and often. Childbirth educators can play a key role in preparing mothers who are anticipating an infant who will require hospitalization immediately post-birth.

  1. DEALING WITH KANO MODEL DYNAMICS: STRENGTHENING THE QUALITY FUNCTION DEPLOYMENT AS A DESIGN FOR SIX SIGMA TOOL

    Directory of Open Access Journals (Sweden)

    Hendry Raharjo

    2007-01-01

    Full Text Available Six Sigma has been known to be a breakthrough business strategy to achieve customer satisfaction through defect reduction and cost optimization. A flawless product or service would, however, be of little value if it does not sell. Thus, it is of considerable importance to begin with the customer. Quality Function Deployment (QFD, as a customer-driven tool in Design for Six Sigma (DFSS toolset, can be regarded as one of the most powerful tools to serve this purpose. The success of QFD use relies heavily on the accuracy of the primary input, that is, the Voice of the Customer (VOC. To better identify and obtain more accurate VOC, the use of Kano Model in QFD has been incorporated in the literature. Unfortunately, the dynamics of Kano Model, such as the fact that what now delights the customer will become an expected need in the future is often oversimplified and has not been adequately addressed. The aim of this paper is to shed some light to Kano Model dynamics modeling by providing a quantitative technique which is based on compositional data analysis. It is expected that a timely update of customer needs data may serve as a useful indicator to monitor the progress of how well a company satisfies its customer over time, and at the same time provide a ground for formulating the next strategies as to enable the company to respond differently and continuously over time of its operations. To give some practical insights, an illustrative example is provided.

  2. Breast cancer early detection and quality assurance in Uruguay

    International Nuclear Information System (INIS)

    Cotelo, Elena D.

    2001-01-01

    In Uruguay, breast cancer incidence is 76.41 per 100.000, and death rate is 25.22 per 100.000. Since 1998, there is a National Programme of breast cancer early detection for females over forty years of age. We studied the state of the mammography facilities throughout the country. There are 657.000 female over forty and 51 mammography X-ray equipment. The Programme includes 2 mammography X-ray equipment in mobile units in the capital and 18 in hospitals all around the country. There are taken 120.000 mammographic exams per year, 15.000 of them belong to women who had participated in the Programme. We found that no mammography facility has established Quality Assurance Programmes. Despite the results of this study showed that is suitable the number and age of the mammography X-ray equipment, the lack of Quality Assurance Programmes will produce, in a short time, a negative cost-benefit balance. The consequences will be serious social, human an economical damages. (author)

  3. Strengthening regional safeguards

    International Nuclear Information System (INIS)

    Palhares, L.; Almeida, G.; Mafra, O.

    1996-01-01

    Nuclear cooperation between Argentina and Brazil has been growing since the early 1980's and as it grew, so did cooperation with the US Department of Energy (DOE). The Brazilian-Argentine Agency for Accounting and Control of Nuclear Materials (ABACC) was formed in December 1991 to operate the Common System of Accounting and Control of Nuclear Materials (SCCC). In April 1994, ABACC and the DOE signed an Agreement of Cooperation in nuclear material safeguards. This cooperation has included training safeguards inspectors, exchanging nuclear material measurement and containment and surveillance technology, characterizing reference materials, and studying enrichment plant safeguards. The goal of the collaboration is to exchange technology, evaluate new technology in Latin American nuclear facilities, and strengthen regional safeguards. This paper describes the history of the cooperation, its recent activities, and future projects. The cooperation is strongly supported by all three governments: the Republics of Argentina and Brazil and the United States

  4. Enhancing early child care quality and learning for toddlers at risk: the responsive early childhood program.

    Science.gov (United States)

    Landry, Susan H; Zucker, Tricia A; Taylor, Heather B; Swank, Paul R; Williams, Jeffrey M; Assel, Michael; Crawford, April; Huang, Weihua; Clancy-Menchetti, Jeanine; Lonigan, Christopher J; Phillips, Beth M; Eisenberg, Nancy; Spinrad, Tracy L; de Villiers, Jill; de Villiers, Peter; Barnes, Marcia; Starkey, Prentice; Klein, Alice

    2014-02-01

    Despite reports of positive effects of high-quality child care, few experimental studies have examined the process of improving low-quality center-based care for toddler-age children. In this article, we report intervention effects on child care teachers' behaviors and children's social, emotional, behavioral, early literacy, language, and math outcomes as well as the teacher-child relationship. The intervention targeted the use of a set of responsive teacher practices, derived from attachment and sociocultural theories, and a comprehensive curriculum. Sixty-five childcare classrooms serving low-income 2- and 3-year-old children were randomized into 3 conditions: business-as-usual control, Responsive Early Childhood Curriculum (RECC), and RECC plus explicit social-emotional classroom activities (RECC+). Classroom observations showed greater gains for RECC and RECC+ teachers' responsive practices including helping children manage their behavior, establishing a predictable schedule, and use of cognitively stimulating activities (e.g., shared book reading) compared with controls; however, teacher behaviors did not differ for focal areas such as sensitivity and positive discipline supports. Child assessments demonstrated that children in the interventions outperformed controls in areas of social and emotional development, although children's performance in control and intervention groups was similar for cognitive skills (language, literacy, and math). Results support the positive impact of responsive teachers and environments providing appropriate support for toddlers' social and emotional development. Possible explanations for the absence of systematic differences in children's cognitive skills are considered, including implications for practice and future research targeting low-income toddlers.

  5. Assessing the outcome of Strengthening Laboratory Management Towards Accreditation (SLMTA) on laboratory quality management system in city government of Addis Ababa, Ethiopia.

    Science.gov (United States)

    Sisay, Abay; Mindaye, Tedla; Tesfaye, Abrham; Abera, Eyob; Desale, Adino

    2015-01-01

    Strengthening Laboratory Management Toward Accreditation (SLMTA) is a competency-based management training programme designed to bring about immediate and measurable laboratory improvement. The aim of this study is to assess the outcome of SLMTA on laboratory quality management system in Addis Ababa, Ethiopia. The study used an Institutional based cross sectional study design that employed a secondary and primary data collection approach on the participated institution of medical laboratory in SLMTA. The study was conducted in Addis Ababa city government and the data was collected from February 'April 2014 and data was entered in to EPI-data version 3.1 and was analyzed by SPSS version 20. The assessment finding indicate that there was a significant improvement in average scores (141.4; range of 65-196, 95%CI=86.275-115.5, p=0.000) at final with 3 laboratories become 3 star, 6 laboratories were at 2 star, 11 were 1 star. Laboratory facilities respondents which thought getting adequate and timely manner mentorship were found 2.5 times more likely to get good success in the final score(AOR=2.501, 95% CI=1.109-4.602) than which did not get it. At the end of SLMTA implementation,3 laboratories score 3 star, 6 laboratories were at 2 star, 11 were at 1 star. The most important contributing factor for not scoring star in the final outcome of SLMTA were not conducting their customer satisfaction survey, poor staff motivation, and lack of regular equipment service maintenance. Mentorship, onsite and offsite coaching and training activities had shown a great improvement on laboratory quality management system in most laboratories.

  6. Using Early Learning Standards to Provide High-Quality Education for All Children: The Early Learning Guidelines Toolkit

    Science.gov (United States)

    Flores, Roseanne L.; Curby, Timothy W.; Coleman, Hardin; Melo, Kristan

    2016-01-01

    Today with the rise in the number of 3- to 6-year-old children enrolled in center-based early childhood programs, and a focus on program quality, it becomes imperative for educators to have a better understanding of the role research plays in establishing high-quality programs as these programs provide much of the foundation that supports early…

  7. Chelated mineral supplements for Nelore: quality and early embryonic development

    Directory of Open Access Journals (Sweden)

    Camila Pasa

    2014-01-01

    Full Text Available ABSTRACT. Pasa C., Hatamoto-Zervoudakis L.K., Zervoudakis J.T. & Soares L. [Chelated mineral supplements for Nelore: quality and early embryonic development.] Suplementos minerais quelatados para vacas Nelore: qualidade e desenvolvimento embrionário inicial. Revista Brasileira de Medicina Veterinária, 36(1:29-34, 2014. Programa de Pós-Graduação em Ciência Animal, Faculdade de Agronomia e Medicina Veterinária, Universidade Federal do Mato Grosso, Av. Fernando Corrêa da Costa, 2367, Bairro Boa Esperança, Cuiabá, MT 78060-900, Brasil. E-mail: pasa_camila@hotmail.com The objective of this study was to evaluate the quality and early development of embryos produced with oocytes of cows supplemented with copper, zinc and selenium in a non-chelated and chelated. The experiment was conducted in Cuiabá-MT during the months April to July 2009. We used 24 adult Nellore multiparous, aged, average weights of the initial 36 months, 395 kg and mean body condition score 4.8, respectively randomly divided into 2 groups: control group (CG, supplemented with conventional mineral and Supplemented Group (GS, animals supplemented with zinc, copper and selenium chelated. Each group was kept in a paddock of Brachiaria brizantha cv Marandu received 1 kg of animal per day. chelated mineral supplementation (GS and conventional mineral (GC delivered via the protein supplement was given during a period of 99 days with daily average 1kg/cabeça. During the experimental period were two follicular aspirations, one to 59 days and another at 99 days of supplementation. Every two weeks the animals were weighed and ECC evaluated. oocytes viable (grades I, II and III were used for in vitro production of embryos. The experiment was completely randomized and data were analyzed by ANOVA and a significance level of 10%. There was no effect (p> 0.10 of supplementation with chelated minerals on the percentage of cleaved oocytes, total embryos produced, percentage of produced

  8. Exploring Educators' Perspectives: How Does Learning through "Happiness" Promote Quality Early Childhood Education?

    Science.gov (United States)

    Ikegami, Kiiko; Agbenyega, Joseph Seyram

    2014-01-01

    The quality of early childhood education has dominated current debates in the ways educators develop and implement learning programs for children yet conceptions of quality vary contextually and culturally. This qualitative case study explored the insider perspectives of six early childhood educators in Sapporo, Japan regarding their conceptions…

  9. Strengthening of Shear Walls

    DEFF Research Database (Denmark)

    Hansen, Christian Skodborg

    The theory for concrete structures strengthened with fiber reinforced polymer materials has been developing for approximately two decades, and there are at the present time numerous guidelines covering strengthening of many commonly encountered structural building elements. Strengthening of in...... that describes a unit width strip of a strengthened disk. The unit width strip is named a strengthened concrete tension member and contains a single tensile crack and four debonding cracks. Analysis of the member results in closed form expressions for the load-crack opening relationship. Further analysis...... of the response, results in the ability to determine and characterize the two-way crack propagation, i.e. the relationship between tensile cracking in the concrete and interface debonding between strengthening and concrete. Using the load-crack opening relationship from the strengthened concrete tension member...

  10. Stability and Patterns of Classroom Quality in German Early Childhood Education and Care

    Science.gov (United States)

    Kuger, Susanne; Kluczniok, Katharina; Kaplan, David; Rossbach, Hans-Guenther

    2016-01-01

    Many education systems worldwide have dedicated a significant amount of resources to improve quality levels in early childhood education and care. Research can contribute to this goal by providing information about conditions of high-quality education and care and reasons for changes in the quality provided to children. This study therefore…

  11. Marital conflict and early adolescents' self-evaluation: the role of parenting quality and early adolescents' appraisals.

    Science.gov (United States)

    Siffert, Andrea; Schwarz, Beate; Stutz, Melanie

    2012-06-01

    Cognitive appraisals and family dynamics have been identified as mediators of the relationship between marital conflict and children's adjustment. Surprisingly little research has investigated both meditational processes in the same study. Guided by the cognitive-contextual framework and the spillover hypothesis, the present study integrated factors from both theories early adolescents' appraisals of threat and self-blame, as well as perceived parenting quality as mediators of the link between early adolescents' perception of marital conflict and their self-evaluations (self-esteem and scholastic competence). Analyses were based on the first two waves of an ongoing longitudinal study. Participants were 176 two-parent families, and their early adolescents (50.5% girls) whose mean age was 10.61 years at Time 1 (SD =0.40) and 11.63 years at Time 2 (SD=0.39). Structural equation modeling analyses indicated that parenting quality and early adolescents' perceived threat provided indirect pathways between marital conflict and early adolescents' self-esteem 1 year later when controlling for their initial level of self-esteem. With respect to scholastic competence, only fathers' parenting was an indirect link. Self-blame did not play a role. Implications for understanding the mechanisms by which exposure to marital conflict predicts early adolescents' maladjustment are discussed.

  12. Working Together for Children: Strengthening Transition Pathways

    Science.gov (United States)

    Collie, Louise; Willis, Felicity; Paine, Crystal; Windsor, Corina

    2007-01-01

    The "Working Together for Children: Strengthening Transition Pathways" Team has identified that there is a gap between the Early Childhood settings and schools within the Dubbo area. Through meetings with early childhood professionals within Dubbo the authors have identified that the current landscape of care and education within their community…

  13. Teacher quality moderates the genetic effects on early reading.

    Science.gov (United States)

    Taylor, J; Roehrig, A D; Soden Hensler, B; Connor, C M; Schatschneider, C

    2010-04-23

    Children's reading achievement is influenced by genetics as well as by family and school environments. The importance of teacher quality as a specific school environmental influence on reading achievement is unknown. We studied first- and second-grade students in Florida from schools representing diverse environments. Comparison of monozygotic and dizygotic twins, differentiating genetic similarities of 100% and 50%, provided an estimate of genetic variance in reading achievement. Teacher quality was measured by how much reading gain the non-twin classmates achieved. The magnitude of genetic variance associated with twins' oral reading fluency increased as the quality of their teacher increased. In circumstances where the teachers are all excellent, the variability in student reading achievement may appear to be largely due to genetics. However, poor teaching impedes the ability of children to reach their potential.

  14. Health-related quality of life in early breast cancer

    DEFF Research Database (Denmark)

    Grønvold, Mogens

    2010-01-01

    The treatment of primary breast cancer usually consists of surgery often followed by adjuvant therapy (radiotherapy, chemotherapy, hormonal treatment, etc.) to reduce the risk of recurrence. The cancer diagnosis and the treatments may have significant impact on the patients' quality of life....... This thesis deals with scientific aspects and clinical results of a study aimed at assessing the impact of breast cancer (and its treatment) on the patients' quality of life. Studies such as this assessing the problems and symptoms experienced by the patients are often referred to as health-related quality...... study to be impaired in patients receiving chemotherapy. Similarly, current review articles on HRQL effects of adjuvant chemotherapy mention only relatively few of these topics. Concerning HRQL after the treatment period, our main finding was that many symptoms and problems had declined or disappeared...

  15. The national curriculum guidelines of early childhood education: In search of a job to educational quality

    Directory of Open Access Journals (Sweden)

    Alessandra de Carvalho Faria

    2014-08-01

    childhood education. This paper intends to discuss the National Curriculum Guidelines for Early Childhood Education, which define how they should be organized teaching practice, and examine how the activities should be developed in early childhood education institutions, to objectify the holistic development of children in seeking quality care this stage of basic education.

  16. Investing in Young Children: A Fact Sheet on Early Care and Education Participation, Access, and Quality

    Science.gov (United States)

    Schmit, Stephanie; Matthews, Hannah; Smith, Sheila; Robbins, Taylor

    2013-01-01

    Across the U.S., large numbers of young children are affected by one or more risk factors that have been linked to academic failure and poor health. High quality early care and education can play a critical role in promoting young children's early learning and success in life, while also supporting families' economic security. Young…

  17. Costs and quality of life for prehabilitation and early rehabilitation after surgery of the lumbar spine

    DEFF Research Database (Denmark)

    Nielsen, Per Rotbøll; Andreasen, Jakob Huus; Asmussen, Mikael

    2008-01-01

    During the recent years improved operation techniques and administrative procedures have been developed for early rehabilitation. At the same time preoperative lifestyle intervention (prehabilitation) has revealed a large potential for additional risk reduction. The aim was to assess the quality...... of life and to estimate the cost-effectiveness of standard care versus an integrated programme including prehabilitation and early rehabilitation....

  18. Early Development of Entrepreneurial Qualities: the Role of Initial Education

    OpenAIRE

    Isobel van der Kuip; Ingrid Verheul

    2003-01-01

    This study attempts to create a better understanding of the role of entrepreneurship education in developing entrepreneurial qualities. Theory and practice are confronted. The paper discusses the extent to which entrepreneurship can be taught, and the way in which it should be taught. The focus is on the phase of initial education.

  19. Transforming the Early Care and Education Workforce

    Science.gov (United States)

    Vecchiotti, Sara

    2018-01-01

    There is ample opportunity for state boards to improve outcomes for children by strengthening the early care and education workforce and thereby improving the quality of early care and education. Ensuring that ECE professionals have the knowledge, supports, and resources they need to support children's learning is one avenue to improving the…

  20. During early and mid-adolescence, greater mental toughness is related to increased sleep quality and quality of life.

    Science.gov (United States)

    Brand, Serge; Kalak, Nadeem; Gerber, Markus; Clough, Peter J; Lemola, Sakari; Pühse, Uwe; Holsboer-Trachsler, Edith

    2016-06-01

    The aim of this study was to explore the association between mental toughness, subjective sleep, physical activity, and quality of life during early and mid-adolescence. A total of 1475 participants (mean age = 13.4 years; range: 11-16 years) took part in the study. They completed questionnaires related to mental toughness, physical activity, subjective sleep, and quality of life. Greater mental toughness was related to more favorable quality of life and increased subjective sleep. Mental toughness was not related to physical activity. Increased mental toughness, favorable quality of life, and sleep are related during early and mid-adolescence. Against our expectations, mental toughness was not related to physical activity. © The Author(s) 2014.

  1. Coaching and Quality Assistance in Quality Rating Improvement Systems: Approaches Used by TA Providers to Improve Quality in Early Care and Education Programs and Home-Based Settings

    Science.gov (United States)

    Smith, Sheila; Robbins, Taylor; Schneider, Will; Kreader, J. Lee; Ong, Christine

    2012-01-01

    Quality Rating Improvement Systems (QRISs) commonly offer on-site technical assistance (TA) and coaching to help early care and education settings achieve quality improvements and a higher QRIS rating. In surveys of administrators overseeing statewide QRISs, almost all states reported the use of on-site TA and coaching in both center-based and…

  2. Probabilistic thinking to support early evaluation of system quality: through requirement analysis

    NARCIS (Netherlands)

    Rajabali Nejad, Mohammadreza; Bonnema, Gerrit Maarten

    2014-01-01

    This paper focuses on coping with system quality in the early phases of design where there is lack of knowledge about a system, its functions or its architect. The paper encourages knowledge based evaluation of system quality and promotes probabilistic thinking. It states that probabilistic thinking

  3. Family Quality of Life: A Key Outcome in Early Childhood Intervention Services--A Scoping Review

    Science.gov (United States)

    Bhopti, Anoo; Brown, Ted; Lentin, Primrose

    2016-01-01

    A scoping review was conducted to identify factors influencing the quality of life of families of children with disability. The review also explored the scales used to measure family quality of life (FQOL) as an outcome in early childhood intervention services (ECIS). Multiple databases were searched from 2000 to 2013 to include studies pertinent…

  4. Regulators' Views of Quality in Early Childhood Care and Education Settings in Ireland

    Science.gov (United States)

    Hanafin, Sinéad

    2016-01-01

    There is a substantial literature on the importance of good-quality early childhood care and education services. There is also, however, some agreement that service quality is a nebulous concept which is difficult to define and therefore difficult to assess. While there is growing literature in the area, the views of one stakeholder group--that of…

  5. Tensions in Constructions of Quality in Australian Early Childhood Education and Care Policy History

    Science.gov (United States)

    Logan, Helen

    2017-01-01

    In pronouncements of early childhood education and care (ECEC) policy the importance of quality appears as a seemingly irrefutable concept. Yet, attention to ECEC policy history reveals tensions between discourses that construct quality in ways that endure whereas other ways are ostensibly forgotten. Drawing on a Foucauldian-influenced…

  6. Dietary protein intake and quality in early life

    DEFF Research Database (Denmark)

    Lind, Mads V; Larnkjær, Anni; Mølgaard, Christian

    2017-01-01

    programming. Finally, infants with catch-up growth or specific genotypes might be particularly vulnerable to high-protein intake. SUMMARY: Recent studies confirm the associations between high-protein intake during the first 2 years and later obesity. Furthermore, knowledge of the mechanisms involved......PURPOSE OF REVIEW: Obesity is an increasing problem and high-protein intake early in life seems to increase later risk of obesity. This review summarizes recent publications in the area including observational and intervention studies and publications on underlying mechanisms. RECENT FINDINGS...... seems to have an effect on obesity. Specific amino acids, such as leucine, have also been implicated in increasing later obesity risk maybe via specific actions on insulin-like growth factor I. Furthermore, additional underlying mechanisms including epigenetics have been linked to long-term obesogenic...

  7. Influence of early postmortem protein oxidation on beef quality.

    Science.gov (United States)

    Rowe, L J; Maddock, K R; Lonergan, S M; Huff-Lonergan, E

    2004-03-01

    The objective of this study was to examine the effect of early postmortem protein oxidation on the color and tenderness of beef steaks. To obtain a range of oxidation levels, the longissimus lumborum muscles (LM) from both strip loins of 20 steers fed either a finishing diet with vitamin E (1,000 IU per steer daily, minimum of 126 d [VITE]; n = 10 steers) or fed the same finishing diet without vitamin E (CON; n = 10 steers) were used. Within 24 h after slaughter, the LM muscle from each carcass was cut into 2.54-cm-thick steaks and individually vacuum packaged. Steaks from each steer were assigned to a nonirradiated group or an irradiated group. Steaks were irradiated within 26 h postmortem, and were aged at 4 degrees C for 0, 1, 3, 7, and 14 d after irradiation. Steaks from each diet/irradiation/aging time treatment were used to determine color, shear force, and degree of protein oxidation (carbonyl content). Steaks from steers fed the VITE diet had higher (P irradiation, steaks that had been irradiated had lower (P Irradiated steaks, regardless of diet, had lower a* (P irradiated steaks compared to nonirradiated steaks at 0, 1, 3, and 7 d postirradiation. Immunoblot analysis showed that vitamin E supplementation decreased the number and extent of oxidized sarcoplasmic proteins. Protein carbonyl content was positively correlated with Warner-Bratzler shear force values. These results indicate that increased oxidation of muscle proteins early postmortem could have negative effects on fresh meat color and tenderness.

  8. Quality in South African early learning centres: Mothers’ and teachers’ views and understanding

    Directory of Open Access Journals (Sweden)

    Judy Van Heerden

    2016-11-01

    Full Text Available This study investigated how quality in early learning centres (preschools in South Africa was experienced and perceived by mothers and teachers. A theoretical framework, based on a model of quality development by Woodhead (1996, informed the study. This framework that consists of input (structural, process and outcome quality indicators is a well-established model for quality development, which has been used in developing countries. The findings generated from a thematical analysis of interview data showed that aspects perceived by mothers and teachers as quality indicators in early learning centres were predominantly process indicators and hard to ‘measure’ in a quantitative way. For mothers and teachers, children’s social-emotional well-being, holistic development, a normative foundation for values and respect, effective infrastructure and accountable learning indicated quality. A quality school climate enhances emotional and social well-being, and the findings suggest that for mothers and teachers quality concerns were not about that which the early learning centres have provided in terms of facilities (input indicators, but rather about the process indicators where centres promote children’s holistic well-being. The only outcome indicator that was regarded as extremely important by mothers and important, but not to the same extent, by teachers, is whether children are happy and content and enjoying school.

  9. Assessing The Quality In Different U S Early Childhood Education Programs

    OpenAIRE

    BULDU, Dr. Mehmet; YILMAZ, Arif

    2013-01-01

    : The aim of this study was to assess the quality of different types of early childhood education programs in a Midwestern university town in the US This study reveals the structural and process characteristics observed in the classrooms according to the results from the application of the Early Childhood Environment Rating Scale Revised Edition ECERS R Additional evidences such as sketches of classrooms photographs of classrooms daily classroom schedules overall program philosophy an...

  10. Health-related quality of life in early breast cancer.

    Science.gov (United States)

    Groenvold, Mogens

    2010-09-01

    The treatment of primary breast cancer usually consists of surgery often followed by adjuvant therapy (radiotherapy, chemotherapy, hormonal treatment, etc.) to reduce the risk of recurrence. The cancer diagnosis and the treatments may have significant impact on the patients' quality of life. This thesis deals with scientific aspects and clinical results of a study aimed at assessing the impact of breast cancer (and its treatment) on the patients' quality of life. Studies such as this assessing the problems and symptoms experienced by the patients are often referred to as health-related quality of life (HRQL) research. HRQL research deals with subjective experiences and raises challenging, scientific questions. Therefore, much attention was directed towards methodological issues in this clinically motivated project. The study was a prospective, longitudinal, questionnaire-based investigation of women with newly diagnosed breast cancer registered in the Danish Breast Cancer Co-operative Group's DBCG 89 Program. The patients were sub-divided into low-risk and high-risk patients. High-risk patients were offered randomisation in one of three randomised adjuvant therapy trials involving chemotherapy, ovarian ablation, and endocrine therapy. After a literature study and interviews with breast cancer patients, a questionnaire was composed that included two widely used standard questionnaires (EORTC QLQ-C30 and Hospital Anxiety and Depression (HAD) Scale) and a DBCG 89 Questionnaire developed for this study. A total of 1,898 eligible patients were invited by post to participate in the study involving six assessments over a 2-year period, and 1,713 patients (90%) completed the first questionnaire. Furthermore, a questionnaire was sent to 872 women selected at random from the general population; 608 (70%) responded. The multi-item scales of the two standard questionnaires were analysed for so-called differential item functioning (DIF) in order to investigate whether the

  11. Quality of life outcomes' in early motherhood in Austria : The impact of internal and external resources

    OpenAIRE

    Mautner, Eva

    2014-01-01

    The aim of this paper is to provide results of two studies, which were conducted in Austria to examine the impact of internal and external factors on quality of life and depressive symptoms in early motherhood. In general early motherhood may be a critical life event for a woman and their partner and can lead to decreased well-being. Emotional aspects such as depression affects not only the quality of life of the mothers but also her new-born child, her other children, partner and relati...

  12. Effects of early life factors on the health and quality of life of older adults.

    Science.gov (United States)

    Yilmaz, Fikriye; N Tekin, Rukiye

    2018-01-01

    Few studies on the effects of early life factors on the health and quality of life of adults have been conducted in Turkey. We aimed to investigate the effects of early life factors on the health and quality of life of older adults. We administered a questionnaire to 350 adults, aged 50-89 years, living in Cankaya, Ankara. The questionnaire covered sociodemographic characteristics, early life characteristics, health status, and the World Health Organization Quality of Life-Ageing scale. Data were analyzed using χ 2 tests, independent samples t-tests, one-way anova, and binary logistic regression analysis. The analyses showed that the most important risk factors for chronic disease were being ≥65 years (odds ratio (OR) = 2.34), having a chronic health problem before 18 years of age (OR = 2.48), experiencing prolonged hospitalization or bed rest before 18 years of age (OR = 2.65), and experiencing parental unconcern during early life (OR = 2.13) (P quality of life (P life factors are among the important determinants of the health and quality of life of older adults in Turkey. © 2017 Japanese Psychogeriatric Society.

  13. Long Term Monitoring of Microbial Induced Soil Strengthening Processes

    Science.gov (United States)

    Saneiyan, S.; Ntarlagiannis, D.; Werkema, D. D., Jr.; Colwell, F. S.; Ohan, J.

    2016-12-01

    Soil strengthening/stabilization processes are used to address some of soil quality issues. Microbial induced calcite precipitation (MICP) is a promising soil stabilization process that could offer long term solution by overcoming problems of commonly used methods (e.g. injecting cement slurry). MICP can be applied in larger spatial scales, allowing the enhanced soils to be maintained in an economic sustainable and environmental friendly way. Methods are sought for the long term monitoring of MICP enhanced soils. The spectral induced polarization (SIP) method is one promising method due to sensitivity on such processes and the ability for long term, even autonomous, operation as well as cost effectiveness. Previous laboratory tests showed the sensitivity of the SIP method on soil strengthening as a result of abiotic calcite precipitation. We extended this work to biotic calcite precipitation through MICP. Early results suggest that the MICP formed calcite is denser and could provide improved strengthening capabilities. Our results are supported by geophysical (SIP and shear-wave velocity), geo-chemical and microbiological monitoring. Destructive analysis and visualization (scanning electron imaging - SEM) is expected to provide conclusive evidence on the MICP long term effectiveness.

  14. Implementation phase – Strengthening community to health facility ...

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

    Home · What we do ... Access to quality sexual and reproductive health information, services, prenatal services, and delivery services is ... should contribute to strengthening and improving the quality of provincial maternal health services.

  15. Cable strengthened arches

    NARCIS (Netherlands)

    Kamerling, M.W.

    2013-01-01

    The structural efficiency of arches, subjected to several variable loads, can be increased by strengthening these arches with cables. For these structures it can be necessary, especially in case the permanent load is small, to post-tension the cables to avoid any compression acting on the cables. A

  16. Observed Gossip Moderates the Link between Anxious Withdrawal and Friendship Quality in Early Adolescence

    Science.gov (United States)

    Menzer, Melissa M.; McDonald, Kristina L.; Rubin, Kenneth H.; Rose-Krasnor, Linda; Booth-LaForce, Cathryn; Schulz, Annie

    2012-01-01

    We evaluated whether gossip between best friends moderated the relation between anxious withdrawal and friendship quality in early adolescence, using an Actor-Partner Interdependence Model ("APIM," Kenny, Kashy, & Cook, 2006) approach. Participants (n = 256) were 5th and 6th grade young adolescents (actors) and their best friends…

  17. An Analysis of Instruments that Measure the Quality of Mathematics Teaching in Early Childhood

    Science.gov (United States)

    Kilday, Carolyn R.; Kinzie, Mable B.

    2009-01-01

    The evaluation of teaching quality in mathematics has become increasingly important following research reports indicating that preschoolers are developmentally able to engage in mathematic thought and that child performance in mathematics at this level is a strong predictor of later school achievement. As attention turns to early mathematics…

  18. Family Quality of Life for Families in Early Intervention in Spain

    Science.gov (United States)

    Mas, Joana M.; Baqués, Natasha; Balcells-Balcells, Anna; Dalmau, Mariona; Giné, Climent; Gràcia, Marta; Vilaseca, Rosa

    2016-01-01

    Early intervention (EI) has been shown to be an essential resource for meeting the needs and priorities of children with intellectual and developmental disability and their families. The objective of this study was to examine (a) the perceived quality of life of families attending EI centers in Spain and (b) its relationship with characteristics…

  19. Intrinsic and extrinsic motivation in early adolescents' friendship development : Friendship selection, influence, and prospective friendship quality

    NARCIS (Netherlands)

    Ojanen, Tiina; Sijtsema, Jelle J.; Hawley, Patricia H.; Little, Todd D.; Ojanen, M.

    2010-01-01

    Friendships are essential for adolescent social development. However, they may be pursued for varying motives, which, in turn, may predict similarity in friendships via social selection or social influence processes, and likely help to explain friendship quality. We examined the effect of early

  20. Intrinsic and Extrinsic Motivation in Early Adolescents' Friendship Development: Friendship Selection, Influence, and Prospective Friendship Quality

    Science.gov (United States)

    Ojanen, Tiina; Sijtsema, Jelle J.; Hawley, Patricia H.; Little, Todd D.

    2010-01-01

    Friendships are essential for adolescent social development. However, they may be pursued for varying motives, which, in turn, may predict similarity in friendships via social selection or social influence processes, and likely help to explain friendship quality. We examined the effect of early adolescents' (N = 374, 12-14 years) intrinsic and…

  1. Early Childhood Educators' Perspectives of the Swedish National Curriculum for Preschool and Quality Work

    Science.gov (United States)

    Brodin, Jane; Renblad, Karin

    2015-01-01

    There is today an increasing global interest in early childhood education, especially with regard to curriculum and quality work. The aim of this article is to study preschool teachers' and child care workers' views on the revised national curriculum for preschool in Sweden (Lpfö 98, rev. 2010), and if the educators perceive that they can conduct…

  2. Early Childhood Education and Care in the Netherlands : Quality, Curriculum, and Relations with Child Development

    NARCIS (Netherlands)

    Slot, P.L.

    2014-01-01

    The studies reported in this dissertation are part of the national cohort study pre-COOL to evaluate the developmental and educational effects of early childhood education and care (ECEC) provisions in the Netherlands. More specifically, we evaluated the quality of a large representative sample of

  3. Children's Cortisol Patterns and the Quality of the Early Learning Environment

    Science.gov (United States)

    Sajaniemi, Nina; Suhonen, Eira; Kontu, Elina; Rantanen, Pekka; Lindholm, Harri; Hyttinen, Sirpa; Hirvonen, Ari

    2011-01-01

    The aim of this study was to evaluate the influence of early educational quality on children's cortisol levels. It was hypothesised that the environmental stressors might load children's immature stress regulative systems thus affecting their diurnal cortisol levels. The study sample consisted of 146 preschool-aged children. Cortisol was measured…

  4. Frameworks for Change: Four Recurrent Themes for Quality in Early Childhood Curriculum Initiatives

    Science.gov (United States)

    Burgess, Jennifer; Fleet, Alma

    2009-01-01

    This paper reports on the first phase of a case study that investigated how early childhood teachers experience organisational change. As one of three levels of quality improvement, State government-funded curriculum initiatives were developed with an aim to promote change. Three curriculum documents, one each focusing on literacy, pedagogy and…

  5. A new air quality monitoring and early warning system: Air quality assessment and air pollutant concentration prediction.

    Science.gov (United States)

    Yang, Zhongshan; Wang, Jian

    2017-10-01

    Air pollution in many countries is worsening with industrialization and urbanization, resulting in climate change and affecting people's health, thus, making the work of policymakers more difficult. It is therefore both urgent and necessary to establish amore scientific air quality monitoring and early warning system to evaluate the degree of air pollution objectively, and predict pollutant concentrations accurately. However, the integration of air quality assessment and air pollutant concentration prediction to establish an air quality system is not common. In this paper, we propose a new air quality monitoring and early warning system, including an assessment module and forecasting module. In the air quality assessment module, fuzzy comprehensive evaluation is used to determine the main pollutants and evaluate the degree of air pollution more scientifically. In the air pollutant concentration prediction module, a novel hybridization model combining complementary ensemble empirical mode decomposition, a modified cuckoo search and differential evolution algorithm, and an Elman neural network, is proposed to improve the forecasting accuracy of six main air pollutant concentrations. To verify the effectiveness of this system, pollutant data for two cities in China are used. The result of the fuzzy comprehensive evaluation shows that the major air pollutants in Xi'an and Jinan are PM 10 and PM 2.5 respectively, and that the air quality of Xi'an is better than that of Jinan. The forecasting results indicate that the proposed hybrid model is remarkably superior to all benchmark models on account of its higher prediction accuracy and stability. Copyright © 2017 Elsevier Inc. All rights reserved.

  6. Comparing Cultural Differences in Two Quality Measures in Chinese Kindergartens: The Early Childhood Environment Rating Scale-Revised and the Kindergarten Quality Rating System

    Science.gov (United States)

    Hu, Bi Ying

    2015-01-01

    This study examined the degrees of congruence between two early childhood evaluation systems on various quality concepts: the Early Childhood Environment Rating Scale-Revised (ECERS-R) and Zhejiang's Kindergarten Quality Rating System (KQRS). Analysis of variance and post hoc least significant difference tests were employed to show the extent to…

  7. Foot muscles strengthener

    Directory of Open Access Journals (Sweden)

    Boris T. Glavač

    2012-04-01

    Full Text Available Previous experience in the correction of flat feet consisted of the use of insoles for shoes and exercises with toys, balls, rollers, inclined planes, etc. A device for strengthening foot muscles is designed for the correction of flat feet in children and, as its name suggests, for strengthening foot muscles in adults. The device is made of wood and metal, with a mechanism and technical solutions, enabling the implementation of specific exercises to activate muscles responsible for the formation of the foot arch. It is suitable for home use with controlled load quantities since it has calibrated springs. The device is patented with the Intellectual Property Office, Republic of Serbia, as a petty patent.

  8. [Quality of life in visual impaired children treated for Early Visual Stimulation].

    Science.gov (United States)

    Messa, Alcione Aparecida; Nakanami, Célia Regina; Lopes, Marcia Caires Bestilleiro

    2012-01-01

    To evaluate the quality of life in visually impaired children followed in the Early Visual Stimulation Ambulatory of Unifesp in two moments, before and after rehabilitational intervention of multiprofessional team. A CVFQ quality of life questionnaire was used. This instrument has a version for less than three years old children and another one for children older than three years (three to seven years) divided in six subscales: General health, General vision health, Competence, Personality, Family impact and Treatment. The correlation between the subscales on two moments was significant. There was a statistically significant difference in general vision health (p=0,029) and other important differences obtained in general health, family impact and quality of life general score. The questionnaire showed to be effective in order to measure the quality of life related to vision on families followed on this ambulatory. The multidisciplinary interventions provided visual function and familiar quality of life improvement. The quality of life related to vision in children followed in Early Visual Stimulation Ambulatory of Unifesp showed a significant improvement on general vision health.

  9. Strengthening the Assessment Trajectory: Engaging Educators in the Policy Process. Making a Measurable Difference: Case Studies from the High-Quality Assessment Project

    Science.gov (United States)

    McClellan, Catherine; Snyder, Rebecca; Woods-Murphy, Maryann; Basset, Katherine

    2018-01-01

    Great teachers recognize great assessments. As policy and education leaders work to make sure state tests are measuring the problem-solving, writing, and critical-thinking skills students need for success, they should convene and rely on teachers to review test quality and help answer the question: Do the questions on our state test reflect…

  10. Conceptual model for quality of life among adults with congenital or early deafness.

    Science.gov (United States)

    Kushalnagar, Poorna; McKee, Michael; Smith, Scott R; Hopper, Melinda; Kavin, Denise; Atcherson, Samuel R

    2014-07-01

    A conceptual model of health-related quality of life (QoL) is needed to describe key themes that impact perceived QoL in adults with congenital or early deafness. To revise University of Washington Center for Disability Policy and Research's conceptual model of health promotion and QoL, with suggestions for applying the model to improving programs or services that target deaf adults with early deafness. Purposive and theoretical sampling of 35 adults who were born or became deaf early was planned in a 1-year study. In-depth semi-structured interviews probed deaf adult participants' perceptions about quality of life as a deaf individual. Data saturation was reached at the 17th interview with 2 additional interviews for validation, resulting in a total sample of 19 deaf adults. Coding and thematic analysis were conducted to develop the conceptual model. Our conceptual model delineates the relationships between health status (self-acceptance, coping with limitations), intrinsic (functional communication skills, navigating barriers/self-advocacy, resilience) and extrinsic (acceptance by others, access to information, educating others) factors in their influence on deaf adult quality of life outcomes at home, college, work, and in the community. Findings demonstrate the need for the programs and services to consider not only factors intrinsic to the deaf individual but also extrinsic factors in enhancing perceived quality of life outcomes among people with a range of functional hearing and language preferences, including American Sign Language. Copyright © 2014 Elsevier Inc. All rights reserved.

  11. More Decent Jobs in Peru: Strengthening Research and ...

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

    More Decent Jobs in Peru: Strengthening Research and Policymaking Capacities. Despite ... In turn, such understanding requires appropriate data. Currently ... Call for new OWSD Fellowships for Early Career Women Scientists now open.

  12. Service quality of Early Childhood Education web portals in Finnish municipalities

    Science.gov (United States)

    Koskivaara, Eija; Pihlaja, Päivi

    Increasing number of governmental organizations have transformed material on their web sites as a way of providing users with information about their products and services. In this paper, we apply Yang et al (2005) instrument for analyzing municipal early childhood education (ECE) web sites in Finland. The objective of the study was to find out the quality of ECE web portals as well as to give hints to improve their value from users' point of view. In general the five dimensions, usability, usefulness of content, adequacy of information, accessibility, and interaction, of the Yang et al model seems to be applicable also in the early childhood education environment.

  13. Enhancing the Quality of Early Childhood Education and Care: ECEC Tutors' Perspectives of Family Engagement in Spain

    Science.gov (United States)

    Paz-Albo Prieto, Jesús

    2018-01-01

    Access to high-quality early childhood education and care (ECEC) is important for developmental outcomes and school success. The first years of life are a critical period for learning and the quality of early experiences can have a significant impact later in life. Parenting is one of the primary influences on children's development and family…

  14. Early definitive treatment rate as a quality indicator of care in acute gallstone pancreatitis.

    Science.gov (United States)

    Green, R; Charman, S C; Palser, T

    2017-11-01

    Early definitive treatment (cholecystectomy or endoscopic sphincterotomy in the same admission or within 2 weeks after discharge) of gallstone disease after a biliary attack of acute pancreatitis is standard of care. This study investigated whether compliance with early definitive treatment for acute gallstone pancreatitis can be used as a care quality indicator for the condition. A retrospective cohort study was conducted using the Hospital Episode Statistics database. All emergency admissions to National Health Service hospitals in England with a first time diagnosis of acute gallstone pancreatitis in the financial years 2008, 2009 and 2010 were examined. Trends in early definitive treatment between hospital trusts were examined and patient morbidity outcomes were determined. During the study interval there were 19 510 patients with an overall rate of early definitive treatment at 34·7 (range 9·4-84·7) per cent. In the 1-year follow-up period, 4661 patients (23·9 per cent) had one or more emergency readmissions for complications related to gallstone pancreatitis. Of these, 2692 (57·8 per cent) were readmissions for acute pancreatitis; 911 (33·8 per cent) were within the first 2 weeks of discharge, with the remaining 1781 (66·2 per cent) occurring after the point at which definitive treatment should have been received. Early definitive treatment resulted in a 39 per cent reduction in readmission risk (adjusted risk ratio (RR) 0·61, 95 per cent c.i. 0·58 to 0·65). The risk was further reduced for acute pancreatitis readmissions to 54 per cent in the early definitive treatment group (adjusted RR 0·46, 0·42 to 0·51). In acute gallstone pancreatitis, compliance with recommended early definitive treatment varied considerably, with associated variation in outcomes. Compliance should be used as a quality indicator to improve care. © 2017 BJS Society Ltd Published by John Wiley & Sons Ltd.

  15. Intrinsic and extrinsic motivation in early adolescents' friendship development: friendship selection, influence, and prospective friendship quality.

    Science.gov (United States)

    Ojanen, Tiina; Sijtsema, Jelle J; Hawley, Patricia H; Little, Todd D

    2010-12-01

    Friendships are essential for adolescent social development. However, they may be pursued for varying motives, which, in turn, may predict similarity in friendships via social selection or social influence processes, and likely help to explain friendship quality. We examined the effect of early adolescents' (N = 374, 12-14 years) intrinsic and extrinsic friendship motivation on friendship selection and social influence by utilizing social network modeling. In addition, longitudinal relations among motivation and friendship quality were estimated with structural equation modeling. Extrinsic motivation predicted activity in making friendship nominations during the sixth grade and lower friendship quality across time. Intrinsic motivation predicted inactivity in making friendship nominations during the sixth, popularity as a friend across the transition to middle school, and higher friendship quality across time. Social influence effects were observed for both motives, but were more pronounced for intrinsic motivation. Copyright © 2010 The Association for Professionals in Services for Adolescents. Published by Elsevier Ltd. All rights reserved.

  16. Nordic Comparative Analysis of Guidelines for Quality and Content in Early Childhood Education

    Directory of Open Access Journals (Sweden)

    Ann-Christine Vallberg Roth

    2014-09-01

    Full Text Available The article is based on a project intended to further develop understanding of similarities and differences in Nordic binding guidelines and non-binding guidance for content and quality in early childhood education. The study is of a descriptive and comparative nature and the process is based on a research tradition connected to curriculum studies. Both variation and standardisation emerge in the comparative analysis with regard to content construction. Quality is expressed and may be interpreted as operationalised as both structure and process. In relation to the study results, quality may be interpreted as primarily oriented towards institutions, activities and secondarily towards individuals. Quality is consistently related to learning (lifelong learning and is more linear and oriented towards goal-rationality than non-linear.

  17. Improving the Quality of Early Childhood Education in Chile: Tensions between Public Policy and Teacher Discourses over the Schoolarisation of Early Childhood Education

    Science.gov (United States)

    Pardo, Marcela; Woodrow, Christine

    2014-01-01

    This article problematises emerging tensions in Chile, in relation to the discourses of early childhood teachers and public policies aimed at improving the quality of early childhood education. The aim of the analysis is to contribute to developing more nuanced understandings of these tensions, through the analytical lenses provided by the…

  18. Early Childhood Educators' Meta-Cognitive Knowledge of Problem-Solving Strategies and Quality of Childcare Curriculum Implementation

    Science.gov (United States)

    Kim, Yeon Ha

    2016-01-01

    This study aims to explore the impact of early childhood educators' meta-cognitive knowledge on the quality of their childcare curriculum implementation, and to gain insights regarding successful problem-solving strategies associated with early education and care. Early childhood educators' implementation of general problem-solving strategies in…

  19. Factors affecting the quality of voice in the early glottic cancer treated with radiotherapy

    International Nuclear Information System (INIS)

    Agarwal, Jai Prakash; Baccher, Gurmit K.; Waghmare, Chaitali M.; Mallick, Indranil; Ghosh-Laskar, Sarbani; Budrukkar, Ashwini; Pai, Prathamesh; Chaturvedi, Pankaj; D'Cruz, Anil; Shrivastava, Shyam K.; Dinshaw, Ketayun A.

    2009-01-01

    Aims: To prospectively analyze the objective voice quality before and after radiotherapy (RT) for early glottic cancer and to evaluate the role of different factors that may affect it. Methods: Patients with T1-T2N0M0 glottic cancer underwent voice quality assessment before treatment and after radical RT. Post-RT voice quality was compared to the voice at diagnosis and the voice of healthy individuals used as controls. A comprehensive set of voice parameters were measured. The effects of age, smoking history, T stage, anterior commissure (AC) involvement, radiation dose, fractionation and volumes on pre-treatment and post-treatment voice quality were analyzed. Results: The voice quality data of 50 patients were analyzed. Following treatment, there was a significant improvement in the majority of measured parameters. However, perturbation and HNR remained inferior compared to controls. A history of smoking, AC involvement and larger RT volumes resulted in poorer voice parameters following RT. There was no significant impact of age alone. T2 tumors had an inferior voice quality before treatment, but did not remain inferior following RT. Hypofractionated RT did not show any negative impact. Conclusions: There is a considerable improvement of voice quality following RT. Several factors may have specific effects on pre-treatment and post-treatment voice

  20. Early-career registered nurses' participation in hospital quality improvement activities.

    Science.gov (United States)

    Djukic, Maja; Kovner, Christine T; Brewer, Carol S; Fatehi, Farida K; Bernstein, Ilya

    2013-01-01

    We surveyed 2 cohorts of early-career registered nurses from 15 states in the US, 2 years apart, to compare their reported participation in hospital quality improvement (QI) activities. We anticipated differences between the 2 cohorts because of the growth of several initiatives for engaging nurses in QI. There were no differences between the 2 cohorts across 14 measured activities, except for their reported use of appropriate strategies to improve hand-washing compliance to reduce nosocomial infection rates.

  1. Early adoption of the effect of IFRS 15 on the quality of accounting information

    Directory of Open Access Journals (Sweden)

    Andreia Carpes Dani

    2017-05-01

    Full Text Available Several changes in the legislation governing accounting practices of construction sector companies boosted the internationalization of information on revenues of customer contracts in accounting. Brazil has stood out for early voluntary adoption of IFRS15 standard. Thus, the study aims to determine the relationship between the quality of accounting information and the early adoption of IFRS 15 by Brazilian construction companies listed on BM &FBovespa. The study is characterized as descriptive, conducted through document analysis and quantitative approach. The sample consists of 23 companies in the construction sector. Were analyzed quarterly data from 2013 to 2015. For the data analysis was made using multiple linear regression with panel data, on the basis of accounting information for quality measurement model of value relevance proposed by Ohlson (1995. The survey results suggest that early adoption of IFRS15 helps to reduce the bias of non-comparability and inconsistencies that could exist previously, due to the adoption of different criteria for accounting of revenues on construction contracts. In addition, organizations that voluntarily adopt the rule in an attempt to account for and properly recognize customer contracts revenue, have greater informational relevance and meet market expectations. Thus, it can be said that the early adoption of information on revenue from construction contracts have relevance to the capital market, impacting the stock price after the publication of financial reports.

  2. Adaptation of the quality by design concept in early pharmaceutical development of an intranasal nanosized formulation.

    Science.gov (United States)

    Pallagi, Edina; Ambrus, Rita; Szabó-Révész, Piroska; Csóka, Ildikó

    2015-08-01

    Regulatory science based pharmaceutical development and product manufacturing is highly recommended by the authorities nowadays. The aim of this study was to adapt regulatory science even in the nano-pharmaceutical early development. Authors applied the quality by design (QbD) concept in the early development phase of nano-systems, where the illustration material was meloxicam. The meloxicam nanoparticles produced by co-grinding method for nasal administration were studied according to the QbD policy and the QbD based risk assessment (RA) was performed. The steps were implemented according to the relevant regulatory guidelines (quality target product profile (QTPP) determination, selection of critical quality attributes (CQAs) and critical process parameters (CPPs)) and a special software (Lean QbD Software(®)) was used for the RA, which represents a novelty in this field. The RA was able to predict and identify theoretically the factors (e.g. sample composition, production method parameters, etc.) which have the highest impact on the desired meloxicam-product quality. The results of the practical research justified the theoretical prediction. This method can improve pharmaceutical nano-developments by achieving shorter development time, lower cost, saving human resource efforts and more effective target-orientation. It makes possible focusing the resources on the selected parameters and area during the practical product development. Copyright © 2015 Elsevier B.V. All rights reserved.

  3. Improving the baking quality of bread wheat by genomic selection in early generations.

    Science.gov (United States)

    Michel, Sebastian; Kummer, Christian; Gallee, Martin; Hellinger, Jakob; Ametz, Christian; Akgöl, Batuhan; Epure, Doru; Löschenberger, Franziska; Buerstmayr, Hermann

    2018-02-01

    Genomic selection shows great promise for pre-selecting lines with superior bread baking quality in early generations, 3 years ahead of labour-intensive, time-consuming, and costly quality analysis. The genetic improvement of baking quality is one of the grand challenges in wheat breeding as the assessment of the associated traits often involves time-consuming, labour-intensive, and costly testing forcing breeders to postpone sophisticated quality tests to the very last phases of variety development. The prospect of genomic selection for complex traits like grain yield has been shown in numerous studies, and might thus be also an interesting method to select for baking quality traits. Hence, we focused in this study on the accuracy of genomic selection for laborious and expensive to phenotype quality traits as well as its selection response in comparison with phenotypic selection. More than 400 genotyped wheat lines were, therefore, phenotyped for protein content, dough viscoelastic and mixing properties related to baking quality in multi-environment trials 2009-2016. The average prediction accuracy across three independent validation populations was r = 0.39 and could be increased to r = 0.47 by modelling major QTL as fixed effects as well as employing multi-trait prediction models, which resulted in an acceptable prediction accuracy for all dough rheological traits (r = 0.38-0.63). Genomic selection can furthermore be applied 2-3 years earlier than direct phenotypic selection, and the estimated selection response was nearly twice as high in comparison with indirect selection by protein content for baking quality related traits. This considerable advantage of genomic selection could accordingly support breeders in their selection decisions and aid in efficiently combining superior baking quality with grain yield in newly developed wheat varieties.

  4. Statewide Quality Improvement Initiative to Reduce Early Elective Deliveries and Improve Birth Registry Accuracy.

    Science.gov (United States)

    Kaplan, Heather C; King, Eileen; White, Beth E; Ford, Susan E; Fuller, Sandra; Krew, Michael A; Marcotte, Michael P; Iams, Jay D; Bailit, Jennifer L; Bouchard, Jo M; Friar, Kelly; Lannon, Carole M

    2018-04-01

    To evaluate the success of a quality improvement initiative to reduce early elective deliveries at less than 39 weeks of gestation and improve birth registry data accuracy rapidly and at scale in Ohio. Between February 2013 and March 2014, participating hospitals were involved in a quality improvement initiative to reduce early elective deliveries at less than 39 weeks of gestation and improve birth registry data. This initiative was designed as a learning collaborative model (group webinars and a single face-to-face meeting) and included individual quality improvement coaching. It was implemented using a stepped wedge design with hospitals divided into three balanced groups (waves) participating in the initiative sequentially. Birth registry data were used to assess hospital rates of nonmedically indicated inductions at less than 39 weeks of gestation. Comparisons were made between groups participating and those not participating in the initiative at two time points. To measure birth registry accuracy, hospitals conducted monthly audits comparing birth registry data with the medical record. Associations were assessed using generalized linear repeated measures models accounting for time effects. Seventy of 72 (97%) eligible hospitals participated. Based on birth registry data, nonmedically indicated inductions at less than 39 weeks of gestation declined in all groups with implementation (wave 1: 6.2-3.2%, Pinitiative, they saw significant decreases in rates of early elective deliveries as compared with wave 3 (control; P=.018). All waves had significant improvement in birth registry accuracy (wave 1: 80-90%, P=.017; wave 2: 80-100%, P=.002; wave 3: 75-100%, Pinitiative enabled statewide spread of change strategies to decrease early elective deliveries and improve birth registry accuracy over 14 months and could be used for rapid dissemination of other evidence-based obstetric care practices across states or hospital systems.

  5. Strengthening nuclear security

    International Nuclear Information System (INIS)

    Kurihara, Hiroyoshi

    2003-01-01

    The international situation after the end of the Cold-War has been quite unstable, due to the occurrence of frequent regional conflicts and domestic wars based on ethnic, religious or racial reasons. Further, threats to the would peace and security by non-state actors, like international terrorist groups, have been recognized after 9.11 terrorist attacks to the World Trade Center buildings and to the Pentagon. Utilization of nuclear energy, which encompasses both peaceful uses and military ones, required an establishment of regulatory system, by which risks associated with the development of nuclear energy can be controlled. Accordingly, nuclear safety control system, and then non-proliferation control system has been developed, both in the international level and notional level. In recognition of the present unstable international situations, it is required to establish, maintain and strengthen a system which control nuclear security aspect, in addition to the present systems. (author)

  6. Diet Quality throughout Early Life in Relation to Allergic Sensitization and Atopic Diseases in Childhood

    Directory of Open Access Journals (Sweden)

    Anh N. Nguyen

    2017-08-01

    Full Text Available Early-life nutrition is an important modifiable determinant in the development of a child’s immune system, and may thereby influence the risk of allergic sensitization and atopic diseases. However, associations between overall dietary patterns and atopic diseases in childhood remain unclear. We examined associations of diet quality in early life with allergic sensitization, self-reported physician-diagnosed inhalant and food allergies, eczema, and asthma among 5225 children participating in a population-based cohort in the Netherlands. Diet was assessed during pregnancy, infancy, and childhood using validated food-frequency questionnaires. We calculated food-based diet quality scores (0–10 or 0–15, reflecting adherence to dietary guidelines. At age 10 years, allergic sensitization was assessed with skin prick tests. Information on physician-diagnosed inhalant and food allergies, eczema, and asthma was obtained with questionnaires. We observed no associations between diet quality during pregnancy and allergic sensitization (odds ratio (OR = 1.05 per point in the diet score, 95% confidence interval (CI: 0.99, 1.13, allergies (0.96, 95% CI: 0.88, 1.04, eczema (0.99, 95% CI: 0.93, 1.06, or asthma (0.93, 95% CI: 0.85, 1.03 in childhood. Also, diet quality in infancy or childhood were not associated with atopic outcomes in childhood. Our findings do not support our hypothesis that a healthy dietary pattern in early life is associated with a lower risk of allergic sensitization or atopic diseases in childhood.

  7. [Evaluation of quality of service in Early Intervention: A systematic review].

    Science.gov (United States)

    Jemes Campaña, Inmaculada Concepción; Romero-Galisteo, Rita Pilar; Labajos Manzanares, María Teresa; Moreno Morales, Noelia

    2018-06-07

    Early Intervention (EI), as a paediatric service, has the duty of quantifying the results and the quality of its services provided. The accessibility of valid and reliable tools allows professionals to evaluate the quality of these services. The aim of this study is to review the scientific literature on tools used to measure the methodological and service quality in EI. A search was made in different databases: Medline (from PubMed), Web of Science, PsycINFO, Cochrane, Scopus, ERIC and Scielo. The methodological quality of the studies was tested using the COSMIN scale. A total of 13 manuscripts met the criteria to be included in this review. Ten of them received a "good" or "reasonable" score based on the COSMIN scale. Despite its importance, there is no consensus among authors on the measurement of service quality in EI. It is often the family of the children attended in EI that are considered the target to study, although the opinion of professionals carries more weight and completes the information. Copyright © 2018. Publicado por Elsevier España, S.L.U.

  8. Orofacial pain and quality of life in early adolescents in India.

    Science.gov (United States)

    Kumar, Sandeep; Badiyani, Bhumika K; Kumar, Amit; Dixit, Garima; Sharma, Prachi; Agrawal, Sugandha

    2016-08-18

    Orofacial pain may have an impact on quality of life. It may affect the overall well-being of an individual. To assess the prevalence of orofacial pain and its impact on quality of life in early adolescents in Indore city, India. This was a cross-sectional study which included a total of 800 children selected from various public and private schools located in Indore city, India. A questionnaire was developed which collected information on sociodemographic characteristics and previous dental visits. The severity of pain was assessed using Von Korff pain scale and quality of life using the General Health Questionnaire 12 (GHQ-12). The chi-square test and logistic regression analysis were performed. The overall prevalence of orofacial pain was found to be 17.9%. Toothache (10.1%) was found to be the most prevalent orofacial pain followed by temporomandibular joint pain (4.3%). The highest severity of pain (Grades 3 and 4) was reported for toothache followed by temporomandibular joint pain. The results of the logistic regression model showed that the prevalence of orofacial pain (odds ratio=7.18, p-valueorofacial pain has a negative influence on the quality of life of adolescents. Effective policies should be created to improve the quality of life of adolescents focusing on oral health education and prevention of oral diseases.

  9. Risk factors for voice quality after radiotherapy for early glottic cancer

    International Nuclear Information System (INIS)

    Hocevar-Boltezar, Irena; Zargi, Miha; Strojan, Primoz

    2009-01-01

    Background and purpose: In the majority of patients irradiated for early glottic cancer an abnormal voice was reported. The purpose of the study was to determine the factors influencing voice quality after radiotherapy for T1 glottic cancer. Methods: The voices of 75 male patients irradiated for T1 glottic carcinoma were assessed subjectively and objectively by acoustic analyses and aerodynamic measurements. The laryngeal function and morphology were evaluated by videolaryngostroboscopy. The data on smoking habits, the associated diseases influencing voice quality, the extent of the tumor, the type of biopsy, and the irradiation technique were collected from the medical records. The data on the factors influencing voice quality were compared for patients with a normal/near-normal voice and those with a hoarse voice. Results: Voice quality was at least slightly abnormal in 94.7% and 81.3% of patients, when assessed perceptively and objectively, respectively. Smoking after the completed treatment, more severe morphologic alterations of the vocal folds, dryness of the throat, incomplete closure of the vocal folds and functional voice disorders expressed as supraglottic activity adversely influenced the voice quality. A good correlation between the perceptive voice assessment and the acoustic analyses was established. Conclusions: After the successful irradiation for T1 glottic carcinoma, the great majority of the patients have at least a slightly hoarse voice. A better voice outcome could be achieved if radiotherapy was followed by the patient's cessation of smoking and the appropriate voice therapy.

  10. Paediatric early warning scores on a children's ward: a quality improvement initiative.

    LENUS (Irish Health Repository)

    Ennis, Linda

    2014-09-09

    The aim of this quality improvement initiative was to incorporate a paediatric early warning score (PEWS) and track and trigger system in the routine care of children in an acute general children\\'s ward at a regional hospital in the Republic of Ireland. In the absence of a nationally recommended specific PEWS strategy, a local plan was developed. The experience of structuring and implementing the PEWS and track and trigger system is presented in this article. Data from the first year of use were collected to evaluate the clinical utility and effectiveness of this system. In the busy acute children\\'s service, the PEWS initiative was found to benefit processes of early detection, prompt referral and timely, appropriate management of children at potential risk of clinical deterioration. Nursing staff were empowered and supported to communicate concerns immediately and to seek rapid medical review, according to an agreed PEWS escalation plan. Outcomes were significantly improved.

  11. Depression and quality of life in monogenic compared to idiopathic, early-onset Parkinson's disease

    DEFF Research Database (Denmark)

    Kasten, Meike; Kertelge, Lena; Tadic, Vera

    2012-01-01

    , and 44% of manifesting carriers of mutations in PD genes, but was rare in the nonmanifesting carriers (7%) and healthy controls (5%). Subjects with Parkinson-associated depression reported fewer feelings of guilt or self-doubt than treated controls, but the occurrence of suicidal ideation was associated......Quality of life (QoL) is decreased in PD and is linked with depression and anxiety. However, little is known about QoL in monogenic PD. Subjects with mutations in PD genes were recruited from ongoing family and genetic studies (manifesting carriers, n = 23; nonmanifesting carriers, n = 19......). For comparison purposes, we included patients with idiopathic PD (IPD; n = 128; early onset, n = 38; late onset, n = 90), healthy controls (n = 127), and data on depressive symptoms of 144 patients with major depression (treated controls). Depression affected 31% of early-onset PD cases, 21% of late-onset cases...

  12. Associations between Relational Pronoun Usage and the Quality of Early Family Interactions

    OpenAIRE

    Galdiolo, Sarah; Roskam, Isabelle; Verhofstadt, Lesley L.; De Mol, Jan; Dewinne, Laura; Vandaudenard, Sylvain

    2016-01-01

    Our study examined the relationships of relational pronouns used in parental conversation to the quality of early family interactions, as indexed by Family Alliance (FA). We hypothesized that more positive family interactions were associated with the use of more we-pronouns (e.g., we, us, our; we-ness) and fewer I- and you-pronouns (e.g., I, me, you, your; separateness) by both mothers and fathers. Our statistical model using a multilevel modeling framework and two levels of analysis (i.e., a...

  13. A Simple Early Warning System for Evaluating the Credit Portfolio's Quality

    Directory of Open Access Journals (Sweden)

    Nicolae Dardac

    2009-05-01

    Full Text Available The last decade has witnessed the development of a vast literature devoted to the study of several phenomena like banking crises or episodes of vulnerability and distress, characterized by inadequate capitalization, impairment of the asset quality and of the credit institutions' rating. The purpose of this study is to design an early warning system in order to highlight at an earlier stage the likelihood of deterioration of the Romanian banking system credit portfolio's quality. We have applied an econometric model which constitutes a reference for this type of analysis, having as purpose the identification of a significant correlation between increasing weight of bad loans in total assets, on the one hand, and a number of macroeconomic variables and indicators of the banking system, on the other hand.

  14. Strengthening safeguards information evaluation

    International Nuclear Information System (INIS)

    Harry, J.; Hudson, P.

    2001-01-01

    The strengthening of safeguards should not be limited to the verification of explicit declarations made by the States. Additional information should guide the IAEA to set priorities for further investigations. Not only all aspects of the State's nuclear programme, including the application of safe, secure and transparent nuclear management, but also the level of compliance with other verifiable treaties, political motivation, economic capabilities, international relations and ties, co-operative attitude to safeguards, and general openness and transparency should be included. The evaluation of the diverse forms of information from different sources requires new reliable processes that will result in a high credibility and detection probability. The IAEA uses the physical model for the evaluation of the technical information, and proposed also Fuzzy Logic, or Calculation with Words, to handle the information. But for the evaluation it is questioned whether fuzziness could lead to a crisp judgement. In this paper an objective method of information evaluation is proposed, which allows to integrate different kinds of information and to include calibration and tests in the establishment of the evaluation process. This method, Delta, uses elicitation of a syndicate of experienced inspectors to integrate obvious indicators together with apparently innocent indicators, into a database that forms the core of the evaluation process. Nominal or ordinal scales could be applied to come to an objective and quantifiable result. Experience with this method can in the course of time result in predictive conclusions. 9 refs

  15. Perceived family relationship quality and use of poly-tobacco products during early and late adolescence.

    Science.gov (United States)

    Luk, Tzu Tsun; Wang, Man Ping; Leung, Lok Tung; Chen, Jianjiu; Wu, Yongda; Lam, Tai Hing; Ho, Sai Yin

    2018-05-24

    The role of family relationship in adolescent use of emerging tobacco products, which have become increasingly popular, is unknown. We examined the associations of perceived family relationship quality with current use of poly-tobacco products including cigarettes, electronic cigarettes (e-cigarettes), waterpipe and smokeless tobacco in adolescents. Data from a representative sample of 42,250 US grade 7-12 equivalent students (mean ± SD age 14.6 ± 1.9 years; 51.3% boys) from 75 randomly selected secondary schools in Hong Kong (2012-13) were analysed. Logistic regressions yielded adjusted odds ratios (AORs) for current (past 30-day) use of cigarettes, e-cigarettes, waterpipe, smokeless tobacco and poly-tobacco (≥2 products) in relation to perceived family relationship quality, adjusted for age, sex, perceived family affluence, parental education, family structure, parental and sibling smoking and secondhand smoke exposure at home. Subgroup analyses were conducted to compare the associations in early (aged ≤14 years) versus late (>14) adolescents. The odds of current use increased with worse perceived family relationship quality with AORs (95% confidence interval) of up to 2.92 (2.32-3.68) for cigarettes, 7.28 (4.71-11.2) for e-cigarettes, 5.04 (3.44-7.40) for waterpipe, 8.09 (4.87-13.4) for smokeless tobacco and 5.25 (3.45-8.01) for poly-tobacco products use (all P for trend relationships were found between negatively perceived family relationship quality and current poly- and individual tobacco product use by Hong Kong Chinese secondary students. The associations were stronger for alternative tobacco products and in early adolescents. Copyright © 2018 Elsevier Ltd. All rights reserved.

  16. Quality of life of early stage colorectal cancer patients in Morocco.

    Science.gov (United States)

    Mrabti, Hind; Amziren, Mounia; ElGhissassi, Ibrahim; Bensouda, Youssef; Berrada, Narjiss; Abahssain, Halima; Boutayeb, Saber; El Fakir, Samira; Nejjari, Chakib; Benider, Abdellatif; Mellas, Nawfel; El Mesbahi, Omar; Bennani, Maria; Bekkali, Rachid; Zidouh, Ahmed; Errihani, Hassan

    2016-10-12

    A multicentre cohort study was held in Morocco, designed to evaluate the quality of life of cancer patients. The aim of this paper is to report the assessment of the quality of life of early colorectal cancer patients, before and after cancer treatment, to identify other factors which are related to this quality of life. We used the third version of the QLQ-C30 questionnaire of the European organization for Research and treatment of Cancer (EORTC) after a transcultural validation. The Data collection was done at inclusion and then every twelve weeks to achieve one year of follow up. Overall 294 patients presented with early colorectal cancer, the median age was 56 years (range: 21-88). The male-female sex ratio was 1.17. At inclusion, the global health status was the most affected functional dimension. For symptoms: financial difficulties and fatigue scores were the highest ones. Emotional and social functions were significantly worse in rectal cancer. Most symptoms were more present in rectal cancer. At inclusion, global health status score was significantly worse in stage III. Anorexia was significantly more important among colorectal female patients. For Patients over 70 years-old, the difference was statistically significant for the physical function item which was lower. Overall, Functional dimensions scores were improved after chemotherapy. The symptoms scores did not differ significantly for patients treated by radiotherapy, between inclusion and at one year. Our EORTC QLQ C30 scores are overall comparable to the reference values. Neither chemotherapy, nor radiotherapy worsened the quality of life at one year.

  17. Identification of the optimal donor quality scoring system and measure of early renal function in kidney transplantation.

    LENUS (Irish Health Repository)

    Moore, Jason

    2009-02-27

    The early identification of kidney allografts at risk of later dysfunction has implications for clinical practice. Donor quality scoring systems (preoperative) and measures of early allograft function (first week postoperative) have previously shown practical utility. This study aimed to determine the optimal parameter(s) (preoperative and postoperative) with greatest predictive power for the development of subsequent allograft dysfunction.

  18. Quality of work, well-being, and intended early retirement of older employees: baseline results from the SHARE Study.

    Science.gov (United States)

    Siegrist, Johannes; Wahrendorf, Morten; von dem Knesebeck, Olaf; Jürges, Hendrik; Börsch-Supan, Axel

    2007-02-01

    Given the challenge of a high proportion of older employees who retire early from work we analyse associations of indicators of a poor psychosocial quality of work with intended premature departure from work in a large sample of older male and female employees in 10 European countries. Baseline data from the 'Survey of Health, Ageing and Retirement in Europe' (SHARE) were obtained from 3523 men and 3318 women in 10 European countries. Data on intended early retirement, four measures of well-being (self-rated health, depressive symptoms, general symptom load, and quality of life), and quality of work (effort-reward imbalance; low control at work) were obtained from structured interviews and questionnaires. Country-specific and total samples are analysed, using logistic regression analysis. Poor quality of work is significantly associated with intended early retirement. After adjustment for well-being odds ratios (OR) of effort-reward imbalance [OR 1.72 (1.43-2.08)] and low control at work [OR 1.51 (1.27-1.80)] on intended early retirement are observed. Poor quality of work and reduced well-being are independently associated with the intention to retire from work. The consistent association of a poor psychosocial quality of work with intended early retirement among older employees across all European countries under study calls for improved investments into better quality of work, in particular increased control and an appropriate balance between efforts spent and rewards received at work.

  19. Correspondence: Strengthening capacity, collaboration and quality ...

    African Journals Online (AJOL)

    Journal Home > Vol 11, No 1 (2009) >. Log in or Register ... Weak south–south networking hampers effective use of limited resources, production of ... enabling environment and incentives to retain scientists and attract back those in diaspora.

  20. Leadership and managerial capacity strengthening for quality ...

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

    Success in the implementation of maternal and newborn health interventions at the country level has been generally attributed to three main interlinked factors: leadership and management, resources, and end-user-related factors. Leadership and managerial capacities are critical for transformational change and ...

  1. Good-quality diet in the early years may have a positive effect on academic achievement.

    Science.gov (United States)

    Nyaradi, Anett; Li, Jianghong; Foster, Jonathan K; Hickling, Siobhan; Jacques, Angela; O'Sullivan, Therese A; Oddy, Wendy H

    2016-05-01

    The aim of this study was to investigate the associations between early diet and academic performance during childhood. Participants were from the Western Australian Pregnancy Cohort (Raine) Study (n = 2287). Frequency of consumption of food and beverages was collected at the one-, two- and three-year follow-ups, using a 24-hour food recall. Diet scores were developed from the number of eating occasions. The Western Australian Literacy and Numeracy Assessment (WALNA) data from grades five (age 10) and seven (age 12) were linked to the Raine study using The Western Australian Data Linkage System. The association between diet scores and WALNA scores was assessed using multivariate linear regression models. A higher (i.e. better quality) diet score at one year of age was associated with significantly higher scores in mathematics, reading, writing and spelling at both grades five and seven. Associations were observed between a higher diet score at two years and academic scores for mathematics, writing and spelling at grade seven. Higher dairy consumption at ages one, two and three, and higher fruit consumption at age one were associated with higher academic scores at all ages. Quality of early diet may be a predictor for later academic achievement. ©2015 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

  2. Quality of life and adherence to treatment in early-treated Brazilian phenylketonuria pediatric patients.

    Science.gov (United States)

    Vieira, E; Maia, H S; Monteiro, C B; Carvalho, L M; Tonon, T; Vanz, A P; Schwartz, I V D; Ribeiro, M G

    2017-12-11

    Early dietary treatment of phenylketonuria (PKU), an inborn error of phenylalanine (Phe) metabolism, results in normal cognitive development. Although health-related quality of life (HRQoL) of PKU patients has been reported as unaffected in high-income countries, there are scarce data concerning HRQoL and adherence to treatment of PKU children and adolescents from Brazil. The present study compared HRQoL scores in core dimensions of Brazilian early-treated PKU pediatric patients with those of a reference population, and explored possible relationships between adherence to treatment and HRQoL. Early-treated PKU pediatric patient HRQoL was evaluated by self- and parent-proxy reports of the Pediatric Quality of Life Inventory (PedsQL) core scales. Adherence to treatment was evaluated by median Phe levels and percentage of results within the therapeutic target range in two periods. Means for total and core scales scores of PedsQL self- and parent proxy-reports of PKU patients were significantly lower than their respective means for controls. Adequacy of median Phe concentrations and the mean percentage of values in the target range fell substantially from the first year of life to the last year of this study. There was no significant difference in mean total and core scale scores for self- and parent proxy-reports between patients with adequate and those with inadequate median Phe concentrations. The harmful consequences for intellectual capacity caused by poor adherence to dietary treatment could explain the observed decrease in all HRQoL scales, especially in school functioning. Healthcare system and financial difficulties may also have influenced negatively all HRQoL dimensions.

  3. RIGIDITY, SENSITIVITY AND QUALITY OF ATTACHMENT - THE ROLE OF MATERNAL RIGIDITY IN THE EARLY SOCIOEMOTIONAL DEVELOPMENT OF PREMATURE-INFANTS

    NARCIS (Netherlands)

    BUTCHER, PR; KALVERBOER, A; MINDERAA, RB; VANDOORMAAL, EF; TENWOLDE, Y

    1993-01-01

    The associations between a mother's rigidity, her sensitivity in early (3 month) interaction and the quality of her premature infant's attachment at 13 months were investigated. Rigidity as a personality characteristic was not found to be significantly associated with sensitivity or quality of

  4. The association of health and voluntary early retirement pension and the modifying effect of quality of supervision

    DEFF Research Database (Denmark)

    De Wind, Astrid; Burr, Hermann; Pohrt, Anne

    2017-01-01

    Objectives: The aims of this article are to (1) determine whether and to what extent general perceived health and quality of supervision predict voluntary early retirement pension (VERP) and (2) assess whether quality of supervision modifies the association between general perceived health and VE...

  5. A More-than-Social Movement: The Post-Human Condition of Quality in the Early Years

    Science.gov (United States)

    Arndt, Sonja; Tesar, Marek

    2016-01-01

    This article explores quality in early childhood education by de-elevating the importance of the human subject and experience, and heightening instead a focus on and tensions with the post-human. The argument traces the intricate web of "qualities" woven throughout entanglements of subjects, objects and things that constitute what is…

  6. Sperm quality before treatment in patients with early stage Hodgkin's lymphoma enrolled in EORTC-GELA Lymphoma Group trials.

    NARCIS (Netherlands)

    Kaaij, M.A. van der; Heutte, N.; Echten-Arends, J. van; Raemaekers, J.M.M.; Carde, P.; Noordijk, E.M.; Ferme, C.; Thomas, J.; Eghbali, H.; Brice, P.; Bonmati, C.; Henry-Amar, M.; Kluin-Nelemans, H.C.

    2009-01-01

    BACKGROUND: Although widely recommended, cryopreservation of sperm is sometimes not performed for patients with Hodgkin's lymphoma because of presumed poor sperm quality related to the disease. We investigated sperm quality and factors determining it in untreated patients with early stage Hodgkin's

  7. Sperm quality before treatment in patients with early stage Hodgkin's lymphoma enrolled in EORTC-GELA Lymphoma Group trials

    NARCIS (Netherlands)

    van der Kaalj, Marleen A. E.; Heutte, Natacha; van Echten-Arends, Jannie; Raemaekers, John M. M.; Carde, Patrice; Noordijk, Evert M.; Ferme, Christophe; Thomas, Jose; Eghbali, Houchingue; Brice, Pauline; Bonmati, Caroline; Henry-Amar, Michel; Kluin-Nelemans, Hanneke C.

    2009-01-01

    Background Although widely recommended, cryopreservation of sperm is sometimes not performed for patients with Hodgkin's lymphoma because of presumed poor sperm quality related to the disease. We investigated sperm quality and factors determining it in untreated patients with early stage Hodgkin's

  8. Quality of life during early radiotherapy in patients with head and neck cancer and pain

    Directory of Open Access Journals (Sweden)

    Schaller A

    2017-07-01

    Full Text Available Anne Schaller,1 Elena Dragioti,1 Gunilla M Liedberg,2 Britt Larsson1 1Department of Medical and Health Sciences, Division of Community Medicine, Faculty of Health Sciences, Linköping University, Pain and Rehabilitation Centre, County Council of Östergötland, Linköping, 2Department of Social and Welfare Studies, Linköping University, Norrköping, Sweden Background: Patients with head and neck cancer (HNC have a potentially severe diagnosis and often suffer from tumor-related pain as well as from adverse side effects of treatment such as radiotherapy (RT. Knowledge about quality of life (QoL during early RT in this group is limited and should be assessed in relation to diagnosis and treatment.Purpose: The purpose of this cross-sectional study was to identify potential factors that may influence QoL in patients with HNC during the early stages of RT (no later than two weeks of ongoing RT. We hypothesized that pain intensity, pain interference, catastrophizing, and mood disturbances are associated with QoL during early RT.Patients and methods: In this study, 54 patients (53% of eligible patients diagnosed with HNC were consecutively recruited from the regular flow to the Pain and Rehabilitation Center at Linköping University. The patients completed self-reported questionnaires on sociodemographics, pain intensity, pain interference, anxiety, depression, pain catastrophizing, and QoL.Results: The patients in this study scored high for QoL, low for pain intensity, and low for pain interference. The patients reported minor depressive symptoms and anxiety symptoms. Regression analyses showed that pain intensity and depressive symptoms negatively influenced QoL. Conclusion: No later than two weeks of RT, pain intensity and depression negatively influenced QoL in patients with HNC. Early screening for pain and depression in a targeted preventive strategy might maintain QoL during the course of the RT for patients with HNC. This assumption needs to

  9. Antisocial boys and their friends in early adolescence: relationship characteristics, quality, and interactional process.

    Science.gov (United States)

    Dishion, T J; Andrews, D W; Crosby, L

    1995-02-01

    This study examines the close friendships of early adolescent boys in relation to antisocial behavior. 186 13-14-year-old boys and their close friends were interviewed, assessed at school, and videotaped in a problem-solving task. Similarity was observed between the demographic characteristics and antisocial behavior of the boys and their close friends. There was a tendency for the close friends of antisocial boys to live within the same neighborhood block and to have met in unstructured, unsupervised activities. Direct observations of interactions with close friends revealed a reliable correlation between antisocial behavior, directives, and negative reciprocity. Positive interactions within the friendship were uncorrelated with antisocial behavior and relationship quality. Implications of these findings for clinical and developmental theory are discussed.

  10. Educational gaps and solutions for early-career nurse managers' education and participation in quality improvement.

    Science.gov (United States)

    Djukic, Maja; Kovner, Christine T; Brewer, Carol S; Fatehi, Farida; Jun, Jin

    2015-04-01

    The objective of this study was to examine early-career frontline nurse managers' (FLNMs') reported educational preparedness and participation in quality improvement (QI). Frontline nurse managers are vitally important for leading QI. However, it is not well known if they have adequate knowledge and skills to lead this important function. We examined cross-sectional survey data from 42 FLNMs using descriptive statistics. About 30% of FLNMs reported being very prepared across 12 measured QI skills by schools or employers and 35% reported participating in a specific clinical effort to improve patient care on their unit more than once a month. More than 50% reported having good organizational support for QI, but only about 30% reported being rewarded for their contributions to QI. Our study highlights opportunities for development in QI for FLNMs and offers some solutions for nurse executives that can bridge the educational gaps.

  11. Early Consequences of Pectus Excavatum Surgery on Self-Esteem and General Quality of Life.

    Science.gov (United States)

    Zuidema, W P; Oosterhuis, J W A; Zijp, G W; van der Heide, S M; van der Steeg, A F W; van Heurn, L W E

    2018-02-06

    An early observation after chest wall correction is direct inspection from the PE patient of their "new" thorax. Changes in self-perception may give raise to other psychological adaptations. The aim of this study was to evaluate the early changes in the fields of self-esteem, body image and QoL. Prospective observational longitudinal multicenter cohort study. Self-esteem, emotional limitations and general health were assessed using the Child Health Questionnaire (CHQ) in patients under 18 and the World Health Organization Quality of Life Questionnaire-bref (WHOQOL-bref) was used for body image, psychological domain and overall QoL in patients over 16 years of age. Measurements were taken before surgery (T1) and 6 weeks (T2), and 6 months thereafter (T3). Scores on post-operative self-esteem were significantly higher compared with scores pre-operatively (p < 0.007). Also body image, psychological domain and emotional limitations showed significant improvement, respectively p < 0.001, p < 0.001, and p < 0.016. Significant improvement in the first three components was mainly achieved in the first 6 weeks post-operative. In emotional limitation, however, the largest change was between 6 weeks and 6 months. Overall quality of life in the WHOQOL-bref and general health domain in the CHQ showed no significant improvement in relation to the pre-operative scores. Post-operative PE patients after Nuss procedure showed an improved body image, increased self-esteem and increased psychological resilience in the first 6 months, with the most marked change in the first 6 weeks. Also emotional limitations changed significantly over time. The changes were not large enough to influence general QoL or general health significantly.

  12. Genetic diversity in upland cotton for cotton leaf curl virus disease, earliness and fiber quality

    International Nuclear Information System (INIS)

    Saeed, F.; Farooq, J.; Mahmood, A.; Hussain, T.

    2014-01-01

    In Pakistan during last two decades the major factor limiting cotton production is cotton leaf curl virus disease (CLCuD). For estimation of genetic diversity regarding CLCuD tolerance, fiber quality and some yield contributing traits, 101 cotton genotypes imported from USA were evaluated. Different statistical procedures like cluster, principle components (PC) and correlation analysis were employed to identify the suitable genotypes that can be further exploited in breeding programme. Significant associations were found between yield contributing trait, boll weight and fiber related trait, staple length. Earliness related traits, like days taken to 1 square and days taken to 1 flower had positive correlation with each other and both these traits also showed their positive association with ginning out turn. The negative significant correlation of CLCuD was obtained with monopodial branches, sympodial branches and plant height. Principal component (PC) analysis showed first five PCs having eigen value >1 explaining 67.8% of the total variation with days to st 1 square and flowering along with plant height and sympodia plant which were being the most important characters in PC1. Cluster analysis classified 101 accessions into five divergent groups. The genotypes in st cluster 1 only showed reasonable values for days to 1 square and flower, sympodia per plant, ginning out turn, staple length and fiber fineness and the genotypes in cluster 5 showed promising values for the traits like cotton leaf curl virus, ginning out turn and fiber fineness. The genotypes in cluster 1 and 5 may be combined to obtain desirable traits related to earliness and better disease tolerance. Scatter plot and tree diagrams demonstrated sufficient diversity among the cotton accessions for various traits and some extent of association between various clusters. It is concluded that diversity among the genotypes could be utilized for the development of CLCuD resistant lines with increased seed

  13. Poor sleep quality predicts deficient emotion information processing over time in early adolescence.

    Science.gov (United States)

    Soffer-Dudek, Nirit; Sadeh, Avi; Dahl, Ronald E; Rosenblat-Stein, Shiran

    2011-11-01

    There is deepening understanding of the effects of sleep on emotional information processing. Emotion information processing is a key aspect of social competence, which undergoes important maturational and developmental changes in adolescence; however, most research in this area has focused on adults. Our aim was to test the links between sleep and emotion information processing during early adolescence. Sleep and facial information processing were assessed objectively during 3 assessment waves, separated by 1-year lags. Data were obtained in natural environments-sleep was assessed in home settings, and facial information processing was assessed at school. 94 healthy children (53 girls, 41 boys), aged 10 years at Time 1. N/A. Facial information processing was tested under neutral (gender identification) and emotional (emotional expression identification) conditions. Sleep was assessed in home settings using actigraphy for 7 nights at each assessment wave. Waking > 5 min was considered a night awakening. Using multilevel modeling, elevated night awakenings and decreased sleep efficiency significantly predicted poor performance only in the emotional information processing condition (e.g., b = -1.79, SD = 0.52, confidence interval: lower boundary = -2.82, upper boundary = -0.076, t(416.94) = -3.42, P = 0.001). Poor sleep quality is associated with compromised emotional information processing during early adolescence, a sensitive period in socio-emotional development.

  14. [Evaluation of quality of life in school children with a history of early severe malnutrition].

    Science.gov (United States)

    De Grandis, E S; Armelini, P A; Cuestas, E

    2014-12-01

    Severe malnutrition in young children may lead to long-term complications, in particular learning and psychosocial disorders linked to health related quality of life (HRQOL). The aim of this study was to evaluate HRQOL in children whit a history of severe malnutrition before 2 years of life, expecting to find lower scores in these patients. A comparative study was performed on schoolchildren between 5 and 12 years with a history of early severe malnutrition, excluding those with chronic diseases. The Controls were healthy siblings of patients. The sample size was estimated as 26 subjects per group (Total=52). Sociodemographic variables were recorded and the HRQOL was assessed with PedsQL4.0. Chi square and Student t test were applied. Significance level: Psocial dimension: 88.80±3.05 vs 95.71±1.52 (P<.0001), and school dimension: 74.58±3.80 vs 85.00±3.51 (P<.0001). Patients with a history of early severe malnutrition, showed significantly lower HRQOL scores compared with controls. Copyright © 2013 Asociación Española de Pediatría. Published by Elsevier Espana. All rights reserved.

  15. Childhood socioeconomic status and risk in early family environments: predictors of global sleep quality in college students.

    Science.gov (United States)

    Counts, Cory J; Grubin, Fiona C; John-Henderson, Neha A

    2018-06-01

    Low socioeconomic status (SES) in childhood associates with poor sleep quality in adulthood. Separately, childhood family environments shape health into adulthood. Here, we investigated whether these early life factors independently or interactively inform global sleep quality in college students. Cross-sectional. College students at a state university (N = 391). As a measure of childhood SES, we asked participants to consider their families' socioeconomic standing relative to the rest of the society during their childhood. We used the Risky Family questionnaire to measure adversity and the presence of warmth and affection in the family environment during childhood, and the Pittsburgh Sleep Quality Index as a measure of current global sleep quality. We used linear regressions adjusting for age and sex to examine relationships between childhood SES, risk in childhood family environments, and global sleep quality. Lower childhood SES and greater risk in childhood family environments independently predicted poor sleep quality. Importantly, in low-risk family environments, there was no significant difference in sleep quality as a function of childhood SES. However, students who were from low childhood SES backgrounds who also reported high levels of risk in their early family environments had the worst sleep quality. Findings highlight the importance of considering socioeconomic and family environments in childhood as informants of sleep quality across the lifespan. Compromised sleep quality in college students could affect academic performance and health over time. Copyright © 2018 National Sleep Foundation. Published by Elsevier Inc. All rights reserved.

  16. A protocol for a pragmatic randomized controlled trial using the Health Teams Advancing Patient Experience: Strengthening Quality (Health TAPESTRY) platform approach to promote person-focused primary healthcare for older adults.

    Science.gov (United States)

    Dolovich, Lisa; Oliver, Doug; Lamarche, Larkin; Agarwal, Gina; Carr, Tracey; Chan, David; Cleghorn, Laura; Griffith, Lauren; Javadi, Dena; Kastner, Monika; Longaphy, Jennifer; Mangin, Dee; Papaioannou, Alexandra; Ploeg, Jenny; Raina, Parminder; Richardson, Julie; Risdon, Cathy; Santaguida, P Lina; Straus, Sharon; Thabane, Lehana; Valaitis, Ruta; Price, David

    2016-04-05

    Healthcare systems are not well designed to help people maintain or improve their health. They are generally not person-focused or well-coordinated. The objective of this study is to evaluate the effectiveness of the Health Teams Advancing Patient Experience: Strengthening Quality (Health TAPESTRY) approach in older adults. The overarching hypothesis is that using the Health TAPESTRY approach to achieve better integration of the health and social care systems into a person's life that centers on meeting a person's health goals and needs will result in optimal aging. This is a 12-month delayed intervention pragmatic randomized controlled trial. The study will be performed in Hamilton, Ontario, Canada in the two-site McMaster Family Health Team. Participants will include 316 patients who are 70 years of age or older. Participants will be randomized to the Health TAPESTRY approach or control group. The Health TAPESTRY approach includes intentional, proactive conversations about a person's life and health goals and health risks and then initiation of congruent tailored interventions that support achievement of those goals and addressing of risks through (1) trained volunteers visiting clients in their homes to serve as a link between the primary care team and the client; (2) the use of novel technology including a personal health record from the home to link directly with the primary healthcare team; and (3) improved processes for connections, system navigation, and care delivery among interprofessional primary care teams, community service providers, and informal caregivers. The primary outcome will be the goal attainment scaling score. Secondary outcomes include self-efficacy for managing chronic disease, quality of life, the participant perspective on their own aging, social support, access to health services, comprehensiveness of care, patient empowerment, patient-centeredness, caregiver strain, satisfaction with care, healthcare resource utilization, and cost

  17. Associations between relational pronoun usage and the quality of early family interactions

    Directory of Open Access Journals (Sweden)

    Sarah Galdiolo

    2016-11-01

    Full Text Available Our study examined the relationships of relational pronouns used in parental conversation to the quality of early family interactions, as indexed by Family Alliance (FA. We hypothesized that more positive family interactions were associated with the use of more we-pronouns (e.g., we, us, our; we-ness and fewer I- and you-pronouns (e.g., I, me, you, your; separateness by both mothers and fathers. Our statistical model using a multilevel modelling framework and two levels of analysis (i.e., a couple level and an individual level was tested on 47 non-referred families (n = 31 primiparous families; child’s age, M = 15.75 months, SD = 2.73 with we-ness and separateness as outcomes and FA functions as between-dyads variables. Analyses revealed that we-ness within the parental couple was only positively associated with family affect sharing while separateness was negatively associated with different FA functions (e.g., communication mistakes. Our main finding suggested that the kinds of personal pronouns used by parental couples when discussing children’s education would be associated to the emotional quality of the family interactions.

  18. Associations between Relational Pronoun Usage and the Quality of Early Family Interactions.

    Science.gov (United States)

    Galdiolo, Sarah; Roskam, Isabelle; Verhofstadt, Lesley L; De Mol, Jan; Dewinne, Laura; Vandaudenard, Sylvain

    2016-01-01

    Our study examined the relationships of relational pronouns used in parental conversation to the quality of early family interactions, as indexed by Family Alliance (FA). We hypothesized that more positive family interactions were associated with the use of more we-pronouns (e.g., we, us, our; we-ness ) and fewer I- and you-pronouns (e.g., I, me, you, your; separateness ) by both mothers and fathers. Our statistical model using a multilevel modeling framework and two levels of analysis (i.e., a couple level and an individual level) was tested on 47 non-referred families ( n = 31 primiparous families; child's age, M = 15.75 months, SD = 2.73) with we-ness and separateness as outcomes and FA functions as between-dyads variables. Analyses revealed that we-ness within the parental couple was only positively associated with family affect sharing while separateness was negatively associated with different FA functions (e.g., communication mistakes). Our main finding suggested that the kinds of personal pronouns used by parental couples when discussing children's education would be associated to the emotional quality of the family interactions.

  19. Sleep Disordered Breathing in Early Childhood: Quality of Life for Children and Families

    Science.gov (United States)

    Jackman, Angela R.; Biggs, Sarah N.; Walter, Lisa M.; Embuldeniya, Upeka S.; Davey, Margot J.; Nixon, Gillian M.; Anderson, Vicki; Trinder, John; Horne, Rosemary S. C.

    2013-01-01

    Objectives: To characterize health-related quality of life (QOL) in preschool children with sleep disordered breathing (SDB) and their families compared with nonsnoring control patients in the community. It was hypothesized that children with SDB and their families would have poorer QOL than control children, that a relationship would be found between SDB severity and QOL, and that even children with mild SDB and their families would have reduced QOL. Participants and Methods: A clinical sample of preschool children (3-5 y) with SDB diagnosed by gold standard polysomnography (primary snoring, PS = 56, mild obstructive sleep apnea, OSA = 35, moderate/severe OSA = 24) and control children recruited from the community (n = 38) were studied. Parents completed health-related QOL and parenting stress questionnaires. Results: Children and families in the PS and mild OSA groups had consistently poorer QOL than control children (both P Biggs SN; Walter LM; Embuldeniya US; Davey MJ; Nixon GM; Anderson V; Trinder J; Horne RSC. Sleep disordered breathing in early childhood: quality of life for children and families. SLEEP 2013;36(11):1639-1646. PMID:24179296

  20. Early relations between language development and the quality of mother-child interaction in very-low-birth-weight children.

    Science.gov (United States)

    Stolt, S; Korja, R; Matomäki, J; Lapinleimu, H; Haataja, L; Lehtonen, L

    2014-05-01

    It is not clearly understood how the quality of early mother-child interaction influences language development in very-low-birth-weight children (VLBW). We aim to analyze associations between early language and the quality of mother-child interaction, and, the predictive value of the features of early mother-child interaction on language development at 24 months of corrected age in VLBW children. A longitudinal prospective follow-up study design was used. The participants were 28 VLBW children and 34 full-term controls. Language development was measured using different methods at 6, 12 and at 24 months of age. The quality of mother-child interaction was assessed using PC-ERA method at 6 and at 12 months of age. Associations between the features of early interaction and language development were different in the groups of VLBW and full-term children. There were no significant correlations between the features of mother-child interaction and language skills when measured at the same age in the VLBW group. Significant longitudinal correlations were detected in the VLBW group especially if the quality of early interactions was measured at six months and language skills at 2 years of age. However, when the predictive value of the features of early interactions for later poor language performance was analyzed separately, the features of early interaction predicted language skills in the VLBW group only weakly. The biological factors may influence on the language development more in the VLBW children than in the full-term children. The results also underline the role of maternal and dyadic factors in early interactions. Copyright © 2014 Elsevier Ltd. All rights reserved.

  1. How early studies on secreted and membrane protein quality control gave rise to the ER associated degradation (ERAD) pathway: the early history of ERAD.

    Science.gov (United States)

    Needham, Patrick G; Brodsky, Jeffrey L

    2013-11-01

    All newly synthesized proteins are subject to quality control check-points, which prevent aberrant polypeptides from harming the cell. For proteins that ultimately reside in the cytoplasm, components that also reside in the cytoplasm were known for many years to mediate quality control. Early biochemical and genetic data indicated that misfolded proteins were selected by molecular chaperones and then targeted to the proteasome (in eukaryotes) or to proteasome-like particles (in bacteria) for degradation. What was less clear was how secreted and integral membrane proteins, which in eukaryotes enter the endoplasmic reticulum (ER), were subject to quality control decisions. In this review, we highlight early studies that ultimately led to the discovery that secreted and integral membrane proteins also utilize several components that constitute the cytoplasmic quality control machinery. This component of the cellular quality control pathway is known as ER associated degradation, or ERAD. This article is part of a Special Issue entitled: Functional and structural diversity of endoplasmic reticulum. Copyright © 2013 Elsevier B.V. All rights reserved.

  2. Strategy for Strengthening Farmer Groups by Institutional Strengthening

    Directory of Open Access Journals (Sweden)

    Purbayu Budi Santoso

    2015-08-01

    Full Text Available Agriculture sector becomes a spotlight because this sector will be full of potential but the welfare of farmers who become the leading actor is not guaranteed and has a poor tendency. The purpose of this study is to formulate strategies to strengthen farmers' groups in order to create the marketing of the agricultural sector that benefit farmers. The method used to achieve this goal is to use a qualitative approach and Analytical Network Process. In addition to the secondary data obtained from several agencies, this study also uses primary data obtained by in-depth interviews and observations. This research results a priority of aspects of the institutional strengthening of farmer groups as well as priority issues and priorities of the solution of each aspect. In addition, the priority of alternative strategies resulted based on the problems and solutions that have been analyzed in order to solve the problems in the institutional strengthening of farmer groups in Demak.

  3. Does higher quality early child care promote low-income children's math and reading achievement in middle childhood?

    Science.gov (United States)

    Dearing, Eric; McCartney, Kathleen; Taylor, Beck A

    2009-01-01

    Higher quality child care during infancy and early childhood (6-54 months of age) was examined as a moderator of associations between family economic status and children's (N = 1,364) math and reading achievement in middle childhood (4.5-11 years of age). Low income was less strongly predictive of underachievement for children who had been in higher quality care than for those who had not. Consistent with a cognitive advantage hypothesis, higher quality care appeared to promote achievement indirectly via early school readiness skills. Family characteristics associated with selection into child care also appeared to promote the achievement of low-income children, but the moderating effect of higher quality care per se remained evident when controlling for selection using covariates and propensity scores.

  4. Early harvest increases post-harvest physiological quality of Araucaria angustifolia (Araucariaceae) seeds.

    Science.gov (United States)

    Shibata, Marília; Medeiros Coelho, Cileide Maria

    2016-06-01

    ; unlike stages II and III which had short root and shoot lengths during storage. Thus, the maintenance of seed moisture content during storage was variable and dependent on the period of collection. Furthermore, the physiological quality differed among earlier and later stages. Early collection favored seed physiological quality, and may be a strategy for better conservation of A. angustifolia seeds.

  5. Perceived Financial Satisfaction, Health Related Quality of Life and depressive Symptoms in Early Pregnancy.

    Science.gov (United States)

    Sahrakorpi, Niina; Koivusalo, Saila B; Eriksson, Johan G; Kautiainen, Hannu; Stach-Lempinen, Beata; Roine, Risto P

    2017-07-01

    Objectives To assess the associations of perceived financial satisfaction and health-related quality of life (HRQoL) and depressive symptoms in an unselected pregnant population in early pregnancy. Methods 750 consecutive pregnant women attending the first communal ultrasound examination before gestational week 14 were invited to participate. Questionnaires assessing HRQoL (15D), depressive symptoms (Edinburgh Depression Scale, EPDS), medical, obstetric, and socioeconomic status were handed out. The participants were divided into three groups according to their satisfaction with their financial status, (unsatisfied, somewhat satisfied, and satisfied). Main outcome measures were 15D and EPDS-scores and dimensions of HRQoL. Results 325 (43,3%) questionnaires were returned. The mean 15D-score for HRQoL was 0,926 (SD 0,056). The financially unsatisfied women had lower HRQoL than women in more satisfied groups (0.906, 0.923 and 0.931, p = 0.012). The result remained significant, even after adjusting for age and education(p = 0.032). The unsatisfied women had a higher mean body mass index (BMI) (25.4, 24.4 and 23.2 kg/m 2 , p for linearity = 0.002), were more often smokers, (13 vs. 4 and 3%, p = 0.029), and had experienced at least one abortion (18, 14 and 7%, p = 0.017). Dimensions of depression, distress and sleep explained the differences between the groups. 27% of unsatisfied women scored EPDS ≥10 points suggesting increased risk of depression. Conclusions Financial satisfaction in early pregnancy associates with HRQoL and risk of perinatal depressive symptoms. Unsatisfied women more often have risk factors for unfavourable pregnancy outcomes which may influence the later health and wellbeing of the mother and child.

  6. Quality of life following endoscopic resection or radio-therapy for early glottic cancer

    International Nuclear Information System (INIS)

    Bahannan, Abdulrahman A.; Zabrodsky, M.; Chovanec, M.; Cerny, L.; Lohynska, R.

    2007-01-01

    To compare post treatment quality of life (QoL) of patients treated by radiotherapy or endoscopic transoral endolaryngeal surgery using two quality of life scoring tools. From May 1998 to July 2005, 48 patients (11 women and 37 men) with early glottic cancer were treated with curative radiotherapy (18 patients) or laser cordectomy (30 patients), and retrospectively evaluated using QoL questionnaires; European Organization for Research and Treatment of Cancer (EORTC) - EORTC-QoL Core Questionnaire (QLQ-C30 version 2.0) and organ specific EORTC - QLQ, Head and Neck Module (QLQ-H and N35) at the University Hospital Motol, Czech Republic. Mean follow-up was 24 months. Only patients in complete remission were enrolled in the study. The overall score calculated separately for both questionnaires was not statistically different between both groups. Statistically significant differences were found only in specific group of questions focusing on saliva production (p=0.034) and sexuality performance (p=0.002). The majority of cases treated with cordectomy were Tis lesions. In the radiotherapy group, T1 lesions predominated (p=0.0001). Patients treated with radiotherapy were significantly older than those treated with cordectomy (p=0.027), which could explain the worsened score in sexuality questions. There were no significant differences found between genders allocated either to cordectomy or radiotherapy group. The overall QoL did not differ between patients treated with cordectomy or radiotherapy, despite the fact that patients treated with radiotherapy had more advanced disease and were older. There was significantly worse saliva and sexuality question score in the radiotherapy group. (author)

  7. Ion exchange for glass strengthening

    International Nuclear Information System (INIS)

    Gy, Rene

    2008-01-01

    This paper presents a short overview of silicate glass strengthening by exchange of alkali ions in a molten salt, below the glass transition temperature (chemical tempering). The physics of alkali inter-diffusion is briefly explained and the main parameters of the process, which control the glass reinforcement, are reviewed. Methods for characterizing the obtained residual stress state and the strengthening are described, along with the simplified modelling of the stress build-up. The fragmentation of chemically tempered glass is discussed. The concept of engineered stress profile glass is presented, and finally, the effect of glass and salt compositions is overviewed

  8. Associations Between Sibling Relationship Quality and Friendship Quality in Early Adolescence: Looking at the Case of Twins.

    Science.gov (United States)

    Bekkhus, Mona; Brendgen, Mara; Czajkowski, Nikolai O; Vitaro, Frank; Dionne, Ginette; Boivin, Michel

    2016-04-01

    Bidirectional pathways between twin relationship quality and friendship quality were investigated in a large longitudinal twin cohort. We examined negative and positive relationship features in 313 monozygotic (MZ) twins and 238 same-sex dizygotic (DZ) twins from ages 13 to 14 years, using latent structural modeling. Results showed stronger stability of the twin relationship quality compared to friendship quality. Positive features in the sibling relationship were associated with increased positive features in the relationship with the best friend a year later. In contrast, no significant association between negative sibling relationship features and change in negative friendship quality features was found. These findings speak to the important role of the sibling relationship in the development of good quality friendship relations in twins.

  9. Quality of life, urogynecological morbidity, and lymphedema after radical vaginal trachelectomy for early-stage cervical cancer

    DEFF Research Database (Denmark)

    Frøding, Ligita Paskeviciute; Ottosen, Christian; Mosgaard, Berit Jul

    2015-01-01

    OBJECTIVE: Radical vaginal trachelectomy (RVT) offers a possibility for future childbearing for young women with early-stage cervical cancer. However, the literature on quality of life and self-reported morbidity in patients undergoing RVT is scarce. The aim of this study was to prospectively...

  10. Maternal Depression and Parenting in Early Childhood: Contextual Influence of Marital Quality and Social Support in Two Samples

    Science.gov (United States)

    Taraban, Lindsay; Shaw, Daniel S.; Leve, Leslie D.; Wilson, Melvin N.; Dishion, Thomas J.; Natsuaki, Misaki N.; Neiderhiser, Jenae M.; Reiss, David

    2017-01-01

    Marital quality and social support satisfaction were tested as moderators of the association between maternal depressive symptoms and parenting during early childhood (18--36 months) among 2 large, divergent, longitudinal samples (n = 526; n = 570). Unexpectedly, in both samples the association between maternal depressive symptoms and reduced…

  11. Quality of life and fear of cancer recurrence after endoscopic and surgical treatment for early neoplasia in Barrett's esophagus

    NARCIS (Netherlands)

    Rosmolen, W. D.; Boer, K. R.; de Leeuw, R. J.; Gamel, C. J.; van Berge Henegouwen, M. I.; Bergman, J. J.; Sprangers, M. A.

    2010-01-01

    Background and study aims: Endoscopic treatment of early neoplasia in Barrett's esophagus preserves the esophagus and is minimally invasive compared with surgical treatment. However, the influence of endoscopic therapy on quality of life (QOL) and fear of cancer recurrence is unknown. We explored

  12. Enhancing Recognition of High Quality, Functional IEP Goals: A Training Activity for Early Childhood Special Education Staff

    Science.gov (United States)

    Lucas, Anne; Gillaspy, Kathi; Peters, Mary Louise; Hurth, Joicey

    2014-01-01

    This training activity was created to support participants' understanding of the criteria needed to develop and write high quality, participation-based Individualized Education Program (IEP) goals. The term "functional" is often used to describe what goals ought to be, yet many Early Childhood Special Education (ECSE) staff (e.g.,…

  13. Beyond a Logic of Quality: Opening Space for Material-Discursive Practices of "Readiness" in Early Years Education

    Science.gov (United States)

    Evans, Katherine

    2016-01-01

    This article is an exploration of the possibilities encountered through shifting from a "logic of quality" to a "space of meaning-making" within early years education. Focusing on ideas of "readiness", this discussion aims to challenge normative understandings that relate this concept to the predictable achievement of…

  14. Parent-Child Book-Reading Styles, Emotional Quality, and Changes in Early Head Start Children's Cognitive Scores

    Science.gov (United States)

    Cline, Keely D.; Edwards, Carolyn Pope

    2017-01-01

    Research Findings: The objective of this study was to understand how instructional book-reading style and emotional quality of reading interact and relate to cognitive skills in a sample of at-risk infants and toddlers. Participants were 81 parents and their children participating in Early Head Start programs in the rural Midwest. Correlation and…

  15. Employability Skills, Personal Qualities, and Early Employment Problems of Entry-Level Auditors: Perspectives from Employers, Lecturers, Auditors, and Students

    Science.gov (United States)

    Lim, Yet-Mee; Lee, Teck Heang; Yap, Ching Seng; Ling, Chui Ching

    2016-01-01

    The authors examine the issue of employability of university accounting students from the perspectives of accounting firm employers, junior auditors, accounting lecturers, and accounting students. Areas of investigation include perceived importance of employability skills and desirable personal qualities; and early employment problems encountered…

  16. Effect of peri-operative chemotherapy on the quality of life of patients with early breast cancer

    NARCIS (Netherlands)

    Kiebert, G. M.; Hanneke, J.; de Haes, J. Hanneke C. J. M.; Kievit, J.; van de Velde, C. J.

    1990-01-01

    Since chemotherapy is assumed to have a negative impact on quality of life, the impact of peri-operative chemotherapy on physical, psychological and social well-being and on the activity level of patients with early stage breast cancer was investigated. 24 women received peri-operative chemotherapy

  17. Disease management of early childhood caries: results of a pilot quality improvement project.

    Science.gov (United States)

    Ng, Man Wai; Torresyap, Gay; White, Alex; Melvin, Patrice; Graham, Dionne; Kane, Daniel; Scoville, Richard; Ohiomoba, Henry

    2012-08-01

    The purpose is to report findings of a quality improvement (QI) project implemented at two hospital-based dental clinics that care for children with early childhood caries (ECC). We tested a disease management (DM) approach in children younger than age 60 months with ECC. After 30 months, for the 403 and 234 DM patients at Children's Hospital Boston (CHB) and Saint Joseph Hospital (SJH) who returned for at least two visits, rates of new cavitation, pain, and referrals to the OR were 26.1, 13.4 and 10.9% for CHB and 41.0, 7.3 and 14.9% for SJH. Rates of new cavitation, pain, and referrals to the OR for historical controls were 75.2, 21.7, and 20.9% for CHB and 71.3, 31.3, and 25.0% for SJH. A risk-based DM approach utilizing QI strategies to address ECC can be implemented into practice and has the potential to improve care and health outcomes.

  18. Quality of life, anxiety and depression symptoms in early and late pregnancy in women with pregestational diabetes

    DEFF Research Database (Denmark)

    Do, Nicoline C; Secher, Anna L; Cramon, Per

    2017-01-01

    INTRODUCTION: The aim of this study was to explore changes in health-related quality of life, anxiety and depression symptoms during pregnancy in women with pregestational diabetes. MATERIAL AND METHODS: An observational cohort study including 137 pregnant women with pregestational diabetes (110...... with type 1 and 27 with type 2). To evaluate changes from early to late pregnancy, the internationally validated questionnaires 36-Item Short-Form Health Survey (SF-36) and Hospital Anxiety and Depression Scale (HADS) were completed at 8 and 33 gestational weeks. RESULTS: From early to late pregnancy....... The HADS anxiety score improved slightly from 5.0 (3.3) to 4.5 (3.4) (p = 0.04) whereas the HADS depression score remained unchanged. The prevalence of women with HADS anxiety or depression score ≥8 did not change. CONCLUSIONS: Physical quality of life deteriorated whereas mental quality of life improved...

  19. A multicenter prospective study to assess the effect of early cleavage on embryo quality, implantation, and live-birth rate.

    Science.gov (United States)

    de los Santos, Maria José; Arroyo, Gemma; Busquet, Ana; Calderón, Gloria; Cuadros, Jorge; Hurtado de Mendoza, Maria Victoria; Moragas, Marta; Herrer, Raquel; Ortiz, Agueda; Pons, Carme; Ten, Jorge; Vilches, Miguel Angel; Figueroa, Maria José

    2014-04-01

    To investigate the impact of early cleavage (EC) on embryo quality, implantation, and live-birth rates. Prospective cross-sectional study. Multicenter study. Seven hundred embryo transfers and 1,028 early-stage human embryos. None. Implantation according to the presence of EC and embryo quality. The presence of EC is associated with embryo quality, especially in cycles with autologous oocytes. However, the use of EC as an additional criterion for selecting an embryo for transfer does not appear to significantly improve likelihood of implantation. Furthermore, embryos that presented EC had live-birth rates per implanted embryo similar to those that did not show any sign of cleavage. At least for conventional embryo culture and morphologic evaluations, the additional evaluation of EC in embryos may not be valuable to improve embryo implantation. Copyright © 2014 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  20. Strengthening the sports data infrastructure

    NARCIS (Netherlands)

    Annet Tiessen-Raaphorst; Jos de Haan; with contributions from Remco van den Dool

    2012-01-01

    Original title: Versterking data-infrastructuur sport Sports research in the Netherlands has developed rapidly over the last ten years; strengthening the data infrastructure will facilitate its further growth in the future. Currently, however, there is no clear overall picture of the available

  1. Supporting Early Math--Rationales and Requirements for High Quality Software

    Science.gov (United States)

    Haake, Magnus; Husain, Layla; Gulz, Agneta

    2015-01-01

    There is substantial evidence that preschooler's performance in early math is highly correlated to math performance throughout school as well as academic skills in general. One way to help children attain early math skills is by using targeted educational software and the paper discusses potential gains of using such software to support early math…

  2. Equity and Quality? Challenges for Early Childhood and Primary Education in Ethiopia, India and Peru. Working Papers in Early Childhood Development, No. 55. Studies in Early Childhood Transitions

    Science.gov (United States)

    Woodhead, Martin; Ames, Patricia; Vennam, Uma; Abebe, Workneh; Streuli, Natalia

    2009-01-01

    Part of the "Studies in Early Transitions" series, this Working Paper draws on interviews and observations carried out as part of "Young Lives", a 15-year longitudinal study of childhood poverty in Ethiopia, India, Peru and Vietnam based at the University of Oxford's Department of International Development. This paper focuses…

  3. Strengthened glass for high average power laser applications

    International Nuclear Information System (INIS)

    Cerqua, K.A.; Lindquist, A.; Jacobs, S.D.; Lambropoulos, J.

    1987-01-01

    Recent advancements in high repetition rate and high average power laser systems have put increasing demands on the development of improved solid state laser materials with high thermal loading capabilities. The authors have developed a process for strengthening a commercially available Nd doped phosphate glass utilizing an ion-exchange process. Results of thermal loading fracture tests on moderate size (160 x 15 x 8 mm) glass slabs have shown a 6-fold improvement in power loading capabilities for strengthened samples over unstrengthened slabs. Fractographic analysis of post-fracture samples has given insight into the mechanism of fracture in both unstrengthened and strengthened samples. Additional stress analysis calculations have supported these findings. In addition to processing the glass' surface during strengthening in a manner which preserves its post-treatment optical quality, the authors have developed an in-house optical fabrication technique utilizing acid polishing to minimize subsurface damage in samples prior to exchange treatment. Finally, extension of the strengthening process to alternate geometries of laser glass has produced encouraging results, which may expand the potential or strengthened glass in laser systems, making it an exciting prospect for many applications

  4. Challenges for strengthening the health workforce in the Lao People's Democratic Republic: perspectives from key stakeholders.

    Science.gov (United States)

    Qian, Yi; Yan, Fei; Wang, Wei; Clancy, Shayna; Akkhavong, Kongsap; Vonglokham, Manithong; Outhensackda, Somphou; Østbye, Truls

    2016-11-29

    The Lao People's Democratic Republic is facing a critical shortage and maldistribution of health workers. Strengthening of the health workforce has been adopted as one of the five priorities of the National Health Sector Strategy (2013-2025). This study aims to identify, explore, and better understand the key challenges for strengthening the Laotian health workforce. This study applied exploratory and descriptive qualitative methods and adapted a working life-span framework. Twenty-three key stakeholders with particular insights into the current situation of the health workforce were purposively recruited for in-depth interviews. Important policy documents were also collected from key informants during the interviews. Thematic analysis was employed for the textual data using MAXQDA 10. The overarching problem is that there is a perceived severe shortage of skilled health workers (doctors, nurses, and midwives) and lab technicians, especially in primary health facilities and rural areas. Key informants also identified five problems: insufficient production of health workers both in quantity and quality, a limited national budget to recruit enough health staff and provide sufficient and equitable salaries and incentives, limited management capacity, poor recruitment for work in rural areas, and lack of well-designed continuing education programs for professional development. These problems are interrelated, both in how the issues arise and in the effect they have on one another. To improve the distribution of health workers in rural areas, strategies for increasing production and strengthening retention should be well integrated for better effectiveness. It is also essential to take the Laotian-specific context into consideration during intervention development and implementation. Furthermore, the government should acknowledge the inadequate health management capacity and invest to improve human resource management capacity at all levels. Finally, assessment of

  5. Preliminary approach on early post mortem stress and quality indexes changes in large size bluefin tuna (Thunnus thynnus

    Directory of Open Access Journals (Sweden)

    R. Ugolini

    2010-01-01

    Full Text Available Bluefin tuna (Thunnus thynnus is very appreciated on Japan and USA market for the preparation of sushi and sahimi. The market price of the fresh product can vary from 8 to 33 Euro/kg (gate farm/producers prices according to size, shape, fat level, meat colour, consistency and freshness (absence of “hyake”, all parameters strictly connected to feeding quality and quantity, rearing and killing stress factors and refrigeration times and conditions after death. Excessive levels of stress during the slaughtering can affect meat quality, contributing to significantly decrease of tuna’s price. The present trial was carried out to evaluate the possible harvesting/slaughtering stress effect on reared bluefin tuna meat quality, starting from the examination of the most important stress and quality parameters changes during the early post mortem period.

  6. Maternal depression and parenting in early childhood: Contextual influence of marital quality and social support in two samples.

    Science.gov (United States)

    Taraban, Lindsay; Shaw, Daniel S; Leve, Leslie D; Wilson, Melvin N; Dishion, Thomas J; Natsuaki, Misaki N; Neiderhiser, Jenae M; Reiss, David

    2017-03-01

    Marital quality and social support satisfaction were tested as moderators of the association between maternal depressive symptoms and parenting during early childhood (18-36 months) among 2 large, divergent, longitudinal samples (n = 526; n = 570). Unexpectedly, in both samples the association between maternal depressive symptoms and reduced parenting quality was strongest in the context of high marital quality and high social support, and largely nonsignificant in the context of low marital quality and low social support. Possible explanations for these surprising findings are discussed. Results point to the importance of accounting for factors in the broader family context in predicting the association between depressive symptoms and maternal parenting. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  7. Strengthening method of concrete structure

    Science.gov (United States)

    Inge, Wewin; Audrey; Nugroho, Sofie; Njo, Helen

    2018-03-01

    Building extension in Indonesia is not favored, and not many people know the advantages of the method because architects and engineers tend to lack the knowledge and experience. The aim of this paper is to explain a method on how to strengthen a concrete building structure that people can use/learn as a better way to cut potential cost and save time. The strengthening method explained in this paper is steel jacketing, providing a case study of this method in the extension of a restaurant located in Medan, Indonesia. In this study, engineers calculated that the tensile stress of the existing RC column and beam is not strong enough to reinforce the building extension applied load. Therefore, the steel jacketing method can be applied to improve the column and beam strength and ductility. The result of the case study proves that this is one of the best methods for building extension applied in Indonesia.

  8. Initial Semantics for Strengthened Signatures

    Directory of Open Access Journals (Sweden)

    André Hirschowitz

    2012-02-01

    Full Text Available We give a new general definition of arity, yielding the companion notions of signature and associated syntax. This setting is modular in the sense requested by Ghani and Uustalu: merging two extensions of syntax corresponds to building an amalgamated sum. These signatures are too general in the sense that we are not able to prove the existence of an associated syntax in this general context. So we have to select arities and signatures for which there exists the desired initial monad. For this, we follow a track opened by Matthes and Uustalu: we introduce a notion of strengthened arity and prove that the corresponding signatures have initial semantics (i.e. associated syntax. Our strengthened arities admit colimits, which allows the treatment of the λ-calculus with explicit substitution.

  9. Assessing the influence of project management on quality during the early phases of construction projects

    Directory of Open Access Journals (Sweden)

    Ljevo Žanesa

    2018-12-01

    Full Text Available Although the quality of a process affects the quality of the end product, there is currently an insignif­icant amount of knowledge about the quality of project management (PM processes that directly affect the quality of the delivered product (constructed building. This study presents a proposal for modeling the impact of the quality of the PM process on the quality of the con­structed building. The quality of the PM process is rep­resented by the main quality factors and product quality indicators. It presents the results of the interviews that were conducted and study cases that were analyzed in Bosnia and Herzegovina with a variety of project partici­pants (with different managerial perspectives in terms of the indicators of quality of the delivered product. All par­ticipants, regardless of managerial perspective, believe that the most important indicator of the quality of prod­ucts for each phase of the project is “customer satisfaction in the end phase”, the measurement of which is different for each project phase that is presented. The results of the factor analysis of the definition and the planning phases show that 11 variables, namely, the quality factors of the PM process, can be grouped into three new factors, which is described as 66.61% (77.046% of the basic set of vari­ables.

  10. Quality Improvement in Early Years Settings in Hong Kong and England

    Science.gov (United States)

    Ho, Dora; Campbell-Barr, Verity; Leeson, Caroline

    2010-01-01

    With a growing awareness of the importance of early childhood education, the governments of Hong Kong and England have both increased investment through providing fee assistance to parents for buying services and providing funding to providers for offering "free" places, respectively. Alongside the increased funding of early childhood…

  11. Strengthening Mechanisms in Microtruss Metals

    Science.gov (United States)

    Ng, Evelyn K.

    Microtrusses are hybrid materials composed of a three-dimensional array of struts capable of efficiently transmitting an externally applied load. The strut connectivity of microtrusses enables them to behave in a stretch-dominated fashion, allowing higher specific strength and stiffness values to be reached than conventional metal foams. While much attention has been given to the optimization of microtruss architectures, little attention has been given to the strengthening mechanisms inside the materials that make up this architecture. This thesis examines strengthening mechanisms in aluminum alloy and copper alloy microtruss systems with and without a reinforcing structural coating. C11000 microtrusses were stretch-bend fabricated for the first time; varying internal truss angles were selected in order to study the accumulating effects of plastic deformation and it was found that the mechanical performance was significantly enhanced in the presence of work hardening with the peak strength increasing by a factor of three. The C11000 microtrusses could also be significantly reinforced with sleeves of electrodeposited nanocrystalline Ni-53wt%Fe. It was found that the strength increase from work hardening and electrodeposition were additive over the range of structures considered. The AA2024 system allowed the contribution of work hardening, precipitation hardening, and hard anodizing to be considered as interacting strengthening mechanisms. Because of the lower formability of AA2024 compared to C11000, several different perforation geometries in the starting sheet were considered in order to more effectively distribute the plastic strain during stretch-bend fabrication. A T8 condition was selected over a T6 condition because it was shown that the plastic deformation induced during the final step was sufficient to enhance precipitation kinetics allowing higher strengths to be reached, while at the same time eliminating one annealing treatment. When hard anodizing

  12. Quality of life in a randomized trial of early closure of temporary ileostomy after rectal resection for cancer (EASY trial)

    DEFF Research Database (Denmark)

    Park, J; Danielsen, A K; Angenete, E

    2018-01-01

    BACKGROUND: A temporary ileostomy may reduce symptoms from anastomotic leakage after rectal cancer resection. Earlier results of the EASY trial showed that early closure of the temporary ileostomy was associated with significantly fewer postoperative complications. The aim of the present study...... was to compare health-related quality of life (HRQOL) following early versus late closure of a temporary ileostomy. METHODS: Early closure of a temporary ileostomy (at 8-13 days) was compared with late closure (at more than 12 weeks) in a multicentre RCT (EASY) that included patients who underwent rectal...... after resection using the European Organisation for Research and Treatment of Cancer (EORTC) questionnaires QLQ-C30 and QLQ-CR29 and Short Form 36 (SF-36®). RESULTS: There were 112 patients available for analysis. Response rates of the questionnaires were 82-95 per cent, except for EORTC QLQ-C30 at 12...

  13. Quality of life in amyotrophic lateral sclerosis patients and caregivers: Impact of assistive communication from early stages.

    Science.gov (United States)

    Londral, Ana; Pinto, Anabela; Pinto, Susana; Azevedo, Luis; De Carvalho, Mamede

    2015-12-01

    In this study we performed a longitudinal investigation to assess the impact of early introduction of assistive communication devices (ACDs) on quality of life (QoL) in amyotrophic lateral sclerosis (ALS) patients and their caregivers. Patients were followed for 7-10 months (3 evaluation periods). Bulbar-onset ALS patients (N = 27) and paired caregivers (N = 17) were included. Fifteen randomly selected patients received early support in ACD use. Patients were assessed using the ALS Functional Rating Scale-revised (ALSFRS-R), the McGill QoL (MQoL), the Communication Effectiveness Index (CETI), and performance in writing; and caregivers were assessed with the MQoL and World Health Organization Quality of Life questionnaire (WHOQOL-BREF). Patients with early support had higher MQoL Psychological and MQoL Existential well-being domains; caregivers had higher MQoL Support domain and their MQoL Psychological domain positively associated with patient CETI. Most patients could communicate using a touchscreen keyboard to write, even when handwriting and speech were not possible. Early intervention with an ACD seems to have a positive impact on QoL and gives patients the opportunity to improve skills for communication in later disease stages. © 2015 Wiley Periodicals, Inc.

  14. Sleep On It: How Snoozing Strengthens Memories

    Science.gov (United States)

    ... Special Issues Subscribe April 2013 Print this issue Sleep On It How Snoozing Strengthens Memories Send us ... the best way to remember it is to sleep on it. That’s because sleeping helps strengthen memories ...

  15. Training in Values to Strengthen Social and Civic Coexistence

    Directory of Open Access Journals (Sweden)

    Yajaira del Valle Cadenas Terán

    2017-02-01

    Full Text Available The purpose of this study is to present significantly values training to strengthen social and citizen considering that the coexistence of human beings has not been entirely easy, but so far they have managed to relate many of their problems with how to relate and interact with the environment, especially with the social environment. This study was conducted with a literature review which is the basis for targeted strengthening coexistence and citizenship therefore falls from a descriptive research training documentary. In conclusion, the importance of the subject since doors for values, dialogues, reflections, quality of life, among others that reflect the actions of teachers based on principles axiological open.

  16. Sleep quality and fatigue after a stress management intervention for women with early-stage breast cancer in southern Florida.

    Science.gov (United States)

    Vargas, Sara; Antoni, Michael H; Carver, Charles S; Lechner, Suzanne C; Wohlgemuth, William; Llabre, Maria; Blomberg, Bonnie B; Glück, Stefan; DerHagopian, Robert P

    2014-12-01

    Sleep disruption and fatigue are ubiquitous among cancer patients and are sources of stress that may compromise treatment outcomes. Previously, we showed that a cognitive behavioral stress management (CBSM) intervention reduced anxiety and other stress-related processes in women undergoing primary treatment for breast cancer. This study examined secondary outcomes from a CBSM intervention trial for women with early-stage breast cancer to test if CBSM would improve sleep quality and fatigue among these patients at a single site in southern Florida. CBSM-related effects have already been demonstrated for indicators of psychosocial adaptation (e.g., general and cancer-related anxiety). Patients were randomized to CBSM (n= 120) or a 1-day psychoeducation control group (n= 120). The Pittsburgh Sleep Quality Index (PSQI) and Fatigue Symptom Inventory were completed prior to randomization and 6 and 12 months after the baseline assignment. In latent growth analyses, women in CBSM reported greater improvements in PSQI sleep quality scores than controls, although there were no significant differences between conditions on PSQI total scores. Women in CBSM also reported greater reductions in fatigue-related daytime interference than controls, though there were no significant differences in changes in fatigue intensity. Changes in sleep quality were associated with changes in fatigue. Future work may consider integrating sleep and fatigue content into stress management interventions for women with early-stage breast cancer.

  17. HOME VISIT QUALITY VARIATIONS IN TWO EARLY HEAD START PROGRAMS IN RELATION TO PARENTING AND CHILD VOCABULARY OUTCOMES.

    Science.gov (United States)

    Roggman, Lori A; Cook, Gina A; Innocenti, Mark S; Jump Norman, Vonda; Boyce, Lisa K; Christiansen, Katie; Peterson, Carla A

    2016-05-01

    Home-visiting programs aiming to improve early child development have demonstrated positive outcomes, but processes within home visits to individual families are rarely documented. We examined family-level variations in the home-visiting process (N = 71) from extant video recordings of home visits in two Early Head Start programs, using an observational measure of research-based quality indicators of home-visiting practices and family engagement, the Home Visit Rating Scales (HOVRS). HOVRS scores, showing good interrater agreement and internal consistency, were significantly associated with parent- and staff-reported positive characteristics of home visiting as well as with parenting and child language outcomes tested at program exit. When home-visiting processes were higher quality during the program, home visit content was more focused on child development, families were more involved in the overall program, and most important, scores on measures of the parenting environment and children's vocabulary were higher at the end of the program. Results showed that home visit quality was indirectly associated with child language outcomes through parenting outcomes. Observation ratings of home visit quality could be useful for guiding program improvement, supporting professional development, and increasing our understanding of the links between home-visiting processes and outcomes. © 2016 Michigan Association for Infant Mental Health.

  18. The role of early-life educational quality and literacy in explaining racial disparities in cognition in late life.

    Science.gov (United States)

    Sisco, Shannon; Gross, Alden L; Shih, Regina A; Sachs, Bonnie C; Glymour, M Maria; Bangen, Katherine J; Benitez, Andreana; Skinner, Jeannine; Schneider, Brooke C; Manly, Jennifer J

    2015-07-01

    Racial disparities in late-life cognition persist even after accounting for educational attainment. We examined whether early-life educational quality and literacy in later life help explain these disparities. We used longitudinal data from the Washington Heights-Inwood Columbia Aging Project (WHICAP). Educational quality (percent white students; urban/rural school; combined grades in classroom) was operationalized using canonical correlation analysis. Late-life literacy (reading comprehension and ability, writing) was operationalized using confirmatory factor analysis. We examined whether these factors attenuated race-related differences in late-life cognition. The sample consisted of 1,679 U.S.-born, non-Hispanic, community-living adults aged 65-102 (71% black, 29% white; 70% women). Accounting for educational quality and literacy reduced disparities by 29% for general cognitive functioning, 26% for memory, and 32% for executive functioning but did not predict differences in rate of cognitive change. Early-life educational quality and literacy in late life explain a substantial portion of race-related disparities in late-life cognitive function. © The Author 2014. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  19. Early childhood cortisol reactivity moderates the effects of parent-child relationship quality on the development of children’s temperament in early childhood

    Science.gov (United States)

    Kopala-Sibley, Daniel C.; Dougherty, Lea R.; Dyson, Margret W.; Laptook, Rebecca S.; Olino, Thomas M.; Bufferd, Sara J.; Klein, Daniel N.

    2017-01-01

    Positive parenting has been related both to lower cortisol reactivity and more adaptive temperament traits in children, whereas elevated cortisol reactivity may be related to maladaptive temperament traits, such as higher negative emotionality (NE) and lower positive emotionality (PE). However, no studies have examined whether hypothalamic-pituitary-adrenal axis activity, as measured by cortisol reactivity, moderates the effect of the quality of the parent-child relationship on changes in temperament in early childhood. In this study, 126 3-year olds were administered the Laboratory Temperament Assessment Battery (Lab-TAB; Goldsmith et al., 1995) as a measure of temperamental NE and PE. Salivary cortisol was collected from the child at 4 time points during this task. The primary parent and the child completed the Teaching Tasks battery (Egeland et al., 1995), from which the quality of the relationship was coded. At age 6, children completed the Lab-TAB again. From age 3 to 6, adjusting for age 3 PE or NE, a better quality relationship with their primary parent predicted decreases in NE for children with elevated cortisol reactivity and predicted increases in PE for children with low cortisol reactivity. Results have implications for our understanding of the interaction of biological stress systems and the parent-child relationship in the development of temperament in childhood. PMID:26689860

  20. Direct and Indirect Effects of a Family-Based Intervention in Early Adolescence on Parent-Youth Relationship Quality, Late Adolescent Health, and Early Adult Obesity

    Science.gov (United States)

    Van Ryzin, Mark J.; Nowicka, Paulina

    2013-01-01

    We explored family processes in adolescence that may influence the likelihood of obesity in early adulthood using a randomized trial of a family-based intervention (the Family CheckUp, or FCU). The FCU has been shown to reduce escalations in antisocial behavior and depression in adolescence by supporting positive family management practices, but no research has examined the mechanisms by which the FCU could influence health-related attitudes and behaviors linked to obesity. Participants were 998 adolescents (n = 526 male; n = 423 European American; M age 12.21 yrs) and their families, recruited in 6th grade from 3 middle schools in the Pacific Northwest. We used structural equation modeling (SEM) and an Intent-To-Treat (ITT) design to evaluate the direct and indirect effects of the FCU on parent–youth relationship quality (ages 12–15), healthy lifestyle behaviors, eating attitudes, depressive symptoms (all measured at age 17), and obesity (age 22). We found that the FCU led to greater parent–youth relationship quality, which predicted enhanced health-related behaviors, reduced maladaptive eating attitudes, and reduced depression. In turn, reduced maladaptive eating attitudes predicted reduced odds of obesity. The indirect effect of the FCU on obesity by way of parent–youth relationship quality and eating attitudes was significant. Our findings illustrate how family processes may influence adolescent health and suggest that family functioning may be an additional factor to consider when developing intervention programs for obesity. PMID:23421838

  1. Parenting and Friendship Quality as Predictors of Internalizing and Externalizing Symptoms in Early Adolescence

    Science.gov (United States)

    Gaertner, Alden E.; Fite, Paula J.; Colder, Craig R.

    2010-01-01

    Research indicates both parents and peers influence child and adolescent adjustment outcomes. Moreover, friendship quality has been found to buffer the influence of parenting on adolescent adjustment, particularly externalizing symptoms. Little to no research, however, has longitudinally examined whether friendship quality moderates the relation…

  2. ADHD and Sleep Quality: Longitudinal Analyses From Childhood to Early Adulthood in a Twin Cohort.

    Science.gov (United States)

    Gregory, Alice M; Agnew-Blais, Jessica C; Matthews, Timothy; Moffitt, Terrie E; Arseneault, Louise

    2017-01-01

    Attention-deficit/hyperactivity disorder (ADHD) is associated with poor sleep quality, but there is more to learn about the longitudinal association and aetiology of this association. We investigated the following: (a) Is there an association between childhood ADHD and poor sleep quality in young adulthood? (b) Is this driven by the long-term effects of childhood ADHD or concurrent associations with ADHD in young adulthood? (c) To what extent do genetic and environmental influences explain the overlap between symptoms of ADHD and poor sleep quality? Participants were from the Environmental Risk Longitudinal Twin Study of 2,232 twin children born in the United Kingdom in 1994-1995. We ascertained ADHD diagnoses at ages 5, 7, 10, 12, and 18. We assessed sleep quality using the Pittsburgh Sleep Quality Index at age 18. We used regression models to examine longitudinal associations and bivariate twin modelling to test genetic and environmental influences. Children with ADHD had poorer sleep quality in young adulthood, but only if their ADHD persisted. Adults with ADHD had more sleep problems than those without ADHD, over and above psychiatric comorbidity and maternal insomnia. ADHD and sleep problems in young adulthood were associated because of genetic (55%) and nonshared environmental influences (45%). Should ADHD remit, children with ADHD do not appear to have an increased risk of later sleep problems. Good quality sleep is important for multiple areas of functioning, and a better understanding of why adults with ADHD have poorer sleep quality will further the goal of improving treatments.

  3. Early comprehensive care of preterm infants-effects on quality of life, childhood development, and healthcare utilization: study protocol for a cohort study linking administrative healthcare data with patient reported primary data.

    Science.gov (United States)

    Schmitt, Jochen; Arnold, Katrin; Druschke, Diana; Swart, Enno; Grählert, Xina; Maywald, Ulf; Fuchs, Andreas; Werblow, Andreas; Schemken, Maryan; Reichert, Jörg; Rüdiger, Mario

    2016-07-22

    About 9 % of all children in Germany are born preterm. Despite significant improvements of medical care, preterm infants are at a greater risk to develop short and long term health complications. Negative consequences of preterm birth include neurodevelopmental disabilities, behavioral problems or learning disorders. Most data on effects of prematurity are derived from single or multi-center studies and not population-based. Since some of the long term problems of preterm delivery are associated with a disturbed parent-child interaction originating in the neonatal period, several intervention programs became available aiming to strengthen the early parent-child relationship. However, there is insufficient knowledge regarding the psychosocial and socioeconomic impact of these interventions. Prior to introducing them into routine care, those effects have to be rigorously evaluated. The population-based cohort study EcoCare-PIn (Early comprehensive Care of Preterm Infants-effects on quality of life, childhood development, and healthcare utilization) will investigate the following primary research questions: 1) What are the short- and long-term consequences of preterm birth with regard to parental stress, parent-child relationship, childhood development, quality of life and healthcare utilization including costs? 2) Does early family-centered psychosocial care prevent the hypothesized negative consequences of preterm birth on the above mentioned outcomes? EcoCare-PIn examines the research questions by means of a linkage of a) pseudonymized administrative individual-level claims data from the German statutory health insurance AOK PLUS on approximately 140,000 children born between 2007 and 2013 in Saxony, and b) primary data collected from the parents/caregivers of all very low birth weight (primary data is a novel approach in neonatal research and probably the only way to overcome shortcomings of studies solely relying on one data source. The study results are based

  4. Health system strengthening in the context of CMAM

    International Nuclear Information System (INIS)

    Israel, Anne-Dominique; Gallagher, Maureen

    2014-01-01

    The approach to the management of acute malnutrition has changed substantially in recent years. There has been recognition that, despite huge advances over the last 25 years on how Severe Acute Malnutrition (SAM) is treated, coverage remains around 7 to 13%. Universal coverage to SAM management can only be achieved by ensuring availability of and access to treatment at all levels of the health system. SAM needs to be considered as a disease to be integrated and mainstreamed as part of the basic package of health services, which highlights the need to review existing implementation approaches to be increasingly horizontal, process oriented instead of vertical, model oriented. In many countries, programs to treat AM now fall under the responsibility and leadership of the Ministry of Health and its sub-national authorities. This provides an enabling environment for AM management within the health system as it is integrated as an additional component of the basic healthcare package. In considering SAM as a disease, we can learn from existing large global health initiatives (GHI) experiences, developed in the early 2000s, targeting specific diseases. GAVI (for immunization), PEPFAR (for HIV/AIDS) and Global Fund (for HIV, malaria & TB), applied, at their early stages a “disease based/ vertical approach”. This approach revealed its limitations as the countries where these global health initiatives were implemented had fragile health systems, continuously struggling to operate effectively and to deliver accessible standard quality care. The nutrition community, in promoting AM management to be integrated into the basic package of health services has been, these last years, faced with similar challenges and questions as GHIs. There is an increased need to recognize that most of the barriers identified in delivering SAM or MAM management are common to those faced by the health system overall. Therefore, a more global/ general and coordinated effort is required to

  5. Early prediction of wheat quality: analysis during grain development using mass spectrometry and multivariate data analysis

    DEFF Research Database (Denmark)

    Ghirardo, A.; Sørensen, Helle Aagaard; Petersen, M.

    2005-01-01

    Matrix-assisted laser desorption/ionisation time-of-flight mass spectrometry and multivariate data analysis have been used for the determination of wheat quality at different stages of grain development. Wheat varieties with one of two different end-use qualities (i.e. suitable or not suitable...... data analysis, offers a method that can replace the traditional rather time-consuming ones such as gel electrophoresis. This study focused on the determination of wheat quality at 15 dpa, when the grain is due for harvest 1 month later....

  6. THE ROLE OF QUALITY: SPANISH WOOL IN PORTUGUESE TRADE IN THE EARLY NINETEENTH CENTURY

    Directory of Open Access Journals (Sweden)

    Maria Cristina Moreira

    2007-01-01

    Full Text Available Cross-referencing qualitative and quantitative statistics from handwritten Portuguese trade sources shows the Spanish in the first half of the 19th century using Portuguese trade to introduce their wool in English and other markets. High quality Spanish merino wool played a key role in Portuguese trade during this period, particularly in the golden years of 1809-1819 and 1825. Its quality intensified both legal trade and smuggling.

  7. Loneliness in Early Adolescence: Friendship Quantity, Friendship Quality, and Dyadic Processes.

    Science.gov (United States)

    Lodder, Gerine M A; Scholte, Ron H J; Goossens, Luc; Verhagen, Maaike

    2017-01-01

    Friendship quantity and quality are related to adolescent loneliness, but the exact link between these constructs is not well understood. The present study aimed to examine whether adolescents' perception of friendship quantity and quality, and the perceptions of their peers, were related to loneliness. We examined the relation between loneliness and the number of unilateral and reciprocal friendships and compared the views of best friendship quality. Overall, 1,172 Dutch adolescents (49.1% male, M age = 12.81, SD = .43) nominated their friends and rated their friendship quality. Friendship quantity was measured using sociometrics to distinguish reciprocated and unilateral (i.e., one-sided) friendships. The analyses indicated that loneliness was related to fewer reciprocal and unilateral-received friendships (i.e., the adolescent received a friendship nomination but did not reciprocate that nomination) and a lower quality of best friendship. Actor-partner interdependence analyses revealed that adolescents' loneliness was related to a less positive evaluation of their friendship, as reported by adolescents themselves (i.e., a significant actor effect) but not by their friends (i.e., nonsignificant partner effect). These findings (a) indicate that loneliness is negatively related to the number of friends adolescents have, as perceived by themselves and their peers and (b) suggest that, once a friendship is established, lonely adolescents may interpret the friendship quality less positively compared to their friends. Implications of these findings for our current understanding of adolescent loneliness are discussed, and suggestions for future research are outlined.

  8. Music and Quality of Life in Early-Deafened Late-Implanted Adult Cochlear Implant Users

    NARCIS (Netherlands)

    Fuller, Christina; Mallinckrodt, Lisa; Maat, Bert; Başkent, Deniz; Free, Rolien

    Hypothesis and Background: The early-deafened, late-implanted (EDLI) CI users constitute a relatively new and understudied clinical population. To contribute to a better understanding of the implantation outcome, this study evaluated this population for self-reported enjoyment and perception of

  9. Changing Policy, Changing Culture: Steps toward Early Learning Quality Improvement in Australia

    Science.gov (United States)

    Tayler, Collette

    2011-01-01

    Across Australia a combined government effort is underway to reform early childhood education and care (ECEC) provision. A National Law Bill passed in 2010 heralds a new legal, regulatory and accountability framework that embraces all types ECEC provision. As a result, service providers face rapid change to address a new orientation and higher…

  10. Engaging Children with Print: Building Early Literacy Skills through Quality Read-Alouds

    Science.gov (United States)

    Justice, Laura M.; Sofka, Amy E.

    2010-01-01

    Preschool teachers and early childhood professionals know that storybook reading is important, but they may not know how to maximize its benefits for later reading achievement. This indispensable guide presents research-based techniques for using reading aloud to intentionally and systematically build children's knowledge of print. Simple yet…

  11. Quality Early Childhood Education for Disadvantaged Children: An Investigation in the MCD Schools

    Science.gov (United States)

    Chopra, Neelima

    2016-01-01

    Schools run by Municipal Corporation of Delhi (MCD) play a pivotal role in providing early childhood education to young children belonging to marginalized sections of Delhi. However, literature review reveals that low learning outcomes are common among children attending these schools. Low levels of learning are often associated with poor quality…

  12. Mechanical characterization of raw material quality and its implication for Early Upper Palaeolithic Moravia

    Czech Academy of Sciences Publication Activity Database

    Monik, M.; Hadraba, Hynek

    2016-01-01

    Roč. 425, DEC (2016), s. 425-436 ISSN 1040-6182 R&D Projects: GA MŠk(CZ) ED1.1.00/02.0068 Institutional support: RVO:68081723 Keywords : Charpy impact test * Microhardness * Early Upper Palaeolithic * Moravia * Lithics Subject RIV: JH - Ceramics, Fire-Resistant Materials and Glass Impact factor: 2.199, year: 2016

  13. Changes in Parent-Child Relationship Quality across Early Adolescence: Implications for Engagement in Sexual Behavior

    Science.gov (United States)

    McElwain, Alyssa D.; Bub, Kristen L.

    2018-01-01

    The present study investigated how changes in specific dimensions of the parent-adolescent relationship predict adolescent engagement in sexual intercourse and oral sex. Longitudinal data from 1,364 participants in the National Institute of Child Health and Human Development (NICHD) Study of Early Child Care and Youth Development were gathered at…

  14. Anorectal Function and Quality of Life in Patients With Early Stage Rectal Cancer Treated With Chemoradiation and Local Excision.

    Science.gov (United States)

    Lynn, Patricio B; Renfro, Lindsay A; Carrero, Xiomara W; Shi, Qian; Strombom, Paul L; Chow, Oliver; Garcia-Aguilar, Julio

    2017-05-01

    Little is known about anorectal function and quality of life after chemoradiation followed by local excision, which is an alternative to total mesorectal excision for selected patients with early rectal cancer. The purpose of this study was to prospectively assess anorectal function and health-related quality of life of patients with T2N0 rectal cancer who were treated with an alternative approach. This was a prospective, phase II trial. The study was multicentric (American College of Surgeons Oncology Group trial Z6041). Patients with stage cT2N0 rectal adenocarcinomas were treated with an oxaliplatin/capecitabine-based chemoradiation regimen followed by local excision. Anorectal function and quality of life were assessed at enrollment and 1 year postoperatively with the Fecal Incontinence Severity Index, Fecal Incontinence Quality of Life scale, and Functional Assessment of Cancer Therapy-Colorectal Questionnaire. Results were compared, and multivariable analysis was performed to identify predictors of outcome. Seventy-one patients (98%) were evaluated at enrollment and 66 (92%) at 1 year. Compared with baseline, no significant differences were found on Fecal Incontinence Severity Index scores at 1 year. Fecal Incontinence Quality of Life results were significantly worse in the lifestyle (p Cancer Therapy overall score, but the physical well-being subscale was significantly worse and emotional well-being was improved after surgery. Treatment with the original chemoradiation regimen predicted worse depression/self-perception and embarrassment scores in the Fecal Incontinence Quality of Life, and male sex was predictive of worse scores in the Functional Assessment of Cancer Therapy overall score and trial outcome index. Small sample size, relatively short follow-up, and absence of information before cancer diagnosis were study limitations. Chemoradiation followed by local excision had minimal impact on anorectal function 1 year after surgery. Overall quality of

  15. Quality of breast cancer early detection services conducted by well woman clinics in the district of Gampaha, Sri Lanka.

    Science.gov (United States)

    Vithana, Palatiyana Vithanage Sajeewanie Chiranthika; Ariyaratne, May; Jayawardana, Pl

    2013-01-01

    Breast cancer is the most common cancer diagnosed in females in Sri Lanka and early detection can lead to reduction in morbidity and mortality. To evaluate selected aspects of breast cancer early detection services implemented through well woman clinics (WWCs) in the Gampaha District. The study consisted of two components. A retrospective descriptive arm assessed clinical breast examination (CBE) coverage of target age group women (TGW) of 35-59 years in all the WWCs in Gampaha district over 2003- 2007. A cross sectional descriptive study additionally assessed quality of breast cancer early detection services. The Lot Quality Assurance Sampling (LQAS) technique was used to decide on the lot size and threshold values, which were computed as twenty and six clinics. Checklists were employed in assessing coverage, physical facilities and clinic activities. Client satisfaction on WWC services was assessed among 200 TGW attending 20 WWCs using an interviewer-administered questionnaire. CBE coverage in the Gampaha district increased only from 1.1-2.2% over 2003-2007. With regard to physical facilities, the number of clinics that were rated substandard varied between 7-18 (35- 90%). The items that were lacking included dust bins, notice boards, stationary, furniture and linen, and cleanliness of outside premises and toilets. With regard to clinic activities, punctuality of staff, late commencement of clinics, provision of health education, supervision, CBE and breast self-examination (BSE) were substandard in 7- 20 clinics (35-100%). Client satisfaction for WWC services was 45.2% (IQR: 38.7-54.8%) and only 11% had a score of ≥70%, the cut off set for satisfaction. Breast cancer early detection service coverage in the Gampaha district remained low (2.2%) in 2007, 11 years after commencing WWCs. All 20 clinics were substandard for overall CBE and BSE.

  16. STRENGTHENING BIOTECHNOLOGY RESEARCH IN INDONESIA

    Directory of Open Access Journals (Sweden)

    S. Sastrapradja

    2012-09-01

    Full Text Available The wave of biotechnology promises has struck not only the developed countries but the developing countries as well. The scientific community in Indonesia is aware of the opportunities and is eager to take an active part in this particular endeavour. Meanwhile resources are required to welcoming the biotech­nology era. The need of trained manpower, appropriate infrastructure and equipment, operational and maintenance costs requires serious consideration if a unit or a laboratory is expected to be functional in biotechnology. There is a good opportunity of applying biotechnology in the field of agriculture and industry considering the availability of biological resources in Indonesia. This paper outlines what have been done so far, the difficulties encountered and the efforts made to strengthening biotechnology research in Indonesia.

  17. Direct and indirect effects of a family-based intervention in early adolescence on parent-youth relationship quality, late adolescent health, and early adult obesity.

    Science.gov (United States)

    Van Ryzin, Mark J; Nowicka, Paulina

    2013-02-01

    We explored family processes in adolescence that may influence the likelihood of obesity in early adulthood using a randomized trial of a family-based intervention (the Family Check-Up, or FCU). The FCU has been shown to reduce escalations in antisocial behavior and depression in adolescence by supporting positive family management practices, but no research has examined the mechanisms by which the FCU could influence health-related attitudes and behaviors linked to obesity. Participants were 998 adolescents (n = 526 male; n = 423 European American; M age 12.21 years) and their families, recruited in 6th grade from 3 middle schools in the Pacific Northwest. We used structural equation modeling (SEM) and an Intent-To-Treat (ITT) design to evaluate the direct and indirect effects of the FCU on parent-youth relationship quality (ages 12-15), healthy lifestyle behaviors, eating attitudes, depressive symptoms (all measured at age 17), and obesity (age 22). We found that the FCU led to greater parent-youth relationship quality, which predicted enhanced health-related behaviors, reduced maladaptive eating attitudes, and reduced depression. In turn, reduced maladaptive eating attitudes predicted reduced odds of obesity. The indirect effect of the FCU on obesity by way of parent-youth relationship quality and eating attitudes was significant. Our findings illustrate how family processes may influence adolescent health and suggest that family functioning may be an additional factor to consider when developing intervention programs for obesity. PsycINFO Database Record (c) 2013 APA, all rights reserved.

  18. Implementation of quality management in early stages of research and development projects at a university.

    Science.gov (United States)

    Fiehe, Sandra; Wagner, Georg; Schlanstein, Peter; Rosefort, Christiane; Kopp, Rüdger; Bensberg, Ralf; Knipp, Peter; Schmitz-Rode, Thomas; Steinseifer, Ulrich; Arens, Jutta

    2014-04-01

    The ultimate objective of university research and development projects is usually to create knowledge, but also to successfully transfer results to industry for subsequent marketing. We hypothesized that the university technology transfer requires efficient measures to improve this important step. Besides good scientific practice, foresighted and industry-specific adapted documentation of research processes in terms of a quality management system might improve the technology transfer. In order to bridge the gap between research institute and cooperating industry, a model project has been accompanied by a project specific amount of quality management. However, such a system had to remain manageable and must not constrain the researchers' creativity. Moreover, topics and research team are strongly interdisciplinary, which entails difficulties regarding communication because of different perspectives and terminology. In parallel to the technical work of the model project, an adaptable quality management system with a quality manual, defined procedures, and forms and documents accompanying the research, development and validation was implemented. After process acquisition and analysis the appropriate amount of management for the model project was identified by a self-developed rating system considering project characteristics like size, innovation, stakeholders, interdisciplinarity, etc. Employees were trained according to their needs. The management was supported and the technical documentation was optimized. Finally, the quality management system has been transferred successfully to further projects.

  19. Infant Massage and Quality of Early Mother-Infant Interactions: Are There Associations with Maternal Psychological Wellbeing, Marital Quality, and Social Support?

    Science.gov (United States)

    Porreca, Alessio; Parolin, Micol; Bozza, Giusy; Freato, Susanna; Simonelli, Alessandra

    2016-01-01

    Infant massage programs have proved to be effective in enhancing post-natal development of highly risk infants, such as preterm newborns and drug or HIV exposed children. Less studies have focused on the role of infant massage in supporting the co-construction of early adult-child relationships. In line with this lack of literature, the present paper reports on a pilot study aimed at investigating longitudinally the quality of mother-child interactions, with specific reference to emotional availability (EA), in a group of mother-child pairs involved in infant massage classes. Moreover, associations between mother-child EA, maternal wellbeing, marital adjustment, and social support were also investigated, with the hypothesis to find a link between low maternal distress, high couple satisfaction and high perceived support and interactions of better quality in the dyads. The study involved 20 mothers and their children, aged between 2 and 7 months, who participated to infant massage classes. The assessment took place at three stages: at the beginning of massage course, at the end of it and at 1-month follow-up. At the first stage of assessment self-report questionnaires were administered to examine the presence of maternal psychiatric symptoms (SCL-90-R), perceived social support (MSPSS), and marital adjustment (Dyadic Adjustment Scale); dyadic interactions were observed and rated with the Emotional Availability Scales (Biringen, 2008) at each stage of data collection. The results showed a significant improvement in the quality of mother-child interactions, between the first and the last evaluation, parallel to the unfolding of the massage program, highlighting a general increase in maternal and child's EA. The presence of maternal psychological distress resulted associated with less optimal mother-child emotional exchanges, while the hypothesis regarding couple satisfaction and social support influence were not confirmed. These preliminary results, if replicated

  20. Associations between nausea, vomiting, fatigue and health-related quality of life of women in early pregnancy: The generation r study

    NARCIS (Netherlands)

    G. Bai (Guannan); I.J. Korfage (Ida); E.H.D. Hafkamp-De Groen (Esther); V.W.V. Jaddoe (Vincent); Mautner, E. (Eva); H. Raat (Hein)

    2016-01-01

    textabstractThe objective of this study was to evaluate the independent associations between nausea, vomiting, fatigue and health-related quality of life of women in early pregnancy in the Generation R study, which is a prospective mother and child cohort. Analyses were based on 5079 women in early

  1. Extension of quality-by-design concept to the early development phase of pharmaceutical R&D processes.

    Science.gov (United States)

    Csóka, Ildikó; Pallagi, Edina; Paál, Tamás L

    2018-03-27

    Here, we propose the extension of the quality-by-design (QbD) concept to also fit the early development phases of pharmaceuticals by adding elements that are currently widely applied, but not yet included in the QbD model in a structured way. These are the introduction of a 'zero' preformulation phase (i.e., selection of drug substance, possible dosage forms and administration routes based on the evaluated therapeutic need); building in stakeholders' (industry, patient, and regulatory) requirements into the quality target product profile (QTTP); and the use of modern quality management tools during the composition and process design phase [collecting critical quality attributes (CQAs) and selection of CPPs) for (still laboratory-scale) design space (DS) development. Moreover, during industrial scale-up, CQAs (as well as critical process parameters; CPPs) can be changed; however, we recommend that the existing QbD elements are reconsidered and updated after this phase. Copyright © 2018 Elsevier Ltd. All rights reserved.

  2. Impact of two early treatment protocols for anterior dental crossbite on children’s quality of life

    Science.gov (United States)

    Miamoto, Cristina Batista; Marques, Leandro Silva; Abreu, Lucas Guimarães; Paiva, Saul Martins

    2018-01-01

    ABSTRACT Objective: To assess the impact of two early treatment protocols for anterior dental crossbite on children’s quality of life. Methods: Thirty children, 8 to 10 years of age, with anterior dental crossbite, participated in this study. Individuals were divided into two groups: Group 1 - 15 children undergoing treatment with an upper removable appliance with digital springs; Group 2 - 15 children undergoing treatment with resin-reinforced glass ionomer cement bite pads on the lower first molars. Quality of life was evaluated using the Brazilian version of the Child Perceptions Questionnaire (CPQ8-10), which contains four subscales: oral symptoms (OS), functional limitations (FL), emotional well-being (EW), and social well-being (SW). A higher score denotes a greater negative impact on children’s quality of life. Children answered the questionnaire before treatment (T1) and twelve months after orthodontic treatment onset (T2). Descriptive statistics, the Wilcoxon test and analysis of covariance (ANCOVA) were performed. Results: Children’s mean age was 9.07 ± 0.79 years in Group 1 and 9.00 ± 0.84 years in Group 2. For Group 1, the FL and EW subscale scores and the overall CPQ8-10 were significantly higher in T1 as compared to T2 (p= 0.004, p= 0.012 and p= 0.015, respectively). For Group 2, there were no statistically significant differences. The ANCOVA showed no significant difference regarding quality of life at T2 between groups, after controlling for quality of life measures at T1. Conclusions: The difference regarding the impact on quality of life between groups is not related to the protocol used. PMID:29791690

  3. Effects of nitrogen rate and application method on early production and fruit quality in highbush blueberry

    Science.gov (United States)

    A field study was conducted to examine the effects of nitrogen (N) rate and method of N fertilizer application on growth, yield, and fruit quality in highbush blueberry (Vaccinium corymbosum L.) during the first 4 years after planting in south-coastal BC. Nitrogen was applied at 0-150% of current pr...

  4. The Quality of Early Childhood Education Curriculum Framework in the Republic of Serbia

    Science.gov (United States)

    Krnjaja, Živka

    2015-01-01

    The paper addresses Serbian preschool education Curriculum Framework as one of dimensions of the preschool education quality. The first part of paper deals with the importance of preschool education worldwide as a social responsibility and its accountability in education policy. The second part provides the evaluation of the preschool education…

  5. Social Participation and Health Related Quality of Life in Early and Established Rheumatoid Arthritis Patients

    NARCIS (Netherlands)

    Benka, Jozef; Nagyova, Iveta; Rosenberger, Jaroslav; Macejova, Zelmira; Lazurova, Ivica; van der Klink, Jac L. L.; Groothoff, Johan W.; van Dijk, Jitse P.

    Social participation has been recognized as one of the key variables to be addressed in disability research yet few studies addressed the association between restriction in participation and quality of life in the context of rheumatoid arthritis. The aim of this study was to explore the associations

  6. Patient-reported quality of life after stereotactic ablative radiotherapy for early-stage lung cancer

    NARCIS (Netherlands)

    Lagerwaard, F.J.; Aaronson, N.K.; Gundy, C.M.; Haasbeek, C.J.A.; Slotman, B.J.; Senan, S.

    2012-01-01

    Background: Deterioration in health-related quality of life (HRQOL) is frequently observed after surgery for stage I non-small-cell lung cancer. As stereotactic ablative radiotherapy (SABR) can result in local control percentages exceeding 90%, we studied baseline and post-treatment HRQOL in SABR

  7. Quality of early parent input predicts child vocabulary 3 years later.

    Science.gov (United States)

    Cartmill, Erica A; Armstrong, Benjamin F; Gleitman, Lila R; Goldin-Meadow, Susan; Medina, Tamara N; Trueswell, John C

    2013-07-09

    Children vary greatly in the number of words they know when they enter school, a major factor influencing subsequent school and workplace success. This variability is partially explained by the differential quantity of parental speech to preschoolers. However, the contexts in which young learners hear new words are also likely to vary in referential transparency; that is, in how clearly word meaning can be inferred from the immediate extralinguistic context, an aspect of input quality. To examine this aspect, we asked 218 adult participants to guess 50 parents' words from (muted) videos of their interactions with their 14- to 18-mo-old children. We found systematic differences in how easily individual parents' words could be identified purely from this socio-visual context. Differences in this kind of input quality correlated with the size of the children's vocabulary 3 y later, even after controlling for differences in input quantity. Although input quantity differed as a function of socioeconomic status, input quality (as here measured) did not, suggesting that the quality of nonverbal cues to word meaning that parents offer to their children is an individual matter, widely distributed across the population of parents.

  8. Chinese Parents' Beliefs about the Importance and Feasibility of Quality Early Childhood Inclusion

    Science.gov (United States)

    Hu, Bi Ying; Mak, Miranda Chi Kuan; Zhang, Chun; Fan, Xitao; Zhu, Jieling

    2018-01-01

    This study aims to explore Chinese parents' understanding about the importance and feasibility of quality pre-school inclusion and how these beliefs are affected by their levels of education and the types of disabilities in the Chinese socio-cultural and policy contexts. Findings support parents are highly supportive of the philosophy of…

  9. Effect of hormone replacement therapy on bone quality in early postmenopausal women

    DEFF Research Database (Denmark)

    Paschalis, E P; Boskey, A L; Kassem, M

    2003-01-01

    HRT is an effective prophylaxis against postmenopausal bone loss. Infrared imaging of paired iliac crest biopsies obtained at baseline and after 2 years of HRT therapy demonstrate an effect on the mineral crystallinity and collagen cross-links that may affect bone quality. Several studies have de...

  10. Surgical quality of wedge resection affects overall survival in patients with early stage non-small cell lung cancer.

    Science.gov (United States)

    Ajmani, Gaurav S; Wang, Chi-Hsiung; Kim, Ki Wan; Howington, John A; Krantz, Seth B

    2018-07-01

    Very few studies have examined the quality of wedge resection in patients with non-small cell lung cancer. Using the National Cancer Database, we evaluated whether the quality of wedge resection affects overall survival in patients with early disease and how these outcomes compare with those of patients who receive stereotactic radiation. We identified 14,328 patients with cT1 to T2, N0, M0 disease treated with wedge resection (n = 10,032) or stereotactic radiation (n = 4296) from 2005 to 2013 and developed a subsample of propensity-matched wedge and radiation patients. Wedge quality was grouped as high (negative margins, >5 nodes), average (negative margins, ≤5 nodes), and poor (positive margins). Overall survival was compared between patients who received wedge resection of different quality and those who received radiation, adjusting for demographic and clinical variables. Among patients who underwent wedge resection, 94.6% had negative margins, 44.3% had 0 nodes examined, 17.1% had >5 examined, and 3.0% were nodally upstaged; 16.7% received a high-quality wedge, which was associated with a lower risk of death compared with average-quality resection (adjusted hazard ratio [aHR], 0.74; 95% confidence interval [CI], 0.67-0.82). Compared with stereotactic radiation, wedge patients with negative margins had significantly reduced hazard of death (>5 nodes: aHR, 0.50; 95% CI, 0.43-0.58; ≤5 nodes: aHR, 0.65; 95% CI, 0.60-0.70). There was no significant survival difference between margin-positive wedge and radiation. Lymph nodes examined and margins obtained are important quality metrics in wedge resection. A high-quality wedge appears to confer a significant survival advantage over lower-quality wedge and stereotactic radiation. A margin-positive wedge appears to offer no benefit compared with radiation. Copyright © 2018 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.

  11. Quality of life, functional outcome, and voice handicap index in partial laryngectomy patients for early glottic cancer

    Directory of Open Access Journals (Sweden)

    Kandogan Tolga

    2005-05-01

    Full Text Available Abstract Background In this study, we aim to gather information about the quality of life issues, functional outcomes and voice problems facing early glottic cancer patients treated with the surgical techniques such as laryngofissure cordectomy, fronto-lateral laryngectomy, or cricohyoidopexi. In particular, consistency of life and voice quality issues with the laryngeal tissue excised during surgery is examined. In addition, the effects of arytenoidectomy to the life and voice quality are also studied. Methods 29 male patients were enrolled voluntarily in the study. The average age was 53.9 years. Three out of 10 patients with laryngofissure cordectomy also had arytenoidectomy. 11 patients had fronto-lateral laryngectomy with Tucker reconstruction, two of which also had arytenoidectomy. There were eight patients with cricohyoidopexi and bilateral functional neck dissection. Three of these patients also had arytenoidectomy. In bilateral functional neck dissection cases, spinal accessory nerve was preserved and level V of the neck was not dissected. None of the patients had neither radiotherapy nor voice therapy. Cordectomy patients never had a temporary tracheotomy or were connected to a feeding tube. Data was collected for 13 months for the cordectomy group, 14 months for fronto-lateral laryngectomy and cricohyoidopexi groups on average post-operatively. Statistical analysis in this study was carried out using the one-way analysis of variance, and the Post-Hoc group comparisons were made after Bonferroni and Scheffé-procedures. In order to determine the effects of arytenoidectomy, a regression analysis is carried out to see if there are statistical differences in answers given to the survey questions among patients who were arytenoidectomized during their surgeries. Results There was a statistically significant difference between cordectomy and cricohyoidopexi group in answers to the University of Washington- Quality of Life- Revised survey

  12. Intimate Partner Violence Is Associated with Stress-Related Sleep Disturbance and Poor Sleep Quality during Early Pregnancy.

    Directory of Open Access Journals (Sweden)

    Sixto E Sanchez

    Full Text Available To examine the associations of Intimate partner violence (IPV with stress-related sleep disturbance (measured using the Ford Insomnia Response to Stress Test [FIRST] and poor sleep quality (measured using the Pittsburgh Sleep Quality Index [PSQI] during early pregnancy.This cross-sectional study included 634 pregnant Peruvian women. In-person interviews were conducted in early pregnancy to collect information regarding IPV history, and sleep traits. Adjusted odds ratios (aOR and 95% confidence intervals (95%CIs were calculated using logistic regression procedures.Lifetime IPV was associated with a 1.54-fold increased odds of stress-related sleep disturbance (95% CI: 1.08-2.17 and a 1.93-fold increased odds of poor sleep quality (95% CI: 1.33-2.81. Compared with women experiencing no IPV during lifetime, the aOR (95% CI for stress-related sleep disturbance associated with each type of IPV were: physical abuse only 1.24 (95% CI: 0.84-1.83, sexual abuse only 3.44 (95%CI: 1.07-11.05, and physical and sexual abuse 2.51 (95% CI: 1.27-4.96. The corresponding aORs (95% CI for poor sleep quality were: 1.72 (95% CI: 1.13-2.61, 2.82 (95% CI: 0.99-8.03, and 2.50 (95% CI: 1.30-4.81, respectively. Women reporting any IPV in the year prior to pregnancy had increased odds of stress-related sleep disturbance (aOR = 2.07; 95% CI: 1.17-3.67 and poor sleep quality (aOR = 2.27; 95% CI: 1.30-3.97 during pregnancy.Lifetime and prevalent IPV exposures are associated with stress-related sleep disturbance and poor sleep quality during pregnancy. Our findings suggest that sleep disturbances may be important mechanisms that underlie the lasting adverse effects of IPV on maternal and perinatal health.

  13. Quality assurance in radiotherapy: analysis of the causes of not starting or early radiotherapy withdrawal

    International Nuclear Information System (INIS)

    Arenas, Meritxell; Sabater, Sebastià; Gascón, Marina; Henríquez, Ivan; Bueno, M José; Rius, Àngels; Rovirosa, Àngels; Gómez, David; Lafuerza, Anna; Biete, Albert; Colomer, Jordi

    2014-01-01

    The aim of this study was to analyse the reasons for not starting or for early of radiotherapy at the Radiation Oncology Department. All radiotherapy treatments from March 2010 to February 2012 were included. Early withdrawals from treatment those that never started recorded. Clinical, demographic and dosimetric variables were also noted. From a total of 3250 patients treated and reviewed, 121 (4%) did not start or complete the planned treatment. Of those, 63 (52%) did not receive any radiotherapy fraction and 58 (48%) did not complete the course, 74% were male and 26% were female. The mean age was 67 ± 13 years. The most common primary tumour was lung (28%), followed by rectum (16%). The aim of treatment was 62% radical and 38% palliative, 44% of patients had metastases; the most common metastatic site was bone, followed by brain. In 38% of cases (46 patients) radiotherapy was administered concomitantly with chemotherapy (10 cases (22%) were rectal cancers). The most common reason for not beginning or for early withdrawal of treatment was clinical progression (58/121, 48%). Of those, 43% died (52/121), 35 of them because of the progression of the disease and 17 from other causes. Incomplete treatment regimens were due to toxicity (12/121 (10%), of which 10 patients underwent concomitant chemotherapy for rectal cancer). The number of patients who did not complete their course of treatment is low, which shows good judgement in indications and patient selection. The most common reason for incomplete treatments was clinical progression. Rectal cancer treated with concomitant chemotherapy was the most frequent reason of the interruption of radiotherapy for toxicity

  14. Strengthening of nuclear power plant construction safety management

    International Nuclear Information System (INIS)

    Yu Jun

    2012-01-01

    The article describes the warning of the Fukushima nuclear accident, and analyzes the major nuclear safety issues in nuclear power development in China, problems in nuclear power plants under construction, and how to strengthen supervision and management in nuclear power construction. It also points out that the development of nuclear power must attach great importance to the safety, and nuclear power plant construction should strictly implement the principle of 'safety first and quality first'. (author)

  15. Personality and Relationship Quality During the Transition From High School to Early Adulthood

    Science.gov (United States)

    Parker, Philip D.; Lüdtke, Oliver; Trautwein, Ulrich; Roberts, Brent W.

    2013-01-01

    The post–high school transition period is believed to be associated with considerable changes in social networks, yet longitudinal studies documenting these changes are scarce. To address this gap, the current research explored 3 relevant issues. First, changes in participants’ relationship characteristics during the transition from high school were examined. Second, the roles of personality traits as antecedents of these changes were studied. Third, the association between change in relationship characteristics and personality during the transition was explored. A sample of over 2,000 German emerging adults, surveyed before leaving school and then 2 years after the transition from high school, was assessed on personality traits and a multidimensional assessment of the quality of their relationships. Findings indicated that participants experienced mostly positive changes in relationship quality during the transition from high school and that antecedent personality at school was an important predictor of the nature of this change. Finally, change in relationship quality was found to be associated with personality change during the post-school transition. Findings indicated that personality traits may influence transition success and that change in relationships during this transition may influence personality development. The implications of the research for post-school transition success are discussed. PMID:22224909

  16. Associations of Perceived Sibling and Parent-Child Relationship Quality with Internalizing and Externalizing Problems: Comparing Indian and Dutch Early Adolescents

    Science.gov (United States)

    Buist, Kirsten L.; Verhoeven, Marjolein; Hoksbergen, René; ter Laak, Jan; Watve, Sujala; Paranjpe, Analpa

    2017-01-01

    The aims of the present study were (a) to examine whether Dutch and Indian early adolescents differ concerning sibling and parent-child relationship quality and externalizing and internalizing problems, and (b) to compare the associations between sibling and parent-child relationship quality and externalizing and internalizing problems for Indian…

  17. Associations of Perceived Sibling and Parent-Child Relationship Quality With Internalizing and Externalizing Problems: Comparing Indian and Dutch Early Adolescents

    NARCIS (Netherlands)

    Buist, K. L.|info:eu-repo/dai/nl/241099218; Verhoeven, Marjolein|info:eu-repo/dai/nl/304349747; Hoksbergen, R.|info:eu-repo/dai/nl/068229127; Ter Laak, J.; Watve, S.; Paranjpe, A.

    2017-01-01

    The aims of the present study were (a) to examine whether Dutch and Indian early adolescents differ concerning sibling and parent-child relationship quality and externalizing and internalizing problems, and (b) to compare the associations between sibling and parent-child relationship quality and

  18. LANDSAT-4 Science Characterization Early Results. Volume 4: Applications. [agriculture, soils land use, geology, hydrology, wetlands, water quality, biomass identification, and snow mapping

    Science.gov (United States)

    Barker, J. L. (Editor)

    1985-01-01

    The excellent quality of TM data allows researchers to proceed directly with applications analyses, without spending a significant amount of time applying various corrections to the data. The early results derived of TM data are discussed for the following applications: agriculture, land cover/land use, soils, geology, hydrology, wetlands biomass, water quality, and snow.

  19. Effects of maternal history of depression and early life maltreatment on children's health-related quality of life.

    Science.gov (United States)

    Dittrich, Katja; Fuchs, Anna; Bermpohl, Felix; Meyer, Justus; Führer, Daniel; Reichl, Corinna; Reck, Corinna; Kluczniok, Dorothea; Kaess, Michael; Hindi Attar, Catherine; Möhler, Eva; Bierbaum, Anna-Lena; Zietlow, Anna-Lena; Jaite, Charlotte; Winter, Sibylle Maria; Herpertz, Sabine C; Brunner, Romuald; Bödeker, Katja; Resch, Franz

    2018-01-01

    There is a well-established link between maternal depression and child mental health. Similar effects have been found for maternal history of early life maltreatment (ELM). However, studies investigating the relationship of children's quality of life and maternal depression are scarce and none have been conducted for the association with maternal ELM. The aim of the present study was to investigate the effects of maternal history of ELM and depression on children's health-related quality of life and to identify mediating factors accounting for these effects. Our study involved 194 mothers with and without history of depression and/or ELM and their children between five and 12 years. Children's health-related quality of life was assessed by maternal proxy- and child self-ratings using the KIDSCREEN. We considered maternal sensitivity and maternal parenting stress as potential mediators. We found an effect of maternal history of depression but not of maternal history of ELM on health-related quality of life. Maternal stress and sensitivity mediated the effects of maternal depression on child global health-related quality of life, as well as on the dimensions Autonomy & Parent Relation, School Environment (maternal and child rating), and Physical Wellbeing (child rating). Due to the cross-sectional design of the study, causal interpretations must be made with caution. Some scales yielded low internal consistency. Maternal impairments in areas of parenting which possibly developed during acute depression persist even after remission of acute affective symptoms. Interventions should target parenting stress and sensitivity in parents with prior depression. Copyright © 2017 Elsevier B.V. All rights reserved.

  20. Maternal Social Coaching Quality Interrupts the Development of Relational Aggression During Early Childhood.

    Science.gov (United States)

    Werner, Nicole E; Eaton, Ashley D; Lyle, Kelsey; Tseng, Heidi; Holst, Brooke

    2014-08-01

    Previous research has shown that parents of socially competent young children provide them with elaborative, explicit, appropriate and emotion-laden advice about peer interactions. The current study analyzed mothers' conversations with preschoolers (N=175; 52% female; M age = 52 months, SD = 7 months) about peer conflicts involving relational aggression. Conversations were coded for maternal elaboration, emotion references, and discussion of norm violations. Information about relational and physical aggression was collected from teachers at two assessments approximately 12 months apart for a subsample of 136 children. Regression analyses, controlling for physical aggression, showed that average and high levels of effective coaching operated as a protective factor against stable high levels of relational aggression. Theoretical and practical implications for our understanding of the early development of relational aggression are discussed.

  1. Early developmental responses to seedling environment modulate later plasticity to light spectral quality.

    Directory of Open Access Journals (Sweden)

    Eric J B von Wettberg

    Full Text Available Correlations between developmentally plastic traits may constrain the joint evolution of traits. In plants, both seedling de-etiolation and shade avoidance elongation responses to crowding and foliage shade are mediated by partially overlapping developmental pathways, suggesting the possibility of pleiotropic constraints. To test for such constraints, we exposed inbred lines of Impatiens capensis to factorial combinations of leaf litter (which affects de-etiolation and simulated foliage shade (which affects phytochrome-mediated shade avoidance. Increased elongation of hypocotyls caused by leaf litter phenotypically enhanced subsequent elongation of the first internode in response to low red:far red (R:FR. Trait expression was correlated across litter and shade conditions, suggesting that phenotypic effects of early plasticity on later plasticity may affect variation in elongation traits available to selection in different light environments.

  2. Strengthening Crypto-1 Cipher Against Algebraic Attacks

    Directory of Open Access Journals (Sweden)

    Farah Afianti

    2015-08-01

    Full Text Available In the last few years, several studies addressed the problem of data security in Mifare Classic. One of its weaknesses is the low random number quality. This causes SAT solver attacks to have lower complexity. In order to strengthen Crypto-1 against SAT solver attacks, a modification of the feedback function with better cryptographic properties is proposed. It applies a primitive polynomial companion matrix. SAT solvers cannot directly attack the feedback shift register that uses the modified Boolean feedback function, the register has to be split into smaller groups. Experimental testing showed that the amount of memory and CPU time needed were highest when attacking the modified Crypto-1 using the modified feedback function and the original filter function. In addition, another modified Crypto-1, using the modified feedback function and a modified filter function, had the lowest percentage of revealed variables. It can be concluded that the security strength and performance of the modified Crypto-1 using the modified feedback function and the modified filter function are better than those of the original Crypto-1.

  3. [Framework for the strengthening of health information systems in Peru].

    Science.gov (United States)

    Curioso, Walter H; Espinoza-Portilla, Elizabeth

    2015-01-01

    In this article we present the essential components and policies that are most relevant regarding the conceptual framework to strengthen the health information systems in Peru. The article also presents the main policies, actions and strategies made in the field of electronic health in Peru that are most significant. The health information systems in Peru play a key role and are expected to achieve an integrated and interoperable information system. This will allow health information to be complete, efficient, of good quality and available in a timely manner to achieve better quality of life for people and allow meaningful modernization of public health in the context of health reform in Peru.

  4. EARLY IDENTIFICATION OF SOFTWARE DEFECTS USING OCL PREDICATES TO IMPROVE SOFTWARE QUALITY

    Directory of Open Access Journals (Sweden)

    A. JALILA

    2015-03-01

    Full Text Available Formal specification-based testing has been used widely to assess potential faults or prove their absence in a given system at the earliest. This research work has proposed an automated fault-based testing framework to test the specification of the system using Object Constraint Language (OCL. Accordingly, the possible faults in OCL specification of the system has been anticipated by mutating its method based on OCL predicate-based fault classes. Then, test cases are generated using Genetic Algorithm with simulated annealing technique. In this paper, a novel OCL-predicate based fitness function is defined to evaluate the generated test data. Finally, this paper presents the experimental results, which indicate that the proposed methodology provides more test coverage with the reduced test suite and test run. This results in cost-effective software development so as to improve software quality.

  5. Investigating social functioning after early mild TBI: the quality of parent-child interactions.

    Science.gov (United States)

    Lalonde, Gabrielle; Bernier, Annie; Beaudoin, Cindy; Gravel, Jocelyn; Beauchamp, Miriam H

    2018-03-01

    The young brain is particularly vulnerable to injury due to inherent physiological and developmental factors, and even mild forms of traumatic brain injury (mTBI) can sometimes result in cognitive and behavioural difficulties. Despite the high prevalence of paediatric mTBI, little is known of its impact on children's social functioning. Parent-child relationships represent the centre of young children's social environments and are therefore ideal contexts for studying the potential effects of mTBI on children's social functioning. The aim of this study was to assess the quality of parent-child interactions after mTBI using observational assessment methods and parental report. The sample included 130 children (18-60 months at recruitment) divided into three groups: children with uncomplicated mTBI (n = 47), children with orthopaedic injury (OI, n = 27), and non-injured children (NI, n = 56). The quality of parent-child interactions was assessed 6 months post-injury using the Mutually Responsive Orientation (MRO) scale, an observational measure which focuses on the dyadic nature of parent-child exchanges, and the Parental Stress Index questionnaire (Parent-Child Dysfunctional Interaction (PCDI) domain). Significant differences with medium effect sizes were found between the mTBI group and the NI group on the MRO, but not between the OI group and the other two groups. PCDI scores did not differ across groups, suggesting that observational measures may be more sensitive to changes in parent-child interactions after TBI. The current findings have implications for children's post-injury social development and highlight the importance of monitoring social outcomes even after minor head injuries. © 2016 The British Psychological Society.

  6. Associations Between Early Family Meal Environment Quality and Later Well-Being in School-Age Children.

    Science.gov (United States)

    Harbec, Marie-Josée; Pagani, Linda S

    Past research suggests a positive link between family meals and child and adolescent health. Although researchers have often relied on how often families eat together, this may not capture the complexity of the experience. Using a birth cohort, this study examines the prospective associations between the environmental quality of the family meal experience at age 6 years and child well-being at age 10. Participants are 1492 children of the Quebec Longitudinal Study of Child Development. When children were age 6, parents reported on their typical family meal environment quality. At age 10, parents, teachers, and children themselves provided information on lifestyle habits, academic achievement, and social adjustment, respectively. The relationship between early family meal environment quality and later child outcomes was analyzed using a series of multivariate linear regression. Family meal environment quality at age 6 predicted higher levels of general fitness and lower levels of soft drink consumption, physical aggression, oppositional behavior, nonaggressive delinquency, and reactive aggression at age 10. These relationships were adjusted for child characteristics (sex, temperament problems and cognitive abilities, and baseline body mass index [BMI]) and family characteristics (family configuration and functioning, maternal education, depression, and BMI). From a population-health perspective, our findings suggest that family meals have long-term influences on children's biopsychosocial well-being. At a time when family meal frequency is on a natural decline in the population, this environmental characteristic can become a target of home-based interventions and could be featured in information campaigns that aim to optimize child development.

  7. Best practices in early phase medical device development: Engineering, prototyping, and the beginnings of a quality management system.

    Science.gov (United States)

    Fearis, Kristy; Petrie, Aidan

    2017-03-01

    Kristy Fearis is the founder and president of KPConsulting. She has held various positions in the medical device and research industry. She has led programs for medical industry leaders Medtronic, Edward Lifesciences, and Kimberly-Clark Healthcare to develop and commercialize Class II and III devices. Although a true quality management systems specialist at heart, Kristy has a passion for effectively and efficiently applying quality systems principles to early stage development to maximize benefit while minimizing impact on resources and time to market. Kristy works with both precommercial and commercial companies to build and implement quality systems that are "right sized" and support both an effective business model and high product quality. Aidan Petrie is the cofounder and chief innovation officer of Ximedica. Aidan drives innovation in Ximedica's core markets of medical device development and consumer healthcare. With a focus on human-centered design, usability, technical innovation and industrial design, Aidan has helped bring hundreds of products to market. Ranging from simple drug compliance aids to wearable therapeutics, home monitoring products, and complex surgical systems, Aidan challenges his teams to rethink the role design plays in the success of each product. Covering topics around usability, sensor and wearable technology, and current trends in medical design and development, Aidan is a sought-after industry speaker and widely published author. In addition to his role at Ximedica, Aidan advises multiple startups in the healthcare space and has interests in a number of related companies. He sits on the Board of MassArt and teaches and lectures at the Rhode Island School of Design, Massachusetts Institute of Technology, the Harvard iLab, and others. Aidan holds an undergraduate degree from Central St Martins in product design/engineering and a Masters in industrial design from the Rhode Island School of Design. Copyright © 2016 Elsevier Inc. All

  8. Strengthening Strategic Stability with Russia

    Science.gov (United States)

    2017-01-01

    political stabil - ity. From the current Russian perspective, both of these compo- nents were thrown out of balance in the 1990s, creating instability ...part of the United States in the early 2000s, stra- tegic stability was replaced with instability and military- political defeats for Russia.27...overall strategic balance of the world political system.8 (As discussed later, the official Russian definition of strategic stability is broadening in

  9. Quality and petrographic characteristics of the lacustrine Ermenek coal (early Miocene), Turkey

    Energy Technology Data Exchange (ETDEWEB)

    Demirel, I.H.; Karayigit, A.I. [Hacettepe Univ., Beytepe-Ankara (Turkey). Dept. of Geological Engineering

    1999-05-01

    The early Miocene Yenimahalle Formation including alluvial-lacustrine sediments and a mineable coal steam with an average of 5 m in thickness rests unconformably upon the basement and is also unconformably overlain by marine limestones of the middle-late Miocene Mut Formation in the Ermenek coal basin. The coal basin in the present study has been subdivided into two areas, Canakci and Pamuklu-Tepebasi, which are separated by the basement and a fault, in order to determine coal properties in detail. The investigated subbituminous coals with an average of 0.40%Ro huminite reflectance often contain gastropod shells (Planorbidae) which commonly maintain the original aragonite and calcite composition. The coals have similar chemical properties and petrographic composition in the two areas, but their sulphur contents are clearly different. In the Canakci area the coals on an air-dried basis contain distinctly less total sulphur (avg. 1.3%) and organic sulphur contents (0.13--0.15%) than in the Pamuklu-Tepebasi area (avg. 4.5% and 4.25%, respectively). This difference is interpreted to be controlled by mire chemistry and sedimentation during peat formation.

  10. Quality and petrographic characteristics of the Lacustrine Ermenek Coal (Early Miocene), Turkey

    Energy Technology Data Exchange (ETDEWEB)

    Demirel, I.H.; Karayigit, A.I.

    1999-04-15

    The early Miocene Yenimahalle Formation including alluvial-lacustrine sediments and a mineable coal seam with an average of 5 m in thickness rests unconformably upon the basement and is also unconformably overlain by marine limestones of the middle-late Miocene Mut Formation in the Ermenek coal basin. The coal basin in the present study has been subdivided into two areas, Canakci and Pamuklu-Tepebasi, which are separated by the basement and a fault, in order to determine coal properties in detail. The investigated subbituminous coals with an average of 0.40% Ro huminite reflectance often contain gastropod shells (Planorbidae) which commonly maintain the original aragonite and calcite composition. The coals have similar chemical properties and petrographic composition in the two areas, but their sulphur contents are clearly different. In the Canakci area the coals on an air-dried basis contain distinctly less total sulphur (avg. 1.3%) and organic sulphur contents (0.13 0.15%) than in the Pamuklu-Tepebasi area (avg. 4.5% and 4.25%, respectively). This difference is interpreted to be controlled by mire chemistry and sedimentation during peat formation. (author)

  11. Health-related quality of life, adiposity, and sedentary behavior in patients with early schizophrenia: preliminary study

    Directory of Open Access Journals (Sweden)

    Strassnig M

    2012-10-01

    Full Text Available Martin Strassnig,1 Jaspreet S Brar,2 Rohan Ganguli31Department of Psychiatry, Miller School of Medicine, University of Miami, Miami, FL, USA; 2Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA; 3Department of Psychiatry, Centre for Addiction and Mental Health, University of Toronto, Toronto, ON, CanadaObjective: To examine adiposity and sedentary behavior in relation to health-related quality of life (QoL in patients with early schizophrenia.Methods: A cross-sectional study was used to assess adiposity by dual-energy X-ray absorptiometry scans, habitual physical activity and idle sitting time by the Short Form International Physical Activity Questionnaire, and health-related QoL by the RAND Medical Outcomes Study SF-36. QoL scores were compared with age-adjusted Canadian normative population data.Results: There were 36 participants with early schizophrenia, average age 25.1 (±3.6. Twenty-nine (72.5% were males. Mean illness duration was 30 (±18 months, and mean body mass index was 28.3 (±5. Females had higher body fat content than males (30.8 ± 6.9 vs 24.7 ± 10.6; t = −2.6, df = 34; P = 0.015. Total body fat (F = 14; P = 0.001, lean body mass (F = 10.2; P = 0.001, and sedentary behavior (F = 5; P = 0.013 significantly increased across body mass index categories. Total body fat was correlated with sedentary behavior (r = 0.62; P = 0.001, and total lean body mass was negatively correlated with sedentary behavior (r = 0.39; P = 0.03. Based on SF-36 scores, participants had significantly lower physical functioning (P = 0.0034, role physical (P = 0.0003, general health (P < 0.0001, vitality (P = 0.03, and physical component scores (P = 0.003 than Canadian population comparisons. Habitual sedentary behavior, more than activity or adiposity levels, was associated with health-related QoL in early schizophrenia.Conclusion: Health-related QoL is lower in early schizophrenia and is predominantly experienced in the physical

  12. Corn silage hybrid type and quality of alfalfa hay affect dietary nitrogen utilization by early lactating dairy cows.

    Science.gov (United States)

    Holt, M S; Neal, K; Eun, J-S; Young, A J; Hall, J O; Nestor, K E

    2013-10-01

    This experiment was conducted to determine the effects of corn silage (CS) hybrids and quality of alfalfa hay (AH) in high-forage dairy diets on N utilization, ruminal fermentation, and lactational performance by early-lactating dairy cows. Eight multiparous Holstein cows were used in a duplicated 4 × 4 Latin square experiment with a 2 × 2 factorial arrangement of dietary treatments. The 8 cows (average days in milk = 23 ± 11.2) were surgically fitted with ruminal cannula, and the 2 squares were conducted simultaneously. Within square, cows were randomly assigned to a sequence of 4 diets: conventional CS (CCS) or brown midrib CS (BMR) was combined with fair-quality AH [FAH: 46.7% neutral detergent fiber (NDF) and 18.4% crude protein (CP)] or high-quality AH (HAH: 39.2% NDF and 20.7% CP) to form 4 treatments: CCS with FAH, CCS with HAH, BMR with FAH, and BMR with HAH. Diets were isonitrogenous across treatments, averaging 15.9% CP. Each period lasted a total of 21 d, with 14 d for treatment adaptation and 7d for data collection and sampling. Intake of DM and milk yield did not differ in response to CS hybrids or AH quality. Although feeding BMR-based diets decreased urinary N output by 24%, it did not affect fecal N output. Feeding HAH decreased urinary N output by 15% but increased fecal N output by 20%. Nitrogen efficiency [milk N (g/d)/intake N (g/d)] tended to increase for BMR treatments. Ruminal ammonia-N concentration was lower for cows fed BMR-based diets than for those fed CCS-based diets but was not affected by quality of AH. Feeding BMR-based diets or HAH decreased milk urea N concentration by 23 or 15%, respectively, compared with CCS-based diets or FAH. Total volatile fatty acid concentration increased with HAH but was not influenced by CS hybrids. Feeding BMR-based diets decreased urinary N-to-fecal N ratio (UN:FN), and it was further reduced by feeding HAH. Although cows fed the BMR-based diets tended to increase milk N-to-manure N ratio, the

  13. [Results of applying a paediatric early warning score system as a healthcare quality improvement plan].

    Science.gov (United States)

    Rivero-Martín, M J; Prieto-Martínez, S; García-Solano, M; Montilla-Pérez, M; Tena-Martín, E; Ballesteros-García, M M

    2016-06-01

    The aims of this study were to introduce a paediatric early warning score (PEWS) into our daily clinical practice, as well as to evaluate its ability to detect clinical deterioration in children admitted, and to train nursing staff to communicate the information and response effectively. An analysis was performed on the implementation of PEWS in the electronic health records of children (0-15 years) in our paediatric ward from February 2014 to September 2014. The maximum score was 6. Nursing staff reviewed scores >2, and if >3 medical and nursing staff reviewed it. Monitoring indicators: % of admissions with scoring; % of complete data capture; % of scores >3; % of scores >3 reviewed by medical staff, % of changes in treatment due to the warning system, and number of patients who needed Paediatric Intensive Care Unit (PICU) admission, or died without an increased warning score. The data were collected from all patients (931) admitted. The scale was measured 7,917 times, with 78.8% of them with complete data capture. Very few (1.9%) showed scores >3, and 14% of them with changes in clinical management (intensifying treatment or new diagnostic tests). One patient (scored 2) required PICU admission. There were no deaths. Parents or nursing staff concern was registered in 80% of cases. PEWS are useful to provide a standardised assessment of clinical status in the inpatient setting, using a unique scale and implementing data capture. Because of the lack of severe complications requiring PICU admission and deaths, we will have to use other data to evaluate these scales. Copyright © 2016 SECA. Published by Elsevier Espana. All rights reserved.

  14. Theory of Mind and its neuropsychological and Quality of Life correlates in the early stages of amyotrophic lateral sclerosis

    Directory of Open Access Journals (Sweden)

    Francesca Trojsi

    2016-12-01

    Full Text Available This study aims to explore the potential impairment of Theory of Mind (ToM (i.e., the ability to represent cognitive and affective mental states to both self and others and the clinical, neuropsychological and Quality of Life (QoL correlates of these cognitive abnormalities in the early stages of amyotrophic lateral sclerosis (ALS, a multisystem neurodegenerative disease recently recognized as a part of the same clinical and pathological spectrum of frontotemporal lobar degeneration.Twenty-two consecutive, cognitively intact ALS patients, and 15 healthy controls, underwent assessment of executive, verbal comprehension, visuospatial, behavioural and QoL measures, as well as of the ToM abilities by Emotion Attribution Task (EAT, Advanced Test of ToM (ATT and Eyes Task (ET.ALS patients obtained significantly lower scores than controls on EAT and ET. No significant difference was found between the two groups on ATT. As regard to type of ALS onset, patients with bulbar onset performed worse than those with spinal onset on ET. Correlation analysis revealed that EAT and ET were positively correlated with education, memory prose, visuo-spatial performances and Mental Health scores among QoL items.Our results suggest that not only cognitive but also affective subcomponents of ToM may be impaired in the early stages of ALS, with significant linkage to disease onset and dysfunctions of less executively demanding conditions, causing potential impact on patients' Mental Health.

  15. Child oral health-related quality of life and early childhood caries: a non-inferiority randomized control trial.

    Science.gov (United States)

    Arrow, P; Klobas, E

    2016-06-01

    The aim of this study was to compare changes in child oral health-related quality of life (COHRQoL) after treatment for early childhood caries (ECC) using two alternative treatment approaches. A randomized control trial with random allocation of parent/child dyads with ECC to test (minimum intervention) or control (standard care). Participating parents completed the Early Childhood Oral Health Impact Scale (ECOHIS) at baseline and follow-up. Changes in ECOHIS scores and extent of COHRQoL impacts between and within groups were tested using the chi-squared statistic for groups, Wilcoxon's rank-sum test, and matched-pairs signed-rank test. Two hundred and fifty-four children were randomized (test = 127; control = 127). At baseline, mean ECOHIS score 11.1, sd 8.2; mean age = 3.8 years, sd 0.90; mean dmft = 4.9, sd 4.0; and 59% male. After a mean interval of 11.4 months, 210 children were followed-up and returned a completed questionnaire (test = 111; control = 99). There was no significant difference in COHRQoL changes between test and control. For all the children combined, there were significantly fewer impacts at follow-up in the child and family domains and the total ECOHIS, Wilcoxon signed-rank test, p test and control in the extent of the improvement. © 2016 Australian Dental Association.

  16. Quality

    International Nuclear Information System (INIS)

    Burnett, N.; Jeffries, J.; Mach, J.; Robson, M.; Pajot, D.; Harrigan, J.; Lebsack, T.; Mullen, D.; Rat, F.; Theys, P.

    1993-01-01

    What is quality? How do you achieve it? How do you keep it once you have got it. The answer for industry at large is the three-step hierarchy of quality control, quality assurance and Total quality Management. An overview is given of the history of quality movement, illustrated with examples from Schlumberger operations, as well as the oil industry's approach to quality. An introduction of the Schlumberger's quality-associated ClientLink program is presented. 15 figs., 4 ills., 16 refs

  17. Predictors of Nutrition Quality in Early Child Education Settings in Connecticut.

    Science.gov (United States)

    Andreyeva, Tatiana; Kenney, Erica L; O'Connell, Meghan; Sun, Xiaohan; Henderson, Kathryn E

    2018-05-01

    This study assessed the dietary quality of lunches and feeding practices (family-style service, teacher role modeling) in Connecticut child care centers and made comparisons by center participation in the federal Child and Adult Care Food Program (CACFP). Plate waste methods and visual observation of lunches served and consumed. A total of 97 randomly selected licensed Connecticut child care centers (53 CACFP and 44 non-CACFP). A total of 838 preschool-aged children. Total energy intake, macronutrient intake, and intake by CACFP meal component as well as use of family-style dining, management of additional helpings, and whether and what teachers consumed in view of children. Child dietary intake at lunch was compared with dietary and CACFP recommendations using a mixed linear regression model. The CACFP centers were more likely to offer family-style service and have staff eat the same foods as the children. Children in non-CACFP centers consumed more saturated fat (4.1 vs 2.7 g; P feeding practices in child care settings require further exploration in the context of serving children at risk for food insecurity and in light of recent work on responsive feeding. Copyright © 2018 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

  18. HIV communication capacity strengthening: a critical review.

    Science.gov (United States)

    Lettenmaier, Cheryl; Kraft, Joan Marie; Raisanen, Keris; Serlemitsos, Elizabeth

    2014-08-15

    HIV communication is most effective and sustainable when it is designed and implemented locally and tailored to the local context. This requires capacity strengthening at national, subnational, and community levels. Through a review of the published and selected "grey" literature, we examine HIV communication capacity strengthening: definitions, measurements, implementation, and effects. We found limited documentation of HIV communication capacity needs or systematic approaches to address them. Most HIV communication capacity strengthening to date has focused on building individual competencies to design and manage social and behavior change communication programs through training courses, often coupled with networking opportunities for participants, post-training mentoring, and technical assistance. A few of these efforts have been evaluated through pre- and post-training tests and qualitative interviews with participants and have shown potential for improvement in individual skills and knowledge. Health communication capacity assessment tools that measure individual and organizational competencies exist, but they have most often been used to identify capacity building needs, not for evaluating capacity strengthening efforts. A new definition of capacity strengthening, grown out of recent efforts to improve effectiveness of international health and development programs, focuses on improving organizational and societal systems that support performance and individual competencies. We propose a holistic model for HIV communication capacity strengthening and call for rigorous documentation and evaluation to determine and scale-up optimal capacity building interventions for strengthening social and behavior change communication for HIV prevention, care, and treatment in developing countries.

  19. Maternal characteristics associated with the obesogenic quality of the home environment in early childhood.

    Science.gov (United States)

    Schrempft, Stephanie; van Jaarsveld, Cornelia H M; Fisher, Abigail; Fildes, Alison; Wardle, Jane

    2016-12-01

    The home environment is likely to influence children's diet and activity patterns and ultimately, their weight trajectories. Identifying family characteristics associated with a more 'obesogenic' home can provide insight into the determinants, and has implications for targeting and tailoring strategies to promote healthier lifestyles. The present study examined maternal characteristics associated with a more obesogenic home environment in 1113 families with preschool children. Primary caregivers (99% mothers) from the Gemini cohort completed the Home Environment Interview (HEI) when their children were 4 years old. Maternal demographics and BMI were assessed in the Gemini baseline questionnaire when the children were on average 8 months old. Maternal eating style was assessed when the children were on average 2 years old, using the Dutch Eating Behaviour Questionnaire (DEBQ). Responses to the HEI were standardised and summed to create a composite score of the obesogenic quality of the home; this was categorised into tertiles. Multivariate ordinal logistic regression showed that mothers who were younger (adjusted OR; 95% CI = 0.96; 0.94-0.98), less educated (1.97; 1.40-2.77), and had lower incomes (1.89; 1.43-2.49) at baseline were more likely to live in an obesogenic home environment at 4 years, as were mothers who scored higher on the DEBQ External Eating scale (1.40; 1.16-1.70) at 2 years, and had a higher baseline BMI (1.05; 1.02-1.08). Using a novel, composite measure of the home environment, this study finds that families who are more socio-economically deprived, and where the mothers are themselves heavier and have a more food responsive eating style, tend to provide a home environment with the hallmarks of a higher risk of weight gain. Copyright © 2016 Elsevier Ltd. All rights reserved.

  20. Accelerate Water Quality Improvement

    Science.gov (United States)

    EPA is committed to accelerating water quality improvement and minimizing negative impacts to aquatic life from contaminants and other stressors in the Bay Delta Estuary by working with California Water Boards to strengthen water quality improvement plans.

  1. Timber Elements: Traditional and Modern Strengthening Techniques

    Directory of Open Access Journals (Sweden)

    Raluca Hohan

    2010-01-01

    Full Text Available The main idea of this paper is to analyse the means for the rehabilitation of our cultural heritage timber structures. Several methods together with their application techniques are described, and also, the reasons for what these strengthening operations become imminent at a point. First of all, the necessity of the timber structural elements strengthening is explained through a short presentation of the factors which are degrading the material. Then, certain precautions and strengthening procedures are presented, all involving the usage of traditional materials like wood, metal, or concrete, and of modern materials like fiber reinforced polymeric composite.

  2. The effects of inspiratory muscle strengthening on MIP and quality of life of elderly nursing home patients. (Los efectos del beneficio de la fuerza del músculo inspiratorio en la PIM y la calidad de la vida de los pacientes mayores de la clínica de reposo.

    Directory of Open Access Journals (Sweden)

    Silvia Correa Bacelar

    2008-01-01

    Full Text Available AbstractThe objective of this study was to compare the effects of inspiratory muscle strengthening on maximal inspiratory pressure (MIP and on quality of life among elderly nursing home patients. The study population was divided in two groups: experimental group- EG (n=21, 76.48 2.12 years and control group- CG (n=13, 75.69 2.26 years. The World Health Organization Quality of Life Group (WHOQOL-100 questionnaire was used to evaluate the quality of life of the subjects. A Manovacuometer (analogical, with an operational interval of –150 to +150 cmH2O; Critical Med/USA-2002 was used to evaluate MIP. The study protocol consisted of a gradual increase in workload (50%-100%; the sessions lasted 20 minutes and were composed of 7 series of strengthening (2 minutes each with a 1-minute interval between the series, 3 times a week for 10 weeks. Variance analysis of multivariate repeated measurements demonstrated significant differences only for MIP between CG (32,69±17,03 cmH2O versus 23,08±10,71 cmH2O and EG (31,67±11,11 cmH2O versus 55,24±23,26 cmH2O, and the latter was higher than the former (p= 0,00000. Therefore, we concluded that inspiratory muscle strengthening led to an increase in MIP that did not improve quality of life. However, further studies should be done in this population to validate a quality of life questionnaire specific for the elderly.ResumenEl objetivo de este estudio era comparar los efectos del músculo inspiratorio que consolidaban en la presión inspiratoria máxima (PIM y en la calidad de la vida entre pacientes mayores de la clínica de reposo. Dividieron a la población del estudio en dos grupos: grupo experimental EG. (n=21,76.48 2.12 años y grupo de control CG (n=13, 75.69 2.26 años. La calidad de la Organización Mundial de la Salud del cuestionario del grupo de la vida(WHOQOL-100 fue utilizada para evaluar la calidad de la vida de los temas. Un Manovacuometer (analógico, con un intervalo operacional - de 150 a

  3. Early quality of life outcomes in patients with prostate cancer managed by high-dose-rate brachytherapy as monotherapy

    International Nuclear Information System (INIS)

    Komiya, Akira; Fujiuchi, Yasuyoshi; Ito, Takatoshi

    2013-01-01

    The purpose of this study was to evaluate the early quality of life outcomes in prostate cancer patients managed by high-dose-rate brachytherapy as monotherapy. A total of 51 patients with cT1c-T3aN0M0 prostate cancer treated between July 2007 and January 2010 were included in this study. The average age was 69?years, and the average initial serum prostate-specific antigen was 10.98?ng/mL. A total of 25, 18 and eight patients were considered to be low, intermediate and high risk, respectively. All patients received one implant of Ir-192 and seven fractions of 6.5?Gy within 3.5?days for a total prescribed dose of 45.5?Gy. For high-risk prostate cancer, neoadjuvant androgen deprivation therapy was carried out for at least 6?months, and continued after high-dose-rate brachytherapy. Quality of life outcomes were measured by using the International Prostate Symptom Score, the Functional Assessment of Cancer Therapy-Prostate and the International Index of Erectile Function Questionnaire. The oncological outcome was assessed by serum prostate-specific antigen and diagnostic imaging. Adverse events were also recorded. The Functional Assessment of Cancer Therapy-Prostate scores decreased for a few months after high-dose-rate brachytherapy, and recovered to pretreatment condition thereafter. The International Prostate Symptom Score significantly increased 2?weeks after treatment for each of its items and their sum, and it returned to baseline after 12?weeks. Sexual function decreased at 2 and 4?weeks, and recovered after 12?weeks. Severe complications were rare. Within a median follow up of 17.2?months, two patients showed a prostate-specific antigen recurrence. High-dose-rate brachytherapy for prostate cancer is a feasible treatment modality with acceptable toxicity and only a limited impact on the quality of life. (author)

  4. Strengthening primary healthcare through community involvement in ...

    African Journals Online (AJOL)

    Strengthening primary healthcare through community involvement in Cross River State, Nigeria: a descriptive study. Hilary Adie, Thomas Igbang, Akaninyene Otu, Ekanem Braide, Okpok Okon, Edet Ikpi, Charles Joseph, Alexander Desousa, Johannes Sommerfeld ...

  5. Strengthening rural health placements for medical students ...

    African Journals Online (AJOL)

    Strengthening rural health placements for medical students: Lessons for South Africa ... rural health, primary healthcare and National Health Insurance strategies. ... preferential selection of students with a rural background, positioning rural ...

  6. Strengthening Governance in Health Systems for Reproductive ...

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

    Home · What we do ... As a result, Pakistan's health system has suffered and health service delivery has worsened. ... This four-year project aims to strengthen health systems governance for reproductive health and rights in Pakistan.

  7. Strengthening Agricultural Research Capacity for Viable Extension ...

    African Journals Online (AJOL)

    Strengthening Agricultural Research Capacity for Viable Extension Policies in Nigeria: An Exploration of Ricoeur's Hermeneutic Theory for Analysing Extension Research. ... Progressively more, researchers use hermeneutic philosophy to inform the conduct of interpretive research. Analogy between the philosophical ...

  8. Cardiovascular fitness strengthening using portable device.

    Science.gov (United States)

    Alqudah, Hamzah; Kai Cao; Tao Zhang; Haddad, Azzam; Su, Steven; Celler, Branko; Nguyen, Hung T

    2016-08-01

    The paper describes a reliable and valid Portable Exercise Monitoring system developed using TI eZ430-Chronos watch, which can control the exercise intensity through audio stimulation in order to increase the Cardiovascular fitness strengthening.

  9. Strengthening entrepreneurship through coaching and developing competencies

    NARCIS (Netherlands)

    Beldman, A.C.G.

    2011-01-01

    Strengthening entrepreneurship is an important strategy for stimulating the transition to sustainable agriculture. But how is that done? One example is the Interactive Strategic Management method, which supports entrepreneurs in the creation and execution of future-focused strategies.

  10. Strengthening Democratic Governance through ICTs : Post Election ...

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

    Strengthening Democratic Governance through ICTs : Post Election ... has had several consequences, culminating in the disputed general elections of December 2007. ... Linking research to urban planning at the ICLEI World Congress 2018.

  11. Assessment of the quality of medical care among patients with early stage prostate cancer undergoing expectant management in the United States.

    Science.gov (United States)

    Ritchey, Jamie; Gay, E Greer; Spencer, Benjamin A; Miller, David C; Wallner, Lauren P; Stewart, Andrew K; Dunn, Rodney L; Litwin, Mark S; Wei, John T

    2012-09-01

    Given the increased attention to the quality and cost of medical care, the Institute of Medicine and Centers for Medicare and Medicaid Services have called for performance measurement and reporting. The clinical management of prostate cancer has been outlined, yet is not intended to describe quality prostate cancer care. Therefore, RAND researchers developed quality indicators for early stage prostate cancer. The ACoS (American College of Surgeons) used these indicators to perform the first national assessment to our knowledge of the quality of care among men with early stage prostate cancer undergoing expectant management. Information from medical records was abstracted for evidence of compliance with the RAND indicators (structure and process). Weighted and stratified proportions were calculated to assess indicator compliance. Logistic regression models were fit and evaluated by hospital type and patient factors. A weighted and stratified total of 13,876 early stage prostate cancer cases on expectant management in 2000 to 2001 were investigated. Compliance with structural indicators was high (greater than 80%) and compliance with process indicators varied (19% to 87%). Differences in process indicators were observed from models by hospital type and comorbid conditions, but not for age, race or insurance status. Using the RAND quality indicators this study revealed several process areas for quality improvement among men with early stage prostate cancer on expectant management in the United States. Efforts to improve the quality of early stage prostate cancer care need to move beyond the paradigm of age, race and insurance status. Copyright © 2012 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  12. Oxide dispersion-strengthened ferritic alloys

    International Nuclear Information System (INIS)

    Asbroeck, P. van.

    1976-10-01

    The publication gives the available data on the DTO2 dispersion-strengthened ferritic alloy developed at C.E.N./S.C.K. Mol, Belgium. DTO2 is a Fe-Cr-Mo ferritic alloy, strengthened by addition of titanium oxide and of titanium leading to the formation of Chi phase. It was developed for use as canning material for fast breeder reactors. (author)

  13. Numerical Investigation of Masonry Strengthened with Composites

    Directory of Open Access Journals (Sweden)

    Giancarlo Ramaglia

    2018-03-01

    Full Text Available In this work, two main fiber strengthening systems typically applied in masonry structures have been investigated: composites made of basalt and hemp fibers, coupled with inorganic matrix. Starting from the experimental results on composites, the out-of-plane behavior of the strengthened masonry was assessed according to several numerical analyses. In a first step, the ultimate behavior was assessed in terms of P (axial load-M (bending moment domain (i.e., failure surface, changing several mechanical parameters. In order to assess the ductility capacity of the strengthened masonry elements, the P-M domain was estimated starting from the bending moment-curvature diagrams. Key information about the impact of several mechanical parameters on both the capacity and the ductility was considered. Furthermore, the numerical analyses allow the assessment of the efficiency of the strengthening system, changing the main mechanical properties. Basalt fibers had lower efficiency when applied to weak masonry. In this case, the elastic properties of the masonry did not influence the structural behavior under a no tension assumption for the masonry. Conversely, their impact became non-negligible, especially for higher values of the compressive strength of the masonry. The stress-strain curve used to model the composite impacted the flexural strength. Natural fibers provided similar outcomes, but a first difference regards the higher mechanical compatibility of the strengthening system with the substrate. In this case, the ultimate condition is due to the failure mode of the composite. The stress-strain curves used to model the strengthening system are crucial in the ductility estimation of the strengthened masonry. However, the behavior of the composite strongly influences the curvature ductility in the case of higher compressive strength for masonry. The numerical results discussed in this paper provide the base to develop normalized capacity models able to

  14. Mild decentration measured by a Scheimpflug camera and its impact on visual quality following SMILE in the early learning curve.

    Science.gov (United States)

    Li, Meiyan; Zhao, Jing; Miao, Huamao; Shen, Yang; Sun, Ling; Tian, Mi; Wadium, Elizabeth; Zhou, Xingtao

    2014-05-20

    To measure decentration following femtosecond laser small incision lenticule extraction (SMILE) for the correction of myopia and myopic astigmatism in the early learning curve, and to investigate its impact on visual quality. A total of 55 consecutive patients (100 eyes) who underwent the SMILE procedure were included. Decentration was measured using a Scheimpflug camera 6 months after surgery. Uncorrected and corrected distance visual acuity (UDVA, CDVA), manifest refraction, and wavefront errors were also measured. Associations between decentration and the preoperative spherical equivalent were analyzed, as well as the associations between decentration and wavefront aberrations. Regarding efficacy and safety, 40 eyes (40%) had an unchanged CDVA; 32 eyes (32%) gained one line; and 11 eyes (11%) gained two lines. Fifteen eyes (15%) lost one line of CDVA, and two eyes (2%) lost two lines. Ninety-nine of the treated eyes (99%) had a postoperative UDVA better than 1.0, and 100 eyes (100%) had a UDVA better than 0.8. The mean decentered displacement was 0.17 ± 0.09 mm. The decentered displacement of all treated eyes (100%) was within 0.50 mm; 70 eyes (70%) were within 0.20 mm; and 90 eyes (90%) were within 0.30 mm. The vertical coma showed the greatest increase in magnitude. The magnitude of horizontal decentration was found to be associated with an induced horizontal coma. This study suggests that, although mild decentration occurred in the early learning curve, good visual outcomes were achieved after the SMILE surgery. Special efforts to minimize induced vertical coma are necessary. Copyright 2014 The Association for Research in Vision and Ophthalmology, Inc.

  15. High-Quality Interactions with Infants: Relationships with Early-Childhood Practitioners' Interpretations and Qualification Levels in Play and Routine Contexts

    Science.gov (United States)

    Degotardi, Sheila

    2010-01-01

    This study investigated factors related to the quality of early-childhood practitioners' interactions with infants in play and routine contexts. Participants were 24 practitioners working with 9-20-month-old infants in long day-care infant programmes. Video-recordings of their interactions with a nominated infant during play and in routine…

  16. Clear associations between demographic and psychosocial factors and health-related quality of life in patients with early inflammatory joint complaints.

    NARCIS (Netherlands)

    Geuskens, G.A.; Burdorf, A.; Evers, A.W.M.; Hazes, J.M.W.

    2008-01-01

    OBJECTIVE: Objective. To identify demographic and psychosocial characteristics associated with health-related quality of life (HRQOL) in patients with early inflammatory joint complaints. METHODS: In this cross-sectional study, patients had inflammatory joint complaints for less than 12 months. Data

  17. Clear associations between demographic and psychosocial factors and health-related quality of life in patients with early inflammatory joint complaints.

    NARCIS (Netherlands)

    G.A. Geuskens (Goedele); A. Burdorf (Alex); A.W.M. Evers (Arne); J.M.W. Hazes (Mieke)

    2008-01-01

    textabstractObjective. To identify demographic and psychosocial characteristics associated with health-related quality of life (HRQOL) in patients with early inflammatory joint complaints. Methods. In this cross-sectional study, patients had inflammatory joint complaints for less than 12 months.

  18. Training for Quality: Improving Early Childhood Programs through Systematic Inservice Training. Monographs of the High/Scope Educational Research Foundation, Number Nine.

    Science.gov (United States)

    Epstein, Ann S.

    The Training of Trainers (ToT) Evaluation investigated the efficacy of the High/Scope model for improving the quality of early childhood programs on a national scale. To address this question, the High/Scope Foundation undertook a multimethod evaluation that collected anecdotal records from the consultants and 793 participants in 40 ToT projects,…

  19. Assessing the Implementation and Cost of High Quality Early Care and Education: A Review of the Literature. OPRE Report 2016-31

    Science.gov (United States)

    Caronongan, Pia; Kirby, Gretchen; Boller, Kimberly; Modlin, Emily; Lyskawa, Julia

    2016-01-01

    This report summarizes the findings of a literature review conducted as part of the Assessing the Implementation and Cost of High-Quality Early Care and Education (ECE-ICHQ) project. The project's goal is to create a technically sound and feasible instrument that will provide consistent, systematic measures of the implementation and costs of…

  20. Strengthening health workforce capacity through work-based training

    Directory of Open Access Journals (Sweden)

    Matovu Joseph KB

    2013-01-01

    Full Text Available Abstract Background Although much attention has been given to increasing the number of health workers, less focus has been directed at developing models of training that address real-life workplace needs. Makerere University School of Public Health (MakSPH with funding support from the Centers for Disease Control and Prevention (CDC developed an eight-month modular, in-service work-based training program aimed at strengthening the capacity for monitoring and evaluation (M&E and continuous quality improvement (CQI in health service delivery. Methods This capacity building program, initiated in 2008, is offered to in-service health professionals working in Uganda. The purpose of the training is to strengthen the capacity to provide quality health services through hands-on training that allows for skills building with minimum work disruptions while encouraging greater involvement of other institutional staff to enhance continuity and sustainability. The hands-on training uses practical gaps and challenges at the workplace through a highly participatory process. Trainees work with other staff to design and implement ‘projects’ meant to address work-related priority problems, working closely with mentors. Trainees’ knowledge and skills are enhanced through short courses offered at specific intervals throughout the course. Results Overall, 143 trainees were admitted between 2008 and 2011. Of these, 120 (84% from 66 institutions completed the training successfully. Of the trainees, 37% were Social Scientists, 34% were Medical/Nursing/Clinical Officers, 5.8% were Statisticians, while 23% belonged to other professions. Majority of the trainees (80% were employed by Non-Government Organizations while 20% worked with the public health sector. Trainees implemented 66 projects which addressed issues such as improving access to health care services; reducing waiting time for patients; strengthening M&E systems; and improving data collection and

  1. Improving the use of health data for health system strengthening

    Directory of Open Access Journals (Sweden)

    Tara Nutley

    2013-02-01

    Full Text Available Background: Good quality and timely data from health information systems are the foundation of all health systems. However, too often data sit in reports, on shelves or in databases and are not sufficiently utilised in policy and program development, improvement, strategic planning and advocacy. Without specific interventions aimed at improving the use of data produced by information systems, health systems will never fully be able to meet the needs of the populations they serve. Objective: To employ a logic model to describe a pathway of how specific activities and interventions can strengthen the use of health data in decision making to ultimately strengthen the health system. Design: A logic model was developed to provide a practical strategy for developing, monitoring and evaluating interventions to strengthen the use of data in decision making. The model draws on the collective strengths and similarities of previous work and adds to those previous works by making specific recommendations about interventions and activities that are most proximate to affect the use of data in decision making. The model provides an organizing framework for how interventions and activities work to strengthen the systematic demand, synthesis, review, and use of data. Results: The logic model and guidance are presented to facilitate its widespread use and to enable improved data-informed decision making in program review and planning, advocacy, policy development. Real world examples from the literature support the feasible application of the activities outlined in the model. Conclusions: The logic model provides specific and comprehensive guidance to improve data demand and use. It can be used to design, monitor and evaluate interventions, and to improve demand for, and use of, data in decision making. As more interventions are implemented to improve use of health data, those efforts need to be evaluated.

  2. Health-Related Quality of Life up to Six Years After 125I Brachytherapy for Early-Stage Prostate Cancer

    International Nuclear Information System (INIS)

    Roeloffzen, Ellen M.A.; Lips, Irene M.; Gellekom, Marion P.R. van; Roermund, Joep van; Frank, Steven J.; Battermann, Jan J.; Vulpen, Marco van

    2010-01-01

    Purpose: Health-related quality of life (HRQOL) after prostate brachytherapy has been extensively described in published reports but hardly any long-term data are available. The aim of the present study was to prospectively assess long-term HRQOL 6 years after 125 I prostate brachytherapy. Methods and Materials: A total of 127 patients treated with 125 I brachytherapy for early-stage prostate cancer between December 2000 and June 2003 completed a HRQOL questionnaire at five time-points: before treatment and 1 month, 6 months, 1 year, and 6 years after treatment. The questionnaire included the RAND-36 generic health survey, the cancer-specific European Organization for Research and Treatment of Cancer core questionnaire (EORTCQLQ-C30), and the tumor-specific EORTC prostate cancer module (EORTC-PR25). A change in a score of ≥10 points was considered clinically relevant. Results: Overall, the HRQOL at 6 years after 125 I prostate brachytherapy did not significantly differ from baseline. Although a statistically significant deterioration in HRQOL at 6 years was seen for urinary symptoms, bowel symptoms, pain, physical functioning, and sexual activity (p 125 I prostate brachytherapy. HRQOL scores returned to approximately baseline values at 1 year and remained stable up to 6 years after treatment. 125 I prostate brachytherapy did not adversely affect patients' long-term HRQOL.

  3. Early Intervention for Post-Traumatic Stress Disorder, Depression, and Quality of Life in Mortuary Affairs Soldiers Postdeployment.

    Science.gov (United States)

    Biggs, Quinn M; Fullerton, Carol S; McCarroll, James E; Liu, Xian; Wang, Leming; Dacuyan, Nicole M; Zatzick, Douglas F; Ursano, Robert J

    2016-11-01

    U.S. Army mortuary affairs (MA) soldiers experience stressors of deployment and exposure to the dead, increasing risk for post-traumatic stress and depression. This study examines Troop Education for Army Morale, a postdeployment early intervention based on Psychological First Aid. MA soldiers (N = 126) were randomized to intervention or comparison groups 1-month postdeployment. Intervention sessions were held at 2, 3, 4, and 7 months. Assessments of post-traumatic stress disorder (PTSD), depression, and quality of life (QOL) were conducted at 1, 2, 3, 4, 7, and 10 months for both groups. At baseline, 25.0% of the total sample had probable PTSD (17-item PTSD Checklist M = 35.4, SD = 16.9) and 23.6% had probable depression (9-item Patient Health Questionnaire Depression Scale M = 7.8, SD = 6.9). Over 10 months, PTSD and depression symptoms decreased and QOL improved for the total sample. At study conclusion, intervention and comparison groups were not different. Intervention group males showed a transient symptom increase at 2 to 3 months. Males attended fewer intervention sessions than females. Lower attendance was associated with more symptoms and lower QOL. Higher attendance was associated with greater intervention benefits. Findings highlight the need for better understanding postdeployment interventions and facilitating attendance. Further intervention for MA soldiers is indicated. Reprint & Copyright © 2016 Association of Military Surgeons of the U.S.

  4. The basis for the strengthening of safeguards

    International Nuclear Information System (INIS)

    Goldschmidt, P.

    1999-01-01

    For the past 30 years, the International Atomic Energy Agency's safeguards system has contributed to the international non-proliferation regime, by providing, inter alia, assurances regarding the peaceful uses of declared nuclear material. However, the discovery of a clandestine nuclear weapons programme in Iraq in 1991 drew world-wide attention to the need to strengthen the system to address the absence of undeclared nuclear material and activities. Efforts to strengthen the IAEA's safeguards system began in 1991 and culminated in 1997 when the IAEA's Board of Governors approved a Model Protocol Additional to IAEA Safeguards Agreements which greatly expands the legal basis and scope of IAEA safeguards. Within this strengthened system it is expected that the IAEA be able to provide assurance not only of the absence of diversion of declared nuclear material but also on the absence of undeclared nuclear material and activities. This is to be done within a safeguards system that uses an optimal combination of all safeguards measures available, thereby achieving maximum effectiveness and efficiency within the available resources. This paper will summarize the evolution of the safeguards system, describe strengthened safeguards, report on the status of implementing the strengthening measures, and outline plans for integrating all available safeguards measures. (author)

  5. Comprehensive and integrated district health systems strengthening: the Rwanda Population Health Implementation and Training (PHIT) Partnership.

    Science.gov (United States)

    Drobac, Peter C; Basinga, Paulin; Condo, Jeanine; Farmer, Paul E; Finnegan, Karen E; Hamon, Jessie K; Amoroso, Cheryl; Hirschhorn, Lisa R; Kakoma, Jean Baptise; Lu, Chunling; Murangwa, Yusuf; Murray, Megan; Ngabo, Fidele; Rich, Michael; Thomson, Dana; Binagwaho, Agnes

    2013-01-01

    Nationally, health in Rwanda has been improving since 2000, with considerable improvement since 2005. Despite improvements, rural areas continue to lag behind urban sectors with regard to key health outcomes. Partners In Health (PIH) has been supporting the Rwanda Ministry of Health (MOH) in two rural districts in Rwanda since 2005. Since 2009, the MOH and PIH have spearheaded a health systems strengthening (HSS) intervention in these districts as part of the Rwanda Population Health Implementation and Training (PHIT) Partnership. The partnership is guided by the belief that HSS interventions should be comprehensive, integrated, responsive to local conditions, and address health care access, cost, and quality. The PHIT Partnership represents a collaboration between the MOH and PIH, with support from the National University of Rwanda School of Public Health, the National Institute of Statistics, Harvard Medical School, and Brigham and Women's Hospital. The PHIT Partnership's health systems support aligns with the World Health Organization's six health systems building blocks. HSS activities focus across all levels of the health system - community, health center, hospital, and district leadership - to improve health care access, quality, delivery, and health outcomes. Interventions are concentrated on three main areas: targeted support for health facilities, quality improvement initiatives, and a strengthened network of community health workers. The impact of activities will be assessed using population-level outcomes data collected through oversampling of the demographic and health survey (DHS) in the intervention districts. The overall impact evaluation is complemented by an analysis of trends in facility health care utilization. A comprehensive costing project captures the total expenditures and financial inputs of the health care system to determine the cost of systems improvement. Targeted evaluations and operational research pieces focus on specific

  6. Defining Quality in Visual Art Education for Young Children: Building on the Position Statement of the Early Childhood Art Educators

    Science.gov (United States)

    McClure, Marissa; Tarr, Patricia; Thompson, Christine Marmé; Eckhoff, Angela

    2017-01-01

    This article reflects the collective voices of four early childhood visual arts educators, each of whom is a member of the Early Childhood Art Educators (ECAE) Issues Group of the National Arts Educators Association. The authors frame the article around the ECAE position statement, "Art: Essential for Early Learning" (2016), which…

  7. Individualized Approaches Have Profitable Clinical Value for Strengthening Fathers' Confidence in the Care of Preterm Infants. Commentary on: "Variations in Early Attachment Mechanisms Contribute to Attachment Quality: Case Studies Including Babies Born Preterm"

    Science.gov (United States)

    Buchheim, Anna

    2016-01-01

    In this commentary, Buchheim states that she recognizes that infant-parent relationship has been shown to be of particular significance to preterm infants' socioemotional development, and that preterm children have been reported to be at higher risk of developing attachment insecurity and disorganized attachment. In the feature paper on attachment…

  8. New concept of critical infrastructure strengthening

    International Nuclear Information System (INIS)

    Gazizov, Talgat R.; Orlov, Pavel E.; Zabolotsky, Alexander M.; Kuksenko, Sergey P.

    2016-01-01

    Strengthening of critical infrastructure is considered. Modal reservation of electronics is proposed as a new concept of the strengthening. The concept combines a widely used cold backup and a recently proposed modal filtration. It makes electronics reliable as well as protected against electromagnetic interference, especially the ultra-wide band pulses. New printed circuit board structure is suggested for implementation of the proposed concept. Results of simulation in time and frequency domains are presented for the suggested structures. Considerable attenuation of dangerous excitations shows that the new concept and structure are promising.

  9. FRP strengthening of RC walls with openings

    DEFF Research Database (Denmark)

    Hansen, Christian Skodborg; Sas, Gabriel; Täljsten, Björn

    2009-01-01

    Strengthening reinforced concrete (RC) walls with openings using fibre reinforced polymers (FRP) has been experimentally proven to be a viable rehabilitation method. However, very few theoretical investigations are reported. In this paper two methods of analysis are presented. Since openings vary...... in size, the analysis of a strengthened wall can be divided into frame idealization method for large openings, and combined disk and frame analysis for smaller openings. The first method provides an easy to use tool in practical engineering, where the latter describes the principles of a ductile...

  10. New concept of critical infrastructure strengthening

    Energy Technology Data Exchange (ETDEWEB)

    Gazizov, Talgat R.; Orlov, Pavel E.; Zabolotsky, Alexander M.; Kuksenko, Sergey P. [Tomsk State University of Control Systems and Radioelectronics, 634050, Lenin Ave., Tomsk (Russian Federation)

    2016-06-08

    Strengthening of critical infrastructure is considered. Modal reservation of electronics is proposed as a new concept of the strengthening. The concept combines a widely used cold backup and a recently proposed modal filtration. It makes electronics reliable as well as protected against electromagnetic interference, especially the ultra-wide band pulses. New printed circuit board structure is suggested for implementation of the proposed concept. Results of simulation in time and frequency domains are presented for the suggested structures. Considerable attenuation of dangerous excitations shows that the new concept and structure are promising.

  11. Strengthened safeguards: Present and future challenges

    International Nuclear Information System (INIS)

    Goldschmidt, Pierre

    2001-01-01

    Full text: The safeguards system is experiencing what has been seen as a revolution and, in doing so, it is confronting a series of challenges. These can be grouped into three areas. Drawing and maintaining safeguards conclusions - The process by which the safeguards conclusions are derived is based upon the analysis, evaluation and review of all the information available to the Agency. This process is on- going, but the State Evaluation Reports are compiled and reviewed periodically. For States with an additional protocol in force, the absence of indicators of the presence of undeclared nuclear material or activities provides the basis for the safeguards conclusion. Future challenges center on States' expectations of, and reactions to, the results of the evaluation and review process. Designing and implementing integrated safeguards - The conceptual framework of integrated safeguards is being actively pursued. Basic principles have been defined and integrated safeguards approaches have been developed for various types of facilities. Work is also progressing on the design of integrated safeguards approaches for specific States. Complementary access is being successfully implemented, and procedures for the use of unannounced inspections are being developed with the prospect of cost- effectiveness gains. Costs neutrality vs. quality and credibility - The Department faces serious staff and financial challenges. It has succeeded so far in 'doing more' and 'doing better' within a zero-real growth budget, but the scope for further significant efficiency gains is exhausted. There is no capacity to absorb new or unexpected tasks. Difficulties in recruiting and retaining qualified and experienced staff exacerbate the problems and add to costs. The Director General of the IAEA has referred to the need for new initiatives to bridge the budgetary gap; a possible measure is proposed. The tasks of meeting the challenges and demands of strengthened safeguards have been added to

  12. Strengthening Indonesia's health workforce through partnerships.

    Science.gov (United States)

    Kurniati, A; Rosskam, E; Afzal, M M; Suryowinoto, T B; Mukti, A G

    2015-09-01

    Indonesia faces critical challenges pertaining to human resources for health (HRH). These relate to HRH policy, planning, mismatch between production and demand, quality, renumeration, and mal-distribution. This paper provides a state of the art review of the existing conditions in Indonesia, innovations to tackle the problems, results of the innovations to date, and a picture of the on-going challenges that have yet to be met. Reversing this crisis level shortage of HRH requires an inclusive approach to address the underlying challenges. In 2010 the government initiated multi-stakeholder coordination for HRH, using the Country Coordination and Facilitation approach. The process requires committed engagement and coordination of relevant stakeholders to address priority health needs. This manuscript is a formative evaluation of the program using documentary study and analysis. Consistent with Indonesia's decentralized health system, since 2011 local governments also started establishing provincial multi-stakeholder committees and working groups for HRH development. Through this multi-stakeholder approach with high level government support and leadership, Indonesia was able to carry out HRH planning by engaging 164 stakeholders. Multi-stakeholder coordination has produced positive results in Indonesia by bringing about a number of innovations in HRH development to achieve UHC, fostered partnerships, attracted international attention, and galvanized multi-stakeholder support in improving the HRH situation. This approach also has facilitated mobilizing technical and financial support from domestic and international partners for HRH development. Applying the multi-stakeholder engagement and coordination process in Indonesia has proved instrumental in advancing the country's work to achieve Universal Health Coverage and the Millennium Development Goals by 2015. Indonesia continues to face an HRH crisis but the collaborative process provides an opportunity to achieve

  13. Comparison of early quality of life in patients treated with radiotherapy following mastectomy or breast conservation therapy: A prospective study

    International Nuclear Information System (INIS)

    Munshi, Anusheel; Dutta, Debnarayan; Kakkar, Sajal; Budrukkar, Ashwini; Jalali, Rakesh; Sarin, Rajiv; Gupta, Sudeep; Parmar, Vani; Badwe, Rajendra

    2010-01-01

    Introduction: To compare quality of life (QOL) in breast cancer patients from a developing country after breast conservation surgery (BCS) or mastectomy and adjuvant radiotherapy (RT). Materials and methods: In a 6-month period, all consecutive early and locally advanced breast cancer patients treated with either BCS or mastectomy and treated with RT were analyzed. All patients who underwent mastectomy were treated with 45 Gray/20/4 weeks. Patients with BCS were treated with a dose of 45-50 Gray/25/5 weeks to whole breast followed by tumor bed boost (15 Gray/6/6 days with suitable energy electrons). Prospective evaluation of QOL using EORTC QLQ C30 and breast cancer specific QLQ BR23 was done before starting RT (baseline), at mid-RT and at RT conclusion for all patients. Results: One hundred and thirteen patients had mastectomy and 142 patients underwent BCS. Reliability test (Cronbach alpha) for questionnaire filling was 0.669-0.886. At pre-RT assessment, global QOL scores in mastectomy and BCS groups were 71.1 and 71.3, respectively. There was no significant difference in pre-RT EORTC QLQ C30 functional and symptom domains between mastectomy and BCS patients. However, social function domain score was higher in patients who underwent mastectomy (83 versus 73.9; p = 0.018). In QLQ BR23 domains, body image and sexual functioning domains were similar between the two groups. However, sexual enjoyment (10.9 versus 47.6; p = 0.006) and future perspective (7.4 versus 37.1; p = 0.036) domains were significantly better in BCS arm. There was no difference between systemic side effect (BRSSE), breast symptom (BRBS) and arm symptom (BRAS) domain scores between the groups. There was no significant difference in change of QOL scores between mastectomy and BCS patients at RT completion as compared to baseline. Conclusions: There was no significant difference in quality of life in patients with BCS versus those with mastectomy. However, patients who underwent BCS had better

  14. Shedding Further Light on the Effects of Various Types and Quality of Early Child Care on Infant-Mother Attachment Relationship: The Haifa Study of Early Child Care.

    Science.gov (United States)

    Sagi, Abraham; Koren-Karie, Nina; Gini, Motti; Ziv, Yair; Joels, Tirtsa

    2002-01-01

    The Haifa Study of Early Child Care examined the unique contribution of various child-care-related correlates to infant-mother attachment. Findings indicated that, after controlling for other potential contributing variables (including mother characteristics, mother-child interaction, and mother- father relationship), center care adversely…

  15. Strengthening Low-Income Families: A Research Agenda for Parenting, Relationship, and Fatherhood Programs

    Science.gov (United States)

    MDRC, 2013

    2013-01-01

    Policymakers need to decide how to invest in strengthening the most basic foundation for early childhood development: family relationships. The challenges: (1) help parents provide the responsive and stimulating environments that will prepare young children for school; and (2) support fathers' engagement with their children regardless of whether…

  16. Study protocol for a randomized controlled trial: tongue strengthening exercises in head and neck cancer patients, does exercise load matter?

    Science.gov (United States)

    Van Nuffelen, Gwen; Van den Steen, Leen; Vanderveken, Olivier; Specenier, Pol; Van Laer, Carl; Van Rompaey, Diane; Guns, Cindy; Mariën, Steven; Peeters, Marc; Van de Heyning, Paul; Vanderwegen, Jan; De Bodt, Marc

    2015-09-04

    Reduced tongue strength is an important factor contributing to early and late dysphagia in head and neck cancer patients previously treated with chemoradiotherapy. The evidence is growing that tongue strengthening exercises can improve tongue strength and swallowing function in both healthy and dysphagic subjects. However, little is known about the impact of specific features of an exercise protocol for tongue strength on the actual outcome (strength or swallowing function). Previous research originating in the fields of sports medicine and physical rehabilitation shows that the degree of exercise load is an influential factor for increasing muscle strength in the limb skeletal muscles. Since the tongue is considered a muscular hydrostat, it remains to be proven whether the same concepts will apply. This ongoing randomized controlled trial in chemoradiotherapy-treated patients with head and neck cancer investigates the effect of three tongue strengthening exercise protocols, with different degrees of exercise load, on tongue strength and swallowing. At enrollment, 51 patients whose dysphagia is primarily related to reduced tongue strength are randomly assigned to a training schedule of 60, 80, or 100% of their maximal tongue strength. Patients are treated three times a week for 8 weeks, executing 120 repetitions of the assigned exercise once per training day. Exercise load is progressively adjusted every 2 weeks. Patients are evaluated before, during and after treatment by means of tongue strength measurements, fiber-optic endoscopic evaluation of swallowing and quality-of-life questionnaires. This randomized controlled trial is the first to systematically investigate the effect of different exercise loads in tongue strengthening exercise protocols. The results will allow the development of more efficacious protocols. Current Controlled Trials ISRCTN14447678.

  17. Strengthening Nordic-Baltic Defense Capabilities

    DEFF Research Database (Denmark)

    Breitenbauch, Henrik Ø.

    2014-01-01

    and troubling challenge to the way international security has been structured in Europe since the end of the Cold War. While most of the existing defense cooperation with a view of strengthening defense capabilities has been carried out within the internationally renowned framework of NORDEFCO...

  18. Strengthening Family Practices for Latino Families

    Science.gov (United States)

    Chartier, Karen G.; Negroni, Lirio K.; Hesselbrock, Michie N.

    2010-01-01

    This study examined the effectiveness of a culturally adapted Strengthening Families Program (SFP) for Latinos to reduce risks for alcohol and drug use in children. Latino families, predominantly Puerto Rican, with a 9- to 12-year-old child and a parent(s) with a substance abuse problem participated in the study. Pre- and post-tests were conducted…

  19. Strengthening Equity through Applied Research Capacity Building ...

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

    There exists limited understanding of how e-Health solutions are perceived, designed, implemented and used. ... The Strengthening Equity through Applied Research Capacity Building in e-Health (SEARCH) program will cultivate local research capacity to examine e-health and ... Liverpool School of Tropical Medicine.

  20. Strengthening Information Society Research Capacity Alliance ...

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

    2011-09-13

    The project is expected to strengthen the body of theoretically based, methodologically sound, interdisciplinary research on information society issues. Project ID. 106618. Project status. Closed. Start Date. September 13, 2011. End Date. August 12, 2014. Duration. 24 months. IDRC Officer. Smith, Matthew. Total funding.

  1. Strengthening Social and Emotional Intelligences through Writing

    Science.gov (United States)

    Burth, Jeanne Hager; McConnell, Michelle

    2017-01-01

    Using writing to allow children with Autism Spectrum Disorder (ASD) to express how they are feeling or to stimulate thinking about a social situation will allow the students the opportunity to strengthen social and emotional intelligences. By giving prompts about different social and emotional situations or ideas to children, the teacher allows…

  2. Does transparent government agencies strengthen trust?

    NARCIS (Netherlands)

    Grimmelikhuijsen, S.G.

    2009-01-01

    Trust in government has been shown to be volatile in recent years and Internet transparency is seen as a solution to strengthen trust. However, critics argue that transparency will only lead to less trust, and sceptics say that it has no effect at all. This debate on transparency is lacking

  3. Condition assessment and strengthening of residential units

    Directory of Open Access Journals (Sweden)

    Tatheer Zahra

    2014-01-01

    Full Text Available About 40, ground plus one (G+1 residential units were designed using a hybrid structural framing system (RC frame and load bearing walls. A few months after the completion of the ground floor of the residential units, cracks appeared at several locations in the structure. Field and Laboratory testing was conducted to ascertain the in situ strength of concrete and steel reinforcement. The results of the experimental work were used in the analytical ETABS model for the structural stability calculations. The results indicated that residential units were marginally safe in the existing condition (completed ground floor, but the anticipated construction of the floor above the ground floor (G+1 could not be carried out as the strength of the structural system was inadequate. To increase the safety of existing ground floor and to provide the option of the construction of one floor above, rehabilitation and strengthening design was performed. The proposed strengthening design made use of welded wire fabric (WWF and carbon fibre reinforced polymer (CFRP laminates/sheets for the strengthening of walls, columns and slabs. The residential units will be strengthened in the near future.

  4. Strengthening partnerships among Africa's science granting ...

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

    The project will support regional training courses and on-site coaching to strengthen the capacity of participating councils to design and manage collaborative agreements. It will also co-fund demand-led collaborative research projects in selected areas of interest to the private sector. Sharing of evidence, lessons learned ...

  5. Institutional strengthening in Egyptian development aid projects

    NARCIS (Netherlands)

    Walbeek, M.M.; Vlotman, W.F.

    2003-01-01

    In recent years Dutch aid projects have focused more on institutional strengthening. The overall impact of this type of aid has been limited. This paper explores possible reasons for this. In Egypt, it appeared to be difficult to make significant changes in the institutional setting. Main

  6. Strengthening Community Land Rights and Responses to ...

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

    Strengthening Community Land Rights and Responses to Involuntary Displacement Caused by Development Projects in Zimbabwe ... The construction of hydro-electric dams and other large mining and agricultural projects, for example, have led to negative consequences due to weak land tenure rights and a more general ...

  7. Strengthening 4-H by Analyzing Enrollment Data

    Science.gov (United States)

    Hamilton, Stephen F.; Northern, Angela; Neff, Robert

    2014-01-01

    The study reported here used data from the ACCESS 4-H Enrollment System to gain insight into strengthening New York State's 4-H programming. Member enrollment lists from 2009 to 2012 were analyzed using Microsoft Excel to determine trends and dropout rates. The descriptive data indicate declining 4-H enrollment in recent years and peak enrollment…

  8. Strengthening Environmental Economics Capacity in Research on ...

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

    Strengthening Environmental Economics Capacity in Research on Climate Change Adaptation ... They will develop environmental economics methods to address specific climate change challenges caused by extreme weather stressors. ... Initiative Villes ciblées : gestion des déchets urbains à Cochabamba, en Bolivie.

  9. Strengthening community participation in reducing GHG emission from forest and peatland fire

    Science.gov (United States)

    Thoha, A. S.; Saharjo, B. H.; Boer, R.; Ardiansyah, M.

    2018-02-01

    Strengthening community participation is needed to find solutions to encourage community more participate in reducing Green House Gas (GHG) from forest and peatland fire. This research aimed to identify stakeholders that have the role in forest and peatland fire control and to formulate strengthening model of community participation through community-based early warning fire. Stakeholder mapping and action research were used to determine stakeholders that had potential influence and interest and to formulate strengthening model of community participation in reducing GHG from forest and peatland fire. There was found that position of key players in the mapping of stakeholders came from the government institution. The existence of community-based fire control group can strengthen government institution through collaborating with stakeholders having strong interest and influence. Moreover, it was found several local knowledge in Kapuas District about how communities predict drought that have potential value for developing the community-based early warning fire system. Formulated institutional model in this research also can be further developed as a model institution in the preservation of natural resources based on local knowledge. In conclusion, local knowledge and community-based fire groups can be integrated within strengthening model of community participation in reducing GHG from forest and peatland fire.

  10. Effects of feeding fatty acid calcium and the interaction of forage quality on production performance and biochemical indexes in early lactation cow.

    Science.gov (United States)

    Hu, Z Y; Yin, Z Y; Lin, X Y; Yan, Z G; Wang, Z H

    2015-10-01

    Multiparous early lactation Holstein cows (n = 16) were used in a randomized complete block design to determine the effects of feeding fatty acid calcium and the interaction of forage quality on production performance and biochemical indexes in early lactation cow. Treatments were as follows: (i) feeding low-quality forage without supplying fatty acid calcium (Diet A), (ii) feeding low-quality forage with supplying 400 g fatty acid calcium (Diet B), (iii) feeding high-quality forage without supplying fatty acid calcium (Diet C) and (iv) feeding high-quality forage with supplying 400 g fatty acid calcium. This experiment consisted 30 days. The milk and blood samples were collected in the last day of the trail. Intakes were recorded in the last 2 days of the trail. Supplementation of fatty acid calcium decreased significantly dry matter intake (DMI) (p < 0.01). Addition fatty acid calcium decreased milk protein percentage (p < 0.01) and milk SNF percentage (p < 0.01), but increased MUN (p < 0.05). Supplemented fatty acid decreased concentration of blood BHBA (p < 0.05), but increased TG, NEFA, glucagon, GLP-1, CCK, leptin, ApoA-IV, serotonin and MSH concentration in blood, the CCK concentration and feed intake showed a significant negative correlation (p < 0.05). Journal of Animal Physiology and Animal Nutrition © 2015 Blackwell Verlag GmbH.

  11. Storage of Hatching Eggs : Effects of storage and early incubation conditions on egg characteristics, embryonic development, hatchability, and chicken quality

    NARCIS (Netherlands)

    Reijrink, I.A.M.

    2010-01-01

    Key words: egg storage, embryonic development, albumen quality, hatchability, chick quality

    It is well known that an increase in the storage duration increases incubation duration and decreases hatchability and chick quality. The negative effects of prolonged egg storage (> 7 days)

  12. [eHealth in Peru: implementation of policies to strengthen health information systems].

    Science.gov (United States)

    Curioso, Walter H

    2014-01-01

    Health information systems play a key role in enabling high quality, complete health information to be available in a timely fashion for operational and strategic decision-making that makes it possible to save lives and improve the health and quality of life of the population. In many countries, health information systems are weak, incomplete, and fragmented. However, there is broad consensus in the literature of the need to strengthen health information systems in countries around the world. The objective of this paper is to present the essential components of the conceptual framework to strengthen health information systems in Peru. It describes the principal actions and strategies of the Ministry of Health of Peru during the process of strengthening health information systems. These systems make it possible to orient policies for appropriate decision-making in public health.

  13. The Ottawa panel clinical practice guidelines for the management of knee osteoarthritis. Part two: strengthening exercise programs.

    Science.gov (United States)

    Brosseau, Lucie; Taki, Jade; Desjardins, Brigit; Thevenot, Odette; Fransen, Marlene; Wells, George A; Mizusaki Imoto, Aline; Toupin-April, Karine; Westby, Marie; Álvarez Gallardo, Inmaculada C; Gifford, Wendy; Laferrière, Lucie; Rahman, Prinon; Loew, Laurianne; De Angelis, Gino; Cavallo, Sabrina; Shallwani, Shirin Mehdi; Aburub, Ala'; Bennell, Kim L; Van der Esch, Martin; Simic, Milena; McConnell, Sara; Harmer, Alison; Kenny, Glen P; Paterson, Gail; Regnaux, Jean-Philippe; Lefevre-Colau, Marie-Martine; McLean, Linda

    2017-05-01

    To identify effective strengthening exercise programs and provide rehabilitation teams and patients with updated, high-quality recommendations concerning traditional land-based exercises for knee osteoarthritis. A systematic search and adapted selection criteria included comparative controlled trials with strengthening exercise programs for patients with knee osteoarthritis. A panel of experts reached consensus on the recommendations using a Delphi survey. A hierarchical alphabetical grading system (A, B, C+, C, D, D+ or D-) was based on statistical significance ( p osteoarthritis management within a six-month period. Strengthening exercise programs demonstrated a significant improvement for pain relief (four Grade A, ten Grade B, two Grade C+), physical function (four Grade A, eight Grade B) and quality of life (three Grade B). Strengthening in combination with other types of exercises (coordination, balance, functional) showed a significant improvement in pain relief (three Grade A, 11 Grade B, eight Grade C+), physical function (two Grade A, four Grade B, three Grade C+) and quality of life (one Grade A, one Grade C+). There are a variety of choices for strengthening exercise programs with positive recommendations for healthcare professionals and knee osteoarthritis patients. There is a need to develop combined behavioral and muscle-strengthening strategies to improve long-term maintenance of regular strengthening exercise programs.

  14. Home Environment Quality Mediates the Effects of an Early Intervention on Children's Social-Emotional Development in Rural Pakistan

    Science.gov (United States)

    Finch, Jenna E.; Obradovic, Jelena; Yousafzai, Aisha

    2016-01-01

    Over 200 million children under the age of 5 are not fulfilling their developmental potential due to poverty, poor health, and lack of cognitive stimulation. Experiences in early childhood have long term-effects on brain development and thus the cognitive and social-emotional skills that promote children's school success. Further, early childhood…

  15. Writing Strengthens Orthography and Alphabetic-Coding Strengthens Phonology in Learning to Read Chinese

    NARCIS (Netherlands)

    Guan, C.Q.; Liu, Y.; Chan, D.H.L.; Ye, F.F.; Perfetti, C.A.

    2011-01-01

    Learning to write words may strengthen orthographic representations and thus support word-specific recognition processes. This hypothesis applies especially to Chinese because its writing system encourages character-specific recognition that depends on accurate representation of orthographic form.

  16. Regional Emphysema Score Predicting Overall Survival, Quality of Life, and Pulmonary Function Recovery in Early-Stage Lung Cancer Patients.

    Science.gov (United States)

    Dai, Jie; Liu, Ming; Swensen, Stephen J; Stoddard, Shawn M; Wampfler, Jason A; Limper, Andrew H; Jiang, Gening; Yang, Ping

    2017-05-01

    Pulmonary emphysema is a frequent comorbidity in lung cancer, but its role in tumor prognosis remains obscure. Our aim was to evaluate the impact of the regional emphysema score (RES) on a patient's overall survival, quality of life (QOL), and recovery of pulmonary function in stage I to II lung cancer. Between 1997 and 2009, a total of 1073 patients were identified and divided into two surgical groups-cancer in the emphysematous (group 1 [n = 565]) and nonemphysematous (group 2 [n = 435]) regions-and one nonsurgical group (group 3 [n = 73]). RES was derived from the emphysematous region and categorized as mild (≤5%), moderate (6%-24%), or severe (25%-60%). In group 1, patients with a moderate or severe RES experienced slight decreases in postoperative forced expiratory volume in 1 second, but increases in the ratio of forced expiratory volume in 1 second to forced vital capacity compared with those with a mild RES (p < 0.01); however, this correlation was not observed in group 2. Posttreatment QOL was lower in patients with higher RESs in all groups, mainly owing to dyspnea (p < 0.05). Cox regression analysis revealed that patients with a higher RES had significantly poorer survival in both surgical groups, with adjusted hazard ratios of 1.41 and 1.43 for a moderate RES and 1.63 and 2.04 for a severe RES, respectively; however, this association was insignificant in the nonsurgical group (adjusted hazard ratio of 0.99 for a moderate or severe RES). In surgically treated patients with cancer in the emphysematous region, RES is associated with postoperative changes in lung function. RES is also predictive of posttreatment QOL related to dyspnea in early-stage lung cancer. In both surgical groups, RES is an independent predictor of survival. Copyright © 2017 International Association for the Study of Lung Cancer. Published by Elsevier Inc. All rights reserved.

  17. Safeguards implementation and strengthening in Belarus

    International Nuclear Information System (INIS)

    Sudakou, I.; Piotukh, O.

    2001-01-01

    Full text: Introduction - It is a matter of common knowledge that non proliferation regime includes such components as accounting and control of nuclear materials, physical protection of nuclear materials, export/import control and measures to combat illicit trafficking of nuclear materials. The task to establish and implement the state system of accounting and control of nuclear materials (SSAC) as well functions of the national competent body for physical protection of nuclear materials (PP) were assigned to the Committee for Supervision of Industrial and Nuclear Safety (PROMATOMNADZOR) by a resolution of the Council of Ministers in 1993. Basic regulatory documents governing functioning of the SSAC and PP both at the state and facility levels were put in force in 1995 by order of Promatomnadzor. System of accounting and control of nuclear materials - Nuclear material accounting is based on a computer program developed with due regard to the requirements of the IAEA. The program is written on FoxPro under control of the MSWINDOWS operating system. The program allows us to work with archives, to take account of material movements in real time, to prepare accounting documents and reports and to record measurement results. The system of measurement of nuclear materials provides authenticity and reliability of data. Measuring instrumentation was selected according to types of material available. With regard to the measurement system employed there are still some problems to be solved. Among them, certification of the instruments, working out and approval of quality assurance procedures, acquisition of standards. Accounting Documents and reports are processed by Promatomnadzor, including completeness and authenticity of reports. Archived data are kept with respect to material quantities in MBA's, inventory changes, etc. Information coding is based on the code 10 of the IAEA. Physical protection of nuclear materials and facilities - Nuclear materials of the Republic of

  18. Associations between Nausea, Vomiting, Fatigue and Health-Related Quality of Life of Women in Early Pregnancy: The Generation R Study.

    Directory of Open Access Journals (Sweden)

    Guannan Bai

    Full Text Available The objective of this study was to evaluate the independent associations between nausea, vomiting, fatigue and health-related quality of life of women in early pregnancy in the Generation R study, which is a prospective mother and child cohort. Analyses were based on 5079 women in early pregnancy in the Rotterdam area, the Netherlands. The information on nausea, vomiting and fatigue in the previous three months was measured in the questionnaire at enrollment, as well as potential confounders (i.e., maternal/gestational age, ethnic background, educational level, parity, marital status, body mass index, tobacco and alcohol use, chronic/infectious conditions, uro-genital conditions/symptoms, sleep quality, headache, anxiety, and depression. Health-related quality of life was assessed by the 12-item Short Form Health Survey and physical and mental component summary scores were calculated. Multivariate regression models were performed to evaluate the independent associations of the presence of nausea, vomiting and fatigue with health-related quality of life, adjusting for potential confounders. 33.6% of women experienced daily presence of nausea, 9.6% for vomiting and 44.4% for fatigue. Comparing with women who never reported nausea, vomiting and fatigue, women with daily presence of at least one of these symptoms had significantly lower scores of physical component summary and mental component summary, after adjusting for potential confounders. Our study shows how common nausea, vomiting and fatigue are among women in early pregnancy and how much each of these symptoms negatively impact on health-related quality of life. We call for awareness of this issue from health care professionals, pregnant women and their families.

  19. Strengthening of the Cooperative Framework for ANENT

    International Nuclear Information System (INIS)

    Han, K. W.; Lee, E. J.; Min, B. J.

    2007-01-01

    The Asian Network for Education in Nuclear Technology (ANENT) was established in February 2004 to promote nuclear education and training in Asia. Initially ANENT member countries cooperated with 5 group activities encompassing broad areas. As of 2006, the cooperative framework was strengthened in a way to focus on web-based nuclear education and training for a period of several years to come. In this context, the Nuclear Training Center (NTC) of KAERI has contributed, in particular, to the development of the ANENT web-portal including a cyber platform, and making available relevant courses and materials on the web-portal. This paper discusses details of the strengthened cooperative framework in terms of NTC's effort for realizing web-based education and training through regional networking

  20. Titanium oxide dispersion-strengthened ferritic alloys

    International Nuclear Information System (INIS)

    Hendrix, W.; Vandermeulen, W.

    1980-04-01

    The available data on the DT02 and DT3911 ferritic dispersion strengthened alloys, developed at SCK/CEN, Mol, Belgium, are presented. Both alloys consist of Fe - 13% Cr - 1.5% Mo to which 2% TiO 2 and about 3.5% Ti are added (wt.%). Their main use is for the fabrication of fast breeder reactor cladding tubes but their application as turbine blade material is also envisaged for cases where high damping is important. (auth.)

  1. Manufacturing Experience for Oxide Dispersion Strengthened Alloys

    Energy Technology Data Exchange (ETDEWEB)

    Bennett, Wendy D. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Doherty, Ann L. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Henager, Charles H. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Lavender, Curt A. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Montgomery, Robert O. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Omberg, Ronald P. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Smith, Mark T. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Webster, Ryan A. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States)

    2016-09-22

    This report documents the results of the development and the manufacturing experience gained at the Pacific Northwest National Laboratories (PNNL) while working with the oxide dispersion strengthened (ODS) materials MA 956, 14YWT, and 9YWT. The Fuel Cycle Research and Development program of the Office of Nuclear Energy has implemented a program to develop a Uranium-Molybdenum metal fuel for light water reactors. ODS materials have the potential to provide improved performance for the U-Mo concept.

  2. Strengthening the non proliferation regime: French views

    International Nuclear Information System (INIS)

    Delaune, P.

    2013-01-01

    3 main issues can be identified in the French policy concerning the backing of non proliferation: 1) responding resolutely to proliferation crises, 2) reinforcing substantive efforts to prevent and impede proliferation, and 3) strengthening the non-proliferation regime. The first issue is very important because combating proliferation is vital to the security of all. Concerning the second issue, France attaches particular importance to strengthening specific measures to prevent and check proliferation. Let me mention a few proposals that we put forward: exports need to be controlled more effectively, proliferation activities have to be criminalized, or the development of proliferation-resistant technologies should be supported. Concerning the third issue it means the strengthening of the non-proliferation regime, France proposes several means: -) aiming at the universalization of the additional protocol; -) ensuring that the Agency continues to have sufficient human, financial and technical resources to fulfill its verification mission effectively; -) encouraging the IAEA to make full use of the authority available to it; -) enhancing the use of information relevant to the delivery of the IAEA mandate; and -) sharing more accurate information concerning the breaches of commitments that happen. The paper is followed by the slides of the presentation. (A.C.)

  3. Preloading Effect on Strengthening Efficiency of RC Beams Strengthened with Non- and Pretensioned NSM Strips

    Directory of Open Access Journals (Sweden)

    Renata Kotynia

    2018-02-01

    Full Text Available The near surface mounted (NSM technique has been shown to be one of the most promising methods for upgrading reinforced concrete (RC structures. Many tests carried out on RC members strengthened in flexure with NSM fiber-reinforced polymer (FRP systems have demonstrated greater strengthening efficiency than the use of externally-bonded (EB FRP laminates. Strengthening with simultaneous pretensioning of the FRP results in improvements in the serviceability limit state (SLS conditions, including the increased cracking moment and decreased deflections. The objective of the reported experimental program, which consisted of two series of RC beams strengthened in flexure with NSM CFRP strips, was to investigate the influence of a number of parameters on the strengthening efficiency. The test program focused on an analysis of the effects of preloading on the strengthening efficiency which has been investigated very rarely despite being one of the most important parameters to be taken into account in strengthening design. Two preloading levels were considered: the beam self-weight only, which corresponded to stresses on the internal longitudinal reinforcement of 25% and 14% of the yield stress (depending on a steel reinforcement ratio, and the self-weight with the additional superimposed load, corresponding to 60% of the yield strength of the unstrengthened beam and a deflection equal to the allowable deflection at the SLS. The influence of the longitudinal steel reinforcement ratio was also considered in this study. To reflect the variability seen in existing structures, test specimens were varied by using different steel bar diameters. Finally, the impact of the composite reinforcement ratio and the number of pretensioned FRP strips was considered. Specimens were divided into two series based on their strengthening configuration: series “A” were strengthened with one pretensioned and two non-pretensioned carbon FRP (CFRP strips, while series

  4. Research and application of a hybrid model based on dynamic fuzzy synthetic evaluation for establishing air quality forecasting and early warning system: A case study in China.

    Science.gov (United States)

    Xu, Yunzhen; Du, Pei; Wang, Jianzhou

    2017-04-01

    As the atmospheric environment pollution has been becoming more and more serious in China, it is highly desirable to develop a scientific and effective early warning system that plays a great significant role in analyzing and monitoring air quality. However, establishing a robust early warning system for warning the public in advance and ameliorating air quality is not only an extremely challenging task but also a public concerned problem for human health. Most previous studies are focused on improving the prediction accuracy, which usually ignore the significance of uncertainty information and comprehensive evaluation concerning air pollutants. Therefore, in this paper a novel robust early warning system was successfully developed, which consists of three modules: evaluation module, forecasting module and characteristics estimating module. In this system, a new dynamic fuzzy synthetic evaluation is proposed and applied to determine air quality levels and primary pollutants, which can be regarded as the research objectives; Moreover, to further mine and analyze the characteristics of air pollutants, four different distribution functions and interval forecasting method are also employed that can not only provide predictive range, confidence level and the other uncertain information of the pollutants future values, but also assist decision-makers in reducing and controlling the emissions of atmospheric pollutants. Case studies utilizing hourly PM 2.5 , PM 10 and SO 2 data collected from Tianjin and Shanghai in China are applied as illustrative examples to estimate the effectiveness and efficiency of the proposed system. Experimental results obviously indicated that the developed novel early warning system is much suitable for analyzing and monitoring air pollution, which can also add a novel viable option for decision-makers. Copyright © 2017 Elsevier Ltd. All rights reserved.

  5. Differential Susceptibility and the Early Development of Aggression: Interactive Effects of Respiratory Sinus Arrhythmia and Environmental Quality

    Science.gov (United States)

    Eisenberg, Nancy; Sulik, Michael J.; Spinrad, Tracy L.; Edwards, Alison; Eggum, Natalie D.; Liew, Jeffrey; Sallquist, Julie; Popp, Tierney K.; Smith, Cynthia L.; Hart, Daniel

    2012-01-01

    The purpose of the current study was to predict the development of aggressive behavior from young children's respiratory sinus arrhythmia (RSA) and environmental quality. In a longitudinal sample of 213 children, baseline RSA, RSA suppression in response to a film of crying babies, and a composite measure of environmental quality (incorporating…

  6. Infrastructure for Large-Scale Quality-Improvement Projects: Early Lessons from North Carolina Improving Performance in Practice

    Science.gov (United States)

    Newton, Warren P.; Lefebvre, Ann; Donahue, Katrina E.; Bacon, Thomas; Dobson, Allen

    2010-01-01

    Introduction: Little is known regarding how to accomplish large-scale health care improvement. Our goal is to improve the quality of chronic disease care in all primary care practices throughout North Carolina. Methods: Methods for improvement include (1) common quality measures and shared data system; (2) rapid cycle improvement principles; (3)…

  7. Effects of an early intervention on maternal post-traumatic stress symptoms and the quality of mother-infant interaction: the case of preterm birth.

    Science.gov (United States)

    Borghini, Ayala; Habersaat, Stephanie; Forcada-Guex, Margarita; Nessi, Jennifer; Pierrehumbert, Blaise; Ansermet, François; Müller-Nix, Carole

    2014-11-01

    Preterm birth may represent a traumatic situation for both parents and a stressful situation for the infant, potentially leading to difficulties in mother-infant relationships. This study aimed to investigate the impact of an early intervention on maternal posttraumatic stress symptoms, and on the quality of mother-infant interactions, in a sample of very preterm infants and their mothers. Half of the very preterm infants involved in the study (n=26) were randomly assigned to a 3-step early intervention program (at 33 and 42 weeks after conception and at 4 months' corrected age). Both groups of preterm infants (with and without intervention) were compared to a group of full-term infants. The impact of the intervention on maternal posttraumatic stress symptoms was assessed 42 weeks after conception and when the infants were 4 and 12 months of age. The impact of the intervention on the quality of mother-infant interactions was assessed when the infants were 4 months old. Results showed a lowering of mothers' posttraumatic stress symptoms between 42 weeks and 12 months in the group of preterm infants who received the intervention. Moreover, an enhancement in maternal sensitivity and infant cooperation during interactions was found at 4 months in the group with intervention. In the case of a preterm birth, an early intervention aimed at enhancing the quality of the mother-infant relationship can help to alleviate maternal post-traumatic stress symptoms and may have a positive impact on the quality of mother-infant interactions. Copyright © 2014 Elsevier Inc. All rights reserved.

  8. Strengthening CRTD-A's Organizational and Program Capacity ...

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

    Strengthening CRTD-A's Organizational and Program Capacity (Lebanon) ... Women's Rights and Citizenship framework; to strengthen and rationalize its institutional ... IDRC “unpacks women's empowerment” at McGill University Conference.

  9. Strengthening rehabilitation services in Indonesia: A brief situation analysis.

    Science.gov (United States)

    Nugraha, Boya; Setyono, Garry Rahardian; Defi, Irma Ruslina; Gutenbrunner, Christoph

    2018-04-18

    People with disability (PWD) in Indonesia are often neglected by society. Improving their life situation towards full participation in society is crucial. As a health strategy, rehabilitation can improve func-tioning, quality of life and participation in society. However, rehabilitation services in Indonesia need improvement. Making a situation analysis of rehabilitation services and their provision in the country is a pre-requisite to taking any action towards improvement. This paper compiles available data related to disability and rehabilitation services in Indonesia, using the Rehabilitation Services Assessment Tool (RSAT) as a framework. Gaps in provision were analysed, resulting in the compilation of a list of generic recommendations to improve rehabilitation services in the country. Indonesia faces many challenges in rehabilitation services, including the health workforce and the provision of services. This situation analysis and list of generic recommendations may be used in further discussions with relevant stakeholders in the country to develop a national strategy to strengthen rehabilitation services.

  10. Using law to strengthen health professions: frameworks and practice.

    Science.gov (United States)

    Verani, André; Shayo, Peter; Howse, Genevieve

    2011-01-01

    The lack of sufficient, high-quality health workers is one of the primary barriers to improving health in sub-saharan africa. An approach to address this challenge is for public health practitioners to increase their cooperation with public health lawyers, regulators and other policymakers in order to develop strengthened health workforce laws, regulations, and policies that are vigorously implemented and enforced. Conceptual frameworks can help clarify the meaning of health system governance and the pathways between law and health. International recommendations for policy interventions governing health workers provide countries with valuable guidance for domestic reforms. Monitoring and evaluation of legal, regulatory, and other policy interventions are required to ascertain their public health impact. At the intersection of law and public health, professionals from both fields can collaborate in concrete ways such as those discussed here to improve laws and policies governing health.

  11. [Sexual hormone and traditional Chinese patent medicine for early postmenopausal women: effect on quality of life and cost-utility analysis].

    Science.gov (United States)

    Zhou, Ling-Ling; Xu, Liang-Zhi; Liu, Hong-Wei; Zhang, Jing; Liu, Ying; Liu, Xiao-Fang; Tang, Liu-Lin; Zhuang, Jing; Liu, Xiao-Xian; Qiao, Lin

    2009-11-01

    To evaluate the effect of Premarin and Kuntai capsule (a traditional Chinese patent medicine) on the quality of life (QOL) and their cost-utility in early postmenopausal women. Fifty-seven women with menopausal syndrome in the early postmenopausal stage were randomly allocated into Premarin group (0.3 mg/day and 0.6 mg/day alternately, n=29) and Kuntai group (4 g/day, n=28). The therapies lasted for one year and the patients were followed up every 3 months. The QOL of the patients was evaluated and the utility scores were obtained from rating scale to conduct a cost-utility analysis (CUA). At each follow-up examination, no significant difference was found in the QOL between the two groups (P>0.05). The QOL obviously increased after the 1-year-long therapy in both the groups, and Kuntai required longer treatment time than Premarin to take effect. The cost-utility ratio of Premarin and Kuntai were 13581.45 yuan/QALY (quality adjusted life year) and 25105.12 yuan/QALY, respectively. Both incremental cost analysis and sensitivity analysis showed that Kuntai was more costly than Premarin. The result of per-protocol analysis was consistent with that of intention-to-treat analysis. At early stage of menopause, the QOL of women with menopausal syndrome can be significantly improved by low-dose Premarin and Kuntai capsule, but the latter is more costly.

  12. Antenatal care strengthening in Jimma, Ethiopia

    DEFF Research Database (Denmark)

    Villadsen, Sarah Fredsted; Tersbøl, Britt Pinkowski; Negussie, Dereje

    2014-01-01

    Objective. We assessed how health system priorities matched user expectations and what the needs for antenatal care (ANC) strengthening were for improved maternal health in Jimma, Ethiopia. Methods. A questionnaire survey among all recent mothers in the study area was conducted to study the content...... was given high priority, and that contributed to a lack of continuity and privacy. To the women, poor user-provider interaction was a serious concern hindering the trust in the health care providers. Further, the care provision was compromised by the inadequate laboratory facilities, unstructured health...

  13. Strengthening Family Practices for Latino Families.

    Science.gov (United States)

    Chartier, Karen G; Negroni, Lirio K; Hesselbrock, Michie N

    2010-01-01

    The study examined the effectiveness of a culturally-adapted Strengthening Families Program (SFP) for Latinos to reduce risks for alcohol and drug use in children. Latino families, predominantly Puerto Rican, with a 9-12 year old child and a parent(s) with a substance abuse problem participated in the study. Pre- and post-tests were conducted with each family. Parental stress, parent-child dysfunctional relations, and child behavior problems were reduced in the families receiving the intervention; family hardiness and family attachment were improved. Findings contribute to the validation of the SFP with Latinos, and can be used to inform social work practice with Puerto Rican families.

  14. Bullialdus - Strengthening the case for lunar plutons

    Science.gov (United States)

    Pieters, Carle M.

    1991-01-01

    Although many craters expose materials of a composition different from that of the local surroundings, Bullialdus has excavated material representing three distinct stratigraphic zones that occur in the upper 6 km of crust, the top two of which are gabbroic and the deepest of which is noritic. This three-component stratigraphy at Bullialdus provides strong evidence that the lunar crust includes pockets of compositionally layered material reminiscent of mafic layered plutons. When combined with previous information on the compositional diversity at other large craters, these remote analyses obtained in a geologic context substantially strengthen the hypothesis suggested from lunar samples that plutons play an integral role in lunar crustal evolution.

  15. Catalysis-enhanced strengthening of porous materials

    International Nuclear Information System (INIS)

    Sokolova, L.N.; Shchukin, E.D.; Burenkova, L.N.; Romanovskij, B.V.

    2000-01-01

    Change in the strength of compressed tablets of the catalyst on the basis of ZrO 2 (84 mass %) and Y 2 O 3 (16 mass %) after conducting the endothermal reaction of the methanol and ethanol dehydration at 700-800 deg C is studied. It is shown, that the key factor, determining the strengthening effect by 65-88% is not at all the reaction exothermal nature, which could lead to local heating of the catalyst surface. In reality significant increase in concentration of surface defects, as compared to the equilibrium at the given temperature is achieved on the account of conjugation of processes of catalysis and surface defects formation [ru

  16. Strengthening health promotion in Australian workplaces.

    Science.gov (United States)

    Fisher, K J; Deeds, S; Siebel, R; Allen, J

    1997-01-01

    The Australian workplace has emerged as an important venue for influencing the health of employees through regulations and behaviour change programs. Recent surveys have highlighted a growth in this activity but the effectiveness of these programs in changing unhealthy work practices and policies is questionable. The need for strengthening programs by stronger designs and evaluation, and addressing organisational factors and employee participation in planning and implementation processes is documented. Efforts in that direction in Queensland are cited, Building on these existing foundations, redirecting existing resources, and building intersectoral cooperation in public-private partnerships hold a creative, exemplary vision of the future for Australian workplace programming.

  17. Gold's monetary roll will be strengthened - Plumbridge

    International Nuclear Information System (INIS)

    Anon.

    1977-01-01

    Delivering his Presidential address at the Chamber's annual general meeting, Mr Plumbridge said the gold market would enter a new phase and listed seven reasons why gold's monetary role would be strengthened. There was a dramatic increase in the demand for gold jewellery. He also forecasted that South African uranium production would again attain its former peak annual production of about 6000t. There is an essential need for a sustained growth in nuclear power and the prospects for uranium mining industry remain encouraging

  18. Plasticity of oxide dispersion strengthened ferritic alloys

    International Nuclear Information System (INIS)

    Zakine, C.; Prioul, C.; Alamo, A.; Francois, D.

    1993-01-01

    Two 13%Cr oxide dispersion strengthened (ODS) ferritic alloys, DT and DY, exhibiting different oxide particle size distribution and a χ phase precipitation were studied. Their tensile properties have been tested from 20 to 700 C. Experimental observations during room temperature tensile tests performed in a scanning electronic microscope have shown that the main damage mechanism consists in microcracking of the χ phase precipitates on grain boundaries. These alloys are high tensile and creep resistant between 500 and 700 C. Their strongly stress-sensitive creep behaviour can be described by usual creep laws and incorporating a threshold stress below which the creep rate is negligible. (orig.)

  19. Mechanical behavior and strengthening mechanisms in ultrafine grain precipitation-strengthened aluminum alloy

    International Nuclear Information System (INIS)

    Ma, Kaka; Wen, Haiming; Hu, Tao; Topping, Troy D.; Isheim, Dieter; Seidman, David N.; Lavernia, Enrique J.; Schoenung, Julie M.

    2014-01-01

    To provide insight into the relationships between precipitation phenomena, grain size and mechanical behavior in a complex precipitation-strengthened alloy system, Al 7075 alloy, a commonly used aluminum alloy, was selected as a model system in the present study. Ultrafine-grained (UFG) bulk materials were fabricated through cryomilling, degassing, hot isostatic pressing and extrusion, followed by a subsequent heat treatment. The mechanical behavior and microstructure of the materials were analyzed and compared directly to the coarse-grained (CG) counterpart. Three-dimensional atom-probe tomography was utilized to investigate the intermetallic precipitates and oxide dispersoids formed in the as-extruded UFG material. UFG 7075 exhibits higher strength than the CG 7075 alloy for each equivalent condition. After a T6 temper, the yield strength (YS) and ultimate tensile strength (UTS) of UFG 7075 achieved 734 and 774 MPa, respectively, which are ∼120 MPa higher than those of the CG equivalent. The strength of as-extruded UFG 7075 (YS: 583 MPa, UTS: 631 MPa) is even higher than that of commercial 7075-T6. More importantly, the strengthening mechanisms in each material were established quantitatively for the first time for this complex precipitation-strengthened system, accounting for grain-boundary, dislocation, solid-solution, precipitation and oxide dispersoid strengthening contributions. Grain-boundary strengthening was the predominant mechanism in as-extruded UFG 7075, contributing a strength increment estimated to be 242 MPa, whereas Orowan precipitation strengthening was predominant in the as-extruded CG 7075 (∼102 MPa) and in the T6-tempered materials, and was estimated to contribute 472 and 414 MPa for CG-T6 and UFG-T6, respectively

  20. Studies on some agronomic and quality characteristics of 271 induced early mutants of rice (Oryza sativa L. cv. Nizersail)

    International Nuclear Information System (INIS)

    Rahman, Mostafizur; Miah, A.J.; Mansur, M.A.; Kaul, A.K.

    1980-01-01

    Nizersail, the most popular, recommended rice variety in Bangladesh, was subjected to gamma-irradiation (10 - 25 kR) or ethyl methane sulfonate (EMS) (0.75 - 1.50%) treatments to obtain the mutants with stiff straw and early maturity. In the M 2 generation, 29 gamma-ray- and 8 EMS-induced mutants were selected mainly for short culm length and earliness. Further selections were made in the segregating M 3 and M 4 populations, and finally 400 plants with short culm length were obtained. These 400 selections were grown in M 5 lines, and 271 of these lines were analyzed for several characters. Heading time had singificantly shifted towards earliness in 40 lines. Yield per plant, 1,000-kernel weight, the length/breadth ratio of kernels, alkali spreading index value (indicator of amylose content) and dye-binding capacity (indicator of protein content) were significantly higher than those in the mother variety in 10 - 30% of the lines examined. However, no positive correlation among these characters was observed. Significant negative correlations were observed between heading time and 1,000-kernel weight, and between yield per plant and dye-binding capacity. These results suggest that the early heading plants may produce fewer tillers with bolder seeds, and that high yielding types may not simultaneously show high protein content. (Kaihara, S.)

  1. High-Quality School-Based Pre-K Can Boost Early Learning for Children with Special Needs

    Science.gov (United States)

    Phillips, Deborah A.; Meloy, Mary E.

    2012-01-01

    This article assesses the effects of Tulsa, Oklahoma's school-based prekindergarten program on the school readiness of children with special needs using a regression discontinuity design. Participation in the pre-K program was associated with significant gains for children with special needs in early literacy scores, but not in math scores. These…

  2. Effect of three postmortem electrical stimulation treatments on the quality of early-deboned broiler breast meat

    Science.gov (United States)

    Electrical stimulation (ES) of animal carcasses during postmortem has been commonly used by beef industry to enhance meat tenderness, and has been recently adapted for commercial use with poultry. Majority of published investigations of ES effects on the tenderness of early-deboned poultry breast m...

  3. Unleashing the Power of Science in Early Childhood: A Foundation for High-Quality Interactions and Learning

    Science.gov (United States)

    Greenfield, Daryl B.; Alexander, Alexandra; Frechette, Elizabeth

    2017-01-01

    When science is integrated into early childhood learning experiences, it becomes a critical area supporting young children's development. Young children are natural scientists, curious about their world, and they engage in scientific practices to learn about and explore their world. This article describes how the K-12 Framework for Science…

  4. Diet Quality during Infancy and Early Childhood in Children with and without Risk of Type 1 Diabetes: A DEDIPAC Study

    Directory of Open Access Journals (Sweden)

    Stefanie Schoen

    2017-01-01

    Full Text Available Previous studies have indicated that mothers of children at increased risk of type 1 diabetes (T1D may modify their child’s diet following risk notification. Our aim was to investigate the diet quality after notified of T1D risk in at-risk children compared to not-at-risk children. The quality of nutrient intake (PANDiet score and food intake (analyzed by a newly developed score and the HuSKY score were assessed using three-day dietary records collected for at-risk children (BABYDIET study, n = 109 and a matched sample of not-at-risk children (DONALD study, n = 205 at nine and 24 months of age. Nutrient and food intake quality were lower at nine months of age and food intake quality was lower at 24 months of age in at-risk than in not-at-risk children (p = 0.01 and p < 0.0001, respectively. The amount of added sugar was higher in at-risk children at both ages (p < 0.0001. In at-risk children, dietary quality was similar between children who were first exposed to gluten at six or 12 months of age. Despite being notified about their child’s risk of T1D, the child’s mother did not switch to healthier diets compared with not-at-risk mothers.

  5. Strengthening the Canadian alcohol advertising regulatory system.

    Science.gov (United States)

    Heung, Carly M; Rempel, Benjamin; Krank, Marvin

    2012-05-24

    Research evidence points to harmful effects from alcohol advertising among children and youth. In particular, exposure to alcohol advertising has been associated with adolescents drinking both earlier and heavier. Although current federal and provincial guidelines have addressed advertising practices to prevent underage drinking, practice has not been supported by existing policy. While protective measures such as social marketing campaigns have the potential for counteracting the effects from alcohol advertising, the effectiveness of such measures can be easily drowned out with increasing advertising activities from the alcohol industry, especially without effective regulation. Research reviewed by the European Focus on Alcohol Safe Environment (FASE) Project has identified a set of key elements that are necessary to make alcohol advertising policy measures effective at protecting children and youth from the harmful effects of alcohol marketing. Using these key elements as an evaluation framework, there are critical components in the Canadian alcohol advertising regulatory system that clearly require strengthening. To protect impressionable children and youth against the harmful effects of alcohol advertising, 13 recommendations to strengthen current alcohol advertising regulations in Canada are provided for Canadian policy-makers, advertising standard agencies, and public health groups.

  6. The strengthening effect of percutaneous vertebroplasty

    Energy Technology Data Exchange (ETDEWEB)

    Dean, J.R.; Ison, K.T.; Gishen, P

    2000-06-01

    AIM: To examine whether single-needle vertebroplasty is effective in strengthening vertebrae. MATERIALS AND METHODS: Four adjacent intact lumbar vertebrae were removed from each of nine adult post-mortem subjects. One or two vertebra of each set was injected with low viscosity acrylic bone cement using a single-track posterolateral approach. Vertebral strength was measured during constant rate axial compression. RESULTS: Single-needle injection delivered different quantities of cement (1-8 ml) in an asymmetric distribution. Injected vertebrae were stronger than controls in 10 out of 12 cases (P < 0.01), suggesting that cement injection increases the load needed to cause initial vertebral fracture. Compression was continued past the point of initial failure, to simulate progressive vertebral collapse. Injected specimens were more resistant to deformation than control specimens (P < 0.05), most of which initially deformed with little increase in load. CONCLUSION: Single-track injection of bone cement appeared to strengthen vertebrae against both initial failure and subsequent collapse. The magnitude of strength increase from vertebroplasty was variable, and did not correlate with the volume of cement injected. Further investigation is needed to optimize the technique. Gishen, P. (2000)

  7. Infrastructure for large-scale quality-improvement projects: early lessons from North Carolina Improving Performance in Practice.

    Science.gov (United States)

    Newton, Warren P; Lefebvre, Ann; Donahue, Katrina E; Bacon, Thomas; Dobson, Allen

    2010-01-01

    Little is known regarding how to accomplish large-scale health care improvement. Our goal is to improve the quality of chronic disease care in all primary care practices throughout North Carolina. Methods for improvement include (1) common quality measures and shared data system; (2) rapid cycle improvement principles; (3) quality-improvement consultants (QICs), or practice facilitators; (4) learning networks; and (5) alignment of incentives. We emphasized a community-based strategy and developing a statewide infrastructure. Results are reported from the first 2 years of the North Carolina Improving Performance in Practice (IPIP) project. A coalition was formed to include professional societies, North Carolina AHEC, Community Care of North Carolina, insurers, and other organizations. Wave One started with 18 practices in 2 of 9 regions of the state. Quality-improvement consultants recruited practices. Over 80 percent of practices attended all quarterly regional meetings. In 9 months, almost all diabetes measures improved, and a bundled asthma measure improved from 33 to 58 percent. Overall, the magnitude of improvement was clinically and statistically significant (P = .001). Quality improvements were maintained on review 1 year later. Wave Two has spread to 103 practices in all 9 regions of the state, with 42 additional practices beginning the enrollment process. Large-scale health care quality improvement is feasible, when broadly supported by statewide leadership and community infrastructure. Practice-collected data and lack of a control group are limitations of the study design. Future priorities include maintaining improved sustainability for practices and communities. Our long-term goal is to transform all 2000 primary-care practices in our state.

  8. Effect of traditional and integrative regimens on quality of life and early renal impairment in elderly patients with isolated systolic hypertension.

    Science.gov (United States)

    Li, Hao; Liu, Long-tao; Zhao, Wen-ming; Liu, Jian-gang; Yao, Ming-jiang; Han, Yong-xiang; Shen, Yan-peng; Liu, Xing-dong; Liu, Li; Wang, Xue-mei; Cai, Lin-lin; Guan, Jie

    2010-06-01

    To observe the effect of Chinese medical regimen and integrative medical regimen on quality of life and early renal impairment in elderly patients with isolated systolic hypertension (EISH). A multi-center, randomized, double-blinded controlled trail was adopted. A total of 270 cases of EISH were randomly divided into 3 groups: Chinese medicine group (CM), combination group and Western medicine group (WM). The course of treatment was 4 weeks. The clinical blood pressure, integral of quality of life (SF-36 scale), immunoglubin G (IgG), microalbumin (mALB), beta(2)-microglobulin (beta(2)-MG), transferrin (TRF) and N-acetyl-beta'-D-glucosa-minidase (NAG) in urine were determined before and after the treatment. After treatment, systolic blood pressure depressed significantly in each group (P<0.05), and the combination group was superior to CM or WM group in depressing SBP (P<0.05); in each group, integral of quality of life improved in different degree, and combination group was superior to WM group in all 8 dimensions (P<0.05). The level of mALB and beta(2)-MG in urine decreased in all groups (P<0.05), and the combination group was superior to CM group or WM group in decreasing mALB (P<0.05). Chinese medical regimen has affirmative effect in treating EISH patients, and could lower the systolic blood pressure, improve quality of life and early renal impairment of the patients, and integrative medical regimen has superiority on account of cooperation, and deserves further study.

  9. Predictors of improvement in subjective sleep quality reported by older adults following group-based cognitive behavior therapy for sleep maintenance and early morning awakening insomnia.

    Science.gov (United States)

    Lovato, Nicole; Lack, Leon; Wright, Helen; Kennaway, David J

    2013-09-01

    Cognitive behavior therapy is an effective nonpharmacologic treatment for insomnia. However, individualized administration is costly and often results in substantial variability in treatment response across individual patients, particularly so for older adults. Group-based administration has demonstrated impressive potential for a brief and inexpensive answer to the effective treatment of insomnia in the older population. It is important to identify potential predictors of response to such a treatment format to guide clinicians when selecting the most suitable treatment for their patients. The aim of our study was to identify factors that predict subjective sleep quality of older adults following group-based administration of cognitive behavior therapy for insomnia (CBT-I). Eighty-six adults (41 men; mean age, 64.10 y; standard deviation [SD], 6.80) with sleep maintenance or early morning awakening insomnia were selected from a community-based sample to participate in a 4-week group-based treatment program of CBT-I. Participants were required to complete 7-day sleep diaries and a comprehensive battery of questionnaires related to sleep quality and daytime functioning. Hierarchical multiple regression analyses were used to identify factors predicting subjective sleep quality immediately following treatment and at 3-month follow-up. Sleep diaries reported average nightly sleep efficiency (SE), which was used as the outcome measure of sleep quality. Participants with the greatest SE following treatment while controlling for pretreatment SE were relatively younger and had more confidence in their ability to sleep at pretreatment. These characteristics may be useful to guide clinicians when considering the use of a group-based CBT-I for sleep maintenance or early morning awakening insomnia in older adults. Copyright © 2013 Elsevier B.V. All rights reserved.

  10. Impact of early childhood caries and its treatment under general anesthesia on orofacial function and quality of life : A prospective comparative study.

    Science.gov (United States)

    Collado, V; Pichot, H; Delfosse, C; Eschevins, C; Nicolas, E; Hennequin, M

    2017-05-01

    Early Childhood Caries (ECC) has become a major public health concern worldwide, mostly affecting children from disadvantaged families in increasingly severe forms. This condition has been frequently reported to alter children's nutrition, growth and general development. It negatively impacts their quality of life, through painful episodes and severe eating difficulties. While this period is crucial for oral praxes development, the impact of dental state on oro-facial functions is poorly documented. This study evaluated the impact of ECC and its treatment under general anesthesia on oro-facial functions and quality of life in pre-school children. The dysfunction and quality of life scores from 25 children with ECC were evaluated before treatment (T0), one month (T1) and three months after treatment (T2), using the Nordic Orofacial Test-Screening (NOT-S) and the Early Childhood Oral Health Impact Scale (ECOHIS), respectively, in comparison with 16 caries-free children. The number and extent of inter-arch dental contacts were also observed. The pre-operative higher NOT-S score observed in children with ECC decreased to reach the control level at T2. The mastication item was the most affected in the ECC group throughout the study. Their mean ECOHIS score also significantly decreased post-operatively and differences remaining between both groups were no longer clinically relevant. In addition, in children with ECC, values of functional inter-arch surfaces tended to increase over the follow-up period. Oro-facial functions and quality of life, altered by ECC, could be restored through a conservative treatment approach. Relations between dental state, orofacial functions and particularly chewing, and nutrition should be investigated further.

  11. Early participation in a prenatal food supplementation program ameliorates the negative association of food insecurity with quality of maternal-infant interaction.

    Science.gov (United States)

    Frith, Amy L; Naved, Ruchira T; Persson, Lars Ake; Rasmussen, Kathleen M; Frongillo, Edward A

    2012-06-01

    Food insecurity is detrimental to child development, yet little is known about the combined influence of food insecurity and nutritional interventions on child development in low-income countries. We proposed that women assigned to an early invitation time to start a prenatal food supplementation program could reduce the negative influence of food insecurity on maternal-infant interaction. A cohort of 180 mother-infant dyads were studied (born between May and October 2003) from among 3267 in the randomized controlled trial Maternal Infant Nutritional Interventions Matlab, which was conducted in Matlab, Bangladesh. At 8 wk gestation, women were randomly assigned an invitation time to start receiving food supplements (2.5 MJ/d; 6 d/wk) either early (~9 wk gestation; early-invitation group) or at the usual start time (~20 wk gestation; usual-invitation group) for the government program. Maternal-infant interaction was observed in homes with the use of the Nursing Child Assessment Satellite Training Feeding Scale, and food-insecurity status was obtained from questionnaires completed when infants were 3.4-4.0 mo old. By using a general linear model for maternal-infant interaction, we found a significant interaction (P = 0.012) between invitation time to start a prenatal food supplementation program and food insecurity. Those in the usual-invitation group with higher food insecurity scores (i.e., more food insecure) had a lower quality of maternal-infant interaction, but this relationship was ameliorated among those in the early-invitation group. Food insecurity limits the ability of mothers and infants to interact well, but an early invitation time to start a prenatal food supplementation program can support mother-infant interaction among those who are food insecure.

  12. Managing Neonatal and Early Childhood Syndromic Sepsis in Sub-District Hospitals in Resource Poor Settings: Improvement in Quality of Care through Introduction of a Package of Interventions in Rural Bangladesh

    Science.gov (United States)

    Iqbal, Afrin; Hoque, D. M. Emdadul; Moinuddin, Md.; Zaman, Sojib Bin; Rahman, Qazi Sadeq-ur; Begum, Tahmina; Chowdhury, Atique Iqbal; Haider, Rafiqul; Arifeen, Shams El; Kissoon, Niranjan; Larson, Charles P.

    2017-01-01

    Introduction Sepsis is dysregulated systemic inflammatory response which can lead to tissue damage, organ failure, and death. With an estimated 30 million cases per year, it is a global public health concern. Severe infections leading to sepsis account for more than half of all under five deaths and around one quarter of all neonatal deaths annually. Most of these deaths occur in low and middle income countries and could be averted by rapid assessment and appropriate treatment. Evidence suggests that service provision and quality of care pertaining to sepsis management in resource poor settings can be improved significantly with minimum resource allocation and investments. Cognizant of the stark realities, a project titled ‘Interrupting Pathways to Sepsis Initiative’ (IPSI) introduced a package of interventions for improving quality of care pertaining to sepsis management at 2 sub-district level public hospitals in rural Bangladesh. We present here the quality improvement process and achievements regarding some fundamental steps of sepsis management which include rapid identification and admission, followed by assessment for hypoxemia, hypoglycaemia and hypothermia, immediate resuscitation when required and early administration of parenteral broad spectrum antibiotics. Materials and Method Key components of the intervention package include identification of structural and functional gaps through a baseline environmental scan, capacity development on protocolized management through training and supportive supervision by onsite ‘Program Coaches’, facilitating triage and rapid transfer of patients through ‘Welcoming Persons’ and enabling rapid treatment through ‘Task Shifting’ from on-call physicians to on-duty paramedics in the emergency department and on-call physicians to on-duty nurses in the inpatient department. Results From August, 2013 to March, 2015, 1,262 under-5 children were identified as syndromic sepsis in the emergency departments; of

  13. Managing Neonatal and Early Childhood Syndromic Sepsis in Sub-District Hospitals in Resource Poor Settings: Improvement in Quality of Care through Introduction of a Package of Interventions in Rural Bangladesh.

    Directory of Open Access Journals (Sweden)

    Ahmed Ehsanur Rahman

    Full Text Available Sepsis is dysregulated systemic inflammatory response which can lead to tissue damage, organ failure, and death. With an estimated 30 million cases per year, it is a global public health concern. Severe infections leading to sepsis account for more than half of all under five deaths and around one quarter of all neonatal deaths annually. Most of these deaths occur in low and middle income countries and could be averted by rapid assessment and appropriate treatment. Evidence suggests that service provision and quality of care pertaining to sepsis management in resource poor settings can be improved significantly with minimum resource allocation and investments. Cognizant of the stark realities, a project titled 'Interrupting Pathways to Sepsis Initiative' (IPSI introduced a package of interventions for improving quality of care pertaining to sepsis management at 2 sub-district level public hospitals in rural Bangladesh. We present here the quality improvement process and achievements regarding some fundamental steps of sepsis management which include rapid identification and admission, followed by assessment for hypoxemia, hypoglycaemia and hypothermia, immediate resuscitation when required and early administration of parenteral broad spectrum antibiotics.Key components of the intervention package include identification of structural and functional gaps through a baseline environmental scan, capacity development on protocolized management through training and supportive supervision by onsite 'Program Coaches', facilitating triage and rapid transfer of patients through 'Welcoming Persons' and enabling rapid treatment through 'Task Shifting' from on-call physicians to on-duty paramedics in the emergency department and on-call physicians to on-duty nurses in the inpatient department.From August, 2013 to March, 2015, 1,262 under-5 children were identified as syndromic sepsis in the emergency departments; of which 82% were admitted. More neonates (30

  14. The Role of Early Head Start Programs in Addressing the Child Care Needs of Low-Income Families with Infants and Toddlers: Influences on Child Care Use and Quality.

    Science.gov (United States)

    Love, John M.; Constantine, Jill; Paulsell, Diane; Boller, Kimberly; Ross, Christine; Raikes, Helen; Brady-Smith, Christy; Brooks-Gunn, Jeanne

    2004-01-01

    In 1994, the Secretary's Advisory Committee on Services for Families with Infants and Toddlers set forth a vision for Early Head Start programs in declaring that all child care settings used by Early Head Start families, whether or not the program provides the care directly, must meet the high standards of quality embodied in the Head Start…

  15. Setting Quality Improvement Priorities for Women Receiving Systemic Therapy for Early-Stage Breast Cancer by Using Population-Level Administrative Data.

    Science.gov (United States)

    Enright, Katherine A; Taback, Nathan; Powis, Melanie Lynn; Gonzalez, Alejandro; Yun, Lingsong; Sutradhar, Rinku; Trudeau, Maureen E; Booth, Christopher M; Krzyzanowska, Monika K

    2017-10-01

    Purpose Routine evaluation of quality measures (QMs) can drive improvement in cancer systems by highlighting gaps in care. Targeting quality improvement at QMs that demonstrate substantial variation has the potential to make the largest impact at the population level. We developed an approach that uses both variation in performance and number of patients affected by the QM to set priorities for improving the quality of systemic therapy for women with early-stage breast cancer (EBC). Patients and Methods Patients with EBC diagnosed from 2006 to 2010 in Ontario, Canada, were identified in the Ontario Cancer Registry and linked deterministically to multiple health care databases. Individual QMs within a panel of 15 QMs previously developed to assess the quality of systemic therapy across four domains (access, treatment delivery, toxicity, and safety) were ranked on interinstitutional variation in performance (using interquartile range) and the number of patients who were affected; then the two rankings were averaged for a summative priority ranking. Results We identified 28,427 patients with EBC who were treated at 84 institutions. The use of computerized physician electronic order entry for chemotherapy, emergency room visits or hospitalizations during chemotherapy, and timely receipt of chemotherapy were identified as the QMs that had the largest potential to improve quality of care at a system level within this cohort. Conclusion A simple ranking system based on interinstitutional variation in performance and patient volume can be used to identify high-priority areas for quality improvement from a population perspective. This approach is generalizable to other health care systems that use QMs to drive improvement.

  16. Nitrogen Fertilization for Optimizing the Quality and Yield of Shade Grown Cuban Cigar Tobacco: Required Nitrogen Amounts, Application Schedules, Adequate Leaf Nitrogen Levels, and Early Season Diagnostic Tests

    Directory of Open Access Journals (Sweden)

    Borges A

    2014-12-01

    Full Text Available Nitrogen (N fertilizers have a decisive influence on the yield and quality of tobacco. Yield, percentage of plant N, wrapper leaf quality, and nicotine content are all important quality characteristics in tobacco growing. This work is an attempt to provide a tool for optimizing mineral N nutrition for Cuban cigar tobacco, using a strategy that links N supply with leaf N concentration and wrapper yield. Similar approaches developed worldwide have mainly involved Virginia and Burley tobacco types but not Cuban cigar tobacco. The objective of the current work is to identify the effects of fertilizer N levels and timing of application on each of the mentioned quality factors for shade grown Cuban cigar tobacco. Another purpose is to explore the usefulness of a quick method of assessing the N status of plants based on measuring leaf transmission at two different wavelengths (650 and 940 nm. The experiments were done in the main tobacco growing area of Cuba (Vueltabajo. In each experiment, nine separate treatments were used covering different levels and times of fertilizer N application. The same experiment was carried out in three different years (2005-2006, 2006-2007, 2007-2008 but as the results were similar only one set of data is described (2006-2007. The patterns of response to N fertilizer of all four quality measurements, including yield and wrapper leaf quality, were similar in the different replications of the experiments. The optimal fertilizer level was 140-190 kg N/ha (40% applied on days 8-10 after transplanting and 60% on days 18-20 after transplanting. The optimal N concentration of leaves taken at the central foliar level of the middle stalk position was 4.3-4.7% at harvest time. Leaf transmission measurements by means of the SPAD-502 Chlorophyll Meter in the early stages of growth were correlated with leaf chlorophyll and N concentration and provide an excellent guide for predicting Cuban cigar tobacco wrapper leaf yield.

  17. Implementing an innovative intervention to increase research capacity for enhancing early psychosis care in Indonesia.

    Science.gov (United States)

    Renwick, L; Irmansyah; Keliat, B A; Lovell, K; Yung, A

    2017-11-01

    WHAT IS KNOWN ON THE TOPIC?: In low- and middle-income settings (LMICs) such as Indonesia, the burden from psychotic illness is significant due to large gaps in treatment provision Mental health workers and community nurses are a growing workforce requiring new evidence to support practice and enhanced roles and advanced competencies among UK mental health nurses also requires greater research capacity Research capacity building projects can strengthen research institutions, enhance trial capacity, improve quality standards and improve attitudes towards the importance of health research. WHAT THIS PAPER ADDS?: Delivering innovative, cross-cultural workshops to enhance research capacity to multidisciplinary, early career researchers in Indonesia and the UK are rated highly by attendees Supporting people in this way helps them to gain competitive grant funding to complete their own research which can improve the health of the population To our knowledge, there are no other studies reporting the attainment of grant income as a successful outcome of international research partnerships for mental health nursing so our finding is novel. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: This method could be implemented to improve networking and collaboration between UK academics and early career researchers in other lower- and middle-income settings This strategy can also strengthen existing partnerships among early career researchers in the UK to meet the demands for greater research mentorship and leadership among mental health nurses and enhance nurses capabilities to contribute to evidence for practice. Aim To strengthen research capacity for nurses and early career researchers in Indonesia and the UK to develop a local evidence base in Indonesia to inform policy and improve the nation's health. These strategies can strengthen research institutions, enhance trial capacity, improve quality standards and improve attitudes towards the importance of health research. Methods Four

  18. Short-Term International Experience (STIE) and Students' Understanding of Quality Early Childhood Service Provision

    Science.gov (United States)

    Sims, Margaret; Nishida, Yukiyo

    2018-01-01

    Exposing pre-service teachers to international professional experiences through a short-term visiting programme serves to challenge their understandings of good quality practice through disturbing assumptions and expectations previously formed through experiences in their own country/culture. Much of the research in international study focuses on…

  19. Discovering metabolic indices for early detection of squash (Cucurbita maxima) storage quality using GC-MS-based metabolite profiling.

    Science.gov (United States)

    Okazaki, K; Kimura, Y; Sugiyama, K; Kami, D; Nakamura, T; Oka, N

    2016-04-01

    Squash (Cucubita maxima) cultivars with good storage qualities are needed for breeding to improve poor crop supply during winter in Japan. We measured changes in squash constituents during different storage periods to identify compounds that were suitable to be used as indices of storage quality. Principal components analysis of compounds at 1-5 months after harvest showed that PC1 scores were lower for cultivars with a higher rather than lower SQ (storage quality) ranks. Partial least-squares regression analysis was performed using the peak areas of all compounds identified from the 15 cultivars at 1 month after harvest as explanation variables and SQ as the target variable. Variable influence on projection scores and rank correlation coefficients were higher for arabinose and xylose, which showed less temporal change during the storage period; hence, they were considered to be suitable indicators for storage evaluation. These data will be useful for future studies aiming to improve storage quality of squash. Copyright © 2015 Elsevier Ltd. All rights reserved.

  20. Effects of feed deprivation and electrical, gas, and captive needle stunning on early postmortem muscle metabolism and subsequent meat quality

    NARCIS (Netherlands)

    Savenije, B; Schreurs, FJG; Winkelman-Goedhart, HA; Gerritzen, MA; Korf, J; Lambooij, E

    The general method for stunning poultry before slaughter is by immersion of a chicken's head into an electrified waterbath. This method results in carcass and meat quality deficiencies. The major problems are hemorrhages and a delay in onset of rigor mortis, which increases the risk of cold

  1. Gender-Related Quality of Parent-Child Interactions and Early Adolescent Problem Behaviors: Exploratory Study with Midwestern Samples

    Science.gov (United States)

    Spoth, Richard; Neppl, Tricia; Goldberg-Lillehoj, Catherine; Jung, Tony; Ramisetty-Mikler, Suhasini

    2006-01-01

    This article reports two exploratory studies testing a model guided by a social interactional perspective, positing an inverse relation between the quality of parent-child interactions and adolescent problem behaviors. It addresses mixed findings in the literature related to gender differences. Study 1 uses cross-sectional survey data from…

  2. Effects of feed deprivation and transport on preslaughter blood metabolites, early postmortem muscle metabolites and meat quality

    NARCIS (Netherlands)

    Savenije, B.; Lambooij, E.; Gerritzen, M.A.; Venema, K.; Korf, J.

    2002-01-01

    In practice, poultry have their feed with drawn several hours before being collected and put on transport to the slaughter plant. With the exhaustion of their internal energy stores, the chickens may lack energy to cope with the conditions to which they are subjected. Meat quality is affected by the

  3. Quality of life after cytoreductive surgery plus early intraperitoneal postoperative chemotherapy for pseudomyxoma peritonei: A prospective study

    DEFF Research Database (Denmark)

    Jess, Per; Iversen, Lene Hjerrild; Nielsen, Mette B

    2008-01-01

    PURPOSE: The modern treatment of pseudomyxoma peritonei is cytoreductive surgery plus intraperitoneal chemotherapy resulting in a survival of up to 70 percent after 20 years. The goal of this study was to investigate the impact on quality of life of this very aggressive treatment, which has not b...

  4. Prospective Links between Friendship and Early Physical Aggression: Preliminary Evidence Supporting the Role of Friendship Quality through a Dyadic Intervention

    Science.gov (United States)

    Salvas, Marie-Claude; Vitaro, Frank; Brendgen, Mara; Cantin, Ste´phane

    2016-01-01

    Positive friendships have been related to decreasing levels of children's physical aggression over time. While this evidence calls for interventions aimed at helping children build good-quality friendships, tests of causality through experimental manipulations are still needed. The goal of this study was to examine whether an intervention aimed to…

  5. Effects of feed deprivation and transport on preslaughter blood metabolites, early postmortem muscle metabolites, and meat quality

    NARCIS (Netherlands)

    Savenije, B; Larnbooij, E; Gerritzen, MA; Venema, K; Korf, J

    In practice, poultry have their feed withdrawn several hours before being collected and put on transport to the slaughter plant. With the exhaustion of their internal energy stores, the chickens may lack energy to cope with the conditions to which they are subjected. Meat quality is affected by the

  6. Effective educator-student relationships in nursing education to strengthen nursing students' resilience.

    Science.gov (United States)

    Froneman, Kathleen; Du Plessis, Emmerentia; Koen, Magdelene P

    2016-06-10

    Little research has been conducted in private nursing schools with regard to the educator-student relationship to strengthen the resilience of nursing students and to improve the educator-student relationship. An effective educator-student relationship is a key factor to ensure a positive learning climate where learning can take place and resilience can be strengthened. The purpose was to explore and describe nursing students' view on the basic elements required for an effective educator-student relationship to strengthen their resilience and the educator-student relationship. This study followed an explorative, descriptive and contextual qualitative design in a private nursing education institution in the North West Province. Purposive sampling was used. The sample consisted of 40 enrolled nursing auxiliary students. The World Café Method was used to collect data, which were analysed by means of content analysis. The following five main themes were identified and included: (1) teaching-learning environment, (2) educator-student interaction, (3) educator qualities, (4) staying resilient and (5) strategies to strengthen resilience. Students need a caring and supportive environment; interaction that is constructive, acknowledges human rights and makes use of appropriate non-verbal communication. The educator must display qualities such as love and care, respect, responsibility, morality, patience, being open to new ideas, motivation, willingness to 'go the extra mile' and punctuality. Students reported on various ways how they manage to stay resilient. It thus seems that basic elements required in an effective educator-student relationship to strengthen the resilience of students include the environment, interaction, educator and student's qualities and resilience.

  7. A Breakthrough for Strengthening Tusi Studies

    Institute of Scientific and Technical Information of China (English)

    Li Liangpin; Peng Furong

    2016-01-01

    Following the inscription of China’s Tusi ( native officials ) relics onto the list of world cultural heritage in 2015 , Tusi studies has already become a current topic. However, if we ignored the numerous and complicated historical events, the tremendous amount of historical materials and cases with different characteristics, it is difficult to realize a theoretical breakthrough and academic in-novation. Hence, if the academic world intends to find a new breakthrough in Tusi studies, enough attention should be given to the analysis of past e-vents, digging out historical materials, and case studies—only by which can Tusi studies be strengthened. 1 . Analysis of past events Scholarly research of the Tusi in the past has paid more attention to the system, culture ,and ap-plication of Tusi relics for inscription onto the list of world cultural heritage, but has ignored analysis of significant events. Due to the influence of the political right, economic benefit, and cultural in-filtration, there had always been competition be-tween the central government and the Tusi regime during the Yuan, Ming and Qing dynasties. When some conflicts could not be resolved through nego-tiation, large-scale events or battles were the re-sult. Judging from current studies on every small or large battle between the central government and a Tusi regime, we can see that scholars always focus their studies on the background, process, result, historical influence and related evaluations. Up to now, no scholars have written a monograph of these big events closely related to the Tusi, which is doubtlessly a pity when it comes to Tusi studies. We think that three issues should be noticed while analyzing big events related to the Tusi:1 ) taking the overall situation into consideration; 2 ) having theoretical sight; and 3 ) having a theoretical awareness. 2 . Uncovering historical materials The historical materials are especially impor-tant for the study of the Tusi system or Tusi issues

  8. Early exercise-based rehabilitation improves health-related quality of life and functional capacity after acute myocardial infarction: a randomized controlled trial.

    Science.gov (United States)

    Peixoto, Thatiana C A; Begot, Isis; Bolzan, Douglas W; Machado, Lais; Reis, Michel S; Papa, Valeria; Carvalho, Antonio C C; Arena, Ross; Gomes, Walter J; Guizilini, Solange

    2015-03-01

    The purpose of this study was to evaluate the influence of an early cardiac rehabilitation (CR) program on health-related quality of life (HRQL) and functional capacity in patients who recently experienced an acute myocardial infarction (AMI). This program was initiated in the inpatient setting and was followed by an unsupervised outpatient intervention. After the same inpatient care plan, low-risk patients who experienced an AMI were randomized into 2 groups: (1) a control group (CG) (n = 43) entailing usual care and (2) an intervention group (IG) (n = 45) entailing outpatient (unsupervised) CR primarily centered on a progressive walking program. Initially, all patients underwent a supervised exercise program with early mobilization beginning 12 hours after an AMI. On hospital discharge, all patients were classified according to cardiovascular risk. Quality of life was evaluated by the MacNew Heart Disease HRQL questionnaire 30 days after discharge. Functional capacity was determined by a 6-minute walk test (6MWT) distance on the day of inpatient discharge as well as 30 days afterward. The HRQL global score was higher in the IG compared with the CG 30 days after discharge (P exercises, initiated by supervised inpatient training and followed by an unsupervised outpatient program, improved HRQL and functional capacity in patients at low cardiovascular risk who recently experienced an AMI. Copyright © 2015 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.

  9. Quality of both parents' cognitive guidance and quantity of early childhood education: Influences on pre-mathematical development.

    Science.gov (United States)

    Sorariutta, Anne; Silvén, Maarit

    2018-06-01

    Only a handful of longitudinal studies have explored the effects of both parents in early parenthood on children's cognitive development, and no study has controlled for simultaneous early childhood education and care (ECEC) experiences. To examine the similarity of each parent's cognitive guidance and contribution to children's pre-mathematical outcomes across parent gender while controlling for amount of ECEC. A longitudinal study on 66 Finnish two-parent families and their children. Both parents' autonomy support and scaffolding behaviour were observed during play interactions with the child at 2;0. Children's numerical and spatial skills were tested at 3;0 and 4;0. Parental reports on amount of ECEC in months were collected at 2;0, 3;0, and 4;0. The two parenting constructs were conceptually similar across parent gender as demonstrated by fairly strong measurement equivalence. While mothers on average showed more scaffolding and equal amounts of autonomy support compared to fathers during play interaction, they displayed less variability in the former and more variability in the latter behaviour. The contribution of mothers' and fathers' cognitive guidance was more similar for children's numerical than spatial development. Both parents' education positively predicted autonomy support but not amount of ECEC exposure, which was positively related to numerical development. As expected, parents' education did not predict ECEC exposure, and child gender was not related to child outcomes. The findings are discussed in relation to measurement invariance and gender-neutral parenting in the context of early childhood. © 2018 The British Psychological Society.

  10. Strengthening Hadfield steel welds by nitrogen alloying

    International Nuclear Information System (INIS)

    Efstathiou, C.; Sehitoglu, H.

    2009-01-01

    Strengthening Hadfield steel weld repairs by introducing nitrogen into the weld region was proven to be feasible via two welding techniques. The first technique required a pure Hadfield steel filler material to be diffusion treated in a high pressure nitrogen gas environment, and subsequently used during tungsten inert gas welding with a pure argon shielding gas. The second technique used a Hadfield steel filler material, and a 10% nitrogen containing argon shielding gas during tungsten inert gas welding. Both techniques increased the yield strength, the hardening rate, and the ultimate strength of the weld region. Using optical microscopy, scanning electron microscopy, and Auger spectroscopy, we determined that the increased strength of the weld region resulted from a combination of nitrogen alloying and microstructural refinement

  11. A multi-state assessment of employer-sponsored quality improvement education for early-career registered nurses.

    Science.gov (United States)

    Djukic, Maja; Kovner, Christine T; Brewer, Carol S; Fatehi, Farida K; Seltzer, Joanna R

    2013-01-01

    Increasing participation of registered nurses (RNs) in quality improvement (QI) is a promising strategy to close the health care quality chasm. For RNs to participate effectively in hospital QI, they must have adequate QI knowledge and skills. This descriptive study assessed employer-sponsored QI education and RNs' preparedness across a wide range of QI steps and processes. RNs from 15 U.S. states who were employed in hospitals and were initially licensed to practice in 2007 to 2008 were surveyed. Fewer than one third of respondents reported being very prepared across all measured QI topics. More than half reported receiving zero hours of training in these same topics in the last year. Lack of educational offerings on the topic was the top reason respondents gave for not obtaining QI training. The QI education offered by employers to RNs could be substantially improved. Nurse educators play a critical role in making these improvements. Copyright 2013, SLACK Incorporated.

  12. Irradiation creep of dispersion strengthened copper alloy

    International Nuclear Information System (INIS)

    Pokrovsky, A.S.; Barabash, V.R.; Fabritsiev, S.A.

    1997-01-01

    Dispersion strengthened copper alloys are under consideration as reference materials for the ITER plasma facing components. Irradiation creep is one of the parameters which must be assessed because of its importance for the lifetime prediction of these components. In this study the irradiation creep of a dispersion strengthened copper (DS) alloy has been investigated. The alloy selected for evaluation, MAGT-0.2, which contains 0.2 wt.% Al 2 O 3 , is very similar to the GlidCop trademark alloy referred to as Al20. Irradiation creep was investigated using HE pressurized tubes. The tubes were machined from rod stock, then stainless steel caps were brazed onto the end of each tube. The creep specimens were pressurized by use of ultra-pure He and the stainless steel caps subsequently sealed by laser welding. These specimens were irradiated in reactor water in the core position of the SM-2 reactors to a fluence level of 4.5-7.1 x 10 21 n/cm 2 (E>0.1 MeV), which corresponds to ∼3-5 dpa. The irradiation temperature ranged from 60-90 degrees C, which yielded calculated hoop stresses from 39-117 MPa. A mechanical micrometer system was used to measure the outer diameter of the specimens before and after irradiation, with an accuracy of ±0.001 mm. The irradiation creep was calculated based on the change in the diameter. Comparison of pre- and post-irradiation diameter measurements indicates that irradiation induced creep is indeed observed in this alloy at low temperatures, with a creep rate as high as ∼2 x 10 -9 s -1 . These results are compared with available data for irradiation creep for stainless steels, pure copper, and for thermal creep of copper alloys

  13. Irradiation creep of dispersion strengthened copper alloy

    Energy Technology Data Exchange (ETDEWEB)

    Pokrovsky, A.S.; Barabash, V.R.; Fabritsiev, S.A. [and others

    1997-04-01

    Dispersion strengthened copper alloys are under consideration as reference materials for the ITER plasma facing components. Irradiation creep is one of the parameters which must be assessed because of its importance for the lifetime prediction of these components. In this study the irradiation creep of a dispersion strengthened copper (DS) alloy has been investigated. The alloy selected for evaluation, MAGT-0.2, which contains 0.2 wt.% Al{sub 2}O{sub 3}, is very similar to the GlidCop{trademark} alloy referred to as Al20. Irradiation creep was investigated using HE pressurized tubes. The tubes were machined from rod stock, then stainless steel caps were brazed onto the end of each tube. The creep specimens were pressurized by use of ultra-pure He and the stainless steel caps subsequently sealed by laser welding. These specimens were irradiated in reactor water in the core position of the SM-2 reactors to a fluence level of 4.5-7.1 x 10{sup 21} n/cm{sup 2} (E>0.1 MeV), which corresponds to {approx}3-5 dpa. The irradiation temperature ranged from 60-90{degrees}C, which yielded calculated hoop stresses from 39-117 MPa. A mechanical micrometer system was used to measure the outer diameter of the specimens before and after irradiation, with an accuracy of {+-}0.001 mm. The irradiation creep was calculated based on the change in the diameter. Comparison of pre- and post-irradiation diameter measurements indicates that irradiation induced creep is indeed observed in this alloy at low temperatures, with a creep rate as high as {approx}2 x 10{sup {minus}9}s{sup {minus}1}. These results are compared with available data for irradiation creep for stainless steels, pure copper, and for thermal creep of copper alloys.

  14. Brownfield regeneration: Towards strengthening social cohesion?

    Directory of Open Access Journals (Sweden)

    Minić Marta

    2016-01-01

    Full Text Available In broader terms, the paper refers to the topic of brownfield regeneration, as one of the most complex mechanisms for sustainable spatial development. In addition to the fact that brownfield regeneration demands a variety of instruments, such as: tax subsidies, the change of land use ownership, soil remediation, planning regulative amendments, etc., the complexity of brownfield regeneration is primarily seen in a number of stakeholders participating in such a process. Thus, the paper focuses on the social aspect of brownfield regeneration - precisely, on researching the community role and reviewing the possibilities for achieving the 'local' interests in complex developmental processes. The main research hypothesis is that brownfield regeneration positively affects the creation of and strengthening the social cohesion in the areas close to the brownfield site. More precisley, the paper presents the ways towards strenghtening social cohesion in the initial phase of the brownfield regeneration process, as well as the effects of such a process in its operationalisation phase on social cohesion. The thesis is examined by two main parameters: 1 participation of local community, and 2 social costs and benefits of brownfield regeneration versus greenfield investment. The research results are presented in the form of argumentative essay. In fact, the critical overview of arguments for and against the main research hypothesis is provided based on the review of interdisciplinary literature in the domain of brownfield regeneration. Such research organisation ensures the identification and description of the measures needed for strengthening social cohesion, as an utmost goal of this research. The final research contribution is about offering the guidelines for similar methodological approach in urban research.

  15. [Strengthening of social participation of Turkish seniors].

    Science.gov (United States)

    Fietz, Jennifer; Stupp, Barbara

    2018-05-04

    Traditional municipal services are not successful at reaching Turkish seniors. Compared to native Germans Turkish seniors have a lower social participation. Do native language groups hosted by a German organization promote the social participation of Turkish seniors? How does social participation take place in the ZWAR networks (between work and retirement; a project to strengthen social participation of seniors) and which factors promote or reduce social participation? Qualitative structuring content analysis of two group discussions, which were based on guided interviews. The social participation of Turkish-speaking seniors was strengthened on three levels: (1) through regular meetings of the Turkish ethnic group social relationships were promoted and German language skills and other skills were improved. Through mutual sharing and understanding of the stressors specific to migration, emotional support was provided. The sharing of mutual cultural and linguistic backgrounds created a sense of community and meetings were perceived as an antidote to migrants' exhausting lives in German society. (2) At the organizational level, participation was promoted through extensive group events. Regardless of their cultural background all participants identified as equal ZWAR members. The ZWAR project functioned as an umbrella organization for participation in the intercultural context. (3) Participation in community events created contacts with community stakeholders and fostered volunteer work. Hence, participants were able to use their skills, and therefore broaden their horizons. Turkish ZWAR networks promoted the social participation of members because integration with their ethnic group reduced access barriers, broadened members' scopes of action, and created new opportunities for participation.

  16. Strengthening Injury Surveillance System in Iran

    Directory of Open Access Journals (Sweden)

    Motevalian Seyed Abbas

    2012-02-01

    Full Text Available 【Abstract】Objective: To strengthen the current Injury Surveillance System (IS System in order to better monitor injury conditions, improve protection ways and promote safety. Methods: At first we carried out a study to evaluate the frameworks of IS System in the developed countries. Then all the available documents from World Health Organization, Eastern Mediterranean Regional Organization, as well as Minister of Health and Medical Education concerning Iran were reviewed. Later a national stakeholder抯 consultation was held to collect opinions and views. A national workshop was also intended for provincial representatives from 41 universities to identify the barriers and limitations of the existing program and further to strengthen injury surveillance. Results: The evaluation of the current IS System revealed many problems, mainly presented as lack of accurate pre- and post-hospital death registry, need of precise injury data registry in outpatient medical centers, incomplete injury data registry in hospitals and lack of accuracy in definition of variables in injury registry. The five main characteristics of current IS System including flexibility, acceptability, simplicity, usefulness and timeliness were evaluated as moderate by experts. Conclusions: Major revisions must be considered in the current IS System in Iran. The following elements should be added to the questionnaire: identifier, manner of arrival to the hospital, situation of the injured patient, consumption of alcohol and opioids, other involved participants in the accident, intention, severity and site of injury, side effects of surgery and medication, as well as one month follow-up results. Data should be collected from 10% of all hospitals in Iran and analyzed every 3 months. Simultaneously data should be online to be retrieved by researches. Key words: Wounds and injuries; Population surveillance; Registries; Iran

  17. Strengthening Injury Surveillance System in Iran

    Institute of Scientific and Technical Information of China (English)

    Seyed Abbas Motevalian; Mashyaneh Haddadi; Hesam Akbari; Reza Khorramirouz; Soheil Saadat; Arash Tehrani; Vafa Rahimi-Movaghar

    2011-01-01

    Objective:To strengthen the current Injury Surveillance System (IS System) in order to better monitor injury conditions,improve protection ways and promote safety.Methods:At first we carried out a study to evaluate the frameworks of IS System in the developed countries.Then all the available documents from World Health OrganizationEastern Mediterranean Regional Organization,as well as Minister of Health and Medical Education concerning Iran were reviewed.Later a national stakeholder's consultation was held to collect opinions and views.A national workshop was also intended for provincial representatives from 41 universities to identify the barriers and limitations of the existing program and further to strengthen injury surveillance.Results:The evaluation of the current IS System revealed many problems,mainly presented as lack of accurate pre- and post-hospital death registry,need of precise injury data registry in outpatient medical centers,incomplete injury data registry in hospitals and lack of accuracy in definition of variables in injury registry.The five main characteristics of current IS System including flexibility,acceptability,simplicity,usefulness and timeliness were evaluated as moderate by experts.Contusions:Major revisions must be considered in the current IS System in Iran.The following elements should be added to the questionnaire:identifier,manner of arrival to the hospital,situation of the injured patient,consumption of alcohol and opioids,other involved participants in the accident,intention,severity and site of injury,side effects of surgery and medication,as well as one month follow-up results.Data should be collected from 10% of all hospitals in Iran and analyzed every 3 months.Simultaneously data should be online to be retrieved by researches.

  18. Strengthening integrated research and capacity development within the Caribbean region

    Directory of Open Access Journals (Sweden)

    Dewailly Eric

    2011-11-01

    Full Text Available Abstract Background The Caribbean region, like other developing regions of the world, faces significant challenges in conducting research, especially in the context of limited resource capacities and capabilities. Further, due to its diverse and multiple island states, research capacity is scattered and unevenly spread within the region. The Caribbean EcoHealth Programme (CEHP is a research program that is structured to improve the capacity and capability of health professionals in the Caribbean region to respond in integrative and innovative ways to on-going and emerging environmental health challenges by means of multi-sectoral interventions. Methods Core parts of the CEHP’s mission are to (1 conduct collaborative research in areas that the region has identified as critical; (2 build and strengthening integrated approaches to research; and (3 develop and enhance basic research capacity within the Caribbean region. Fundamental to the success of the CEHP’s human and resource development mission has been its use of the Atlantis Mobile Laboratory (AML. The AML has allowed the CEHP program to move throughout the Caribbean and be able to respond to calls for specific research and capacity building opportunities. Results The CEHP’s five main research projects have generated the following results: (1 the Persistent Organic Pollutants (POPs study has evaluated human exposures to POPs, heavy metals, pesticides, and zoonotic infections; (2 the Burden of Illness (BOI studies have developed protocols for the testing of foodborne microorganisms, strengthen laboratory analytical capabilities, and determined the prevalence and incidence of food-borne illness; (3 the Rainwater Harvesting (RWH study has evaluated the microbial and chemical quality of rainwater harvesting systems; (4 the Ecotoxicology Water (ETW studies have provided much needed data on the quality of recreational and drinking water supplies, and (5 the Food Safety Training Program has

  19. Children enrolled in public pre-K: the relation of family life, neighborhood quality, and socioeconomic resources to early competence.

    Science.gov (United States)

    Barbarin, Oscar; Bryant, Donna; McCandies, Terry; Burchinal, Margaret; Early, Diane; Clifford, Richard; Pianta, Robert; Howes, Carollee

    2006-04-01

    This article presents data on the family and social environments of 501 children enrolled in public sponsored pre-K in 5 states and tests the relation of these resources to child competence. Structured interviews and questionnaires provide information from parents about the family's social and economic status. Direct assessments and teacher reports provide data on children's literacy, numeracy, and behavioral problems. A majority of the children served in public pre-K lived in poverty and showed decrements in language but not in other domains. A socioeconomic resource factor consisting of parental education, household income, and material need predicted all domains of children's functioning. Children from households high in socioeconomic resources entered pre-K with more well developed language and math skill but fewer behavioral problems than their disadvantaged peers. Neighborhood quality status was related to language competence and mother's marital status to math competence. Neighborhood quality and income level may have their impact on child competence through their relation to dyadic quality and the health and the psychological well-being of the parents. Copyright 2006 APA, all rights reserved.

  20. INCREASING PROFIT IN TOURISM THROUGH STRENGTHENING OF MANAGEMENT COMPETENCIES

    Directory of Open Access Journals (Sweden)

    Jagoda Jankovska

    2013-07-01

    Full Text Available Tourism economy is the most significant industry in the world. It holds a central position and plays an important role in the economic development of a country, especially of countries with high unemployment rate, such as the Republic of Macedonia. Strengthening of, and investing in, tourism capacities directly contribute to further development, integration, and promotion of a country. It is especially important to indicate that creating a strategy, developing and educating human potential, as well as successfully managing the said potential, bear huge significance for good-quality development of tourism economy. Human resources are a crucial factor for achieving good-quality service and the effect of satisfied guests, which is the goal of each tourism organization in view of increasing their competitiveness. In a situation of an open world market, competitiveness and profitability of tourism organizations will, to a greater extent, depend on the competence of tourism managers, as well as on their ability to successfully manage human resources. Certainly, a prerequisite for all this is possessing of competent and creative workforce, which, rather than being content with their present knowledge level, will make continuous initiatives for advanced learning, perfecting their work, and promoting their career

  1. Continuum of Care Services for Maternal and Child Health using mobile technology - a health system strengthening strategy in low and middle income countries.

    Science.gov (United States)

    Balakrishnan, Ramkrishnan; Gopichandran, Vijayaprasad; Chaturvedi, Sharadprakash; Chatterjee, Rahul; Mahapatra, Tanmay; Chaudhuri, Indrajit

    2016-07-07

    Mobile phone technology is utilized for better delivery of health services worldwide. In low-and-middle income countries mobile phones are now ubiquitous. Thus leveraging mHealth applications in health sector is becoming popular rapidly in these countries. To assess the effectiveness of the Continuum of Care Services (CCS) mHealth platform in terms of strengthening the delivery of maternal and child health (MCH) services in a district in Bihar, a resource-poor state in India. The CommCare mHealth platform was customized to CCS as one of the innovations under a project funded by the Bill and Melinda Gates Foundation to improve the maternal and newborn health services in Bihar. The intervention was rolled out in one project district in Bihar, during July 2012. More than 550 frontline workers out of a total of 3000 including Accredited Social Health Activists, Anganwadi Workers, Auxilliary Nurse Midwives and Lady Health Supervisors were trained to use the mHealth platform. The service delivery components namely early registration of pregnant women, three antenatal visits, tetanus toxoid immunization of the mother, iron and folic acid tablet supply, institutional delivery, postnatal home visits and early initiation of breastfeeding were used as indicators for good quality services. The resultant coverage of these services in the implementation area was compared with rest of Bihar and previous year statistics of the same area. The time lag between delivery of a service and its record capture in the maternal and child tracking system (MCTS) database was computed in a random sample of 16,000 beneficiaries. The coverage of services among marginalized and non-marginalized castes was compared to indicate equity of service delivery. Health system strengthening was viewed from the angle of coverage, quality, equity and efficiency of services. The implementation blocks had higher coverage of all the eight indicator services compared to rest of Bihar and the previous year. There

  2. The Role of Maternal Nutrition on Oocyte Size and Quality, with Respect to Early Larval Development in The Coral-Eating Starfish, Acanthaster planci.

    Directory of Open Access Journals (Sweden)

    Ciemon Frank Caballes

    Full Text Available Variation in local environmental conditions can have pronounced effects on the population structure and dynamics of marine organisms. Previous studies on crown-of-thorns starfish, Acanthaster planci, have primarily focused on effects of water quality and nutrient availability on larval growth and survival, while the role of maternal nutrition on reproduction and larval development has been overlooked. To examine the effects of maternal nutrition on oocyte size and early larval development in A. planci, we pre-conditioned females for 60 days on alternative diets of preferred coral prey (Acropora abrotanoides versus non-preferred coral prey (Porites rus and compared resulting gametes and progeny to those produced by females that were starved over the same period. Females fed ad libitum with Acropora increased in weight, produced heavier gonads and produced larger oocytes compared to Porites-fed and starved females. Fed starfish (regardless of whether it was Acropora or Porites produced bigger larvae with larger stomachs and had a higher frequency of normal larvae that reached the late bipinnaria / early brachiolaria stage compared to starved starfish. Females on Acropora diet also produced a higher proportion of larvae that progressed to more advanced stages faster compared to Porites-fed starfish, which progressed faster than starved starfish. These results suggest that maternal provisioning can have important consequences for the quality and quantity of progeny. Because food quality (coral community structure and quantity (coral abundance varies widely among reef locations and habitats, local variation in maternal nutrition of A. planci is likely to moderate reproductive success and may explain temporal and spatial fluctuations in abundance of this species.

  3. The Role of Maternal Nutrition on Oocyte Size and Quality, with Respect to Early Larval Development in The Coral-Eating Starfish, Acanthaster planci.

    Science.gov (United States)

    Caballes, Ciemon Frank; Pratchett, Morgan S; Kerr, Alexander M; Rivera-Posada, Jairo A

    2016-01-01

    Variation in local environmental conditions can have pronounced effects on the population structure and dynamics of marine organisms. Previous studies on crown-of-thorns starfish, Acanthaster planci, have primarily focused on effects of water quality and nutrient availability on larval growth and survival, while the role of maternal nutrition on reproduction and larval development has been overlooked. To examine the effects of maternal nutrition on oocyte size and early larval development in A. planci, we pre-conditioned females for 60 days on alternative diets of preferred coral prey (Acropora abrotanoides) versus non-preferred coral prey (Porites rus) and compared resulting gametes and progeny to those produced by females that were starved over the same period. Females fed ad libitum with Acropora increased in weight, produced heavier gonads and produced larger oocytes compared to Porites-fed and starved females. Fed starfish (regardless of whether it was Acropora or Porites) produced bigger larvae with larger stomachs and had a higher frequency of normal larvae that reached the late bipinnaria / early brachiolaria stage compared to starved starfish. Females on Acropora diet also produced a higher proportion of larvae that progressed to more advanced stages faster compared to Porites-fed starfish, which progressed faster than starved starfish. These results suggest that maternal provisioning can have important consequences for the quality and quantity of progeny. Because food quality (coral community structure) and quantity (coral abundance) varies widely among reef locations and habitats, local variation in maternal nutrition of A. planci is likely to moderate reproductive success and may explain temporal and spatial fluctuations in abundance of this species.

  4. Outcomes following Hip and Quadriceps Strengthening Exercises for Patellofemoral Syndrome: A Systematic Review and Meta-Analysis

    Directory of Open Access Journals (Sweden)

    Adebisi Bisi-Balogun

    2015-10-01

    Full Text Available There is growing evidence to support change in the rehabilitation strategy of patellofemoral pain syndrome (PFPS from traditional quadriceps strengthening exercises to inclusion of hip musculature strengthening in individuals with PFPS. Several studies have evaluated effects of quadriceps and hip musculature strengthening on PFPS with varying outcomes on pain and function. This systematic review and meta-analysis aims to synthesize outcomes of pain and function post-intervention and at follow-up to determine whether outcomes vary depending on the exercise strategy in both the short and long term. Electronic databases including MEDLINE, EMBASE, CINAHL, Web of Science, PubMed, Pedro database, Proquest, Science direct, and EBscoHost databases were searched for randomized control trials published between 1st of January 2005 and 31st of June 2015, comparing the outcomes of pain and function following quadriceps strengthening and hip musculature strengthening exercises in patients with PFPS. Two independent reviewers assessed each paper for inclusion and quality. Means and SDs were extracted from each included study to allow effect size calculations and comparison of results. Six randomized control trials met the inclusion criteria. Limited to moderate evidence indicates that hip abductor strengthening was associated with significantly lower pain post-intervention (SMD −0.88, −1.28 to −0.47 95% CI, and at 12 months (SMD −3.10, −3.71 to −2.50 95% CI with large effect sizes (greater than 0.80 compared to quadriceps strengthening. Our findings suggest that incorporating hip musculature strengthening in management of PFPS tailored to individual ability will improve short-term and long-term outcomes of rehabilitation. Further research evaluating the effects of quadriceps and hip abductors strengthening focusing on reduction in anterior knee pain and improvement in function in management of PFPS is needed.

  5. Quality of life, clinical outcomes and safety of early prophylactic levothyroxine administration in patients with Graves' hyperthyroidism undergoing radioiodine therapy: a randomized controlled study.

    Science.gov (United States)

    Taïeb, David; Bournaud, Claire; Eberle, Marie-Claude; Catargi, Bogdan; Schvartz, Claire; Cavarec, Marie-Béatrice; Faugeron, Isabelle; Toubert, Marie-Elisabeth; Benisvy, Danielle; Archange, Cendrine; Mundler, Olivier; Caron, Philippe; Abdullah, Ahmad Esmaeel; Baumstarck, Karine

    2016-04-01

    While radioiodine therapy is commonly used for treating Graves' disease, a prolonged and clinical hypothyroidism may result in disabling symptoms leading to deterioration of quality of life (QoL) of patients. Introducing levothyroxine (LT4) treatment in the early post-therapeutic period may be an interesting approach to limit this phenomenon. A multicenter, prospective, open-label randomized controlled trial enrolled 94 patients with Graves' hyperthyroidism randomly assigned to the experimental group (n=46) (group A: early prophylactic LT4 treatment) or the control group (n=48) (group B: standard follow-up). The primary endpoint was the 6-month QoL. The secondary endpoints were other QoL scores such as Graves' ophthalmopathy (GO) outcomes, thyroid function tests and safety. The primary endpoint at 6 months was achieved: the mental composite score (MCS) of Short Form 36 (SF-36) was significantly higher in group A compared to group B (P=0.009). Four other dimension scores of the SF-36 and four dimension scores of the thyroid-specific patient-reported outcome (ThyPRO) significantly differed between the two groups, indicating better QoL in group A. After adjustment for variables, the early LT4 administration strategy was found as an independent factor for only two scores of SF-36: the MCS and the general health (GH) score. There were no differences in GO, final thyroid status and changes in the anti-TSH receptor antibodies (TRAbs) levels between the two groups. No adverse cardiovascular event was reported. Early LT4 administration post-radioactive iodine (RAI) could represent a safe potential benefit for patients with regard to QoL. The optimal strategy taking into account administered RAI activities and LT4 treatment dosage and timing remains to be determined. © 2016 European Society of Endocrinology.

  6. Early results of quality of life for curatively treated rectal cancers in Chinese patients with EORTC QLQ-CR29

    International Nuclear Information System (INIS)

    Peng, Junjie; Shi, Debing; Goodman, Karyn A; Goldstein, David; Xiao, Changchun; Guan, Zuqing; Cai, Sanjun

    2011-01-01

    To assess the quality of life in curatively treated patients with rectal cancer in a prospectively collected cohort. Patients with stage I-III rectal cancer who were treated curatively in a single institution were accrued prospectively. Quality of life was assessed by use of the European Organization for Research and Treatment of Cancer questionnaire module for all cancer patients (QLQ-C30) and for colorectal cancer patients (QLQ-CR29). Quality of life among different treatment modalities and between stoma and nonstoma patients was evaluated in all patients. A total of 154 patients were assessed. The median time of completion for the questionnaires was 10 months after all the treatments. For patients with different treatment modalities, faecal incontinence and diarrhea were significantly higher in radiation group (p = 0.002 and p = 0.001, respectively), and no difference in male or female sexual function was found between radiation group and non-radiation group. For stoma and nonstoma patients, the QLQ-CR29 module found the symptoms of Defaecation and Embarrassment with Bowel Movement were more prominent in stoma patients, while no difference was detected in scales QLQ-C30 module. Our study provided additional information in evaluating QoL of Chinese rectal cancer patients with currently widely used QoL questionnaires. As a supplement to the QLQ-C30, EORTC QLQ-CR29 is a useful questionnaire in evaluating curatively treated patients with rectal cancer. Bowel dysfunction (diarrhea and faecal incontinence) was still the major problem compromising QoL in patients with either pre- or postoperative chemoradiotherapy

  7. Changes in equipment and image quality. Impact of one year Austrian breast cancer early detection programme; Aenderungen in der Geraetelandschaft und Bildqualitaet. Auswirkungen nach einem Jahr Oesterreichischem Brustkrebsfrueherkennungsprogramm

    Energy Technology Data Exchange (ETDEWEB)

    Menhart, S.; Osanna-Elliott, A.; Semturs, F.; Schloegl, C.; Wildner, S.; Zwettler, G. [AGES, Wien (Austria). Referenzzentrum fuer technische Qualitaetssicherung im Brustkrebsfrueherkennungsprogramm

    2015-07-01

    The nationwide Austrian Breast Cancer Early Detection Programme (''BKFP'') started in January 2014. The Austrian Agency for Health and Food Safety Ltd. was entrusted with running the reference center for technical quality control (''RefZQS'') on April 1, 2014. The quality of the radiologists' equipment is evaluated against the standards described in the EUREF-Oeprotocol, which is based on the European guidelines for quality assurance in breast cancer screening and diagnosis (EPQC V4, 2006) and has been optimized for Austrian requirements. In its first year of operation the RefZQS has controlled the entire equipment (mammography, periphery and ultrasound system) of all participating radiologists. A significant number of systems had to be adjusted to meet the EUREF-Oecriteria. Some of the systems could not be adjusted accordingly, and had to be replaced. In the wake of the start of the screening programme, several sites switched from CR to more modern DR systems, yielding a significant benefit by reduction of radiation burden. The most important data after one year of RefZQS, especially according to adjustments and replacements, are presented.

  8. Benefits of the quality assured double and arbitration reading of mammograms in the early diagnosis of breast cancer in symptomatic women

    International Nuclear Information System (INIS)

    Waldmann, Annika; Katalinic, Alexander; Kapsimalakou, Smaragda; Grande-Nagel, Isabell; Barkhausen, Joerg; Vogt, Florian M.; Stoeckelhuber, Beate M.; Fischer, Dorothea

    2012-01-01

    To address the benefits of double and arbitration reading regarding tumour detection rates, percentage of in situ tumours, and number (of patients) needed to send for expert reading (number needed to treat; NNT) for one additional tumour finding. QuaMaDi is a quality assured breast cancer diagnosis programme; with two-view mammography (craniocaudal, mediolateral oblique) and, in case of breast density ACR 3 or 4, routine ultrasound imaging; and with independent double reading of all images. A consecutive sample of symptomatic women, i.e. women at risk for breast cancer, women aged 70 and above, and/or women with preceding BI-RADS III findings, was analysed. 28,558 mammograms were performed (mean age of women: 57.3 [standard deviation: 12.3] years). Discordant findings were present in 3,837 double readings and were sent for arbitration reading. After histopathological assessment, 52 carcinomas were found (thereof 32% in situ). These carcinomas accounted for 1.8 tumours per 1,000 examinations in the total cohort and increased the tumour detection rate up to 16.4/1,000. The NNT in discordant cases was 74. Double and arbitration reading appears to be a useful tool to ensure the quality of early detection of breast lesions in symptomatic women during indication-based, standardised mammography. circle Quality assured breast cancer diagnosis is feasible outside organised screening structures. (orig.)

  9. Clinical factors are not the best predictors of quality of sexual life and sexual functioning in women with early stage breast cancer.

    Science.gov (United States)

    Den Oudsten, Brenda L; Van Heck, Guus L; Van der Steeg, Alida F W; Roukema, Jan A; De Vries, Jolanda

    2010-06-01

    Few studies have prospectively assessed the impact of breast cancer (BC) on women's sexual lives. Therefore, this study examines the determinants of quality of sexual life (QOSL), sexual functioning (SF), and sexual enjoyment (SE) at 6 and 12 months after surgical treatment. All participants completed a measure of QOSL (The World Health Organization Quality of Life assessment instrument-100 (WHOQOL-100)-facet Sexual Activity) before diagnosis (Time-1), and 1 (Time-2), 3 (Time-3), 6 (Time-4) and 12 months (Time-5) after surgical treatment. At Time-1, women also completed questionnaires on personality (The State Trait Anxiety Inventory-trait, NEO-FFI), body image and self-esteem (WHOQOL-100), depressive symptoms (Center for Epidemiological Studies-Depression Scale), and fatigue (Fatigue Assessment Scale). Furthermore, SF and SE (The European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Breast Cancer module) were measured from Time-2 onwards. At baseline, the analysis included 223 women with early stage BC. Clinical factors did not predict QOSL, SF or SE. In the final analyses, trait anxiety predicted QOSL and SF at Time-4 (p'swomen with a mastectomy did not differ from women with breast conserving therapy. Mainly personality and psychological factors affect patients' sexuality after surgical treatment. Clinical factors did not predict QOSL, SF or SE. More knowledge in this field will help professionals to identify women who are at risk of experiencing sexual problems and consequently will contribute to provide adequate support. (c) 2009 John Wiley & Sons, Ltd.

  10. Early experience in the use of quantitative image quality measurements for the quality assurance of full field digital mammography x-ray systems

    International Nuclear Information System (INIS)

    Marshall, N W

    2007-01-01

    Quantitative image quality results in the form of the modulation transfer function (MTF), normalized noise power spectrum (NNPS) and detective quantum efficiency (DQE) are presented for nine full field digital mammography (FFDM) systems. These parameters are routinely measured as part of the quality assurance (QA) programme for the seven FFDM units covered by our centre. Just one additional image is required compared to the standard FFDM protocol; this is the image of an edge, from which the MTF is calculated. A variance image is formed from one of the flood images used to measure the detector response and this provides useful information on the condition of the detector with respect to artefacts. Finally, the NNPS is calculated from the flood image acquired at a target detector air kerma (DAK) of 100 μGy. DQE is then estimated from these data; however, no correction is currently made for effects of detector cover transmission on DQE. The coefficient of variation (cov) of the 50% point of the MTF for five successive MTF results was 1%, while the cov for the 50% MTF point for an a-Se system over a period of 17 months was approximately 3%. For four a-Se based systems, the cov for the NNPS at 1 mm -1 for a target DAK of 100 μGy was approximately 4%; the same result was found for four CsI based FFDM units. With regard to the stability of NNPS over time, the cov for four NNPS results acquired over a period of 12 months was also approximately 4%. The effect of acquisition geometry on NNPS was also assessed for a CsI based system. NNPS data acquired with the antiscatter grid in place showed increased noise at low spatial frequency; this effect was more severe as DAK increased. DQE results for the three detector types (a-Se, CsI and CR) are presented as a function of DAK. Some reduction in DQE was found for both the a-Se and CsI based systems at a target DAK of 12.5 μGy when compared to DQE data acquired at 100 μGy. For the CsI based systems, DQE at 1 mm -1 fell from 0

  11. Is knowledge translation adequate? A quality assurance study of staging investigations in early stage breast cancer patients.

    Science.gov (United States)

    Han, Dolly; Hogeveen, Sophie; Sweet Goldstein, Miriam; George, Ralph; Brezden-Masley, Christine; Hoch, Jeffrey; Haq, Rashida; Simmons, Christine E

    2012-02-01

    After primary surgery, patients diagnosed with early stage breast cancer undergo radiological investigations based on pathologic stage of disease to rule out distant metastases. Published guidelines can aid clinicians in determining which tests are appropriate based on stage of disease. We wished to assess the consistency of radiological staging in an academic community oncology setting with standard guidelines and to determine the overall impact of non-adherence to these guidelines. A retrospective cohort study was conducted for new breast cancer patients seen at a single institution between January 2009 and April 2010. Patients were included if initial diagnosis and primary surgery was at this institution. Pathologic stage and radiological tests completed were recorded. A literature review was performed and the results were compared with those from this study to determine overall adherence rates. Subsequently, a cost analysis was performed to determine the financial impact at this centre. 231 patients met eligibility criteria for inclusion in this study. A large proportion of patients were over-staged with 129 patients (55%) undergoing unnecessary investigations according to guidelines. Specifically, 59% of stage I patients and 58% of stage II patients were over-investigated. Distant metastases at the time of diagnosis were found in three patients, all of whom had stage III disease (1.3%). The literature reviewed revealed similar non-adherence rates in other centres. The estimated cost of such non-adherence is in the range of $78 (CDN) per new early stage breast cancer patient seen at this centre. This oncology centre has a low adherence to practice guidelines for staging investigations in breast cancer patients, with 55% of patients undergoing unnecessary tests. Very few patients had metastases at diagnosis, and all had pathological stage III disease. Efforts may need to focus on improving knowledge translation across clinical oncology settings to increase

  12. Modeling of crack propagation in strengthened concrete disks

    DEFF Research Database (Denmark)

    Hansen, Christian Skodborg; Stang, Henrik

    2013-01-01

    Crack propagation in strengthened concrete disks is a problem that has not yet been addressed properly. To investigate it, a cracked half-infinite disk of concrete is strengthened with a linear elastic material bonded to the surface, and analyzed using two different finite element modeling...... instead of 3D calculations to predict the response of a structure and that it opens up for simpler evaluation of strengthened concrete structures using the finite element method....

  13. An approach to health system strengthening in the Democratic Peoples Republic of Korea (North Korea).

    Science.gov (United States)

    Grundy, John; Moodie, Rob

    2009-01-01

    The Democratic Peoples Republic of Korea (DPRK), under the leadership of the Ministry of Public Health (MOPH), undertook the development of a Health System Strengthening (HSS) proposal through the support of the Global Alliance for Vaccines and Immunization (GAVI). The aim of this paper is to outline the approach to the development of the HSS strategy in DPRK, and describe opportunities and challenges associated with its development and future implementation. Sources of information for this review have included national programme plans, in country social sector reviews, information generated through HSS proposal developments and the international literature. Updated assessments in DPRK indicate some recent improvements in the health situation for women and children, but there remain ongoing concerns regarding health management, human resource and physical infrastructure barriers to health services access. In response to this situation, the DPRK developed a health system strengthening strategy, the main elements of which are the strengthening of health management and service delivery systems at the implementing agency levels of county (district) and Ri (sub district). Three success factors were associated with the reaching of consensus on HSS strategy in DPRK. These were partnerships formed between system planners and programme planners, the identification of an overall health sector strategic framework, and high-level leadership of the MOPH. Although DPRK is in the very early stages of health system reconstruction, there are significant and new opportunities to alleviate the health conditions of women and children in DPRK, through implementation of health system strengthening strategies that are nationally coordinated and internationally supported.

  14. Experimental study on flexural members strengthened with variable bonded pre-stressed CFRP plates

    Science.gov (United States)

    Zhang, Baojing; Shang, Shouping

    2017-08-01

    Aiming at the problem that the structural adhesive between CFRP and concrete interface is aging with time and then lost the bond strength, the concept of variable bond prestressed CFRP is put forward. In order to obtain the bearing capacity and failure pattern of the beam strengthened with variable bonding prestressed CFRP plate, three concrete beams of 5.6m long were strengthened by the technology of non-bonding, bonding and variable bonding strengthened with prestressed CFRP plates respectively, the mechanical properties and crack changes of the test beams under three conditions had been compared and analyzed. Test results show that the variable bond strengthened with prestressed CFRP plates with unbonded prestressed CFRP, cracking load was increased by 36%, yield load increased by 4%, the ultimate load increased by 12%; The reinforcement technology of variable bonding prestressed CFRP plate has the characteristics of non-bonding and bonding prestressed CFRP plate reinforcement, which is similar to that of the bonded reinforcement in the early stage of the development of the cracks, then is gradually developing into the non-bonding prestressed reinforcement, the crack spacing and width have the same characteristics as the bonding reinforcement (both crack spacing and width are small), which is more conducive to enhance the durability of the structure.

  15. Epidemiology, surgical management and early postoperative outcome in a cohort of gastric cancer patients of a tertiary referral center in relation to multi-center quality assurance studies.

    Science.gov (United States)

    Garlipp, Benjamin; Schwalenberg, Jens; Adolf, Daniela; Lippert, Hans; Meyer, Frank

    2011-03-01

    The aim of the study was to analyze epidemiologic parameters, treatment-related data and prognostic factors in the management of gastric cancer patients of a university surgical center under conditions of routine clinical care before the onset of the era of multimodal therapies. By analyzing our data in relation with multi-center quality assurance trials [German Gastric Cancer Study - GGCS (1992) and East German Gastric Cancer Study - EGGCS (2004)] we aimed at providing an instrument of internal quality control at our institution as well as a base for comparison with future analyses taking into account the implementation of evolving (multimodal) therapies and their influence on treatment results. Retrospective analysis of prospectively gathered data of gastric cancer patients treated at a single institution during a defined 10-year time period with multivariate analysis of risk factors for early postoperative outcome. From 04/01/1993 through 03/31/2003, a total of 328 gastric cancer patients were treated. In comparison with the EGGCS cohort there was a larger proportion of patients with locally advanced and proximally located tumors. 272 patients (82.9%) underwent surgery with curative intent; in 88.4% of these an R0 resection was achieved (EGGCS/GGCS: 82.5%/71.5%). 68.2% of patients underwent preoperative endoluminal ultrasound (EUS) (EGGCS: 27.4%); the proportion of patients undergoing EUS increased over the study period. Diagnostic accuracy of EUS for T stage was 50.6% (EGGCS: 42.6%). 77.2% of operated patients with curative intent underwent gastrectomy (EGGCS/GGCS: 79.8%/71.1%). Anastomotic leaks at the esophagojejunostomy occurred slightly more frequently (8.8%) than in the EGGCS (5.9%) and GGCS (7.2%); however, postoperative morbidity (36.1%) and early postoperative mortality (5.3%) were not increased compared to the multi-center quality assurance study results (EGGCS morbidity, 45%); EGGCS/GGCS mortality, 8%/8.9%). D2 lymphadenectomy was performed in 72

  16. Self-regulation as a mediator between sibling relationship quality and early adolescents' positive and negative outcomes.

    Science.gov (United States)

    Padilla-Walker, Laura M; Harper, James M; Jensen, Alexander C

    2010-08-01

    The current study examined the role of adolescents' self-regulation as a mediator between sibling relationship quality and adolescent outcomes, after controlling for the quality of the parent-child relationship. Participants were 395 families (282 two parent; 113 single parent) with an adolescent child (M age of child at Time 1 = 11.15, SD = .96, 49% female) who took part in [project name masked for blind review] at both Time 1 and Time 2. Path analysis via structural equation modeling suggested that sibling affection was longitudinally and positively related to self-regulation and prosocial behaviors, and negatively related to externalizing behaviors; while sibling hostility was positively, and having a sister was negatively related to internalizing behaviors (in general, paths were stronger for adolescents from two- vs. single-parent families). There was also evidence that adolescents' self-regulation partially mediated the relation between sibling affection and positive and negative adolescent outcomes. The discussion focuses on the importance of continued research examining the mechanisms through which the sibling relationship influences development during adolescence.

  17. Potential Bacillus probiotics enhance bacterial numbers, water quality and growth during early development of white shrimp (Litopenaeus vannamei).

    Science.gov (United States)

    Nimrat, Subuntith; Suksawat, Sunisa; Boonthai, Traimat; Vuthiphandchai, Verapong

    2012-10-12

    Epidemics of epizootics and occurrence of multiresistant antibiotics of pathogenic bacteria in aquaculture have put forward a development of effective probiotics for the sustainable culture. This study examined the effectiveness of forms of mixed Bacillus probiotics (probiotic A and probiotic B) and mode of probiotic administration on growth, bacterial numbers and water quality during rearing of white shrimp (Litopenaeus vannamei) in two separated experiments: (1) larval stages and (2) postlarval (PL) stages. Forms of Bacillus probiotics and modes of probiotic administration did not affect growth and survival of larval to PL shrimp. The compositions of Bacillus species in probiotic A and probiotic B did not affect growth and survival of larvae. However, postlarvae treated with probiotic B exhibited higher (Pshrimp. Total heterotrophic bacteria and Bacillus numbers in larval and PL shrimp or culture water of the treated groups were higher (Pshrimp were significantly decreased, compared to the controls. Microencapsulated Bacillus probiotic was effective for rearing of PL L. vannamei. This investigation showed that administration of mixed Bacillus probiotics significantly improved growth and survival of PL shrimp, increased beneficial bacteria in shrimp and culture water and enhanced water quality for the levels of pH, ammonia and nitrite of culture water. Copyright © 2012 Elsevier B.V. All rights reserved.

  18. Monolithic Approach to Oxide Dispersion Strengthened Aluminum, Phase I

    Data.gov (United States)

    National Aeronautics and Space Administration — Nassau Stern Company is investigating an approach for manufacturing oxide dispersion strengthened (ODS) aluminum in bulk rather than powder form. The approach...

  19. Evaluating the performance of skewed prestressed concrete bridge after strengthening

    Science.gov (United States)

    Naser, Ali Fadhil; Zonglin, Wang

    2013-06-01

    The objectives of this paper are to explain the application of repairing and strengthening methods on the damaged members of the bridge structure, to analyze the static and dynamic structural response under static and dynamic loads after strengthening, and to evaluate the structural performance after application of strengthening method. The repairing and strengthening methods which are used in this study include treatment of the cracks, thickening the web of box girder along the bridge length and adding internal pre-stressing tendons in the thickening web, and construct reinforced concrete cross beams (diaphragms) between two box girders. The results of theoretical analysis of static and dynamic structural responses after strengthening show that the tensile stresses are decreased and become less than the allowable limit values in the codes. The values of vertical deflection are decreased after strengthening. The values of natural frequencies after strengthening are increased, indicating that the strengthening method is effective to reduce the vibration of the bridge structure. Therefore, the strengthening methods are effective to improve the bearing capacity and elastic working state of the bridge structure and to increase the service life of the bridge structure.

  20. Structural improvement of strengthened deck panels with externally bonded plates

    International Nuclear Information System (INIS)

    Sim, Jongsung; Oh, Hongseob

    2005-01-01

    Concrete bridge decks require eventual replacement and rehabilitation due to decreasing load-carrying capacity. This paper compares different strengthening design procedures that improve the usability and structural performance of bridge decks. The failure characteristics of bridge decks strengthened with various materials such as carbon fiber sheet, glass fiber sheet, steel plate, and grid CFRP and GFRP are analyzed, and the theoretical load-carrying capacities are evaluated using traditional beam and yield line theory, and punching shear analysis. The strengthening materials increase the punching shear strength of the deck and change the failure mode of the strengthened panel

  1. Training for Better Management: Avante Zambézia, PEPFAR and Improving the Quality of Administrative Services Comment on "Implementation of a Health Management Mentoring Program: Year-1 Evaluation of Its Impact on Health System Strengthening in Zambézia Province, Mozambique".

    Science.gov (United States)

    Schwarcz, Sandra K; Rutherford, George W; Horvath, Hacsi

    2015-07-23

    The United States President's Emergency Plan for AIDS Relief (PEPFAR) emphasizes health systems strengthening as a cornerstone of programmatic success. Health systems strengthening, among other things, includes effective capacity building for clinical care, administrative management and public health practice. Avante Zambézia is a district-level in-service training program for administrative staff. It is associated with improved accounting practices and human resources and transportation management but not monitoring and evaluation. We discuss other examples of successful administrative training programs that vary in the proportion of time that is spent learning on the job and the proportion of time spent in classrooms. We suggest that these programs be more rigorously evaluated so that lessons learned can be generalized to other countries and regions. © 2015 by Kerman University of Medical Sciences.

  2. Training for Better Management: Avante Zambézia, PEPFAR and Improving the Quality of Administrative Services; Comment on “Implementation of a Health Management Mentoring Program: Year-1 Evaluation of Its Impact on Health System Strengthening in Zambézia Province, Mozambique”

    Directory of Open Access Journals (Sweden)

    Sandra K. Schwarcz

    2015-11-01

    Full Text Available The United States President’s Emergency Plan for AIDS Relief (PEPFAR emphasizes health systems strengthening as a cornerstone of programmatic success. Health systems strengthening, among other things, includes effective capacity building for clinical care, administrative management and public health practice. Avante Zambéziais a district-level in-service training program for administrative staff. It is associated with improved accounting practices and human resources and transportation management but not monitoring and evaluation. We discuss other examples of successful administrative training programs that vary in the proportion of time that is spent learning on the job and the proportion of time spent in classrooms. We suggest that these programs be more rigorously evaluated so that lessons learned can be generalized to other countries and regions.

  3. Strengthening IAEA Safeguards for Research Reactors

    Energy Technology Data Exchange (ETDEWEB)

    Reid, Bruce D. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Anzelon, George A. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Budlong-Sylvester, Kory [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

    2016-09-01

    During their December 10-11, 2013, workshop in Grenoble France, which focused on the history and future of safeguarding research reactors, the United States, France and the United Kingdom (UK) agreed to conduct a joint study exploring ways to strengthen the IAEA’s safeguards approach for declared research reactors. This decision was prompted by concerns about: 1) historical cases of non-compliance involving misuse (including the use of non-nuclear materials for production of neutron generators for weapons) and diversion that were discovered, in many cases, long after the violations took place and as part of broader pattern of undeclared activities in half a dozen countries; 2) the fact that, under the Safeguards Criteria, the IAEA inspects some reactors (e.g., those with power levels under 25 MWt) less than once per year; 3) the long-standing precedent of States using heavy water research reactors (HWRR) to produce plutonium for weapons programs; 4) the use of HEU fuel in some research reactors; and 5) various technical characteristics common to some types of research reactors that could provide an opportunity for potential proliferators to misuse the facility or divert material with low probability of detection by the IAEA. In some research reactors it is difficult to detect diversion or undeclared irradiation. In addition, infrastructure associated with research reactors could pose a safeguards challenge. To strengthen the effectiveness of safeguards at the State level, this paper advocates that the IAEA consider ways to focus additional attention and broaden its safeguards toolbox for research reactors. This increase in focus on the research reactors could begin with the recognition that the research reactor (of any size) could be a common path element on a large number of technically plausible pathways that must be considered when performing acquisition pathway analysis (APA) for developing a State Level Approach (SLA) and Annual Implementation Plan (AIP). To

  4. A qualidade da educação infantil brasileira: alguns resultados de pesquisa Brazilian early childhood education quality: some research results

    Directory of Open Access Journals (Sweden)

    Maria Malta Campos

    2006-04-01

    Full Text Available O artigo analisa dados obtidos por meio de levantamento sobre resultados recentes de pesquisas empíricas acerca da qualidade da educação nas instituições de educação infantil brasileiras, divulgadas entre 1996 e 2003. A revisão cobriu estudos publicados nas principais revistas brasileiras de educação e apresentados na mais importante reunião científica da área, a Reunião Anual da Associação Nacional de Pós-Graduação e Pesquisa em Educação - ANPEd -, no Grupo de Trabalho Educação da Criança de zero a seis anos. Os dados foram classificados segundo os principais aspectos relacionados à qualidade da educação infantil de acordo com a literatura: formação dos professores; propostas pedagógicas; condições de funcionamento; práticas educativas e relação com as famílias. O quadro geral que emerge do estudo aponta para uma situação dinâmica mas ainda contraditória, revelando que é grande a distância entre as metas legais e a situação vivida pela maioria de crianças e adultos no cotidiano das instituições de educação infantil.This paper discusses data obtained from a review of empirical studies on the quality of early childhood education in Brazil published between 1996 and 2003. The sources were the main education journals published in the country and the papers presented at the most important scientific meeting of the area, The National Association of Graduate Studies and Research on Education (ANPEd Annual Congress, Work Group on Education of 0-6 Year-Old Children (WG 7. The information gathered was selected according to main criteria for assessment of early childhood education quality as published in the literature: teacher education; curricula; infrastructure; educational practices, and relationships between schools and families. The general picture of early childhood education systems described in this review suggests a dynamic but contradictory reality characterized by an enormous distance between

  5. Strengthening the diagnostic capacity to detect Bio Safety Level 3 organisms in unusual respiratory viral outbreaks.

    Science.gov (United States)

    van Asten, Liselotte; van der Lubben, Mariken; van den Wijngaard, Cees; van Pelt, Wilfrid; Verheij, Robert; Jacobi, Andre; Overduin, Pieter; Meijer, Adam; Luijt, Dirk; Claas, Eric; Hermans, Mirjam; Melchers, Willem; Rossen, John; Schuurman, Rob; Wolffs, Petra; Boucher, Charles; Bouchier, Charles; Schirm, Jurjen; Kroes, Louis; Leenders, Sander; Galama, Joep; Peeters, Marcel; van Loon, Anton; Stobberingh, Ellen; Schutten, Martin; Koopmans, Marion

    2009-07-01

    Experience with a highly pathogenic avian influenza outbreak in the Netherlands (2003) illustrated that the diagnostic demand for respiratory viruses at different biosafety levels (including BSL3), can increase unexpectedly and dramatically. We describe the measures taken since, aimed at strengthening national laboratory surge capacity and improving preparedness for dealing with diagnostic demand during outbreaks of (emerging) respiratory virus infections, including pandemic influenza virus. Academic and peripheral medical-microbiological laboratories collaborated to determine minimal laboratory requirements for the identification of viruses in the early stages of a pandemic or a large outbreak of avian influenza virus. Next, an enhanced collaborative national network of outbreak assistance laboratories (OAL) was set up. An inventory was made of the maximum diagnostic throughput that this network can deliver in a period of intensified demand. For an estimate of the potential magnitude of this surge demand, historical counts were calculated from hospital- and physician-based registries of patients presenting with respiratory symptoms. Number of respiratory physician-visits ranged from 140,000 to 615,000 per month and hospitalizations ranged from 3000 to 11,500 per month. The established OAL-network provides rapid diagnostic response with agreed quality requirements and a maximum throughput capacity of 1275 samples/day (38,000 per month), assuming other routine diagnostic work needs to be maintained. Thus surge demand for diagnostics for hospitalized cases (if not distinguishable from other respiratory illness) could be handled by the OAL network. Assessing etiology of community acquired acute respiratory infection however, may rapidly exceed the capacity of the network. Therefore algorithms are needed for triaging for laboratory diagnostics; currently this is not addressed in pandemic preparedness plans.

  6. Effectiveness of muscle strengthening and description of protocols for preventing falls in the elderly: a systematic review

    Directory of Open Access Journals (Sweden)

    Erika Y. Ishigaki

    2014-05-01

    Full Text Available Background: Falls are a geriatric syndrome that is considered a significant public health problem in terms of morbidity and mortality because they lead to a decline in functional capacity and an impaired quality of life in the elderly. Lower limb muscle strengthening seems to be an effective intervention for preventing falls; however, there is no consensus regarding the best method for increasing lower limb muscle strength. Objectives: To analyze the effectiveness of lower limb muscle strengthening and to investigate and describe the protocols used for preventing falls in elderly subjects. Method: We performed a systematic review of randomized and controlled clinical trials published between 2002 and 2012 in the databases PubMed, EMBASE, Scopus, Web of Science, and PEDro that cited some type of lower limb muscle strengthening protocol and that evaluated the incidence of falls as the primary outcome exclusively in elderly subjects. Twelve studies met the inclusion criteria. Qualitative analysis was performed by independent reviewers applying the PEDro scale. Results: The data obtained from the selected studies showed lower fall rates in the intervention groups compared to controls. Six studies described the lower limb muscle strengthening protocol in detail. High methodological quality was found in 6 studies (PEDro score ≥7/10 points. Conclusions: The methodological quality of the studies in this area appears to leave little doubt regarding the effectiveness of lower limb strengthening exercises for preventing falls in elderly subjects, however the interventions in these studies were poorly reported.

  7. The Effect of Dose and Quality Assurance in Early Prostate Cancer Treated with Low Dose Rate Brachytherapy as Monotherapy.

    Science.gov (United States)

    Henry, A M; Rodda, S L; Mason, M; Musunuru, H; Al-Qaisieh, B; Bownes, P; Smith, J; Franks, K; Carey, B; Bottomley, D

    2015-07-01

    To examine the relationship between post-implant computed tomography dosimetry and long-term prostate-specific antigen relapse-free survival in patients treated with iodine 125 (I-125) low dose rate prostate brachytherapy as monotherapy and, second, to audit recent practice against Royal College of Radiologists' (RCR) guidelines after the re-introduction of post-implant dosimetry for all patients in our centre. Between March 1995 and September 2007, 2157 consecutive patients with localised prostate cancer underwent I-125 permanent prostate brachytherapy as monotherapy in a single UK centre. All patients were transrectal ultrasound planned delivering a 145 Gy (TG 43) minimum peripheral dose. None received supplemental external beam radiotherapy. Post-implant computed tomography-based dosimetry was undertaken between 4 and 6 weeks after treatment and was available for 711 (33%). Outcomes were analysed in terms of the relationship of D90 to prostate-specific antigen relapse-free survival (nadir 2+ definition) and all patients had a minimum follow-up of 5 years. For contemporary patients from 2011, quality metrics from post-implant computed tomography as defined by RCR guidelines are presented. A mean D90 of 138.7 Gy (standard deviation 24.7) was achieved for the historic cohort. Biochemical control at 10 years was 76% in patients with D90 > 140 Gy and 68% in those with D90 standard deviation) D90 has increased from 154 (15.3) Gy in 2011 to 164 (13.5) Gy in 2013. Similarly, an increase in the mean (standard deviation) V100 from 92 (4.4) to 95 (3.2) % is noted over time. No difference between clinicians was noted. D90 values of less than 140 Gy continue to be predictive of increased risk of recurrence of prostate cancer across risk groups with longer follow-up. Quality assurance can be used to ensure improved and consistent implant quality in a team with multiple clinicians. Copyright © 2015 The Royal College of Radiologists. Published by Elsevier Ltd. All rights

  8. Improving transport service delivery in the Capricorn district municipality by strengthening ITS transport function

    CSIR Research Space (South Africa)

    Mashiri, M

    2010-08-01

    Full Text Available , transport authority, functions, capacity building, funding, institutional strengthening, legislative mandates, South Africa 224 1 INTRODUCTION Since the advent of the democratic political dispensation in South Africa in 1994, the nature and functions... in that it influences the quality and style of life, the range and location of productive and leisure activities, and the goods and services which will be available for consumption (Morlok, 1978; Fuller, 2004). Given that transport plays this important triple role...

  9. Strengthening health professions regulation in Cambodia: a rapid assessment.

    Science.gov (United States)

    Clarke, David; Duke, Jan; Wuliji, Tana; Smith, Alyson; Phuong, Keat; San, Un

    2016-03-10

    This paper describes a rapid assessment of Cambodia's current system for regulating its health professions. The assessment forms part of a co-design process to set strategic priorities for strengthening health profession regulation to improve the quality and safety of health services. A health system approach for strengthening health professions' regulation is underway and aims to support the Government of Cambodia's plans for scaling up its health workforce, improving health services' safety and quality, and meeting its Association of South East Asian Nations (ASEAN) obligations to facilitate trade in health care services. The assessment used a mixed methods approach including: A desktop review of key laws, plans, reports and other documents relating to the regulation of the health professions in Cambodia (medicine, dentistry, midwifery, nursing and pharmacy); Key informant interviews with stakeholders in Cambodia (The term "stakeholders" refers to government officials, people working on health professional regulation, people working for the various health worker training institutions and health workers at the national and provincial level); Surveys and questionnaires to assess Cambodian stakeholder knowledge of regulation; Self-assessments by members of the five Cambodian regulatory councils regarding key capacities and activities of high-performing regulatory bodies; and A rapid literature review to identify: The key functions of health professional regulation; The key issues affecting the Cambodian health sector (including relevant developments in the wider ASEAN region); and "Smart" health profession regulation practices of possible relevance to Cambodia. We found that the current regulatory system only partially meets Cambodia's needs. A number of key regulatory functions are being performed, but overall, the current system was not designed with Cambodia's specific needs in mind. The existing system is also overly complex, with considerable duplication and

  10. Supplementation of monensin and Optimase to beef cows consuming low-quality forage during late gestation and early lactation.

    Science.gov (United States)

    Linneen, S K; McGee, A L; Cole, J R; Jennings, J S; Stein, D R; Horn, G W; Lalman, D L

    2015-06-01

    Two experiments were designed to investigate the effects of feeding monensin and/or slow release urea with a fibrolytic feed enzyme (Optimase; Alltech, Inc., Nicholasville, KY) on performance, milk production, calf growth performance, and blood metabolites in beef cows. Spring-calving cows and heifers were used in a completely randomized design in Exp. 1 (N = 84; 534 ± 68 kg initial BW) and Exp. 2 (N = 107; 508 ± 72 kg initial BW). Exp. 1 supplements were formulated to meet cow protein requirements and fed daily and included 1) cottonseed meal with no monensin (control); or 2) monensin added to control to supply 200 mg per head per d (MON). In Exp. 2, experimental supplements included 1) cottonseed meal/wheat middlings (CS) fed at a rate to provide adequate DIP and CP according to , 2) the CS plus soybean hulls and 61 g per cow per d Optimase (OPT), 3) the CS plus monensin to supply 200 mg per cow per d (MON2), and 4) OPT plus MON2 (Combo). Cows were fed in last trimester through early lactation in Exp. 1 and during 2nd trimester in Exp. 2. Data were analyzed using the Mixed procedure in SAS with animal as the experimental unit. In Exp. 1, treatment did not affect cow BW or BCS change (P > 0.19). Calf birth BW was not affected by dam treatment (P = 0.24); however, calves from dams consuming MON weighed more (P Milk production did not significantly differ among treatments (P > 0.41). In Exp. 2, mean cow BW and BCS were similar (P > 0.35) among treatments on d 90. However, from d 0 to 54, cows assigned to the OPT supplement gained less BCS (P = 0.02) compared with cows assigned to the CS supplement. Cumulative BCS gain was greater (P calf performance during early lactation seems to be clearer. Replacing a portion of oilseed N in the supplement with Optimase may marginally reduce cow performance. Further research is needed to determine both the effects of monensin and the implications of combining monensin with Optimase on forage intake and cow performance at

  11. Strengthening Regulatory Competence in a Changing Nuclear Regulatory Environment

    International Nuclear Information System (INIS)

    Illizastigui, P.F.

    2016-01-01

    The paper addresses the approach followed by the Cuban National Center for Nuclear Safety for the management of current and new competences of its regulatory staff with the aim of allowing those staff to effectively fulfill their core regulatory functions. The approach is realized through an Integrated System for Competence Building, which is based on the IAEA recommendations, shown to be effective in ensuring the necessary competence in the relevant areas. In the author’s opinion, competence of the regulatory staff in the area of human and organizational factors is of paramount importance and needs to be further strengthened in order to be able to assess safety performance at the facilities and detect early signs of deteriorating safety performance. The former is defined by the author as the core regulatory function “Analysis” which covers the entire spectrum of assessment tasks carried out by the regulatory staff to: a) detect declining safety performance, b) diagnose latent weaknesses (root causes) and c) make effective safety culture interventions. The author suggests that competence associated with the fulfillment of the analysis function is distinctly identified and dealt with separately in the current system of managing regulatory competence. (author)

  12. Strengthening links between waterfowl research and management

    Science.gov (United States)

    Roberts, Anthony J.; Eadie, John M.; Howerter, David; Johnson, Fred A.; Nichols, James; Runge, Michael C.; Vrtiska, Mark; Williams, Byron K.

    2018-01-01

    Waterfowl monitoring, research, regulation, and adaptive planning are leading the way in supporting science-informed wildlife management. However, increasing societal demands on natural resources have created a greater need for adaptable and successful linkages between waterfowl science and management. We presented a special session at the 2016 North American Duck Symposium, Annapolis, Maryland, USA on the successes and challenges of linking research and management in waterfowl conservation, and we summarize those thoughts in this commentary. North American waterfowl management includes a diversity of actions including management of harvest and habitat. Decisions for waterfowl management are structured using decision analysis by incorporating stakeholder values into formal objectives, identifying research relevant to objectives, integrating scientific knowledge, and choosing an optimal strategy with respect to objectives. Recently, the consideration of the value of information has been proposed as a means to evaluate the utility of research designed to meet objectives. Despite these advances, the ability to conduct waterfowl research with direct management application may be increasingly difficult in research institutions for several reasons including reduced funding for applied research and the lower perceived value of applied versus theoretical research by some university academics. In addition, coordination between researchers and managers may be logistically constrained, and communication may be ineffective between the 2 groups. Strengthening these links would help develop stronger and more coordinated approaches for the conservation of waterfowl and the wetlands upon which they depend.

  13. Precipitate strengthening of nanostructured aluminium alloy.

    Science.gov (United States)

    Wawer, Kinga; Lewandowska, Malgorzata; Kurzydlowski, Krzysztof J

    2012-11-01

    Grain boundaries and precipitates are the major microstructural features influencing the mechanical properties of metals and alloys. Refinement of the grain size to the nanometre scale brings about a significant increase in the mechanical strength of the materials because of the increased number of grain boundaries which act as obstacles to sliding dislocations. A similar effect is obtained if nanoscale precipitates are uniformly distributed in coarse grained matrix. The development of nanograin sized alloys raises the important question of whether or not these two mechanisms are "additive" and precipitate strengthening is effective in nanostructured materials. In the reported work, hydrostatic extrusion (HE) was used to obtain nanostructured 7475 aluminium alloy. Nanosized precipitates were obtained by post-HE annealing. It was found that such annealing at the low temperatures (100 degrees C) results in a significant increase in the microhardness (HV0.2) and strength of the nanostructured 7475 aluminium alloy. These results are discussed in terms of the interplay between the precipitation and deformation of nanocrystalline metals.

  14. Teaching Strategies for Strengthening Environmental Values

    Directory of Open Access Journals (Sweden)

    Marilin del Carmen González Castillo

    2017-02-01

    Full Text Available This study aims to apply teaching strategies for strengthening the environmental values in the teachers of School Children's House "Linda Barinas" located in the Carmen parish, municipality Barinas, Barinas state. The nature of the study was inserted into the qualitative paradigm, the kind of research in an action research based on a field study. Key informants were five (05 teachers working in the aforementioned institution. The technique for collecting information through an in-depth interview. The technique and data analysis was performed by means of categorization, triangulation and theorizing. The study led to the conclusion: teachers are unaware of employed teaching strategies, learning strategies in addressing environmental education. In addition, the institution lacks the promotion of educational activities that contribute to improving the environment. Similarly, the absence of a positive attitude towards the environment in which every member of the institution appropriates the existing environmental problems at school. In implementing the action plan training workshops conducted for teachers regarding teaching strategies, environmental values and environmental education, produced a motivation and interest of how to implement that knowledge, when planning, organizing and controlling.

  15. Brazing copper to dispersion-strengthened copper

    Science.gov (United States)

    Ryding, David G.; Allen, Douglas; Lee, Richard H.

    1996-11-01

    The advanced photon source is a state-of-the-art synchrotron light source that will produce intense x-ray beams, which will allow the study of smaller samples and faster reactions and processes at a greater level of detail than has ben possible to date. The beam is produced by using third- generation insertion devices in a 7-GeV electron/positron storage ring that is 1,104 meters in circumference. The heat load from these intense high-power devices is very high, and certain components must sustain total heat loads of 3 to 15 kW and heat fluxes of 30 W/mm$_2). Because the beams will cycle on and off many times, thermal shock and fatigue will be a problem. High heat flux impinging on a small area causes a large thermal gradient that results in high stress. GlidCop, a dispersion-strengthened copper, is the desired design material because of its high thermal conductivity and superior mechanical properties as compared to copper and its alloys. GlidCop is not amenable to joining by fusion welding, and brazing requires diligence because of high diffusivity. Brazing procedures were developed using optical and scanning electron microscopy.

  16. Health-system strengthening and tuberculosis control.

    Science.gov (United States)

    Atun, Rifat; Weil, Diana E C; Eang, Mao Tan; Mwakyusa, David

    2010-06-19

    Weak health systems are hindering global efforts for tuberculosis care and control, but little evidence is available on effective interventions to address system bottlenecks. This report examines published evidence, programme reviews, and case studies to identify innovations in system design and tuberculosis control to resolve these bottlenecks. We outline system bottlenecks in relation to governance, financing, supply chain management, human resources, health-information systems, and service delivery; and adverse effects from rapid introduction of suboptimum system designs. This report also documents innovative solutions for disease control and system design. Solutions pursued in individual countries are specific to the nature of the tuberculosis epidemic, the underlying national health system, and the contributors engaged: no one size fits all. Findings from countries, including Bangladesh, Cambodia, India, Tanzania, Thailand, and Vietnam, suggest that advances in disease control and system strengthening are complementary. Tuberculosis care and control are essential elements of health systems, and simultaneous efforts to innovate systems and disease response are mutually reinforcing. Highly varied and context-specific responses to tuberculosis show that solutions need to be documented and compared to develop evidence-based policies and practice. Copyright 2010 Elsevier Ltd. All rights reserved.

  17. Austenite strengthening and softening during hot deformation

    International Nuclear Information System (INIS)

    Tushinskij, L.I.; Vlasov, V.S.; Kazimirova, I.E.; Tokarev, A.O.

    1981-01-01

    Processes of formation of austenite structure of 20 and 12Kh18N10T steels during hot deformation and postdeformation isothermal holdings have been investigated by the methods of analysis of curves of hot deformation, high-temperature metallography and light microscopy. Deformation has been exercised by extention in vacuum with average 4x10 -2 s -1 rate. Deformation temperatures of steel 20 are 930 and 1000 deg C, of steel 12Kh18N10T - 1100 deg C. It is stated that dynamic recrystallization takes place in both investigated steels during hot deformation. In the carbonic steel it is developed by shifting sections of high-angular boundaries, flow stress in this case remains constant. Recrystallization is developed by subgrain coalescence in austenite steel, that brings about preservation of increased defect density in recrystallized volumes. As a result strengthening of steel is continued up to fracture during the increase of the deformation degree. Postdeformation weakening of 12Kh18N10T steel is slowed down as compared with weakening of carbonic steel [ru

  18. Strengthening CERN’s international relations

    CERN Multimedia

    2010-01-01

    Council’s decision in June to open membership of CERN to the world in a clear and well-defined way means that it’s time to strengthen our international relations. Non-Member State interest, and participation, in CERN has been rising for many years, and with the LHC running smoothly that trend is continuing.   Furthermore, the long-term future of particle physics may well see Europe contributing to facilities in other regions of the world, with European participation coordinated through CERN. It was with these developments in mind that I established the External Relations Office under Felicitas Pauss at the start of my mandate last year. Council’s decision underlines the need for that office, and clarifies its liaison role of with Member and non-Member States. Clarity of function demands clarity of name, so from now on, the Office will be known as the Office for International Relations. It will continue to be headed by Felicitas Pauss. The Office’s main r...

  19. Strengthening foundation phase teacher education through mentoring

    Directory of Open Access Journals (Sweden)

    Kerryn Dixon

    2012-07-01

    Full Text Available This paper explores a multidimensional mentorship model implemented between lecturers from the foundation phase at the Wits School of Education and four master’s students from the University of Limpopo, as part of the Departments of Education’s research initiative to strengthen foundation phase teacher education. Using three critical incidents, we interrogate mentors’ experiences of their mentoring practices. Two sets of literature, mentoring and social capital are used as a lens for analysing these incidents. Initial findings suggest the relationship has moved from the initiation to cultivation stage (Kram, 1985; Ragins & Kram, 2007. But, cultural preconceptions, implicit assumptions and institutional practices can impede or enhance information flows and trust. It is argued that weak ties characterised by mentors’ heterogeneity is a strength that has resulted in growing professional development. Through a process of reflection-on-practice, we have begun to think of ourselves as a fledging community of practice. This opens up possibilities for the larger research project.

  20. Achievements to date in strengthened safeguards

    International Nuclear Information System (INIS)

    Heinonen, O.

    1999-01-01

    There is substantial progress in developing and implementing measures to strengthen the effectiveness and improve the efficiency of the Safeguards System. The measures comprise those to be implemented pursuant to the Agency's legal authority conferred by existing safeguards agreements as well as those to be implemented under the complementary legal authority conferred by Additional Protocols concluded on the basis of Document INFCIRC/540(Corrected). Activities on implementing measures under existing legal authority, particularly with respect to the evaluation of States' nuclear programmes, environmental sampling and the use of remote monitoring for safeguards purposes had been carried continuously ion the recent post. In 1998, additional protocols entered into force with four States (the Holy See, Jordan, New Zealand and Uzbekistan). Additional protocols with a further 27 States were approved by the Board and were awaiting ratification by the respective States. The additional protocol with Australia, which entered into force in December 1997, was being implemented following receipt of its Article 2 declaration. Agency consultations on concluding additional protocols take place with a number of States on a regular basis. As of 1 October 1999, Additional Protocols had been concluded and approved by the Board of Governors with a total of 45 States. Of these, Additional Protocols with 44 States had been signed and five had entered into force. (author)

  1. Strengthened enforcement enhances marine sanctuary performance

    Directory of Open Access Journals (Sweden)

    Brendan P. Kelaher

    2015-01-01

    Full Text Available Marine sanctuaries are areas where the extraction of biota is not permitted. Although most marine sanctuaries have a positive influence on biotic communities, not all sanctuaries are meeting their conservation objectives. Amidst possible explanations (e.g., size, age and isolation, insufficient enforcement is often speculated to be a key driver of marine sanctuary underperformance. Despite this, there are few studies directly linking quantitative enforcement data to changes in biotic communities within marine sanctuaries. Here, we used an asymmetrical-BACI experimental design from 2006–2012 to test whether new enforcement initiatives enhanced abundances of target fishes and threatened species in an existing large sub-tropical marine sanctuary relative to areas open to fishing. Implementation of the new enforcement initiatives in 2010 was associated with a 201% increase in annual fine rate and a significant increase in target fish and elasmobranch abundance, as well as sightings of a critically-endangered shark, in the marine sanctuary relative to areas open to fishing. Overall, these results demonstrate that strengthening enforcement can have a rapid positive influence on target fish and perhaps threatened species in a subtropical marine sanctuary. From this, we contend that increased enforcement guided by risk-based compliance planning and operations may be a useful first step for improving underperforming marine sanctuaries.

  2. Strengthening Self-efficacy through Supportive Mentoring

    Science.gov (United States)

    Haacker, R.

    2015-12-01

    The geosciences have had a chronic problem of underrepresentation of students from diverse ethnic, cultural, gender and socio-economic backgrounds. As a community we need to strengthen our support of young scientists from all backgrounds to sustain their enthusiasm and ensure their success in our field. Investing in mentoring programs that empower students and young professionals is one of the best ways to do so. The Significant Opportunities in Atmospheric Research and Science (SOARS) program, now entering its 20th year, has successfully developed and tested several mentoring models. The personalized, caring and consistent support is one of the key elements of the program's success; since its inception, 90% of SOARS participants have entered graduate school, research or science related careers after graduation. Many of our alumni who are now faculty apply the same mentoring strategies to build self-esteem and perseverance in their students. This presentation will cover the design and implementation of our four mentoring strategies, and provide insights on potential challenges, training aspects and impact assessment. The mentoring strategies include: 1) Multi-faceted, long-term mentoring of undergraduate and graduate students from diverse backgrounds. 2) Empowering advanced students to serve as peer mentors and role models. 3) Training faculty and professional scientists from all backgrounds to become mentors who are aware of diversity issues. 4) Providing mentor training for partner programs and laboratories. All four strategies have contributed to the creation of a mentoring culture in the geosciences.

  3. Early predictors of health-related quality of life outcomes in polytrauma patients with spine injuries: a level 1 trauma center study.

    Science.gov (United States)

    Tee, J W; Chan, C H P; Gruen, R L; Fitzgerald, M C B; Liew, S M; Cameron, P A; Rosenfeld, J V

    2014-02-01

    Study Design Retrospective review on clinical-quality trauma registry prospective data. Objective To identify early predictors of suboptimal health status in polytrauma patients with spine injuries. Methods A retrospective review on a prospective cohort was performed on spine-injured polytrauma patients with successful discharge from May 2009 to January 2011. The Short Form 12-Questionnaire Health Survey (SF-12) was used in the health status assessment of these patients. Univariate and multivariate logistic regression models were applied to investigate the effects of the Injury Severity Score, age, blood sugar level, vital signs, brain trauma severity, comorbidities, coagulation profile, spine trauma-related neurologic status, and spine injury characteristics of the patients. Results The SF-12 had a 52.3% completion rate from 915 patients. The patients who completed the SF-12 were younger, and there were fewer patients with severe spinal cord injuries (American Spinal Injury Association classifications A, B, and C). Other comparison parameters were satisfactorily matched. Multivariate logistic regression revealed five early predictive factors with statistical significance (p ≤ 0.05). They were (1) tachycardia (odds ratio [OR] = 1.88; confidence interval [CI] = 1.11 to 3.19), (2) hyperglycemia (OR = 2.65; CI = 1.51 to 4.65), (3) multiple chronic comorbidities (OR = 2.98; CI = 1.68 to 5.26), and (4) thoracic spine injuries (OR = 1.54; CI = 1.01 to 2.37). There were no independent early predictive factors identified for suboptimal mental health-related qualify of life outcomes. Conclusion Early independent risk factors predictive of suboptimal physical health status identified in a level 1 trauma center in polytrauma patients with spine injuries were tachycardia, hyperglycemia, multiple chronic medical comorbidities, and thoracic spine injuries. Early spine trauma risk factors were shown not to predict suboptimal mental

  4. [The importance of an early accompanying evaluation of new care forms for the development of indicators for quality assurance in outpatient psychiatric integrated care].

    Science.gov (United States)

    Hausen, A; Glaeske, G

    2015-05-01

    Aim of this contribution is to illustrate the imp-ortance of an early accompanying evaluation of new care forms for the development of indicators. The illustration uses the experience of the accompanying evaluation of the integrated care model for optimisation of outpatient psychiatric care. For the integrated care model we could develop potential indicators by using medical-psychiatric and insured-related routine data, but all potential indicators need further development to enable reliable statements about achieved quality targets. It is shown that the development of indicators in the outpatient psychiatric integrated care is affected by many different factors such as vague target agreements in the contract and missing contractual agreements for the data. As a result it is illustrated that in this project the evaluation was introduced after implementation of this new form of care and the already established contract and the data management impeded the development of indicators. © Georg Thieme Verlag KG Stuttgart · New York.

  5. Assessing the outcome of Strengthening Laboratory Management ...

    African Journals Online (AJOL)

    SLMTA) is a competency-based management training programme designed to bring about immediate and measurable laboratory improvement. The aim of this study is to assess the outcome of SLMTA on laboratory quality management system in ...

  6. STRengthening analytical thinking for observational studies

    DEFF Research Database (Denmark)

    Sauerbrei, Willi; Abrahamowicz, Michal; Altman, Douglas G.

    2014-01-01

    The validity and practical utility of observational medical research depends critically on good study design, excellent data quality, appropriate statistical methods and accurate interpretation of results. Statistical methodology has seen substantial development in recent times. Unfortunately, ma...

  7. Strengthening Environmental Economics Capacity in Research on ...

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

    ... change are likely to have a negative impact on water availability and quality. ... on water provision services in Latin America using environmental economics methods. ... Effect of hydro-meteorological emergencies on internal migration.

  8. ORIGINAL ARTICLES Academic hospital accreditation strengthens ...

    African Journals Online (AJOL)

    This case study originated from the combined experiences of the accreditation process of a ... (iv) the benefits of hospital accreditation and quality management. The study ... Tertiary healthcare is in a crisis after nearly 3 decades of neglect,2,3.

  9. The wider social environment and changes in self-reported quality of life in the transition from late childhood to early adolescence: a cohort study

    Science.gov (United States)

    Drukker, Marjan; Kaplan, Charles; Schneiders, Josien; Feron, Frans JM; van Os, Jim

    2006-01-01

    Background Neighbourhood socioeconomic disadvantage and social capital have been associated with adolescent well-being, but the majority of studies were cross-sectional, and the time window over which the neighbourhood may impact on development is unknown. Therefore, the contribution of the neighbourhood environment to adolescents' quality of life and the course of these effects during the period of transition from childhood to early adolescence was examined. Methods A cohort of adolescents living in Maastricht (The Netherlands), with a mean age of 11.2 years at baseline and of 13.5 years at follow-up was followed. Adolescents who responded both at baseline and at follow-up were included in the analysis (n = 475). Multilevel regression analyses estimated neighbourhood effects while controlling for individual-level effects. Neighbourhood-level socioeconomic and social capital variables, individual-level confounders, and baseline values of the outcome measures were included in the models. Results None of the neighbourhood factors was associated with changes in general health or mental health over the two-year period. However, two-year exposure to greater disparity between individual level socioeconomic status on the one hand and neighbourhood level of socioeconomic status on the other (e.g. high socioeconomic status adolescents living in deprived neighbourhoods and vice versa) negatively impacted on self-esteem and satisfaction. Conclusion The neighbourhood environment per se does not contribute to change in quality of life during the transition to early adolescence. However, adolescents living in families whose socioeconomic status deviates from the mean level of neighbourhood socioeconomic deprivation may be negatively affected. PMID:16707015

  10. The wider social environment and changes in self-reported quality of life in the transition from late childhood to early adolescence: a cohort study

    Directory of Open Access Journals (Sweden)

    Schneiders Josien

    2006-05-01

    Full Text Available Abstract Background Neighbourhood socioeconomic disadvantage and social capital have been associated with adolescent well-being, but the majority of studies were cross-sectional, and the time window over which the neighbourhood may impact on development is unknown. Therefore, the contribution of the neighbourhood environment to adolescents' quality of life and the course of these effects during the period of transition from childhood to early adolescence was examined. Methods A cohort of adolescents living in Maastricht (The Netherlands, with a mean age of 11.2 years at baseline and of 13.5 years at follow-up was followed. Adolescents who responded both at baseline and at follow-up were included in the analysis (n = 475. Multilevel regression analyses estimated neighbourhood effects while controlling for individual-level effects. Neighbourhood-level socioeconomic and social capital variables, individual-level confounders, and baseline values of the outcome measures were included in the models. Results None of the neighbourhood factors was associated with changes in general health or mental health over the two-year period. However, two-year exposure to greater disparity between individual level socioeconomic status on the one hand and neighbourhood level of socioeconomic status on the other (e.g. high socioeconomic status adolescents living in deprived neighbourhoods and vice versa negatively impacted on self-esteem and satisfaction. Conclusion The neighbourhood environment per se does not contribute to change in quality of life during the transition to early adolescence. However, adolescents living in families whose socioeconomic status deviates from the mean level of neighbourhood socioeconomic deprivation may be negatively affected.

  11. Factors associated with sustainability of 2 quality improvement programs after achieving early implementation success. A qualitative case study.

    Science.gov (United States)

    Ament, Stephanie M C; Gillissen, Freek; Moser, Albine; Maessen, José M C; Dirksen, Carmen D; von Meyenfeldt, Maarten F; van der Weijden, Trudy

    2017-12-01

    Sustainability of innovations is a relatively new concept in health care research and has become an issue of growing interest. The current study explored factors related to the sustainability of 2 multidisciplinary hospital-based programs 3 to 6 years after achieving early implementation success. An exploratory qualitative study was conducted into 2 implementation cases, an Enhanced Recovery After Surgery program for colorectal surgery and a short-stay program for breast cancer surgery. Semistructured interviews were held with key persons involved in the care process in 14 hospitals from both cases minimally 3 years after the implementation, between March 2012 and May 2013. The Consolidated Framework for Implementation Research was used to direct the development of the interview guide, during data collection and during analysis. A directed content analysis was performed. A total of 21 interviews with 26 individuals were held, 18 regarding the Enhanced Recovery After Surgery case and 8 regarding the short-stay program case. Respondents mentioned the following factors associated with sustainability of the programs: modification and adaptability of the program, cost-effectiveness, institutionalization into existing systems, short communication lines within the multidisciplinary team, an innovative culture, benefits for patients, cosmopolitanism, the existence of external policies and incentives, trust and belief in the program, and spread of the program to other settings. Two factors are not covered by the Consolidated Framework for Implementation Research, ie, modification of the program over the years and spread of the program to other contexts. The factors associated with sustainability put forward in both cases were largely the same. Leadership and the implementation project were not mentioned as having influenced the long-term sustainability of the benefits achieved. Sustainability of the innovations is influenced by determinants stemming from all ecological

  12. Influence of Pre- and Postharvest Summer Pruning on the Growth, Yield, Fruit Quality, and Carbohydrate Content of Early Season Peach Cultivars

    Science.gov (United States)

    Ikinci, Ali

    2014-01-01

    Winter and summer pruning are widely applied processes in all fruit trees, including in peach orchard management. This study was conducted to determine the effects of summer prunings (SP), as compared to winter pruning (WP), on shoot length, shoot diameter, trunk cross sectional area (TCSA) increment, fruit yield, fruit quality, and carbohydrate content of two early ripening peach cultivars (“Early Red” and “Maycrest”) of six years of age, grown in semiarid climate conditions, in 2008 to 2010. The trees were grafted on GF 677 rootstocks, trained with a central leader system, and spaced 5 × 5 m apart. The SP carried out after harvesting in July and August decreased the shoot length significantly; however, it increased its diameter. Compared to 2009, this effect was more marked in year 2010. In general, control and winter pruned trees of both cultivars had the highest TCSA increment and yield efficiency. The SP increased the average fruit weight and soluble solids contents (SSC) more than both control and WP. The titratable acidity showed no consistent response to pruning time. The carbohydrate accumulation in shoot was higher in WP and in control than in SP trees. SP significantly affected carbohydrate accumulation; postharvest pruning showed higher carbohydrate content than preharvest pruning. PMID:24737954

  13. Epidemiological evaluation quality of life in patients suffering from early rheumatoid arthritis: a pragmatic, prospective, randomized, blind allocation controlled of a modular program group intervention

    Directory of Open Access Journals (Sweden)

    Hadi Yousefi

    2015-11-01

    Full Text Available OBJECTIVES: Epidemiology has taken on new roles in the management of health care services. In this study, we developed a non-pharmacological self-management modular program group intervention and evaluated its efficacy as an adjunct therapy in patients suffering from early rheumatoid arthritis (RA. METHODS: Patients were randomized to either participate in a non-equivalent intervention group along with the standard of care or only receive standard-of-care treatment at a community rheumatology center. The outcomes measured were a pain visual analog scale (VAS, patient general health (GH on a VAS, and the Short Form 36 Health Survey version 2 scale measuring quality of life. These parameters were evaluated in the first week to obtain baseline values, and at 20, 32, 48, and 60 weeks to evaluate the efficacy of the intervention group. RESULTS: The patients were randomized, with 100 patients in the intervention group and 106 in the control group. The intervention and control groups were similar with regard to the percentage of women (86% vs. 89.6%, tobacco usage (25% vs. 19.8%, mean age (42.6±13.2 years vs. 46.6±10.9 years, and disease duration (15.3±6.7 months vs. 14.5±6.6 months. The mean outcomes were significantly different between the two groups, and post-hoc pairwise analysis demonstrated significant deterioration in the control group in contrast to improvement in the intervention group at the second, third, fourth, and fifth evaluations. Improvements were often seen as early as the 12-week and 24-week follow-up visits. CONCLUSIONS: Epidemiology contributes to the evaluation of how well specific therapies or other health interventions prevent or control health problems. The modular program group intervention implemented in this study appears to be a suitable and feasible method to facilitate much more comprehensive management of early RA in socioeconomically challenged communities.

  14. Comparison of the Psychological Symptoms and Disease-Specific Quality of Life between Early- and Typical-Onset Parkinson’s Disease Patients

    Directory of Open Access Journals (Sweden)

    Seyed-Mohammad Fereshtehnejad

    2014-01-01

    Full Text Available The impact of Parkinson’s disease (PD on psychological status and quality of life (QoL may vary depending on age of disease onset. The aim of this study was to compare psychological symptoms and disease-specific QoL between early onset versus the rest of the PD patients. A total number of 140 PD patients with the mean current age of 61.3 (SD=10.4 yr were recruited in this study. PD patients with the onset age of ≤50 yr were defined as “early-onset” (EOPD group (n=45, while the ones with >50 yr at the time of diagnosis were categorized as the “typical-onset” (TOPD patients (n=95. Different questionnaires and scales were used for between-group comparisons including PDQ39, HADS (hospital anxiety and depression scale, FSS (fatigue severity scale, MNA (mininutritional assessment, and the UPDRS. Depression score was significantly higher in EOPD group (6.3 (SD=4.5 versus 4.5 (SD=4.2, P=0.02. Among different domains of QoL, emotion score was also significantly higher in the EOPD group (32.3 (SD=21.6 versus 24.4 (SD=22.7, P=0.05. Our findings showed more severe depression and more impaired emotional domain of QoL in early-onset PD patients. Depression and anxiety play an important role to worsen QoL among both EOPD and TOPD patients, while no interaction was observed in the efficacy of these two psychiatric symptoms and the onset age of PD patients.

  15. Personality variables as predictors of early non-metastatic colorectal cancer patients' psychological distress and health-related quality of life: a one-year prospective study.

    Science.gov (United States)

    Hyphantis, Thomas; Paika, Vassiliki; Almyroudi, Augoustina; Kampletsas, Eleftherios O; Pavlidis, Nicholas

    2011-05-01

    We aimed to assess the course of early non-metastatic colorectal cancer patients' psychological distress and health-related quality of life (HRQOL) and to identify relevant clinical and psychological predictors during a one-year period. Of the 144 early non-metastatic colorectal cancer patients initially assessed for psychological distress symptoms (SCL-90-R), HRQOL (WHOQOL-BREF), sense of coherence (SOC), defense mechanisms (LSI) and hostility (HDHQ), 84 (58.3%) completed the one-year follow-up. Mean (SD) age was 65.1 (9.8) years and 67.4% were male. Mean (SD) disease duration was 1.7 (2.2) years, with 49.3% being diagnosed within the last six months. In 75.0% the site was at colon and in 25.0% at rectum; 2.1% had stage I, 59.0% stage II and 38.9% stage III disease. Paranoid ideation, psychoticism, interpersonal sensitivity, anxiety and depressive symptoms increased significantly over the one-year period of the study and most of the HRQOL components were significantly decreased over the same period. Men were at greater risk for further developing depressive symptomatology. Low SOC was independent predictor of depression, while hostility independently predicted anxiety, interpersonal sensitivity and psychoticism symptoms. General psychological distress and low SOC were independent predictors of HRQOL, while repression was also an independent predictor of Physical HRQOL. In early non-metastatic colorectal cancer patients, psychological distress symptoms are increased and HRQOL is decreased over one-year period. Symptoms of psychological distress are strong predictors of HRQOL, while personality variables can also predict psychological distress symptoms' increase and HRQOL decrease over time, and this could be relevant to psychological interventions. Copyright © 2010 Elsevier Inc. All rights reserved.

  16. Improving the engineering strength of heat strengthened glass

    NARCIS (Netherlands)

    Veer, F.A.; Rodichev, YM

    2016-01-01

    Although glass is increasingly used as a structural material, glass is not produced to strength standards, like steel and concrete. Of the three types of glass: annealed, heat strengthened and fully tempered, only heat strengthened glass has the properties to function as a safe structural material.

  17. Using Evidence to Strengthen Health Systems in Africa and the ...

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

    The project is timely for Lebanon, a country that is working to strengthen its primary health care system to respond to current priorities such as the emerging crisis of Syrian refugees. Timely access to information The project will strengthen institutional and individual abilities to conduct and use systematic and rapid reviews to ...

  18. South-South cooperation as a mechanism to strengthen public ...

    African Journals Online (AJOL)

    South-South cooperation as a mechanism to strengthen public health services in Africa: ... PROMOTING ACCESS TO AFRICAN RESEARCH ... Implementation of new models of development cooperation have been on the increase ... health system strengthening, aid effectiveness, sustainable development goals, Africa ...

  19. Comparison of quality of life after stereotactic body radiotherapy and surgery for early-stage prostate cancer

    Directory of Open Access Journals (Sweden)

    Katz Alan

    2012-11-01

    Full Text Available Abstract Background As the long-term efficacy of stereotactic body radiation therapy (SBRT becomes established and other prostate cancer treatment approaches are refined and improved, examination of quality of life (QOL following prostate cancer treatment is critical in driving both patient and clinical treatment decisions. We present the first study to compare QOL after SBRT and radical prostatectomy, with QOL assessed at approximately the same times pre- and post-treatment and using the same validated QOL instrument. Methods Patients with clinically localized prostate cancer were treated with either radical prostatectomy (n = 123 Spanish patients or SBRT (n = 216 American patients. QOL was assessed using the Expanded Prostate Cancer Index Composite (EPIC grouped into urinary, sexual, and bowel domains. For comparison purposes, SBRT EPIC data at baseline, 3 weeks, 5, 11, 24, and 36 months were compared to surgery data at baseline, 1, 6, 12, 24, and 36 months. Differences in patient characteristics between the two groups were assessed using Chi-squared tests for categorical variables and t-tests for continuous variables. Generalized estimating equation (GEE models were constructed for each EPIC scale to account for correlation among repeated measures and used to assess the effect of treatment on QOL. Results The largest differences in QOL occurred in the first 1–6 months after treatment, with larger declines following surgery in urinary and sexual QOL as compared to SBRT, and a larger decline in bowel QOL following SBRT as compared to surgery. Long-term urinary and sexual QOL declines remained clinically significantly lower for surgery patients but not for SBRT patients. Conclusions Overall, these results may have implications for patient and physician clinical decision making which are often influenced by QOL. These differences in sexual, urinary and bowel QOL should be closely considered in selecting the right treatment

  20. Comparison of quality of life after stereotactic body radiotherapy and surgery for early-stage prostate cancer

    International Nuclear Information System (INIS)

    Katz, Alan; Ferrer, Montserrat; Suárez, José Francisco

    2012-01-01

    As the long-term efficacy of stereotactic body radiation therapy (SBRT) becomes established and other prostate cancer treatment approaches are refined and improved, examination of quality of life (QOL) following prostate cancer treatment is critical in driving both patient and clinical treatment decisions. We present the first study to compare QOL after SBRT and radical prostatectomy, with QOL assessed at approximately the same times pre- and post-treatment and using the same validated QOL instrument. Patients with clinically localized prostate cancer were treated with either radical prostatectomy (n = 123 Spanish patients) or SBRT (n = 216 American patients). QOL was assessed using the Expanded Prostate Cancer Index Composite (EPIC) grouped into urinary, sexual, and bowel domains. For comparison purposes, SBRT EPIC data at baseline, 3 weeks, 5, 11, 24, and 36 months were compared to surgery data at baseline, 1, 6, 12, 24, and 36 months. Differences in patient characteristics between the two groups were assessed using Chi-squared tests for categorical variables and t-tests for continuous variables. Generalized estimating equation (GEE) models were constructed for each EPIC scale to account for correlation among repeated measures and used to assess the effect of treatment on QOL. The largest differences in QOL occurred in the first 1–6 months after treatment, with larger declines following surgery in urinary and sexual QOL as compared to SBRT, and a larger decline in bowel QOL following SBRT as compared to surgery. Long-term urinary and sexual QOL declines remained clinically significantly lower for surgery patients but not for SBRT patients. Overall, these results may have implications for patient and physician clinical decision making which are often influenced by QOL. These differences in sexual, urinary and bowel QOL should be closely considered in selecting the right treatment, especially in evaluating the value of non-invasive treatments, such as SBRT

  1. Improved quality of life with immediate versus deferred initiation of antiretroviral therapy in early asymptomatic HIV infection.

    Science.gov (United States)

    Lifson, Alan R; Grund, Birgit; Gardner, Edward M; Kaplan, Richard; Denning, Eileen; Engen, Nicole; Carey, Catherine L; Chen, Fabian; Dao, Sounkalo; Florence, Eric; Sanz, Jesus; Emery, Sean

    2017-04-24

    To determine if immediate compared to deferred initiation of antiretroviral therapy (ART) in healthy persons living with HIV had a more favorable impact on health-related quality of life (QOL), or self-assessed physical, mental, and overall health status. QOL was measured in the Strategic Timing of Antiretroviral Therapy study, which randomized healthy ART-naive persons living with HIV with CD4 cell counts above 500 cells/μl from 35 countries to immediate versus deferred ART. At baseline, months 4 and 12, then annually, participants completed a visual analog scale (VAS) for 'perceived current health' and the Short-Form 12-Item Health Survey version 2 from which the following were computed: general health perception; physical component summary (PCS); and mental component summary (MCS); the VAS and general health were rated from 0 (lowest) to 100 (highest). QOL at study entry was high (mean scores: VAS = 80.9, general health = 72.5, PCS = 53.7, MCS = 48.2). Over a mean follow-up of 3 years, changes in all QOL measures favored the immediate group (P < 0.001); estimated differences were as follows: VAS = 1.9, general health = 3.6, PCS = 0.8, MCS = 0.9. When QOL changes were assessed across various demographic and clinical subgroups, treatment differences continued to favor the immediate group. QOL was poorer in those experiencing primary outcomes; however, when excluding those with primary events, results remained favorable for immediate ART recipients. In an international randomized trial in ART-naive participants with above 500 CD4 cells/μl, there were modest but significant improvements in self-assessed QOL among those initiating ART immediately compared to deferring treatment, supporting patient-perceived health benefits of initiating ART as soon as possible after an HIV diagnosis.

  2. Early Response of Protein Quality Control in Gills Is Associated with Survival of Hypertonic Shock in Mozambique tilapia

    Science.gov (United States)

    Tang, Cheng-Hao; Lee, Tsung-Han

    2013-01-01

    The protein quality control (PQC) mechanism is essential for cell function and viability. PQC with proper biological function depends on molecular chaperones and proteases. The hypertonicity-induced protein damage and responses of PQC mechanism in aquatic organisms, however, are poorly understood. In this study, we examine the short-term effects of different hypertonic shocks on the levels of heat shock proteins (HSPs, e.g., HSP70 and HSP90), ubiquitin-conjugated proteins and protein aggregation in gills of the Mozambique tilapia (Oreochromis mossambicus). Following transfer from fresh water (FW) to 20‰ hypertonicity, all examined individuals survived to the end of experiment. Moreover, the levels of branchial HSPs and ubiquitin-conjugated proteins significantly increased at 3 and 24 h post-transfer, respectively. Up-regulation of HSPs and ubiquitin-conjugated proteins was sufficient to prevent the accumulation of aggregated proteins. However, the survival rate of tilapia dramatically declined at 5 h and all fish died within 7 h after direct transfer to 30‰ hypertonicity. We presumed that this result was due to the failed activation of gill PQC system, which resulted in elevating the levels of aggregated proteins at 3 and 4 h. Furthermore, in aggregated protein fractions, the amounts of gill Na+/K+-ATPase (NKA) remained relatively low when fish were transferred to 20‰ hypertonicity, whereas abundant NKA was found at 4 h post-transfer to 30‰ hypertonicity. This study demonstrated that the response of PQC in gills is earlier than observable changes in localization of ion-secreting transport proteins upon hypertonic challenge. To our knowledge, this is the first study to investigate the regulation of PQC mechanism in fish and characterize its important role in euryhaline teleost survival in response to hypertonic stress. PMID:23690986

  3. Fermentation quality and nutritive value of total mixed ration silages based on desert wormwood (Artemisia desertorum Spreng.) combining with early stage corn.

    Science.gov (United States)

    Yin, Guomei; Bai, Chunsheng; Sun, Juanjuan; Sun, Lin; Xue, Yanlin; Zhang, Yuanyuan; Zhao, Heping; Yu, Zhu; Liu, Sibo; Zhang, Kewei

    2017-12-01

    This study aimed to investigate the fermentation quality and nutritive value of total mixed ration (TMR) silages based on desert wormwood (DW) combined with early stage corn (ESC) as forage and determine an optimum formula. Desert wormwood and ESC were harvested, chopped, and mixed with other ingredients according to a formula, packed into laboratory silos at densities of 500-550 g/L, and stored in the dark for 60 days. The DW proportions in the forage of TMR were 1, 0.75, 0.50, 0.25 and 0, based on fresh weight. As the proportion of DW decreased, the pH also decreased (P total nitrogen in the TMR silages with DW proportions of 0.75, 0.25 and 0 in the forage was more than 10%. These results indicated that the quality of the TMR silage containing DW alone as forage was poor, TMR silages containing DW proportions of 0.75 and 0.25, and ESC alone, in the forage were not well preserved. The optimum TMR silage formula contained a DW proportion of 0.5 in the forage. © 2017 Japanese Society of Animal Science.

  4. Breast cancer early detection and quality assurance in Uruguay; Deteccion precoz de cancer de mama e garantia de calidad en Uruguay

    Energy Technology Data Exchange (ETDEWEB)

    Cotelo, Elena D. [Universidad de la Republica, Montevideo (Uruguay). Facultad de Medicina. Escuela Universitaria de Tecnologia Medica]. E-mail: elecote@adinet.com.uy

    2001-07-01

    In Uruguay, breast cancer incidence is 76.41 per 100.000, and death rate is 25.22 per 100.000. Since 1998, there is a National Programme of breast cancer early detection for females over forty years of age. We studied the state of the mammography facilities throughout the country. There are 657.000 female over forty and 51 mammography X-ray equipment. The Programme includes 2 mammography X-ray equipment in mobile units in the capital and 18 in hospitals all around the country. There are taken 120.000 mammographic exams per year, 15.000 of them belong to women who had participated in the Programme. We found that no mammography facility has established Quality Assurance Programmes. Despite the results of this study showed that is suitable the number and age of the mammography X-ray equipment, the lack of Quality Assurance Programmes will produce, in a short time, a negative cost-benefit balance. The consequences will be serious social, human an economical damages. (author)

  5. Regeneration of Mature Norway Spruce Stands: Early Effects of Selective Cutting and Clear Cutting on Seepage Water Quality and Soil Fertility

    Directory of Open Access Journals (Sweden)

    Wendelin Weis

    2001-01-01

    Full Text Available The cutting of trees influences element turnover in the forest ecosystem. The reduction of plant uptake, as well as an increased mineralization and nitrification due to higher soil temperature and soil moisture, can lead to considerable losses of nutrients from the main rooting zone. This may result in a reduced soil fertility and a decrease in drinking water quality due to high nitrate concentrations in the seepage water. In Bavaria (Germany selective cutting is preferred to clear cutting when initiating the regeneration of Norway spruce stands with European beech. This paper summarizes the early effects of both forest management practices on soil fertility and seepage water quality for three different sites. Shown are the concentrations of nitrogen and base cations in the seepage water as well as the water and ion fluxes during the first year after tree cut. Nutrient inputs decreased on thinned plots and even more at clear-cuts. Nitrate concentrations in the seepage water are hardly affected by moderate thinning; however, on clear-cuts, the nitrate concentration increases significantly, and base cations are lost from the upper mineral soil. This effect is less obvious at sites where a dense ground vegetation, which is able to take up excess nitrogen, exists.

  6. Research and Application of an Air Quality Early Warning System Based on a Modified Least Squares Support Vector Machine and a Cloud Model

    Science.gov (United States)

    Wang, Jianzhou; Niu, Tong; Wang, Rui

    2017-01-01

    The worsening atmospheric pollution increases the necessity of air quality early warning systems (EWSs). Despite the fact that a massive amount of investigation about EWS in theory and practicality has been conducted by numerous researchers, studies concerning the quantification of uncertain information and comprehensive evaluation are still lacking, which impedes further development in the area. In this paper, firstly a comprehensive warning system is proposed, which consists of two vital indispensable modules, namely effective forecasting and scientific evaluation, respectively. For the forecasting module, a novel hybrid model combining the theory of data preprocessing and numerical optimization is first developed to implement effective forecasting for air pollutant concentration. Especially, in order to further enhance the accuracy and robustness of the warning system, interval forecasting is implemented to quantify the uncertainties generated by forecasts, which can provide significant risk signals by using point forecasting for decision-makers. For the evaluation module, a cloud model, based on probability and fuzzy set theory, is developed to perform comprehensive evaluations of air quality, which can realize the transformation between qualitative concept and quantitative data. To verify the effectiveness and efficiency of the warning system, extensive simulations based on air pollutants data from Dalian in China were effectively implemented, which illustrate that the warning system is not only remarkably high-performance, but also widely applicable. PMID:28257122

  7. Objectively Assessed Exercise Behavior in Chinese Patients with Early-Stage Cancer: A Predictor of Perceived Benefits, Communication with Doctors, Medical Coping Modes, Depression and Quality of Life.

    Science.gov (United States)

    Liu, Zhunzhun; Zhang, Lanfeng; Shi, Songsong; Xia, Wenkai

    2017-01-01

    This study sought to identify factors associated with objectively assessed exercise behavior in Chinese patients with early-stage cancer. Three hundred and fifty one cancer patients were recruited from the Affiliated Jiangyin Hospital of Southeast University Medical College and the Nantong Tumor Hospital. One-way ANOVA, Pearson Chi-square tests and regression analysis were employed to identify the correlations between physical exercise and the measured factors. The results showed that occupation type (χ2 = 14.065; p = 0.029), monthly individual monthly income level (χ2 = 24.795; p = 0.003), BMI (χ2 = 15.709; p = 0.015) and diagnosis (χ2 = 42.442; p exercise with different frequency per week. Differences in the frequency of exercise were associated with different degrees of reported Benefit Finding (BF) (F = 24.651; p exercise. Our results indicated that benefit finding, medical coping modes, communication with doctors, social support, depression and quality of life were significantly correlated with exercise. The variance in several psychosocial factors (benefit finding, medical coping modes, the communication with doctors, depression and quality of life) could be explained by exercise. Psychosocial factors should be addressed and examined over time when evaluating the effect of physical exercise that is prescribed as a clinically relevant treatment.

  8. Strengthening and stress relaxation of Opalinus Clay

    International Nuclear Information System (INIS)

    Schulze, Otto

    2010-01-01

    undisturbed far-field for the long lasting periods of geological times. Consequently, demands on concepts for backfilling and closure of a repository in a clay-stone formation as well as model calculations for safety analyses generally do not take into account convergence by viscous deformation, which would result from stress re-distribution at underground openings. Although there is some doubt, whether Opalinus Clay is creeping at all, some very long lasting laboratory tests were performed on this item in the author's laboratory. A nearly linear dependence of the long-term creep rate on the deviatoric stress was found. In recent work, the technique of stress-relaxation was used. For this, strengthening by strain rate controlled deformation was stopped, i.e. the strain was kept constant for a long time, and the relaxation of the stress was measured. In course of this technique, the deformability which may result from artefacts is ruled out as far as possible by compaction and strengthening. Then, the stress relaxation - if any - will be maintained by true long-term deformation processes which should be active and responsible for any convergence in an at least only partly backfilled mine. In this contribution, the results of the laboratory work and their discussion will be presented. (authors)

  9. Strengthening the regulatory control of consumer goods through international harmonization

    International Nuclear Information System (INIS)

    Yus Rusdian Akhmad

    2013-01-01

    The International Atomic Energy Agency (IAEA) is currently working on a recommendation in the form of guidelines for regulating consumer goods. Preparation of this document has a significant dimension of international issues, especially in terms of the application of the principles of justification and application of the concept of exemption. International harmonization among regulators ranging from the regional to the global level is a central issue and considering the complex issues that arise in addition to covering the scientific aspects also involve consideration of the legal aspects or values espoused by any State which may differ from one another. PERKA BAPETEN on consumer goods is still in the preparation stage so that the discussion of the material will be useful for improving the quality of the regulation in time. There is a significant gap of understanding to the related materials by the parties concerned (between local and international parties were among the local party). This paper intends to propose the understanding and views on radiation protection and regulatory control for consumer goods and hopely could contributed significantly to strengthening its regulatory control which is primarily through a reduction in the gap of understanding to the related concept that potentially multi perceptions and encourage stronger cooperation among regulatory bodies. (author)

  10. Strengthening the academic usage of social media: An exploratory study

    Directory of Open Access Journals (Sweden)

    Murad Ali

    2017-10-01

    Full Text Available Technology strengthens learning and dominates over the conventional methods in too many aspects. Technologies are advancing learning procedure by their multiple formats, variety of resources, numerous delivery channels and not restricted to time space and place. Social media is a new form of communication that transformed the entire landscape of information access and dissemination online. This platform consists of a range of communication channels, considerably popular among students and assists them in various types of communication and collaborative learning. However, the platform of social media can also be considered as a source of distractions and divert student’s attention from learning and academic achievements. The principal objective of the current study is to understand the recent trends of social media use, the phenomenon of distractions and factors out convincing students for the academic use of social media. Interviews administered to enquire the phenomenon and analyzed with the help of ATLAS-Ti-7 and MS Excel. It is concluded from the results that individual psychological characteristics, social influences, information quality and system usefulness are the leading factors. Furthermore, the survey established the importance of this platform for academic purposes and perception concerning the phenomenon of distraction. In addition, future research directions and study limitations are discussed.

  11. RAF 9054 - Strengthening Radioactive Waste Management in Africa

    International Nuclear Information System (INIS)

    Atogo, M.

    2017-01-01

    Radioactive waste is waste that contains Radioactive Material . It is usually a by-product of nuclear power generation and other applications of nuclear fission or nuclear technology, such as research and medicine. Radioactive waste management is a requirement to protect human beings and the environment from radioactive hazards now and for the long term. The application of management system requirements shall be graded to deploy resources at appropriate levels. Grading should not be used as a justification for not applying all of the necessary management system elements or required quality controls. The classification of RW is important to allow for easy handling and transportation and enhancement of safety while going through the process of waste management. The AFRA project “Strengthening Waste Management Infrastructure”, RAF/4/015 was initiated in 1996 by the IAEA. The objective of the project was to build the RWM infrastructure of AFRA member state. A follow-up project “Sustaining Waste Management Infrastructure”, RAF/3/005, was approved in 2005 for a duration of 5 years to help sustain the RWM capabilities and programs initiated in the AFRA member states as well as to help the new African countries joining the IAEA. RAF 9054 provides for a framework for the formulation of relevant legislations and technical skills for the establishment for a framework for the safe management of radioactive waste

  12. Information collection strategies to support strengthened safeguards

    International Nuclear Information System (INIS)

    Costantini, L.; Hill, J.

    2001-01-01

    The IAEA Board of Governors approved the implementation of Part 1 of Strengthened Safeguards in June 1995. Since then, the collection and analysis of information beyond that provided by States parties and acquired by inspectors under NPT Safeguards Agreements has been an integral part of IAEA safeguards. The Agency has formally established internal structures and procedures to facilitate the effective use of open-source and other information not previously used in safeguards. Over this period the IAEA Division of Safeguards Information Technology (SGIT) has been building its collections of electronically held open source information. Some of these collections are quite nuclear-specific, such as material from the Monterey Institute in California, and nuclear news collections provided voluntarily by a number of Member States. Others are completely general news sources. Several of these collections contain many more reports than could possibly be reviewed by a human analyst. So a need has arisen for computerised search facilities to identify nuclear-relevant items from those collections. The Agency has more than one piece of software available to help searching and analysis of substantial collections of reports. Search 97 from Verity was chosen for this particular application because it is very straightforward to use, and it was expected that personnel from all over the Department of Safeguards would carry out these searches on a routine basis. The approach whereby special-purpose search mechanisms are designed for use by a large number of users, who are unfamiliar with the details of the search software, seems to be unusual if not unique to the Agency

  13. Quality improvement and emerging global health priorities

    Science.gov (United States)

    Mensah Abrampah, Nana; Syed, Shamsuzzoha Babar; Hirschhorn, Lisa R; Nambiar, Bejoy; Iqbal, Usman; Garcia-Elorrio, Ezequiel; Chattu, Vijay Kumar; Devnani, Mahesh; Kelley, Edward

    2018-01-01

    Abstract Quality improvement approaches can strengthen action on a range of global health priorities. Quality improvement efforts are uniquely placed to reorient care delivery systems towards integrated people-centred health services and strengthen health systems to achieve Universal Health Coverage (UHC). This article makes the case for addressing shortfalls of previous agendas by articulating the critical role of quality improvement in the Sustainable Development Goal era. Quality improvement can stimulate convergence between health security and health systems; address global health security priorities through participatory quality improvement approaches; and improve health outcomes at all levels of the health system. Entry points for action include the linkage with antimicrobial resistance and the contentious issue of the health of migrants. The work required includes focussed attention on the continuum of national quality policy formulation, implementation and learning; alongside strengthening the measurement-improvement linkage. Quality improvement plays a key role in strengthening health systems to achieve UHC. PMID:29873793

  14. Effects of Meditation versus Music Listening on Perceived Stress, Mood, Sleep, and Quality of Life in Adults with Early Memory Loss: A Pilot Randomized Controlled Trial.

    Science.gov (United States)

    Innes, Kim E; Selfe, Terry Kit; Khalsa, Dharma Singh; Kandati, Sahiti

    2016-04-08

    Older adults with subjective cognitive decline (SCD) are at increased risk not only for Alzheimer's disease, but for poor mental health, impaired sleep, and diminished quality of life (QOL), which in turn, contribute to further cognitive decline, highlighting the need for early intervention. In this randomized controlled trial, we assessed the effects of two 12-week relaxation programs, Kirtan Kriya Meditation (KK) and music listening (ML), on perceived stress, sleep, mood, and health-related QOL in older adults with SCD. Sixty community-dwelling older adults with SCD were randomized to a KK or ML program and asked to practice 12 minutes daily for 12 weeks, then at their discretion for the following 3 months. At baseline, 12 weeks, and 26 weeks, perceived stress, mood, psychological well-being, sleep quality, and health-related QOL were measured using well-validated instruments. Fifty-three participants (88%) completed the 6-month study. Participants in both groups showed significant improvement at 12 weeks in psychological well-being and in multiple domains of mood and sleep quality (p's≤0.05). Relative to ML, those assigned to KK showed greater gains in perceived stress, mood, psychological well-being, and QOL-Mental Health (p's≤0.09). Observed gains were sustained or improved at 6 months, with both groups showing marked and significant improvement in all outcomes. Changes were unrelated to treatment expectancies. Findings suggest that practice of a simple meditation or ML program may improve stress, mood, well-being, sleep, and QOL in adults with SCD, with benefits sustained at 6 months and gains that were particularly pronounced in the KK group.

  15. Health-related quality of life and chronic obstructive pulmonary disease in early stages - longitudinal results from the population-based KORA cohort in a working age population.

    Science.gov (United States)

    Wacker, Margarethe E; Hunger, Matthias; Karrasch, Stefan; Heinrich, Joachim; Peters, Annette; Schulz, Holger; Holle, Rolf

    2014-08-09

    It is widely recognized that health-related quality of life (HRQL) is impaired in patients with Chronic Obstructive Pulmonary Disease (COPD), but there is a lack of research on longitudinal associations of COPD and HRQL. This study examined the effects of COPD in early stages of disease on HRQL over ten years in a working-age general population setting in Southern Germany while considering the influence of common comorbidities. In the population-based KORA F4 study (2006-08) 1,321 participants aged 41-61 years performed spirometry and reported information on HRQL (measured by the generic SF-12) and comorbidities. For the same participants, HRQL information was available seven years before and three years after the lung function test from the previous S4 (1999-2001) and the F4L follow-up study (2010). Using linear mixed models, the physical and mental component summary scores (PCS-12 / MCS-12) of the SF-12 were compared over time between COPD groups. 7.8% of participants were classified as having COPD (according to the LLN definition and the Global Lungs Initiative), 59.4% of them in grade 1. Regression models showed a negative cross-sectional association of COPD grade 2+ with PCS-12 which persisted when comorbidities were considered. Adjusted mean PCS-12 scores for the COPD grade 2+ group were reduced (-3.5 (p=0.008) in F4, -3.3 (p=0.014) in S4 and -4.7 (p=0.003) in F4L) compared to the group without airflow limitation. The size of the COPD effect in grade 2+ was similar to the effect of myocardial infarction and cancer. Over ten years, a small decline in PCS-12 was observed in all groups. This decline was larger in participants with COPD grade 2+, but insignificant. Regarding MCS-12, no significant cross-sectional or longitudinal associations with COPD were found. Despite small HRQL differences between COPD patients in early disease stages and controls and small changes over ten years, our results indicate that it is important to prevent subjects with airflow

  16. Strengthening Health Systems to Accelerate Achievement of ...

    African Journals Online (AJOL)

    AJRH Managing Editor

    to urban area due to unavailability of the service facilities. ... established to improve access and quality of health care in Ghana. ... programmes de planification et de services de santé à base communautaire ont été mis en place pour améliorer .... pregnancies, they can reduce the body's reserve ... emergency prenatal care.

  17. Strengthening and expanding the capacity of health worker education in Zambia.

    Science.gov (United States)

    Michelo, Charles; Zulu, Joseph Mumba; Simuyemba, Moses; Andrews, Benjamin; Katubulushi, Max; Chi, Benjamin; Njelesani, Evariste; Vwalika, Bellington; Bowa, Kasonde; Maimbolwa, Margaret; Chipeta, James; Goma, Fastone; Nzala, Selestine; Banda, Sekelani; Mudenda, John; Ahmed, Yusuf; Hachambwa, Lotti; Wilson, Craig; Vermund, Sten; Mulla, Yakub

    2017-01-01

    Zambia is facing a chronic shortage of health care workers. The paper aimed at understanding how the Medical Education Partnership Initiative (MEPI) program facilitated strengthening and expanding of the national capacity and quality of medical education as well as processes for retaining faculty in Zambia. Data generated through documentary review, key informant interviews and observations were analyzed using a thematic approach. The MEPI program triggered the development of new postgraduate programs thereby increasing student enrollment. This was achieved by leveraging of existing and new partnerships with other universities and differentiating the old Master in Public Health into specialized curriculum. Furthermore, the MEPI program improved the capacity and quality of training by facilitating installation and integration of new technology such as the eGranary digital library, E-learning methods and clinical skills laboratory into the Schools. This technology enabled easy access to relevant data or information, quicker turn around of experiments and enhanced data recording, display and analysis features for experiments. The program also facilitated transforming of the academic environment into a more conducive work place through strengthening the Staff Development program and support towards research activities. These activities stimulated work motivation and interest in research by faculty. Meanwhile, these processes were inhibited by the inability to upload all courses on to Moodle as well as inadequate operating procedures and feedback mechanisms for the Moodle. Expansion and improvement in training processes for health care workers requires targeted investment within medical institutions and strengthening local and international partnerships.

  18. Initiatives to strengthen physical protection in Japan

    International Nuclear Information System (INIS)

    Kurihara, H.; Yagi, T.; Endo, M.; Murajiri, M.

    2001-01-01

    Full text: The Nuclear Material Control Center (NMCC) was established under the approval of the Japanese Government in 1972 to function as an important organization to implement national safeguards system together with the Government. It has been also working on R and D of physical protection of nuclear materials and facilities, and enhancing the awareness of the importance of the physical protection among physical protection related people. Japan has now 52 nuclear power reactors, accounting for about one-third of the nations electricity generation. Also nuclear fuel cycle facilities as enrichment plants, radioactive waste disposal facilities and reprocessing plant are either in operation or under construction at Rokkasho-Mura, Aomori prefecture. NMCC is doing several initiatives to strengthen and increase the understanding of the physical protection in Japan by disseminating necessary information to people which are described in the following: 1. Physical protection seminar for the physical protection specialists and management people - It is very important for the physical protection specialists as well as management people who are working at nuclear facilities to be able to get access to the related sophisticated information on the information on the global physical protection issues, physical protection regulations, physical protection systems and equipment etc. This kind of seminar was started in 19xx and is held once a year for two days in Tokyo. The curriculum includes global physical protection issues, physical protection related activities such as terrorism, current R and D, and application of equipment, experiences gained at nuclear facilities. About 70 people participate in the seminar every year. 2. Physical protection seminar for the physical protection related local people - It is more and more important for the nuclear industry to disseminate information to the local people about the nuclear facility operation. Such local people as local government

  19. Elements for harnessing participatory action research to strengthen health managers' capacity: a critical interpretative synthesis.

    Science.gov (United States)

    Tetui, Moses; Zulu, Joseph Mumba; Hurtig, Anna-Karin; Ekirapa-Kiracho, Elizabeth; Kiwanuka, Suzanne N; Coe, Anna-Britt

    2018-04-19

    Health managers play a key role in ensuring that health services are responsive to the needs of the population. Participatory action research (PAR) is one of the approaches that have been used to strengthen managers' capacity. However, collated knowledge on elements for harnessing PAR to strengthen managers' capacity is missing. This paper bridges this gap by reviewing existing literature on the subject matter. A critical interpretive synthesis method was used to interrogate eight selected articles. These articles reported the use of PAR to strengthen health managers' capacity. The critical interpretive synthesis method's approach to analysis guided the synthesis. Here, the authors interpretively made connections and linkages between different elements identified in the literature. Finally, the Atun et al. (Heal Pol Plann, 25:104-111, 2010) framework on integration was used to model the elements synthesised in the literature into five main domains. Five elements with intricate bi-directional interactions were identified in the literature reviewed. These included a shared purpose, skilled facilitation and psychological safety, activity integration into organisational procedures, organisational support, and external supportive monitoring. A shared purpose of the managers' capacity strengthening initiative created commitment and motivation to learn. This purpose was built upon a set of facilitation skills that included promoting participation, self-efficacy and reflection, thereby creating a safe psychological space within which the managers interacted and learnt from each other and their actions. Additionally, an integrated intervention strengthened local capacity and harnessed organisational support for learning. Finally, supportive monitoring from external partners, such as researchers, ensured quality, building of local capacity and professional safety networks essential for continued learning. The five elements identified in this synthesis provide a basis upon

  20. Optimal cost for strengthening or destroying a given network

    Science.gov (United States)

    Patron, Amikam; Cohen, Reuven; Li, Daqing; Havlin, Shlomo

    2017-05-01

    Strengthening or destroying a network is a very important issue in designing resilient networks or in planning attacks against networks, including planning strategies to immunize a network against diseases, viruses, etc. Here we develop a method for strengthening or destroying a random network with a minimum cost. We assume a correlation between the cost required to strengthen or destroy a node and the degree of the node. Accordingly, we define a cost function c (k ) , which is the cost of strengthening or destroying a node with degree k . Using the degrees k in a network and the cost function c (k ) , we develop a method for defining a list of priorities of degrees and for choosing the right group of degrees to be strengthened or destroyed that minimizes the total price of strengthening or destroying the entire network. We find that the list of priorities of degrees is universal and independent of the network's degree distribution, for all kinds of random networks. The list of priorities is the same for both strengthening a network and for destroying a network with minimum cost. However, in spite of this similarity, there is a difference between their pc, the critical fraction of nodes that has to be functional to guarantee the existence of a giant component in the network.

  1. Strengthening of defected beam–column joints using CFRP

    Directory of Open Access Journals (Sweden)

    Mohamed H. Mahmoud

    2014-01-01

    Full Text Available This paper presents an experimental study for the structural performance of reinforced concrete (RC exterior beam–column joints rehabilitated using carbon-fiber-reinforced polymer (CFRP. The present experimental program consists of testing 10 half-scale specimens divided into three groups covering three possible defects in addition to an adequately detailed control specimen. The considered defects include the absence of the transverse reinforcement within the joint core, insufficient bond length for the beam main reinforcement and inadequate spliced implanted column on the joint. Three different strengthening schemes were used to rehabilitate the defected beam–column joints including externally bonded CFRP strips and sheets in addition to near surface mounted (NSM CFRP strips. The failure criteria including ultimate capacity, mode of failure, initial stiffness, ductility and the developed ultimate strain in the reinforcing steel and CFRP were considered and compared for each group for the control and the CFRP-strengthened specimens. The test results showed that the proposed CFRP strengthening configurations represented the best choice for strengthening the first two defects from the viewpoint of the studied failure criteria. On the other hand, the results of the third group showed that strengthening the joint using NSM strip technique enabled the specimen to outperform the structural performance of the control specimen while strengthening the joints using externally bonded CFRP strips and sheets failed to restore the strengthened joints capacity.

  2. Strengthening of defected beam-column joints using CFRP.

    Science.gov (United States)

    Mahmoud, Mohamed H; Afefy, Hamdy M; Kassem, Nesreen M; Fawzy, Tarek M

    2014-01-01

    This paper presents an experimental study for the structural performance of reinforced concrete (RC) exterior beam-column joints rehabilitated using carbon-fiber-reinforced polymer (CFRP). The present experimental program consists of testing 10 half-scale specimens divided into three groups covering three possible defects in addition to an adequately detailed control specimen. The considered defects include the absence of the transverse reinforcement within the joint core, insufficient bond length for the beam main reinforcement and inadequate spliced implanted column on the joint. Three different strengthening schemes were used to rehabilitate the defected beam-column joints including externally bonded CFRP strips and sheets in addition to near surface mounted (NSM) CFRP strips. The failure criteria including ultimate capacity, mode of failure, initial stiffness, ductility and the developed ultimate strain in the reinforcing steel and CFRP were considered and compared for each group for the control and the CFRP-strengthened specimens. The test results showed that the proposed CFRP strengthening configurations represented the best choice for strengthening the first two defects from the viewpoint of the studied failure criteria. On the other hand, the results of the third group showed that strengthening the joint using NSM strip technique enabled the specimen to outperform the structural performance of the control specimen while strengthening the joints using externally bonded CFRP strips and sheets failed to restore the strengthened joints capacity.

  3. Strengthening of RC bridge slabs using CFRP sheets

    Directory of Open Access Journals (Sweden)

    Fahmy A. Fathelbab

    2014-12-01

    Full Text Available Many old structures became structurally insufficient to carry the new loading conditions requirements. Moreover, they suffer from structural degradation, reinforcement steel bars corrosion, bad weather conditions…etc. Many official authorities in several countries had recognized many old bridges and buildings as structurally deficient by today’s standards. Due to these reasons, structural strengthening became an essential requirement and different strengthening techniques appeared in market. Fiber Reinforced Polymer (FRP strengthening techniques established a good position among all other techniques, giving excellent structural results, low time required and moderate cost compared with the other techniques. The main purpose of this research is to study analytically the strengthening of a reinforced concrete bridge slabs due to excessive loads, using externally bonded FRP sheets technique. A commercial finite element program ANSYS was used to perform a structural linear and non-linear analysis for strengthened slab models using several schemes of FRP sheets. A parametric study was performed to evaluate analytically the effect of changing both FRP stiffness and FRP schemes in strengthening RC slabs. Comparing the results with control slab (reinforced concrete slab without strengthening it is obvious that attaching FRP sheets to the RC slab increases its capacity and enhances the ductility/toughness.

  4. EFFECTS OF KINESIOTAPING ALONG WITH QUADRICEPS STRENGTHENING EXERCISES ON PAIN, JOINT RANGE OF MOTION AND FUNCTIONAL ACTIVITIES OF KNEE IN SUBJECTS WITH PATELLOFEMORAL OSTEOARTHRITIS

    Directory of Open Access Journals (Sweden)

    M. Harshitha

    2014-08-01

    Full Text Available Background: Patello femoral Osteoarthritis is the most common degenerative disease in older age group, causing pain, physical disability, and decreased quality of life.As many treatment options available, kinesiotaping is an efficacious treatment for management of pain & disability in patellofemoral joint osteoarthritis. Previous studies have shown that kinesiotaping as well as quadriceps strengthening significantly yields functional benefits. But there is lack of evidence revealing combined effectiveness & effects of kinesiotaping along with quadriceps strengthening in subjects with patellofemoral joint osteoarthritis. Methods: 30 subjects with symptoms of patellofemoral osteoarthritis fulfilled the inclusion criteria were randomly assigned into 2 groups of 15 in each group. Taping along with quadriceps strengthening program is compared to the quadriceps strengthening program alone. Pain were measured by Visual Analogue Scale (VAS, knee ROM were measured by Goniometer, Functional status were measured by Western Ontario McMaster Universities index (WOMAC, score. Measurements were taken pre & post intervention. Results: The results indicated that kinesiotaping along with quadriceps strengthening exercises showed there was statistically significant improvement in pain (<0.05, knee ROM (<0.05 and functional activities (<0.05 after 6 weeks compared to quadriceps strengthening alone. Conclusion: Subjects with kinesiotaping along with quadriceps strengthening showed significant improvement in reducing pain, in improving ROM & functional activities at the end of 6th week treatment when compared to subjects with patellofemoral osteoarthritis underwent quadriceps strengthening exercises alone.

  5. Self-flowing mortar for ferrocement in strengthening applications

    Directory of Open Access Journals (Sweden)

    Shamir Sakir

    2016-09-01

    Full Text Available Ferrocement technology is becoming more and more important nowadays for strengthening and retrofitting of concrete structures mainly due to its inherent strength properties. However, its labour intensive nature makes it undesirable for rapid strengthening works. In narrow spaces, strengthening with conventional ferrocement is very critical and also time consuming. Self-flowing mortar (SFM could be used with this technology to overcome these limitations. This article discusses the applicability of SFM in ferrocement technology. The aim of this study is to summarize available knowledge on SFM to make it feasible for optimization in different industrial applications.

  6. FIRE PROTECTION OF TIMBER STRUCTURES STRENGTHENED WITH FRP MATERIALS

    Directory of Open Access Journals (Sweden)

    Radek Zigler

    2015-12-01

    Full Text Available Modern, progressive methods of structures’ strengthening based on the use of composite materials composed of high strength fibers (carbon, glass, aramid or basalt and matrices based on epoxy resins brings, among many indisputable advantages (low weight, high effectiveness, easy application etc. also some disadvantages. One of the major disadvantages is a low fire resistance of these materials due to the low glass transition temperature Tg of the resin used. Based on an extensive research of strengthening of historic structures with FRP materials [1], the article outlines possible approaches to this problem, especially while strengthening timber load- bearing structures of historic buildings.

  7. Nanostructured thin film coatings with different strengthening effects

    Directory of Open Access Journals (Sweden)

    Panfilov Yury

    2017-01-01

    Full Text Available A number of articles on strengthening thin film coatings were analyzed and a lot of unusual strengthening effects, such as super high hardness and plasticity simultaneously, ultra low friction coefficient, high wear-resistance, curve rigidity increasing of drills with small diameter, associated with process formation of nanostructured coatings by the different thin film deposition methods were detected. Vacuum coater with RF magnetron sputtering system and ion-beam source and arc evaporator for nanostructured thin film coating manufacture are represented. Diamond Like Carbon and MoS2 thin film coatings, Ti, Al, Nb, Cr, nitride, carbide, and carbo-nitride thin film materials are described as strengthening coatings.

  8. A Prospective Longitudinal Clinical Trial Evaluating Quality of Life After Breast-Conserving Surgery and High-Dose-Rate Interstitial Brachytherapy for Early-Stage Breast Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Garsa, Adam A.; Ferraro, Daniel J.; DeWees, Todd A. [Department of Radiation Oncology, Siteman Cancer Center, Barnes-Jewish Hospital and Washington University School of Medicine, St. Louis, Missouri (United States); Deshields, Teresa L. [Department of Medicine, Siteman Cancer Center, Barnes-Jewish Hospital and Washington University School of Medicine, St. Louis, Missouri (United States); Margenthaler, Julie A.; Cyr, Amy E. [Department of Surgery, Siteman Cancer Center, Barnes-Jewish Hospital and Washington University School of Medicine, St. Louis, Missouri (United States); Naughton, Michael [Department of Medicine, Siteman Cancer Center, Barnes-Jewish Hospital and Washington University School of Medicine, St. Louis, Missouri (United States); Aft, Rebecca [Department of Surgery, Siteman Cancer Center, Barnes-Jewish Hospital and Washington University School of Medicine, St. Louis, Missouri (United States); Department of Surgery, John Cochran Veterans Hospital, St. Louis, Missouri (United States); Gillanders, William E.; Eberlein, Timothy [Department of Surgery, Siteman Cancer Center, Barnes-Jewish Hospital and Washington University School of Medicine, St. Louis, Missouri (United States); Matesa, Melissa A.; Ochoa, Laura L. [Department of Radiation Oncology, Siteman Cancer Center, Barnes-Jewish Hospital and Washington University School of Medicine, St. Louis, Missouri (United States); Zoberi, Imran, E-mail: izoberi@radonc.wustl.edu [Department of Radiation Oncology, Siteman Cancer Center, Barnes-Jewish Hospital and Washington University School of Medicine, St. Louis, Missouri (United States)

    2013-12-01

    Purpose: To prospectively examine quality of life (QOL) of patients with early stage breast cancer treated with accelerated partial breast irradiation (APBI) using high-dose-rate (HDR) interstitial brachytherapy. Methods and Materials: Between March 2004 and December 2008, 151 patients with early stage breast cancer were enrolled in a phase 2 prospective clinical trial. Eligible patients included those with Tis-T2 tumors measuring ≤3 cm excised with negative surgical margins and with no nodal involvement. Patients received 3.4 Gy twice daily to a total dose of 34 Gy. QOL was measured using European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30, version 3.0, and QLQ-BR23 questionnaires. The QLQ-C30 and QLQ-BR23 questionnaires were evaluated during pretreatment and then at 6 to 8 weeks, 3 to 4 months, 6 to 8 months, and 1 and 2 years after treatment. Results: The median follow-up was 55 months. Breast symptom scores remained stable in the months after treatment, and they significantly improved 6 to 8 months after treatment. Scores for emotional functioning, social functioning, and future perspective showed significant improvement 2 years after treatment. Symptomatic fat necrosis was associated with several changes in QOL, including increased pain, breast symptoms, systemic treatment side effects, dyspnea, and fatigue, as well as decreased role functioning, emotional functioning, and social functioning. Conclusions: HDR multicatheter interstitial brachytherapy was well tolerated, with no significant detrimental effect on measured QOL scales/items through 2 years of follow-up. Compared to pretreatment scores, there was improvement in breast symptoms, emotional functioning, social functioning, and future perspective 2 years after treatment.

  9. A Prospective Longitudinal Clinical Trial Evaluating Quality of Life After Breast-Conserving Surgery and High-Dose-Rate Interstitial Brachytherapy for Early-Stage Breast Cancer

    International Nuclear Information System (INIS)

    Garsa, Adam A.; Ferraro, Daniel J.; DeWees, Todd A.; Deshields, Teresa L.; Margenthaler, Julie A.; Cyr, Amy E.; Naughton, Michael; Aft, Rebecca; Gillanders, William E.; Eberlein, Timothy; Matesa, Melissa A.; Ochoa, Laura L.; Zoberi, Imran

    2013-01-01

    Purpose: To prospectively examine quality of life (QOL) of patients with early stage breast cancer treated with accelerated partial breast irradiation (APBI) using high-dose-rate (HDR) interstitial brachytherapy. Methods and Materials: Between March 2004 and December 2008, 151 patients with early stage breast cancer were enrolled in a phase 2 prospective clinical trial. Eligible patients included those with Tis-T2 tumors measuring ≤3 cm excised with negative surgical margins and with no nodal involvement. Patients received 3.4 Gy twice daily to a total dose of 34 Gy. QOL was measured using European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30, version 3.0, and QLQ-BR23 questionnaires. The QLQ-C30 and QLQ-BR23 questionnaires were evaluated during pretreatment and then at 6 to 8 weeks, 3 to 4 months, 6 to 8 months, and 1 and 2 years after treatment. Results: The median follow-up was 55 months. Breast symptom scores remained stable in the months after treatment, and they significantly improved 6 to 8 months after treatment. Scores for emotional functioning, social functioning, and future perspective showed significant improvement 2 years after treatment. Symptomatic fat necrosis was associated with several changes in QOL, including increased pain, breast symptoms, systemic treatment side effects, dyspnea, and fatigue, as well as decreased role functioning, emotional functioning, and social functioning. Conclusions: HDR multicatheter interstitial brachytherapy was well tolerated, with no significant detrimental effect on measured QOL scales/items through 2 years of follow-up. Compared to pretreatment scores, there was improvement in breast symptoms, emotional functioning, social functioning, and future perspective 2 years after treatment

  10. Evaluation of Oral Health-Related Quality of Life to Assess Dental Treatment in Preschool Children with Early Childhood Caries: A Preliminary Study.

    Science.gov (United States)

    Vollú, Ana Lúcia; da Costa, Maria da Encarnação Perez Requejo; Maia, Lucianne Cople; Fonseca-Gonçalves, Andréa

    The oral health-related quality of life (OHRQoL) of preschool children with Early Childhood Caries (ECC) was used to assess the outcome of dental treatment. Children (3.56±1.31years) affected by ECC were selected. Anamnesis, clinical and radiographic exams were performed. Data about sociodemographic aspects, OHRQoL and dmf-t index were collected. The Brazilian version of Early Childhood Oral health Impact Scale (B-ECOHIS) was applied in two time intervals: before and after 30 days of treatment. B-ECOHIS scores and effect size (ES) were used to evaluate the OHRQoL of preschool children. The Student's-t test was used for comparison between the B-ECOHIS averages, considering the following aspects: gender, age, socioeconomic status, severity of caries and type of treatment. The mean dmf-t was 6.25±4.20 and no differences between boys (6.00±4.32) and girls (6.83±4.35) (p=0,942) were found. Pain and psychological problems among children and parents feeling upset and guilty were the most frequently reported impacts at baseline. There was a greater impact on girls (17.67±8.68) than on boys (13.30±10.53) (pchildren younger than 4 years (16.71±9.96) (pchildren showed a large effect size for these subjects (ES=1.19) and their families (ES=1.00). Dental treatment resulted in significant improvement of the preschool children's OHRQoL.

  11. Xerostomia and quality of life after intensity-modulated radiotherapy vs. conventional radiotherapy for early-stage nasopharyngeal carcinoma: Initial report on a randomized controlled clinical trial

    International Nuclear Information System (INIS)

    Pow, Edmond; Kwong, Dora; McMillan, Anne S.; Wong, May; Sham, Jonathan; Leung, Lucullus; Leung, W. Keung

    2006-01-01

    Purpose: To compare directly the effect of intensity-modulated radiotherapy (IMRT) vs. conventional radiotherapy (CRT) on salivary flow and quality of life (QoL) in patients with early-stage nasopharyngeal carcinoma (NPC). Methods and Materials: Fifty-one patients with T2, N0/N1, M0 NPC took part in a randomized controlled clinical study and received IMRT or CRT. Stimulated whole (SWS) and parotid (SPS) saliva flow were measured and Medical Outcomes Short Form 36 (SF-36), European Organization for Research and Treatment of Cancer (EORTC) core quetionnaire, and EORTC head-and-neck module (QLQ-H and N35) were completed at baseline and 2, 6, and 12 months after radiotherapy. Results: Forty-six patients (88%) were in disease remission 12 months after radiotherapy. At 12 months postradiotherapy, 12 (50.0%) and 20 patients (83.3%) in the IMRT group had recovered at least 25% of preradiotherapy SWS and SPS flow respectively, compared with 1 (4.8%) and 2 patients (9.5%), respectively, in the CRT group. Global health scores showed continuous improvement in QoL after both treatments (p < 0.001). However, after 12 months subscale scores for role-physical, bodily pain, and physical function were significantly higher in the IMRT group, indicating a better condition (p < 0.05). Dry mouth and sticky saliva were problems in both groups 2 months after treatment. In the IMRT group, there was consistent improvement over time with xerostomia-related symptoms significantly less common than in the CRT group at 12 months postradiotherapy. Conclusions: IMRT was significantly better than CRT in terms of parotid sparing and improved QoL for early-stage disease. The findings support the case for assessment of health-related QoL in relation to head-and-neck cancer using a site-specific approach

  12. Strengthening maintenance and reconstruction of scientific experiment building and creating a good working environment for scientific research and production

    International Nuclear Information System (INIS)

    Fu Jianping

    2005-01-01

    The quality of scientific experiment building directly influences the scientific research work and production. To create a good working environment for scientific research and production, it is necessary to strengthen the maintenance and reconstruction for old scientific experiment building. The paper briefly introduces the site supervisory work of maintaining and reconstructing old scientific experiment building in Beijing Research Institute of Uranium Geology, as well as some measures taken to ensure the project quality, and the reconstructed building. (authors)

  13. Intensity Modulated Radiation Therapy for Early-Stage Primary Gastric Diffuse Large B-Cell Lymphoma: Dosimetric Analysis, Clinical Outcome, and Quality of Life

    Energy Technology Data Exchange (ETDEWEB)

    Liu, Xin; Fang, Hui; Tian, Yuan; Wang, Wei-Hu; Song, Yong-Wen; Wang, Shu-Lian; Liu, Yue-Ping [Department of Radiation Oncology, Cancer Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing (China); He, Xiao-Hui; Dong, Mei [Department of Medical Oncology, Cancer Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing (China); Ren, Hua; Jin, Jing [Department of Radiation Oncology, Cancer Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing (China); Li, Ye-Xiong, E-mail: yexiong@yahoo.com [Department of Radiation Oncology, Cancer Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing (China)

    2016-06-01

    Purpose: To evaluate the dosimetric superiority, efficacy, toxicity, and quality of life (QOL) data of intensity modulated radiation therapy (IMRT) in patients with primary gastric diffuse large B-cell lymphoma (PG-DLBCL). Methods and Materials: Forty-six consecutive patients with early-stage PG-DLBCL underwent IMRT after chemotherapy. The majority of patients (61.5%) were subclassified as the non-germinal center B cell–like subtype. Dosimetric parameters of the planning target volume (PTV) and organs at risk were assessed. Survival rates were depicted with the Kaplan-Meier method and compared with the log-rank test. Quality of life was evaluated using the QLQ-C30-STO22 questionnaires at the last follow-up contact. Results: The median PTV mean dose was 41.6 Gy. Only 0.73% of the PTV received <95% of the prescribed dose, indicating excellent target coverage. The median kidney V20 and liver V30 were 14.1% and 16.1%, respectively. The 5-year overall survival (OS), progression-free survival, and locoregional control rates for all patients were 80.4%, 75.0%, and 93.2%, respectively. Stage, lactate dehydrogenase level, and immunophenotype were significant prognostic factors for OS, and only stage was a significant factor for locoregional control. Consolidation IMRT in patients with complete response after chemotherapy resulted in significantly better OS and progression-free survival than salvage IMRT in patients with non-complete response. Two of 8 patients who had chronic liver disease experienced grade 4 or grade 5 acute hepatic failure after 4 to 5 cycles of rituximab-based chemotherapy and IMRT (40 Gy). No other serious acute or late toxicity was observed. The long-term global and functional QOL scales were excellent, with negligible symptom scales. Conclusions: Intensity modulated radiation therapy yielded excellent target coverage and critical tissue sparing and achieved favorable outcomes with acceptable toxicity and good long-term QOL in early-stage PG-DLBCL.

  14. Intensity Modulated Radiation Therapy for Early-Stage Primary Gastric Diffuse Large B-Cell Lymphoma: Dosimetric Analysis, Clinical Outcome, and Quality of Life

    International Nuclear Information System (INIS)

    Liu, Xin; Fang, Hui; Tian, Yuan; Wang, Wei-Hu; Song, Yong-Wen; Wang, Shu-Lian; Liu, Yue-Ping; He, Xiao-Hui; Dong, Mei; Ren, Hua; Jin, Jing; Li, Ye-Xiong

    2016-01-01

    Purpose: To evaluate the dosimetric superiority, efficacy, toxicity, and quality of life (QOL) data of intensity modulated radiation therapy (IMRT) in patients with primary gastric diffuse large B-cell lymphoma (PG-DLBCL). Methods and Materials: Forty-six consecutive patients with early-stage PG-DLBCL underwent IMRT after chemotherapy. The majority of patients (61.5%) were subclassified as the non-germinal center B cell–like subtype. Dosimetric parameters of the planning target volume (PTV) and organs at risk were assessed. Survival rates were depicted with the Kaplan-Meier method and compared with the log-rank test. Quality of life was evaluated using the QLQ-C30-STO22 questionnaires at the last follow-up contact. Results: The median PTV mean dose was 41.6 Gy. Only 0.73% of the PTV received <95% of the prescribed dose, indicating excellent target coverage. The median kidney V20 and liver V30 were 14.1% and 16.1%, respectively. The 5-year overall survival (OS), progression-free survival, and locoregional control rates for all patients were 80.4%, 75.0%, and 93.2%, respectively. Stage, lactate dehydrogenase level, and immunophenotype were significant prognostic factors for OS, and only stage was a significant factor for locoregional control. Consolidation IMRT in patients with complete response after chemotherapy resulted in significantly better OS and progression-free survival than salvage IMRT in patients with non-complete response. Two of 8 patients who had chronic liver disease experienced grade 4 or grade 5 acute hepatic failure after 4 to 5 cycles of rituximab-based chemotherapy and IMRT (40 Gy). No other serious acute or late toxicity was observed. The long-term global and functional QOL scales were excellent, with negligible symptom scales. Conclusions: Intensity modulated radiation therapy yielded excellent target coverage and critical tissue sparing and achieved favorable outcomes with acceptable toxicity and good long-term QOL in early-stage PG-DLBCL.

  15. Compliance to consensus recommendations, surgeon's experience, and introduction of a quality assurance and management program: influence on therapy of early-stage ovarian carcinoma.

    Science.gov (United States)

    Kommoss, Stefan; Harter, Philipp; Traut, Alexander; Strutas, Deivis; Riegler, Nina; Buhrmann, Christine; Gomez, Ruth; du Bois, Andreas

    2009-05-01

    State-of-the-art surgical staging and adjuvant chemotherapy in early-stage ovarian carcinoma have an impact on patient's outcome, but compliance to guidelines and consensus recommendations is still poor. This article reports on our results before and after introduction of a quality assurance and management program in our clinic in 2001. Patients with ovarian carcinoma limited to the pelvis who underwent primary surgery in our hospital from 1997 to October 2007 were eligible for this study. Univariate and multivariate logistic regression analyses were performed to evaluate the impact of compliance with our management program and physician's experience in ovarian carcinoma surgery on achieving both standards of surgery and chemotherapy. In a total of 117 women, a significant impact on adherence to guideline-defined comprehensive surgical staging was found for poor Eastern Cooperative Oncology Group performance status (odds ratio [OR], 22.16; confidence interval [CI] 3.2-152.0; P = 0.002) and year of surgery before 2001 (OR, 47.60; CI, 9.20-245.22; P grading less than G3 (OR, 4.14; CI, 1.20-14.22; P = 0.02) was a statistically significant predictor for receiving standard adjuvant chemotherapy. Survival analyses showed a trend toward improved survival for patients having received guideline-adopted therapy, but event numbers were too low for adequate analyses. The introduction of a quality assurance program for treatment of ovarian carcinoma represents a major improvement of patient care. It led to a higher compliance with consensus recommendations and showed already a trend toward improved outcome. Further outcome research should focus on methods for implementation of guidelines in daily practice in institutions caring for patients with ovarian carcinoma.

  16. Food insecurity among students living with HIV: Strengthening safety ...

    African Journals Online (AJOL)

    Food insecurity among students living with HIV: Strengthening safety nets at the Nelson Mandela Metropolitan University, South Africa. ... of age and managed as part of the Campus Health Service antiretroviral therapy (ART) programme.

  17. Strengthening African Union for African Integration: An African ...

    African Journals Online (AJOL)

    Toshiba

    to secure African continent, speed up development process, and strengthen our survival ... Regional integration generally involves a somewhat complex web of cooperation ... networking of various government institutions to provide and shape.

  18. Strengthening Science-based Environmental Policy Development in ...

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

    Strengthening Science-based Environmental Policy Development in Burma's Democratic ... IDRC is providing funding to Simon Fraser University to support a network of ... The project will also encourage and assist in the creation of a business ...

  19. 1 The West Africa Initiative to Strengthen Capacities through Health ...

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

    Afekwo Mbonu

    2012-08-31

    ) governance and governance structures of health systems. .... Strengthened evidence base from the awarded research projects complemented by a set of ..... Canadian recipients which purchase equipment using IDRC funds ...

  20. West African think tank strengthens outreach and partnerships ...

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

    2016-04-28

    Apr 28, 2016 ... ... on organizational strengthening measures to increase its financial autonomy. ... were then put into practice with key financial and technical partners. ... Développement Afrique) is an independent non-profit organization ...

  1. Strengthening of metallic alloys with nanometer-size oxide dispersions

    Science.gov (United States)

    Flinn, John E.; Kelly, Thomas F.

    1999-01-01

    Austenitic stainless steels and nickel-base alloys containing, by wt. %, 0.1 to 3.0% V, 0.01 to 0.08% C, 0.01 to 0.5% N, 0.05% max. each of Al and Ti, and 0.005 to 0.10% O, are strengthened and ductility retained by atomization of a metal melt under cover of an inert gas with added oxygen to form approximately 8 nanometer-size hollow oxides within the alloy grains and, when the alloy is aged, strengthened by precipitation of carbides and nitrides nucleated by the hollow oxides. Added strengthening is achieved by nitrogen solid solution strengthening and by the effect of solid oxides precipitated along and pinning grain boundaries to provide temperature-stabilization and refinement of the alloy grains.

  2. Direct dorsal hippocampal-prelimbic cortex connections strengthen fear memories.

    Science.gov (United States)

    Ye, Xiaojing; Kapeller-Libermann, Dana; Travaglia, Alessio; Inda, M Carmen; Alberini, Cristina M

    2017-01-01

    The ability to regulate the consolidation and strengthening of memories for threatening experiences is critical for mental health, and its dysregulation may lead to psychopathologies. Re-exposure to the context in which the threat was experienced can either increase or decrease fear response through distinct processes known, respectively, as reconsolidation or extinction. Using a context retrieval-dependent memory-enhancement model in rats, we report that memory strengthens through activation of direct projections from dorsal hippocampus to prelimbic (PL) cortex and activation of critical PL molecular mechanisms that are not required for extinction. Furthermore, while sustained PL brain-derived neurotrophic factor (BDNF) expression is required for memory consolidation, retrieval engages PL BDNF to regulate excitatory and inhibitory synaptic proteins neuroligin 1 and neuroligin 2, which promote memory strengthening while inhibiting extinction. Thus, context retrieval-mediated fear-memory enhancement results from a concerted action of mechanisms that strengthen memory through reconsolidation while suppressing extinction.

  3. Practical approaches to implementing facility wide equipment strengthening programs

    International Nuclear Information System (INIS)

    Kincaid, R.H.; Smietana, E.A.

    1989-01-01

    Equipment strengthening programs typically focus on components required to ensure operability of safety related equipment or to prevent the release of toxic substances. Survival of non-safety related equipment may also be crucial to ensure rapid recovery and minimize business interruption losses. Implementing a strengthening program for non-safety related equipment can be difficult due to the large amounts of equipment involved and limited budget availability. EQE has successfully implemented comprehensive equipment strengthening programs for a number of California corporations. Many of the lessons learned from these projects are applicable to DOE facilities. These include techniques for prioritizing equipment and three general methodologies for anchoring equipment. Pros and cons of each anchorage approach are presented along with typical equipment strengthening costs

  4. Strengthening of non-seismically detailed reinforced concrete beam ...

    Indian Academy of Sciences (India)

    work and in order to carry the anchorages sufficiently away from the column face ..... Owing to the strengthening application, joint shear stress–strain behaviour was ..... structures (ACI 352R-02), MI: American Concrete Institute, Farmington Hills.

  5. Strengthening industry-research linkage for small scale industrial ...

    African Journals Online (AJOL)

    Strengthening industry-research linkage for small scale industrial development in Ghana - the relevance of scientific and technological information. ... Journal of Applied Science and Technology. Journal Home · ABOUT · Advanced Search ...

  6. Seismic strengthening of RC structures with exterior shear walls

    Indian Academy of Sciences (India)

    Nowadays, most of the strengthening strategies are based on global ..... In the present work, sliding shear capacity was calculated based on the code formulations, ... This study has been carried out with the financial support of State Planning ...

  7. Behaviour of Strengthened RC Frames with Eccentric Steel Braced Frames

    Directory of Open Access Journals (Sweden)

    Kamanli Mehmet

    2017-01-01

    Full Text Available After devastating earthquakes in recent years, strengthening of reinforced concrete buildings became an important research topic. Reinforced concrete buildings can be strengthened by steel braced frames. These steel braced frames may be made of concentrically or eccentrically indicated in Turkish Earthquake Code 2007. In this study pushover analysis of the 1/3 scaled 1 reinforced concrete frame and 1/3 scaled 4 strengthened reinforced concrete frames with internal eccentric steel braced frames were conducted by SAP2000 program. According to the results of the analyses conducted, load-displacement curves of the specimens were compared and evaluated. Adding eccentric steel braces to the bare frame decreased the story drift, and significantly increased strength, stiffness and energy dissipation capacity. In this strengthening method lateral load carrying capacity, stiffness and dissipated energy of the structure can be increased.

  8. Behaviour of Strengthened RC Frames with Eccentric Steel Braced Frames

    Science.gov (United States)

    Kamanli, Mehmet; Unal, Alptug

    2017-10-01

    After devastating earthquakes in recent years, strengthening of reinforced concrete buildings became an important research topic. Reinforced concrete buildings can be strengthened by steel braced frames. These steel braced frames may be made of concentrically or eccentrically indicated in Turkish Earthquake Code 2007. In this study pushover analysis of the 1/3 scaled 1 reinforced concrete frame and 1/3 scaled 4 strengthened reinforced concrete frames with internal eccentric steel braced frames were conducted by SAP2000 program. According to the results of the analyses conducted, load-displacement curves of the specimens were compared and evaluated. Adding eccentric steel braces to the bare frame decreased the story drift, and significantly increased strength, stiffness and energy dissipation capacity. In this strengthening method lateral load carrying capacity, stiffness and dissipated energy of the structure can be increased.

  9. Strengthening of metallic alloys with nanometer-size oxide dispersions

    Science.gov (United States)

    Flinn, J.E.; Kelly, T.F.

    1999-06-01

    Austenitic stainless steels and nickel-base alloys containing, by wt. %, 0.1 to 3.0% V, 0.01 to 0.08% C, 0.01 to 0.5% N, 0.05% max. each of Al and Ti, and 0.005 to 0.10% O, are strengthened and ductility retained by atomization of a metal melt under cover of an inert gas with added oxygen to form approximately 8 nanometer-size hollow oxides within the alloy grains and, when the alloy is aged, strengthened by precipitation of carbides and nitrides nucleated by the hollow oxides. Added strengthening is achieved by nitrogen solid solution strengthening and by the effect of solid oxides precipitated along and pinning grain boundaries to provide temperature-stabilization and refinement of the alloy grains. 20 figs.

  10. Predicting sales performance: Strengthening the personality – job performance linkage

    NARCIS (Netherlands)

    T.B. Sitser (Thomas)

    2014-01-01

    markdownabstract__Abstract__ Many organizations worldwide use personality measures to select applicants for sales jobs or to assess incumbent sales employees. In the present dissertation, consisting of four independent studies, five approaches to strengthen the personality-sales performance

  11. Percepción de la calidad en Centros de Atención Temprana: Resultados de un análisis comparativo (Perceived Quality in Early Intervention Centres: Results of a Comparative Analysis

    Directory of Open Access Journals (Sweden)

    Rita Pilar Romero-Galisteo

    2015-08-01

    Full Text Available Early Intervention is currently regarded as an essential strategy to promote the development of children with developmental disorders, or who are at risk of them, and to promote the wellbeing of their families. This article analysed perceived service quality in Early Intervention Centres. The sample comprised 397 families receiving Early Intervention at two centres, where they were administered the Early Intervention Centre Quality Inventory. The results of both studies suggest that the users of both centres positively appraised the service they had received: the dimensions Qualified Staff (M=4.77, SD=0.48 and Technical Information (M=4.54, SD=0.70 obtained the highest mean values. There were significant differences between the studies in the dimensions Facilities (M=4.39, SD=0.41 and Treatment Rooms (M=4.66, SD=0.55. The evaluation of the perceived quality by the families attending Early Intervention Centres serves to identify and weaknesses to be improved and strengths to be maintained in a context of the continuous improvement established in these kinds of services.

  12. Early Child Care and Education: HHS and Education Are Taking Steps to Improve Workforce Data and Enhance Worker Quality. Report to the Chairman, Committee on Finance, U.S. Senate. GAO-12-248

    Science.gov (United States)

    Brown, Kay E.

    2012-01-01

    Research shows that well trained and educated early child care and education (ECCE) workers are key to helping children in care reach their full developmental potential. Federal and state governments spend billions of dollars each year to improve ECCE programs, including the quality of its caregivers and teachers. Because of the importance of this…

  13. Strengthening of a railway bridge with NSMR and CFRP tubes

    DEFF Research Database (Denmark)

    Täljsten, Björn; Bennitz, Anders; Danielsson, Georg

    2008-01-01

    Strengthening of structures with CFRP is today considered an accepted method to upgrade concrete structures. In this paper two different CFRP strengthening systems are combined to give extended service life to a Swedish double-trough-double-track railway bridge, constructed in concrete with a 10 ....... Sensors on bars and tubes display proofs of utilization of the CFRP while displacement sensors and strain gauges on the steel reinforcement due to the small loads in the service limit state show minor effect....

  14. Modeling and characterization of strengthened concrete tension members

    DEFF Research Database (Denmark)

    Hansen, Christian Skodborg; Stang, Henrik

    2011-01-01

    The structural potential for cracking of externally strengthened concrete tension members, can be predicted with three parameters, describing the structural cracking potential based on fracture mechanical properties of the of concrete and interface between concrete and strengthening medium....... With these parameters, it is possible to design reinforcement and obtain a required cracking behavior of a given structure. Design recommendations for single and multiple cracking of the tension specimen are given in terms of fracture mechanical parameters, and a structural stiffness parameter....

  15. Strengthening Leadership Competencies of Thai Secondary School Teachers

    OpenAIRE

    Chaiyot Wanutha; Kowat Tesaputa; Anan Sri-Ampai

    2017-01-01

    The research aimed 1) to investigate components and indicators of the leadership competencies of secondary school teachers, 2) to explore the existing situations and desirable situations of secondary school teachers’ leadership competencies, 3) to study the techniques to strengthen teachers’ leadership competencies, 4) to develop the teacher-leadership competencies strengthening program, and 5) to find out the results of implementing the program to improve the teacher’s ...

  16. Effect of pre- and post-marination aging on meat quality attributes of early deboned (2 h postmortem) broiler breast fillets.

    Science.gov (United States)

    Kuttappan, V A; Gunsaulis, V B; Mauromoustakos, A; Meullenet, J F; Owens, C M

    2016-11-01

    Marination is an effective method that can be used to improve the tenderness of early deboned breast fillets. The present study was designed to evaluate the effect of pre- and post-marination aging of 2 h postmortem (PM) deboned chicken fillets to get optimum meat quality. In this study, a total of 300 broilers (43 to 46 d of age) were processed using an in-line system and deboned at 2 h PM. Fillets were marinated, at either 2.5, 4, 6, 8 or 24 h PM, using vacuum tumbling (20 min) with a 15% marinade (final concentration of 0.5% salt and 0.45% phosphate). A non-marinated control (CON) was included. The left (HOLD) fillets were aged (held at 4°C for 24 h) prior to freezing post-marination while the right (NO HOLD) fillets were frozen immediately after marination to simulate various commercial practices. Marination pickup (MPU), total marinade retained after thawing (TMR), total purge loss after thawing (TPL), cook loss (CL), and Meullenet-Owens Razor Shear energy (MORSE) values were measured. Both in HOLD and NO HOLD fillets, there was an increase (P water holding capacity. However, both in HOLD and NO HOLD groups, the MORSE values for the marinated fillets decreased (P retention as well as tenderness (or lower shear values). © 2016 Poultry Science Association Inc.

  17. Pre-harvest application of calcium chloride and chitosan on fruit quality and storability of ‘Early Swelling’ peach during cold storage

    Directory of Open Access Journals (Sweden)

    Ahmed Abdel Nabi Abdel Gayed

    Full Text Available ABSTRACT Studies related with the storage of peach fruits have received great relevance in Egypt. In this study, the effect of pre-harvest sprays of calcium chloride and chitosan, separately and in combination, on quality attributes and storability of peach fruits stored at 0±1 °C was studied. ‘Early Swelling’ peach trees were sprayed twice with 1% or 2% calcium chloride. The first spraying was at pea stage, while the second one was performed at 10 days before harvesting. Chitosan sprays were performed at 0.5 or 1%, alone or in combination with 1 and 2% calcium chloride, at 10 days before harvesting. Untreated trees served as control. Fruits were harvested at maturity stage, then packaged and stored at 0±1 °C and 85-90% of relative humidity. Fruit physical and chemical properties were evaluated at 7-day intervals. Results showed that pre-harvest application with 2% CaCl2+1% chitosan was most effective in minimizing weight loss (% and decay (%, as well as in maintaining maximum firmness and lengthening shelf life. Fruit color was not affected by any of the treatments, while untreated fruits and calcium chloride treatment alone, at both applied concentrations, maintained higher total soluble solids (TSS, %, total phenolic content, and lower titratable acidity percentage.

  18. RC T beams strengthened to shear with carbon fiber composites

    Directory of Open Access Journals (Sweden)

    L. A. Spagnolo JR

    Full Text Available This paper presents the experimental data of the behavior of reinforced concrete beams strengthened to shear with carbon fiber composites. The tests were composed of eight T beams, b w=15 cm, h=40 cm, flange width 40 cm, flange height 8 cm, and length 300 cm, divided into two series with the same longitudinal steel reinforcement and a reference beam without strengthening in each series. The beams had two types of arrangement of internal steel stirrups. The test variables were the internal and external geometric ratio of the transverse reinforcement and the mechanical ratio of carbon fiber composites stirrups. All the beams were loaded at two points. The strengthened beams were submitted to a preloading and the strengthening was applied to the cracked beam. All the beams were designed in order to guarantee shear failure, and the ultimate load of the strengthened beams was 36% to 54% greater than the reference beams. The Cracking Sliding Model applied to the strengthened beams was evaluated and showed good agreement with the experimental results.

  19. Behavior of masonry strengthened infilled reinforced concrete frames under in-plane load

    Directory of Open Access Journals (Sweden)

    Lila M. Abdel-Hafez

    2015-08-01

    The ductility of infilled frame strengthened with ferrocement was the best of all strengthened frames, while strengthening with GFRP increases its ultimate load carrying capacity but reduces its ductility.

  20. Strengthening the relationship between industry and academia

    International Nuclear Information System (INIS)

    Jackson, K.J.; Medford, M.O.

    1991-01-01

    Both industry and academia recognize that there are potential benefits in developing a partnership. Interaction between industry and academia is necessary if students are to be given the skills that are most critical to industry. These more appropriately educated students will then be able to make a greater and more immediate contribution once in the work force. This interaction can continue throughout the employee's career by providing opportunities for lifelong learning through training - both technical training to prevent obsolescence and training to broaden or add to employee skills (e.g., management or quality training). Local universities and colleges in the Tennessee River Valley provide help with curriculum development and provide expertise and the latest information and techniques that are lacking within the Tennessee Valley Authority (TVA) for training and broadening employees. Two examples are provided of current programs designed to address industrial demands for education