Conceptual design studies for the European DEMO divertor: Rationale and first results

International Nuclear Information System (INIS)

You, J.H.; Mazzone, G.; Visca, E.; Bachmann, Ch.; Autissier, E.; Barrett, T.; Cocilovo, V.; Crescenzi, F.; Domalapally, P.K.; Dongiovanni, D.; Entler, S.; Federici, G.; Frosi, P.; Fursdon, M.; Greuner, H.; Hancock, D.; Marzullo, D.; McIntosh, S.; Müller, A.V.; Porfiri, M.T.

2016-01-01

Highlights: • A brief overview is given on the overall R&D activities of the work package Divertor which is a project of the EUROfusion Consortium. • The rationale of the hydraulic, thermal and structural design scheme is described. • The first results obtained for the preliminary DEMO divertor cassette model are presented. - Abstract: In the European fusion roadmap, reliable power handling has been defined as one of the most critical challenges for realizing a commercially viable fusion power. In this context, the divertor is the key in-vessel component, as it is responsible for power exhaust and impurity removal for which divertor target is subjected to very high heat flux loads. To this end, an integrated R&D project was launched in the EUROfusion Consortium in order to deliver a holistic conceptual design solution together with the core technologies for the entire divertor system of a DEMO reactor. The work package ‘Divertor’ consists of two project areas: ‘Cassette design and integration’ and ‘Target development’. The essential mission of the project is to develop and verify advanced design concepts and the required technologies for a divertor system being capable of meeting the physical and system requirements defined for the next-generation European DEMO reactor. In this contribution, a brief overview is presented of the works from the first project year (2014). Focus is put on the loads specification, design boundary conditions, materials requirements, design approaches, and R&D strategy. Initial ideas and first estimates are presented.

Conceptual design studies for the European DEMO divertor: Rationale and first results

Energy Technology Data Exchange (ETDEWEB)

You, J.H., E-mail: you@ipp.mpg.de [Max Planck Institute for Plasma Physics, Boltzmann Str. 2, 85748 Garching (Germany); Mazzone, G.; Visca, E. [ENEA, Unità Tecnica Fusione, ENEA C. R. Frascati, via E. Fermi 45, 00044 Frascati (Italy); Bachmann, Ch. [EUROfusion PMU, c/o IPP, Boltzmann Str. 2, 85748 Garching (Germany); Autissier, E. [CEA, IRFM, F-13108 Saint Paul Lez Durance (France); Barrett, T. [CCFE, Culham Science Centre, Abingdon OX14 3DB (United Kingdom); Cocilovo, V.; Crescenzi, F. [ENEA, Unità Tecnica Fusione, ENEA C. R. Frascati, via E. Fermi 45, 00044 Frascati (Italy); Domalapally, P.K. [Research Cnter Rez, Hlavní 130, 250 68 Husinec–Řež (Czech Republic); Dongiovanni, D. [ENEA, Unità Tecnica Fusione, ENEA C. R. Frascati, via E. Fermi 45, 00044 Frascati (Italy); Entler, S. [Institute of Plasma Physics CAS, Za Slovankou 3, 182 00 Praha 8 (Czech Republic); Federici, G. [EUROfusion PMU, c/o IPP, Boltzmann Str. 2, 85748 Garching (Germany); Frosi, P. [ENEA, Unità Tecnica Fusione, ENEA C. R. Frascati, via E. Fermi 45, 00044 Frascati (Italy); Fursdon, M. [CCFE, Culham Science Centre, Abingdon OX14 3DB (United Kingdom); Greuner, H. [Max Planck Institute for Plasma Physics, Boltzmann Str. 2, 85748 Garching (Germany); Hancock, D. [CCFE, Culham Science Centre, Abingdon OX14 3DB (United Kingdom); Marzullo, D. [CREATE, University of Naples Federico II, P.le Tecchio 80, 80125 Napoli (Italy); McIntosh, S. [CCFE, Culham Science Centre, Abingdon OX14 3DB (United Kingdom); Müller, A.V. [Max Planck Institute for Plasma Physics, Boltzmann Str. 2, 85748 Garching (Germany); Porfiri, M.T. [ENEA, Unità Tecnica Fusione, ENEA C. R. Frascati, via E. Fermi 45, 00044 Frascati (Italy); and others

2016-11-01

Highlights: • A brief overview is given on the overall R&D activities of the work package Divertor which is a project of the EUROfusion Consortium. • The rationale of the hydraulic, thermal and structural design scheme is described. • The first results obtained for the preliminary DEMO divertor cassette model are presented. - Abstract: In the European fusion roadmap, reliable power handling has been defined as one of the most critical challenges for realizing a commercially viable fusion power. In this context, the divertor is the key in-vessel component, as it is responsible for power exhaust and impurity removal for which divertor target is subjected to very high heat flux loads. To this end, an integrated R&D project was launched in the EUROfusion Consortium in order to deliver a holistic conceptual design solution together with the core technologies for the entire divertor system of a DEMO reactor. The work package ‘Divertor’ consists of two project areas: ‘Cassette design and integration’ and ‘Target development’. The essential mission of the project is to develop and verify advanced design concepts and the required technologies for a divertor system being capable of meeting the physical and system requirements defined for the next-generation European DEMO reactor. In this contribution, a brief overview is presented of the works from the first project year (2014). Focus is put on the loads specification, design boundary conditions, materials requirements, design approaches, and R&D strategy. Initial ideas and first estimates are presented.

Rationales for Commonly "Challenged" Taught Books.

Science.gov (United States)

Shugert, Diane P., Ed.; And Others

1983-01-01

Intended for teachers, this focused journal issue contains separate rationales for teaching books that have been challenged as appropriate instructional materials. Following a discussion of the purpose for rationales and suggestions for using them, the journal presents rationales for teaching the following books: "To Kill a Mockingbird,""The Diary…

Physics rationale for the engineering specifications for ZTH

International Nuclear Information System (INIS)

Dimarco, J.N.

1987-01-01

This report presents the physics rationale that established the engineering design of ZTH. The physics criteria are given and the implications regarding the engineering design are presented. Experimental and theoretical background evidence is given in support of the criteria but the justification is left to other reports and peer reviews. The physics criteria discussed here are limited to the ones deemed to be of highest engineering priority. 32 refs., 9 figs

Design Rationale Behind the Serious Self-Regulation Game Intervention "Balance It": Overweight Prevention Among Secondary Vocational Education Students in The Netherlands.

Science.gov (United States)

Spook, Jorinde E; Paulussen, Theo; Paulissen, Rosie; Visschedijk, Gillian; Kok, Gerjo; van Empelen, Pepijn

2015-10-01

This article describes the design rationale behind a serious self-regulation game intervention. The aim of the game is to promote healthy dietary intake and physical activity among secondary vocational educational students in The Netherlands (approximately 16-20 years of age). The game "Balance It" was developed according to an intervention mapping (IM) protocol. Following IM, we specified health promotion and usability objectives and linked these objectives to selected behavior change and persuasive methods. Accordingly, these methods were translated into a coherent intervention program. The health behavior change objectives were derived from the determinants of the behavior and from Self-Regulation Theory (e.g., students are asked to set goals, monitor and evaluate their behavior, and create coping plans). Usability objectives were derived from the RE-AIM model (i.e., Reach, Effectiveness, Adoption, Implementation, and Maintenance). Next, behavior change and persuasive techniques were selected (e.g., goal setting and prompting, respectively) that did fit with the targeted change objectives and were translated in the design of a (mobile) serious self-regulation game intervention. Subsequently, three concept and usability tests were performed to improve intervention usability, and an evaluation plan was developed. The aim of this study was to provide a design rationale for game interventions targeting health-related behaviors. We developed a coherent program design in which both health behavior change and usability factors are addressed. The IM protocol can serve as a useful guide for decision making in program development and evaluation.

Rationale of Early Adopters of Fossil Fuel Divestment

Science.gov (United States)

Beer, Christopher Todd

2016-01-01

Purpose: This research uses the social science perspectives of institutions, ecological modernization and social movements to analyze the rationale used by the early-adopting universities of fossil fuel divestment in the USA. Design/methodology/approach: Through analysis of qualitative data from interviews with key actors at the universities that…

The Mediterranean healthy eating, ageing, and lifestyle (MEAL) study: rationale and study design.

Science.gov (United States)

Grosso, Giuseppe; Marventano, Stefano; D'Urso, Maurizio; Mistretta, Antonio; Galvano, Fabio

2017-08-01

There is accumulating evidence suggesting that Mediterranean lifestyles, including nutrition and sleeping patterns as well as social integration, may play a role in reducing age-related diseases. However, the literature is mostly deficient of evidence provided by Italian Mediterranean islands that more closely adhered to the originally described lifestyles. In this paper, we described the rationale and the study design of the Mediterranean healthy Eating, Ageing, and Lifestyle (MEAL) study, a prospective population-based cohort established in Sicily, southern Italy. The main exposures investigated are classical determinants of health, including demographic, nutritional habits, smoking and physical activity status, as well as eating-related behaviors, sleeping habits, sun exposure, social resources, and perceived stress. Anthropometric measurements will be collected. The main outcomes included depression, quality of life, and, after the follow-up period, also cardiovascular disease and cancer. The MEAL study may provide important data to increase our knowledge regarding the prevalence, incidence, and risk factors of age-related disorders in the Mediterranean region.

Rationale for statistical characteristics of road safety parameters

Directory of Open Access Journals (Sweden)

Dormidontova Tatiana

2017-01-01

Full Text Available When making engineering decisions at the stage of designing auto-roads and man-made structures it is necessary to take into account the statistical variability of physical and mechanical characteristics of the used materials as well as the different effects on the structures. Thus the rationale for the statistical characteristics of the parameters that determine the reliability of roads and man-made engineering facilities is of particular importance.There are many factors to be considered while designing roads, such as natural climatic factors, the accidental effects of the operating loads, the strength and deformation characteristics of the materials, the geometric parameters of the structure, etc. which affect the strength characteristics of roads and man-made structures. The rationale for statistical characteristics of the parameters can help an engineer assess the reliability of the decision and the economic risk, as well as avoid making mistakes in the design of roads and man-made structures.However, some statistical characteristics of the parameters that define the reliability of a road and man-made structures play a key role in the design. These are the visibility distance in daytime for the peak curve, variation coefficient of radial acceleration, the reliability of visibility distance and other parameters.

Oral Health Promotion in Schools: Rationale and Evaluation

Science.gov (United States)

Kizito, Alex; Caitlin, Meredith; Wang, Yili; Kasangaki, Arabat; Macnab, Andrew J.

2014-01-01

Purpose: The purpose of this paper is to explain the rationale and potential for the WHO health promoting schools (HPS) to improve children's oral health, and describe validated quantitative methodologies and qualitative approaches to measure program impact. Design/Methodology/Approach: Critical discussion of the impact of poor oral health and…

Justifying Design Decisions with Theory-based Design Principles

OpenAIRE

Schermann, Michael;Gehlert, Andreas;Pohl, Klaus;Krcmar, Helmut

2014-01-01

Although the role of theories in design research is recognized, we show that little attention has been paid on how to use theories when designing new artifacts. We introduce design principles as a new methodological approach to address this problem. Design principles extend the notion of design rationales that document how a design decision emerged. We extend the concept of design rationales by using theoretical hypotheses to support or object to design decisions. At the example of developing...

Design and rationale for examining neuroimaging genetics in ischemic stroke

Science.gov (United States)

Giese, Anne-Katrin; Schirmer, Markus D.; Donahue, Kathleen L.; Cloonan, Lisa; Irie, Robert; Winzeck, Stefan; Bouts, Mark J.R.J.; McIntosh, Elissa C.; Mocking, Steven J.; Dalca, Adrian V.; Sridharan, Ramesh; Xu, Huichun; Frid, Petrea; Giralt-Steinhauer, Eva; Holmegaard, Lukas; Roquer, Jaume; Wasselius, Johan; Cole, John W.; McArdle, Patrick F.; Broderick, Joseph P.; Jimenez-Conde, Jordi; Jern, Christina; Kissela, Brett M.; Kleindorfer, Dawn O.; Lemmens, Robin; Lindgren, Arne; Meschia, James F.; Rundek, Tatjana; Sacco, Ralph L.; Schmidt, Reinhold; Sharma, Pankaj; Slowik, Agnieszka; Thijs, Vincent; Woo, Daniel; Worrall, Bradford B.; Kittner, Steven J.; Mitchell, Braxton D.; Rosand, Jonathan; Golland, Polina; Wu, Ona

2017-01-01

Objective: To describe the design and rationale for the genetic analysis of acute and chronic cerebrovascular neuroimaging phenotypes detected on clinical MRI in patients with acute ischemic stroke (AIS) within the scope of the MRI–GENetics Interface Exploration (MRI-GENIE) study. Methods: MRI-GENIE capitalizes on the existing infrastructure of the Stroke Genetics Network (SiGN). In total, 12 international SiGN sites contributed MRIs of 3,301 patients with AIS. Detailed clinical phenotyping with the web-based Causative Classification of Stroke (CCS) system and genome-wide genotyping data were available for all participants. Neuroimaging analyses include the manual and automated assessments of established MRI markers. A high-throughput MRI analysis pipeline for the automated assessment of cerebrovascular lesions on clinical scans will be developed in a subset of scans for both acute and chronic lesions, validated against gold standard, and applied to all available scans. The extracted neuroimaging phenotypes will improve characterization of acute and chronic cerebrovascular lesions in ischemic stroke, including CCS subtypes, and their effect on functional outcomes after stroke. Moreover, genetic testing will uncover variants associated with acute and chronic MRI manifestations of cerebrovascular disease. Conclusions: The MRI-GENIE study aims to develop, validate, and distribute the MRI analysis platform for scans acquired as part of clinical care for patients with AIS, which will lead to (1) novel genetic discoveries in ischemic stroke, (2) strategies for personalized stroke risk assessment, and (3) personalized stroke outcome assessment. PMID:28852707

Efficacy of Internet-Based Guided Treatment for Genito-Pelvic Pain/Penetration Disorder: Rationale, Treatment Protocol, and Design of a Randomized Controlled Trial

OpenAIRE

Zarski, Anna-Carlotta; Berking, Matthias; Ebert, David Daniel

2018-01-01

Introduction Genito-pelvic pain/penetration disorder (GPPPD) not only adversely affects women’s sexuality and sexual satisfaction but is also associated with a wide range of psychosocial consequences such as reduced quality of life and well-being, mental health comorbidities, and relationship distress. Evidence for effective treatment options is scarce. Aim This article describes the rationale, treatment protocol, and study design for a randomized controlled trial examining the efficacy of an...

Design and Rationale for an In Situ Cryogenic Deformation Capability at a Neutron Source

International Nuclear Information System (INIS)

Livescu, V.; Clausen, B.; Sisneros, T.; Bourke, M.A.M.; Woodruff, T.R.; Vaidyanathan, R.; Notardonato, W.U.

2004-01-01

When performed in conjunction with neutron diffraction, in situ loading offers unique insights on microstructural deformation mechanisms. This is by virtue of the penetration and phase sensitivity of neutrons. At Los Alamos National Laboratory room and high temperature (up to 1500 deg. C) polycrystalline constitutive response is modeled using finite element and self-consistent models. The models are compared to neutron diffraction measurements. In doing so the implications of slip and creep to microstructural response have been explored. Recently we have been considering low temperature phenomena. This includes changes in deformation mechanisms such as the increased predilection for twinning over slip. Since this is associated with measurable texture changes as well as microstructural strain effects, it is well suited for study using neutron diffraction. This paper outlines the design and rationale for a cryogenic loading capability that will be used on the Spectrometer for MAterials Research at Temperature and Stress (SMARTS) at the Los Alamos Neutron Science Center (LANSCE)

Child/Adolescent Anxiety Multimodal Study (CAMS: rationale, design, and methods

Directory of Open Access Journals (Sweden)

Waslick Bruce D

2010-01-01

Full Text Available Abstract Objective To present the design, methods, and rationale of the Child/Adolescent Anxiety Multimodal Study (CAMS, a recently completed federally-funded, multi-site, randomized placebo-controlled trial that examined the relative efficacy of cognitive-behavior therapy (CBT, sertraline (SRT, and their combination (COMB against pill placebo (PBO for the treatment of separation anxiety disorder (SAD, generalized anxiety disorder (GAD and social phobia (SoP in children and adolescents. Methods Following a brief review of the acute outcomes of the CAMS trial, as well as the psychosocial and pharmacologic treatment literature for pediatric anxiety disorders, the design and methods of the CAMS trial are described. Results CAMS was a six-year, six-site, randomized controlled trial. Four hundred eighty-eight (N = 488 children and adolescents (ages 7-17 years with DSM-IV-TR diagnoses of SAD, GAD, or SoP were randomly assigned to one of four treatment conditions: CBT, SRT, COMB, or PBO. Assessments of anxiety symptoms, safety, and functional outcomes, as well as putative mediators and moderators of treatment response were completed in a multi-measure, multi-informant fashion. Manual-based therapies, trained clinicians and independent evaluators were used to ensure treatment and assessment fidelity. A multi-layered administrative structure with representation from all sites facilitated cross-site coordination of the entire trial, study protocols and quality assurance. Conclusions CAMS offers a model for clinical trials methods applicable to psychosocial and psychopharmacological comparative treatment trials by using state-of-the-art methods and rigorous cross-site quality controls. CAMS also provided a large-scale examination of the relative and combined efficacy and safety of the best evidenced-based psychosocial (CBT and pharmacologic (SSRI treatments to date for the most commonly occurring pediatric anxiety disorders. Primary and secondary results

Rationale, design and baseline results of the Treatment Optimisation in Primary care of Heart failure in the Utrecht region (TOPHU) study : a cluster randomised controlled trial

NARCIS (Netherlands)

Valk, Mark J.; Hoes, Arno W.; Mosterd, Arend; Landman, Marcel A.; Broekhuizen, Berna D L; Rutten, Frans H.

2015-01-01

BACKGROUND: Heart failure (HF) is mainly detected and managed in primary care, but the care is considered suboptimal. We present the rationale, design and baseline results of the Treatment Optimisation in Primary care of Heart failure in the Utrecht region (TOPHU) study. In this study we assess the

Efficacy of Internet-Based Guided Treatment for Genito-Pelvic Pain/Penetration Disorder: Rationale, Treatment Protocol, and Design of a Randomized Controlled Trial

OpenAIRE

Anna-Carlotta Zarski; Anna-Carlotta Zarski; Matthias Berking; David Daniel Ebert

2018-01-01

IntroductionGenito-pelvic pain/penetration disorder (GPPPD) not only adversely affects women’s sexuality and sexual satisfaction but is also associated with a wide range of psychosocial consequences such as reduced quality of life and well-being, mental health comorbidities, and relationship distress. Evidence for effective treatment options is scarce.AimThis article describes the rationale, treatment protocol, and study design for a randomized controlled trial examining the efficacy of an In...

Improved StrongARM latch comparator: Design, analysis and performance evaluation

KAUST Repository

Almansouri, Abdullah Saud Mohammed

2017-07-13

This paper presents an improved StrongARM latch comparator, designed and simulated in 90nm and 32nm CMOS technologies. The proposed design provides an improvement of 7% in energy efficiency, 14% in speed and an average reduction of 41% in the clock feedthrough, compared to the conventional design. The new architecture also minimizes the area by reducing the required transistors needed for the enhanced performance.

The Pediatric Obsessive-Compulsive Disorder Treatment Study II: rationale, design and methods

Directory of Open Access Journals (Sweden)

March John S

2009-01-01

Full Text Available Abstract This paper presents the rationale, design, and methods of the Pediatric Obsessive-Compulsive Disorder Treatment Study II (POTS II, which investigates two different cognitive-behavior therapy (CBT augmentation approaches in children and adolescents who have experienced a partial response to pharmacotherapy with a serotonin reuptake inhibitor for OCD. The two CBT approaches test a "single doctor" versus "dual doctor" model of service delivery. A specific goal was to develop and test an easily disseminated protocol whereby child psychiatrists would provide instructions in core CBT procedures recommended for pediatric OCD (e.g., hierarchy development, in vivo exposure homework during routine medical management of OCD (I-CBT. The conventional "dual doctor" CBT protocol consists of 14 visits over 12 weeks involving: (1 psychoeducation, (2, cognitive training, (3 mapping OCD, and (4 exposure with response prevention (EX/RP. I-CBT is a 7-session version of CBT that does not include imaginal exposure or therapist-assisted EX/RP. In this study, we compared 12 weeks of medication management (MM provided by a study psychiatrist (MM only with two types of CBT augmentation: (1 the dual doctor model (MM+CBT; and (2 the single doctor model (MM+I-CBT. The design balanced elements of an efficacy study (e.g., random assignment, independent ratings with effectiveness research aims (e.g., differences in specific SRI medications, dosages, treatment providers. The study is wrapping up recruitment of 140 youth ages 7–17 with a primary diagnosis of OCD. Independent evaluators (IEs rated participants at weeks 0,4,8, and 12 during acute treatment and at 3,6, and 12 month follow-up visits. Trial registration NCT00074815

Response of base isolated structure during strong ground motions beyond design earthquakes

International Nuclear Information System (INIS)

Yabana, Shuichi; Ishida, Katsuhiko; Shiojiri, Hiroo

1991-01-01

In Japan, some base isolated structures for fast breeder reactors (FBR) are tried to design. When a base isolated structure are designed, the relative displacement of isolators are generally limited so sa to be remain in linear state of those during design earthquakes. But to estimate safety margin of a base isolated structure, the response of that until the failure must be obtained experimentally to analytically during strong ground motions of beyond design earthquake. The aim of this paper is to investigate the response of a base isolated structure when the stiffness of the isolators hardens and to simulate the response during strong ground motions of beyond design earthquakes. The optimum characteristics of isolators, with which the margin of the structure are increased, are discussed. (author)

The rationale for energy efficiency policy: Assessing the recognition of the multiple benefits of energy efficiency retrofit policy

International Nuclear Information System (INIS)

Kerr, Niall; Gouldson, Andy; Barrett, John

2017-01-01

The rationale for energy efficiency policy can be framed in terms of a variety of different benefits. This paper considers how different benefits have been used within the overall rationale for energy efficient retrofit policy in different contexts. We posit that different rationales may be used for the same policy response, and that the form of rationale used may affect the design, delivery or the level of policy support, with different rationales making it easier to account for different results. Considering retrofit policy in the contexts of the UK, Germany, New Zealand and Ireland, we characterise policy rationale in each case, assessing what the key perceived benefits have been, and whether they have changed over time. The analysis identifies some marked differences between cases with the recognition of benefits and the ensuing policy rationale resulting from a complex mix of political, social and economic influences. We find that recognition of multiple benefits may not equate with multiplied policy support, and instead it is more likely that different rationales will have relevance at different times, for different audiences. The findings highlight that, alongside evidence for policy, it is important to also consider how the overall rationale for policy is eventually framed. - Highlights: • Energy efficiency as a policy issue with perceived multiple benefits. • Assessment of the influence of different benefits on rationale for energy efficient retrofit policy. • How does the rationale for retrofit policy differ in different national policy contexts. • To what extent are the perceived multiple benefits of policy recognised. • What influence does eventual rationale for policy have on the policy implemented.

PRagmatic trial Of Video Education in Nursing homes: The design and rationale for a pragmatic cluster randomized trial in the nursing home setting.

Science.gov (United States)

Mor, Vincent; Volandes, Angelo E; Gutman, Roee; Gatsonis, Constantine; Mitchell, Susan L

2017-04-01

Background/Aims Nursing homes are complex healthcare systems serving an increasingly sick population. Nursing homes must engage patients in advance care planning, but do so inconsistently. Video decision support tools improved advance care planning in small randomized controlled trials. Pragmatic trials are increasingly employed in health services research, although not commonly in the nursing home setting to which they are well-suited. This report presents the design and rationale for a pragmatic cluster randomized controlled trial that evaluated the "real world" application of an Advance Care Planning Video Program in two large US nursing home healthcare systems. Methods PRagmatic trial Of Video Education in Nursing homes was conducted in 360 nursing homes (N = 119 intervention/N = 241 control) owned by two healthcare systems. Over an 18-month implementation period, intervention facilities were instructed to offer the Advance Care Planning Video Program to all patients. Control facilities employed usual advance care planning practices. Patient characteristics and outcomes were ascertained from Medicare Claims, Minimum Data Set assessments, and facility electronic medical record data. Intervention adherence was measured using a Video Status Report embedded into electronic medical record systems. The primary outcome was the number of hospitalizations/person-day alive among long-stay patients with advanced dementia or cardiopulmonary disease. The rationale for the approaches to facility randomization and recruitment, intervention implementation, population selection, data acquisition, regulatory issues, and statistical analyses are discussed. Results The large number of well-characterized candidate facilities enabled several unique design features including stratification on historical hospitalization rates, randomization prior to recruitment, and 2:1 control to intervention facilities ratio. Strong endorsement from corporate leadership made randomization

Rationale and Design of the Echocardiographic Study of Hispanics/Latinos (ECHO-SOL).

Science.gov (United States)

Rodriguez, Carlos J; Dharod, Ajay; Allison, Matthew A; Shah, Sanjiv J; Hurwitz, Barry; Bangdiwala, Shrikant I; Gonzalez, Franklyn; Kitzman, Dalane; Gillam, Linda; Spevack, Daniel; Dadhania, Rupal; Langdon, Sarah; Kaplan, Robert

2015-01-01

Information regarding the prevalence and determinants of cardiac structure and function (systolic and diastolic) among the various Hispanic background groups in the United States is limited. The Echocardiographic Study of Latinos (ECHO-SOL) ancillary study recruited 1,824 participants through a stratified-sampling process representative of the population-based Hispanic Communities Health Study - Study of Latinos (HCHS-SOL) across four sites (Bronx, NY; Chicago, Ill; San Diego, Calif; Miami, Fla). The HCHS-SOL baseline cohort did not include an echo exam. ECHO-SOL added the echocardiographic assessment of cardiac structure and function to an array of existing HCHS-SOL baseline clinical, psychosocial, and socioeconomic data and provides sufficient statistical power for comparisons among the Hispanic subgroups. Standard two-dimensional (2D) echocardiography protocol, including M-mode, spectral, color and tissue Doppler study was performed. The main objectives were to: 1) characterize cardiac structure and function and its determinants among Hispanics and Hispanic subgroups; and 2) determine the contributions of specific psychosocial factors (acculturation and familismo) to cardiac structure and function among Hispanics. We describe the design, methods and rationale of currently the largest and most comprehensive study of cardiac structure and function exclusively among US Hispanics. ECHO-SOL aims to enhance our understanding of Hispanic cardiovascular health as well as help untangle the relative importance of Hispanic subgroup heterogeneity and sociocultural factors on cardiac structure and function.

The PROgnostic Value of unrequested Information in Diagnostic Imaging (PROVIDI) Study: rationale and design

International Nuclear Information System (INIS)

Gondrie, M. J. A.; Mali, W. P. Th. M.; Buckens, C. F. M.; Jacobs, P. C. A.; Grobbee, D. E.; Graaf, Y van der

2010-01-01

We describe the rationale for a new study examining the prognostic value of unrequested findings in diagnostic imaging. The deployment of more advanced imaging modalities in routine care means that such findings are being detected with increasing frequency. However, as the prognostic significance of many types of unrequested findings is unknown, the optimal response to such findings remains uncertain and in many cases an overly defensive approach is adopted, to the detriment of patient-care. Additionally, novel and promising image findings that are newly available on many routine scans cannot be used to improve patient care until their prognostic value is properly determined. The PROVIDI study seeks to address these issues using an innovative multi-center case-cohort study design. PROVIDI is to consist of a series of studies investigating specific, selected disease entities and clusters. Computed Tomography images from the participating hospitals are reviewed for unrequested findings. Subsequently, this data is pooled with outcome data from a central population registry. Study populations consist of patients with endpoints relevant to the (group of) disease(s) under study along with a random control sample from the cohort. This innovative design allows PROVIDI to evaluate selected unrequested image findings for their true prognostic value in a series of manageable studies. By incorporating unrequested image findings and outcomes data relevant to patients, truly meaningful conclusions about the prognostic value of unrequested and emerging image findings can be reached and used to improve patient-care.

Effects of Role and Assignment Rationale on Attitudes Formed During Peer Tutoring

Science.gov (United States)

Bierman, Karen Linn; Furman, Wyndol

2012-01-01

This study examined the role of contextual factors, such as assignment rationale, on the attitudinal effects of peer tutoring. Fourth-grade children engaged in brief tutoring experiences as either a tutor or tutee. Subjects received four rationales for being selected as tutor or tutee: (a) a competence rationale, (b) a physical characteristic rationale, (c) a chance rationale, or (d) no rationale. As predicted, tutors had more positive attitudes than tutees when they had been given a competence or physical characteristic rationale but not when the tutors were provided a chance rationale or no rationale. Additionally, the tutors’ and tutees’ attitudes were enhanced when no rationale was provided. Results are discussed in terms of their implications for a role-theory analysis of tutoring and their implications for applied programs. PMID:23946549

Rationale and methods of the EFCOSUM project

NARCIS (Netherlands)

Brussaard, J.H.; Johansson, L.; Kearney, J.

2002-01-01

Objective: To describe the rationale and methods for a European project (EFCOSUM) to develop a method for a European food consumption survey that delivers internationally comparable data on a set of policy-relevant nutritional indicators. Rationale and methods: Currently Member States are collecting

Rationale and design of a large registry on renal denervation: the Global SYMPLICITY registry.

Science.gov (United States)

Böhm, Michael; Mahfoud, Felix; Ukena, Christian; Bauer, Axel; Fleck, Eckart; Hoppe, Uta C; Kintscher, Ulrich; Narkiewicz, Krzysztof; Negoita, Manuela; Ruilope, Luis; Rump, L Christian; Schlaich, Markus; Schmieder, Roland; Sievert, Horst; Weil, Joachim; Williams, Bryan; Zeymer, Uwe; Mancia, Giuseppe

2013-08-22

Hypertension is a global healthcare concern associated with a wide range of comorbidities. The recognition that elevated sympathetic drive plays an important role in the pathogenesis of hypertension led to the use of renal artery denervation to interrupt the efferent and afferent sympathetic nerves between the brain and kidneys to lower blood pressure. Clinical trials of the Symplicity™ renal denervation system have demonstrated that radiofrequency ablation of renal artery nerves is safe and significantly lowers blood pressure in patients with severe resistant (systolic BP >160 mmHg) hypertension. Smaller ancillary studies in hypertensive patients suggest a benefit from renal denervation in a variety of conditions such as chronic kidney disease, glucose intolerance, sleep apnoea and heart failure. The Global SYMPLICITY registry, which incorporates the GREAT SYMPLICITY registry initiated in Germany, is being conducted worldwide to evaluate the safety and efficacy of treatment with the Symplicity renal denervation system in real-world uncontrolled hypertensive patients, looking first at subjects with severe resistant hypertension to confirm the results of prior clinical trials, but then also subjects with a wider range of baseline blood pressure and coexisting comorbidities. The rationale, design and first baseline data from the Global SYMPLICITY registry are presented.

Prediction and design of first super-strong liquid-crystalline polymers

International Nuclear Information System (INIS)

Dowell, F.

1989-01-01

This paper presents the details of the theoretical prediction and design (atom by atom, bond by bond) of the molecule chemical structures of the first candidate super-strong liquid-crystalline polymers (SS LCPs). These LCPs are the first LCPs designed to have good compressive strengths, as well as to have tensile strengths and tensile moduli significantly larger than those of existing strong LCPs (such as Kevlar). The key feature of this new class of LCPs is that the exceptional strength is three dimensional on a microscopic, molecular level (thus, on a macroscopic level), in contrast to present LCPs (such as Kevlar) with their one-dimensional exceptional strength. These SS LCPs also have some solubility and processing advantages over existing strong LCPs. These SS LCPs are specially-designed combined LCPs such that the side chains of a molecule interdigitate with the side chains of other molecules. This paper also presents other essential general and specific features required for SS LCPs. Considerations in the design of SS LCPs include the spacing distance between side chains along the backbone, the need for rigid sections in the backbone and side chains, the degree of polymerization, the length of the side chains, the regularity of spacing of the side chains along the backbone, the interdigitation of side chains in submolecular strips, the packing of the side chains on one or two sides of the backbone, the symmetry of the side chains, the points of attachment of the side chains to the backbone, the flexibility and size of the chemical group connecting each side chain to the backbone, the effect of semiflexible sections in the backbone and side chains, and the choice of types of dipolar and/or hydrogen bonding forces in the backbones and side chains for easy alignment

Rationale and Design of the Women and Inclusion in Academic Medicine Study.

Science.gov (United States)

Hill, Emorcia V; Wake, Michael; Carapinha, René; Normand, Sharon-Lise; Wolf, Robert E; Norris, Keith; Reede, Joan Y

2016-04-21

Women of color (WOC) (African American, Hispanic, Native American/Alaskan Native, and Asian American) faculty remain disproportionately underrepresented among medical school faculty and especially at senior ranks compared with White female faculty. The barriers or facilitators to the career advancement of WOC are poorly understood. The Women and Inclusion in Academic Medicine (WIAM) study was developed to characterize individual, institutional and sociocultural factors that influence the entry, progression and persistence, and advancement of women faculty in academic medical careers with a focus on WOC. Using a purposive sample of 13 academic medical institutions, we collected qualitative interview data from 21 WOC junior faculty and quantitative data from 3,127 (38.9% of 8,053 eligible women) respondents via an online survey. To gather institutional data, we used an online survey and conducted 23 key administrative informant interviews from the 13 institutions. Grounded theory methodology will be used to analyze qualitative data. Multivariable analysis including hierarchical linear modeling will be used to investigate outcomes, such as the inclusiveness of organizational gender climate and women faculty's intent to stay. We describe the design, methods, rationale and limitations of one of the largest and most comprehensive studies of women faculty in academic medicine with a focus on WOC. This study will enhance our understanding of challenges that face women, and, especially WOC, faculty in academic medicine and will provide solutions at both the individual and institutional levels.

Advanced water-cooled reactor technologies. Rationale, state of progress and outlook

International Nuclear Information System (INIS)

Anon.

1989-01-01

Eighty per cent of the world's power reactors are water cooled and moderated. Many improvements in their design and operation have been implemented since the first such reactor started commercial operation in 1957. This report addresses the safety, environmental and economic rationales for further improvements, as well as their relevance to currently operating water reactors

New Rationales for Women on Boards

OpenAIRE

Choudhury, B.

2014-01-01

Should measures promoting women to corporate boards be solely justified in terms of economic arguments? Traditionally, such measures have tended to rely on utilitarian arguments, despite the fact that the most prominent of these arguments—the relationship between women’s presence on boards and firm financial performance—is equivocal. Conversely, this article argues that rationales for increasing women on boards should be based on both equality and economics grounds. An equality rationale is n...

Rationales for the Lightning Launch Commit Criteria

Science.gov (United States)

Willett, John C. (Editor); Merceret, Francis J. (Editor); Krider, E. Philip; O'Brien, T. Paul; Dye, James E.; Walterscheid, Richard L.; Stolzenburg, Maribeth; Cummins, Kenneth; Christian, Hugh J.; Madura, John T.

2016-01-01

Since natural and triggered lightning are demonstrated hazards to launch vehicles, payloads, and spacecraft, NASA and the Department of Defense (DoD) follow the Lightning Launch Commit Criteria (LLCC) for launches from Federal Ranges. The LLCC were developed to prevent future instances of a rocket intercepting natural lightning or triggering a lightning flash during launch from a Federal Range. NASA and DoD utilize the Lightning Advisory Panel (LAP) to establish and develop robust rationale from which the criteria originate. The rationale document also contains appendices that provide additional scientific background, including detailed descriptions of the theory and observations behind the rationales. The LLCC in whole or part are used across the globe due to the rigor of the documented criteria and associated rationale. The Federal Aviation Administration (FAA) adopted the LLCC in 2006 for commercial space transportation and the criteria were codified in the FAA's Code of Federal Regulations (CFR) for Safety of an Expendable Launch Vehicle (Appendix G to 14 CFR Part 417, (G417)) and renamed Lightning Flight Commit Criteria in G417.

Predicting asthma in preschool children with asthma symptoms: study rationale and design

Directory of Open Access Journals (Sweden)

Hafkamp-de Groen Esther

2012-10-01

Full Text Available Abstract Background In well-child care it is difficult to determine whether preschool children with asthma symptoms actually have or will develop asthma at school age. The PIAMA (Prevention and Incidence of Asthma and Mite Allergy Risk Score has been proposed as an instrument that predicts asthma at school age, using eight easy obtainable parameters, assessed at the time of first asthma symptoms at preschool age. The aim of this study is to present the rationale and design of a study 1 to externally validate and update the PIAMA Risk Score, 2 to develop an Asthma Risk Appraisal Tool to predict asthma at school age in (specific subgroups of preschool children with asthma symptoms and 3 to test implementation of the Asthma Risk Appraisal Tool in well-child care. Methods and design The study will be performed within the framework of Generation R, a prospective multi-ethnic cohort study. In total, consent for postnatal follow-up was obtained from 7893 children, born between 2002 and 2006. At preschool age the PIAMA Risk Score will be assessed and used to predict asthma at school age. Discrimination (C-index and calibration will be assessed for the external validation. We will study whether the predictive ability of the PIAMA Risk Score can be improved by removing or adding predictors (e.g. preterm birth. The (updated PIAMA Risk Score will be converted to the Asthma Risk Appraisal Tool- to predict asthma at school age in preschool children with asthma symptoms. Additionally, we will conduct a pilot study to test implementation of the Asthma Risk Appraisal Tool in well-child care. Discussion Application of the Asthma Risk Appraisal Tool in well-child care will help to distinguish preschool children at high- and low-risk of developing asthma at school age when asthma symptoms appear. This study will increase knowledge about the validity of the PIAMA risk score and might improve risk assessment of developing asthma at school age in (specific subgroups

Advanced control room evaluation: General approach and rationale

International Nuclear Information System (INIS)

O'Hara, J.M.; Wachtel, J.

1991-01-01

Advanced control rooms (ACRs) for future nuclear power plants (NPPs) are being designed utilizing computer-based technologies. The US Nuclear Regulatory Commission reviews the human engineering aspects of such control rooms to ensure that they are designed to good human factors engineering principles and that operator performance and reliability are appropriately supported in order to protect public health and safety. This paper describes the rationale and general approach to the development of a human factors review guideline for ACRs. The factors influencing the guideline development are discussed, including the review environment, the types of advanced technologies being addressed, the human factors issues associated with advanced technology, and the current state-of-the-art of human factors guidelines for advanced human-system interfaces (HSIs). The proposed approach to ACR review would track the design and implementation process through the application of review guidelines reflecting four review modules: planning, design process analysis, human factors engineering review, and dynamic performance evaluation. 21 refs

Description and Rationale for the Planning, Monitoring, and Implementation (PMI) Model: Rationale.

Science.gov (United States)

Cort, H. Russell

The rationale for the Planning, Monitoring, and Implementation Model (PMI) is the subject of this paper. The Superintendent of the District of Columbia Public Schools requested a model for systematic evaluation of educational programs to determine their effectiveness. The school system's emphasis on objective-referenced instruction and testing,…

Educational Rationale Metadata for Learning Objects

Directory of Open Access Journals (Sweden)

Tom Carey

2002-10-01

Full Text Available Instructors searching for learning objects in online repositories will be guided in their choices by the content of the object, the characteristics of the learners addressed, and the learning process embodied in the object. We report here on a feasibility study for metadata to record process-oriented information about instructional approaches for learning objects, though a set of Educational Rationale [ER] tags which would allow authors to describe the critical elements in their design intent. The prototype ER tags describe activities which have been demonstrated to be of value in learning, and authors select the activities whose support was critical in their design decisions. The prototype ER tag set consists descriptors of the instructional approach used in the design, plus optional sub-elements for Comments, Importance and Features which implement the design intent. The tag set was tested by creators of four learning object modules, three intended for post-secondary learners and one for K-12 students and their families. In each case the creators reported that the ER tag set allowed them to express succinctly the key instructional approaches embedded in their designs. These results confirmed the overall feasibility of the ER tag approach as a means of capturing design intent from creators of learning objects. Much work remains to be done before a usable ER tag set could be specified, including evaluating the impact of ER tags during design to improve instructional quality of learning objects.

Overcoming limitations in previous research on exercise as a smoking cessation treatment: rationale and design of the "Quit for Health" trial.

Science.gov (United States)

Williams, David M; Ussher, Michael; Dunsiger, Shira; Miranda, Robert; Gwaltney, Chad J; Monti, Peter M; Emerson, Jessica

2014-01-01

Aerobic exercise has been proposed as a stand-alone or adjunct smoking cessation treatment, but findings have been mixed. Laboratory studies have shown that individual exercise sessions lead to decreases in withdrawal symptoms and cigarette cravings, but findings are limited by lack of follow-up and artificial settings. On the other hand, smoking cessation treatment RCTs have generally failed to show positive effects of exercise on smoking cessation, but have been plagued by poor and/or unverified compliance with exercise programs. This paper describes the rationale and design for Quit for Health (QFH)--an RCT designed to determine the efficacy of aerobic exercise as an adjunct smoking cessation treatment among women. To overcome limitations of previous research, compliance with the exercise (and wellness contact control) program is incentivized and directly observed, and ecological momentary assessment is used to examine change over time in withdrawal symptoms and cigarette cravings in participants' natural environments. Copyright © 2013 Elsevier Inc. All rights reserved.

The evaluation of subcutaneous proleukin (interleukin-2) in a randomized international trial: rationale, design, and methods of ESPRIT.

Science.gov (United States)

Emery, Sean; Abrams, Donald I; Cooper, David A; Darbyshire, Janet H; Lane, H Clifford; Lundgren, Jens D; Neaton, James D

2002-04-01

The Evaluation of Subcutaneous Proleukin in a Randomized International Trial (ESPRIT) is a large ongoing randomized trial of subcutaneous interleukin-2 (IL-2) plus antiretroviral therapy versus antiretroviral therapy alone in patients with HIV (human immunodeficiency virus) disease and CD4 cell counts of at least 300 cells/mm(3). The primary objective is to determine whether the addition of IL-2 to combination antiretroviral therapy improves morbidity and mortality. The aim is to recruit 4000 participants and follow them for an average of 5 years. Eligible subjects will be recruited at 275 investigational sites in 23 countries around the world. Coupled with broad eligibility criteria this will ensure widely applicable results. A range of secondary objectives will also be addressed in this setting that will include the conduct of observational studies and nested substudies with a public health focus. This article describes the rationale supporting the trial in addition to reviewing the study design, coordination, and governance.

Tranexamic acid for acute intracerebral hemorrhage growth predicted by spot sign trial: Rationale and design.

Science.gov (United States)

Liu, Liping; Wang, Yilong; Meng, Xia; Li, Na; Tan, Ying; Nie, Ximing; Liu, Dacheng; Zhao, Xingquan

2017-04-01

Rationale Acute intracerebral hemorrhage inflicts a high-economic and -health burden. Computed tomography angiography spot sign is a predictor of hematoma expansion, is associated with poor clinical outcome and is an important stratifying variable for patients treated with haemostatic therapy. Aims We aim to compare the effect of treatment with tranexamic acid to placebo for the prevention of hemorrhage growth in patients with high-risk acute intracerebral hemorrhage with a positive spot sign. Design The tranexamic acid for acute intracerebral hemorrhage growth predicted by spot sign (TRAIGE) is a prospective, multicenter, placebo-controlled, double-blind, investigator-led, randomized clinical trial that will include an estimated 240 participants. Patients with intracerebral hemorrhage demonstrating symptom onset within 8 h and with the spot sign as a biomarker for ongoing hemorrhage, and no contraindications for antifibrinolytic therapy, will be enrolled to receive either tranexamic acid or placebo. The primary outcome measure is the presence of hemorrhage growth defined as an increase in intracerebral hemorrhage volume >33% or >6 ml from baseline to 24 ± 2 h. The secondary outcomes include safety and clinical outcomes. Conclusion The TRAIGE trial evaluates the efficacy of haemostatic therapy with tranexamic acid in the prevention of hemorrhage growth among high-risk patients with acute intracerebral hemorrhage.

An anthology: Rationale for a US ballistic missile defense (1969 - 1984)

Science.gov (United States)

Tircuit, E. C.

1985-04-01

This anthology is a selection and short synopsis of representative articles on the rationale for a US ballistic missile defense (BMD). Unclassified articles and documents were reviewed and analyzed to identify and include nine representative articles in the anthology. The anthology reduces the search for quality material on the subject and documents the fundamental rationale for a BMD. The author concluded that the fundamental rationale for a US BMD is to deter nuclear war. In addition, specific rationale for a US BMD is provided in the anthology. Finally, an extensive bibliography is included in the anthology to enhance further research on the subject.

Longitudinal Andhra Pradesh Eye Disease Study: rationale, study design and research methodology.

Science.gov (United States)

Khanna, Rohit C; Murthy, Gudlavalleti Vs; Marmamula, Srinivas; Mettla, Asha Latha; Giridhar, Pyda; Banerjee, Seema; Shekhar, Konegari; Chakrabarti, Subhabrata; Gilbert, Clare; Rao, Gullapalli N

2016-03-01

The rationale, objectives, study design and procedures for the longitudinal Andhra Pradesh Eye Disease Study are described. A longitudinal cohort study was carried out. Participants include surviving cohort from the rural component of Andhra Pradesh Eye Disease Study. During 1996-2000, Andhra Pradesh Eye Disease Survey was conducted in three rural (n = 7771) and one urban (n = 2522) areas (now called Andhra Pradesh Eye Disease Study 1). In 2009-2010, a feasibility exercise (Andhra Pradesh Eye Disease Study 2) for a longitudinal study (Andhra Pradesh Eye Disease Study 3) was undertaken in the rural clusters only, as urban clusters no longer existed. In Andhra Pradesh Eye Disease Study 3, a detailed interview will be carried out to collect data on sociodemographic factors, ocular and systemic history, risk factors, visual function, knowledge of eye diseases and barriers to accessing services. All participants will also undergo a comprehensive eye examination including photography of lens, optic disc and retina, Optic Coherence Tomography of the posterior segment, anthropometry, blood pressure and frailty measures. Measures include estimates of the incidence of visual impairment and age-related eye disease (lens opacities, glaucoma and age-related macular degeneration) and the progression of eye disease (lens opacities and myopia) and associated risk factors. Of the 7771 respondents examined in rural areas in Andhra Pradesh Eye Disease Study 1, 5447 (70.1%) participants were traced in Andhra Pradesh Eye Disease Study 2. These participants will be re-examined. Andhra Pradesh Eye Disease Study 3 will provide data on the incidence and progression of visual impairment and major eye diseases and their associated risk factors in India. The study will provide further evidence to aid planning eye care services. © 2015 Royal Australian and New Zealand College of Ophthalmologists.

A Multi-site, Two-Phase, Prescription Opioid Addiction Treatment Study (POATS): Rationale, Design, and Methodology

Science.gov (United States)

Weiss, Roger D.; Potter, Jennifer Sharpe; Provost, Scott E.; Huang, Zhen; Jacobs, Petra; Hasson, Albert; Lindblad, Robert; Connery, Hilary Smith; Prather, Kristi; Ling, Walter

2010-01-01

The National Institute on Drug Abuse Clinical Trials Network launched the Prescription Opioid Addiction Treatment Study (POATS) in response to rising rates of prescription opioid dependence and gaps in understanding the optimal course of treatment for this population. POATS employed a multi-site, two-phase adaptive, sequential treatment design to approximate clinical practice. The study took place at 10 community treatment programs around the United States. Participants included men and women age ≥18 who met Diagnostic and Statistical Manual, 4th Edition criteria for dependence upon prescription opioids, with physiologic features; those with a prominent history of heroin use (according to pre-specified criteria) were excluded. All participants received buprenorphine/naloxone (bup/nx). Phase 1 consisted of 4 weeks of bup/nx treatment, including a 14-day dose taper, with 8 weeks of follow-up. Phase 1 participants were monitored for treatment response during these 12 weeks. Those who relapsed to opioid use, as defined by pre-specified criteria, were invited to enter Phase 2; Phase 2 consisted of 12 weeks of bup/nx stabilization treatment, followed by a 4-week taper and 8 weeks of post-treatment follow-up. Participants were randomized at the beginning of Phase 1 to receive bup/nx, paired with either Standard Medical Management (SMM) or Enhanced Medical Management (EMM; defined as SMM plus individual drug counseling). Eligible participants entering Phase 2 were re-randomized to either EMM or SMM. POATS was developed to determine what benefit, if any, EMM offers over SMM in short-term and longer-term treatment paradigm. This paper describes the rationale and design of the study. PMID:20116457

Overcoming Limitations in Previous Research on Exercise as a Smoking Cessation Treatment: Rationale and Design of the “Quit for Health” Trial

Science.gov (United States)

Williams, David M.; Ussher, Michael; Dunsiger, Shira; Miranda, Robert; Gwaltney, Chad J.; Monti, Peter M.; Emerson, Jessica

2013-01-01

Aerobic exercise has been proposed as a stand-alone or adjunct smoking cessation treatment, but findings have been mixed. Laboratory studies have shown that individual exercise sessions lead to decreases in withdrawal symptoms and cigarette cravings, but findings are limited by lack of follow-up and artificial settings. On the other hand, smoking cessation treatment RCTs have generally failed to show positive effects of exercise on smoking cessation, but have been plagued by poor and/or unverified compliance with exercise programs. This paper describes the rationale and design for Quit for Health (QFH)—an RCT designed to determine the efficacy of aerobic exercise as an adjunct smoking cessation treatment among women. To overcome limitations of previous research, compliance with the exercise (and wellness contact control) program is incentivized and directly observed, and ecological momentary assessment is used to examine change over time in withdrawal symptoms and cigarette cravings in participants’ natural environments. PMID:24246818

Design and rationale for examining neuroimaging genetics in ischemic stroke: The MRI-GENIE study.

Science.gov (United States)

Giese, Anne-Katrin; Schirmer, Markus D; Donahue, Kathleen L; Cloonan, Lisa; Irie, Robert; Winzeck, Stefan; Bouts, Mark J R J; McIntosh, Elissa C; Mocking, Steven J; Dalca, Adrian V; Sridharan, Ramesh; Xu, Huichun; Frid, Petrea; Giralt-Steinhauer, Eva; Holmegaard, Lukas; Roquer, Jaume; Wasselius, Johan; Cole, John W; McArdle, Patrick F; Broderick, Joseph P; Jimenez-Conde, Jordi; Jern, Christina; Kissela, Brett M; Kleindorfer, Dawn O; Lemmens, Robin; Lindgren, Arne; Meschia, James F; Rundek, Tatjana; Sacco, Ralph L; Schmidt, Reinhold; Sharma, Pankaj; Slowik, Agnieszka; Thijs, Vincent; Woo, Daniel; Worrall, Bradford B; Kittner, Steven J; Mitchell, Braxton D; Rosand, Jonathan; Golland, Polina; Wu, Ona; Rost, Natalia S

2017-10-01

To describe the design and rationale for the genetic analysis of acute and chronic cerebrovascular neuroimaging phenotypes detected on clinical MRI in patients with acute ischemic stroke (AIS) within the scope of the MRI-GENetics Interface Exploration (MRI-GENIE) study. MRI-GENIE capitalizes on the existing infrastructure of the Stroke Genetics Network (SiGN). In total, 12 international SiGN sites contributed MRIs of 3,301 patients with AIS. Detailed clinical phenotyping with the web-based Causative Classification of Stroke (CCS) system and genome-wide genotyping data were available for all participants. Neuroimaging analyses include the manual and automated assessments of established MRI markers. A high-throughput MRI analysis pipeline for the automated assessment of cerebrovascular lesions on clinical scans will be developed in a subset of scans for both acute and chronic lesions, validated against gold standard, and applied to all available scans. The extracted neuroimaging phenotypes will improve characterization of acute and chronic cerebrovascular lesions in ischemic stroke, including CCS subtypes, and their effect on functional outcomes after stroke. Moreover, genetic testing will uncover variants associated with acute and chronic MRI manifestations of cerebrovascular disease. The MRI-GENIE study aims to develop, validate, and distribute the MRI analysis platform for scans acquired as part of clinical care for patients with AIS, which will lead to (1) novel genetic discoveries in ischemic stroke, (2) strategies for personalized stroke risk assessment, and (3) personalized stroke outcome assessment.

Critical Conversations: Feedback As A Stimulus To Creativity In Software Design

Directory of Open Access Journals (Sweden)

Raymond McCall

2010-01-01

Full Text Available Three decades of creating software to support design rationale showed the author how rationale processes can promote generation of novel ideas. Rationale can promote creative design by promoting critical conversations among designers and other project participants. Critical conversations intertwine ideation and evaluation, using feedback about consequences of decisions to challenge designers to devise new ideas. Such conversations take two forms. The first is discussion involving feedback from speculation about consequences of design decisions for implementation and use. The second is discussion involving feedback from actual experiences of implementation and use of the software being designed. The former is purely a process of reflective discourse, the latter a process of situated cognition involving both action and reflective discourse. Thus, the former is pure argumentation, the latter situated argumentation. Exploiting the full potential of critical conversations for creative design requires rethinking rationale methods and integrating them into software supporting implementation and use.

Do Architectural Design Decisions Improve the Understanding of Software Architecture? Two Controlled Experiments

NARCIS (Netherlands)

Shahin, M.; Liang, P.; Li, Z.

2014-01-01

Architectural design decision (ADD) and its design rationale, as a paradigm shift on documenting and enriching architecture design description, is supposed to facilitate the understanding of architecture and the reasoning behind the design rationale, which consequently improves the architecting

The steps to health employee weight management randomized control trial: rationale, design and baseline characteristics.

Science.gov (United States)

Østbye, Truls; Stroo, Marissa; Brouwer, Rebecca J N; Peterson, Bercedis L; Eisenstein, Eric L; Fuemmeler, Bernard F; Joyner, Julie; Gulley, Libby; Dement, John M

2013-07-01

The workplace can be an important setting for addressing obesity. An increasing number of employers offer weight management programs. Present the design, rationale and baseline characteristics of the Steps to Health study (STH), a randomized trial to evaluate the effectiveness of two preexisting employee weight management programs offered at Duke University and Medical Center. 550 obese (BMI ≥30) employee volunteers were randomized 1:1 to two programs. Baseline data, collected between January 2011 and July 2012, included height/weight, accelerometry, workplace injuries, health care utilization, and questionnaires querying socio-cognitive factors, perceptions of health climate, physical activity, and dietary intake. In secondary analyses participants in the two programs will also be compared to a non-randomized observational control group of obese employees. At baseline, the mean age was 45 years, 83% were female, 41% white, and 53% black. Mean BMI was 37.2. Participants consumed a mean of 2.37 servings of fruits and vegetables per day (in the past week), participated in 11.5 min of moderate-to-vigorous physical activity, and spent 620 min being sedentary. STH addresses the need for evaluation of worksite interventions to promote healthy weight. In addition to having direct positive effects on workers' health, worksite programs have the potential to increase productivity and reduce health care costs. Copyright © 2013 Elsevier Inc. All rights reserved.

Kids and adults now! Defeat Obesity (KAN-DO): rationale, design and baseline characteristics.

Science.gov (United States)

Ostbye, Truls; Zucker, Nancy L; Krause, Katrina M; Lovelady, Cheryl A; Evenson, Kelly R; Peterson, Bercedis L; Bastian, Lori A; Swamy, Geeta K; West, Deborah G; Brouwer, Rebecca J N

2011-05-01

Prevention of childhood obesity is a public health priority. Parents influence a child's weight by modeling healthy behaviors, controlling food availability and activity opportunities, and appropriate feeding practices. Thus interventions should target education and behavioral change in the parent, and positive, mutually reinforcing behaviors within the family. This paper presents the design, rationale and baseline characteristics of Kids and Adults Now! - Defeat Obesity (KAN-DO), a randomized controlled behavioral intervention trial targeting weight maintenance in children of healthy weight, and weight reduction in overweight children. 400 children aged 2-5 and their overweight or obese mothers in the Triangle and Triad regions of North Carolina are randomized equally to control or the KAN-DO intervention, consisting of mailed family kits encouraging healthy lifestyle change. Eight (monthly) kits are supported by motivational counseling calls and a single group session. Mothers are targeted during a hypothesized "teachable moment" for health behavior change (the birth of a new baby), and intervention content addresses: parenting skills ((e.g., emotional regulation, authoritative parenting), healthy eating, and physical activity. The 400 mother-child dyads randomized to trial are 75% white and 22% black; 19% have a household income of $30,000 or below. At baseline, 15% of children are overweight (85th-95th percentile for body mass index) and 9% are obese (≥ 95th percentile). This intervention addresses childhood obesity prevention by using a family-based, synergistic approach, targeting at-risk children and their mothers during key transitional periods, and enhancing maternal self-regulation and responsive parenting as a foundation for health behavior change. Copyright © 2011 Elsevier Inc. All rights reserved.

Rationale for the Design of a Web-based Programming Course for Adults

DEFF Research Database (Denmark)

Bennedsen, Jens; Caspersen, Michael Edelgaard

2003-01-01

Web-based distance education is becoming more and more popular in particular for part-time educations primarily because it flexibly adapts to a busy life where family and work has first priority. Students can follow the course without wasting precious time traveling to and from campus several...... evenings a week, and participation can take place also in situations where it would otherwise be impossible (e.g. a sick child or a business trip). However, these advantages don't come for free: the students lose the social relations following from face-to-face contact with the lecturer and teaching...... assistant as well as the other students. Another serious drawback is the reduced bandwidth in communication among the different actors. Precautions have to be taken in order to compensate for these and other drawbacks. We describe a web-based introductory programming course for adults and the rationale...

Cultural Variables Underlying Obesity in Latino Men: Design, Rationale and Participant Characteristics from the Latino Men's Health Initiative.

Science.gov (United States)

Sanchez-Johnsen, Lisa; Craven, Meredith; Nava, Magdalena; Alonso, Angelica; Dykema-Engblade, Amanda; Rademaker, Alfred; Xie, Hui

2017-08-01

Overweight and obesity are associated with significant health problems and rates of obesity are high among Latino men. This paper describes the design, rationale and participant characteristics of the key demographic variables assessed in an NIH-funded study (R21-CA143636) addressing culture and several obesity-related variables (diet, physical activity, and body image) among Mexican and Puerto Rican men using a community-based participatory research framework. Participants completed objective measures (height, weight, body fat, hip, waist), a health and culture interview, a diet questionnaire, and used an accelerometer to measure their level of physical activity. A total of 203 participants completed the measures and the health and culture interview and 193 completed all study components. Puerto Ricans were older than Mexicans (p health insurance, Body Mass Index, body fat, hip and waist measurements, and the language preference of the interview. Results have implications for the development of a future intervention that incorporates the role of cultural factors into a community participatory obesity intervention for Latino men.

Protein structures in Alzheimer's disease: The basis for rationale therapeutic design.

Science.gov (United States)

Montoliu-Gaya, Laia; Villegas, Sandra

2015-12-15

Alzheimer's disease (AD) is a neurodegenerative disorder that affects memory, behavior, thinking and emotion. Current therapies to treat AD patients are only capable for temporarily slowing-down the cognitive decline, as they are focused on ameliorating symptoms instead of targeting its underlying causes. The aim of this review is to describe what is known about the protein structures implicated in AD pathogenesis, amyloid cascade members, as well as those structures involved in Aβ clearance. Thus, structural information available for APP, α- β- and γ-secretases, CTFβ and derived Aβ peptides, AICDs, apoE and apoJ, LRP-1 and RAGE, and neprilysin and insulin-degrading enzyme is provided. The recently solved structure for the γ-secretase complex opens the rational design of a new generation of inhibitors, whereas that for Aβ oligomers offers a putative mechanism explaining why monoclonal antibodies targeted to the N-terminus are effective. Then, an overview on therapies targeting some of these molecules presents their benefits and drawbacks. As a general conclusion our knowledge on the protein structures involved in AD has recently substantially advanced, allowing for the rational design of different therapeutic approaches. Hopefully, we are getting closer to finding a strong disease-modifying drug to cure this devastating disease. Copyright © 2015 Elsevier Inc. All rights reserved.

Bioethics: A Rationale and a Model

Science.gov (United States)

Barman, Charles R.; Rusch, John J.

1978-01-01

Discusses the rationale for and development of an undergraduate bioethics course. Based on experiences with the course, general suggestions are offered to instructors planning to add bioethics to existing curricula. (MA)

Design and rationale of the Procalcitonin Antibiotic Consensus Trial (ProACT), a multicenter randomized trial of procalcitonin antibiotic guidance in lower respiratory tract infection.

Science.gov (United States)

Huang, David T; Angus, Derek C; Chang, Chung-Chou H; Doi, Yohei; Fine, Michael J; Kellum, John A; Peck-Palmer, Octavia M; Pike, Francis; Weissfeld, Lisa A; Yabes, Jonathan; Yealy, Donald M

2017-08-29

Overuse of antibiotics is a major public health problem, contributing to growing antibiotic resistance. Procalcitonin has been reported to be commonly elevated in bacterial, but not viral infection. Multiple European trials found procalcitonin-guided care reduced antibiotic use in lower respiratory tract infection, with no apparent harm. However, applicability to US practice is limited due to trial design features impractical in the US, between-country differences, and residual safety concerns. The Procalcitonin Antibiotic Consensus Trial (ProACT) is a multicenter randomized trial to determine the impact of a procalcitonin antibiotic prescribing guideline, implemented with basic reproducible strategies, in US patients with lower respiratory tract infection. We describe the trial methods using the Consolidated Standards of Reporting Trials (CONSORT) framework, and the rationale for key design decisions, including choice of eligibility criteria, choice of control arm, and approach to guideline implementation. ClinicalTrials.gov NCT02130986 . Registered May 1, 2014.

"Socialized Music": Historical Formations of Community Music through Social Rationales

Science.gov (United States)

Yerichuk, Deanna

2014-01-01

This article traces the formation of community music through professional and scholarly articles over the last century in North America, and argues that community music has been discursively formed through social rationales, although the specific rationales have shifted. The author employs an archaeological framework inspired by Michel Foucault to…

The Sanitation Hygiene Infant Nutrition Efficacy (SHINE) Trial: Rationale, Design, and Methods.

Science.gov (United States)

Humphrey, Jean H; Jones, Andrew D; Manges, Amee; Mangwadu, Goldberg; Maluccio, John A; Mbuya, Mduduzi N N; Moulton, Lawrence H; Ntozini, Robert; Prendergast, Andrew J; Stoltzfus, Rebecca J; Tielsch, James M

2015-12-15

among a subgroup of infants enrolled in an EED substudy. This article describes the rationale, design, and methods underlying the SHINE trial. NCT01824940. © The Author 2015. Published by Oxford University Press for the Infectious Diseases Society of America.

The Reversal Intervention for Metabolic Syndrome (TRIMS study: rationale, design, and baseline data

Directory of Open Access Journals (Sweden)

Troughton Jacqui

2011-05-01

Full Text Available Abstract Background Recent attention has focused on strategies to combat the forecast epidemic of type-2 diabetes (T2DM and its major vascular sequelae. Metabolic syndrome (MetS comprises a constellation of factors that increase the risk of cardiovascular disease (CVD and T2DM. Our study aims to develop a structured self-management education programme for people with MetS, which includes management of cardiovascular and diabetes risk factors, and to determine its impact. This paper describes the rationale and design of the TRIMS study, including intervention development, and presents baseline data. Methods Subjects recruited from a mixed-ethnic population with MetS were randomised to intervention or control arms. The intervention arm received structured group education based on robust psychological theories and current evidence. The control group received routine care. Follow-up data will be collected at 6 and 12 months. The primary outcome measure will be reversal of metabolic syndrome in the intervention group subjects compared to controls at 12 months follow-up. Results 82 participants (44% male, 22% South Asian were recruited between November 2009 and July 2010. Baseline characteristics were similar for both the intervention (n = 42 and control groups (n = 40. Median age was 63 years (IQR 57 - 67, mean waist size 106 cm (SD ± 11, and prescribing of statins and anti-hypertensives was 51% in each case. Conclusion Results will provide information on changes in diabetes and CVD risk factors and help to inform primary prevention strategies in people with MetS from varied ethnic backgrounds who are at high risk of developing T2DM and CVD. Information gathered in relation to the programme's acceptability and effectiveness in a multi-ethnic population would ensure that our results are widely applicable. Trial registration The study is registered at ClinicalTrials.gov, study identifier: NCT01043770.

When Regional Innovation Policies Meet Policy Rationales and Evidence:

DEFF Research Database (Denmark)

Borrás, Susana; Jordana, Jacint

regions, and to understand how rationales and evidence can be translated into policy-making. To this purpose, this paper develops a framework to study the extent to which regional innovation policies have changed during the past few years. Since the mid-2000s there has been an important development......In spite of recent advancements regarding regional innovation policy rationales and evidence, there are few analyses about the actual features of existing regional innovation policies. Nevertheless, a policy analysis perspective is important in order to recognise their distinctive patterns across...... of innovation policy rationales, advocating for more specialisation; likewise, greater data availability at the regional level has allowed more sophisticated assessment of innovation performance. Finally, the crisis since 2008 has had ravaging effects in some regions, with job losses and severe economic...

When Regional Innovation Policies Meet Policy Rationales and Evidence

DEFF Research Database (Denmark)

Borrás, Susana; Jordana, Jacint

2016-01-01

regions, and to understand how rationales and evidence can be translated into policy-making. To this purpose, this paper develops a framework to study the extent to which regional innovation policies have changed during the past few years. Since the mid-2000s, there has been an important development......In spite of recent advancements regarding regional innovation policy rationales and evidence, there are few analyses about the actual features of existing regional innovation policies. Nevertheless, a policy analysis perspective is important in order to recognize their distinctive patterns across...... of innovation policy rationales, advocating for more specialization; likewise, greater data availability at the regional level has allowed more sophisticated assessment of innovation performance. Finally, the crisis since 2008 has had ravaging effects in some regions, with job losses and severe economic...

Rationale and design of Mi-CARE: The mile square colorectal cancer screening, awareness and referral and education project.

Science.gov (United States)

Buscemi, Joanna; Miguel, Yazmin San; Tussing-Humphreys, Lisa; Watts, Elizabeth A; Fitzgibbon, Marian L; Watson, Karriem; Winn, Robert A; Matthews, Kameron L; Molina, Yamile

2017-01-01

Although colorectal cancer (CRC) is largely preventable through identification of pre-cancerous polyps through various screening modalities, morbidity and mortality rates remain a challenge, especially in African-American, Latino, low-income and uninsured/underinsured patients. Barriers to screening include cost, access to health care facilities, lack of recommendation to screen, and psychosocial factors such as embarrassment, fear of the test, anxiety about testing preparation and fear of a cancer diagnosis. Various intervention approaches to improve CRC screening rates have been developed. However, comparative effectiveness research (CER) to investigate the relative performance of different approaches has been understudied, especially across different real-life practice settings. Assessment of differential efficacy across diverse vulnerable populations is also lacking. The current paper describes the rationale and design for the Mile Square Colorectal Cancer Screening, Awareness and Referral and Education Project (Mi-CARE), which aims to increase CRC screening rates in 3 clinics of a large Federally Qualified Health Center (FQHC) by reducing prominent barriers to screening for low-income, minority and underserved patients. Patients attending these clinics will receive one of three interventions to increase screening uptake: lay patient navigator (LPN)-based navigation, provider level navigation, or mailed birthday CRC screening reminders. The design of our program allows for comparison of the effectiveness of the tailored interventions across sites and patient populations. Data from Mi-CARE may help to inform the dissemination of tailored interventions across FQHCs to reduce health disparities in CRC. Copyright © 2016 Elsevier Inc. All rights reserved.

The "BIOmarkers associated with Sarcopenia and PHysical frailty in EldeRly pErsons" (BIOSPHERE) study: Rationale, design and methods.

Science.gov (United States)

Calvani, Riccardo; Picca, Anna; Marini, Federico; Biancolillo, Alessandra; Cesari, Matteo; Pesce, Vito; Lezza, Angela Maria Serena; Bossola, Maurizio; Leeuwenburgh, Christiaan; Bernabei, Roberto; Landi, Francesco; Marzetti, Emanuele

2018-05-10

Sarcopenia, the progressive and generalised loss of muscle mass and strength/function, is a major health issue in older adults given its high prevalence and burdensome clinical implications. Over the years, this condition has been endorsed as a marker for discriminating biological from chronological age. However, the absence of a unified operational definition has hampered its full appreciation by healthcare providers, researchers and policy-makers. In addition to this unsolved debate, the complexity of musculoskeletal ageing represents a major challenge to the identification of clinically meaningful biomarkers. Here, we illustrate the advantages of biomarker discovery procedures in muscle ageing based on multivariate methodologies as an alternative approach to traditional single-marker strategies. The rationale, design and methods of the "BIOmarkers associated with Sarcopenia and PHysical frailty in EldeRly pErsons" (BIOSPHERE) study are described as an application of a multi-marker strategy for the development of biomarkers for the newly operationalised Physical Frailty & Sarcopenia condition. Copyright © 2018 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.

Commercially-driven human interplanetary propulsion systems: Rationale, concept, technology, and performance requirements

International Nuclear Information System (INIS)

Williams, C.H.; Borowski, S.K.

1996-01-01

Previous studies of human interplanetary missions are largely characterized by long trip times, limited performance capabilities, and enormous costs. Until these missions become dramatically more open-quote open-quote commercial-friendly close-quote close-quote, their funding source and rationale will be restricted to national governments and their political/scientific interests respectively. A rationale is discussed for human interplanetary space exploration predicated on the private sector. Space propulsion system requirements are identified for interplanetary transfer times of no more than a few weeks/months to and between the major outer planets. Nuclear fusion is identified as the minimum requisite space propulsion technology. A conceptual design is described and evolutionary catalyzed-DD to DHe 3 fuel cycles are proposed. Magnetic nozzles for direct thrust generation and quantifying the operational aspects of the energy exchange mechanisms between high energy reaction products and neutral propellants are identified as two of the many key supporting technologies essential to satisfying system performance requirements. Government support of focused, breakthrough technologies is recommended at funding levels appropriate to other ongoing federal research. copyright 1996 American Institute of Physics

Design, rationale and feasibility of a multidimensional experimental protocol to study early life stress

Directory of Open Access Journals (Sweden)

M. Dillwyn Bartholomeusz

2017-09-01

Full Text Available There is a rapidly accumulating body of evidence regarding the influential role of early life stress (ELS upon medical and psychiatric conditions. While self-report instruments, with their intrinsic limitations of recall, remain the primary means of detecting ELS in humans, biological measures are generally limited to a single biological system. This paper describes the design, rationale and feasibility of a study to simultaneously measure neuroendocrine, immune and autonomic nervous system (ANS responses to psychological and physiological stressors in relation to ELS. Five healthy university students were recruited by advertisement. Exclusion criteria included chronic medical conditions, psychotic disorders, needle phobia, inability to tolerate pain, and those using anti-inflammatory medications. They were clinically interviewed and physiological recordings made over a two-hour period pre, during and post two acute stressors: the cold pressor test and recalling a distressing memory. The Childhood Trauma Questionnaire and the Parental Bonding Index were utilised to measure ELS. Other psychological measures of mood and personality were also administered. Measurements of heart rate, blood pressure, respiratory rate, skin conductance, skin blood flow and temporal plasma samples were successfully obtained before, during and after acute stress. Participants reported the extensive psychological and multisystem physiological data collection and stress provocations were tolerable. Most (4/5 participants indicated a willingness to return to repeat the protocol, indicating acceptability. Our protocol is viable and safe in young physically healthy adults and allows us to assess simultaneously neuroendocrine, immune and autonomic nervous system responses to stressors in persons assessed for ELS. Keywords: Childhood-stress, Adverse-childhood-events, Childhood-trauma questionnaire, Parental-bonding-instrument, Type D scale (DS14

Applying Semiotic Theories to Graphic Design Education: An Empirical Study on Poster Design Teaching

Science.gov (United States)

Yang, Chao-Ming; Hsu, Tzu-Fan

2015-01-01

The rationales behind design are dissimilar to those behind art. Establishing an adequate theoretical foundation for conducting design education can facilitate scientising design methods. Thus, from the perspectives of the semiotic theories proposed by Saussure and Peirce, we investigated graphic design curricula by performing teaching…

Placement Of Cardiac PacemaKEr Trial (POCKET – rationale and design: a randomized controlled trial

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Peter Magnusson

2017-04-01

Full Text Available BackgroundA pacemaker system consists of one or two leads connected to a device that is implanted into a pocket formed just below the collarbone. This pocket is typically subcutaneous, that is, located just above the pectoral fascia. Even though the size of pacemakers has decreased markedly, complications due to superficial implants do occur. An alternative technique would be intramuscular placement of the pacemaker device, but there are no randomized controlled trials (RCTs to support this approach, which is the rationale for the Placement Of Cardiac PacemaKEr Trial (POCKET. The aim is to study if intramuscular is superior to subcutaneous placement of a pacemaker pocket.MethodsIn October 2016, we started to enroll 200 consecutive patients with an indication for bradycardia pacemaker implantation. Patients are randomized to random block sizes, stratified by age group (cut-off: 65 years and sex, and then randomized to either subcutaneous or intramuscular implant. A concealed allocation procedure is employed, using sequentially numbered, sealed envelopes. Pocket site is blinded to the patient and in all subsequent care. The primary endpoint is patient overall satisfaction with the pocket location at 24 months as measured using a visual analog scale (VAS 0-10. Secondary endpoints are: complications, patient-reported satisfaction at 1, 12, and 24 months (overall satisfaction, pain, discomfort, degree of unsightly appearance, movement problems, and sleep problems due to device.ConclusionsPOCKET is a prospective interventional RCT designed to evaluate if intramuscular is superior to subcutaneous placement of a bradycardia pacemaker during a two-year follow-up.

Placement Of Cardiac PacemaKEr Trial (POCKET – rationale and design: a randomized controlled trial

Directory of Open Access Journals (Sweden)

Peter Magnusson

2017-04-01

Full Text Available Background: A pacemaker system consists of one or two leads connected to a device that is implanted into a pocket formed just below the collarbone. This pocket is typically subcutaneous, that is, located just above the pectoral fascia. Even though the size of pacemakers has decreased markedly, complications due to superficial implants do occur. An alternative technique would be intramuscular placement of the pacemaker device, but there are no randomized controlled trials (RCTs to support this approach, which is the rationale for the Placement Of Cardiac PacemaKEr Trial (POCKET. The aim is to study if intramuscular is superior to subcutaneous placement of a pacemaker pocket. Methods: In October 2016, we started to enroll 200 consecutive patients with an indication for bradycardia pacemaker implantation. Patients are randomized to random block sizes, stratified by age group (cut-off: 65 years and sex, and then randomized to either subcutaneous or intramuscular implant. A concealed allocation procedure is employed, using sequentially numbered, sealed envelopes. Pocket site is blinded to the patient and in all subsequent care. The primary endpoint is patient overall satisfaction with the pocket location at 24 months as measured using a visual analog scale (VAS 0-10. Secondary endpoints are: complications, patient-reported satisfaction at 1, 12, and 24 months (overall satisfaction, pain, discomfort, degree of unsightly appearance, movement problems, and sleep problems due to device. Conclusions: POCKET is a prospective interventional RCT designed to evaluate if intramuscular is superior to subcutaneous placement of a bradycardia pacemaker during a two-year follow-up.

Novel Ion Trap Design for Strong Ion-Cavity Coupling

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Alejandro Márquez Seco

2016-04-01

Full Text Available We present a novel ion trap design which facilitates the integration of an optical fiber cavity into the trap structure. The optical fibers are confined inside hollow electrodes in such a way that tight shielding and free movement of the fibers are simultaneously achievable. The latter enables in situ optimization of the overlap between the trapped ions and the cavity field. Through numerical simulations, we systematically analyze the effects of the electrode geometry on the trapping characteristics such as trap depths, secular frequencies and the optical access angle. Additionally, we simulate the effects of the presence of the fibers and confirm the robustness of the trapping potential. Based on these simulations and other technical considerations, we devise a practical trap configuration that isviable to achieve strong coupling of a single ion.

Evaluation oF FactORs ImpacTing CLinical Outcome and Cost EffectiveneSS of the S-ICD: Design and Rationale of the EFFORTLESS S-ICD Registry

DEFF Research Database (Denmark)

Pedersen, Susanne S; Lambiase, Pier; Boersma, Lucas V A

2012-01-01

utilization. Methods: The Registry is an observational, nonrandomized, standard of care evaluation to be conducted at approximately 50 investigational centers in Europe and New Zealand where the S-ICD is approved for use and distribution. Clinical Registry endpoints include perioperative (30 days postimplant......Background: Leads in and on the heart of the transvenous implantable cardioverter defibrillator (ICD) form the Achilles' heel of this system due to potential for peri- and postimplant complications. The S-ICD is a newer generation of the ICD that does not require leads on the heart...... or in the vasculature. We present the rationale and study design of the Evaluation oF FactORs ImpacTing CLinical Outcome and Cost EffectiveneSS of the S-ICD (EFFORTLESS S-ICD) Registry which was designed to evaluate the long-term performance of the S-ICD including patient quality of life and long-term resource...

Glucocorticoid augmentation of prolonged exposure therapy: rationale and case report

Directory of Open Access Journals (Sweden)

Laura Pratchett

2010-12-01

Full Text Available Rationale: Prolonged exposure (PE therapy has been found to reduce symptoms of posttraumatic stress disorder (PTSD; however, it is difficult for many patients to engage fully in the obligatory retelling of their traumatic experiences. This problem is compounded by the fact that habituation and cognitive restructuring – the main mechanisms through which PE is hypothesized to work – are not instantaneous processes, and often require several weeks before the distress associated with imaginal exposure abates. Case reports: Two cases are described that respectively illustrate the use of hydrocortisone and placebo, in combination with PE, for the treatment of combat-related PTSD. Based on known effects of glucocorticoids on learning and memory performance, we hypothesized that augmentation with hydrocortisone would improve the therapeutic effects of PE by hastening “new” learning and facilitating decreases in the emotional impact of fear memories during the course of treatment. The veteran receiving hydrocortisone augmentation of PE displayed an accelerated and ultimately greater decline in PTSD symptoms than the veteran receiving placebo. Conclusions: While no general conclusion can be derived from comparison of two patients, the findings are consistent with the rationale for augmentation. These case reports support the potential for an appropriately designed and powered clinical trial to examine the efficacy of glucocorticoids in augmenting the effects of psychotherapy for PTSD.

Engendering healthy masculinities to prevent sexual violence: Rationale for and design of the Manhood 2.0 trial.

Science.gov (United States)

Abebe, Kaleab Z; Jones, Kelley A; Culyba, Alison J; Feliz, Nayck B; Anderson, Heather; Torres, Irving; Zelazny, Sarah; Bamwine, Patricia; Boateng, Adwoa; Cirba, Benjamin; Detchon, Autumn; Devine, Danielle; Feinstein, Zoe; Macak, Justin; Massof, Michael; Miller-Walfish, Summer; Morrow, Sarah Elizabeth; Mulbah, Paul; Mulwa, Zabi; Paglisotti, Taylor; Ripper, Lisa; Ports, Katie A; Matjasko, Jennifer L; Garg, Aapta; Kato-Wallace, Jane; Pulerwitz, Julie; Miller, Elizabeth

2018-05-23

Violence against women and girls is an important global health concern. Numerous health organizations highlight engaging men and boys in preventing violence against women as a potentially impactful public health prevention strategy. Adapted from an international setting for use in the US, "Manhood 2.0" is a "gender transformative" program that involves challenging harmful gender and sexuality norms that foster violence against women while promoting bystander intervention (i.e., giving boys skills to interrupt abusive behaviors they witness among peers) to reduce the perpetration of sexual violence (SV) and adolescent relationship abuse (ARA). Manhood 2.0 is being rigorously evaluated in a community-based cluster-randomized trial in 21 lower resource Pittsburgh neighborhoods with 866 adolescent males ages 13-19. The comparison intervention is a job readiness training program which focuses on the skills needed to prepare youth for entering the workforce, including goal setting, accountability, resume building, and interview preparation. This study will provide urgently needed information about the effectiveness of a gender transformative program, which combines healthy sexuality education, gender norms change, and bystander skills to interrupt peers' disrespectful and harmful behaviors to reduce SV/ARA perpetration among adolescent males. In this manuscript, we outline the rationale for and evaluation design of Manhood 2.0. Clinical Trials #: NCT02427061. Copyright © 2018 The Authors. Published by Elsevier Inc. All rights reserved.

Apixaban for treatment of embolic stroke of undetermined source (ATTICUS randomized trial): Rationale and study design.

Science.gov (United States)

Geisler, Tobias; Poli, Sven; Meisner, Christoph; Schreieck, Juergen; Zuern, Christine S; Nägele, Thomas; Brachmann, Johannes; Jung, Werner; Gahn, Georg; Schmid, Elisabeth; Bäezner, Hansjörg; Keller, Timea; Petzold, Gabor C; Schrickel, Jan-Wilko; Liman, Jan; Wachter, Rolf; Schön, Frauke; Schabet, Martin; Lindner, Alfred; Ludolph, Albert C; Kimmig, Hubert; Jander, Sebastian; Schlegel, Uwe; Gawaz, Meinrad; Ziemann, Ulf

2017-12-01

Rationale Optimal secondary prevention of embolic stroke of undetermined source is not established. The current standard in these patients is acetylsalicylic acid, despite high prevalence of yet undetected paroxysmal atrial fibrillation. Aim The ATTICUS randomized trial is designed to determine whether the factor Xa inhibitor apixaban administered within 7 days after embolic stroke of undetermined source, is superior to acetylsalicylic acid for prevention of new ischemic lesions documented by brain magnetic resonance imaging within 12 months after index stroke. Design Prospective, randomized, blinded, parallel-group, open-label, German multicenter phase III trial in approximately 500 patients with embolic stroke of undetermined source. A key inclusion criterion is the presence or the planned implantation of an insertable cardiac monitor. Patients are 1:1 randomized to apixaban or acetylsalicylic acid and treated for a 12-month period. It is an event-driven trial aiming for core-lab adjudicated primary outcome events. Study outcomes The primary outcome is the occurrence of at least one new ischemic lesion identified by axial T2-weighted FLAIR magnetic resonance imaging and/or axial DWI magnetic resonance imaging at 12 months when compared with the baseline magnetic resonance imaging. Key secondary outcomes are the combination of recurrent ischemic strokes, hemorrhagic strokes, systemic embolism; combination of MACE including recurrent stroke, myocardial infarction, and cardiovascular death and combination of major and clinically relevant non-major bleeding defined according to ISTH, and change of cognitive function and quality of life (EQ-5D, Stroke Impact Scale). Discussion Embolic stroke of undetermined source is caused by embolic disease and associated with a high risk of recurrent ischemic strokes and clinically silent cerebral ischemic lesions. ATTICUS will investigate the impact of atrial fibrillation detected by insertable cardiac monitor and the effects of

Ethical implications of co-benefits rationale within climate change mitigation strategy

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Rita Vasconcellos Oliveira

2016-10-01

Full Text Available Climate change mitigation effort is being translated into several actions and discourses that make collateral benefits and their rationale increasingly relevant for sustainability, in such a way that they are now a constant part of the political agenda. Taking a border and consensual perspective, co-benefits are considered here to be emerging advantages of the implementation of measures regarding the lowering of greenhouse gases.Departing from the analysis of policy documents referring to two European urban transportation strategies, the emergent co-benefits are problematized and discussed to better understand their moral aspect. Further ethical reflection is conducted after an analysis of some unintended consequences of co-benefits rationale coming from the mentioned examples. The focus is primarily on the challenges of an integrative moral justification for co-benefits and also for their role in the climate change mitigation effort. We also discuss the limitations of the current normative models that frame co-benefits rationale, from a moral viewpoint and in relation to the overall climate change mitigation strategy.In this article, we propose the concepts of well-being and freedom, as portrayed by Capabilities Approach, as possible guiding notions for the moral and social evaluation of goodness of these emergent benefits and their rationale too. Additionally, some preliminary conclusions are drawn regarding the potential of the presented concepts to favour the climate change mitigation action. Finally, a scenario is drawn where Capabilities Approach is the moral guideline for co-benefits rationale showing this way its potential in terms of enhancing climate change mitigation strategy.

Evaluating web-based cognitive-affective remediation in recent trauma survivors: study rationale and protocol.

Science.gov (United States)

Fine, Naomi B; Achituv, Michal; Etkin, Amit; Merin, Ofer; Shalev, Arieh Y

2018-01-01

Background : The immediate aftermath of traumatic events is a period of enhanced neural plasticity, following which some survivors remain with post-traumatic stress disorder (PTSD) whereas others recover. Evidence points to impairments in emotional reactivity, emotion regulation, and broader executive functions as critically contributing to PTSD. Emerging evidence further suggests that the neural mechanisms underlying these functions remain plastic in adulthood and that targeted retraining of these systems may enhance their efficiency and could reduce the likelihood of developing PTSD. Administering targeted neurocognitive training shortly after trauma exposure is a daunting challenge. This work describes a study design addressing that challenge. The study evaluated the direct effects of cognitive remediation training on neurocognitive mechanisms that hypothetically underlay PTSD, and the indirect effect of this intervention on emerging PTSD symptoms. Method : We describe a study rationale, design, and methodological choices involving: (a) participants' enrolment; (b) implementation and management of a daily self-administered, web-based intervention; (c) reliable, timely screening and assessment of treatment of eligible survivors; and (d) defining control conditions and outcome measures. We outline the rationale of choices made regarding study sample, timing of intervention, measurements, monitoring participants' adherence, and ways to harmonize and retain interviewers' fidelity and mitigate eventual burnout by repeated contacts with recently traumatized survivors. Conclusion : Early web-based interventions targeting causative mechanisms of PTSD can be informed by the model presented in this paper.

The Family Spirit trial for American Indian teen mothers and their children: CBPR rationale, design, methods and baseline characteristics.

Science.gov (United States)

Mullany, Britta; Barlow, Allison; Neault, Nicole; Billy, Trudy; Jones, Tanya; Tortice, Iralene; Lorenzo, Sherilynn; Powers, Julia; Lake, Kristin; Reid, Raymond; Walkup, John

2012-10-01

The purpose of this paper is to describe the rationale, design, methods and baseline results of the Family Spirit trial. The goal of the trial is to evaluate the impact of the paraprofessional-delivered "Family Spirit" home-visiting intervention to reduce health and behavioral risks for American Indian teen mothers and their children. A community based participatory research (CBPR) process shaped the design of the current randomized controlled trial of the Family Spirit intervention. Between 2006 and 2008, 322 pregnant teens were randomized to receive the Family Spirit intervention plus Optimized Standard Care, or Optimized Standard Care alone. The Family Spirit intervention is a 43-session home-visiting curriculum administered by American Indian paraprofessionals to teen mothers from 28 weeks gestation until the baby's third birthday. A mixed methods assessment administered at nine intervals measures intervention impact on parental competence, mother's and children's social, emotional and behavioral risks for drug use, and maladaptive functioning. Participants are young (mean age = 18.1 years), predominantly primiparous, unmarried, and challenged by poverty, residential instability and low educational attainment. Lifetime and pregnancy drug use were ~2-4 times higher and ~5-6 times higher, respectively, than US All Races. Baseline characteristics were evenly distributed between groups, except for higher lifetime cigarette use and depressive symptoms among intervention mothers. If study aims are achieved, the public health field will have new evidence supporting multi-generational prevention of behavioral health disparities affecting young American Indian families and the utility of indigenous paraprofessional interventionists in under-resourced communities.

Not just another multi-professional course! Part 1. Rationale for a transformative curriculum.

Science.gov (United States)

Duncan, Madeleine; Alperstein, Melanie; Mayers, Pat; Olckers, Lorna; Gibbs, Trevor

2006-02-01

Undergraduate inter- and multi-professional education has traditionally aimed to develop health professionals who are able to collaborate effectively in comprehensive healthcare delivery. The respective professions learn from and about each other through comparisons of roles, responsibilities, powers, duties and perspectives in order to promote integrated service. Described here is the educational rationale of a multi-professional course with a difference; one that injects value to undergraduate health professional education through the development of critical cross-field knowledge, skills and attitudes that unite rather than differentiate professions. The aim of this course, offered at the Faculty of Health Sciences, University of Cape Town, is to lay an integrated, pan-professional foundation for the advancement of collective commitment to and understanding of national health and social development objectives such as primary health care, human rights and professionalism. Pan-professional refers to curriculum content that is core and of critical relevance to all participating professions. What is learned, how it is learned, how learning is facilitated and how it is applied, has been co-constructed by a multi-professional design team representing a range of health professions (audiology, medicine, occupational therapy, nursing, physiotherapy and speech therapy) and academic disciplines (anthropology, sociology, psychology, history, African studies and social development, information technology and language literacy). Education specialists facilitate the ongoing design process ensuring that the structure and content of the curriculum complies with contemporary adult learning principles and national higher education imperatives. Designing the original curriculum required the deconstruction of intra-professional and disciplinary canons of knowledge and ways of 'doing things' in order to identify and develop shared interpretations of critical epistemology and axiology

SWITCH: rationale, design, and implementation of a community, school, and family-based intervention to modify behaviors related to childhood obesity

Directory of Open Access Journals (Sweden)

Callahan Randi

2008-06-01

Full Text Available Abstract Background Although several previous projects have attempted to address the issue of child obesity through school-based interventions, the overall effectiveness of school-based programs on health-related outcomes in youth has been poor. Thus, it has been suggested that multi-level interventions that aim to influence healthy lifestyle behaviors at the community, school and family levels may prove more successful in the prevention of childhood obesity. Methods/Design This paper describes the rationale, design, and implementation of a community-, school-, and family-based intervention aimed at modifying key behaviors (physical activity, screen time (Internet, television, video games, and nutrition related to childhood obesity among third through fifth graders in two mid-western cities. The intervention involves a randomized study of 10 schools (5 intervention and 5 control schools. The intervention is being conducted during the duration of the academic year – approximately 9 months – and includes baseline and post-intervention measurements of physical activity, dietary intake, screen time and body composition. Discussion We hope this report will be useful to researchers, public health professionals, and school administrators and health professionals (nurses and physical/health educators seeking to develop similar prevention programs. It is obvious that more collaborative, inter-disciplinary, multi-level work is needed before a proven, effective intervention package to modify behaviors related to childhood obesity can be generally recommended. It is our hope that SWITCH is a step in that direction. Trial Registration ClinicalTrials.gov NCT00685555

Tracing the Rationale Behind UML Model Change Through Argumentation

Science.gov (United States)

Jureta, Ivan J.; Faulkner, Stéphane

Neglecting traceability—i.e., the ability to describe and follow the life of a requirement—is known to entail misunderstanding and miscommunication, leading to the engineering of poor quality systems. Following the simple principles that (a) changes to UML model instances ought be justified to the stakeholders, (b) justification should proceed in a structured manner to ensure rigor in discussions, critique, and revisions of model instances, and (c) the concept of argument instantiated in a justification process ought to be well defined and understood, the present paper introduces the UML Traceability through Argumentation Method (UML-TAM) to enable the traceability of design rationale in UML while allowing the appropriateness of model changes to be checked by analysis of the structure of the arguments provided to justify such changes.

Blood irradiation: Rationale and technique

International Nuclear Information System (INIS)

Lewis, M.C.

1990-01-01

Upon request by the local American Red Cross, the Savannah Regional Center for Cancer Care irradiates whole blood or blood components to prevent post-transfusion graft-versus-host reaction in patients who have severely depressed immune systems. The rationale for blood irradiation, the total absorbed dose, the type of patients who require irradiated blood, and the regulations that apply to irradiated blood are presented. A method of irradiating blood using a linear accelerator is described

In search of design principles for developing digital learning & performance support for a student design task

NARCIS (Netherlands)

Bollen, Lars; Van der Meij, Hans; Leemkuil, Henny; McKenney, Susan

2016-01-01

A digital learning and performance support environment for university student design tasks was developed. This paper describes on the design rationale, process, and the usage results to arrive at a core set of design principles for the construction of such an environment. We present a collection of

In search of design principles for developing digital learning & performance support for a student design task

NARCIS (Netherlands)

Bollen, Lars; van der Meij, Hans; Leemkuil, Hendrik H.; McKenney, Susan

2015-01-01

A digital learning and performance support environment for university student design tasks was developed. This paper describes on the design rationale, process, and the usage results to arrive at a core set of design principles for the construction of such an environment. We present a collection of

Images and visuality in ICT educational design> strong>

DEFF Research Database (Denmark)

Buhl, Mie

2010-01-01

The concept of educational design emphasises the educational dimension in the development of ICT-based learning tools and environments, and in the form of models for the use of existing applications in learning cultures. The intrinsic breadth of various types of images creates new possibilities a...

The Land Use Model Intercomparison Project (LUMIP) contribution to CMIP6: rationale and experimental design

Science.gov (United States)

Lawrence, David M.; Hurtt, George C.; Arneth, Almut; Brovkin, Victor; Calvin, Kate V.; Jones, Andrew D.; Jones, Chris D.; Lawrence, Peter J.; de Noblet-Ducoudré, Nathalie; Pongratz, Julia; Seneviratne, Sonia I.; Shevliakova, Elena

2016-09-01

complementary to simulations requested in the CMIP6 DECK and historical simulations and other CMIP6 MIPs including ScenarioMIP, C4MIP, LS3MIP, and DAMIP. LUMIP includes a two-phase experimental design. Phase one features idealized coupled and land-only model simulations designed to advance process-level understanding of LULCC impacts on climate, as well as to quantify model sensitivity to potential land-cover and land-use change. Phase two experiments focus on quantification of the historic impact of land use and the potential for future land management decisions to aid in mitigation of climate change. This paper documents these simulations in detail, explains their rationale, outlines plans for analysis, and describes a new subgrid land-use tile data request for selected variables (reporting model output data separately for primary and secondary land, crops, pasture, and urban land-use types). It is essential that modeling groups participating in LUMIP adhere to the experimental design as closely as possible and clearly report how the model experiments were executed.

The ExStroke Pilot Trial: rationale, design, and baseline data of a randomized multicenter trial comparing physical training versus usual care after an ischemic stroke

DEFF Research Database (Denmark)

Krarup, L.H.; Gluud, C.; Truelsen, T.

2008-01-01

of increasing stroke patients' level of physical activity and secondarily to associate the level of physical activity to the risk of recurrent stroke, myocardial infarction, and all-cause mortality in the two groups. We describe the rationale, design, and baseline data of the ExStroke Pilot Trial. METHODS......INTRODUCTION: A high level of physical activity is associated with a decreased risk of first stroke and physical activity modifies recognized stroke risk factors and is recommended for stroke survivors. Available research shows that stroke patients can increase their level of physical performance...... over a short period. When the intervention period is over, physical performance often declines towards baseline level. Currently, there is no evidence on the association between physical activity and the risk of recurrent stroke. The ExStroke Pilot Trial is a randomized clinical trial with the aim...

Readiness for diabetes prevention and barriers to lifestyle change in women with a history of gestational diabetes mellitus: rationale and study design.

Science.gov (United States)

Lipscombe, Lorraine L; Banerjee, Ananya Tina; McTavish, Sarah; Mukerji, Geetha; Lowe, Julia; Ray, Joel; Evans, Marilyn; Feig, Denice S

2014-10-01

Women with gestational diabetes mellitus (GDM) have a high risk of future diabetes, which can be prevented with lifestyle modification. Prior diabetes prevention programmes in this population have been limited by lack of adherence. The aim of this study is to evaluate readiness for behaviour change at different time points after GDM diagnosis and identify barriers and facilitators, to inform a lifestyle modification programme specifically designed for this group. The objective of this paper is to present the rationale and methodological design of this study. The ongoing prospective cohort study has recruited a multi-ethnic cohort of 1353 women with GDM from 7 Ontario, Canada hospitals during their pregnancy. A questionnaire was developed to evaluate stage of readiness for behaviour change, and sociodemographic, psychosocial, and clinical predictors of healthy diet and physical activity. Thus far, 960 women (71%) have completed a baseline survey prior to delivery. Prospective postpartum follow-up is ongoing. We are surveying women at 2 time-points after delivery: 3-12 months postpartum, and 13-24 months postpartum. Survey data will be linked to health care administrative databases for long-term follow-up for diabetes. Qualitative interviews were conducted in a subset of women to gain a deeper understanding of barriers and facilitators to lifestyle change. Our study is a fundamental first step in effectively addressing diabetes prevention in women with GDM. Our findings will aid in the design of a diabetes prevention intervention specifically targeted to women with recent GDM, which can then be evaluated in a clinical trial. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Placebo versus "standard" hypnosis rationale: attitudes, expectancies, hypnotic responses, and experiences.

Science.gov (United States)

Accardi, Michelle; Cleere, Colleen; Lynn, Steven Jay; Kirsch, Irving

2013-10-01

In this study participants were provided with either the standard rationale that accompanies the Harvard Group Scale of Hypnotic Susceptibility: A (Shor & Orne, 1962) or a rationale that presented hypnosis as a nondeceptive placebo, consistent with Kirsch's (1994) sociocognitive perspective of hypnosis. The effects of the placebo and standard rationales were highly comparable with respect to hypnotic attitudes; prehypnotic expectancies; objective, subjective, and involuntariness measures of hypnotic responding; as well as a variety of subjective experiences during hypnosis, as measured by the Phenomenology of Consciousness Inventory (Pekala, 1982). Differences among correlations were not evident when measures were compared across groups. However, indices of hypnotic responding were correlated with attitudes in the hypnosis but not the placebo condition, and, generally speaking, the link between subjective experiences during hypnosis and measures of hypnotic responding were more reliable in the placebo than the hypnosis group. Researcher findings are neutral with respect to providing support for altered state versus sociocognitive models of hypnosis.

Considerations in the rationale, design and methods of the Strategic Timing of AntiRetroviral Treatment (START) study

Science.gov (United States)

Babiker, Abdel G; Emery, Sean; Fätkenheuer, Gerd; Gordin, Fred M; Grund, Birgit; Lundgren, Jens D; Neaton, James D; Pett, Sarah L; Phillips, Andrew; Touloumi, Giota; Vjecha, Michael J

2012-01-01

Background Untreated human immunodeficiency virus (HIV) infection is characterized by progressive depletion of CD4+ T lymphocyte (CD4) count leading to the development of opportunistic diseases (acquired immunodeficiency syndrome (AIDS)), and more recent data suggest that HIV is also associated with an increased risk of serious non-AIDS (SNA) diseases including cardiovascular, renal, and liver diseases and non-AIDS-defining cancers. Although combination antiretroviral treatment (ART) has resulted in a substantial decrease in morbidity and mortality in persons with HIV infection, viral eradication is not feasible with currently available drugs. The optimal time to start ART for asymptomatic HIV infection is controversial and remains one of the key unanswered questions in the clinical management of HIV-infected individuals. Purpose In this article, we outline the rationale and methods of the Strategic Timing of AntiRetroviral Treatment (START) study, an ongoing multicenter international trial designed to assess the risks and benefits of initiating ART earlier than is currently practiced. We also describe some of the challenges encountered in the design and implementation of the study and how these challenges were addressed. Methods A total of 4000 study participants who are HIV type 1 (HIV-1) infected, ART naïve with CD4 count > 500 cells/μL are to be randomly allocated in a 1:1 ratio to start ART immediately (early ART) or defer treatment until CD4 count is AIDS, SNA, or death. The study had a pilot phase to establish feasibility of accrual, which was set as the enrollment of at least 900 participants in the first year. Results Challenges encountered in the design and implementation of the study included the limited amount of data on the risk of a major component of the primary endpoint (SNA) in the study population, changes in treatment guidelines when the pilot phase was well underway, and the complexities of conducting the trial in a geographically wide

Teacher Grading Decisions: Influences, Rationale, and Practices

Science.gov (United States)

Kunnath, Joshua P.

2017-01-01

This mixed-methods study applied a decision-making theoretical framework to an investigation of teacher grading in a large urban school district in California. A sample of 251 high school teachers of core subjects were surveyed, and 15 teachers participated in four focus group interviews in order provide data on the influences, rationale, and…

Learning Rationales and Virtual Reality Technology in Education.

Science.gov (United States)

Chiou, Guey-Fa

1995-01-01

Defines and describes virtual reality technology and differentiates between virtual learning environment, learning material, and learning tools. Links learning rationales to virtual reality technology to pave conceptual foundations for application of virtual reality technology education. Constructivism, case-based learning, problem-based learning,…

Documenting the Engineering Design Process

Science.gov (United States)

Hollers, Brent

2017-01-01

Documentation of ideas and the engineering design process is a critical, daily component of a professional engineer's job. While patent protection is often cited as the primary rationale for documentation, it can also benefit the engineer, the team, company, and stakeholders through creating a more rigorously designed and purposeful solution.…

Mineralized Collagen: Rationale, Current Status, and Clinical Applications

Directory of Open Access Journals (Sweden)

Zhi-Ye Qiu

2015-07-01

Full Text Available This paper presents a review of the rationale for the in vitro mineralization process, preparation methods, and clinical applications of mineralized collagen. The rationale for natural mineralized collagen and the related mineralization process has been investigated for decades. Based on the understanding of natural mineralized collagen and its formation process, many attempts have been made to prepare biomimetic materials that resemble natural mineralized collagen in both composition and structure. To date, a number of bone substitute materials have been developed based on the principles of mineralized collagen, and some of them have been commercialized and approved by regulatory agencies. The clinical outcomes of mineralized collagen are of significance to advance the evaluation and improvement of related medical device products. Some representative clinical cases have been reported, and there are more clinical applications and long-term follow-ups that currently being performed by many research groups.

Cognitive rehabilitation: the role of theoretical rationales and respect for the maturational process needed for our evidence.

Science.gov (United States)

Gonzalez-Rothi, Leslie J

2006-01-01

The challenge to presenters at the Galveston Brain Injury Conference held in April 2005 was to discuss examples of the use of theory to motivate the design of treatments for cognitive deficits resulting from traumatic brain injury. This article considers the role of theoretical rationales as well as the new optimism embracing neurorehabilitation today. However, caution to respect the maturational process needed to adequately prepare treatment evidence for clinical application is affected.

Designing Design into an Advanced Desktop Publishing Course (A Teaching Tip).

Science.gov (United States)

Guthrie, Jim

1995-01-01

Describes an advanced desktop publishing course that combines instruction in a few advanced techniques for using software with extensive discussion of such design principles as consistency, proportion, asymmetry, appropriateness, contrast, and color. Describes computer hardware and software, class assignments, problems, and the rationale for such…

DOE LLW classification rationale

International Nuclear Information System (INIS)

Flores, A.Y.

1991-01-01

This report was about the rationale which the US Department of Energy had with low-level radioactive waste (LLW) classification. It is based on the Nuclear Regulatory Commission's classification system. DOE site operators met to review the qualifications and characteristics of the classification systems. They evaluated performance objectives, developed waste classification tables, and compiled dose limits on the waste. A goal of the LLW classification system was to allow each disposal site the freedom to develop limits to radionuclide inventories and concentrations according to its own site-specific characteristics. This goal was achieved with the adoption of a performance objectives system based on a performance assessment, with site-specific environmental conditions and engineered disposal systems

Rationale for combination of therapeutic antibodies targeting tumor cells and immune checkpoint receptors: Harnessing innate and adaptive immunity through IgG1 isotype immune effector stimulation.

Science.gov (United States)

Ferris, Robert L; Lenz, Heinz-Josef; Trotta, Anna Maria; García-Foncillas, Jesús; Schulten, Jeltje; Audhuy, François; Merlano, Marco; Milano, Gerard

2018-02-01

Immunoglobulin (Ig) G1 antibodies stimulate antibody-dependent cell-mediated cytotoxicity (ADCC). Cetuximab, an IgG1 isotype monoclonal antibody, is a standard-of-care treatment for locally advanced and recurrent and/or metastatic squamous cell carcinoma of the head and neck (SCCHN) and metastatic colorectal cancer (CRC). Here we review evidence regarding the clinical relevance of cetuximab-mediated ADCC and other immune functions and provide a biological rationale concerning why this property positions cetuximab as an ideal partner for immune checkpoint inhibitors (ICIs) and other emerging immunotherapies. We performed a nonsystematic review of available preclinical and clinical data involving cetuximab-mediated immune activity and combination approaches of cetuximab with other immunotherapies, including ICIs, in SCCHN and CRC. Indeed, cetuximab mediates ADCC activity in the intratumoral space and primes adaptive and innate cellular immunity. However, counterregulatory mechanisms may lead to immunosuppressive feedback loops. Accordingly, there is a strong rationale for combining ICIs with cetuximab for the treatment of advanced tumors, as targeting CTLA-4, PD-1, and PD-L1 can ostensibly overcome these immunosuppressive counter-mechanisms in the tumor microenvironment. Moreover, combining ICIs (or other immunotherapies) with cetuximab is a promising strategy for boosting immune response and enhancing response rates and durability of response. Cetuximab immune activity-including, but not limited to, ADCC-provides a strong rationale for its combination with ICIs or other immunotherapies to synergistically and fully mobilize the adaptive and innate immunity against tumor cells. Ongoing prospective studies will evaluate the clinical effect of these combination regimens and their immune effect in CRC and SCCHN and in other indications. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

The rationale of scored tablets as dosage form.

NARCIS (Netherlands)

Rodenhuis, N.; Smet, P.A.G.M. de; Barends, D.M.

2004-01-01

The aim of the study was to get insight into the rationale of scored tablets. This was pursued by studying patient's reasons for subdividing ("breaking") scored and unscored tablets. Patients who picked up their prescriptions in 5 community pharmacies in The Netherlands were questioned. Two-hundred

Practices and rationales of community engagement with wind farms: awareness raising, consultation, empowerment

DEFF Research Database (Denmark)

Aitken, Mhairi; Haggett, Claire; Rudolph, David Philipp

2016-01-01

In light of the growing emphasis on community engagement in the literature on renewable energy planning, and given the acknowledgement of the complexity of community engagement as a concept, we conducted an empirical review of practice relating to community engagement with onshore wind farms...... in the UK, exploring what is actually happening in terms of community engagement relating to onshore wind farms, and examining the rationales underpinning approaches to community engagement. We found that a wide range of engagement methods are being used in relation to onshore wind farms across the UK......-hierarchical classification of community engagement approaches: awareness raising; consultation and empowerment. This provides a useful tool for reflecting on practices and rationales of community engagement. By considering the three approaches non-hierarchically, this model allows for an examination of how such rationales...

Rationale and design of A Trial of Sertraline vs. Cognitive Behavioral Therapy for End-stage Renal Disease Patients with Depression (ASCEND).

Science.gov (United States)

Hedayati, S Susan; Daniel, Divya M; Cohen, Scott; Comstock, Bryan; Cukor, Daniel; Diaz-Linhart, Yaminette; Dember, Laura M; Dubovsky, Amelia; Greene, Tom; Grote, Nancy; Heagerty, Patrick; Katon, Wayne; Kimmel, Paul L; Kutner, Nancy; Linke, Lori; Quinn, Davin; Rue, Tessa; Trivedi, Madhukar H; Unruh, Mark; Weisbord, Steven; Young, Bessie A; Mehrotra, Rajnish

2016-03-01

Major Depressive Disorder (MDD) is highly prevalent in patients with End Stage Renal Disease (ESRD) treated with maintenance hemodialysis (HD). Despite the high prevalence and robust data demonstrating an independent association between depression and poor clinical and patient-reported outcomes, MDD is under-treated when identified in such patients. This may in part be due to the paucity of evidence confirming the safety and efficacy of treatments for depression in this population. It is also unclear whether HD patients are interested in receiving treatment for depression. ASCEND (Clinical Trials Identifier Number NCT02358343), A Trial of Sertraline vs. Cognitive Behavioral Therapy (CBT) for End-stage Renal Disease Patients with Depression, was designed as a multi-center, 12-week, open-label, randomized, controlled trial of prevalent HD patients with comorbid MDD or dysthymia. It will compare (1) a single Engagement Interview vs. a control visit for the probability of initiating treatment for comorbid depression in up to 400 patients; and (2) individual chair-side CBT vs. flexible-dose treatment with a selective serotonin reuptake inhibitor, sertraline, for improvement of depressive symptoms in 180 of the up to 400 patients. The evolution of depressive symptoms will also be examined in a prospective longitudinal cohort of 90 HD patients who choose not to be treated for depression. We discuss the rationale and design of ASCEND, the first large-scale randomized controlled trial evaluating efficacy of non-pharmacologic vs. pharmacologic treatment of depression in HD patients for patient-centered outcomes. Published by Elsevier Inc.

Rationale and Design of A Trial of Sertraline vs. Cognitive Behavioral Therapy for End-stage Renal Disease Patients with Depression (ASCEND)

Science.gov (United States)

Hedayati, S. Susan; Daniel, Divya M.; Cohen, Scott; Comstock, Bryan; Cukor, Daniel; Diaz-Linhart, Yaminette; Dember, Laura M.; Dubovsky, Amelia; Greene, Tom; Grote, Nancy; Heagerty, Patrick; Katon, Wayne; Kimmel, Paul L.; Kutner, Nancy; Linke, Lori; Quinn, Davin; Rue, Tessa; Trivedi, Madhukar H.; Unruh, Mark; Weisbord, Steven; Young, Bessie A.; Mehrotra, Rajnish

2015-01-01

Major Depressive Disorder (MDD) is highly prevalent in patients with End Stage Renal Disease (ESRD) treated with maintenance hemodialysis (HD). Despite the high prevalence and robust data demonstrating an independent association between depression and poor clinical and patient-reported outcomes, MDD is under-treated when identified in such patients. This may in part be due to the paucity of evidence confirming the safety and efficacy of treatments for depression in this population. It is also unclear whether HD patients are interested in receiving treatment for depression. ASCEND (Clinical Trials Identifier Number NCT02358343), A Trial of Sertraline vs. Cognitive Behavioral Therapy (CBT) for End-stage Renal Disease Patients with Depression, was designed as a multi-center, 12-week, open-label, randomized, controlled trial of prevalent HD patients with comorbid MDD or dysthymia. It will compare (1) a single Engagement Interview vs. a control visit for the probability of initiating treatment for comorbid depression in up to 400 patients; and (2) individual chair-side CBT vs. flexible-dose treatment with a selective serotonin reuptake inhibitor, sertraline, for improvement of depressive symptoms in 180 of the up to 400 patients. The evolution of depressive symptoms will also be examined in a prospective longitudinal cohort of 90 HD patients who choose not to be treated for depression. We discuss the rationale and design of ASCEND, the first large-scale randomized controlled trial evaluating efficacy of non-pharmacologic vs. pharmacologic treatment of depression in HD patients for patient-centered outcomes. PMID:26621218

Specialization in i* strategic rationale diagrams

OpenAIRE

López Cuesta, Lidia; Franch Gutiérrez, Javier; Marco Gómez, Jordi

2012-01-01

ER 2012 Best Student Paper Award The specialization relationship is offered by the i* modeling language through the is-a construct defined over actors (a subactor is-a superactor). Although the overall meaning of this construct is highly intuitive, its semantics when it comes to the fine-grained level of strategic rationale (SR) diagrams is not defined, hampering seriously its appropriate use. In this paper we provide a formal definition of the specialization relationship at the lev...

General approach to quality in design

International Nuclear Information System (INIS)

Osborne, W.J.

1981-01-01

Design engineers, either consciously or unconsciously, use quality work elements to achieve quality in design. these quality work elements are identified, classified as basic or optional, and explained. The rationale for applying them to the design of fusion devices is presented in terms of effects on performance and costs. Relevant quality terms are defined, and elements of the design quality system are described. Quality of design is the direct responsibility of the design engineer

Building "Applied Linguistic Historiography": Rationale, Scope, and Methods

Science.gov (United States)

Smith, Richard

2016-01-01

In this article I argue for the establishment of "Applied Linguistic Historiography" (ALH), that is, a new domain of enquiry within applied linguistics involving a rigorous, scholarly, and self-reflexive approach to historical research. Considering issues of rationale, scope, and methods in turn, I provide reasons why ALH is needed and…

Rationale, design, and baseline findings from HIPP: A randomized controlled trial testing a home-based, individually-tailored physical activity print intervention for African American women in the Deep South.

Science.gov (United States)

Pekmezi, Dori; Ainsworth, Cole; Joseph, Rodney; Bray, Molly S; Kvale, Elizabeth; Isaac, Shiney; Desmond, Renee; Meneses, Karen; Marcus, Bess; Demark-Wahnefried, Wendy

2016-03-01

African American women report high rates of physical inactivity and related health disparities. In our previous formative research, we conducted a series of qualitative assessments to examine physical activity barriers and intervention preferences among African American women in the Deep South. These data were used to inform a 12-month Home-based, Individually-tailored Physical activity Print (HIPP) intervention, which is currently being evaluated against a wellness contact control condition among 84 post-menopausal African American women residing in the metropolitan area of Birmingham, Alabama. This paper reports the rationale, design and baseline findings of the HIPP trial. The accrued participants had an average age of 57 (SD=4.7), a BMI of 32.1 kg/m(2) (SD=5.16) with more than half (55%) having a college education and an annual household income under $50,000 (53.6%). At baseline, participants reported an average of 41.5 min/week (SD=49.7) of moderate intensity physical activity, and 94.1% were in the contemplation or preparation stages of readiness for physical activity. While social support for exercise from friends and family was low, baseline levels of self-efficacy, cognitive and behavioral processes of change, decisional balance, outcome expectations, and enjoyment appeared promising. Baseline data indicated high rates of obesity and low levels of physical activity, providing strong evidence of need for intervention. Moreover, scores on psychosocial measures suggested that such efforts may be well received. This line of research in technology-based approaches for promoting physical activity in African American women in the Deep South has great potential to address health disparities and impact public health. Copyright © 2016 Elsevier Inc. All rights reserved.

A community-based obesity prevention program for minority children: rationale and study design for Hip-Hop to Health Jr.

Science.gov (United States)

Fitzgibbon, Marian L; Stolley, Melinda R; Dyer, Alan R; VanHorn, Linda; KauferChristoffel, Katherine

2002-02-01

BACKGROUND; The increasing prevalence of overweight among children in the United States presents a national health priority. Higher rates of overweight/obesity among minority women place their children at increased risk. Although increased rates of overweight are observed in 4- to 5-year-old children, they are not observed in 2- to 3-year-old children. Therefore, early prevention efforts incorporating families are critical. The primary aim of Hip-Hop to Health Jr. is to alter the trajectory toward overweight/obesity among preschool African-American and Latino children. This 5-year randomized intervention is conducted in 24 Head Start programs, where each site is randomized to either a 14-week dietary/physical activity intervention or a general health intervention. This paper presents the rationale and design of the study. Efficacy of the intervention will be determined by weight change for the children and parent/caretaker. Secondary measures include reductions in dietary fat and increases in fiber, fruit/vegetable intake, and physical activity. Baseline data will be presented in future papers. The problem of overweight/obesity is epidemic in the United States. Behaviors related to diet and physical activity are established early in life and modeled by family members. Early intervention efforts addressing the child and family are needed to prevent obesity later in life. This paper describes a comprehensive, family-oriented obesity prevention program for minority preschool children. Copyright 2002 American Health Foundation and Elsevier Science (USA).

"ComPost": A Writing Program Newsletter and Its Rationale.

Science.gov (United States)

Hall, Dennis R.

1993-01-01

Discusses the development and rationale of "ComPost," a weekly newsletter of the Composition Program at the University of Louisville. Suggests that a vehicle like ComPost can promote the communications that contribute to accomplishing collegiality and genuine program consensus. (RS)

Soft Power as a Policy Rationale for International Education in the UK: A Critical Analysis

Science.gov (United States)

Lomer, Sylvie

2017-01-01

This article presents the results of a textual analysis conducted on policy discourses on international students in the UK between 1999 and 2013. A number of rationales for and against increasing their numbers have been made, which have largely remained consistent over changing political administrations. One key rationale is that international…

The design rationale of the Integral Fast Reactor (IFR)

International Nuclear Information System (INIS)

Wade, D.C.; Hill, R.N.

1997-01-01

The Integral Fast Reactor (IFR) concept has been developed over the last ten years to provide technical solutions to perceptual concerns associated with nuclear power. Beyond the traditional advanced reactor objectives of increased safety, improved economy and more efficient fuel utilization, the IFR is designed to simplify waste disposal and increase resistance to proliferation. Only a fast reactor with an efficient recycle technology can provide for total consumption of actinides. The basic physics governing reactor design dictates that, for efficient recycle, the fuel form should be limited in burnup only by radiation damage to fuel cladding. The recycle technology must recover essentially all actinides. In a fast reactor, not all fission products need to be removed from the recycled fuel, and there is no need to produce pure plutonium. Recovery, recycle, and ultimate consumption of all actinides resolves several waste-disposal concerns. The IFR can be configured to achieve safe passive response to any of the traditional postulated reactor accident initiators, and can be configured for a variety of power output levels. Passive heat removal is achieved by use of a large inventory sodium coolant and a physical configuration that emphasizes natural circulation. An IFR can be designed to consume excess fissile material, to produce a surplus, or to maintain inventory. It appears that commercial designs should be economically competitive with other available alternatives. (author)

Lessons Learnt from Experts in Design Rationale Knowledge Capture

DEFF Research Database (Denmark)

Hall, Mark; Bermell-Garcia, Pablo; Ravindranath, Ranjitun

2017-01-01

The focus of this paper is on the use of argumentation models and software tools to support knowledge capture in the design of long-life engineering products. The results of semi-structured interviews with a number of experts in the field are presented, exploring their collective experience...... of knowledge capture and eliciting guidelines for successful implementation of such models and tools. The results of this research may be used as the basis for the design of future tools and techniques for knowledge capture....

Making Design Decisions Visible: Applying the Case-Based Method in Designing Online Instruction

Directory of Open Access Journals (Sweden)

Heng Luo,

2011-01-01

Full Text Available The instructional intervention in this design case is a self-directed online tutorial that applies the case-based method to teach educators how to design and conduct entrepreneurship programs for elementary school students. In this article, the authors describe the major decisions made in each phase of the design and development process, explicate the rationales behind them, and demonstrate their effect on the production of the tutorial. Based on such analysis, the guidelines for designing case-based online instruction are summarized for the design case.

The anti-interleukin-1 in type 1 diabetes action trial--background and rationale

DEFF Research Database (Denmark)

Pickersgill, Linda M S; Mandrup-Poulsen, Thomas R

2009-01-01

Type 1 diabetes (T1D) is caused by an inflammatory destruction of pancreatic beta-cells. Pro-inflammatory cytokines, in particular interleukin-1 (IL-1), have been suggested to be effector molecules based on the observations that pro-inflammatory cytokines cause beta-cell apoptosis in vitro...... and aggravate diabetes in vivo, and that inhibition of the action of these cytokines reduce diabetes incidence in animal models of type 1 diabetes and islet graft destruction. This review presents the rationale for and design of a recently launched double-blind, multicenter, randomized clinical trial...... that investigates the effect of interleukin-1 antagonism on beta-cell function in subjects with T1D of recent-onset....

Weight loss intervention for young adults using mobile technology: design and rationale of a randomized controlled trial - Cell Phone Intervention for You (CITY).

Science.gov (United States)

Batch, Bryan C; Tyson, Crystal; Bagwell, Jacqueline; Corsino, Leonor; Intille, Stephen; Lin, Pao-Hwa; Lazenka, Tony; Bennett, Gary; Bosworth, Hayden B; Voils, Corrine; Grambow, Steven; Sutton, Aziza; Bordogna, Rachel; Pangborn, Matthew; Schwager, Jenifer; Pilewski, Kate; Caccia, Carla; Burroughs, Jasmine; Svetkey, Laura P

2014-03-01

The obesity epidemic has spread to young adults, leading to significant public health implications later in adulthood. Intervention in early adulthood may be an effective public health strategy for reducing the long-term health impact of the epidemic. Few weight loss trials have been conducted in young adults. It is unclear what weight loss strategies are beneficial in this population. To describe the design and rationale of the NHLBI-sponsored Cell Phone Intervention for You (CITY) study, which is a single center, randomized three-arm trial that compares the impact on weight loss of 1) a behavioral intervention that is delivered almost entirely via cell phone technology (Cell Phone group); and 2) a behavioral intervention delivered mainly through monthly personal coaching calls enhanced by self-monitoring via cell phone (Personal Coaching group), each compared to 3) a usual care, advice-only control condition. A total of 365 community-dwelling overweight/obese adults aged 18-35 years were randomized to receive one of these three interventions for 24 months in parallel group design. Study personnel assessing outcomes were blinded to group assignment. The primary outcome is weight change at 24 [corrected] months. We hypothesize that each active intervention will cause more weight loss than the usual care condition. Study completion is anticipated in 2014. If effective, implementation of the CITY interventions could mitigate the alarming rates of obesity in young adults through promotion of weight loss. ClinicalTrial.gov: NCT01092364. Published by Elsevier Inc.

Data book: Space station/base food system study. Book 3: Study selection rationale sheets

Science.gov (United States)

1970-01-01

The supporting rationale sheets are presented which were utilized in the selection and support of the concepts considered in the final phase of the study. Each concept, conceived to fulfill a specific function of the food system, was assessed in terms of the eight critical factors depicted on the rationale sheet. When weighted and totaled, the resulting selection factor was used as a guide in making the final decision.

A beginner's guide to writing the nursing conceptual model-based theoretical rationale.

Science.gov (United States)

Gigliotti, Eileen; Manister, Nancy N

2012-10-01

Writing the theoretical rationale for a study can be a daunting prospect for novice researchers. Nursing's conceptual models provide excellent frameworks for placement of study variables, but moving from the very abstract concepts of the nursing model to the less abstract concepts of the study variables is difficult. Similar to the five-paragraph essay used by writing teachers to assist beginning writers to construct a logical thesis, the authors of this column present guidelines that beginners can follow to construct their theoretical rationale. This guide can be used with any nursing conceptual model but Neuman's model was chosen here as the exemplar.

Jump starting shared medical appointments for diabetes with weight management: Rationale and design of a randomized controlled trial.

Science.gov (United States)

Crowley, Matthew J; Edelman, David; Voils, Corrine I; Maciejewski, Matthew L; Coffman, Cynthia J; Jeffreys, Amy S; Turner, Marsha J; Gaillard, Leslie A; Hinton, Teresa A; Strawbridge, Elizabeth; Zervakis, Jennifer; Barton, Anna Beth; Yancy, William S

2017-07-01

Rates of glycemic control remain suboptimal nationwide. Medication intensification for diabetes can have undesirable side effects (weight gain, hypoglycemia), which offset the benefits of glycemic control. A Shared Medical Appointment (SMA) intervention for diabetes that emphasizes weight management could improve glycemic outcomes and reduce weight while simultaneously lowering diabetes medication needs, resulting in less hypoglycemia and better quality of life. We describe the rationale and design for a study evaluating a novel SMA intervention for diabetes that primarily emphasizes low-carbohydrate diet-focused weight management. Jump Starting Shared Medical Appointments for Diabetes with Weight Management (Jump Start) is a randomized, controlled trial that is allocating overweight Veterans (body mass index≥27kg/m 2 ) with type 2 diabetes into two arms: 1) a traditional SMA group focusing on medication management and self-management counseling; or 2) an SMA group that combines low-carbohydrate diet-focused weight management (WM/SMA) with medication management. Hemoglobin A1c reduction at 48weeks is the primary outcome. Secondary outcomes include hypoglycemic events, diabetes medication use, weight, medication adherence, diabetes-related quality of life, and cost-effectiveness. We hypothesize that WM/SMA will be non-inferior to standard SMA for glycemic control, and will reduce hypoglycemia, diabetes medication use, and weight relative to standard SMA, while also improving quality of life and costs. Jump Start targets two common problems that are closely related but infrequently managed together: diabetes and obesity. By focusing on diet and weight loss as the primary means to control diabetes, this intervention may improve several meaningful patient-centered outcomes related to diabetes. Copyright © 2017. Published by Elsevier Inc.

Apixaban for the Secondary Prevention of Thrombosis Among Patients With Antiphospholipid Syndrome: Study Rationale and Design (ASTRO-APS).

Science.gov (United States)

Woller, Scott C; Stevens, Scott M; Kaplan, David A; Branch, D Ware; Aston, Valerie T; Wilson, Emily L; Gallo, Heather M; Johnson, Eric G; Rondina, Matthew T; Lloyd, James F; Evans, R Scott; Elliott, C Gregory

2016-04-01

Antiphospholipid syndrome (APS) is an acquired thrombophilia characterized by thrombosis, pregnancy morbidity, and the presence of characteristic antibodies. Current therapy for patients having APS with a history of thrombosis necessitates anticoagulation with the vitamin K antagonist warfarin, a challenging drug to manage. Apixaban, approved for the treatment and prevention of venous thrombosis with a low rate of bleeding observed, has never been studied among patients with APS. We report study rationale and design of Apixaban for the Secondary Prevention of Thrombosis Among Patients With Antiphospholipid Syndrome (ASTRO-APS), a prospective randomized open-label blinded event pilot study that will randomize patients with a clinical diagnosis of APS receiving therapeutic anticoagulation to either adjusted-dose warfarin or apixaban 2.5 mg twice a day. We aim to report our ability to identify, recruit, randomize, and retain patients with APS randomized to apixaban compared with warfarin. We will report clinically important outcomes of thrombosis and bleeding. All clinical outcomes will be adjudicated by a panel blinded to the treatment arm. A unique aspect of this study is the enrollment of patients with an established clinical diagnosis of APS. Also unique is our use of electronic medical record interrogation techniques to identify patients who would likely meet our inclusion criteria and use of an electronic portal for follow-up visit data capture. ASTRO-APS will be the largest prospective study to date comparing a direct oral anticoagulant with warfarin among patients with APS for the secondary prevention of thrombosis. Our inclusion criteria assure that outcomes obtained will be clinically applicable to the routine management of patients with APS receiving indefinite anticoagulation. © The Author(s) 2015.

Rationales behind the choice of administration form with fentanyl

DEFF Research Database (Denmark)

Jacobsen, Ramune; Møldrup, Claus; Christrup, Lona

2010-01-01

BACKGROUND AND AIM: The aim of this study was to describe the rationale behind the choice of fentanyl administration forms among Danish general practitioners (GPs). METHODS: Thirty-eight Danish GPs were contacted via an Internet survey system to perform a Delphi survey. In the brainstorming phase...

Inertial Fusion Energy reactor design studies: Prometheus-L, Prometheus-H

International Nuclear Information System (INIS)

Waganer, L.M.; Driemeyer, D.E.; Lee, V.D.

1992-03-01

This report contains a review of design studies for Inertial Confinement reactor. This second of three volumes discussions is some detail the following: Objectives, requirements, and assumptions; rationale for design option selection; key technical issues and R ampersand D requirements; and conceptual design selection and description

STRONG LENS TIME DELAY CHALLENGE. I. EXPERIMENTAL DESIGN

Energy Technology Data Exchange (ETDEWEB)

Dobler, Gregory [Kavli Institute for Theoretical Physics, University of California Santa Barbara, Santa Barbara, CA 93106 (United States); Fassnacht, Christopher D.; Rumbaugh, Nicholas [Department of Physics, University of California, 1 Shields Avenue, Davis, CA 95616 (United States); Treu, Tommaso; Liao, Kai [Department of Physics, University of California, Santa Barbara, CA 93106 (United States); Marshall, Phil [Kavli Institute for Particle Astrophysics and Cosmology, P.O. Box 20450, MS29, Stanford, CA 94309 (United States); Hojjati, Alireza [Department of Physics and Astronomy, University of British Columbia, 6224 Agricultural Road, Vancouver, B.C. V6T 1Z1 (Canada); Linder, Eric, E-mail: tt@astro.ucla.edu [Lawrence Berkeley National Laboratory and University of California, Berkeley, CA 94720 (United States)

2015-02-01

The time delays between point-like images in gravitational lens systems can be used to measure cosmological parameters. The number of lenses with measured time delays is growing rapidly; the upcoming Large Synoptic Survey Telescope (LSST) will monitor ∼10{sup 3} strongly lensed quasars. In an effort to assess the present capabilities of the community, to accurately measure the time delays, and to provide input to dedicated monitoring campaigns and future LSST cosmology feasibility studies, we have invited the community to take part in a ''Time Delay Challenge'' (TDC). The challenge is organized as a set of ''ladders'', each containing a group of simulated data sets to be analyzed blindly by participating teams. Each rung on a ladder consists of a set of realistic mock observed lensed quasar light curves, with the rungs' data sets increasing in complexity and realism. The initial challenge described here has two ladders, TDC0 and TDC1. TDC0 has a small number of data sets, and is designed to be used as a practice set by the participating teams. The (non-mandatory) deadline for completion of TDC0 was the TDC1 launch date, 2013 December 1. The TDC1 deadline was 2014 July 1. Here we give an overview of the challenge, we introduce a set of metrics that will be used to quantify the goodness of fit, efficiency, precision, and accuracy of the algorithms, and we present the results of TDC0. Thirteen teams participated in TDC0 using 47 different methods. Seven of those teams qualified for TDC1, which is described in the companion paper.

Creating a Strong Foundation with Engineering Design Graphics.

Science.gov (United States)

Newcomer, Jeffrey L.; McKell, Eric K.; Raudebaugh, Robert A.; Kelley, David S.

2001-01-01

Describes the two-course engineering design graphics sequence on introductory design and graphics topics. The first course focuses on conceptual design and the development of visualization and sketching skills while the second one concentrates on detail design and parametric modeling. (Contains 28 references.) (Author/ASK)

Aspirin for the prevention of cognitive decline in the elderly: rationale and design of a neuro-vascular imaging study (ENVIS-ion

Directory of Open Access Journals (Sweden)

Reid Christopher M

2012-02-01

Full Text Available Abstract Background This paper describes the rationale and design of the ENVIS-ion Study, which aims to determine whether low-dose aspirin reduces the development of white matter hyper-intense (WMH lesions and silent brain infarction (SBI. Additional aims include determining whether a changes in retinal vascular imaging (RVI parameters parallel changes in brain magnetic resonance imaging (MRI; b changes in RVI parameters are observed with aspirin therapy; c baseline cognitive function correlates with MRI and RVI parameters; d changes in cognitive function correlate with changes in brain MRI and RVI and e whether factors such as age, gender or blood pressure influence the above associations. Methods/Design Double-blind, placebo-controlled trial of three years duration set in two Australian academic medical centre outpatient clinics. This study will enrol 600 adults aged 70 years and over with normal cognitive function and without overt cardiovascular disease. Subjects will undergo cognitive testing, brain MRI and RVI at baseline and after 3 years of study treatment. All subjects will be recruited from a 19,000-patient clinical outcome trial conducted in Australia and the United States that will evaluate the effects of aspirin in maintaining disability-free longevity over 5 years. The intervention will be aspirin 100 mg daily versus matching placebo, randomized on a 1:1 basis. Discussion This study will improve understanding of the mechanisms at the level of brain and vascular structure that underlie the effects of aspirin on cognitive function. Given the limited access and high cost of MRI, RVI may prove useful as a tool for the identification of individuals at high risk for the development of cerebrovascular disease and cognitive decline. Trial Registration clinicaltrials.gov Identifier: NCT01038583

Weight loss intervention for young adults using mobile technology: design and rationale of a randomized controlled trial – Cell phone Intervention for You (CITY)

Science.gov (United States)

Batch, Bryan C.; Tyson, Crystal; Bagwell, Jacqueline; Corsino, Leonor; Intille, Stephen; Lin, Pao-Hwa; Lazenka, Tony; Bennett, Gary; Bosworth, Hayden B.; Voils, Corrine; Grambow, Steven; Sutton, Aziza; Bordogna, Rachel; Pangborn, Matthew; Schwager, Jenifer; Pilewski, Kate; Caccia, Carla; Burroughs, Jasmine; Svetkey, Laura P.

2014-01-01

Background The obesity epidemic has spread to young adults, leading to significant public health implications later in adulthood. Intervention in early adulthood may be an effective public health strategy for reducing the long-term health impact of the epidemic. Few weight loss trials have been conducted in young adults. It is unclear what weight loss strategies are beneficial in this population. Purpose To describe the design and rationale of the NHLBI-sponsored Cell Phone Intervention for You (CITY) study, which is a single center, randomized three-arm trial that compares the impact on weight loss of 1) a behavioral intervention that is delivered almost entirely via cell phone technology (Cell Phone group); and 2) a behavioral intervention delivered mainly through monthly personal coaching calls enhanced by self-monitoring via cell phone (Personal Coaching group), each compared to; 3) a usual care, advice-only control condition. Methods A total of 365 community-dwelling overweight/obese adults aged 18–35 years were randomized to receive one of these three interventions for 24 months in parallel group design. Study personnel assessing outcomes were blinded to group assignment. The primary outcome is weight change at 12 months. We hypothesize that each active intervention will cause more weight loss than the usual care condition. Study completion is anticipated in 2014. Conclusions If effective, implementation of the CITY interventions could mitigate the alarming rates of obesity in young adults through promotion of weight loss. PMID:24462568

Effect of strong-column weak-beam design provision on the seismic fragility of RC frame buildings

Science.gov (United States)

Surana, Mitesh; Singh, Yogendra; Lang, Dominik H.

2018-04-01

Incremental dynamic analyses are conducted for a suite of low- and mid-rise reinforced-concrete special moment-resisting frame buildings. Buildings non-conforming and conforming to the strong-column weak-beam (SCWB) design criterion are considered. These buildings are designed for the two most severe seismic zones in India (i.e., zone IV and zone V) following the provisions of Indian Standards. It is observed that buildings non-conforming to the SCWB design criterion lead to an undesirable column failure collapse mechanism. Although yielding of columns cannot be avoided, even for buildings conforming to a SCWB ratio of 1.4, the observed collapse mechanism changes to a beam failure mechanism. This change in collapse mechanism leads to a significant increase in the building's global ductility capacity, and thereby in collapse capacity. The fragility analysis study of the considered buildings suggests that considering the SCWB design criterion leads to a significant reduction in collapse probability, particularly in the case of mid-rise buildings.

The Action to Control Cardiovascular Risk in Diabetes Memory in Diabetes Study (ACCORD-MIND): rationale, design, and methods.

Science.gov (United States)

Williamson, Jeff D; Miller, Michael E; Bryan, R Nick; Lazar, Ronald M; Coker, Laura H; Johnson, Janice; Cukierman, Tali; Horowitz, Karen R; Murray, Anne; Launer, Lenore J

2007-06-18

Type 2 diabetes mellitus and cognitive impairment are 2 of the most common chronic conditions found in persons aged > or = 60 years. Clinical studies have shown a greater prevalence of global cognitive impairment, incidence of cognitive decline, and incidence of Alzheimer disease in patients with type 2 diabetes. To date, there have been no randomized trials of the effects of long-term glycemic control on cognitive function and structural brain changes in patients with type 2 diabetes. The primary aim of the Action to Control Cardiovascular Risk in Diabetes (ACCORD) Memory in Diabetes Study (ACCORD-MIND) is to test whether there is a difference in the rate of cognitive decline and structural brain change in patients with diabetes treated with standard-care guidelines compared with those treated with intensive-care guidelines. This comparison will be made in a subsample of 2,977 patients with diabetes participating in the ongoing ACCORD trial, a clinical trial sponsored by the National Heart, Lung, and Blood Institute (NHLBI) with support from the National Institute on Aging (NIA). Data from this ACCORD substudy on the possible beneficial or adverse effects of intensive treatment on cognitive function will be obtained from a 30-minute test battery, administered at baseline and 20-month and 40-month visits. In addition, full-brain magnetic resonance imaging will be performed on 630 participants at baseline and at 40 months to assess the relation between the ACCORD treatments and structural brain changes. The general aim of ACCORD-MIND is to determine whether the intensive treatment of diabetes, a major risk factor for Alzheimer disease and vascular dementia, can reduce the early decline in cognitive function that could later evolve into more cognitively disabling conditions. This report presents the design, rationale, and methods of the ACCORD-MIND substudy.

Significance of Haemodynamic and Haemostatic Factors in the Course of Different Manifestations of Cerebral Small Vessel Disease: The SHEF-CSVD Study—Study Rationale and Protocol

Directory of Open Access Journals (Sweden)

Jacek Staszewski

2013-01-01

Full Text Available Rationale. This paper describes the rationale and design of the SHEF-CSVD Study, which aims to determine the long-term clinical and radiological course of cerebral small vessel disease (CSVD and to evaluate haemostatic and haemodynamic prognostic factors of the condition. Design. This single-centre, prospective, non-interventional cohort study will follow 150 consecutive patients with different clinical manifestations of CSVD (lacunar ischaemic stroke, vascular dementia, vascular parkinsonism or spontaneous deep, intracerebral haemorrhage and 50 age- and sex-matched controls over a period of 24 months. The clinical and radiological course will be evaluated basing on a detailed neurological, neuropsychological and MRI examinations. Haemodynamic (cerebral vasoreactivity, 24 h blood pressure control and haemostatic factors (markers of endothelial and platelet dysfunction, brachial artery flow-mediated dilatation test will be determined. Discussion. The scheduled study will specifically address the issue of haemodynamic and haemostatic prognostic factors and their course over time in various clinical manifestations of CSVD. The findings may aid the development of prophylactic strategies and individualised treatment plans, which are critical during the early stages of the disease.

Rationales Shaping International Linkages in Higher Education: A Qualitative Case Study of the ASU-ITESM Strategic Alliance

Science.gov (United States)

Camacho Lizarraga, Monica Irene

2011-01-01

This qualitative case study examines the rationales of the relationship between Arizona State University (ASU)--an American public research university--and Tecnologico de Monterrey (ITESM), a Mexican private not for profit research university. The focus of the study is to document the different meanings participants attached to the rationales of…

Genomewide Association Studies: History, Rationale, and Prospects for Psychiatric Disorders

NARCIS (Netherlands)

Cichon, S.; Craddock, N.; Daly, M.J.; Faraone, S.V.; Gejman, P.V.; Kelsoe, J.; Lehner, T.; Levinson, D.F.; Moran, A.P.; Sklar, P.; Sullivan, P.F.; Boomsma, D.I.; de Geus, E.J.C.; Posthuma, D.; Willemsen, G.

2009-01-01

Objective: The authors conducted a review of the history and empirical basis of genomewide association studies (GWAS), the rationale for GWAS of psychiatric disorders, results to date, limitations, and plans for GWAS meta-analyses. Method: A literature review was carried out, power and other issues

Genomewide association studies: history, rationale, and prospects for psychiatric disorders.

NARCIS (Netherlands)

Franke, B.; Buitelaar, J.K.; Cichon, S.; Craddock, N.; Daly, M.; Faraone, S.V.; Gejman, P.V.; Kelsoe, J.; Lehner, T.; Levinson, D.F.; Moran, A.; Sklar, P.; Sullivan, P.F.

2009-01-01

OBJECTIVE: The authors conducted a review of the history and empirical basis of genomewide association studies (GWAS), the rationale for GWAS of psychiatric disorders, results to date, limitations, and plans for GWAS meta-analyses. METHOD: A literature review was carried out, power and other issues

A preliminary report of music-based training for adult cochlear implant users: rationales and development

Science.gov (United States)

Gfeller, Kate; Guthe, Emily; Driscoll, Virginia; Brown, Carolyn J.

2015-01-01

Objective This paper provides a preliminary report of a music-based training program for adult cochlear implant (CI) recipients. Included in this report are descriptions of the rationale for music-based training, factors influencing program development, and the resulting program components. Methods Prior studies describing experience-based plasticity in response to music training, auditory training for persons with hearing impairment, and music training for cochlear implant recipients were reviewed. These sources revealed rationales for using music to enhance speech, factors associated with successful auditory training, relevant aspects of electric hearing and music perception, and extant evidence regarding limitations and advantages associated with parameters for music training with CI users. This information formed the development of a computer-based music training program designed specifically for adult CI users. Results Principles and parameters for perceptual training of music, such as stimulus choice, rehabilitation approach, and motivational concerns were developed in relation to the unique auditory characteristics of adults with electric hearing. An outline of the resulting program components and the outcome measures for evaluating program effectiveness are presented. Conclusions Music training can enhance the perceptual accuracy of music, but is also hypothesized to enhance several features of speech with similar processing requirements as music (e.g., pitch and timbre). However, additional evaluation of specific training parameters and the impact of music-based training on speech perception of CI users are required. PMID:26561884

Design preferences and cognitive styles: experimentation by automated website synthesis.

Science.gov (United States)

Leung, Siu-Wai; Lee, John; Johnson, Chris; Robertson, David

2012-06-29

This article aims to demonstrate computational synthesis of Web-based experiments in undertaking experimentation on relationships among the participants' design preference, rationale, and cognitive test performance. The exemplified experiments were computationally synthesised, including the websites as materials, experiment protocols as methods, and cognitive tests as protocol modules. This work also exemplifies the use of a website synthesiser as an essential instrument enabling the participants to explore different possible designs, which were generated on the fly, before selection of preferred designs. The participants were given interactive tree and table generators so that they could explore some different ways of presenting causality information in tables and trees as the visualisation formats. The participants gave their preference ratings for the available designs, as well as their rationale (criteria) for their design decisions. The participants were also asked to take four cognitive tests, which focus on the aspects of visualisation and analogy-making. The relationships among preference ratings, rationale, and the results of cognitive tests were analysed by conservative non-parametric statistics including Wilcoxon test, Krustal-Wallis test, and Kendall correlation. In the test, 41 of the total 64 participants preferred graphical (tree-form) to tabular presentation. Despite the popular preference for graphical presentation, the given tabular presentation was generally rated to be easier than graphical presentation to interpret, especially by those who were scored lower in the visualization and analogy-making tests. This piece of evidence helps generate a hypothesis that design preferences are related to specific cognitive abilities. Without the use of computational synthesis, the experiment setup and scientific results would be impractical to obtain.

Community-based physical activity as adjunctive smoking cessation treatment: Rationale, design, and baseline data for the Lifestyle Enhancement Program (LEAP randomized controlled trial

Directory of Open Access Journals (Sweden)

Mark W. Vander Weg

2018-03-01

Full Text Available Despite advances in behavioral and pharmacological treatment for tobacco use and dependence, quit rates remain suboptimal. Increasing physical activity has shown some promise as a strategy for improving cessation outcomes. However, initial efficacy studies focused on intensive, highly structured exercise programs that may not be applicable to the general population of smokers. We describe the rationale and study design and report baseline participant characteristics from the Lifestyle Enhancement Program (LEAP, a two-group, randomized controlled trial. Adult smokers who engaged in low levels of leisure time physical activity were randomly assigned to treatment conditions consisting of an individualized physical activity intervention delivered by health fitness instructors in community-based exercise facilities or an equal contact wellness control. All participants received standard cognitive behavioral smoking cessation counseling combined with nicotine replacement therapy. The primary outcomes are seven-day point prevalence abstinence at seven weeks, six- and 12 months. Secondary outcomes include self-reported physical activity, dietary intake, body mass index, waist circumference, percent body fat, and nicotine withdrawal symptoms. Participants consist of 392 sedentary smokers (mean [standard deviation] age = 44.6 [10.2] = years; 62% female; 31% African American. Results reported here provide information regarding experiences recruiting smokers willing to change multiple health behaviors including smoking and physical activity.

Karl Popper and Jean Piaget: A Rationale for Constructivism

Science.gov (United States)

Harlow, Steve; Cummings, Rhoda; Aberasturi, Suzanne M.

2006-01-01

The current faddish use of the term constructivism has taken on as many different definitions as the number of people attempting to define it. This essay clarifies the meaning of constructivism through an examination of Karl Popper's and Jean Piaget's theories. The authors provide a rationale for the use of Popper's paradigm of "Three Worlds" and…

Working Inside for Smoking Elimination (Project W.I.S.E. study design and rationale to prevent return to smoking after release from a smoke free prison

Directory of Open Access Journals (Sweden)

Mello Jennifer

2011-10-01

Full Text Available Abstract Background Incarcerated individuals suffer disproportionately from the health effects of tobacco smoking due to the high smoking prevalence in this population. In addition there is an over-representation of ethnic and racial minorities, impoverished individuals, and those with mental health and drug addictions in prisons. Increasingly, prisons across the U.S. are becoming smoke free. However, relapse to smoking is common upon release from prison, approaching 90% within a few weeks. No evidence based treatments currently exist to assist individuals to remain abstinent after a period of prolonged, forced abstinence. Methods/Design This paper describes the design and rationale of a randomized clinical trial to enhance smoking abstinence rates among individuals following release from a tobacco free prison. The intervention is six weekly sessions of motivational interviewing and cognitive behavioral therapy initiated approximately six weeks prior to release from prison. The control group views six time matched videos weekly starting about six weeks prior to release. Assessments take place in-person 3 weeks after release and then for non-smokers every 3 months up to 12 months. Smoking status is confirmed by urine cotinine. Discussion Effective interventions are greatly needed to assist these individuals to remain smoke free and reduce health disparities among this socially and economically challenged group. Trial Registration NCT01122589

Conflicting rationales: leader's experienced ethical challenges in community health care for older people.

Science.gov (United States)

Slettebø, Åshild; Skaar, Ragnhild; Brodtkorb, Kari; Skisland, Anne

2017-08-22

Ethical challenges arise in all types of care, and leaders need to be aware of how to resolve these challenges. Healthcare systems tend to be organised around medical conditions, and the patient is often faced with a series of uncoordinated visits to multiple specialties. Ideally, care should be organised around the patient's needs. The purpose of this article was to highlight some ethical challenges perceived by leaders with responsibility for management and service distribution, finance and ensuring quality of community health services for older people. This study had a qualitative design with a qualitative content analysis of one focus group with six leaders that met four times in total. Leaders from the community healthcare sector in one Norwegian municipality were included, representing both nursing homes and home-based health care. The study followed the intentions of the Declaration of Helsinki and standard ethical principles. The Norwegian Social Science Data Services approved the study. All participants voluntarily gave written informed consent. The main theme that emerged from this study was the ethical challenge leaders felt in the form of an inherent conflict between a caring rationale versus economic or technological rationales. Four categories emerged: (i) Management: quality versus economy; (ii) Prioritisation: fair distribution of healthcare services; (iii) Responsibility: considering individuals' needs versus the needs of the whole community; and (iv) Welfare technology: possibilities and challenges. Leaders' responsibilities in community health care for older people need to strike a balance between ethical principles in the management of limited resources. © 2017 Nordic College of Caring Science.

A workplace email-linked website intervention for modifying cancer-related dietary and lifestyle risk factors: rationale, design and baseline findings.

Science.gov (United States)

Ang, Y K; Mirnalini, K; Zalilah, M S

2013-04-01

The use of email and website as channels for workplace health information delivery is not fully explored. This study aims to describe the rationale, design, and baseline findings of an email-linked website intervention to improve modifiable cancer risk factors. Employees of a Malaysian public university were recruited by systematic random sampling and randomised into an intervention (n = 174) or control group (n = 165). A website was developed for the intervention and educational modules were uploaded onto the website. The intervention group received ten consecutive weekly emails with hypertext links to the website for downloading the modules and two individual phone calls as motivational support whilst the control group received none. Diet, lifestyle, anthropometric measurements, psychosocial factors and stages of change related to dietary fat, fruit and vegetable intake, and physical activity were assessed. Participants were predominantly female and in non-academic positions. Obesity was prevalent in 15% and 37% were at risk of co-morbidities. Mean intake of fats was 31%, fruit was -1 serving/day and vegetable was < 1 serving/day. Less than 20% smoked and drank alcohol and about 40% were physically inactive. The majority of the participants fell into the Preparation stage for decreasing fat intake, eating more fruit and vegetables, and increasing physical activity. Self-efficacy and perceived benefits were lowest among participants in the Precontemplation/Contemplation stage compared to the Preparation and Action/Maintenance stages. Baseline data show that dietary and lifestyle practices among the employees did not meet the international guidelines for cancer prevention. Hence the findings warrant the intervention planned.

Rationale, design, and results of the first screening round of a comprehensive, register-based, Chlamydia screening implementation programme in the Netherlands

Directory of Open Access Journals (Sweden)

Koekenbier Rik H

2010-10-01

Full Text Available Abstract Background Implementing Chlamydia trachomatis screening in the Netherlands has been a point of debate for several years. The National Health Council advised against implementing nationwide screening until additional data collected from a pilot project in 2003 suggested that screening by risk profiles could be effective. A continuous increase in infections recorded in the national surveillance database affirmed the need for a more active approach. Here, we describe the rationale, design, and implementation of a Chlamydia screening demonstration programme. Methods A systematic, selective, internet-based Chlamydia screening programme started in April 2008. Letters are sent annually to all 16 to 29-year-old residents of Amsterdam, Rotterdam, and selected municipalities of South Limburg. The letters invite sexually active persons to login to http://www.chlamydiatest.nl with a personal code and to request a test kit. In the lower prevalence area of South Limburg, test kits can only be requested if the internet-based risk assessment exceeds a predefined value. Results We sent invitations to 261,025 people in the first round. One-fifth of the invitees requested a test kit, of whom 80% sent in a sample for testing. The overall positivity rate was 4.2%. Conclusions This programme advances Chlamydia control activities in the Netherlands. Insight into the feasibility, effectiveness, cost-effectiveness, and impact of this large-scale screening programme will determine whether the programme will be implemented nationally.

Studying the effects of classic hallucinogens in the treatment of alcoholism: rationale, methodology, and current research with psilocybin.

Science.gov (United States)

Bogenschutz, Michael P

2013-03-01

Recent developments in the study of classic hallucinogens, combined with a re-appraisal of the older literature, have led to a renewal of interest in possible therapeutic applications for these drugs, notably their application in the treatment of addictions. This article will first provide a brief review of the research literature providing direct and indirect support for the possible therapeutic effects of classic hallucinogens such as psilocybin and lysergic acid diethylamide (LSD) in the treatment of addictions. Having provided a rationale for clinical investigation in this area, we discuss design issues in clinical trials using classic hallucinogens, some of which are unique to this class of drug. We then discuss the current status of this field of research and design considerations in future randomized trials.

Constructing a Theory- and Evidence-Based Treatment Rationale for Complex eHealth Interventions: Development of an Online Alcohol Intervention Using an Intervention Mapping Approach.

Science.gov (United States)

Brendryen, Håvar; Johansen, Ayna; Nesvåg, Sverre; Kok, Gerjo; Duckert, Fanny

2013-01-23

Due to limited reporting of intervention rationale, little is known about what distinguishes a good intervention from a poor one. To support improved design, there is a need for comprehensive reports on novel and complex theory-based interventions. Specifically, the emerging trend of just-in-time tailoring of content in response to change in target behavior or emotional state is promising. The objective of this study was to give a systematic and comprehensive description of the treatment rationale of an online alcohol intervention called Balance. We used the intervention mapping protocol to describe the treatment rationale of Balance. The intervention targets at-risk drinking, and it is delivered by email, mobile phone text messaging, and tailored interactive webpages combining text, pictures, and prerecorded audio. The rationale of the current treatment was derived from a self-regulation perspective, and the overarching idea was to support continued self-regulation throughout the behavior change process. Maintaining the change efforts over time and coping adaptively during critical moments (eg, immediately before and after a lapse) are key factors to successful behavior change. Important elements of the treatment rationale to achieving these elements were: (1) emotion regulation as an inoculation strategy against self-regulation failure, (2) avoiding lapses by adaptive coping, and (3) avoiding relapse by resuming the change efforts after a lapse. Two distinct and complementary delivery strategies were used, including a day-to-day tunnel approach in combination with just-in-time therapy. The tunnel strategy was in accordance with the need for continuous self-regulation and it functions as a platform from which just-in-time therapy was launched. Just-in-time therapy was used to support coping during critical moments, and started when the client reports either low self-efficacy or that they were drinking above target levels. The descriptions of the treatment

Effect of genetic testing for risk of type 2 diabetes mellitus on health behaviors and outcomes: study rationale, development and design

Directory of Open Access Journals (Sweden)

Cho Alex H

2012-01-01

Full Text Available Abstract Background Type 2 diabetes is a prevalent chronic condition globally that results in extensive morbidity, decreased quality of life, and increased health services utilization. Lifestyle changes can prevent the development of diabetes, but require patient engagement. Genetic risk testing might represent a new tool to increase patients' motivation for lifestyle changes. Here we describe the rationale, development, and design of a randomized controlled trial (RCT assessing the clinical and personal utility of incorporating type 2 diabetes genetic risk testing into comprehensive diabetes risk assessments performed in a primary care setting. Methods/Design Patients are recruited in the laboratory waiting areas of two primary care clinics and enrolled into one of three study arms. Those interested in genetic risk testing are randomized to receive either a standard risk assessment (SRA for type 2 diabetes incorporating conventional risk factors plus upfront disclosure of the results of genetic risk testing ("SRA+G" arm, or the SRA alone ("SRA" arm. Participants not interested in genetic risk testing will not receive the test, but will receive SRA (forming a third, "no-test" arm. Risk counseling is provided by clinic staff (not study staff external to the clinic. Fasting plasma glucose, insulin levels, body mass index (BMI, and waist circumference are measured at baseline and 12 months, as are patients' self-reported behavioral and emotional responses to diabetes risk information. Primary outcomes are changes in insulin resistance and BMI after 12 months; secondary outcomes include changes in diet patterns, physical activity, waist circumference, and perceived risk of developing diabetes. Discussion The utility, feasibility, and efficacy of providing patients with genetic risk information for common chronic diseases in primary care remain unknown. The study described here will help to establish whether providing type 2 diabetes genetic risk

Sampling in Qualitative Research: Rationale, Issues, and Methods

OpenAIRE

LUBORSKY, MARK R.; RUBINSTEIN, ROBERT L.

1995-01-01

In gerontology the most recognized and elaborate discourse about sampling is generally thought to be in quantitative research associated with survey research and medical research. But sampling has long been a central concern in the social and humanistic inquiry, albeit in a different guise suited to the different goals. There is a need for more explicit discussion of qualitative sampling issues. This article will outline the guiding principles and rationales, features, and practices of sampli...

Use of self-controlled designs in pharmacoepidemiology

DEFF Research Database (Denmark)

Hallas, J.; Pottegård, Anton

2014-01-01

Self-controlled observational study designs, such as the case-crossover design and the self-controlled case series, are reviewed, and their respective rationale, strengths and limitations are compared. Although no single design is generally superior to the others, they share the trait of being...... robust towards confounders that are stable over time. The self-controlled designs can be particularly useful when using secondary healthcare data for pharmacoepidemiological research and might be useful in screening for adverse drug effects. The main limitations of self-controlled designs...

The rationales of resilience in English and Dutch flood risk policies

NARCIS (Netherlands)

Wiering, M.A.; Green, C.; Rijswick, M. van; Priest, S.J.; Keessen, A.M.

2015-01-01

We compared the governance of flood risk in England and the Netherlands, focusing on the general policies, instruments used and underlying principles. Both physical and political environments are important in explaining how countries evolved towards very different rationales of

200-UP-1 groundwater remedial design/remedial action work plan. Revision 1

International Nuclear Information System (INIS)

1997-07-01

This 200-UP-1 remedial design report presents the objective and rationale developed for the design and implementation of the selected interim remedial measure for the 200-UP-1 Operable Unit, located in the 200 West Area of the Hanford Site

Design review of the INTOR mechanical configuration

International Nuclear Information System (INIS)

Brown, T.G.

1981-01-01

The INTOR conceptual design has been carried out by design teams working in the home countries with periodic workshop sessions in Vienna to review the ongoing work and to make decisions on the evolving design. The decisions taken at each workshop session were then incorporated into each national design activity, so that the four national design contributions would progressively converge toward a single design with increasingly greater detail. This paper defines the final INTOR configuration that has evolved during the conceptual design phase, defining the major system design alternatives that were considered and the rationale for selecting the final system configuration

Design for All in Scandinavia - a strong concept.

Science.gov (United States)

Bendixen, Karin; Benktzon, Maria

2015-01-01

Design for All is more than an appealing point of view. It is a concept that offers a set of challenges capable of generating innovation and giving design added value and weight. In the Scandinavian tradition, the concept has developed from a purely social dimension to a design topic that is discussed both in terms of its business potential and in relation to Corporate Social Responsibility, CSR. This article gives a State of the Art of the development of Design for All in the Scandinavian countries: Denmark, Norway, Sweden and Finland during the past 15 years, beginning with a common review and joint Scandinavian projects, followed by an overall review country by country which include selected case studies over the past 15 years. Copyright © 2013 Elsevier Ltd and The Ergonomics Society. All rights reserved.

Rationale for the Cultural Construction of School Mental Health Programming

Science.gov (United States)

Arora, Prerna G.; Nastasi, Bonnie K.; Leff, Stephen S.

2017-01-01

The implementation of evidence-based psychological programming to meet the needs of a global population has been impeded by the translation of theories and research findings across populations and settings without due consideration of cultural factors. The purpose of this article is to discuss the rationale for use of partnership-based methods in…

The Combination of Physical Exercise with Muscle-Directed Antioxidants to Counteract Sarcopenia: A Biomedical Rationale for Pleiotropic Treatment with Creatine and Coenzyme Q10

Directory of Open Access Journals (Sweden)

Michele Guescini

2017-01-01

Full Text Available Sarcopenia represents an increasing public health risk due to the rapid aging of the world’s population. It is characterized by both low muscle mass and function and is associated with mobility disorders, increased risk of falls and fractures, loss of independence, disabilities, and increased risk of death. Despite the urgency of the problem, the development of treatments for sarcopenia has lagged. Increased reactive oxygen species (ROS production and decreased antioxidant (AO defences seem to be important factors contributing to muscle impairment. Studies have been conducted to verify whether physical exercise and/or AOs could prevent and/or delay sarcopenia through a normalization of the etiologically relevant ROS imbalance. Despite the strong rationale, the results obtained were contradictory, particularly with regard to the effects of the tested AOs. A possible explanation might be that not all the agents included in the general heading of “AOs” could fulfill the requisites to counteract the complex series of events causing/accelerating sarcopenia: the combination of the muscle-directed antioxidants creatine and coenzyme Q10 with physical exercise as a biomedical rationale for pleiotropic prevention and/or treatment of sarcopenia is discussed.

Proton therapy for head and neck cancer: Rationale, potential indications, practical considerations, and current clinical evidence

International Nuclear Information System (INIS)

Mendenhall, Nancy P.; Malyapa, Robert S.; Su, Zhong; Yeung, Daniel; Mendenhall, William M.; Li, Zuofeng

2011-01-01

There is a strong rationale for potential benefits from proton therapy (PT) for selected cancers of the head and neck because of the opportunity to improve the therapeutic ratio by improving radiation dose distributions and because of the significant differences in radiation dose distribution achievable with x-ray-based radiation therapy (RT) and PT. Comparisons of dose distributions between x-ray-based and PT plans in selected cases show specific benefits in dose distribution likely to translate into improved clinical outcomes. However, the use of PT in head and neck cancers requires special considerations in the simulation and treatment planning process, and currently available PT technology may not permit realization of the maximum potential benefits of PT. To date, few clinical data are available, but early clinical experiences in sinonasal tumors in particular suggest significant improvements in both disease control and radiation-related toxicity

Proton therapy for head and neck cancer: Rationale, potential indications, practical considerations, and current clinical evidence

Energy Technology Data Exchange (ETDEWEB)

Mendenhall, Nancy P.; Malyapa, Robert S.; Su, Zhong; Yeung, Daniel; Mendenhall, William M.; Li, Zuofeng (Univ. of Florida Proton Therapy Inst., Jacksonville, Florida (United States)), e-mail: menden@shands.ufl.edu

2011-08-15

There is a strong rationale for potential benefits from proton therapy (PT) for selected cancers of the head and neck because of the opportunity to improve the therapeutic ratio by improving radiation dose distributions and because of the significant differences in radiation dose distribution achievable with x-ray-based radiation therapy (RT) and PT. Comparisons of dose distributions between x-ray-based and PT plans in selected cases show specific benefits in dose distribution likely to translate into improved clinical outcomes. However, the use of PT in head and neck cancers requires special considerations in the simulation and treatment planning process, and currently available PT technology may not permit realization of the maximum potential benefits of PT. To date, few clinical data are available, but early clinical experiences in sinonasal tumors in particular suggest significant improvements in both disease control and radiation-related toxicity

Design of strong wooden box coated with fiberglass reinforced resin for shipping and burial of contaminated glove boxes. Final report

International Nuclear Information System (INIS)

1982-01-01

The project scope of work included the complete decontamination and decommissioning (D and D) of the Westinghouse ARD Fuel Laboratories at the Cheswick Site in the shortest possible time. This has been accomplished in the following four phases: (1) preparation of documents and necessary paperwork; packaging and shipping of all special nuclear materials in an acceptable form to a reprocessing agency; (2) decontamination of all facilities, glove boxes and equipment; loading of generated waste into bins, barrels and strong wooden boxes; (3) shipping of al bins, barrels and boxes containing waste to the designated burial site; removal of all utility services from the laboratories; and (4) final survey of remaining facilities and certification for nonrestricted use; preparation of final report. This attachment contains design of strong wooden box coated with fiberglass reinforced resin for shipping and burial of contaminated glove boxes

Meeting a Moral Imperative: A Rationale for Teaching the Holocaust

Science.gov (United States)

Lindquist, David H.

2011-01-01

A primary rationale for studying the Holocaust (Shoah) involves the opportunity to consider the moral implications that can be drawn from examining the event. Studying the Shoah forces students to consider what it means to be human and humane by examining the full continuum of individual behavior, from "ultimate evil" to "ultimate good". This…

The ‘grey’ assessment practice of IA screening: Prevalence, influence and applied rationale

International Nuclear Information System (INIS)

Bidstrup, Morten

2017-01-01

Research focusing on the practices surrounding screening in Impact Assessment (IA) is limited. Yet, it has been found that development proposals sometimes are adjusted through an informal dialog with IA practitioners prior to or during screening. Such practice is often referred to as ‘grey IA’ in Denmark. This article explores the prevalence, influence and applied rationale of grey IA. Through a questionnaire, data was collected from 121 IA practitioners working within the fields of environmental impact assessment and strategic environmental assessment. It was found that grey IA is a common practice, which influences the outcomes of formal screening procedures through consideration of impacts on neighbours and spatial zones of protection. Grey IA is to some extent motivated by the opportunity to save the resources required for full-scale IA, but an additional ‘green’ rationale also exists. Grey IA may influence the effectiveness of IA systems, but further research is needed before any conclusions can be made. - Highlights: • Screening procedures may function as an informal, ‘grey’ assessment. • Grey assessment is common and influences formal screening outcomes. • Grey assessment is motivated by an opportunity to cut IA costs. • Yet, an environmental, ‘green’ rationale for grey assessment also exists.

The ‘grey’ assessment practice of IA screening: Prevalence, influence and applied rationale

Energy Technology Data Exchange (ETDEWEB)

Bidstrup, Morten, E-mail: Bidstrup@plan.aau.dk

2017-01-15

Research focusing on the practices surrounding screening in Impact Assessment (IA) is limited. Yet, it has been found that development proposals sometimes are adjusted through an informal dialog with IA practitioners prior to or during screening. Such practice is often referred to as ‘grey IA’ in Denmark. This article explores the prevalence, influence and applied rationale of grey IA. Through a questionnaire, data was collected from 121 IA practitioners working within the fields of environmental impact assessment and strategic environmental assessment. It was found that grey IA is a common practice, which influences the outcomes of formal screening procedures through consideration of impacts on neighbours and spatial zones of protection. Grey IA is to some extent motivated by the opportunity to save the resources required for full-scale IA, but an additional ‘green’ rationale also exists. Grey IA may influence the effectiveness of IA systems, but further research is needed before any conclusions can be made. - Highlights: • Screening procedures may function as an informal, ‘grey’ assessment. • Grey assessment is common and influences formal screening outcomes. • Grey assessment is motivated by an opportunity to cut IA costs. • Yet, an environmental, ‘green’ rationale for grey assessment also exists.

Small sustainable monetary incentives versus charitable donations to promote exercise: Rationale, design, and baseline data from a randomized pilot study.

Science.gov (United States)

Williams, David M; Lee, Harold H; Connell, Lauren; Boyle, Holly; Emerson, Jessica; Strohacker, Kelley; Galárraga, Omar

2018-03-01

Regular physical activity (PA) enhances weight-loss and reduces risk of chronic disease. However, as few as 10% of U.S. adults engage in regular PA. Incentive programs to promote PA have shown some promise, but have typically used incentives that are too large to sustain over time and have not demonstrated habit formation or been tested in community settings. This report presents the rationale and design of a randomized pilot study testing the feasibility and preliminary efficacy of small monetary incentives for PA (n=25) versus charitable donations in the same amount (n=25) versus control (n=25) over 12months among 75 low-active but otherwise healthy adults at a local YMCA. Incentives are based on YMCA attendance, which is verified by electronic swipe card data and is the primary study outcome, with self-reported minutes/week of PA assessed as a secondary outcome. Incentives are intentionally small enough-$1/session, maximum of $5/week-such that they could be indefinitely sustained by community organizations, privately-owned health clubs, healthcare organizations, or employers (e.g., employer fitness facilities). Costs of the incentive program for the sponsoring organization may be partially offset by increases in membership resulting from the appeal of the program. Moreover, if efficacious, the charitable donation incentive program may have the added benefit of building social capital for the sponsoring organization and potentially serving as a tax write-off, thus further offsetting the cost of the incentives. Findings will also have implications for the use of financially sustainable community-based incentive programs for other health-related behaviors (e.g., weight loss, smoking). Copyright © 2018 Elsevier Inc. All rights reserved.

Designer Drug Confusion: A Focus on MDMA.

Science.gov (United States)

Beck, Jerome; Morgan, Patricia A.

1986-01-01

Discusses the competing definitions and issues surrounding various designer drugs, primarily 3, 4-methylenedioxy-methamphetamine (MDMA). Offers a rationale for why interest in MDMA, which possesses both stimulant and psychedelic properties, will continue to grow despite the drug's recent illegality and increasing evidence of neurotoxicity.…

Critique of rationale for transmutation of nuclear waste

International Nuclear Information System (INIS)

Smith, C.F.; Cohen, J.J.

1980-07-01

It has been suggested that nuclear transmutation could be used in the elimination or reduction of hazards from radioactive wastes. The rationale for this suggestion is the subject of this paper. The objectives of partitioning-transmutation are described. The benefits are evaluated. The author concludes that transmutation would appear at best to offer the opportunity of reducing an already low risk. This would not seem to be justifiable considering the cost. If non-radiological risks are considered, there is a negative total benefit

Inertial Fusion Energy reactor design studies: Prometheus-L, Prometheus-H. Volume 2, Final report

Energy Technology Data Exchange (ETDEWEB)

Waganer, L.M.; Driemeyer, D.E.; Lee, V.D.

1992-03-01

This report contains a review of design studies for Inertial Confinement reactor. This second of three volumes discussions is some detail the following: Objectives, requirements, and assumptions; rationale for design option selection; key technical issues and R&D requirements; and conceptual design selection and description.

CEBAF design overview and project status

International Nuclear Information System (INIS)

Leemann, C.

1988-01-01

The Continuous Beam Accelerator Facility (CEBAF) will be an electron accelerator for nuclear physics research providing continuous beams with energies up to at least 4 GeV. The CEBAF is a recirculating linac. The design rationale, performance objectives, concept and fundamental choices for the CEBAF are discussed. 19 references, 10 figures, 1 table

Designing, Probing, and Stabilizing Exotic Fabry-Perot Cavities for Studying Strongly Correlated Light

Science.gov (United States)

Ryou, Albert

Synthetic materials made of engineered quasiparticles are a powerful platform for studying manybody physics and strongly correlated systems due to their bottom-up approach to Hamiltonian modeling. Photonic quasiparticles called polaritons are particularly appealing since they inherit fast dynamics from light and strong interaction from matter. This thesis describes the experimental demonstration of cavity Rydberg polaritons, which are composite particles arising from the hybridization of an optical cavity with Rydberg EIT, as well as the tools for probing and stabilizing the cavity. We first describe the design, construction, and testing of a four-mirror Fabry-Perot cavity, whose small waist size on the order of 10 microns is comparable to the Rydberg blockade radius. By achieving strong coupling between the cavity photon and an atomic ensemble undergoing electromagnetically induced transparency (EIT), we observe the emergence of the dark-state polariton and characterize its single-body properties as well as the single-quantum nonlinearity. We then describe the implementation of a holographic spatial light modulator for exciting different transverse modes of the cavity, an essential tool for studying polariton-polariton scattering. For compensating optical aberrations, we employ a digital micromirror device (DMD), combining beam shaping with adaptive optics to produce diffraction-limited light. We quantitatively measure the purity of the DMD-produced Hermite-Gauss modes and confirm up to 99.2% efficiency. One application of the technique is to create Laguerre-Gauss modes, which have been used to probe synthetic Landau levels for photons in a twisted, nonplanar cavity. Finally, we describe the implementation of an FPGA-based FIR filter for stabilizing the cavity. We digitally cancel the acoustical resonances of the feedback-controlled mechanical system, thereby demonstrating an order-of-magnitude enhancement in the feedback bandwidth from 200 Hz to more than 2 k

LCoMotion - Learning, Cognition and Motion; a multicomponent cluster randomized school-based intervention aimed at increasing learning and cognition - rationale, design and methods.

Science.gov (United States)

Bugge, Anna; Tarp, Jakob; Østergaard, Lars; Domazet, Sidsel Louise; Andersen, Lars Bo; Froberg, Karsten

2014-09-18

The aim of the study; LCoMotion - Learning, Cognition and Motion was to develop, document, and evaluate a multi-component physical activity (PA) intervention in public schools in Denmark. The primary outcome was cognitive function. Secondary outcomes were academic skills, body composition, aerobic fitness and PA. The primary aim of the present paper was to describe the rationale, design and methods of the LCoMotion study. LCoMotion was designed as a cluster-randomized controlled study. Fourteen schools from all five regions in Denmark participated. All students from 6th and 7th grades were invited to participate (n = 869) and consent was obtained for 87% (n = 759). Baseline measurements were obtained in November/December 2013 and follow-up measurements in May/June 2014. The intervention lasted five months and consisted of a "package" of three main components: PA during academic lessons, PA during recess and PA homework. Furthermore a cycling campaign was conducted during the intervention period. Intervention schools should endeavor to ensure that students were physically active for at least 60 min every school day. Cognitive function was measured by a modified Eriksen flanker task and academic skills by a custom made mathematics test. PA was objectively measured by accelerometers (ActiGraph, GT3X and GT3X+) and aerobic fitness assessed by an intermittent shuttle-run test (the Andersen intermittent running test). Furthermore, compliance with the intervention was assessed by short message service (SMS)-tracking and questionnaires were delivered to students, parents and teachers. LCoMotion has ability to provide new insights on the effectiveness of a multicomponent intervention on cognitive function and academic skills in 6th and 7th grade students. Clinicaltrials.gov: NCT02012881 (10/10/2013).

Reregulation of the Swedish pharmacy sector-A qualitative content analysis of the political rationale.

Science.gov (United States)

Wisell, Kristin; Winblad, Ulrika; Sporrong, Sofia Kälvemark

2015-05-01

In 2009, a reregulation of the Swedish pharmacy sector took place, and a fundamental change in ownership and structure followed. The reregulation provides an opportunity to reveal the politicians' views on pharmacies. The aim of this study was to explore and analyze the political arguments for the reregulation of the Swedish pharmacy sector in 2009. The method used was a qualitative content analysis of written political documents regarding the reregulation. The primary rationales for the reregulation were better availability, efficiency, price pressure, and safe usage of medicines. During the preparatory work, the rationales of diversity on the market and entrepreneurship were added, while the original rationales of efficiency, price pressure, and better usage of medicines were abandoned. The reform can be seen as a typical New Public Management reform influenced by the notion that private actors are better equipped to perform public activities. The results point to that the reform was done almost solely in order to introduce private ownership in the pharmacy sector, and was not initiated in order to solve any general problems, or to enhance patient outcomes of medicine use. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Translation of the Care of Persons with Dementia in their Environments (COPE) intervention in a publicly-funded home care context: Rationale and research design.

Science.gov (United States)

Fortinsky, Richard H; Gitlin, Laura N; Pizzi, Laura T; Piersol, Catherine Verrier; Grady, James; Robison, Julie T; Molony, Sheila

2016-07-01

Dementia is the leading cause of loss of independence in older adults worldwide. In the U.S., approximately 15 million family members provide care to relatives with dementia. This paper presents the rationale and design for a translational study in which an evidence-based, non-pharmacologic intervention for older adults with dementia and family caregivers (CGs) is incorporated into a publicly-funded home care program for older adults at risk for nursing home admission. The 4-month Care of Persons with Dementia in their Environments (COPE) intervention is designed to optimize older adults' functional independence, and to improve CG dementia management skills and health-related outcomes. COPE features 10 in-home occupational therapy visits, and 1 in-home visit and 1 telephone contact by an advanced practice nurse. COPE was deemed efficacious in a published randomized clinical trial. In the present study, older adults with dementia enrolled in the Connecticut Home Care Program for Elders (CHCPE) and their CGs are randomly assigned to receive COPE plus their ongoing CHCPE services, or to continue receiving CHCPE services only. The primary outcome for older adults with dementia is functional independence; secondary outcomes are activity engagement, quality of life, and prevention or alleviation of neuropsychiatric symptoms. CG outcomes include perceived well-being and confidence in using activities to manage dementia symptoms. Translational outcomes include net financial benefit of COPE, and feasibility and acceptability of COPE implementation into the CHCPE. COPE has the potential to improve health-related outcomes while saving Medicaid waiver and state revenue-funded home care program costs nationwide. Copyright © 2016 Elsevier Inc. All rights reserved.

Rationale, design and methods for the RIGHT Track Health Study: pathways from childhood self-regulation to cardiovascular risk in adolescence

Directory of Open Access Journals (Sweden)

Laurie Wideman

2016-06-01

Full Text Available Abstract Background Cardiovascular risk factors during adolescence—including obesity, elevated lipids, altered glucose metabolism, hypertension, and elevated low-grade inflammation—is cause for serious concern and potentially impacts subsequent morbidity and mortality. Despite the importance of these cardiovascular risk factors, very little is known about their developmental origins in childhood. In addition, since adolescence is a time when individuals are navigating major life changes and gaining increasing autonomy from their parents or parental figures, it is a period when control over their own health behaviors (e.g. drug use, sleep, nutrition also increases. The primary aim of this paper is to describe the rationale, design and methods for the RIGHT Track Health Study. This study examines self-regulation as a key factor in the development of cardiovascular risk, and further explores health behaviors as an explanatory mechanism of this association. We also examine potential moderators (e.g. psychosocial adversities such as harsh parenting of this association. Method/design RIGHT Track is a longitudinal study that investigates social and emotional development. The RIGHT Track Health Study prospectively follows participants from age 2 through young adulthood in an effort to understand how self-regulatory behavior throughout childhood alters the trajectories of various cardiovascular risk factors during late adolescence via health behaviors. Individuals from RIGHT Track were re-contacted and invited to participate in adolescent data collection (~16.5, 17.5 and 18+ years old. Individuals completed assessments of body composition, anthropometric indicators, fitness testing (via peak oxygen consumption, heart rate variability during orthostatic challenge, 7-day accelerometry for physical activity and sleep, 24-h dietary recalls, and blood analysis for biomarkers related to metabolic syndrome, inflammatory status and various hormones and

Test design requirements: Thermal conductivity probe testing

International Nuclear Information System (INIS)

Heath, R.E.

1985-01-01

This document establishes the test design requirements for development of a thermal conductivity probe test. The thermal conductivity probe determines in situ thermal conductivity using a line source transient heat conduction analysis. This document presents the rationale for thermal conductivity measurement using a thermal conductivity probe. A general test description is included. Support requirements along with design constraints are detailed to allow simple design of the thermal conductivity probe and test. The schedule and delivery requirements of the responsible test designer are also included. 7 refs., 1 fig

Designing for Children's Collective Music Making

DEFF Research Database (Denmark)

Grønbæk, Jens Emil; Jakobsen, Kasper; Petersen, Marianne Graves

2016-01-01

Hitmachine empowers children to make music through building physical, shared interactive instruments from Lego MindstormsTM and playing them to a beat. The design rationale for Hitmachine draws upon the collective interaction model, theories of proxemics and F-formations, as well as a framework...... for social interaction. Hitmachine was evaluated during a 4-day workshop where 150 children aged 3-13 engaged with the system. Based on lessons from this workshop we point to key issues to consider when designing for collective music making. This includes designing for multiple access points and spatial...

Current Issues in Art and Design Education: Modularization and Course Ethos: The Case of Art and Design Higher Education.

Science.gov (United States)

Wayte, Gillian; Wayte, Nick

1990-01-01

Examines why art and design educators resist the modularization of degree-level courses. Identifies key characteristics of art education in England through an ethnographic study. Discusses government policy and rationales for modular and integrated courses. Concludes that the holistic approach to education allows students to expound and develop…

Intelligent Data-Driven Reverse Engineering of Software Design Patterns

OpenAIRE

Alhusain, Sultan

2016-01-01

Recognising implemented instances of Design Patterns (DPs) in software design discloses and recovers a wealth of information about the intention of the original designers and the rationale for their design decisions. Because it is often the case that the documentation available for software systems, if any, is poor and/or obsolete, recovering such information can be of great help and importance for maintenance tasks. However, since DPs are abstractly and vaguely defined, a set of software cla...

Five Big, Big Five Issues : Rationale, Content, Structure, Status, and Crosscultural Assessment

NARCIS (Netherlands)

De Raad, Boele

1998-01-01

This article discusses the rationale, content, structure, status, and crosscultural assessment of the Big Five trait factors, focusing on topics of dispute and misunderstanding. Taxonomic restrictions of the original Big Five forerunner, the "Norman Five," are discussed, and criticisms regarding the

[Sex and gender equity in research: rationale for the SAGER guidelines and recommended use].

Science.gov (United States)

Heidari, Shirin; Babor, Thomas F; De Castro, Paola; Tort, Sera; Curno, Mirjam

2018-05-03

Sex and gender differences are often overlooked in research design, study implementation and scientific reporting, as well as in general science communication. This oversight limits the generalizability of research findings and their applicability to clinical practice, in particular for women but also for men. This article describes the rationale for an international set of guidelines to encourage a more systematic approach to the reporting of sex and gender in research across disciplines. A panel of 13 experts representing nine countries developed the guidelines through a series of teleconferences, conference presentations and a 2-day workshop. An internet survey of 716 journal editors, scientists and other members of the international publishing community was conducted as well as a literatura search on sex and gender policies in scientific publishing. The Sex and Gender Equity in Research (SAGER) guidelines are a comprehensive procedure for reporting of sex and gender information in study design, data analyses, results and interpretation of findings. The SAGER guidelines are designed primarily to guide authors in preparing their manuscripts, but they are also useful for editors, as gatekeepers of science, to integrate assessment of sex and gender into all manuscripts as an integral part of the editorial process. Copyright © 2018 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.

Design and Implementation of Therapist Online Counseling

Science.gov (United States)

Thomas, Aaron O.; Lee, Geoff; Ess, Brian

2015-01-01

The following paper describes the rationale for creating an online therapy program of cognitive behavioral therapy, or CBT, for students at the University of Florida who are struggling with stress and anxiety. In addition, the paper discusses the unique challenges of the instructional design process of creating psychoeducational materials through…

The Living Donor Lost Wages Trial: Study Rationale and Protocol.

Science.gov (United States)

Rodrigue, James R; Fleishman, Aaron; Carroll, Michaela; Evenson, Amy R; Pavlakis, Martha; Mandelbrot, Didier A; Baliga, Prabhakar; Howard, David H; Schold, Jesse D

2018-03-01

This paper describes the background, rationale, and design of an NIH-funded, single-center study to test the impact of offering reimbursement for donor lost wages incurred during the post-nephrectomy recovery period on the live donor kidney transplant (LDKT) rate in newly evaluated kidney transplant candidates, to examine whether offering reimbursement for donor lost wages reduces racial disparity in LDKT rates, and to determine whether higher reimbursement amounts lead to higher LDKT rates. LDKT is the optimal treatment for renal failure. However, living kidney donation has declined in the past decade, particularly among men, younger adults, blacks, and low-income adults. There is evidence that donation-related costs may deter both transplant candidates and potential donors from considering LDKT. Lost wages is a major source of financial loss for some living donors and, unlike travel and lodging expenses, is not reimbursed by financial assistance programs. The study addresses the transplant community's call to reduce the financial burden of living donation and examine its impact on LDKT rates. Findings have the potential to influence policy, clinical practice, LDKT access, and income-related and racial disparities in LDKT and living donation.

Designing a community engagement strategy for Limerick Smarter travel using focus groups and precedent studies

OpenAIRE

Cullinane, Kathleen Clair

2012-01-01

peer-reviewed This research aims to create a rational basis for designing and implementing a plan for Limerick Smarter Travel. This plan will pay particular attention to community engagement. This research establishes a rationale for a community engagement strategy. Precedent studies also provide direct guidance for this rationale. The objective of the plan is to develop a local culture of Smarter Travel in Limerick communities using best international practice, and thereby achieving behav...

Rationale of a quick adjustment method for crystal orientation in oscillation photography

International Nuclear Information System (INIS)

Suh, I.H.; Suh, J.M.; Ko, T.S.

1988-01-01

The rationale for a convenient crystal orientation method for oscillation photography is presented. The method involves the measurement of the deviations of reflection spots from the equator. These deviations are added or subtracted to give the horizontal and vertical arc corrections. (orig.)

inverse correction of fourier transforms for one-dimensional strongly ...

African Journals Online (AJOL)

Hsin Ying-Fei

2016-05-01

May 1, 2016 ... As it is widely used in periodic lattice design theory and is particularly useful in aperiodic lattice design [12,13], the accuracy of the FT algorithm under strong scattering conditions is the focus of this paper. We propose an inverse correction approach for the inaccurate FT algorithm in strongly scattering ...

Designing asymmetric multiferroics with strong magnetoelectric coupling

Science.gov (United States)

Lu, Xuezeng; Xiang, Hongjun; Rondinelli, James; Materials Theory; Design Group Team

2015-03-01

Multiferroics offer exciting opportunities for electric-field control of magnetism. Single-phase multiferroics suitable for such applications at room temperature need much more study. Here, we propose the concept of an alternative type of multiferroics, namely, the ``asymmetric multiferroic.'' In asymmetric multiferroics, two locally stable ferroelectric states are not symmetrically equivalent, leading to different magnetic properties between these two states. Furthermore, we predict from first principles that a Fe-Cr-Mo superlattice with the LiNbO3-type structure is such an asymmetric multiferroic. The strong ferrimagnetism, high ferroelectric polarization, and significant dependence of the magnetic transition temperature on polarization make this asymmetric multiferroic an ideal candidate for realizing electric-field control of magnetism at room temperature. Our study suggests that the asymmetric multiferroic may provide an alternative playground for voltage control of magnetism and find its applications in spintronics and quantum computing.

Study rationale and design of OPTIMISE, a randomised controlled trial on the effect of benchmarking on quality of care in type 2 diabetes mellitus

Science.gov (United States)

2011-01-01

Background To investigate the effect of physician- and patient-specific feedback with benchmarking on the quality of care in adults with type 2 diabetes mellitus (T2DM). Methods Study centres in six European countries were randomised to either a benchmarking or control group. Physicians in both groups received feedback on modifiable outcome indicators (glycated haemoglobin [HbA1c], glycaemia, total cholesterol, high density lipoprotein-cholesterol, low density lipoprotein [LDL]-cholesterol and triglycerides) for each patient at 0, 4, 8 and 12 months, based on the four times yearly control visits recommended by international guidelines. The benchmarking group also received comparative results on three critical quality indicators of vascular risk (HbA1c, LDL-cholesterol and systolic blood pressure [SBP]), checked against the results of their colleagues from the same country, and versus pre-set targets. After 12 months of follow up, the percentage of patients achieving the pre-determined targets for the three critical quality indicators will be assessed in the two groups. Results Recruitment was completed in December 2008 with 3994 evaluable patients. Conclusions This paper discusses the study rationale and design of OPTIMISE, a randomised controlled study, that will help assess whether benchmarking is a useful clinical tool for improving outcomes in T2DM in primary care. Trial registration NCT00681850 PMID:21939502

Design of the OPUS School Meal Study: A randomised controlled trial assessing the impact of serving school meals based on the New Nordic Diet

DEFF Research Database (Denmark)

Damsgaard, Camilla T.; Dalskov, Stine-Mathilde; Petersen, Rikke A.

2012-01-01

Introduction: Danish children consume too much sugar and not enough whole grain, fish, fruit, and vegetables. The Nordic region is rich in such foods with a strong health-promoting potential. We lack randomised controlled trials that investigate the developmental and health impact of serving school...... meals based on Nordic foods. Aim: This paper describes the rationale, design, study population, and potential implications of the Optimal well-being, development and health for Danish children through a healthy New Nordic Diet (OPUS) School Meal Study. Methods: In a cluster-randomised cross-over design...... activity, cardiorespiratory fitness, sleep, growth, body composition, early metabolic and cardiovascular risk markers, illness, absence from school, wellbeing, cognitive function, social and cultural features, food acceptance, waste, and cost were assessed. Results: In total, 834 children (82% of those...

Near-term hybrid vehicle program, phase 1. Appendix C: Preliminary design data package

Science.gov (United States)

1979-01-01

The design methodology, the design decision rationale, the vehicle preliminary design summary, and the advanced technology developments are presented. The detailed vehicle design, the vehicle ride and handling and front structural crashworthiness analysis, the microcomputer control of the propulsion system, the design study of the battery switching circuit, the field chopper, and the battery charger, and the recent program refinements and computer results are presented.

Early markers of airways inflammation and occupational asthma: Rationale, study design and follow-up rates among bakery, pastry and hairdressing apprentices

Directory of Open Access Journals (Sweden)

Hannhart Bernard

2009-04-01

Full Text Available Abstract Background Occupational asthma is a common type of asthma caused by a specific agent in the workplace. The basic alteration of occupational asthma is airways inflammation. Although most patients with occupational asthma are mature adults, there is evidence that airways inflammation starts soon after inception of exposure, including during apprenticeship. Airways hyper responsiveness to methacholine is a valid surrogate marker of airways inflammation, which has proved useful in occupational epidemiology. But it is time-consuming, requires active subject's cooperation and is not readily feasible. Other non-invasive and potentially more useful tests include the forced oscillation technique, measurement of fraction exhaled nitric oxide, and eosinophils count in nasal lavage fluid. Methods and design This study aims to investigate early development of airways inflammation and asthma-like symptoms in apprentice bakers, pastry-makers and hairdressers, three populations at risk of occupational asthma whose work-related exposures involve agents of different nature. The objectives are to (i examine the performance of the non-invasive tests cited above in detecting early airways inflammation that might eventually develop into occupational asthma; and (ii evaluate whether, and how, constitutional (e.g. atopy and behavioural (e.g. smoking risk factors for occupational asthma modulate the effects of allergenic and/or irritative substances involved in these occupations. This paper presents the study rationale and detailed protocol. Discussion Among 441 volunteers included at the first visit, 354 attended the fourth one. Drop outs were investigated and showed unrelated to the study outcome. Sample size and follow-up participation rates suggest that the data collected in this study will allow it to meet its objectives.

Exercise for methamphetamine dependence: rationale, design, and methodology.

Science.gov (United States)

Mooney, Larissa J; Cooper, Christopher; London, Edythe D; Chudzynski, Joy; Dolezal, Brett; Dickerson, Daniel; Brecht, Mary-Lynn; Peñate, Jose; Rawson, Richard A

2014-01-01

Effective pharmacotherapies to treat methamphetamine (MA) dependence have not been identified, and behavioral therapies are marginally effective. Based on behavioral studies demonstrating the potential efficacy of aerobic exercise for improving depressive symptoms, anxiety, cognitive deficits, and substance use outcomes, the study described here is examining exercise as a potential treatment for MA-dependent individuals. This study is randomizing 150 participants with MA dependence at a residential treatment facility for addictive disorders to receive either a thrice-weekly structured aerobic and resistance exercise intervention or a health education condition. Recruitment commenced in March, 2010. Enrollment and follow-up phases are ongoing, and recruitment is exceeding targeted enrollment rates. Seeking evidence for a possibly effective adjunct to traditional behavioral approaches for treatment of MA dependence, this study is assessing the ability of an 8-week aerobic and resistance exercise protocol to reduce relapse to MA use during a 12-week follow-up period after discharge from residential-based treatment. The study also is evaluating improvements in health and functional outcomes during and after the protocol. This paper describes the design and methods of the study. Copyright © 2013 Elsevier Inc. All rights reserved.

Illusory Paschen curves associated with strongly electronegative gases

DEFF Research Database (Denmark)

McAllister, Iain Wilson

1991-01-01

Using analytical linear regression analysis, it is shown that, for a strongly electronegative gas, the (direct) breakdown voltage curve obtained with a moderately nonuniform field is effectively linear. For a strongly electronegative gas, breakdown voltage measurements made on a moderately...... nonuniform field test gap give rise to an apparently liner curve. The curve can be designated a Paschen curve, but the erroneous nature of this designation becomes apparent from a linear regression analysis of the experimental breakdown data...

Mechanism of inhibition of human secretory phospholipase A2 by flavonoids: rationale for lead design

Science.gov (United States)

Lättig, Jens; Böhl, Markus; Fischer, Petra; Tischer, Sandra; Tietböhl, Claudia; Menschikowski, Mario; Gutzeit, Herwig O.; Metz, Peter; Pisabarro, M. Teresa

2007-08-01

The human secretory phospholipase A2 group IIA (PLA2-IIA) is a lipolytic enzyme. Its inhibition leads to a decrease in eicosanoids levels and, thereby, to reduced inflammation. Therefore, PLA2-IIA is of high pharmacological interest in treatment of chronic diseases such as asthma and rheumatoid arthritis. Quercetin and naringenin, amongst other flavonoids, are known for their anti-inflammatory activity by modulation of enzymes of the arachidonic acid cascade. However, the mechanism by which flavonoids inhibit Phospholipase A2 (PLA2) remained unclear so far. Flavonoids are widely produced in plant tissues and, thereby, suitable targets for pharmaceutical extractions and chemical syntheses. Our work focuses on understanding the binding modes of flavonoids to PLA2, their inhibition mechanism and the rationale to modify them to obtain potent and specific inhibitors. Our computational and experimental studies focused on a set of 24 compounds including natural flavonoids and naringenin-based derivatives. Experimental results on PLA2-inhibition showed good inhibitory activity for quercetin, kaempferol, and galangin, but relatively poor for naringenin. Several naringenin derivatives were synthesized and tested for affinity and inhibitory activity improvement. 6-(1,1-dimethylallyl)naringenin revealed comparable PLA2 inhibition to quercetin-like compounds. We characterized the binding mode of these compounds and the determinants for their affinity, selectivity, and inhibitory potency. Based on our results, we suggest C(6) as the most promising position of the flavonoid scaffold to introduce chemical modifications to improve affinity, selectivity, and inhibition of PLA2-IIA by flavonoids.

Socio-technical Betwixtness

DEFF Research Database (Denmark)

Bossen, Claus

2017-01-01

the intrinsically social and technical interwovenness of design, and the necessity of including affected people and stakeholders in the design process. This betwixtness of socio-technical design is demonstrated by the analysis of two IT systems for healthcare: a foundational model for electronic healthcare records......This chapter focusses on two challenges for socio-technical design: Having to choose between different rationales for design, and the adequate understanding and depiction of the work to be redesigned. These two challenges betwixt the otherwise strong tenets of socio-technical design of pointing out......, and an IT system organizing hospital porters’ work. The conceptual background for the analysis of the cases is provided by a short introduction to different rationales for organizational design, and by pointing to the differences between a linear, rationalistic versus an interactional depiction of work....

A room for design: Through participatory design young adults with schizophrenia become strong collaborators.

Science.gov (United States)

Terp, Malene; Laursen, Birgitte Schantz; Jørgensen, Rikke; Mainz, Jan; Bjørnes, Charlotte D

2016-12-01

Smartphone technology is being increasingly viewed as key to engaging young adults with schizophrenia in their own mental health care. In an attempt to use smartphones as an engagement tool, we conducted a participatory design process, where young adults with schizophrenia (n = 4), healthcare providers (n = 7), software designers (n = 3), graphic designer (n = 1), graphic recorder (n = 1), and team leader (n = 1) co-designed a smartphone application for use in early phase schizophrenia care. This paper reports the co-design process. Based on a variety of written data-sources, the paper describes if, and how, participatory design can help construct a physical and relational environment that enables young adults with schizophrenia to become active participants in the design of a more participatory mental health practice. Guided by Etienne Wenger's construct of Community of Practice, three major categories of characteristics and construction of a physical and relational environment supporting and inspiring participation and engagement were identified: (i) a pre-narrative about a community of practice, (ii) the room for design is a community of practice and (iii) the community of practice as a practice of special qualities. It is concluded that participatory design can support and inspire participation and engagement in the development of mental health care with young adults with schizophrenia, given that the environment in which participatory design unfolds is transparent, flexible, secure and informal. © 2016 Australian College of Mental Health Nurses Inc.

The effectiveness and cost-evaluation of manual therapy and physical therapy in patients with sub-acute and chronic non specific neck pain. Rationale and design of a Randomized Controlled Trial (RCT

Directory of Open Access Journals (Sweden)

van Assen Luite

2010-01-01

Full Text Available Abstract Background Manual Therapy applied to patients with non specific neck pain has been investigated several times. In the Netherlands, manual therapy as applied according to the Utrecht School of Manual Therapy (MTU has not been the subject of a randomized controlled trial. MTU differs in diagnoses and treatment from other forms of manual therapy. Methods/Design This is a single blind randomized controlled trial in patients with sub-acute and chronic non specific neck pain. Patients with neck complaints existing for two weeks (minimum till one year (maximum will participate in the trial. 180 participants will be recruited in thirteen primary health care centres in the Netherlands. The experimental group will be treated with MTU during a six week period. The control group will be treated with physical therapy (standard care, mainly active exercise therapy, also for a period of six weeks. Primary outcomes are Global Perceived Effect (GPE and functional status (Neck Disability Index (NDI-DV. Secondary outcomes are neck pain (Numeric Rating Scale (NRS, Eurocol, costs and quality of life (SF36. Discussion This paper presents details on the rationale of MTU, design, methods and operational aspects of the trial. Trial registration ClinicalTrials.gov Identifier: NCT00713843

Assessment of diagnostic technology in health care: rationale, methods, problems, and directions

National Research Council Canada - National Science Library

Sox, Harold C

1989-01-01

... Rationale, Methods, Problems, and Directions Harold Sox, Susan Stern, Douglas Owens, and Herbert L. Abrams Institute of Medicine NATIONAL ACADEMY PRESS WASHINGTON, D.C. 1989 Copyrightthe cannot be not from book, paper however, version for formatting, original authoritative the typesetting-specific the as from created publication files XML from...

Design Decisions in Developing Learning Trajectories-Based Assessments in Mathematics: A Case Study

Science.gov (United States)

Penuel, William R.; Confrey, Jere; Maloney, Alan; Rupp, André A.

2014-01-01

This article analyzes the design decisions of a team developing diagnostic assessments for a learning trajectory focused on rational number reasoning. The analysis focuses on the design rationale for key decisions about how to develop the cognitive assessments and related validity arguments within a fluid state and national policy context. The…

The Escitalopram versus Electric Current Therapy for Treating Depression Clinical Study (ELECT-TDCS: rationale and study design of a non-inferiority, triple-arm, placebo-controlled clinical trial

Directory of Open Access Journals (Sweden)

André Russowsky Brunoni

Full Text Available CONTEXT AND OBJECTIVE: Major depressive disorder (MDD is a common psychiatric condition, mostly treated with antidepressant drugs, which are limited due to refractoriness and adverse effects. We describe the study rationale and design of ELECT-TDCS (Escitalopram versus Electric Current Therapy for Treating Depression Clinical Study, which is investigating a non-pharmacological treatment known as transcranial direct current stimulation (tDCS.DESIGN AND SETTING: Phase-III, randomized, non-inferiority, triple-arm, placebo-controlled study, ongoing in São Paulo, Brazil.METHODS: ELECT-TDCS compares the efficacy of active tDCS/placebo pill, sham tDCS/escitalopram 20 mg/day and sham tDCS/placebo pill, for ten weeks, randomizing 240 patients in a 3:3:2 ratio, respectively. Our primary aim is to show that tDCS is not inferior to escitalopram with a non-inferiority margin of at least 50% of the escitalopram effect, in relation to placebo. As secondary aims, we investigate several biomarkers such as genetic polymorphisms, neurotrophin serum markers, motor cortical excitability, heart rate variability and neuroimaging.RESULTS: Proving that tDCS is similarly effective to antidepressants would have a tremendous impact on clinical psychiatry, since tDCS is virtually devoid of adverse effects. Its ease of use, portability and low price are further compelling characteristics for its use in primary and secondary healthcare. Multimodal investigation of biomarkers will also contribute towards understanding the antidepressant mechanisms of action of tDCS.CONCLUSION: Our results have the potential to introduce a novel technique to the therapeutic arsenal of treatments for depression.

The role of Amazonian anthropogenic soils in shifting cultivation: learning from farmers’ rationales

NARCIS (Netherlands)

Braga Junqueira, A.; Almekinders, C.J.M.; Stomph, T.J.; Clement, C.R.; Struik, P.C.

2016-01-01

We evaluated farmers’ rationales to understand their decision making in relation to the use of fertile anthropogenic soils, i.e., Amazonian dark earths (ADE), and for dealing with changes in shifting cultivation in Central Amazonia. We analyzed qualitative information from 196 interviews with

Photometry in the workplace: the rationale for a new method.

Science.gov (United States)

Piccoli, B; Soci, G; Zambelli, P L; Pisaniello, D

2004-01-01

The assessment of lighting conditions in workplaces has traditionally focused on the measurement of illuminance. The rationale for a new method for the detailed evaluation of natural and artificial light in 'near work' situations, involving the assessment of luminance, is described. The procedure comprises four successive phases: (1) identify object/images observed during work tasks; (2) outline the area of the operator's visual field where gaze is predominantly directed; (3) measure luminances in the visual field, pin-pointing all sources of primary and secondary luminance, and constructing iso-luminance maps; and (4) compare luminance ratios. The procedure was illustrated using the common example of near work in an office environment. Illuminance was found to be inadequate to evaluate the effects of natural and artificial environmental light in the workplace. This is due to the fact that the luxmeter is designed to integrate the light detected over a large angle, whereas in near work the operator's retina is mainly stimulated by light originating from objects/images placed in the occupational visual field. A detailed measurement of luminance within the occupational visual field is consistent with ocular anatomy and physiology, and can be used as part of a risk assessment for visual disturbances and to rationalize lighting at workstations.

The PXIE LEBT Design Choices

Energy Technology Data Exchange (ETDEWEB)

Prost, Lionel [Fermilab; Shemyakin, Alexander [Fermilab

2016-06-01

Typical front-ends of modern light-ion high-intensity accelerators typically consist of an ion source, a Low Energy Beam Transport (LEBT), a Radiofrequency Quadrupole and a Medium Energy Beam Transport (MEBT), which is followed by the main linac accelerating structures. Over the years, many LEBTs have been designed, constructed and operated very successfully. In this paper, we present the guiding principles and compromises that lead to the design choices of the PXIE LEBT, including the rationale for a beam line that allows un-neutralized transport over a significant portion of the LEBT whether the beam is pulsed or DC.

A performance goal-based seismic design philosophy for waste repository facilities

International Nuclear Information System (INIS)

Hossain, Q.A.

1994-02-01

A performance goal-based seismic design philosophy, compatible with DOE's present natural phenomena hazards mitigation and ''graded approach'' philosophy, has been proposed for high level nuclear waste repository facilities. The rationale, evolution, and the desirable features of this method have been described. Why and how the method should and can be applied to the design of a repository facility are also discussed

Overview of advanced LMR design in the US

International Nuclear Information System (INIS)

Wade, D.C.

1988-01-01

The current generation of US advanced LMR conceptual designs have resulted from a goal to address the economic and institutional issues facing the US nuclear industry in the late 70's and early 80's. They are focused technically on achieving passive safety characteristics and favorable capital and operating costs. The design strategies which have been taken were motivated as well by the coal to favorably impact the institutional and public perception regimes regarding safety, diversion, nonproliferation, and waste. The rationales and tradeoffs influencing the resulting design decisions are discussed in this paper, with a focus on core design issues. 1 fig

Cost-effectiveness of home telemonitoring in chronic kidney disease patients at different stages by a pragmatic randomized controlled trial (eNephro): rationale and study design.

Science.gov (United States)

Thilly, Nathalie; Chanliau, Jacques; Frimat, Luc; Combe, Christian; Merville, Pierre; Chauveau, Philippe; Bataille, Pierre; Azar, Raymond; Laplaud, David; Noël, Christian; Kessler, Michèle

2017-04-05

Home telemonitoring has developed considerably over recent years in chronic diseases in order to improve communication between healthcare professionals and patients and to promote early detection of deteriorating health status. In the nephrology setting, home telemonitoring has been evaluated in home dialysis patients but data are scarce concerning chronic kidney disease (CKD) patients before and after renal replacement therapy. The eNephro study is designed to assess the cost effectiveness, clinical/biological impact, and patient perception of a home telemonitoring for CKD patients. Our purpose is to present the rationale, design and organisational aspects of this study. eNephro is a pragmatic randomised controlled trial, comparing home telemonitoring versus usual care in three populations of CKD patients: stage 3B/4 (n = 320); stage 5D CKD on dialysis (n = 260); stage 5 T CKD treated with transplantation (n= 260). Five hospitals and three not-for-profit providers managing self-care dialysis situated in three administrative regions in France are participating. The trial began in December 2015, with a scheduled 12-month inclusion period and 12 months follow-up. Outcomes include clinical and biological data (e.g. blood pressure, haemoglobin) collected from patient records, perceived health status (e.g. health related quality of life) collected from self-administered questionnaires, and health expenditure data retrieved from the French health insurance database (SNIIRAM) using a probabilistic matching procedure. The hypothesis is that home telemonitoring enables better control of clinical and biological parameters as well as improved perceived health status. This better control should limit emergency consultations and hospitalisations leading to decreased healthcare expenditure, compensating for the financial investment due to the telemedicine system. This study has been registered at ClinicalTrials.gov under NCT02082093 (date of registration: February 14

Operation Design of Wind Turbines in Strong Wind Conditions

DEFF Research Database (Denmark)

Shen, Wen Zhong; Montes, Melissa Barroso; Odgaard, Peter Fogh

2012-01-01

and variable speed pitch regulated wind turbines. The variable speed design is more suitable for wind turbines to run at very high wind speeds which can help the turbine braking system to stop the turbine at the new "cut-out" wind speed. Reference power, rotational speed and pitch angle have been designed...... optimally. In order to reduce the possible increased loading, fatigue due to the wind gusts, control strategies have been considered for both constant sped and variable speed pitch regulated wind turbines. The control study shows that the designed controllers can reduce the standard deviations efficiently......In order to reduce the impact on the electrical grid from the shutdown of MW wind turbines at wind speeds higher than the cut-out wind speed of 25 m/s, we propose in this paper to run the turbines at high wind speeds up to 40 m/s. Two different operation designs are made for both constant speed...

Radiosensitizers: rationale and potential

International Nuclear Information System (INIS)

Brown, J.M.

1981-01-01

This paper briefly reviews agents that are capable of sensitizing hypoxic cells to radiation and chemotherapeutic agents. The first part is a synopsis of the development of hypoxic radiosensitizers, which concludes that misonidazole can be effective against human tumors. Unfortunately, neurotoxicity limits its effectiveness in humans because the dose that can be given in conjunction with daily fractionated radiation is five to ten times lower than is required for full radiosensitization of the hypoxic cells. The second part covers our recent efforts to develop a drug that does not produce such limiting neurotoxicity. The primary rationale of our program was to synthesize a drug with a short plasma half-life that was too hydrophilic to cross the blood-brain barrier but was able to penetrate tumors and radiosensitize hypoxic cells. From this program, a new drug, SR-2508, has been found that is as efficient as misonidazole in its radiosensitizing ability, but is four to ten times less toxic. Finally, the potential of radiosensitizers not only as agents that can sensitize tumor cells to radiation, but also as agents that can specifically sensitize tumors to chemotherapeutic agents, is discussed. In addition, these drugs may be potential cytotoxic agents that produce toxicity only in solid tumors

The design, rationale, and baseline characteristics of a nationwide cohort registry in China: blood pressure and clinical outcome in TIA or ischemic stroke.

Science.gov (United States)

Xu, Jie; Liu, Yi; Tao, Yongli; Xie, Xuewei; Gu, Hongqiu; Pan, Yuesong; Zhao, Xingquan; Wang, Yongjun; Yan, Aoshuang; Wang, Yilong

2016-01-01

The relationship between poststroke blood pressure (BP) and clinical outcomes in ischemic stroke (IS) is still controversial. However, there is no large BP database for IS or transient ischemic attack (TIA) in China. This study aims to describe the rationale, study design, and baseline characteristics of a nationwide BP database in IS or TIA patients in China. The BOSS (blood pressure and clinical outcome in TIA or ischemic stroke) study was a hospital-based, prospective cohort study aiming to assess BP parameters and clinical outcome in IS/TIA patients. BP parameters were based on office BP, ambulatory BP, and home BP. Clinical outcomes included stroke recurrence, combined vascular events, and disability. Electronic case-report forms were used to record baseline and follow-up data. The patients were followed up for clinical outcomes at 3 months through face-to-face interview and at 12 months by telephone. Between October 2012 and February 2014, the BOSS registry recruited 2,608 patients from 61 hospitals, with a mean age of 62.5 years, 32.4% of whom were female, 88.9% with an entry diagnosis of IS, and 86% diagnosed with hypertension. The rates of patients lost-to-follow-up were 3.1% at 3 months and 5.1% at 1 year; 93% of patients completed ambulatory BP monitoring during hospitalization and 94.7% finished a 3-month BP diary. The BOSS registry will provide important evidence about BP management in the acute phase and secondary prevention for IS/TIA patients.

Legitimizing Technical Communication in English Departments: Carolyn Miller's "Humanistic Rationale for Technical Writing"

Science.gov (United States)

Moore, Patrick

2006-01-01

Carolyn Miller's oft-cited "Humanistic Rationale for Technical Writing," published in 1979, tries to give technical communication faculty more cultural capital in English departments controlled by literature professors. Miller replaces a positivistic emphasis in technical communication pedagogy with rhetoric. She shows how technical knowledge is…

Resource Pack on Curriculum Design and Assessment to Promote Effective Learning.

OpenAIRE

O'Connor, Christine

2008-01-01

This resource pack is an overview of current considerations for academics designing programmes for third level education. The changing demographic of third level students along with employers’ demands has resulted in programme development with a focus on skills basis (Hyslop-Margison, 2001) to support a knowledge based society. The rationale behind the changes in curriculum design is introduced and further focus is emphasised in the areas of curriculum design models, assessment models and eva...

Plato's Cosmic Theology: A Rationale for a Polytheistic Astrology?

Science.gov (United States)

Henriques, André

2015-05-01

Plato's cosmology influenced classical astronomy and religion, but was in turn influenced by the polytheistic context of its time. Throughout his texts, including the cosmological treatise Timaeus, and the discussions on the soul in the Phaedrus, Plato (c.428-c.348 BC) established what can be generalised as Platonic cosmological thought. An understanding of the philosophical and mythical levels of Platonic thought can provide a rationale for polytheistic and astrological worldviews, pointing to some cosmological continuity, alongside major shifts, from ancient Greek religion to the astrological thought of ancient astronomers such as Claudius Ptolemy.

The Healthy Children, Strong Families Intervention: Design and Community Participation

Science.gov (United States)

Adams, Alexandra K.; LaRowe, Tara L.; Cronin, Kate A.; Prince, Ronald J.; Wubben, Deborah P.; Parker, Tassy; Jobe, Jared B.

2012-01-01

Healthy Children, Strong Families (HCSF) is a 2-year, community-driven, family-based randomized controlled trial of a healthy lifestyles intervention conducted in partnership with four Wisconsin American Indian tribes. HCSF is composed of 1 year of targeted home visits to deliver nutritional and physical activity curricula. During Year 1, trained…

Optimization design of strong and tough nacreous nanocomposites through tuning characteristic lengths

Science.gov (United States)

Ni, Yong; Song, Zhaoqiang; Jiang, Hongyuan; Yu, Shu-Hong; He, Linghui

2015-08-01

How nacreous nanocomposites with optimal combinations of stiffness, strength and toughness depend on constituent property and microstructure parameters is studied using a nonlinear shear-lag model. We show that the interfacial elasto-plasticity and the overlapping length between bricks dependent on the brick size and brick staggering mode significantly affect the nonuniformity of the shear stress, the stress-transfer efficiency and thus the failure path. There are two characteristic lengths at which the strength and toughness are optimized respectively. Simultaneous optimization of the strength and toughness is achieved by matching these lengths as close as possible in the nacreous nanocomposite with regularly staggered brick-and-mortar (BM) structure where simultaneous uniform failures of the brick and interface occur. In the randomly staggered BM structure, as the overlapping length is distributed, the nacreous nanocomposite turns the simultaneous uniform failure into progressive interface or brick failure with moderate decrease of the strength and toughness. Specifically there is a parametric range at which the strength and toughness are insensitive to the brick staggering randomness. The obtained results propose a parametric selection guideline based on the length matching for rational design of nacreous nanocomposites. Such guideline explains why nacre is strong and tough while most artificial nacreous nanocomposites aere not.

Design Transformations

DEFF Research Database (Denmark)

Morrison, Ann; Knoche, Hendrik

2014-01-01

Purpose – Taking a case study approach, we synchronised two courses to focus on the students working with learning and applying tools in the one course and acting on understandings gained to produce artefacts in the other. Design/methodology/approach – Working with real users throughout all stages...... focused evaluation methods using tangible representations; identified the relationship from these findings for subsequent re-design rationales; and discussed and critiqued each other’s work using multiple feedback, teach-back and discursive strategies. Findings – We found that in-depth coverage...... of material, working with real data and users at all stages of assessment and producing visualisations from evaluations, naturally forced student motivation to act and redesign better solutions. We noted improved attendance and students reported high engagement and content appreciation. Research limitations...

Nature of Science Progression in School Year 1-9: a Case Study of Teachers' Suggestions and Rationales

Science.gov (United States)

Leden, Lotta; Hansson, Lena

2017-07-01

The inclusion of nature of science (NOS) in science education has for a long time been regarded as crucial. There is, however, a lack of research on appropriate NOS aspects for different educational levels. An even more neglected area of research is that focusing on teachers' perspectives on NOS teaching at different levels. The aim of this article is to examine NOS progression in the light of teachers' suggestions and rationales. In order to obtain teachers' informed perspectives, we chose to involve six teachers (teaching grades 1-9) in a 3-year research project. They took part in focus group discussions about NOS and NOS teaching as well as implemented jointly planned NOS teaching sessions. Data that this article builds on was collected at the end of the project. The teachers' suggestions for NOS progression often relied on adding more NOS issues at every stage, thereby creating the foundations of a broader but not necessarily deeper understanding of NOS. Five rationales, for if/when specific NOS issues are appropriate to introduce, emerged from the analysis of the teacher discussions. Some of these rationales, including practice makes perfect and increasing levels of depth can potentially accommodate room for many NOS issues in the science classroom, while maturity and experience instead has a restricting effect on NOS teaching. Also, choice of context and teaching approaches play an important role in teachers' rationales for whether specific NOS issues should be included or not at different stages. The article discusses the implications for teacher education and professional development.

Rationale for single molecule detection by means of Raman spectroscopy

International Nuclear Information System (INIS)

Gaponenko, S.V.; Guzatov, D.V.

2009-01-01

A consistent quantum electrodynamical description is proposed of Raman scattering of light by a molecule in a medium with a modified photon density of states. Enhanced local density of states near a metal nanobody is shown to increase a scattering rate by several orders of magnitude, thus providing a rationale for experimental detection of single molecules by means of Raman spectroscopy. For an ellipsoidal particle 10 14 -fold enhancement of the Raman scattering cross-section is obtained. (authors)

The Nutrition and Enjoyable Activity for Teen Girls (NEAT girls) randomized controlled trial for adolescent girls from disadvantaged secondary schools: rationale, study protocol, and baseline results

OpenAIRE

Okely Anthony D; Plotnikoff Ronald C; Collins Clare E; Dewar Deborah; Morgan Philip J; Lubans David R; Batterham Marijka J; Finn Tara; Callister Robin

2010-01-01

Abstract Background Child and adolescent obesity predisposes individuals to an increased risk of morbidity and mortality from a range of lifestyle diseases. Although there is some evidence to suggest that rates of pediatric obesity have leveled off in recent years, this has not been the case among youth from low socioeconomic backgrounds. The purpose of this paper is to report the rationale, study design and baseline findings of a school-based obesity prevention program for low-active adolesc...

Rationale and Methods for Archival Sampling and Analysis of Atmospheric Trace Chemical Contaminants On Board Mir and Recommendations for the International Space Station

Science.gov (United States)

Perry, J. L.; James, J. T.; Cole, H. E.; Limero, T. F.; Beck, S. W.

1997-01-01

Collection and analysis of spacecraft cabin air samples are necessary to assess the cabin air quality with respect to crew health. Both toxicology and engineering disciplines work together to achieve an acceptably clean cabin atmosphere. Toxicology is concerned with limiting the risk to crew health from chemical sources, setting exposure limits, and analyzing air samples to determine how well these limits are met. Engineering provides the means for minimizing the contribution of the various contaminant generating sources by providing active contamination control equipment on board spacecraft and adhering to a rigorous material selection and control program during the design and construction of the spacecraft. A review of the rationale and objectives for sampling spacecraft cabin atmospheres is provided. The presently-available sampling equipment and methods are reviewed along with the analytical chemistry methods employed to determine trace contaminant concentrations. These methods are compared and assessed with respect to actual cabin air quality monitoring needs. Recommendations are presented with respect to the basic sampling program necessary to ensure an acceptably clean spacecraft cabin atmosphere. Also, rationale and recommendations for expanding the scope of the basic monitoring program are discussed.

A performance goal-based seismic design philosophy for waste repository facilities

International Nuclear Information System (INIS)

Hossain, Q.A.

1994-01-01

A performance goal-based seismic design philosophy, compatible with DOE's present natural phenomena hazards mitigation and open-quotes graded approachclose quotes philosophy, has been proposed for high level nuclear waste repository facilities. The rationale, evolution, and the desirable features of this method have been described. Why and how the method should and can be applied to the design of a repository facility are also discussed

Rationale and design of the multiethnic Pharmacogenomics in Childhood Asthma consortium

NARCIS (Netherlands)

Farzan, Niloufar; Vijverberg, Susanne J.; Andiappan, Anand K.; Arianto, Lambang; Berce, Vojko; Blanca-López, Natalia; Bisgaard, Hans; Bønnelykke, Klaus; Burchard, Esteban G.; Campo, Paloma; Canino, Glorisa; Carleton, Bruce; Celedón, Juan C.; Chew, Fook Tim; Chiang, Wen Chin; Cloutier, Michelle M.; Daley, Denis; den Dekker, Herman T.; Dijk, F. Nicole; Duijts, Liesbeth; Flores, Carlos; Forno, Erick; Hawcutt, Daniel B.; Hernandez-Pacheco, Natalia; de Jongste, Johan C.; Kabesch, Michael; Koppelman, Gerard H.; Manolopoulos, Vangelis G.; Melén, Erik; Mukhopadhyay, Somnath; Nilsson, Sara; Palmer, Colin N.; Pino-Yanes, Maria; Pirmohamed, Munir; Potočnik, Uros; Raaijmakers, Jan A.; Repnik, Katja; Schieck, Maximilian; Sio, Yang Yie; Smyth, Rosalind L.; Szalai, Csaba; Tantisira, Kelan G.; Turner, Steve; van der Schee, Marc P.; Verhamme, Katia M.; Maitland-van der Zee, Anke H.

2017-01-01

Aim: International collaboration is needed to enable large-scale pharmacogenomics studies in childhood asthma. Here, we describe the design of the Pharmacogenomics in Childhood Asthma (PiCA) consortium. Materials & methods: Investigators of each study participating in PiCA provided data on the study

Rationale and design of the multiethnic Pharmacogenomics in Childhood Asthma consortium

NARCIS (Netherlands)

Farzan, Niloufar; Vijverberg, Susanne J.; Andiappan, Anand K.; Arianto, Lambang; Berce, Vojko; Blanca-Lopez, Natalia; Bisgaard, Hans; Bonnelykke, Klaus; Burchard, Esteban G.; Campo, Paloma; Canino, Glorisa; Carleton, Bruce; Celedon, Juan C.; Chew, Fook Tim; Chiang, Wen Chin; Cloutier, Michelle M.; Daley, Denis; Den Dekker, Herman T.; Dijk, Nicole F.; Duijts, Liesbeth; Flores, Carlos; Forno, Erick; Hawcutt, Daniel B.; Hernandez-Pacheco, Natalia; de Jongste, Johan C.; Kabesch, Michael; Koppelman, Gerard H.; Manolopoulos, Vangelis G.; Melen, Erik; Mukhopadhyay, Somnath; Nilsson, Sara; Palmer, Colin N.; Pino-Yanes, Maria; Pirmohamed, Munir; Potocnki, Uros; Raaijmakers, Jan A.; Repnik, Katja; Schieck, Maximilian; Sio, Yang Yie; Smyth, Rosalind L.; Szalai, Csaba; Tantisira, Kelan G.; Turner, Steve; van der Schee, Marc P.; Verhamme, Katia M.; Maitland-van der Zee, Anke H.

2017-01-01

Aim: International collaboration is needed to enable large-scale pharmacogenomics studies in childhood asthma. Here, we describe the design of the Pharmacogenomics in Childhood Asthma (PiCA) consortium.  Materials & methods: Investigators of each study participating in PiCA provided data on the

The Importance of Rationales for Internationalization at a Local Level--University and Individual

Science.gov (United States)

Willis, Ian; Taylor, John

2014-01-01

This study examines rationales for internationalization at a research intensive university in the UK. Internationalization is often described at a macro level without reaching down to explore the individual motivations that may support or constrain internationalization at a particular institution. The article argues that it is important to…

Rationale for energy research and development programme

Energy Technology Data Exchange (ETDEWEB)

1976-04-01

This paper describes the rationale for the expenditure of government money on energy research and development. The Committee, organized in 1974, established the following order of project priorities: projects to determine current and future energy demand; projects concerned with the conservation and more efficient use of energy; projects concerned with the assessment of indigenous energy resources; projects concerned with the assessment of the human, financial, and organizational resources for energy production and use; and projects concerned with economic, technological, social, and environmental aspects of energy use and production over the next 15 years and beyond the next 15 years. Significant factors affecting the national energy economy, the strategy for energy research and development, and the results of committee activities are summarized. An energy scenario research is laid out. (MCW)

Proposed energy conservation contingency plan: emergency restrictions on advertising lighting. Authorities, need, rationale, and operation

Energy Technology Data Exchange (ETDEWEB)

1977-04-01

The emergency restrictions on advertising lighting proposed in Energy Conservation Contingency Plan No. 5 of 1977 are presented. A statement is given on the need for rationale and operation of the Contingency Plan.

Energetic rationale for an unexpected and abrupt reversal of guanidinium chloride-induced unfolding of peptide deformylase.

Science.gov (United States)

Berg, Alexander K; Manokaran, Sumathra; Eiler, Daniel; Kooren, Joel; Mallik, Sanku; Srivastava, D K

2008-01-01

Peptide deformylase (PDF) catalyzes the removal of formyl group from the N-terminal methionine residues of nascent proteins in prokaryotes, and this enzyme is a high priority target for antibiotic design. In pursuit of delineating the structural-functional features of Escherichia coli PDF (EcPDF), we investigated the mechanistic pathway for the guanidinium chloride (GdmCl)-induced unfolding of the enzyme by monitoring the secondary structural changes via CD spectroscopy. The experimental data revealed that EcPDF is a highly stable enzyme, and it undergoes slow denaturation in the presence of varying concentrations of GdmCl. The most interesting aspect of these studies has been the abrupt reversal of the unfolding pathway at low to moderate concentrations of the denaturant, but not at high concentration. An energetic rationale for such an unprecedented feature in protein chemistry is offered.

The rationale for early intervention in schizophrenia and related disorders

DEFF Research Database (Denmark)

Nordentoft, Merete; Jeppesen, Pia; Petersen, Lone

2009-01-01

, adherence to treatment, comorbid drug abuse, relapse and readmission. Some benefits persist after cessation of the intervention. Conclusions: Early intervention in schizophrenia is justified to reduce the negative personal and social impact of prolonged periods of untreated symptoms. Furthermore, phase......Abstract Aim: To examine the rationale and evidence supporting an early intervention approach in schizophrenia. Methods: A selective literature review was conducted. Results: During the onset of schizophrenia, there is often a significant delay between the emergence of psychotic symptoms...

Synthetic strong ground motions for engineering design utilizing empirical Green`s functions

Energy Technology Data Exchange (ETDEWEB)

Hutchings, L.J.; Jarpe, S.P.; Kasameyer, P.W.; Foxall, W.

1996-04-11

We present a methodology for developing realistic synthetic strong ground motions for specific sites from specific earthquakes. We analyzed the possible ground motion resulting from a M = 7.25 earthquake that ruptures 82 km of the Hayward fault for a site 1.4 km from the fault in the eastern San Francisco Bay area. We developed a suite of 100 rupture scenarios for the Hayward fault earthquake and computed the corresponding strong ground motion time histories. We synthesized strong ground motion with physics-based solutions of earthquake rupture and applied physical bounds on rupture parameters. By having a suite of rupture scenarios of hazardous earthquakes for a fixed magnitude and identifying the hazard to the site from the statistical distribution of engineering parameters, we introduce a probabilistic component into the deterministic hazard calculation. Engineering parameters of synthesized ground motions agree with those recorded from the 1995 Kobe, Japan and the 1992 Landers, California earthquakes at similar distances and site geologies.

Design of the Dutch prevention of influenza, surveillance and management (PRISMA) study

NARCIS (Netherlands)

Hak, E; van Loon, S; Buskens, E; van Essen, G A; de Bakker, D; Tacken, M A J B; van Hout, B A; Grobbee, D E; Verheij, Th J M

2003-01-01

Rationale and design of a study on the cost-effectiveness of the Dutch influenza vaccination campaign are described. During two influenza epidemics, about 75,000 primary care patients recommended for influenza vaccination are included. Cases have fatal or non-fatal influenza, pneumonia, otitis

Participatory design methods in telemedicine research

DEFF Research Database (Denmark)

Danbjørg, Dorthe Boe; Clemensen, Jane; Rothmann, Mette Juel

together with the patients. Participatory design is a research design and methodology that encourages the participation of users in the design process of technological solutions. Therefore, it has a potential for designing technologies that actually reflect the needs of the users, why it is relevant within...... telemedicine. The aim of this presentation is to explain the process and theoretical framework of a PD project; give an example of a project including the applied methods, and to determine its application to telemedicine with focus on the rationale for genuine participation. Theory: Participation implies....... Methods: Key activities of a Participatory Design project comprise methods such as fieldwork; literature reviewing; development and testing, and user activities as workshops. Methods that support telling, making, enacting. For instance telling activities as drivers for participation, where practitioners...

An ecological dynamics rationale to explain home advantage in professional football

Science.gov (United States)

Gama, José; Dias, Gonçalo; Couceiro, Micael; Passos, Pedro; Davids, Keith; Ribeiro, João

2016-03-01

Despite clear findings, research on home advantage in team sports lacks a comprehensive theoretical rationale for understanding why this phenomenon is so compelling. The aim of this study was to provide an explanatory theoretical rationale in ecological dynamics for the influence of home advantage observed in research on professional football. We recorded 30 competitive matches and analyzed 13958 passes, from one highly successful team in the Portuguese Premier League, during season 2010/2011. Performance data were analyzed using the Match Analysis Software—Amisco® (version 3.3.7.25), allowing us to characterize team activity profiles. Results were interpreted from an ecological dynamics perspective, explaining how task and environmental constraints of a competitive football setting required performers to continuously co-adapt to teammate behaviors. Despite slight differences in percentage of ball possession when playing home or away, the number of passes achieved by the team, while in possession of the ball, was quite different between home or away venues. When playing at home, the number of passes performed by the team was considerably higher than when playing away. The explanation proposed in this study for a home advantage effect can be understood from studying interpersonal coordination tendencies of team sports players as agents in a complex adaptive system.

Using social media to deliver weight loss programming to young adults: Design and rationale for the Healthy Body Healthy U (HBHU) trial.

Science.gov (United States)

Napolitano, Melissa A; Whiteley, Jessica A; Mavredes, Meghan N; Faro, Jamie; DiPietro, Loretta; Hayman, Laura L; Neighbors, Charles J; Simmens, Samuel

2017-09-01

The transitional period from late adolescence to early adulthood is a vulnerable period for weight gain, with a twofold increase in overweight/obesity during this life transition. In the United States, approximately one-third of young adults have obesity and are at a high risk for weight gain. To describe the design and rationale of a National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) sponsored randomized, controlled clinical trial, the Healthy Body Healthy U (HBHU) study, which compares the differential efficacy of three interventions on weight loss among young adults aged 18-35years. The intervention is delivered via Facebook and SMS Text Messaging (text messaging) and includes: 1) targeted content (Targeted); 2) tailored or personalized feedback (Tailored); or 3) contact control (Control). Recruitment is on-going at two campus sites, with the intervention delivery conducted by the parent site. A total of 450 students will be randomly-assigned to receive one of three programs for 18months. We hypothesize that: a) the Tailored group will lose significantly more weight at the 6, 12, 18month follow-ups compared with the Targeted group; and that b) both the Tailored and Targeted groups will have greater weight loss at the 6, 12, 18month follow-ups than the Control group. We also hypothesize that participants who achieve a 5% weight loss at 6 and 18months will have greater improvements in their cardiometabolic risk factors than those who do not achieve this target. We will examine intervention costs to inform implementation and sustainability other universities. Expected study completion date is 2019. This project has significant public health impact, as the successful translation could reach as many as 20 million university students each year, and change the current standard of practice for promoting weight management within university campus communities. ClinicalTrial.gov: NCT02342912. Copyright © 2017. Published by Elsevier Inc.

Efficacy of Internet-Based Guided Treatment for Genito-Pelvic Pain/Penetration Disorder: Rationale, Treatment Protocol, and Design of a Randomized Controlled Trial

Directory of Open Access Journals (Sweden)

Anna-Carlotta Zarski

2018-01-01

Full Text Available IntroductionGenito-pelvic pain/penetration disorder (GPPPD not only adversely affects women’s sexuality and sexual satisfaction but is also associated with a wide range of psychosocial consequences such as reduced quality of life and well-being, mental health comorbidities, and relationship distress. Evidence for effective treatment options is scarce.AimThis article describes the rationale, treatment protocol, and study design for a randomized controlled trial examining the efficacy of an Internet-based guided intervention for GPPPD.MethodTwo hundred women who meet the criteria for GPPPD and have not been able to experience sexual intercourse for at least the last 6 months will be recruited and randomly assigned either to the intervention group (IG or a 6-month waitlist control group. Assessments take place at baseline (T1, peritreatment after completion of Session 5 in IG (T2, after completion of Session 8 or 12 weeks after randomization (T3, and after 6 months (T4. Data will be analyzed on an intention-to-treat and a completer basis.Main outcome measuresThe primary outcome will be sexual intercourse involving the insertion of the partner’s penis at posttreatment. Secondary outcomes include, e.g., improved non-intercourse penetration, sexual functioning, dyadic stress coping, reduced fear of sexuality and negative penetration-related cognitions. Fear of sexuality, penetration-related cognitions, and exercise intensity will be assessed as mediators of intercourse in the IG. Sexual dysfunctions of partners will be measured at baseline (T1 and investigated as a potential moderator of the primary treatment outcome.DiscussionGiven the burden associated with GPPPD and the need for specialized treatment, there is a surprising lack of evidence-based treatment options. This study aims to assess whether Internet-based interventions could contribute to closing this treatment gap.Clinical Trial RegistrationGerman Register of Clinical Studies (DRKS

Efficacy of Internet-Based Guided Treatment for Genito-Pelvic Pain/Penetration Disorder: Rationale, Treatment Protocol, and Design of a Randomized Controlled Trial.

Science.gov (United States)

Zarski, Anna-Carlotta; Berking, Matthias; Ebert, David Daniel

2017-01-01

Genito-pelvic pain/penetration disorder (GPPPD) not only adversely affects women's sexuality and sexual satisfaction but is also associated with a wide range of psychosocial consequences such as reduced quality of life and well-being, mental health comorbidities, and relationship distress. Evidence for effective treatment options is scarce. This article describes the rationale, treatment protocol, and study design for a randomized controlled trial examining the efficacy of an Internet-based guided intervention for GPPPD. Two hundred women who meet the criteria for GPPPD and have not been able to experience sexual intercourse for at least the last 6 months will be recruited and randomly assigned either to the intervention group (IG) or a 6-month waitlist control group. Assessments take place at baseline (T1), peritreatment after completion of Session 5 in IG (T2), after completion of Session 8 or 12 weeks after randomization (T3), and after 6 months (T4). Data will be analyzed on an intention-to-treat and a completer basis. The primary outcome will be sexual intercourse involving the insertion of the partner's penis at posttreatment. Secondary outcomes include, e.g., improved non-intercourse penetration, sexual functioning, dyadic stress coping, reduced fear of sexuality and negative penetration-related cognitions. Fear of sexuality, penetration-related cognitions, and exercise intensity will be assessed as mediators of intercourse in the IG. Sexual dysfunctions of partners will be measured at baseline (T1) and investigated as a potential moderator of the primary treatment outcome. Given the burden associated with GPPPD and the need for specialized treatment, there is a surprising lack of evidence-based treatment options. This study aims to assess whether Internet-based interventions could contribute to closing this treatment gap. German Register of Clinical Studies (DRKS): DRKS00010228.

Of Private, Common, and Public Property and the Rationale for Total Privatization

Directory of Open Access Journals (Sweden)

Hans-Hermann Hoppe

2011-02-01

Full Text Available In this paper, first, I want to clarify the nature and function of private property. Second, I want to clarify the distinction between “common” goods and property and “public” goods and property, and explain the construction error inherent in the institution of public goods and property. Third, I want to explain the rationale and principle of privatization.

Rationale, design and baseline characteristics of a randomized controlled trial of a web-based computer-tailored physical activity intervention for adults from Quebec City.

Science.gov (United States)

Boudreau, François; Walthouwer, Michel Jean Louis; de Vries, Hein; Dagenais, Gilles R; Turbide, Ginette; Bourlaud, Anne-Sophie; Moreau, Michel; Côté, José; Poirier, Paul

2015-10-09

The relationship between physical activity and cardiovascular disease (CVD) protection is well documented. Numerous factors (e.g. patient motivation, lack of facilities, physician time constraints) can contribute to poor PA adherence. Web-based computer-tailored interventions offer an innovative way to provide tailored feedback and to empower adults to engage in regular moderate- to vigorous-intensity PA. To describe the rationale, design and content of a web-based computer-tailored PA intervention for Canadian adults enrolled in a randomized controlled trial (RCT). 244 men and women aged between 35 and 70 years, without CVD or physical disability, not participating in regular moderate- to vigorous-intensity PA, and familiar with and having access to a computer at home, were recruited from the Quebec City Prospective Urban and Rural Epidemiological (PURE) study centre. Participants were randomized into two study arms: 1) an experimental group receiving the intervention and 2) a waiting list control group. The fully automated web-based computer-tailored PA intervention consists of seven 10- to 15-min sessions over an 8-week period. The theoretical underpinning of the intervention is based on the I-Change Model. The aim of the intervention was to reach a total of 150 min per week of moderate- to vigorous-intensity aerobic PA. This study will provide useful information before engaging in a large RCT to assess the long-term participation and maintenance of PA, the potential impact of regular PA on CVD risk factors and the cost-effectiveness of a web-based computer-tailored intervention. ISRCTN36353353 registered on 24/07/2014.

Enhancing physical and social environments to reduce obesity among public housing residents: rationale, trial design, and baseline data for the Healthy Families study.

Science.gov (United States)

Quintiliani, Lisa M; DeBiasse, Michele A; Branco, Jamie M; Bhosrekar, Sarah Gees; Rorie, Jo-Anna L; Bowen, Deborah J

2014-11-01

Intervention programs that change environments have the potential for greater population impact on obesity compared to individual-level programs. We began a cluster randomized, multi-component multi-level intervention to improve weight, diet, and physical activity among low-socioeconomic status public housing residents. Here we describe the rationale, intervention design, and baseline survey data. After approaching 12 developments, ten were randomized to intervention (n=5) or assessment-only control (n=5). All residents in intervention developments are welcome to attend any intervention component: health screenings, mobile food bus, walking groups, cooking demonstrations, and a social media campaign; all of which are facilitated by community health workers who are residents trained in health outreach. To evaluate weight and behavioral outcomes, a subgroup of female residents and their daughters age 8-15 were recruited into an evaluation cohort. In total, 211 households completed the survey (RR=46.44%). Respondents were Latino (63%), Black (24%), and had ≤ high school education (64%). Respondents reported ≤2 servings of fruits & vegetables/day (62%), visiting fast food restaurants 1+ times/week (32%), and drinking soft drinks daily or more (27%). The only difference between randomized groups was race/ethnicity, with more Black residents in the intervention vs. control group (28% vs. 19%, p=0.0146). Among low-socioeconomic status urban public housing residents, we successfully recruited and randomized families into a multi-level intervention targeting obesity. If successful, this intervention model could be adopted in other public housing developments or entities that also employ community health workers, such as food assistance programs or hospitals. Copyright © 2014 Elsevier Inc. All rights reserved.

Rationale and study design of a patient-centered intervention to improve health status in chronic heart failure: The Collaborative Care to Alleviate Symptoms and Adjust to Illness (CASA) randomized trial.

Science.gov (United States)

Bekelman, David B; Allen, Larry A; Peterson, Jamie; Hattler, Brack; Havranek, Edward P; Fairclough, Diane L; McBryde, Connor F; Meek, Paula M

2016-11-01

While contemporary heart failure management has led to some improvements in morbidity and mortality, patients continue to report poor health status (i.e., burdensome symptoms, impaired function, and poor quality of life). The Collaborative Care to Alleviate Symptoms and Adjust to Illness (CASA) trial is a NIH-funded, three-site, randomized clinical trial that examines the effect of the CASA intervention compared to usual care on the primary outcome of patient-reported health status at 6months in patients with heart failure and poor health status. The CASA intervention involves a nurse who works with patients to treat symptoms (e.g., shortness of breath, fatigue, pain) using disease-specific and palliative approaches, and a social worker who provides psychosocial care targeting depression and adjustment to illness. The intervention uses a collaborative care team model of health care delivery and is structured and primarily phone-based to enhance reproducibility and scalability. This article describes the rationale and design of the CASA trial, including several decision points: (1) how to design a patient-centered intervention to improve health status; (2) how to structure the intervention so that it is reproducible and scalable; and (3) how to systematically identify outpatients with heart failure most likely to need and benefit from the intervention. The results should provide valuable information to providers and health systems about the use of team care to manage symptoms and provide psychosocial care in chronic illness. Published by Elsevier Inc.

Rationale, design and methods of the HEALTHY study nutrition intervention component.

Science.gov (United States)

Gillis, B; Mobley, C; Stadler, D D; Hartstein, J; Virus, A; Volpe, S L; El ghormli, L; Staten, M A; Bridgman, J; McCormick, S

2009-08-01

The HEALTHY study was a randomized, controlled, multicenter and middle school-based, multifaceted intervention designed to reduce risk factors for the development of type 2 diabetes. The study randomized 42 middle schools to intervention or control, and followed students from the sixth to the eighth grades. Here we describe the design of the HEALTHY nutrition intervention component that was developed to modify the total school food environment, defined to include the following: federal breakfast, lunch, after school snack and supper programs; a la carte venues, including snack bars and school stores; vending machines; fundraisers; and classroom parties and celebrations. Study staff implemented the intervention using core and toolbox strategies to achieve and maintain the following five intervention goals: (1) lower the average fat content of foods, (2) increase the availability and variety of fruits and vegetables, (3) limit the portion sizes and energy content of dessert and snack foods, (4) eliminate whole and 2% milk and all added sugar beverages, with the exception of low fat or nonfat flavored milk, and limit 100% fruit juice to breakfast in small portions and (5) increase the availability of higher fiber grain-based foods and legumes. Other nutrition intervention component elements were taste tests, cafeteria enhancements, cafeteria line messages and other messages about healthy eating, cafeteria learning laboratory (CLL) activities, twice-yearly training of food service staff, weekly meetings with food service managers, incentives for food service departments, and twice yearly local meetings and three national summits with district food service directors. Strengths of the intervention design were the integration of nutrition with the other HEALTHY intervention components (physical education, behavior change and communications), and the collaboration and rapport between the nutrition intervention study staff members and food service personnel at both school

Physiology, regulation and multifunctional activity of the gut wall: a rationale for multicompartmental modelling

NARCIS (Netherlands)

Bannink, A.; Dijkstra, J.; Koopmans, S.J.; Mroz, Z.

2006-01-01

A rationale is given for a modelling approach to identify the mechanisms involved in the functioning and metabolic activity of tissues in the wall of the gastrointestinal tract. Maintenance and productive functions are discussed and related to the distinct compartments of the gastrointestinal tract

Human factors design review guidelines for advanced nuclear control room technologies

International Nuclear Information System (INIS)

O'Hara, J.; Brown, W.; Granda, T.; Baker, C.

1991-01-01

Advanced control rooms (ACRs) for future nuclear power plants are being designed utilizing computer-based technologies. The US Nuclear Regulatory Commission reviews the human engineering aspects of such control rooms to ensure that they are designed to good human factors engineering principles and that operator performance and reliability are appropriately supported in order to protect public health and safety. This paper describes the rationale, general approach, and initial development of an NRC Advanced Control Room Design Review Guideline. 20 refs., 1 fig

Introduction to the Biomass Project: An Illustration of Evidence-Centered Assessment Design and Delivery Capability. CSE Report.

Science.gov (United States)

Steinberg, Linda S.; Mislevy, Robert J.; Almond, Russell G.; Baird, Andrew B.; Cahallan, Cara; Dibello, Louis V.; Senturk, Deniz; Yan, Duanli; Chernick, Howard; Kindfield, Ann C. H.

This paper describes the design rationale for a prototype of an innovative assessment product, and the process that led to the design. The goals of the Biomass project were to demonstrate: (1) an assessment product designed to serve two new purposes in the transition from high school to college; and (2) the capability needed to produce this kind…

The declining demand for hospital care as a rationale for duty hour reform.

Science.gov (United States)

Jena, Anupam B; DePasse, Jacqueline W; Prasad, Vinay

2014-10-01

The regulation of duty hours of physicians in training remains among the most hotly debated subjects in medical education. Although recent duty hour reforms have been chiefly motivated by concerns about resident well-being and medical errors attributable to resident fatigue, the debate surrounding duty hour reform has infrequently involved discussion of one of the most important secular changes in hospital care that has affected nearly all developed countries over the last 3 decades: the declining demand for hospital care. For example, in 1980, we show that resident physicians in US teaching hospitals provided, on average, 1,302 inpatient days of care per resident physician compared to 593 inpatient days in 2011, a decline of 54%. This decline in the demand for hospital care by residents provides an under-recognized economic rationale for reducing residency duty hours, a rationale based solely on supply and demand considerations. Work hour reductions and growing requirements for outpatient training can be seen as an appropriate response to the shrinking demand for hospital care across the health-care sector.

Qubit absorption refrigerator at strong coupling

Science.gov (United States)

Mu, Anqi; Agarwalla, Bijay Kumar; Schaller, Gernot; Segal, Dvira

2017-12-01

We demonstrate that a quantum absorption refrigerator (QAR) can be realized from the smallest quantum system, a qubit, by coupling it in a non-additive (strong) manner to three heat baths. This function is un-attainable for the qubit model under the weak system-bath coupling limit, when the dissipation is additive. In an optimal design, the reservoirs are engineered and characterized by a single frequency component. We then obtain closed expressions for the cooling window and refrigeration efficiency, as well as bounds for the maximal cooling efficiency and the efficiency at maximal power. Our results agree with macroscopic designs and with three-level models for QARs, which are based on the weak system-bath coupling assumption. Beyond the optimal limit, we show with analytical calculations and numerical simulations that the cooling efficiency varies in a non-universal manner with model parameters. Our work demonstrates that strongly-coupled quantum machines can exhibit function that is un-attainable under the weak system-bath coupling assumption.

Design of Phase I Combination Trials: Recommendations of the Clinical Trial Design Task Force of the NCI Investigational Drug Steering Committee

Science.gov (United States)

Paller, Channing J.; Bradbury, Penelope A.; Ivy, S. Percy; Seymour, Lesley; LoRusso, Patricia M.; Baker, Laurence; Rubinstein, Larry; Huang, Erich; Collyar, Deborah; Groshen, Susan; Reeves, Steven; Ellis, Lee M.; Sargent, Daniel J.; Rosner, Gary L.; LeBlanc, Michael L.; Ratain, Mark J.

2014-01-01

Anticancer drugs are combined in an effort to treat a heterogeneous tumor or to maximize the pharmacodynamic effect. The development of combination regimens, while desirable, poses unique challenges. These include the selection of agents for combination therapy that may lead to improved efficacy while maintaining acceptable toxicity, the design of clinical trials that provide informative results for individual agents and combinations, and logistical and regulatory challenges. The phase 1 trial is often the initial step in the clinical evaluation of a combination regimen. In view of the importance of combination regimens and the challenges associated with developing them, the Clinical Trial Design (CTD) Task Force of the National Cancer Institute (NCI) Investigational Drug Steering Committee developed a set of recommendations for the phase 1 development of a combination regimen. The first two recommendations focus on the scientific rationale and development plans for the combination regimen; subsequent recommendations encompass clinical design aspects. The CTD Task Force recommends that selection of the proposed regimens be based on a biological or pharmacological rationale supported by clinical and/or robust and validated preclinical evidence, and accompanied by a plan for subsequent development of the combination. The design of the phase 1 clinical trial should take into consideration the potential pharmacokinetic and pharmacodynamic interactions as well as overlapping toxicity. Depending on the specific hypothesized interaction, the primary endpoint may be dose optimization, pharmacokinetics, and/or pharmacodynamic (i.e., biomarker). PMID:25125258

Rationale for a spallation neutron source target system test facility at the 1-MW Long-Pulse Spallation Source

International Nuclear Information System (INIS)

Sommer, W.F.

1995-12-01

The conceptual design study for a 1-MW Long-Pulse Spallation Source at the Los Alamos Neutron Science Center has shown the feasibility of including a spallation neutron test facility at a relatively low cost. This document presents a rationale for developing such a test bed. Currently, neutron scattering facilities operate at a maximum power of 0.2 MW. Proposed new designs call for power levels as high as 10 MW, and future transmutation activities may require as much as 200 MW. A test bed will allow assessment of target neutronics; thermal hydraulics; remote handling; mechanical structure; corrosion in aqueous, non-aqueous, liquid metal, and molten salt systems; thermal shock on systems and system components; and materials for target systems. Reliable data in these areas are crucial to the safe and reliable operation of new high-power facilities. These tests will provide data useful not only to spallation neutron sources proposed or under development, but also to other projects in accelerator-driven transmutation technologies such as the production of tritium

Rationale and design of ARTS

DEFF Research Database (Denmark)

Pitt, Bertram; Filippatos, Gerasimos; Gheorghiade, Mihai

2012-01-01

. placebo (primary endpoint) and vs. spironolactone, safety and tolerability, biomarkers of cardiac and renal function or injury, eGFR, and albuminuria. BAY 94-8862 pharmacokinetics are also assessed. Perspectives ARTS is the first phase II clinical trial of BAY 94-8862 and is expected to provide a wealth...

Rationale and design of WEBCARE

DEFF Research Database (Denmark)

Pedersen, Susanne S.; Spek, Viola; Theuns, Dominic A M J

2009-01-01

The implantable cardioverter defibrillator (ICD) is generally well accepted, but 25-33% of patients experience clinical levels of anxiety, depression, and impaired quality of life (QoL) following implantation. Few trials in ICD patients have investigated whether behavioral intervention may mitiga...

Rationale and design of XAMOS

DEFF Research Database (Denmark)

Turpie, Alexander G G; Schmidt, André C; Kreutz, Reinhold

2012-01-01

, noninterventional, parallel-group study to gain insight into the safety (major bleeding, side effects) and effectiveness (prevention of symptomatic thromboembolic events) of rivaroxaban in daily clinical practice. XAMOS will follow 15,000 patients after major orthopedic surgery in approximately 200 centers...

A school-based intervention to promote physical activity among adolescent girls: Rationale, design, and baseline data from the Girls in Sport group randomised controlled trial

Directory of Open Access Journals (Sweden)

Puglisi Lauren

2011-08-01

Full Text Available Abstract Background Physical activity levels decline markedly among girls during adolescence. School-based interventions that are multi-component in nature, simultaneously targeting curricular, school environment and policy, and community links, are a promising approach for promoting physical activity. This report describes the rationale, design and baseline data from the Girls in Sport group randomised trial, which aims to prevent the decline in moderate-to-vigorous intensity physical activity (MVPA among adolescent girls. Methods/Design A community-based participatory research approach and action learning framework are used with measurements at baseline and 18-month follow-up. Within each intervention school, a committee develops an action plan aimed at meeting the primary objective (preventing the decline in accelerometer-derived MVPA. Academic partners and the State Department of Education and Training act as critical friends. Control schools continue with their usual school programming. 24 schools were matched then randomized into intervention (n = 12 and control (n = 12 groups. A total of 1518 girls (771 intervention and 747 control completed baseline assessments (86% response rate. Useable accelerometer data (≥10 hrs/day on at least 3 days were obtained from 79% of this sample (n = 1199. Randomisation resulted in no differences between intervention and control groups on any of the outcomes. The mean age (SE of the sample was 13.6 (± 0.02 years and they spent less than 5% of their waking hours in MVPA (4.85 ± 0.06. Discussion Girls in Sport will test the effectiveness of schools working towards the same goal, but developing individual, targeted interventions that bring about changes in curriculum, school environment and policy, and community links. By using community-based participatory research and an action learning framework in a secondary school setting, it aims to add to the body of literature on effective school

Randomized placebo controlled blinded study to assess valsartan efficacy in preventing left ventricle remodeling in patients with dual chamber pacemaker--Rationale and design of the trial.

Science.gov (United States)

Tomasik, Andrzej; Jacheć, Wojciech; Wojciechowska, Celina; Kawecki, Damian; Białkowska, Beata; Romuk, Ewa; Gabrysiak, Artur; Birkner, Ewa; Kalarus, Zbigniew; Nowalany-Kozielska, Ewa

2015-05-01

Dual chamber pacing is known to have detrimental effect on cardiac performance and heart failure occurring eventually is associated with increased mortality. Experimental studies of pacing in dogs have shown contractile dyssynchrony leading to diffuse alterations in extracellular matrix. In parallel, studies on experimental ischemia/reperfusion injury have shown efficacy of valsartan to inhibit activity of matrix metalloproteinase-9, to increase the activity of tissue inhibitor of matrix metalloproteinase-3 and preserve global contractility and left ventricle ejection fraction. To present rationale and design of randomized blinded trial aimed to assess whether 12 month long administration of valsartan will prevent left ventricle remodeling in patients with preserved left ventricle ejection fraction (LVEF ≥ 40%) and first implantation of dual chamber pacemaker. A total of 100 eligible patients will be randomized into three parallel arms: placebo, valsartan 80 mg/daily and valsartan 160 mg/daily added to previously used drugs. The primary endpoint will be assessment of valsartan efficacy to prevent left ventricle remodeling during 12 month follow-up. We assess patients' functional capacity, blood plasma activity of matrix metalloproteinases and their tissue inhibitors, NT-proBNP, tumor necrosis factor alpha, and Troponin T. Left ventricle function and remodeling is assessed echocardiographically: M-mode, B-mode, tissue Doppler imaging. If valsartan proves effective, it will be an attractive measure to improve long term prognosis in aging population and increasing number of pacemaker recipients. ClinicalTrials.org (NCT01805804). Copyright © 2015 Elsevier Inc. All rights reserved.

Methods for a multicenter randomized trial for mixed urinary incontinence: rationale and patient-centeredness of the ESTEEM trial

Science.gov (United States)

Sung, Vivian W.; Borello-France, Diane; Dunivan, Gena; Gantz, Marie; Lukacz, Emily S.; Moalli, Pamela; Newman, Diane K.; Richter, Holly E.; Ridgeway, Beri; Smith, Ariana L.; Weidner, Alison C.; Meikle, Susan

2016-01-01

Introduction Mixed urinary incontinence (MUI) can be a challenging condition to manage. We describe the protocol design and rationale for the Effects of Surgical Treatment Enhanced with Exercise for Mixed Urinary Incontinence (ESTEEM) trial, designed to compare a combined conservative and surgical treatment approach versus surgery alone for improving patient-centered MUI outcomes at 12 months. Methods ESTEEM is a multi-site, prospective, randomized trial of female participants with MUI randomized to a standardized perioperative behavioral/pelvic floor exercise intervention plus midurethral sling versus midurethral sling alone. We describe our methods and four challenges encountered during the design phase: defining the study population, selecting relevant patient-centered outcomes, determining sample size estimates using a patient-reported outcome measure, and designing an analysis plan that accommodates MUI failure rates. A central theme in the design was patient-centeredness, which guided many key decisions. Our primary outcome is patient-reported MUI symptoms measured using the Urogenital Distress Inventory (UDI) score at 12 months. Secondary outcomes include quality of life, sexual function, cost-effectiveness, time to failure and need for additional treatment. Results The final study design was implemented in November 2013 across 8 clinical sites in the Pelvic Floor Disorders Network. As of February 27, 2016, 433 total /472 targeted participants have been randomized. Conclusions We describe the ESTEEM protocol and our methods for reaching consensus for methodological challenges in designing a trial for MUI by maintaining the patient perspective at the core of key decisions. This trial will provide information that can directly impact patient care and clinical decision-making. PMID:27287818

How Computer Technology Expands Educational Options: A Rationale, Recommendations, and a Pamphlet for Administrators.

Science.gov (United States)

Kelch, Panette Evers; Karr-Kidwell, PJ

The purpose of this paper is to provide a historical rationale on how computer technology, particularly the Internet, expands educational options for administrators and teachers. A review of the literature includes a brief history of computer technology and its growing use, and a discussion of computer technology for distance learning, for…

Learning Environments’ Activity Potential for Preschoolers (LEAPP): Study Rationale and Design

OpenAIRE

Tucker, Patricia; Vanderloo, Leigh M.; Newnham-Kanas, Courtney; Burke, Shauna M.; Irwin, Jennifer D.; Johnson, Andrew M.; van Zandvoort, Melissa M.

2013-01-01

Background The purpose of this paper is to provide an overview of the study protocol for the Learning Environments’ Activity Potential for Preschoolers (LEAPP) study, the goal of which is to describe the activity levels of preschoolers attending various early learning venues and explore which attributes of these facilities (e.g. curriculum, policies, equipment, etc.) support activity participation. Design and methods This cross-sectional study aimed to recruit approximately 30 early learning ...

Biomimetic design method for innovation and sustainability

CERN Document Server

Helfman Cohen, Yael

2017-01-01

Presenting a novel biomimetic design method for transferring design solutions from nature to technology, this book focuses on structure-function patterns in nature and advanced modeling tools derived from TRIZ, the theory of inventive problem-solving. The book includes an extensive literature review on biomimicry as an engine of both innovation and sustainability, and discusses in detail the biomimetic design process, current biomimetic design methods and tools. The structural biomimetic design method for innovation and sustainability put forward in this text encompasses (1) the research method and rationale used to develop and validate this new design method; (2) the suggested design algorithm and tools including the Findstructure database, structure-function patterns and ideality patterns; and (3) analyses of four case studies describing how to use the proposed method. This book offers an essential resource for designers who wish to use nature as a source of inspiration and knowledge, innovators and sustain...

The new Childhood Arthritis and Rheumatology Research Alliance (CARRA) registry: design, rationale, and characteristics of patients enrolled in the first 12 months.

Science.gov (United States)

Beukelman, Timothy; Kimura, Yukiko; Ilowite, Norman T; Mieszkalski, Kelly; Natter, Marc D; Burrell, Grendel; Best, Brian; Jones, Jason; Schanberg, Laura E

2017-04-17

Herein we describe the history, design, and rationale of the new Childhood Arthritis and Rheumatology Research Alliance (CARRA) Registry and present the characteristics of patients with juvenile idiopathic arthritis (JIA) enrolled in the first 12 months of operation. The CARRA Registry began prospectively collecting data in the United States and Canada in July 2015 to evaluate the safety of therapeutic agents in persons with childhood-onset rheumatic disease, initially restricted to JIA. Secondary objectives include the evaluation of disease outcomes and their associations with medication use and other factors. Data are collected every 6 months and include clinical assessments, detailed medication use, patient-reported outcomes, and safety events. Follow-up is planned for at least 10 years for each participant and is facilitated by a telephone call center. As of July 2016, 1192 patients with JIA were enrolled in the CARRA Registry at 49 clinical sites. At enrollment, their median age was 12.4 years old and median disease duration was 2.6 years. Owing to preferential enrollment, patients with systemic JIA (13%) and with a polyarticular course (75%) were over-represented compared to patients in typical clinical practice. Approximately 49% were currently using biologic agents and ever use of oral glucocorticoids was common (47%). The CARRA Registry provides safety surveillance data to pharmaceutical companies to satisfy their regulatory requirements, and several independently-funded sub-studies that use the Registry infrastructure are underway. The new CARRA Registry successfully enrolled nearly 1200 participants with JIA in the first 12 months of its operation. Sustainable funding has been secured from multiple sources. The CARRA Registry may serve as a model for the study of other uncommon diseases.

Rationale, design and methods for the RIGHT Track Health Study: pathways from childhood self-regulation to cardiovascular risk in adolescence.

Science.gov (United States)

Wideman, Laurie; Calkins, Susan D; Janssen, James A; Lovelady, Cheryl A; Dollar, Jessica M; Keane, Susan P; Perrin, Eliana M; Shanahan, Lilly

2016-06-01

Cardiovascular risk factors during adolescence-including obesity, elevated lipids, altered glucose metabolism, hypertension, and elevated low-grade inflammation-is cause for serious concern and potentially impacts subsequent morbidity and mortality. Despite the importance of these cardiovascular risk factors, very little is known about their developmental origins in childhood. In addition, since adolescence is a time when individuals are navigating major life changes and gaining increasing autonomy from their parents or parental figures, it is a period when control over their own health behaviors (e.g. drug use, sleep, nutrition) also increases. The primary aim of this paper is to describe the rationale, design and methods for the RIGHT Track Health Study. This study examines self-regulation as a key factor in the development of cardiovascular risk, and further explores health behaviors as an explanatory mechanism of this association. We also examine potential moderators (e.g. psychosocial adversities such as harsh parenting) of this association. RIGHT Track is a longitudinal study that investigates social and emotional development. The RIGHT Track Health Study prospectively follows participants from age 2 through young adulthood in an effort to understand how self-regulatory behavior throughout childhood alters the trajectories of various cardiovascular risk factors during late adolescence via health behaviors. Individuals from RIGHT Track were re-contacted and invited to participate in adolescent data collection (~16.5, 17.5 and 18(+) years old). Individuals completed assessments of body composition, anthropometric indicators, fitness testing (via peak oxygen consumption), heart rate variability during orthostatic challenge, 7-day accelerometry for physical activity and sleep, 24-h dietary recalls, and blood analysis for biomarkers related to metabolic syndrome, inflammatory status and various hormones and cytokines. Individuals also completed extensive self

Corporate Governance Against Recommendations: The Cases of the Strong Executive and the Strong Ownership

Directory of Open Access Journals (Sweden)

Král Pavel

2012-09-01

Full Text Available There are several basic configurations of corporate governance according to the separation of ownership and control (Jensen’s theory. Effective governance is described as a situation whenan owner (or group of owners keeps the right to ratify and monitor strategic decisions while management has the right to initiate and implement those decisions. There are two particular situations how this recommendation is partially broken and both situations are linked to CEO duality. The first case happens when an owner loses or does not exercise the right to monitor management of the organization and is termed as the strong executive. The second case is calledthe strong ownership and is distinguished by an owner taking over implementations of the decisions. The focus of the study was to explore particularly configurations of the strong executive and the strong governance. A mixed method research design was chosen to explore the differences between the basic governance configurations. The sample was chosen by purposive sampling and covered a hundred for-profit organizations of all size and from all sectors of economy.The data were collected through interviews with representatives, mainly members of top management. We revealed that both of these configurations can bear good corporate performance but also bigger risks. The strong executive is typical for organizations with dispersed ownership or a publicly owned organization and the performance of the organization is fully dependent on competencies but also personalities of managers. This configuration contains a high risk of misuse of authority. The strong ownership is effective in small organizations while in a larger organization leads to an overexertion of owners and low performance because they usually faceproblems to keep focus on the strategic issues of the organization.

Astigmatism treatment during phacoemulsification: a review of current surgical strategies and their rationale

Directory of Open Access Journals (Sweden)

Giuliano de Oliveira Freitas

2013-12-01

Full Text Available Preexisting corneal astigmatism, present at the time of cataract surgery, is reviewed in detail throughout this article on its most important aspects such as occurrence rates, clinical relevance and current treatment options. Special emphasis is given to the latter aspect. Each method's rationale, advantage and limitation ishigh lightened. Comparisons between treatment options, whenever possible, are also provided.

Rationale and design of the multiethnic Pharmacogenomics in Childhood Asthma consortium

DEFF Research Database (Denmark)

Farzan, Niloufar; Vijverberg, Susanne J; Andiappan, Anand K

2017-01-01

AIM: International collaboration is needed to enable large-scale pharmacogenomics studies in childhood asthma. Here, we describe the design of the Pharmacogenomics in Childhood Asthma (PiCA) consortium. MATERIALS & METHODS: Investigators of each study participating in PiCA provided data...... corticosteroid users. Among patients from 13 studies with available data on asthma exacerbations, a third reported exacerbations despite inhaled corticosteroid use. In the future pharmacogenomics studies within the consortium, the pharmacogenomics analyses will be performed separately in each center...

Computational design of proteins with novel structure and functions

International Nuclear Information System (INIS)

Yang Wei; Lai Lu-Hua

2016-01-01

Computational design of proteins is a relatively new field, where scientists search the enormous sequence space for sequences that can fold into desired structure and perform desired functions. With the computational approach, proteins can be designed, for example, as regulators of biological processes, novel enzymes, or as biotherapeutics. These approaches not only provide valuable information for understanding of sequence–structure–function relations in proteins, but also hold promise for applications to protein engineering and biomedical research. In this review, we briefly introduce the rationale for computational protein design, then summarize the recent progress in this field, including de novo protein design, enzyme design, and design of protein–protein interactions. Challenges and future prospects of this field are also discussed. (topical review)

The Videographic Requirements Gathering Method for Adolescent-Focused Interaction Design

Directory of Open Access Journals (Sweden)

Tamara Peyton

2014-08-01

Full Text Available We present a novel method for conducting requirements gathering with adolescent populations. Called videographic requirements gathering, this technique makes use of mobile phone data capture and participant creation of media images. The videographic requirements gathering method can help researchers and designers gain intimate insight into adolescent lives while simultaneously reducing power imbalances. We provide rationale for this approach, pragmatics of using the method, and advice on overcoming common challenges facing researchers and designers relying on this technique.

Telework rationale and implementation for people with disabilities: considerations for employer policymaking.

Science.gov (United States)

Moon, Nathan W; Linden, Maureen A; Bricout, John C; Baker, Paul M A

2014-01-01

Telework has been promoted as a viable workplace accommodation for people with disabilities since the 1990s, when information and communication technologies (ICT) had developed sufficiently to facilitate its widespread adoption. This initial research and accompanying policy recommendations were prescriptive in nature and frequently aimed at employers. This article adds to existing policy models for facilitating successful telework outcomes for people with disabilities. Drawing upon two studies by the Rehabilitation Engineering Research Center on Workplace Accommodations, we expound on employee-side considerations in the implementation of telework. Our policy model utilizes established typologies for policy evaluation to develop a process model that considers rationales and implementation factors for telework among people with physical disabilities. Telework may be used as an accommodation for disability, but employee rationales for telework are more complex, involving work-life balance, strategies for pain and fatigue not formally recognized as disability, and expediency in travel and transportation. Implementation of telework as a component of workplace operations is similarly multifaceted, involving non-technology accommodations to realize job restructuring left incomplete by telework. Our model grounds new empirical research in this area. We also renew our call for additional research on effective telework practices for people with disabilities.

The Role(s) of Process Models in Design Practice

DEFF Research Database (Denmark)

Iversen, Søren; Jensen, Mads Kunø Nyegaard; Vistisen, Peter

2018-01-01

This paper investigates how design process models are implemented and used in design-driven organisations. The archetypical theoretical framing of process models, describe their primary role as guiding the design process, and assign roles and deliverables throughout the process. We hypothesise...... that the process models also take more communicative roles in practice, both in terms of creating an internal design rationale, as well as demystifying the black box of design thinking to external stakeholders. We investigate this hypothesis through an interview study of four major danish design......-driven organisations, and analyse the different roles their archetypical process models take in their organisations. The main contribution is the identification of three, often overlapping roles, which design process models showed to assume in design-driven organisations: process guidance, adding transparency...

Simplified methods and application to preliminary design of piping for elevated temperature service

International Nuclear Information System (INIS)

Severud, L.K.

1975-01-01

A number of simplified stress analysis methods and procedures that have been used on the FFTF project for preliminary design of piping operating at elevated temperatures are described. The rationale and considerations involved in developing the procedures and preliminary design guidelines are given. Applications of the simplified methods to a few FFTF pipelines are described and the success of these guidelines are measured by means of comparisons to pipeline designs that have had detailed Code type stress analyses. (U.S.)

Salt Repository Project input to seismic design: Revision 0

International Nuclear Information System (INIS)

1987-12-01

The Salt Repository Program (SRP) Input to Seismic Design (ISD) documents the assumptions, rationale, approaches, judgments, and analyses that support the development of seismic-specific data and information to be used for shaft design in accordance with the SRP Shaft Design Guide (SDG). The contents of this document are divided into four subject areas: (1) seismic assessment, (2) stratigraphy and material properties for seismic design, (3) development of seismic design parameters, and (4) host media stability. These four subject areas have been developed considering expected conditions at a proposed site in Deaf Smith County, Texas. The ISD should be used only in conjunction with seismic design of the exploratory and repository shafts. Seismic design considerations relating to surface facilities are not addressed in this document. 54 refs., 55 figs., 18 tabs

Design challenges for long-term interaction with a robot in a science classroom

NARCIS (Netherlands)

Davison, Daniel Patrick; Charisi, Vasiliki; Wijnen, Frances Martine; Papenmeier, Andrea; van der Meij, Jan; Reidsma, Dennis; Evers, Vanessa

This paper aims to present the main challenges that emerged during the process of the research design of a longitudinal study on child-robot interaction for science education and to discuss relevant suggestions in the context. The theoretical rationale is based on aspects of the theory of social

Rationale and design of the DARWIN-T2D (DApagliflozin Real World evIdeNce in Type 2 Diabetes): A multicenter retrospective nationwide Italian study and crowdsourcing opportunity.

Science.gov (United States)

Fadini, G P; Zatti, G; Consoli, A; Bonora, E; Sesti, G; Avogaro, A

2017-12-01

Randomized controlled trials (RCTs) in the field of diabetes have limitations inherent to the fact that design, setting, and patient characteristics may be poorly transferrable to clinical practice. Thus, evidence from studies using routinely accumulated clinical data are increasingly valued. We herein describe rationale and design of the DARWIN-T2D (DApagliflozin Real World evIdeNce in Type 2 Diabetes), a multicenter retrospective nationwide study conducted at 50 specialist outpatient clinics in Italy and promoted by the Italian Diabetes Society. The primary objective of the study is to describe the baseline clinical characteristics (particularly HbA1c) of patients initiated on dapagliflozin from marketing authorization approval to the end of 2016. Secondary and exploratory objectives will evaluate the changes in glycaemic and extraglycaemic efficacy parameters after initiation of dapagliflozin or after initiation of comparator glucose lowering medications (DPP-4 inhibitors, gliclazide extended release, and long-acting GLP-1 receptor agonists). An automated software will extract relevant data from the same electronic chart system at all centres, thereby minimizing data treatment and human intervention. The study is expected to collect an enormous dataset of information on dapagliflozin- and comparator-using patients. After study completion, the Italian Diabetes Society will launch an open crowdsourcing call on the DARWIN-T2D database, challenging diabetes researchers to apply their ideas and approaches to address new unmet needs and knowledge gaps in diabetes. We believe this will move DARWIN-T2D to the next generation of real world studies. Copyright © 2017 The Italian Society of Diabetology, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition, and the Department of Clinical Medicine and Surgery, Federico II University. Published by Elsevier B.V. All rights reserved.

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