Vaginal birth after cesarean: neonatal outcomes and United States birth setting.

Science.gov (United States)

Tilden, Ellen L; Cheyney, Melissa; Guise, Jeanne-Marie; Emeis, Cathy; Lapidus, Jodi; Biel, Frances M; Wiedrick, Jack; Snowden, Jonathan M

2017-04-01

Women who seek vaginal birth after cesarean delivery may find limited in-hospital options. Increasing numbers of women in the United States are delivering by vaginal birth after cesarean delivery out-of-hospital. Little is known about neonatal outcomes among those who deliver by vaginal birth after cesarean delivery in- vs out-of-hospital. The purpose of this study was to compare neonatal outcomes between women who deliver via vaginal birth after cesarean delivery in-hospital vs out-of-hospital (home and freestanding birth center). We conducted a retrospective cohort study using 2007-2010 linked United States birth and death records to compare singleton, term, vertex, nonanomolous, and liveborn neonates who delivered by vaginal birth after cesarean delivery in- or out-of-hospital. Descriptive statistics and multivariate regression analyses were conducted to estimate unadjusted, absolute, and relative birth-setting risk differences. Analyses were stratified by parity and history of vaginal birth. Sensitivity analyses that involved 3 transfer status scenarios were conducted. Of women in the United States with a history of cesarean delivery (n=1,138,813), only a small proportion delivered by vaginal birth after cesarean delivery with the subsequent pregnancy (n=109,970; 9.65%). The proportion of home vaginal birth after cesarean delivery births increased from 1.78-2.45%. A pattern of increased neonatal morbidity was noted in unadjusted analysis (neonatal seizures, Apgar score birthing their second child by vaginal birth after cesarean delivery in out-of-hospital settings had higher odds of neonatal morbidity and death compared with women of higher parity. Women who had not birthed vaginally prior to out-of-hospital vaginal birth after cesarean delivery had higher odds of neonatal morbidity and mortality compared with women who had birthed vaginally prior to out-of-hospital vaginal birth after cesarean delivery. Sensitivity analyses generated distributions of plausible

Family members' informal roles in end-of-life decision making in adult intensive care units.

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Quinn, Jill R; Schmitt, Madeline; Baggs, Judith Gedney; Norton, Sally A; Dombeck, Mary T; Sellers, Craig R

2012-01-01

To support the process of effective family decision making, it is important to recognize and understand informal roles that various family members may play in the end-of-life decision-making process. To describe some informal roles consistently enacted by family members involved in the process of end-of-life decision making in intensive care units. Ethnographic study. Data were collected via participant observation with field notes and semistructured interviews on 4 intensive care units in an academic health center in the mid-Atlantic United States from 2001 to 2004. The units studied were a medical, a surgical, a burn and trauma, and a cardiovascular intensive care unit. Health care clinicians, patients, and family members. Informal roles for family members consistently observed were primary caregiver, primary decision maker, family spokesperson, out-of-towner, patient's wishes expert, protector, vulnerable member, and health care expert. The identified informal roles were part of families' decision-making processes, and each role was part of a potentially complicated family dynamic for end-of-life decision making within the family system and between the family and health care domains. These informal roles reflect the diverse responses to demands for family decision making in what is usually a novel and stressful situation. Identification and description of these informal roles of family members can help clinicians recognize and understand the functions of these roles in families' decision making at the end of life and guide development of strategies to support and facilitate increased effectiveness of family discussions and decision-making processes.

Valuing setting-based recreation for selected visitors to national forests in the southern United States

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Kavita Sardana; John C. Bergstrom; J. M.  Bowker

2016-01-01

In this study we estimate selected visitors’ demand and value for recreational trips to settings such as developed vs. undeveloped sites in U.S. national forests in the Southern United States using the travel cost method. The setting-based approach allows for valuation of multi-activity trips to particular settings. The results from an adjusted Poisson lognormal...

Family perceptions of intensive care unit nurses’ roles: a Greek perspective

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Maria Malliarou

2014-01-01

Full Text Available This study was done in order to examine the role of the nurse in families with critically ill patients as perceived by family members. A descriptive design was conducted with 93 family members aged 18-53 years from a 6-bed intensive care unit in a Greek Hospital. An anonymous self-completed questionnaire recording demographic data and the questionnaire Family members perception of nurses behavioral role expectation/enactment scale of Hickey and Lewandowski was used. Parametric statistic tests were used to examine the research questions. Intensive care unit (ICU patients’ family members expect nurses to make them feel they can ask whatever they want whenever they want, placing great emphasis on communicating with one another and on participating in decision making to the progress of patient care. The age seems to correlate with the expectation from nurse to meet the role of training on how to handle the patient. Nurses did well with regard to meeting family members’ expectations. Most family members assessed positively the role of ICU nurse confirming the need for communication, and clear support of families.

[Influence of Nurses' Self-leadership on Individual and Team Members' Work Role Performance].

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Kim, Se Young; Kim, Eun Kyung; Kim, Byungsoo; Lee, Eunpyo

2016-06-01

The purpose of this study was to examine correlations between nurses' self-leadership and individual work role performance and correlations between self-leadership in nursing units and team members' work role performance. Participants were 202 conveniently selected general nurses from 5 general hospitals in Korea. The study was carried out on 35 nursing units. Data were collected during February 2015 with self-report questionnaires. For factors affecting individual work role performance, self-expectation, self-goal setting, constructive thought, clinical career in the present nursing unit and marital status accounted for 44.0% of proficiency, while self-expectation, self-goal setting, constructive thought, and marital status accounted for 42.3% of adaptivity. Self-expectation, self-goal setting, constructive thought, self-reward, clinical career in the present nursing unit and position accounted for 26.4% of proactivity. In terms of team members' work role performance, self-reward and self-expectation in nursing units explained 29.0% of team members' proficiency. Self-reward and self-expectation in nursing units explained 31.6% of team members' adaptivity, and self-reward in nursing units explained 16.8% of team members' proactivity. The results confirm that nurses' self-leadership affects not only individual self-leadership but also team members' work role performance. Accordingly, to improve nurses' work role performance in nursing units of nursing organizations, improvement in nursing environment based on self-leadership education is necessary and nurses' tasks rearranged so they can appreciate work-autonomy and challenges of work.

Roles of Carbohydrate Supply and Ethylene,Polyamines in Maize Kernel Set

Institute of Scientific and Technical Information of China (English)

Han-Yu Feng; Zhi-Min Wang; Fan-Na Kong; Min-Jie Zhang; Shun-Li Zhou

2011-01-01

Glucose appears to have an antagonistic relationship with ethylene and ethylene and polyaminesappear to play antagonistic roles in the abortion of seeds and fruits.Moreover,ethylene,spermidine,and spermine share a common biosynthetic precursor.The synchronous changes of them and therelationships with kernel set are currently unclear.Here,we stimulated maize(Zea mays L.)apical kernelset and studied their changes at 4,8,12,and 16 d after pollination(DAP).The status of the apicalkernels changed from abortion to set,showing a pattern similar to that of the middle kernels,withslow decrease in glucose and rapid decline in ethylene production,and a sharp increase in spermidineand spermine after four DAP.Synchronous changes in ethylene and spermidine were also observed.However,the ethylene production decreased slowly in the aborted apical kernels,the glucose andpolyamines concentrations were lower.Ethephon application did not block the change from abortion toset for the setting apical kernels.These data indicate that the developmental change may be accompaniedby an inhibition of adequate glucose to ethylene synthesis and subsequent promotion of spermidine andspermine synthesis,and adequate carbohydrate supply may play a key role in the developmental process.

A Cross-Country Comparison of Virtual Discussion Board Use in United States and Costa Rican Education Settings

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Hodge, Kari; Saxon, Terrill F.; Trumble, Jason

2013-01-01

The purpose of the current study was to compare the use of virtual discussion boards in various educational settings in the United States and Costa Rica. Participants included professors of education, in-service and pre-service teachers in the United States and Costa Rica where a survey was used that included demographic, knowledge, attitude, and…

Role and services of the Nuclear Energy Unit

International Nuclear Information System (INIS)

Ahmad Tajuddin bin Ali

1985-01-01

This article contains the research and development activities planned to be undertaken, and the services to be provided by the Nuclear Energy Unit. The fields of research have been selected to aid the development in the use of Nuclear Science and Technology, whilst the proposed services are geared towards widening the use to this technology in socio-economic development. Objectives in the research fields have been identified following a number of consultations with IAEA, foreign and local experts, and involved careful study of local requirements. The services provided will cater for all, especially institutions involved in nuclear technology both from the public and private sectors. This effort is in line with the role of the Unit as the national promoter and coordinator in the utilization of nuclear technology in the country

Detrital zircon provenance of the Hartselle Sandstone Unit, Southeastern USA: Insights into sediment source, paleogeography, and setting

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Harthy, M. A.; Gifford, J.

2017-12-01

The Hartselle sandstone is an excellent example of an Oil sand, a resource rich in bitumen. The unit is a light-colored thick-bedded to massive quartzose sandstone, that is widespread across an area from Georgia in the east to Mississippi in the west, and south from Alabama to Kentucky as a northern border. Formation thickness ranges from 0 to more than 150 feet. The unit has been stratigraphically dated to the Middle-Upper Mississippian age. One hypothesis suggests that the sandstone unit formed from the geological remains of barrier islands located in the ocean between Gondwana and Laurentia. The Hartselle is thought to have formed by the movement waves and currents along the shoreline, which carried sand and concentrated it into a set of northwest to southeast trending barrier islands. Transgression-regression events shifted the islands back and forth in relation to the position of the shoreline, leading to the large areal extent of the unit. However, the current data are not enough to explain the geographical position of the Hartselle sandstone unit as it is not running parallel to the ancient shoreline. Another mystery is the source of the sand, some believing the source was from the south (Gondwana) and others that erosion was from the north (Laurentia). Detrital zircon provenance analysis will address the uncertainty in sediment source. We will compare zircon U-Pb age spectra to possible Laurentian and Gondwanan source areas to discriminate between these possibilities. In addition, the age of the youngest detrital zircon population will provide additional constraints on the maximum age of deposition for the unit. These detrital ages will also help us to understand the tectonic setting at the time of Hartselle deposition. Lastly, we aim to explain the widespread nature of the unit and the processes involved in the formation of the Hartselle sandstone. When taken together, these interpretations will illuminate the age, depositional and tectonic setting of a

Setting Sight on Role Playing: To Accommodate or to Repudiate?

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Ika Apriani Fata

2016-11-01

Full Text Available To set sight on role play by means to look at EFL teacher’s experience and students’ perspectives of role play (RP technique enactment in teaching speaking by using qualitative design. This research was a qualitative study. It was discharged at a Senior high school in Banda Aceh, Indonesia. It provided work for the instrument of observation sheet, field notes and interview guide, and also questionnaire. The methodology designated the combination of four mountainsides to expose in-depth the urgency of role play in which applied since 1936. The result of interview was exposed that the English teacher claimed that role play was a technique applied to promote speaking and it was corroborated by the result of field note. Likewise, regarding students’ perspective depicted that the students indeed agreed on themselves of the usefulness of role play to enhance their speaking skill and motivation. Thus, Students asserted that the learning was more fun and enjoyable through role play itself. It is merely found in this research study that role playing can accommodate students’ need and teacher’s side in English language teaching. Nevertheless, this article applies a small subject as the participant. Therefore, the researchers recommended to have a deep look at reasoning students’ point of view in terms of role play technique implementation in non-English class. And see ascertains how beneficial it is in terms of role play (RP in a large classroom.

Patients' perceptions of their roles in goal setting in a spinal cord injury regional rehabilitation program.

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Draaistra, Harriett; Singh, Mina D; Ireland, Sandra; Harper, Theresa

2012-01-01

Goal setting is a common practice in rehabilitation, yet there is a paucity of literature exploring patients' perceptions of their roles in this process. This study was conducted using a qualitative descriptive methodology to explore patients' perceptions of their roles in setting goals in a spinal cord injury regional rehabilitation program. Imogene King's theory of goal attainment was used to frame the study. Data were collected through interviews and analyzed using a content analysis. The results revealed four themes: Visioning, Redefining, Brainstorming, and Rebuilding Participants (n = 13) envisioned their roles as setting an overarching priority goal, defining detailed rehabilitation goals, sharing knowledge with the team, and rebuilding skills to attain goals. Implications for nursing practice include the need to understand patients' experiences and perceptions, share knowledge, and support effective communication to promote collaborative goal setting. A need to enhance health professionals' education to fully understand factors influencing patients' abilities to set rehabilitation goals, and future research in methods to promote patients' engagement in goal setting was also clearly indicated.

[Need for the role of the patient's family members at the intensive care unit].

Science.gov (United States)

Aliberch Raurell, A M; Miquel Aymar, I M

2015-01-01

To know the current status for the role of family members in the intensive care unit and its evolution, analyzing areas for improvement and learning about the nursing role. This work is a literature review. The selected articles included two of the key words in their title. Articles before year 2000 were excluded, except some work of great interest. Family members lose their role and suffer a crisis when one of them is at the intensive care unit. Their normal role into the family changes or disappears. Obtaining a participation role increases satisfaction and decreases anxiety in relatives. Nursing professionals are essential in addressing this need. Solving the need for this role decreases anxiety and stress on relatives and patients. Their implication on the patient process enhances and helps professionals to know the patient's background. Copyright © 2014 Elsevier España, S.L.U. y SEEIUC. All rights reserved.

Leader performance evaluations and role congruity expectations in a community college setting

OpenAIRE

Trickey, Edward

2011-01-01

To investigate the relationships among evaluator attitudes, the role congruity biases many people consciously and unconsciously maintain, evaluation practices, perceptions of leader efficacy and success, and leader persistence in two community college settings, a mixed-methods study was conducted. Leaders are the products of their experiences, environments, the greater society within which they live, their personal attitudes and biases, and the attitudes and role biases of others. Over time, ...

Research on Role Sets and Emotional Relationships in Military Personnel Marriage

Science.gov (United States)

Murtazina, Elmira I.; Minullina, Aida F.

2016-01-01

An urgent demand of society to conduct effective work with the family substantiates the relevance of the research. The article provides the investigation of role sets and emotional relationships in marriage through the study of military personnel and nonmilitary personnel families. Practical implementation of psychological ideas represents one of…

Predictors of CPAP compliance in different clinical settings: primary care versus sleep unit.

Science.gov (United States)

Nadal, Núria; de Batlle, Jordi; Barbé, Ferran; Marsal, Josep Ramon; Sánchez-de-la-Torre, Alicia; Tarraubella, Nuria; Lavega, Merce; Sánchez-de-la-Torre, Manuel

2018-03-01

Good adherence to continuous positive airway pressure (CPAP) treatment improves the patient's quality of life and decreases the risk of cardiovascular disease. Previous studies that have analyzed the adherence to CPAP were performed in a sleep unit (SU) setting. The involvement of primary care (PC) in the management of obstructive sleep apnea (OSA) patients receiving CPAP treatment could introduce factors related to the adherence to treatment. The objective was to compare the baseline predictors of CPAP compliance in SU and PC settings. OSA patients treated with CPAP were followed for 6 months in SU or PC setting. We included baseline clinical and anthropometrical variables, the Epworth Sleep Scale (ESS) score, the quality of life index, and the Charlson index. A logistic regression was performed for each group to determine the CPAP compliance predictors. Discrimination and calibration were performed using the area under the curve and Hosmer-Lemeshow tests. We included 191 patients: 91 in the PC group and 100 in the SU group. In 74.9% of the patients, the compliance was ≥ 4 h per day, with 80% compliance in the SU setting and 69.2% compliance in the PC setting (p = 0.087). The predictors of CPAP compliance were different between SU and PC settings. Body mass index, ESS, and CPAP pressure were predictors in the SU setting, and ESS, gender, and waist circumference were predictors in the PC setting. The predictors of adequate CPAP compliance vary between SU and PC settings. Detecting compliance predictors could help in the planning of early interventions to improve CPAP adherence.

Valuing setting-based recreation for selected visitors to national forests in the southern United States.

Science.gov (United States)

Sardana, Kavita; Bergstrom, John C; Bowker, J M

2016-12-01

In this study we estimate selected visitors' demand and value for recreational trips to settings such as developed vs. undeveloped sites in U.S. national forests in the Southern United States using the travel cost method. The setting-based approach allows for valuation of multi-activity trips to particular settings. The results from an adjusted Poisson lognormal estimator corrected for truncation and endogenous stratification reveal that economic value per trip estimates are higher for wilderness compared to day-use developed settings, overnight-use developed settings, and general forest areas. Estimates of these economic values are important to resource managers because their management decisions and actions typically control recreational settings. For example, managers control developed campground capacity in a national forest, but typically not the number of campers below the capacity constraint and the number and types of activities visitors engage in during a multi-activity trip to a developed campground (within limits since some activities such as discharging a firearm are not permitted in a developed campground). Copyright © 2016 Elsevier Ltd. All rights reserved.

The Influence of Setting on Care Coordination for Childhood Asthma

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Kelly, R. Patrick; Stoll, Shelley C.; Bryant-Stephens, Tyra; Janevic, Mary R.; Lara, Marielena; Ohadike, Yvonne U.; Persky, Victoria; Ramos-Valencia, Gilberto; Uyeda, Kimberly; Malveaux, Floyd J.

2015-01-01

Asthma affects 7.1 million children in the United States, disproportionately burdening African American and Latino children. Barriers to asthma control include insufficient patient education and fragmented care. Care coordination represents a compelling approach to improve quality of care and address disparities in asthma. The sites of The Merck Childhood Asthma Network Care Coordination Programs implemented different models of care coordination to suit specific settings—school district, clinic or health care system, and community—and organizational structures. A variety of qualitative data sources were analyzed to determine the role setting played in the manifestation of care coordination at each site. There were inherent strengths and challenges of implementing care coordination in each of the settings, and each site used unique strategies to deliver their programs. The relationship between the lead implementing unit and entities that provided (1) access to the priority population and (2) clinical services to program participants played a critical role in the structure of the programs. The level of support and infrastructure provided by these entities to the lead implementing unit influenced how participants were identified and how asthma care coordinators were integrated into the clinical care team. PMID:26232778

The roles and functions of occupational health nurses in Brazil and in the United States.

Science.gov (United States)

Marziale, Maria Helena Palucci; Hong, Oi Saeng; Morris, Judy A; Rocha, Fernanda Ludmilla Rossi

2010-01-01

Cross-sectional exploratory research developed to outline the roles and functions of occupational health nurses (OHNs) in Brazil and compare them with those in the United States. The sample consisted of 154 Brazilian occupational health nurses. First, the instrument Job Analysis Survey of Occupational Health Nursing Practice was translated into Portuguese, followed by data collection and data analysis, comparing the results of the proposed study in Brazil with the findings of a job delineation study conducted in the United States. It was found that most were women, white, between 41 and 50 years of age and working primarily at hospitals or medical centers as clinicians and managers/administrators. Besides, it was found that most Brazilian OHNs spend more time in managerial roles, followed by consultant and educator responsibilities while, in the United States, OHNs spend significantly more time in education/advisory roles.

Role Strain, Part 2: Perceptions Among Athletic Trainers Employed in the Professional Practice Setting.

Science.gov (United States)

Romero, Manuel G; Pitney, William A; Mazerolle, Stephanie M; Brumels, Kirk

2018-02-01

  Athletic trainers (ATs) employed in the professional sport setting (ATPSSs) demonstrate moderate to high degrees of role strain. The experiences and perceptions of these ATs provide insight regarding the sources of role strain as well as ways to reduce it.   To investigate the perceptions of ATPSSs regarding role strain.   Qualitative study.   From a purposeful sampling of 389 ATs employed in the 5 major sport leagues (Major League Baseball, Major League Soccer, National Basketball Association, National Football League, and National Hockey League), we identified 34 participants willing to participate in phone interviews. Data Collection and Procedures:  Semistructured phone interviews. Inductive data analysis was based on a grounded theory approach. Credibility was addressed with member checks and a peer debriefing.   Three first-order emergent themes materialized from the data: (1) sources of role strain, (2) consequences of role strain, and (3) strategies to alleviate role strain in ATPSSs. Participants described the antecedents of role strain as emerging from the competing expectations of the professional athlete, the organization, and the sport league. Consequences of role strain included effects on direct patient care and work-life imbalance. Improving organizational factors such as inadequate staffing and poor communication within the organization were strategies described by participants for decreasing role strain in the professional sports setting.   Our participants discussed experiencing role strain, which was facilitated by trying to meet the competing demands placed on them with limited time and often with an inadequate support staff. Participant role strain affected health care and contributed to work-life imbalance. Participants described changing the organizational factors that contributed to role strain as a strategy to alleviate the perceived stress.

Developing the Role of a Health Information Professional in a Clinical Research Setting

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Helen M. Seeley

2010-06-01

Full Text Available Objective ‐ This paper examines the role of a health information professional in a large multidisciplinary project to improve services for head injury.Methods ‐ An action research approach was taken, with the information professional acting as co‐ordinator. Change management processes were guided by theory and evidence. The health information professional was responsible for an ongoing literature review on knowledge management (clinical and political issues, data collection and analysis (from patient records, collating and comparing data (to help develop standards, and devising appropriate dissemination strategies.Results ‐ Important elements of the health information management role proved to be 1 co‐ordination; 2 setting up mechanisms for collaborative learning through information sharing; and 3 using the theoretical frameworks (identified from the literature review to help guide implementation. The role that emerged here has some similarities to the informationist role that stresses domain knowledge, continuous learning and working in context (embedding. This project also emphasised the importance of co‐ordination, and the ability to work across traditional library information analysis (research literature discovery and appraisal and information analysis of patient data sets (the information management role.Conclusion ‐ Experience with this project indicates that health information professionals will need to be prepared to work with patient record data and synthesis of that data, design systems to co‐ordinate patient data collection, as well as critically appraise external evidence.

Midwives' experiences of labour care in midwifery units. A qualitative interview study in a Norwegian setting.

Science.gov (United States)

Skogheim, Gry; Hanssen, Tove A

2015-12-01

In some economically developed countries, women's choice of birth care and birth place is encouraged. The aim of this study was to explore and describe the experiences of midwives who started working in alongside/free-standing midwifery units (AMU/FMU) and their experiences with labour care in this setting. A qualitative explorative design using a phenomenographic approach was used. Semi-structured interviews were conducted with ten strategically sampled midwives working in midwifery units. The analysis revealed the following five categories of experiences noted by the midwives: mixed emotions and de-learning obstetric unit habits, revitalising midwifery philosophy, alertness and preparedness, presence and patience, and coping with time. Starting to work in an AMU/FMU can be a distressing period for a midwife. First, it may require de-learning the medical approach to birth, and, second, it may entail a revitalisation (and re-learning) of birth care that promotes physiological birth. Midwifery, particularly in FMUs, requires an especially careful assessment of the labouring process, the ability to be foresighted, and capability in emergencies. The autonomy of midwives may be constrained also in AMUs/FMUs. However, working in these settings is also viewed as experiencing "the art of midwifery" and enables revitalisation of the midwifery philosophy. Copyright © 2015 Elsevier B.V. All rights reserved.

Experiences of Nigerian Internationally Educated Nurses Transitioning to United States Health Care Settings.

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Iheduru-Anderson, Kechinyere C; Wahi, Monika M

2018-04-01

Successful transition to practice of internationally educated nurses (IENs) can critically affect quality of care. The aim of this study was to characterize the facilitators and barriers to transition of Nigerian IENs (NIENs) to the United States health care setting. Using a descriptive phenomenology approach, 6 NIENs were interviewed about their transitional experiences in the United States. Thematic methods were used for data analysis. The three major themes identified from the participants' stories were "fear/anger and disappointment" (FAD), "road/journey to success/overcoming challenges" (RJO), and "moving forward" (MF). The FAD theme predominated, including experiences of racism, bullying, and inequality. The RJO theme included resilience, and the MF theme encompassed personal growth. NIENs face personal and organizational barriers to adaptation, especially fear, anger and disappointment. Future research should seek to develop a model for optimal adaptation that focuses on improving both personal and organizational facilitators and decreasing barriers.

A comprehensive dwelling unit choice model accommodating psychological constructs within a search strategy for consideration set formation.

Science.gov (United States)

2015-12-01

This study adopts a dwelling unit level of analysis and considers a probabilistic choice set generation approach for residential choice modeling. In doing so, we accommodate the fact that housing choices involve both characteristics of the dwelling u...

Mobile Unit and Its Role in the Case of Nuclear Emergencies

International Nuclear Information System (INIS)

Franic, Z.

1998-01-01

Emergency response mobile units play a significant role in the case of nuclear emergencies. The functioning and practice of such teams depend on the nature and phase of the nuclear emergency. In the acute phase, several teams with good navigational and communication abilities performing simple measurements can provide essential data for characterization of plume location and its magnitude. Therefore, such activities are complemental with the network of telemetric radiation monitors. However, in the late phase of an accident, in order to gather reliable data needed for utilization of remedial and recovery measures, a better equipped mobile units are necessary. (author)

On Fréchet theorem in the set of measure preserving functions over the unit interval

Directory of Open Access Journals (Sweden)

So-Hsiang Chou

1990-01-01

Full Text Available In this paper, we study the Fréchet theorem in the set of measure preserving functions over the unit interval and show that any measure preserving function on [0,1] can be approximated by a sequence of measure preserving piecewise linear continuous functions almost everywhere. Some application is included.

From agenda-setting to implementation: The role of multisectoral partnerships in addressing urban climate risks

Science.gov (United States)

Surminski, Swenja; Leck, Hayley

2017-10-01

Multisectoral partnerships (MSPs) form an increasingly popular and important part of the global climate and disaster risk governance landscape, but the literature offers little critical investigation of this phenomenon. In particular it remains unclear how MSPs can support the transition from agenda setting to implementation in response to multiple current and future pressures threatening the resilience of cities. Through the lens of the London Climate Change Partnership (LCCP) and drawing from other MSP examples, this paper investigates the scope for MSPs to enhance climate adaptation in an urban context. Our paper has two main aims: to expand understanding of the role of MSPs in the adaptation decision process in the context of the wider governance literature, and to shed some light on the complexities of transitioning through that process. To clarify the role of a MSP we propose a distinction between "first generation" and "second generation" MSPs, illustrating the progression from agenda-setting to implementation: "first generation" MSPs are focused on agenda setting and knowledge sharing in order to support decision makers, while "second generation" MSPs are aimed at implementing solutions. We consider this distinction from the perspective of the individual members and their perceptions, motivations, and expectations. We find that the dynamic nature of urban adaptation with a shifting focus from initial agenda setting toward the implementation of actions presents challenges for existing MSPs, particularly such long-established ones like the LCCP. Our investigation shows that "first generation" MSPs can play important roles in agenda setting, but finds little evidence of "second generation" MSPs achieving implementation.

Productivity Effects of United States Multinational Enterprises : The Roles of Market Orientation and Regional Integration

NARCIS (Netherlands)

Smeets, Roger; Wei, Yingqi

2010-01-01

Smeets R. and Wei Y. Productivity effects of United States multinational enterprises: the roles of market orientation and regional integration, Regional Studies. This paper considers the role of market orientation and regional integration in foreign direct investment (FDI) productivity effects.

The Cultural Influence in Accounting Standard Setting: A Comparative Analysis of the United States, Canada, and England.

Science.gov (United States)

Bloom, Robert; And Others

A study of the processes for establishing the principles and policies of measurement and disclosure in preparing financial reports examines differences in these processes in the United States, Canada, and England. Information was drawn from international accounting literature on standard setting. The differences and similarities in the…

Nurse managers' decision-making in daily unit operation in peri-operative settings: a cross-sectional descriptive study.

Science.gov (United States)

Siirala, Eriikka; Peltonen, Laura-Maria; Lundgrén-Laine, Heljä; Salanterä, Sanna; Junttila, Kristiina

2016-09-01

To describe the tactical and the operational decisions made by nurse managers when managing the daily unit operation in peri-operative settings. Management is challenging as situations change rapidly and decisions are constantly made. Understanding decision-making in this complex environment helps to develop decision support systems to support nurse managers' operative and tactical decision-making. Descriptive cross-sectional design. Data were collected from 20 nurse managers with the think-aloud method during the busiest working hours and analysed using thematic content analysis. Nurse managers made over 700 decisions; either ad hoc (n = 289), near future (n = 268) or long-term (n = 187) by nature. Decisions were often made simultaneously with many interruptions. Ad hoc decisions covered staff allocation, ensuring adequate staff, rescheduling surgical procedures, confirmation tangible resources and following-up the daily unit operation. Decisions in the near future were: planning of surgical procedures and tangible resources, and planning staff allocation. Long-term decisions were: human recourses, nursing development, supplies and equipment, and finances in the unit. Decision-making was vulnerable to interruptions, which sometimes complicated the managing tasks. The results can be used when planning decision support systems and when defining the nurse managers' tasks in peri-operative settings. © 2016 John Wiley & Sons Ltd.

Role of Social Protection Unit District Cilacap

Directory of Open Access Journals (Sweden)

Gunawan

2015-12-01

Full Text Available Implementation of security and peace, order and protection of the people especially those who are within the settlement is the duty and responsibility of member units of community protection (Satlinmas, and what happens when members Satlinmas in carrying out its duties and functions not supported by the human resources of adequate quality and quantity , so the expectations and desires of the community to get security and peace, order and public protection are not met in full and result in (Satlinmas presence cannot be felt by the community. The method used in this study using qualitative research with descriptive analysis, the data obtained through documentation, observation, and interviews, sample locations were selected based on purposive sample of Cilacap, Cilacap is a district that has accommodated the institutional Linmas the organizational structure of Civil Service Police Unit and a barometer for other regions in the implementation of the enforcement of local regulations. The purpose of the study wanted to know how far Satlinmas can act in accordance with its duties and functions. Research results that Satlinmas role in organizing disaster management, the handling of security, peace and order, protection of the public at the district level are generally already be implemented, but at the neighbourhood level and harmonious citizens tasks and functions are yet to be implemented optimally.

Environmental and hydrologic setting of the Ozark Plateaus study unit, Arkansas, Kansas, Missouri, and Oklahoma

Science.gov (United States)

Adamski, James C.; Petersen, James C.; Freiwald, David A.; Davis, Jerri V.

1995-01-01

The environmental and hydrologic setting of the Ozark Plateaus National Water-Quality Assessment (NAWQA) study unit and the factors that affect water quality are described in this report. The primary natural and cultural features that affect water- quality characteristics and the potential for future water-quality problems are described. These environmental features include climate, physio- graphy, geology, soils, population, land use, water use, and surface- and ground-water flow systems. The study-unit area is approximately 47,600 square miles and includes most of the Ozark Plateaus Province and parts of the adjacent Osage Plains and Mississippi Alluvial Plain in parts of Arkansas, Kansas, Missouri, and Oklahoma. The geology is characterized by basement igneous rocks overlain by a thick sequence of dolomites, limestones, sandstones, and shales of Paleozoic age. Land use in the study unit is predominantly pasture and forest in the southeastern part, and pasture and cropland in the northwestern part. All or part of the White, Neosho-lllinois, Osage, Gasconade, Meramec, St. Francis, and Black River Basins are within the study unit. Streams in the Boston Mountains contain the least mineralized water, and those in the Osage Plains contain the most mineralized water. The study unit contains eight hydrogeologic units including three major aquifers--the Springfield Plateau, Ozark, and St. Francois aquifers. Streams and aquifers in the study unit generally contain calcium or calcium-magnesium bicarbonate waters. Ground- and surface-water interactions are greatest in the Salem and Springfield Plateaus and least in the Boston Mountains and Osage Plains. Geology, land use, and population probably are the most important environmental factors that affect water quality.

Magic, science and masculinity: marketing toy chemistry sets.

Science.gov (United States)

Al-Gailani, Salim

2009-12-01

At least since the late nineteenth century, toy chemistry sets have featured in standard scripts of the achievement of eminence in science, and they remain important in constructions of scientific identity. Using a selection of these toys manufactured in Britain and the United States, and with particular reference to the two dominant American brands, Gilbert and Chemcraft, this paper suggests that early twentieth-century chemistry sets were rooted in overlapping Victorian traditions of entertainment magic and scientific recreations. As chemistry set marketing copy gradually reoriented towards emphasising scientific modernity, citizenship, discipline and educational value, pre-twentieth-century traditions were subsumed within domestic-and specifically masculine-tropes. These developments in branding strategies point to transformations in both users' engagement with their chemistry sets and the role of scientific toys in domestic play. The chemistry set serves here as a useful tool for measuring cultural change and lay engagement with chemistry.

The Role of Proprioception in the Sagittal Setting of Anticipatory Postural Adjustments During Gait Initiation

Directory of Open Access Journals (Sweden)

Pereira Marcelo P.

2015-12-01

Full Text Available Purpose. Previous studies have studied the role of proprioception on the setting of anticipatory postural adjustments (APA during gait initiation. However, these studies did not investigate the role of proprioception in the sagittal APA setting. We aimed to investigate the role of proprioception manipulation to induce APA sagittal adaptations on gait initiation. Methods. Fourteen healthy adults performed gait initiation without, and with, vibration applied before movement onset, and during movement. In addition, the effects of two different vibration frequencies (80 and 120Hz were tested. Vibration was applied bilaterally on the tibialis anterior, rectus femoris and trapezius superior. The first step characteristics, ground reaction forces and CoP behaviour were assessed. Results. Vibration improved gait initiation performance regardless of the moment it was applied. CoP velocity during the initial phase of APA was increased by vibration only when it was applied before movement. When vibration was applied to disturb the movement, no effects on the CoP behaviour were observed. Manipulation of vibration frequency had no effects. Conclusions. Rather than proprioception manipulation, the results suggest that post-vibratory effects and attentional mechanisms were responsible for our results. Taken together, the results show that sagittal APA setting is robust to proprioception manipulation.

The Role of eHealth in Optimizing Preventive Care in the Primary Care Setting.

Science.gov (United States)

Carey, Mariko; Noble, Natasha; Mansfield, Elise; Waller, Amy; Henskens, Frans; Sanson-Fisher, Rob

2015-05-22

Modifiable health risk behaviors such as smoking, overweight and obesity, risky alcohol consumption, physical inactivity, and poor nutrition contribute to a substantial proportion of the world's morbidity and mortality burden. General practitioners (GPs) play a key role in identifying and managing modifiable health risk behaviors. However, these are often underdetected and undermanaged in the primary care setting. We describe the potential of eHealth to help patients and GPs to overcome some of the barriers to managing health risk behaviors. In particular, we discuss (1) the role of eHealth in facilitating routine collection of patient-reported data on lifestyle risk factors, and (2) the role of eHealth in improving clinical management of identified risk factors through provision of tailored feedback, point-of-care reminders, tailored educational materials, and referral to online self-management programs. Strategies to harness the capacity of the eHealth medium, including the use of dynamic features and tailoring to help end users engage with, understand, and apply information need to be considered and maximized. Finally, the potential challenges in implementing eHealth solutions in the primary care setting are discussed. In conclusion, there is significant potential for innovative eHealth solutions to make a contribution to improving preventive care in the primary care setting. However, attention to issues such as data security and designing eHealth interfaces that maximize engagement from end users will be important to moving this field forward.

A Commentary on "The Role of the Unit in Physics and Psychometrics" by Stephen Humphry

Science.gov (United States)

Andrich, David

2011-01-01

This commentary examines the role of the unit from the perspective of the definition of measurement in physics as the ratio of two magnitudes, one of which is defined as the unit; it is an important and timely contribution to measurement in the social sciences. There are many different points that could be commented upon, but the author will…

Using CollaboRATE, a brief patient-reported measure of shared decision making: Results from three clinical settings in the United States.

Science.gov (United States)

Forcino, Rachel C; Barr, Paul J; O'Malley, A James; Arend, Roger; Castaldo, Molly G; Ozanne, Elissa M; Percac-Lima, Sanja; Stults, Cheryl D; Tai-Seale, Ming; Thompson, Rachel; Elwyn, Glyn

2018-02-01

CollaboRATE is a brief patient survey focused on shared decision making. This paper aims to (i) provide insight on facilitators and challenges to implementing a real-time patient survey and (ii) evaluate CollaboRATE scores and response rates across multiple clinical settings with varied patient populations. All adult patients at three United States primary care practices were eligible to complete CollaboRATE post-visit. To inform key learnings, we aggregated all mentions of unanticipated decisions, problems and administration errors from field notes and email communications. Mixed-effects logistic regression evaluated the impact of site, clinician, patient age and patient gender on the CollaboRATE score. While CollaboRATE score increased only slightly with increasing patient age (OR 1.018, 95% CI 1.014-1.021), female patient gender was associated with significantly higher CollaboRATE scores (OR 1.224, 95% CI 1.073-1.397). Clinician also predicts CollaboRATE score (random effect variance 0.146). Site-specific factors such as clinical workflow and checkout procedures play a key role in successful in-clinic implementation and are significantly related to CollaboRATE scores, with Site 3 scoring significantly higher than Site 1 (OR 1.759, 95% CI 1.216 to 2.545) or Site 2 (z=-2.71, 95% CI -1.114 to -0.178). This study demonstrates that CollaboRATE can be used in diverse primary care settings. A clinic's workflow plays a crucial role in implementation. Patient experience measurement risks becoming a burden to both patients and administrators. Episodic use of short measurement tools could reduce this burden. © 2017 The Authors Health Expectations Published by John Wiley & Sons Ltd.

Increased mechanical cost of walking in children with diplegia: the role of the passenger unit cannot be neglected.

Science.gov (United States)

Van de Walle, P; Hallemans, A; Truijen, S; Gosselink, R; Heyrman, L; Molenaers, G; Desloovere, K

2012-01-01

Gait efficiency in children with cerebral palsy is decreased. To date, most research did not include the upper body as a separate functional unit when exploring these changes in gait efficiency. Since children with spastic diplegia often experience problems with trunk control, they could benefit from separate evaluation of the so-called 'passenger unit'. Therefore, the aim of the current study was to improve insights in the role of the passenger unit in decreased gait efficiency in children with diplegia. Mechanical cost of walking was investigated by calculating work by the integrated joint power approach in 18 children with diplegia and 25 age-related typical developing controls. The total mechanical work in children with diplegia was 1.5 times higher than in typical children. In children with diplegia work at the lower limbs was increased by 37% compared to typical children. Substantially higher increases, up to 222%, were noted at the passenger unit. Trunk and head were the main contributors to the increased work of the passenger unit, but the role of the arms cannot be neglected. Due to these disproportional increases in locomotor and passenger unit, the demands of the passenger unit in pathological gait can no longer be considered minor, as in typical gait. Therefore, the role of the passenger unit must be recognized in the decrease of gait efficiency in children with spastic diplegia and should be part of the evaluation of gait efficiency in clinical practice. Copyright © 2012 Elsevier Ltd. All rights reserved.

Work-Family Conflict, Resources, and Role Set Density: Assessing Their Effects on Distress among Working Mothers

Science.gov (United States)

Kulik, Liat; Liberman, Gabriel

2013-01-01

We explored the relationships between the experience of work-family conflict and levels of distress in the family and at work among a sample of 227 Israeli working mothers. We also examined how role set density (RSD, the number of roles they perform) and personal and environmental resources are related to the women's experience of distress.…

The influence of role models in undergraduate nurse education.

Science.gov (United States)

Jack, Kirsten; Hamshire, Claire; Chambers, Alison

2017-12-01

To explore the concept of role modelling in undergraduate nurse education and its effect on the personal and professional development of student nurses. Effective educative strategies are important for student nurses, who have to cope with learning in both clinical and university settings. Given the contemporary issues facing nurse education and practice in the United Kingdom (UK), it is timely and important to undertake pedagogical research into the concept of role modelling as an effective educative method. A descriptive narrative approach. Unstructured interviews were conducted with 14 current/recently discontinued students from Adult and Mental Health branches of nursing degree programmes in the north-west region of England, United Kingdom (UK). Data were thematically analysed. Students valued exposure to positive role models in clinical and university settings and viewed them as beneficial to their learning. Exposure to negative role models occurred, and this provided students with opportunities to consider the type of nurse they aspired to become. In some cases, students' exposure to perceived poor practice had an adverse effect on their learning and led to negative feelings about nursing work. Clinical staff might be perceived as more relevant role models than those in the university setting although there were still opportunities for academic staff to model professional behaviours. The study found that role modelling is an effective way to support learning and led to student satisfaction across both clinical and university settings. The findings support the use of role models in nurse education, and further research about conscious positive modelling of practice is required. Exploring the use of role models is important when examining ways in which the quality of nurse education might be developed. © 2017 John Wiley & Sons Ltd.

The Role of Equivalence and Order Relations in the Development and Coordination of the Concepts of Unit Size and Number of Units in Selected Conservation Type Measurement Problems.

Science.gov (United States)

Carpenter, Thomas P.

The major purpose of this study was 1) to investigate the development of the concept of a unit of measure and the coordination of unit size and the number of units 2) to relate this development to the development of conservation and 3) to determine the role of equivalence and nonequivalence relations in certain conservation and measurement…

The role of leader behaviors in hospital-based emergency departments' unit performance and employee work satisfaction.

Science.gov (United States)

Lin, Blossom Yen-Ju; Hsu, Chung-Ping C; Juan, Chi-Wen; Lin, Cheng-Chieh; Lin, Hung-Jung; Chen, Jih-Chang

2011-01-01

The role of the leader of a medical unit has evolved over time to expand from simply a medical role to a more managerial one. This study aimed to explore how the behavior of a hospital-based emergency department's (ED's) leader might be related to ED unit performance and ED employees' work satisfaction. One hundred and twelve hospital-based EDs in Taiwan were studied: 10 in medical centers, 32 in regional hospitals, and 70 in district hospitals. Three instruments were designed to assess leader behaviors, unit performance and employee satisfaction in these hospital-based EDs. A mail survey revealed that task-oriented leader behavior was positively related to ED unit performance. Both task- and employee-oriented leader behaviors were found to be positively related to ED nurses' work satisfaction. However, leader behaviors were not shown to be related to ED physicians' work satisfaction at a statistically significant level. Some ED organizational characteristics, however, namely departmentalization and hospital accreditation level, were found to be related to ED physicians' work satisfaction. Copyright © 2010 Elsevier Ltd. All rights reserved.

Polish Phoneme Statistics Obtained On Large Set Of Written Texts

Directory of Open Access Journals (Sweden)

Bartosz Ziółko

2009-01-01

Full Text Available The phonetical statistics were collected from several Polish corpora. The paper is a summaryof the data which are phoneme n-grams and some phenomena in the statistics. Triphonestatistics apply context-dependent speech units which have an important role in speech recognitionsystems and were never calculated for a large set of Polish written texts. The standardphonetic alphabet for Polish, SAMPA, and methods of providing phonetic transcriptions are described.

Navigating Motherhood and the Role of the Head Athletic Trainer in the Collegiate Setting

Science.gov (United States)

Mazerolle, Stephanie M.; Eason, Christianne M.

2016-01-01

Context:  Motherhood has been identified as a barrier to the head athletic trainer (AT) position. Role models have been cited as a possible facilitator for increasing the number of women who pursue and maintain this role in the collegiate setting. Objective:  To examine the experiences of female ATs balancing motherhood and head AT positions in the National Collegiate Athletic Association Division II and III and National Association of Intercollegiate Athletics settings. Design:  Qualitative study. Setting:  National Collegiate Athletic Association Divisions II and III and National Association of Intercollegiate Athletics. Patients or Other Participants:  A total of 22 female head ATs (average age = 40 ± 8 years) who were married with children completed our study. Our participants had been certified for 15.5 ± 7.5 years and in their current positions as head ATs for 9 ± 8 years. Data Collection and Analysis:  We conducted online interviews with all participants. Participants journaled their reflections on a series of open-ended questions pertaining to their experiences as head ATs. Data were analyzed following a general inductive approach. Credibility was confirmed through peer review and researcher triangulation. Results:  We identified 3 major contributors to work-life conflict. Two speak to organizational influences on conflict: work demands and time of year. The role of motherhood, which was more of a personal contributor, also precipitated conflict for our ATs. Four themes emerged as work-life balance facilitators: planning, attitude and perspective, support networks, and workplace integration. Support was defined at both the personal and professional levels. Conclusions:  In terms of the organization, our participants juggled long work hours, travel, and administrative tasks. Individually and socioculturally, they overcame their guilt and their need to be present and an active part of the parenting process. These mothers demonstrated the

Price Setting Transactions and the Role of Denominating Currency in FX Markets

OpenAIRE

Friberg, Richard; Wilander, Fredrik

2007-01-01

This report, commissioned by Sveriges Riksbank, examines the role of currency denomination in international trade transactions. It is divided in two parts. The first part consists of a survey of the price setting and payment practices of a large sample of Swedish exporting firms. The second part analyzes payments data from the Swedish settlement reports from 1999-2002. We examine whether invoicing patterns of Swedish and European companies changed following the creation of the EMU and how the...

Community Intellectual Disability Nurses' Public Health Roles in the United Kingdom: An Exploratory Documentary Analysis

Science.gov (United States)

Mafuba, Kay; Gates, Bob; Cozens, Maria

2018-01-01

The aim of this study was to explore how public health policy in the United Kingdom was reflected in community intellectual disability nurses' (CIDNs)' job descriptions and person's specifications. The role of CIDNs has evolved due to policy changes. As these roles evolve, job descriptions and person specifications are important in highlighting…

Impact of role-, job- and organizational characteristics on Nursing Unit Managers' work related stress and well-being.

Science.gov (United States)

Van Bogaert, Peter; Adriaenssens, Jef; Dilles, Tinne; Martens, Daisy; Van Rompaey, Bart; Timmermans, Olaf

2014-11-01

To study the impact of role, job- and organizational characteristics on nurse managers' work related stress and well-being such as feelings of emotional exhaustion, work engagement, job satisfaction and turnover intention. Various studies investigated role-, job- and organizational characteristics influencing nurse-related work environments. Research on nurse managers' related work environments define influencing factors, but, a clear understanding of the impact of nurse-managers' work-environment characteristics on their work related stress and well-being is limited. A cross-sectional design with a survey. A cross-sectional survey (N = 365) was carried out between December 2011-March 2012. The questionnaire was based on various validated measurement instruments identified by expert meetings (e.g. staff nurses, nurse managers and executives and physicians). Hierarchical regression analyses were performed using emotional exhaustion, work engagement, job satisfaction and turnover intentions as outcome variables. Study results showed one out of six nursing unit managers have high to very high feelings of emotional exhaustion and two out of three respondents have high to very high work engagement. Hierarchical regression models showed that role conflict and role meaningfulness were strong predictors of nursing unit managers' work related stress and well-being, alongside with job- and organizational characteristics. Several risk factors and stimulating factors influencing nurse unit managers' work related stress and well-being were identified. Further challenges will be to develop proper interventions and strategies to support nursing unit managers and their team in daily practice to deliver the best and safest patient care. © 2014 John Wiley & Sons Ltd.

The role of the United Nations in the field of verification

International Nuclear Information System (INIS)

1991-01-01

By resolution 43/81 B of 7 December 1988, the General Assembly requested the Secretary General to undertake, with the assistance of a group of qualified governmental experts, an in-depth study of the role of the United Nations in the field of verification. In August 1990, the Secretary-General transmitted to the General Assembly the unanimously approved report of the experts. The report is structured in six chapters and contains a bibliographic appendix on technical aspects of verification. The Introduction provides a brief historical background on the development of the question of verification in the United Nations context, culminating with the adoption by the General Assembly of resolution 43/81 B, which requested the study. Chapters II and III address the definition and functions of verification and the various approaches, methods, procedures and techniques used in the process of verification. Chapters IV and V examine the existing activities of the United Nations in the field of verification, possibilities for improvements in those activities as well as possible additional activities, while addressing the organizational, technical, legal, operational and financial implications of each of the possibilities discussed. Chapter VI presents the conclusions and recommendations of the Group

Informational Element of Power: The Role of Public Diplomacy in United States-Cuba Policy Implementation

National Research Council Canada - National Science Library

Andujar, Roberto C

2005-01-01

THESIS: The United States should reassess its Public Diplomacy strategy toward Cuba and the key role that Public Diplomacy plays in preparing the Cuban people to transition to a free and democratic state. RATIONALE...

The Role of Cognitive Factors in Predicting Balance and Fall Risk in a Neuro-Rehabilitation Setting.

Science.gov (United States)

Saverino, A; Waller, D; Rantell, K; Parry, R; Moriarty, A; Playford, E D

2016-01-01

There is a consistent body of evidence supporting the role of cognitive functions, particularly executive function, in the elderly and in neurological conditions which become more frequent with ageing. The aim of our study was to assess the role of different domains of cognitive functions to predict balance and fall risk in a sample of adults with various neurological conditions in a rehabilitation setting. This was a prospective, cohort study conducted in a single centre in the UK. 114 participants consecutively admitted to a Neuro-Rehabilitation Unit were prospectively assessed for fall accidents. Baseline assessment included a measure of balance (Berg Balance Scale) and a battery of standard cognitive tests measuring executive function, speed of information processing, verbal and visual memory, visual perception and intellectual function. The outcomes of interest were the risk of becoming a faller, balance and fall rate. Two tests of executive function were significantly associated with fall risk, the Stroop Colour Word Test (IRR 1.01, 95% CI 1.00-1.03) and the number of errors on part B of the Trail Making Test (IRR 1.23, 95% CI 1.03-1.49). Composite scores of executive function, speed of information processing and visual memory domains resulted in 2 to 3 times increased likelihood of having better balance (OR 2.74 95% CI 1.08 to 6.94, OR 2.72 95% CI 1.16 to 6.36 and OR 2.44 95% CI 1.11 to 5.35 respectively). Our results show that specific subcomponents of executive functions are able to predict fall risk, while a more global cognitive dysfunction is associated with poorer balance.

The Role of Cognitive Factors in Predicting Balance and Fall Risk in a Neuro-Rehabilitation Setting.

Directory of Open Access Journals (Sweden)

A Saverino

Full Text Available There is a consistent body of evidence supporting the role of cognitive functions, particularly executive function, in the elderly and in neurological conditions which become more frequent with ageing. The aim of our study was to assess the role of different domains of cognitive functions to predict balance and fall risk in a sample of adults with various neurological conditions in a rehabilitation setting.This was a prospective, cohort study conducted in a single centre in the UK. 114 participants consecutively admitted to a Neuro-Rehabilitation Unit were prospectively assessed for fall accidents. Baseline assessment included a measure of balance (Berg Balance Scale and a battery of standard cognitive tests measuring executive function, speed of information processing, verbal and visual memory, visual perception and intellectual function. The outcomes of interest were the risk of becoming a faller, balance and fall rate.Two tests of executive function were significantly associated with fall risk, the Stroop Colour Word Test (IRR 1.01, 95% CI 1.00-1.03 and the number of errors on part B of the Trail Making Test (IRR 1.23, 95% CI 1.03-1.49. Composite scores of executive function, speed of information processing and visual memory domains resulted in 2 to 3 times increased likelihood of having better balance (OR 2.74 95% CI 1.08 to 6.94, OR 2.72 95% CI 1.16 to 6.36 and OR 2.44 95% CI 1.11 to 5.35 respectively.Our results show that specific subcomponents of executive functions are able to predict fall risk, while a more global cognitive dysfunction is associated with poorer balance.

Alleviating gender role strain in adult men with traumatic brain injury: an evaluation of a set of guidelines for occupational therapy.

Science.gov (United States)

Gutman, S A

1999-01-01

A set of guidelines to assist men with traumatic brain injury (TBI) to alleviate gender role strain was assessed to determine its effectiveness and acceptability to participants. Four adult male participants with TBI received the intervention (the set of guidelines) for 4 months. The intervention consisted of rebuilding self-identified gendered social roles and activities. Focused interviews and participant observation were used to determine whether gender role strain changed after intervention. The participants reported that the intervention enabled them to (a) enhance their gender role satisfaction through newly rebuilt roles and activities, (b) attain certain long-held personal goals, (c) feel more like members of society, (d) perceive a greater congruency between their internal self-images and external postinjury roles, (e) learn more about personal skills and values as men, (f) feel more comfortable using help-seeking behaviors, (g) feel a sense of shared experience and affinity, (h) feel more understood and accepted, and (i) contribute to others through community member roles. The set of guidelines for alleviating gender role strain was effective in assisting these participants to enhance their gender role satisfaction through rebuilding desired male-gendered social roles and activities. Dating, courtship, extended family member, community member, friend, and mentor-protege roles, lost as a result of TBI, were rebuilt through gender-neutral activities that facilitated a sense of volitional control, competency, and normalcy. Nonetheless, the men continued to lack desired rites of passage leading from male adolescence to adulthood.

Enhanced Decision Support Systems in Intensive Care Unit Based on Intuitionistic Fuzzy Sets

Directory of Open Access Journals (Sweden)

Hanen Jemal

2017-01-01

Full Text Available In areas of medical diagnosis and decision-making, several uncertainty and ambiguity shrouded situations are most often imposed. In this regard, one may well assume that intuitionistic fuzzy sets (IFS should stand as a potent technique useful for demystifying associated with the real healthcare decision-making situations. To this end, we are developing a prototype model helpful for detecting the patients risk degree in Intensive Care Unit (ICU. Based on the intuitionistic fuzzy sets, dubbed Medical Intuitionistic Fuzzy Expert Decision Support System (MIFEDSS, the shown work has its origins in the Modified Early Warning Score (MEWS standard. It is worth noting that the proposed prototype effectiveness validation is associated through a real case study test at the Polyclinic ESSALEMA cited in Sfax, Tunisia. This paper does actually provide some practical initial results concerning the system as carried out in real life situations. Indeed, the proposed system turns out to prove that the MIFEDSS does actually display an imposing capability for an established handily ICU related uncertainty issues. The performance of the prototypes is compared with the MEWS standard which exposed that the IFS application appears to perform highly better in deferring accuracy than the expert MEWS score with higher degrees of sensitivity and specificity being recorded.

Gender, sex role ideology, and self-esteem among East Asian immigrants in the United States.

Science.gov (United States)

Barry, Declan T; Bernard, Matthew J; Beitel, Mark

2006-09-01

This study examined the relationship between gender, sex role ideology, and self-esteem among 170 (88 male, 82 female) East Asian immigrants in the United States. Participants were administered a battery of psychometrically established measures. Men and women did not differ on personal or collective self-esteem (CSE). Women who endorsed traditional sex roles were significantly more likely to report higher private, identity, and total CSE. Personal self-esteem was a significant independent predictor of traditional sex role for women. Participants who endorsed sex role equality were significantly more likely to report public, membership, and total CSE. Sex role equality was associated with enhanced private CSE for men and attenuated personal self-esteem for women. These findings point to the importance of assessing multiple facets of self-esteem, which appear to be differentially associated with sex role ideology for men and women.

Sex trafficking of adolescents and young adults in the United States: healthcare provider's role.

Science.gov (United States)

Chaffee, Tonya; English, Abigail

2015-10-01

Sex trafficking of adolescents and young adults is both a human rights violation and a public health problem, globally and in the United States. Healthcare providers, including obstetricians and gynecologists, interact with victims, often while they remain under their traffickers' control, but because of providers' lack of training in identification and response many victims go unrecognized and unaided. This review provides an overview of the definitions of sex trafficking and commercial sexual exploitation, contributing factors, health consequences, recruitment of victims, and identification and response by healthcare providers. The literature on definitions and risk factors associated with sex trafficking is growing; however, literature on healthcare providers' role in addressing sex trafficking remains more limited. It is increasingly recognized that healthcare providers have an important role in victim identification and response and as advocates, collaborating with national, regional, and local agencies to increase awareness of sex trafficking as a public health problem and to address the needs of adolescent and young adult victims and survivors globally and in the United States. As professionals who interact with adolescent and young adult victims of sex trafficking, healthcare providers have an important role: in collaboration with other professionals and agencies they can help to identify, respond to, extricate, protect, and advocate for victims and survivors.

The Role of Cognitive Factors in Predicting Balance and Fall Risk in a Neuro-Rehabilitation Setting

OpenAIRE

Saverino, A.; Waller, D.; Rantell, K.; Parry, R.; Moriarty, A.; Playford, E. D.

2016-01-01

Introduction\\ud \\ud There is a consistent body of evidence supporting the role of cognitive functions, particularly executive function, in the elderly and in neurological conditions which become more frequent with ageing. The aim of our study was to assess the role of different domains of cognitive functions to predict balance and fall risk in a sample of adults with various neurological conditions in a rehabilitation setting.\\ud \\ud Methods\\ud \\ud This was a prospective, cohort study conduct...

Progressing recovery-oriented care in psychiatric inpatient units: Occupational therapy’s role in supporting a stronger peer workforce

Directory of Open Access Journals (Sweden)

Chris Lloyd

2017-10-01

Full Text Available Purpose - Initiated by the service user movement, recovery-oriented practices are one of the keystones of modern mental health care. Over the past two decades, substantial gains have been made with introducing recovery-oriented practice in many areas of mental health practice, but there remain areas where progress is delayed, notably, the psychiatric inpatient environment. The peer support workforce can play a pivotal role in progressing recovery-oriented practices. The purpose of this paper is to provide a pragmatic consideration of how occupational therapists can influence mental health systems to work proactively with a peer workforce. Design/methodology/approach - The authors reviewed current literature and considered practical approaches to building a peer workforce in collaboration with occupational therapists. Findings - It is suggested that the peer support workforce should be consciously enhanced in the inpatient setting to support culture change as a matter of priority. Occupational therapists working on inpatient units should play a key role in promoting and supporting the growth in the peer support workforce. Doing so will enrich the Occupational Therapy profession as well as improving service user outcomes. Originality/value - This paper seeks to provide a pragmatic consideration of how occupational therapists can influence mental health systems to work proactively with a peer workforce.

Nations United: The United Nations, the United States, and the Global Campaign Against Terrorism. A Curriculum Unit & Video for Secondary Schools.

Science.gov (United States)

Houlihan, Christina; McLeod, Shannon

This curriculum unit and 1-hour videotape are designed to help students understand the purpose and functions of the United Nations (UN) and explore the relationship between the United Nations and the United States. The UN's role in the global counterterrorism campaign serves as a case study for the unit. The students are asked to develop a basic…

Managing across levels of government: evaluation of federal-state roles and responsibilities involving nonfederal forests in the United States

Science.gov (United States)

Paul V. Ellefson; Calder M. Hibbard; Michael A. Kilgore

2006-01-01

With the assistance of state foresters and federal agency executives, an evaluation was made of federal and state government roles and responsibilities focused nonfederal forests in the United States. The evaluation involved an inventory of legally (and administratively) defined federal roles, identification bf federal programs supporting accomplishment of such roles,...

Interface unit

NARCIS (Netherlands)

Keyson, D.V.; Freudenthal, A.; De Hoogh, M.P.A.; Dekoven, E.A.M.

2001-01-01

The invention relates to an interface unit comprising at least a display unit for communication with a user, which is designed for being coupled with a control unit for at least one or more parameters in a living or working environment, such as the temperature setting in a house, which control unit

Navigating Motherhood and the Role of the Head Athletic Trainer in the Collegiate Setting.

Science.gov (United States)

Mazerolle, Stephanie M; Eason, Christianne M

2016-07-01

Motherhood has been identified as a barrier to the head athletic trainer (AT) position. Role models have been cited as a possible facilitator for increasing the number of women who pursue and maintain this role in the collegiate setting. To examine the experiences of female ATs balancing motherhood and head AT positions in the National Collegiate Athletic Association Division II and III and National Association of Intercollegiate Athletics settings. Qualitative study. National Collegiate Athletic Association Divisions II and III and National Association of Intercollegiate Athletics. A total of 22 female head ATs (average age = 40 ± 8 years) who were married with children completed our study. Our participants had been certified for 15.5 ± 7.5 years and in their current positions as head ATs for 9 ± 8 years. We conducted online interviews with all participants. Participants journaled their reflections on a series of open-ended questions pertaining to their experiences as head ATs. Data were analyzed following a general inductive approach. Credibility was confirmed through peer review and researcher triangulation. We identified 3 major contributors to work-life conflict. Two speak to organizational influences on conflict: work demands and time of year. The role of motherhood, which was more of a personal contributor, also precipitated conflict for our ATs. Four themes emerged as work-life balance facilitators: planning, attitude and perspective, support networks, and workplace integration. Support was defined at both the personal and professional levels. In terms of the organization, our participants juggled long work hours, travel, and administrative tasks. Individually and socioculturally, they overcame their guilt and their need to be present and an active part of the parenting process. These mothers demonstrated the ability to cope with their demanding roles as both moms and head ATs.

Role of oral care to prevent VAP in mechanically ventilated Intensive Care Unit patients.

Science.gov (United States)

Gupta, A; Gupta, A; Singh, T K; Saxsena, A

2016-01-01

Ventilator associated pneumonia (VAP) is the most common nosocomial infection in Intensive Care Unit. One major factor causing VAP is the aspiration of oral colonization because of poor oral care practices. We feel the role of simple measure like oral care is neglected, despite the ample evidence of it being instrumental in preventing VAP.

Role of oral care to prevent VAP in mechanically ventilated Intensive Care Unit patients

OpenAIRE

A Gupta; A Gupta; T K Singh; A Saxsena

2016-01-01

Ventilator associated pneumonia (VAP) is the most common nosocomial infection in Intensive Care Unit. One major factor causing VAP is the aspiration of oral colonization because of poor oral care practices. We feel the role of simple measure like oral care is neglected, despite the ample evidence of it being instrumental in preventing VAP.

Social Set Analysis

DEFF Research Database (Denmark)

Vatrapu, Ravi; Mukkamala, Raghava Rao; Hussain, Abid

2016-01-01

, conceptual and formal models of social data, and an analytical framework for combining big social data sets with organizational and societal data sets. Three empirical studies of big social data are presented to illustrate and demonstrate social set analysis in terms of fuzzy set-theoretical sentiment...... automata and agent-based modeling). However, when it comes to organizational and societal units of analysis, there exists no approach to conceptualize, model, analyze, explain, and predict social media interactions as individuals' associations with ideas, values, identities, and so on. To address...... analysis, crisp set-theoretical interaction analysis, and event-studies-oriented set-theoretical visualizations. Implications for big data analytics, current limitations of the set-theoretical approach, and future directions are outlined....

The strategy role of transitional care units to support Integrated Care and Personalised pathways for frail persons

OpenAIRE

Morando, Verdiana; Tozzi, Valeria D.

2017-01-01

The paper presents a comparative analysis of three models of transitional care units that have been set up in Italy in the last three years within the processes of Regional Healthcare Services and healthcare organisations’ reforms. The comparative analysis is worth of providing interesting insights and generalizable lessons learnt from integrated care in practice. The three cases of transitional care units belong to a similar background wherein greater needs for care coordination across the s...

Role of oral care to prevent VAP in mechanically ventilated Intensive Care Unit patients

Directory of Open Access Journals (Sweden)

A Gupta

2016-01-01

Full Text Available Ventilator associated pneumonia (VAP is the most common nosocomial infection in Intensive Care Unit. One major factor causing VAP is the aspiration of oral colonization because of poor oral care practices. We feel the role of simple measure like oral care is neglected, despite the ample evidence of it being instrumental in preventing VAP.

The use of the Statscan digital X-ray unit in paediatric polytrauma

Energy Technology Data Exchange (ETDEWEB)

Pitcher, Richard D. [University of Cape Town, Division of Paediatric Radiology, Red Cross War Memorial Children' s Hospital, School of Child and Adolescent Health, Cape Town (South Africa); Wilde, Jim C.H. [University of Cape Town, Division of Paediatric Surgery, Red Cross War Memorial Children' s Hospital, School of Child and Adolescent Health, Cape Town (South Africa); University of Amsterdam, Paediatric Surgical Centre of Amsterdam, Emma Children' s Hospital, Academic Medical Centre, Amsterdam (Netherlands); Douglas, Tania S. [University of Cape Town, MRC/UCT Medical Imaging Research Unit, Department of Human Biology, Cape Town (South Africa); As, Arjan Bastiaan van [University of Cape Town, Division of Paediatric Surgery, Red Cross War Memorial Children' s Hospital, School of Child and Adolescent Health, Cape Town (South Africa)

2009-05-15

We present a 3-year review of clinical paediatric experience with the statscan (Lodox Systems, Johannesburg, South Africa), a low-dose, digital, whole-body, slit-scanning X-ray machine. While focusing on the role of the unit in paediatric polytrauma, insight into its applications in other paediatric settings is provided. (orig.)

The use of the Statscan digital X-ray unit in paediatric polytrauma

International Nuclear Information System (INIS)

Pitcher, Richard D.; Wilde, Jim C.H.; Douglas, Tania S.; As, Arjan Bastiaan van

2009-01-01

We present a 3-year review of clinical paediatric experience with the statscan (Lodox Systems, Johannesburg, South Africa), a low-dose, digital, whole-body, slit-scanning X-ray machine. While focusing on the role of the unit in paediatric polytrauma, insight into its applications in other paediatric settings is provided. (orig.)

A New Model of Delirium Care in the Acute Geriatric Setting: Geriatric Monitoring Unit

Directory of Open Access Journals (Sweden)

Chong Mei

2011-08-01

Full Text Available Abstract Background Delirium is a common and serious condition, which affects many of our older hospitalised patients. It is an indicator of severe underlying illness and requires early diagnosis and prompt treatment, associated with poor survival, functional outcomes with increased risk of institutionalisation following the delirium episode in the acute care setting. We describe a new model of delirium care in the acute care setting, titled Geriatric Monitoring Unit (GMU where the important concepts of delirium prevention and management are integrated. We hypothesize that patients with delirium admitted to the GMU would have better clinical outcomes with less need for physical and psychotropic restraints compared to usual care. Methods/Design GMU models after the Delirium Room with adoption of core interventions from Hospital Elder Life Program and use of evening bright light therapy to consolidate circadian rhythm and improve sleep in the elderly patients. The novelty of this approach lies in the amalgamation of these interventions in a multi-faceted approach in acute delirium management. GMU development thus consists of key considerations for room design and resource planning, program specific interventions and daily core interventions. Assessments undertaken include baseline demographics, comorbidity scoring, duration and severity of delirium, cognitive, functional measures at baseline, 6 months and 12 months later. Additionally we also analysed the pre and post-GMU implementation knowledge and attitude on delirium care among staff members in the geriatric wards (nurses, doctors and undertook satisfaction surveys for caregivers of patients treated in GMU. Discussion This study protocol describes the conceptualization and implementation of a specialized unit for delirium management. We hypothesize that such a model of care will not only result in better clinical outcomes for the elderly patient with delirium compared to usual geriatric care

What is the role of general internists in the tertiary or academic setting?

Science.gov (United States)

Tanriover, Mine Durusu; Rigby, Shirley; van Hulsteijn, L Harry; Ferreira, Faustino; Oliveira, Narcisso; Schumm-Draeger, Petra-Maria; Weidanz, Frauke; Kramer, Mark H H

2015-01-01

The changing demography of European populations mandates a vital role for internists in caring for patients in each level of healthcare. Internists in the tertiary or academic setting are highly ranked in terms of their responsibilities: they are clinicians, educators, researchers, role models, mentors and administrators. Contrary to the highly focused approach of sub-specialties, general internists working in academic settings can ensure that coordinated care is delivered in the most cost-conscious and efficient way. Moreover, internal medicine is one of the most appropriate specialties in which to teach clinical reasoning skills, decision-making and analytical thinking, as well as evidence based, patient oriented medicine. Internists deal with challenging patients of the new millennium with a high burden of chronic diseases and polypharmacy; practice personalised medicine with a wide scientific background and so they are the perfect fit to establish and implement new tools for scientific research. In conclusion, internal medicine is developing a new identity as a specialty in its own right. The European Federation of Internal Medicine supports the concept of academic internists and calls upon the member countries to construct academic (general) internal medicine departments in their respective countries. As 'internal medicine is the cornerstone of every national healthcare system', academic (general) internal medicine should strive to be the cornerstone of every integrated, patient-centred, modern medical care and training system. Copyright © 2014 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.

Consideration Sets and Their Role in Modelling Doctor Recommendations About Contraceptives.

Science.gov (United States)

Fiebig, Denzil G; Viney, Rosalie; Knox, Stephanie; Haas, Marion; Street, Deborah J; Hole, Arne R; Weisberg, Edith; Bateson, Deborah

2017-01-01

Decisions about prescribed contraception are typically the result of a consultation between a woman and her doctor. In order to better understand contraceptive choice within this environment, stated preference methods are utilized to ask doctors about what contraceptive options they would discuss with different types of women. The role of doctors is to confine their discussion to a subset of products that best match their patient. This subset of options forms the consideration set from which the ultimate recommendation is made. Given the existence of consideration sets we address the issue of how to model appropriately the ultimate recommendations. The estimated models enable us to characterize doctor recommendations and how they vary with patient attributes and to highlight where recommendations are clear and when they are uncertain. The results also indicate systematic variation in recommendations across different types of doctors, and in particular we observe that some doctors are reluctant to embrace new products and instead recommend those that are more familiar. Such effects are one possible explanation for the relatively low uptake of more cost effective longer acting reversible contraceptives and indicate that further education and training of doctors may be warranted. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.

SU-F-T-78: Minimum Data Set of Measurements for TG 71 Based Electron Monitor-Unit Calculations

International Nuclear Information System (INIS)

Xu, H; Guerrero, M; Prado, K; Yi, B

2016-01-01

Purpose: Building up a TG-71 based electron monitor-unit (MU) calculation protocol usually involves massive measurements. This work investigates a minimum data set of measurements and its calculation accuracy and measurement time. Methods: For 6, 9, 12, 16, and 20 MeV of our Varian Clinac-Series linear accelerators, the complete measurements were performed at different depth using 5 square applicators (6, 10, 15, 20 and 25 cm) with different cutouts (2, 3, 4, 6, 10, 15 and 20 cm up to applicator size) for 5 different SSD’s. For each energy, there were 8 PDD scans and 150 point measurements for applicator factors, cutout factors and effective SSDs that were then converted to air-gap factors for SSD 99–110cm. The dependence of each dosimetric quantity on field size and SSD was examined to determine the minimum data set of measurements as a subset of the complete measurements. The “missing” data excluded in the minimum data set were approximated by linear or polynomial fitting functions based on the included data. The total measurement time and the calculated electron MU using the minimum and the complete data sets were compared. Results: The minimum data set includes 4 or 5 PDD’s and 51 to 66 point measurements for each electron energy, and more PDD’s and fewer point measurements are generally needed as energy increases. Using only <50% of complete measurement time, the minimum data set generates acceptable MU calculation results compared to those with the complete data set. The PDD difference is within 1 mm and the calculated MU difference is less than 1.5%. Conclusion: Data set measurement for TG-71 electron MU calculations can be minimized based on the knowledge of how each dosimetric quantity depends on various setup parameters. The suggested minimum data set allows acceptable MU calculation accuracy and shortens measurement time by a few hours.

SU-F-T-78: Minimum Data Set of Measurements for TG 71 Based Electron Monitor-Unit Calculations

Energy Technology Data Exchange (ETDEWEB)

Xu, H; Guerrero, M; Prado, K; Yi, B [University of Maryland School of Medicine, Baltimore, MD (United States)

2016-06-15

Purpose: Building up a TG-71 based electron monitor-unit (MU) calculation protocol usually involves massive measurements. This work investigates a minimum data set of measurements and its calculation accuracy and measurement time. Methods: For 6, 9, 12, 16, and 20 MeV of our Varian Clinac-Series linear accelerators, the complete measurements were performed at different depth using 5 square applicators (6, 10, 15, 20 and 25 cm) with different cutouts (2, 3, 4, 6, 10, 15 and 20 cm up to applicator size) for 5 different SSD’s. For each energy, there were 8 PDD scans and 150 point measurements for applicator factors, cutout factors and effective SSDs that were then converted to air-gap factors for SSD 99–110cm. The dependence of each dosimetric quantity on field size and SSD was examined to determine the minimum data set of measurements as a subset of the complete measurements. The “missing” data excluded in the minimum data set were approximated by linear or polynomial fitting functions based on the included data. The total measurement time and the calculated electron MU using the minimum and the complete data sets were compared. Results: The minimum data set includes 4 or 5 PDD’s and 51 to 66 point measurements for each electron energy, and more PDD’s and fewer point measurements are generally needed as energy increases. Using only <50% of complete measurement time, the minimum data set generates acceptable MU calculation results compared to those with the complete data set. The PDD difference is within 1 mm and the calculated MU difference is less than 1.5%. Conclusion: Data set measurement for TG-71 electron MU calculations can be minimized based on the knowledge of how each dosimetric quantity depends on various setup parameters. The suggested minimum data set allows acceptable MU calculation accuracy and shortens measurement time by a few hours.

Methicillin Resistant Staphylococcus aureus Transmission in a Ghanaian Burn Unit: The Importance of Active Surveillance in Resource-Limited Settings

Directory of Open Access Journals (Sweden)

Nana Ama Amissah

2017-10-01

Full Text Available Objectives:Staphylococcus aureus infections in burn patients can lead to serious complications and death. The frequency of S. aureus infection is high in low- and middle-income countries presumably due to limited resources, misuse of antibiotics and poor infection control. The objective of the present study was to apply population genomics to precisely define, for the first time, the transmission of antibiotic resistant S. aureus in a resource-limited setting in sub-Saharan Africa.Methods:Staphylococcus aureus surveillance was performed amongst burn patients and healthcare workers during a 7-months survey within the burn unit of the Korle Bu Teaching Hospital in Ghana.Results: Sixty-six S. aureus isolates (59 colonizing and 7 clinical were obtained from 31 patients and 10 healthcare workers. Twenty-one of these isolates were ST250-IV methicillin-resistant S. aureus (MRSA. Notably, 25 (81% of the 31 patients carried or were infected with S. aureus within 24 h of admission. Genome comparisons revealed six distinct S. aureus clones circulating in the burn unit, and demonstrated multiple transmission events between patients and healthcare workers. Further, the collected S. aureus isolates exhibited a wide range of genotypic resistances to antibiotics, including trimethoprim (21%, aminoglycosides (33%, oxacillin (33%, chloramphenicol (50%, tetracycline (59% and fluoroquinolones (100%.Conclusion: Population genomics uncovered multiple transmission events of S. aureus, especially MRSA, within the investigated burn unit. Our findings highlight lapses in infection control and prevention, and underscore the great importance of active surveillance to protect burn victims against multi-drug resistant pathogens in resource-limited settings.

Methicillin Resistant Staphylococcus aureus Transmission in a Ghanaian Burn Unit: The Importance of Active Surveillance in Resource-Limited Settings.

Science.gov (United States)

Amissah, Nana Ama; Buultjens, Andrew H; Ablordey, Anthony; van Dam, Lieke; Opoku-Ware, Ampomah; Baines, Sarah L; Bulach, Dieter; Tetteh, Caitlin S; Prah, Isaac; van der Werf, Tjip S; Friedrich, Alexander W; Seemann, Torsten; van Dijl, Jan Maarten; Stienstra, Ymkje; Stinear, Timothy P; Rossen, John W

2017-01-01

Objectives: Staphylococcus aureus infections in burn patients can lead to serious complications and death. The frequency of S. aureus infection is high in low- and middle-income countries presumably due to limited resources, misuse of antibiotics and poor infection control. The objective of the present study was to apply population genomics to precisely define, for the first time, the transmission of antibiotic resistant S. aureus in a resource-limited setting in sub-Saharan Africa. Methods: Staphylococcus aureus surveillance was performed amongst burn patients and healthcare workers during a 7-months survey within the burn unit of the Korle Bu Teaching Hospital in Ghana. Results: Sixty-six S. aureus isolates (59 colonizing and 7 clinical) were obtained from 31 patients and 10 healthcare workers. Twenty-one of these isolates were ST250-IV methicillin-resistant S. aureus (MRSA). Notably, 25 (81%) of the 31 patients carried or were infected with S. aureus within 24 h of admission. Genome comparisons revealed six distinct S. aureus clones circulating in the burn unit, and demonstrated multiple transmission events between patients and healthcare workers. Further, the collected S. aureus isolates exhibited a wide range of genotypic resistances to antibiotics, including trimethoprim (21%), aminoglycosides (33%), oxacillin (33%), chloramphenicol (50%), tetracycline (59%) and fluoroquinolones (100%). Conclusion: Population genomics uncovered multiple transmission events of S. aureus , especially MRSA, within the investigated burn unit. Our findings highlight lapses in infection control and prevention, and underscore the great importance of active surveillance to protect burn victims against multi-drug resistant pathogens in resource-limited settings.

Effect of Intrafix® SafeSet infusion apparatus on phlebitis in a neurological intensive care unit: a case-control study.

Science.gov (United States)

Liu, F; Chen, D; Liao, Y; Diao, L; Liu, Y; Wu, M; Xue, X; You, C; Kang, Y

2012-01-01

To investigate the effect of the Intrafix(®) SafeSet infusion apparatus on the incidence of phlebitis in patients being intravenously infused in a neurological intensive care unit (ICU). Patients aged > 12 years, with no history of diabetes mellitus and no existing phlebitis, requiring a daily peripheral intravenous infusion of ≥ 8 h with the total period lasting ≥ 3 days, were enrolled. Infusions were performed using the Intrafix(®) SafeSet or normal infusion apparatus. Incidence of phlebitis (scored according to the Infusion Nursing Standards of Practice of the American Infusion Nurses Society) was analysed. Patients (n = 1545) were allocated to Intrafix(®) SafeSet (n = 709) or normal infusion (n = 836) groups, matched for age, gender and preliminary diagnosis. Incidence of phlebitis was significantly higher using normal infusion apparatus compared with the Intrafix(®) SafeSet (23.4% versus 17.9%, respectively). Intrafix(®) SafeSet infusion apparatus significantly reduced the incidence of phlebitis in patients in the neurological ICU, compared with normal infusion apparatus, and may be suitable for use in routine clinical practice.

The role of transnational companies as oil suppliers to the United States

International Nuclear Information System (INIS)

Palazuelos, Enrique

2010-01-01

This paper analyzes the extent to which the international oil production of transnational companies meets the oil requirements of the United States. Disaggregated data from each company have been used to determine which companies (refineries) are importing crude oil, how much oil each transnational company is produced abroad, and where this production goes to. The analysis show that American international oil production represents a small part of U.S. oil imports. Two conclusions are reached. The first is that U.S. refineries buy the majority of the crude oil they process on the international market and, as a result, are dependent on the unstable conditions of this market. The second is that the economic interests the large American oil companies have abroad are far greater than those they have within the United States and, as a result, these companies do not play a decisive role in a national strategy to guarantee foreign supply.

Characteristics of flattening filter free beams at low monitor unit settings

International Nuclear Information System (INIS)

Akino, Yuichi; Ota, Seiichi; Inoue, Shinichi; Mizuno, Hirokazu; Sumida, Iori; Yoshioka, Yasuo; Ogawa, Kazuhiko; Isohashi, Fumiaki

2013-01-01

Purpose: Newer linear accelerators (linacs) have been equipped to deliver flattening filter free (FFF) beams. When FFF beams are used for step-and-shoot intensity-modulated radiotherapy (IMRT), the stability of delivery of small numbers of monitor units (MU) is important. The authors developed automatic measurement techniques to evaluate the stability of the dose profile, dose linearity, and consistency. Here, the authors report the performance of the Artiste™ accelerator (Siemens, Erlangen, Germany) in delivering low-MU FFF beams.Methods: A 6 MV flattened beam (6X) with 300 MU/min dose rate and FFF beams of 7 (7XU) and 11 MV (11XU), each with a 500 MU/min dose rate, were measured at 1, 2, 3, 5, 8, 10, and 20 MU settings. For the 2000 MU/min dose rate, the 7 (7XUH) and 11 MV (11XUH) beams were set at 10, 15, 20, 25, and 30 MU because of the limits of the minimum MU settings. Beams with 20 × 20 and 10 × 10 cm 2 field sizes were alternately measured ten times in intensity modulated (IM) mode, with which Siemens linacs regulate beam delivery for step-and-shoot IMRT. The in- and crossplane beam profiles were measured using a Profiler™ Model 1170 (Sun Nuclear Corporation, Melbourne, FL) in multiframe mode. The frames of 20 × 20 cm 2 beams were identified at the off-axis profile. The 6X beam profile was normalized at the central axis. The 7 and 11 MV FFF beam profiles were rescaled to set the dose at the central axis at 145% and 170%, respectively. Point doses were also measured using a Farmer-type ionization chamber and water-equivalent solid phantom to evaluate the linearity and consistency of low-MU beam delivery. The values displayed on the electrometer were recognized with a USB-type camera and read with open-source optical character recognition software.Results: The symmetry measurements of the 6X, 7XU, and 11XU beam profiles were better than 2% for beams ≥2 MU and improved with increasing MU. The variations in flatness of FFF beams ≥2 MU were ±5%. The

Characteristics of flattening filter free beams at low monitor unit settings

Energy Technology Data Exchange (ETDEWEB)

Akino, Yuichi [Department of Radiology, Osaka University Hospital, Suita, Osaka 565-0871, Japan and Department of Radiation Oncology, Osaka University Graduate School of Medicine, Suita, Osaka 565-0871 (Japan); Ota, Seiichi; Inoue, Shinichi; Mizuno, Hirokazu [Department of Radiology, Osaka University Hospital, Suita, Osaka 565-0871 (Japan); Sumida, Iori; Yoshioka, Yasuo; Ogawa, Kazuhiko [Department of Radiation Oncology, Osaka University Graduate School of Medicine, Suita, Osaka 565-0871 (Japan); Isohashi, Fumiaki [Oncology Center, Osaka University Hospital, Suita, Osaka 565-0871 (Japan)

2013-11-15

Purpose: Newer linear accelerators (linacs) have been equipped to deliver flattening filter free (FFF) beams. When FFF beams are used for step-and-shoot intensity-modulated radiotherapy (IMRT), the stability of delivery of small numbers of monitor units (MU) is important. The authors developed automatic measurement techniques to evaluate the stability of the dose profile, dose linearity, and consistency. Here, the authors report the performance of the Artiste™ accelerator (Siemens, Erlangen, Germany) in delivering low-MU FFF beams.Methods: A 6 MV flattened beam (6X) with 300 MU/min dose rate and FFF beams of 7 (7XU) and 11 MV (11XU), each with a 500 MU/min dose rate, were measured at 1, 2, 3, 5, 8, 10, and 20 MU settings. For the 2000 MU/min dose rate, the 7 (7XUH) and 11 MV (11XUH) beams were set at 10, 15, 20, 25, and 30 MU because of the limits of the minimum MU settings. Beams with 20 × 20 and 10 × 10 cm{sup 2} field sizes were alternately measured ten times in intensity modulated (IM) mode, with which Siemens linacs regulate beam delivery for step-and-shoot IMRT. The in- and crossplane beam profiles were measured using a Profiler™ Model 1170 (Sun Nuclear Corporation, Melbourne, FL) in multiframe mode. The frames of 20 × 20 cm{sup 2} beams were identified at the off-axis profile. The 6X beam profile was normalized at the central axis. The 7 and 11 MV FFF beam profiles were rescaled to set the dose at the central axis at 145% and 170%, respectively. Point doses were also measured using a Farmer-type ionization chamber and water-equivalent solid phantom to evaluate the linearity and consistency of low-MU beam delivery. The values displayed on the electrometer were recognized with a USB-type camera and read with open-source optical character recognition software.Results: The symmetry measurements of the 6X, 7XU, and 11XU beam profiles were better than 2% for beams ≥2 MU and improved with increasing MU. The variations in flatness of FFF beams ≥2 MU were

Role of the pediatric nurse practitioner in promoting breastfeeding for late preterm infants in primary care settings.

Science.gov (United States)

Ahmed, Azza H

2010-01-01

The preterm birth rate has been increasing steadily during the past two decades. Up to two thirds of this increase has been attributed to the increasing rate of late preterm births (34 to stamina; difficulty with latch, suck, and swallow; temperature instability; increased vulnerability to infection; hyperbilirubinemia, and more respiratory problems than the full-term infant. Late preterm infants usually are treated as full term and discharged within 48 hours of birth, so pediatric nurse practitioners in primary care settings play a critical role in promoting breastfeeding through early assessment and detection of breastfeeding difficulties and by providing anticipatory guidance related to breastfeeding and follow-up. The purpose of this article is to describe the developmental and physiologic immaturity of late preterm infants and to highlight the role of pediatric nurse practitioners in primary care settings in supporting and promoting breastfeeding for late preterm infants.

An Exploration of the Perspectives of Associate Nurse Unit Managers Regarding the Implementation of Smoke-free Policies in Adult Mental Health Inpatient Units.

Science.gov (United States)

Dean, Tania D; Cross, Wendy; Munro, Ian

2018-04-01

In Adult Mental Health Inpatient Units, it is not unexpected that leadership of Associate Nurse Unit Managers contributes to successful implementation of smoke-free policies. In light of challenges facing mental health nursing, and limited research describing their leadership and the role it plays in addressing smoke-free policy implementation, the aim of this study is to explore Associate Nurse Unit Managers perspectives' regarding the implementation of smoke-free policies, which were introduced on 1 July, 2015. Individual in-depth semi-structured interviews were undertaken six months post the implementation of smoke-free policies. In this qualitative descriptive study, six Associate Nurse Unit Managers working in a Victorian public Adult Mental Health Inpatient Unit, were asked eight questions which targeted leadership and the implementation and enforcement of smoke-free policies. Associate Nurse Unit Managers provide leadership and role modeling for staff and they are responsible for setting the standards that govern the behavior of nurses within their team. All participants interviewed believed that they were leaders in the workplace. Education and consistency were identified as crucial for smoke-free policies to be successful. Participants acknowledged that the availability of therapeutic interventions, staff resources and the accessibility of nicotine replacement therapy were crucial to assist consumers to remain smoke-free while on the unit. The findings from this research may help to improve the understanding of the practical challenges that Associate Nurse Unit Manager's face in the implementation of smoke-free policies with implications for policies, nursing practice, education and research.

Fairer to Fathers: The Role of Schools in Nurturing Positive Fatherhood--A United Kingdom Perspective

Science.gov (United States)

Carpenter, Barry

2007-01-01

Fatherhood in this 21st century is changing. There is wider societal recognition that, for the sake of our children, we need to value fathers and the contribution they make to family life. In the United Kingdom, various initiatives are actively supporting "Dads" in their role. For fathers of children with disabilities, there are even…

Fathers' Needs and Masculinity Dilemmas in a Neonatal Intensive Care Unit in Denmark.

Science.gov (United States)

Noergaard, Betty; Ammentorp, Jette; Fenger-Gron, Jesper; Kofoed, Poul-Erik; Johannessen, Helle; Thibeau, Shelley

2017-08-01

Most healthcare professionals in neonatal intensive care units typically focus on the infants and mothers; fathers often feel powerless and find it difficult to establish a father-child relationship. In family-centered healthcare settings, exploring fathers' experiences and needs is important because men's roles in society, especially as fathers, are changing. To describe fathers' needs when their infants are admitted to a neonatal intensive care unit and to discuss these needs within a theoretical framework of masculinity to advance understanding and generate meaningful knowledge for clinical practices. This qualitative study used participant observation, interviews, multiple sequential interviews, and a focus group discussion. Data were analyzed using grounded theory principles. Analysis of the fathers' needs generated 2 primary themes: (1) Fathers as caregivers and breadwinners and (2) fathers and emotions. Fathers wished to be involved and to take care of their infants but have to balance cultural and social norms and expectations of being breadwinners with their wishes to be equal coparents. Health professionals in neonatal intensive care units must be aware of fathers' need and desire to be equal coparents. Nurses should play a key role by, for example, showing that fathers are as important to their infants as are the mothers, helping them become involved in childcare, and ensuring that they are directly informed about their children's progress. Further research in other cultural settings would contribute to knowledge regarding fatherhood and the role of fathers in childcare.

APPLICATION OF GOAL SETTING THEORY

OpenAIRE

Yurtkoru, E. Serra; Bozkurt, Tulay; Bekta, Fatos; Ahmed, Mahir Jibril; Kola, Vehap

2017-01-01

The purpose of this study is to test the goal theorymodel originally developed by Locke and Latham in organizational setting inTurkey, and explain its influence on job satisfaction and affective commitment.Also mediating role of task specific strategy and moderating role ofselfefficacy are examined. Locke and Latham’s goal setting measure is adaptedto Turkish. Survey method is employed to collect data from 222 respondents fromautomotive industry. Goal setting dimensions predicted affective co...

Role of medial cortical, hippocampal and striatal interactions during cognitive set-shifting.

Science.gov (United States)

Graham, Steven; Phua, Elaine; Soon, Chun Siong; Oh, Tomasina; Au, Chris; Shuter, Borys; Wang, Shih-Chang; Yeh, Ing Berne

2009-05-01

To date, few studies have examined the functional connectivity of brain regions involved in complex executive function tasks, such as cognitive set-shifting. In this study, eighteen healthy volunteers performed a cognitive set-shifting task modified from the Wisconsin card sort test while undergoing functional magnetic resonance imaging. These modifications allowed better disambiguation between cognitive processes and revealed several novel findings: 1) peak activation in the caudate nuclei in the first instance of negative feedback signaling a shift in rule, 2) lowest caudate activation once the rule had been identified, 3) peak hippocampal activation once the identity of the rule had been established, and 4) decreased hippocampal activation during the generation of new rule candidates. This pattern of activation across cognitive set-shifting events suggests that the caudate nuclei play a role in response generation when the identity of the new rule is unknown. In contrast, the reciprocal pattern of hippocampal activation suggests that the hippocampi help consolidate knowledge about the correct stimulus-stimulus associations, associations that become inappropriate once the rule has changed. Functional connectivity analysis using Granger Causality Mapping revealed that caudate and hippocampal regions interacted indirectly via a circuit involving the medial orbitofrontal and posterior cingulate regions, which are known to bias attention towards stimuli based on expectations built up from task-related feedback. Taken together, the evidence suggests that these medial regions may mediate striato-hippocampal interactions and hence affect goal-directed attentional transitions from a response strategy based on stimulus-reward heuristics (caudate-dependent) to one based on stimulus-stimulus associations (hippocampus-dependent).

Is there a role of palliative care in the neonatal intensive care unit in India?

Directory of Open Access Journals (Sweden)

Manjiri P Dighe

2011-01-01

Full Text Available Recent advances in medical care have improved the survival of newborn babies born with various problems. Despite this death in the neonatal intensive care unit (NICU is an inevitable reality. For babies who are not going to "get better," the health care team still has a duty to alleviate the physical suffering of the baby and to support the family. Palliative care is a multidisciplinary approach to relieve the physical, psycho social, and spiritual suffering of patients and their families. Palliative care provision in the Indian NICU settings is almost nonexistent at present. In this paper we attempt to "build a case" for palliative care in the Indian NICU setting.

The Roles of Feature-Specific Task Set and Bottom-Up Salience in Attentional Capture: An ERP Study

Science.gov (United States)

Eimer, Martin; Kiss, Monika; Press, Clare; Sauter, Disa

2009-01-01

We investigated the roles of top-down task set and bottom-up stimulus salience for feature-specific attentional capture. Spatially nonpredictive cues preceded search arrays that included a color-defined target. For target-color singleton cues, behavioral spatial cueing effects were accompanied by cue-induced N2pc components, indicative of…

Emerging roles for biomedical librarians: a survey of current practice, challenges, and changes.

Science.gov (United States)

Crum, Janet A; Cooper, I Diane

2013-10-01

This study is intended to (1) identify emerging roles for biomedical librarians and determine how common these roles are in a variety of library settings, (2) identify barriers to taking on new roles, and (3) determine how librarians are developing the capacity to take on new roles. A survey was conducted of librarians in biomedical settings. Most biomedical librarians are taking on new roles. The most common roles selected by survey respondents include analysis and enhancement of user experiences, support for social media, support for systematic reviews, clinical informationist, help for faculty or staff with authorship issues, and implementation of researcher profiling and collaboration tools. Respondents in academic settings are more likely to report new roles than hospital librarians are, but some new roles are common in both settings. Respondents use a variety of methods to free up time for new roles, but predominant methods vary between directors and librarians and between academic and hospital respondents. Lack of time is the biggest barrier that librarians face when trying to adopt new roles. New roles are associated with increased collaboration with individuals and/or groups outside the library. This survey documents the widespread incorporation of new roles in biomedical libraries in the United States, as well as the barriers to adopting these roles and the means by which librarians are making time for them. The results of the survey can be used to inform strategic planning, succession planning, library education, and career development for biomedical librarians.

77 FR 54659 - Price for the 2012 Annual Uncirculated Dollar Coin Set

Science.gov (United States)

2012-09-05

... DEPARTMENT OF THE TREASURY United States Mint Price for the 2012 Annual Uncirculated Dollar Coin Set AGENCY: United States Mint, Department of the Treasury. ACTION: Notice. SUMMARY: The United States Mint is announcing a price of $54.95 for the 2012 Annual Uncirculated Dollar Coin Set. This set...

[Work setting, satisfaction and burnout of the nurses in critical care units and hospitalization units. RN4CAST-Spain project].

Science.gov (United States)

Fuentelsaz-Gallego, C; Moreno-Casbas, T; Gómez-García, T; González-María, E

2013-01-01

To know if there are differences between the critical care units and the medical-surgical care units regarding the perception of the nurses working in National Health System hospitals about their work environment, burnout level and job satisfaction. A cross-sectional study was conducted with 6,417 nurses from the medical-surgical care units and with 1,122 nurses from critical care units of 59 Spanish hospitals with more than 150 beds. Socio-demographic, job satisfaction, perception of work environment (Practice Environment Scale of the Nursing Work Index [PES-NWI questionnaire]) and burnout measured with the Maslach Burnout Inventory (MBI) data were collected. The PES-NWI showed differences in 4 out of its 5 factors. It showed better values in medical-surgical units in all the factors, except for Staffing and resource adequacy (P<.001), where critical care units showed a mean level of agreement of 2.41 versus 2.19 for the medical-surgical units. Regarding burnout, this was higher in the medical-surgical care units (P=.039) where 23% (952) of the nurses had high levels. Job satisfaction was lower in the critical care units (P=.044) with 70% (578) of nurses being very or strongly satisfied. The opinion of the nurses, working in critical care units about their hospital is unfavorable. They showed lower levels of burnout than those working in medical-surgical units. Copyright © 2013 Elsevier España, S.L. y SEEIUC. All rights reserved.

The motivational theory of role modeling : How role models influence role aspirants' goals

NARCIS (Netherlands)

Morgenroth, Thekla; Ryan, Michelle K.; Peters, Kim

2015-01-01

Role models are often suggested as a way of motivating individuals to set and achieve ambitious goals, especially for members of stigmatized groups in achievement settings. Yet, the literature on role models tends not to draw on the motivational literature to explain how role models may help role

"Seeing the Life": Redefining self-worth and family roles among Iraqi refugee families resettled in the United States.

Science.gov (United States)

Nelson, Matthew; Hess, Julia Meredith; Isakson, Brian; Goodkind, Jessica

2016-08-01

Social and geographic displacement is a global phenomenon that precipitates novel stressors and disruptions that intersect with longstanding familial and social roles. Among the displaced are war-torn Iraqi refugee families, who must address these new obstacles in unconventional ways. This study explores how such disruptions have influenced associations between gender and apparent self-worth experienced by Iraqi refugee families upon relocation to the United States. Further, the psychosocial mechanisms requisite of any novel approach to a new social construct are explored and reveal that production in the family is at the core of instability and shifting power dynamics during resettlement, preventing family members from "seeing the life" in the United States that they had envisioned prior to immigration. Over 200 semi-structured qualitative interviews with Iraqi participants and mental health providers were conducted over the course of the study, and demonstrate a plasticity among social roles in the family and community that transcends the notion of a simple role reversal, and illustrate the complex positionalities that families under stress must approximate during such physical and social displacement.

Role of intraocular Leptospira infections in the pathogenesis of Equine Recurrent Uveitis in the Southern United States

Science.gov (United States)

To investigate the role of intraocular leptospiral infections in horses with Equine Recurrent Uveitis (ERU) in the southern United States, blood and ocular fluid samples were collected from horses with a history and ocular findings consistent with ERU. Samples were also obtained from control horses ...

Goal setting with mothers in child development services.

Science.gov (United States)

Forsingdal, S; St John, W; Miller, V; Harvey, A; Wearne, P

2014-07-01

The aim of this grounded theory study was to explore mothers' perspectives of the processes of collaborative goal setting in multidisciplinary child development services involving follow-up home therapy. Semi-structured interviews were conducted in South East Queensland, Australia with 14 mothers of children aged 3-6 years who were accessing multidisciplinary child development services. Interviews were focussed around the process of goal setting. A grounded theory of Maternal Roles in Goal Setting (The M-RIGS Model) was developed from analysis of data. Mothers assumed Dependent, Active Participator and Collaborator roles when engaging with the therapist in goal-setting processes. These roles were characterized by the mother's level of dependence on the therapist and insight into their child's needs and therapy processes. Goal Factors, Parent Factors and Therapist Factors influenced and added complexity to the goal-setting process. The M-RIGS Model highlights that mothers take on a range of roles in the goal-setting process. Although family-centred practice encourages negotiation and collaborative goal setting, parents may not always be ready to take on highly collaborative roles. Better understanding of parent roles, goal-setting processes and influencing factors will inform better engagement with families accessing multidisciplinary child development services. © 2013 John Wiley & Sons Ltd.

Changes in Default Alarm Settings and Standard In-Service are Insufficient to Improve Alarm Fatigue in an Intensive Care Unit: A Pilot Project.

Science.gov (United States)

Sowan, Azizeh Khaled; Gomez, Tiffany Michelle; Tarriela, Albert Fajardo; Reed, Charles Calhoun; Paper, Bruce Michael

2016-01-11

Clinical alarm systems safety is a national concern, specifically in intensive care units (ICUs) where alarm rates are known to be the highest. Interventional projects that examined the effect of changing default alarm settings on overall alarm rate and on clinicians' attitudes and practices toward clinical alarms and alarm fatigue are scarce. To examine if (1) a change in default alarm settings of the cardiac monitors and (2) in-service nursing education on cardiac monitor use in an ICU would result in reducing alarm rate and in improving nurses' attitudes and practices toward clinical alarms. This quality improvement project took place in a 20-bed transplant/cardiac ICU with a total of 39 nurses. We implemented a unit-wide change of default alarm settings involving 17 parameters of the cardiac monitors. All nurses received an in-service education on monitor use. Alarm data were collected from the audit log of the cardiac monitors 10 weeks before and 10 weeks after the change in monitors' parameters. Nurses' attitudes and practices toward clinical alarms were measured using the Healthcare Technology Foundation National Clinical Alarms Survey, pre- and postintervention. Alarm rate was 87.86 alarms/patient day (a total of 64,500 alarms) at the preintervention period compared to 59.18 alarms/patient day (49,319 alarms) postintervention (P=.01). At baseline, Arterial Blood Pressure (ABP), Pair Premature Ventricular Contractions (PVCs), and Peripheral Capillary Oxygen Saturation (SpO2) alarms were the highest. ABP and SpO2 alarms remained among the top three at the postproject period. Out of the 39 ICU nurses, 24 (62%) provided complete pre- and postproject survey questionnaires. Compared to the preintervention survey, no remarkable changes in the postproject period were reported in nurses' attitudes. Themes in the narrative data were related to poor usability of cardiac monitors and the frequent alarms. The data showed great variation among nurses in terms of changing

The Role of an Academic Development Unit in Supporting Institutional VET Learning and Teaching Change Management

Science.gov (United States)

Fotinatos, Nina

2016-01-01

The aim of this paper is to examine the role and impact of a central academic development unit (ADU) within an institutional strategic and operational change management project. The primary goal of this project was to improve vocational education and training (VET) learning and teaching practice in an Australian dual-sector regional university.…

Science Roles and Interactions in Adaptive Management of Large River Restoration Projects, Midwest United States

Science.gov (United States)

Jacobson, R. B.; Galat, D. L.; Smith, C. B.

2010-12-01

Most large-river restoration projects include formal or informal implementations of adaptive management strategies which acknowledge uncertainty and use scientific inquiry to learn and refine management options. Although the central role of science in reducing uncertainty is acknowledged in such projects, specific roles and interactions can vary widely, including how science relates to decision-making within the governance of these projects. Our objective is to present some structured generalizations about science roles and interactions as developed from the authors’ experiences in adaptive management of large river restoration in the Midwest United States. Scientific information may be introduced into decision making by scientists acting in any of the three roles common to adaptive management -- action agency representative, stakeholder, or science provider. We have observed that confusion and gridlock can arise when it is unclear if a scientist is acting as an advocate for a stakeholder or management position, or instead as an independent, “honest broker” of science. Although both advocacy and independence are proper and expected in public decision making, it is useful when scientists unambiguously identify their role. While complete scientific independence may be illusory, transparency and peer review can promote the ideal. Transparency comes from setting clear directions and objectives at the decision-making level and defining at the outset how learning will help assess progress and inform decisions. Independent peer reviews of proposals, study plans, and publications serve as a powerful tool to advance scientific independence, even if funding sources present a potential conflict of interest. Selection of experts for scientific advice and review often requires consideration of the balance between benefits of the “outside” expert (independent, knowledgeable but with little specific understanding of the river system), compared to those provided by the �

Assessment of Orthographical Processing in Spanish Children with Dyslexia: The Role of Lexical and Sublexical Units

Science.gov (United States)

Rodrigo, Mercedes; Jimenez, Juan E.; Garcia, Eduardo; Diaz, Alicia; Ortiz, M. Rosario; Guzman, Remedios; Hernandez-Valle, Isabel; Estevez, Adelina; Hernandez, Sergio

2004-01-01

Introduction: The aim of this study was to examine the role of multiletter units, such as the morpheme and whole word, in accessing the lexicon, in Spanish children with dyslexia. Method: A sample of 60 participants were selected and organised i n three different groups: 1) an experimental group of 18 reading-disabled children, (2) a control group…

Relationships between work unit climate and labour productivity in the financial sector: A longitudinal test of the mediating role of work satisfaction

NARCIS (Netherlands)

Voorde, F.C. van de; Veldhoven, M.J.P.M. van; Paauwe, J.

2014-01-01

This study is designed to test the mediating role of work satisfaction in the relationship between work unit climate and labour productivity. Two work unit climate facets are examined: goals and service orientation. Longitudinal data obtained from more than 14,000 employees in 171 branches of a

Relationships between work unit climate and labour productivity in the financial sector : A longitudinal test of the mediating role of work satisfaction

NARCIS (Netherlands)

van de Voorde, F.C.; van Veldhoven, M.J.P.M.; Paauwe, J.

2014-01-01

This study is designed to test the mediating role of work satisfaction in the relationship between work unit climate and labour productivity. Two work unit climate facets are examined: goals and service orientation. Longitudinal data obtained from more than 14,000 employees in 171 branches of a

Operable Unit 3-13, Group 3, Other Surface Soils Remediation Sets 4-6 (Phase II) Waste Management Plan

International Nuclear Information System (INIS)

G. L. Schwendiman

2006-01-01

This Waste Management Plan describes waste management and waste minimization activities for Group 3, Other Surface Soils Remediation Sets 4-6 (Phase II) at the Idaho Nuclear Technology and Engineering Center located within the Idaho National Laboratory. The waste management activities described in this plan support the selected response action presented in the Final Record of Decision for Idaho Nuclear Technology and Engineering Center, Operable Unit 3-13. This plan identifies the waste streams that will be generated during implementation of the remedial action and presents plans for waste minimization, waste management strategies, and waste disposition

Nurses' and nurse assistants' beliefs, attitudes and actions related to role and function in an inpatient stroke rehabilitation unit-A qualitative study

DEFF Research Database (Denmark)

Loft, Mia I; Poulsen, Ingrid; Esbensen, Bente A

2017-01-01

AIMS AND OBJECTIVES: To explore nurses' and nurse assistants' beliefs, attitudes and actions related to their function in an inpatient stroke rehabilitation unit. BACKGROUND: Several attempts have been made to describe nurses' roles and functions in inpatient neurorehabilitation. However, current...... understandings of the contributions that nurses and nurse assistants make to neurorehabilitation remain sparse. DESIGN: Descriptive, interpretive qualitative study. METHODS: Participant observations were conducted during 1 month in a stroke rehabilitation unit at a university hospital in the Capital Region...... stroke rehabilitation. We obtained insights into nursing staff's beliefs and attitudes about rehabilitation-as well as their own role and function-and furthermore how the latter affects their actions in daily practice. RELEVANCE TO CLINICAL PRACTICE: The nursing role and function are still not clearly...

Do critical care units play a role in the management of gynaecological oncology patients? The contribution of gynaecologic oncologist in running critical care units.

Science.gov (United States)

Davidovic-Grigoraki, Miona; Thomakos, Nikolaos; Haidopoulos, Dimitrios; Vlahos, Giorgos; Rodolakis, Alexandros

2017-03-01

Routine post-operative care in high dependency unit (HDU), surgical intensive care unit (SICU) and intensive care unit (ICU) after high-risk gynaecological oncology surgical procedures may allow for greater recognition and correct management of post-operative complications, thereby reducing long-term morbidity and mortality. On the other hand, unnecessary admissions to these units lead to increased morbidity - nosocomial infections, increased length of hospital stay and higher hospital costs. Gynaecological oncology surgeons continue to look after their patient in the HDU/SICU and have the final role in decision-making on day-to-day basis, making it important to be well versed in critical care management and ensure the best care for their patients. Post-operative monitoring and the presence of comorbid illnesses are the most common reasons for admission to the HDU/SICU. Elderly and malnutritioned patients, as well as, bowel resection, blood loss or greater fluid resuscitation during the surgery have prolonged HDU/SICU stay. Patients with ovarian cancer have a worse survival outcome than the patients with other types of gynaecological cancer. Dependency care is a part of surgical management and it should be incorporated formally into gynaecologic oncology training programme. © 2016 John Wiley & Sons Ltd.

Abstract sets and finite ordinals an introduction to the study of set theory

CERN Document Server

Keene, G B

2007-01-01

This text unites the logical and philosophical aspects of set theory in a manner intelligible both to mathematicians without training in formal logic and to logicians without a mathematical background. It combines an elementary level of treatment with the highest possible degree of logical rigor and precision.Starting with an explanation of all the basic logical terms and related operations, the text progresses through a stage-by-stage elaboration that proves the fundamental theorems of finite sets. It focuses on the Bernays theory of finite classes and finite sets, exploring the system's basi

Lung segmentation from HRCT using united geometric active contours

Science.gov (United States)

Liu, Junwei; Li, Chuanfu; Xiong, Jin; Feng, Huanqing

2007-12-01

Accurate lung segmentation from high resolution CT images is a challenging task due to various detail tracheal structures, missing boundary segments and complex lung anatomy. One popular method is based on gray-level threshold, however its results are usually rough. A united geometric active contours model based on level set is proposed for lung segmentation in this paper. Particularly, this method combines local boundary information and region statistical-based model synchronously: 1) Boundary term ensures the integrality of lung tissue.2) Region term makes the level set function evolve with global characteristic and independent on initial settings. A penalizing energy term is introduced into the model, which forces the level set function evolving without re-initialization. The method is found to be much more efficient in lung segmentation than other methods that are only based on boundary or region. Results are shown by 3D lung surface reconstruction, which indicates that the method will play an important role in the design of computer-aided diagnostic (CAD) system.

“Seeing the Life”: Redefining self-worth and family roles among Iraqi refugee families resettled in the United States

Science.gov (United States)

Nelson, Matthew; Hess, Julia Meredith; Isakson, Brian; Goodkind, Jessica

2017-01-01

Social and geographic displacement is a global phenomenon that precipitates novel stressors and disruptions that intersect with longstanding familial and social roles. Among the displaced are war-torn Iraqi refugee families, who must address these new obstacles in unconventional ways. This study explores how such disruptions have influenced associations between gender and apparent self-worth experienced by Iraqi refugee families upon relocation to the United States. Further, the psychosocial mechanisms requisite of any novel approach to a new social construct are explored and reveal that production in the family is at the core of instability and shifting power dynamics during resettlement, preventing family members from “seeing the life” in the United States that they had envisioned prior to immigration. Over 200 semi-structured qualitative interviews with Iraqi participants and mental health providers were conducted over the course of the study, and demonstrate a plasticity among social roles in the family and community that transcends the notion of a simple role reversal, and illustrate the complex positionalities that families under stress must approximate during such physical and social displacement. PMID:28966556

The Scope of Practice of Occupational Therapy in U.S. Criminal Justice Settings.

Science.gov (United States)

Muñoz, Jaime P; Moreton, Emily M; Sitterly, Audra M

2016-09-01

In the past 40 years, prison populations in the U.S. have nearly quadrupled while funding for rehabilitation, education and other programmes has been cut. Despite accounting for a small fraction of the world's population more than 20% of the worlds incarcerated population is in the U.S. and the rate of recidivism remains alarmingly high. Occupational therapists have the capability to play a significant role in addressing the needs of persons within the criminal justice system. However, the profession has been slow to delineate of the role occupational therapy within criminal justice settings. This study sought to provide a descriptive analysis of current occupational therapy roles and practices within the U.S. criminal justice system. Using survey research methods, the researchers collected data from respondents (N = 45; Response Rate + 51.7%) to establish a baseline of the scope of practices employed by occupational therapists working in the U.S. criminal justice system. U.S. practitioners work within institutional and community based criminal justice settings. Primary practice models, assessments and group interventions were catalogued. Respondents strongly valued the creation of networking to build the professions' presence within criminal justice settings. Occupational therapy in the criminal justice system remains an emerging practice arena. Understanding the current scope of practice in the U.S. and creating a mechanism for collaboration may help increase the depth, breadth and overall growth of the profession's role in these settings. The sampling method does not guarantee a representative sample of the population and is limited to practice within the United States. Survey design may not have allowed for respondents to fully describe their practice experiences. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

Cubical sets and the topological topos

DEFF Research Database (Denmark)

Spitters, Bas

2016-01-01

: 1. Johnstone's topological topos was created to present the geometric realization of simplicial sets as a geometric morphism between toposes. Johnstone shows that simplicial sets classify strict linear orders with disjoint endpoints and that (classically) the unit interval is such an order. Here we...

Structure, diversity and environmental role of foraminiferal assemblages from reefal settings of Moorea (Society Islands, French Polynesia)

Science.gov (United States)

Fajemila, Olugbenga; Langer, Martin R.

2015-04-01

Reefal and shallow lagoonal environments around the island Moorea (Society Islands, French Polynesia) offer a spectacular variety of microhabitats providing a multitude niches and ideal settings for rich assemblages of tropical benthic foraminifera. The Society Islands are located near the hotspot of tropical marine diversity and represent a transitional location between the high diversity assemblages of the coral triangle and the low diversity biotas of the eastern Pacific. This area constitutes an important biogeographic link and stepping stone between the eastern and western biotas of the tropical Pacific Ocean. We have analyzed the structure, diversity and composition of benthic foraminiferal assemblages from around Moorea to document the composition, species richness and environmental role of larger and smaller benthic foraminifera from within the lagoonal system, the mangrove habitats and fore-reef sites. Foraminifera are prominent producers of calcium carbonate and contribute significantly to structures in reefal settings of the tropical Pacific. We evaluate the potential of larger symbiont-bearing foraminifera as environmental engineers and apply the FORAM-Index as proxy to assess the conditions around Moorea Island. We also evaluate the role of the Society Islands as stepping stone between biogeographic regions of the Pacific Ocean.

Unit Cost Compendium Calculations

Data.gov (United States)

U.S. Environmental Protection Agency — The Unit Cost Compendium (UCC) Calculations raw data set was designed to provide for greater accuracy and consistency in the use of unit costs across the USEPA...

Building visual identity of scientific and research units and the role of visualization in cooperation with business

Directory of Open Access Journals (Sweden)

Alfreda Kamińska

2014-12-01

Full Text Available The need for commercialization of scientific research leads to the necessity of changing the orientation of scientific-research units to marketing orientation, which is characterized by, among others, conducting research aimed at learning the clients’ needs and building better communication with the recipients. What is an important element of a unit’s marketing communication is its visual identity system, which the recipients use to build their opinion and their picture of the unit. The goal of this article is an attempt to define the key rules of designing visual identity of scientific and research institutions, as well as presenting the role of visualization in their cooperation with business. In the article the notions of image, identity, corporate identity and visual identity are subject to analysis. The article also presents the significance of visualization in the functioning of research and scientific units, elements of visual identity system and the rules of designing visual identity of scientific and research institutions. An analysis of chosen research-scientific units was carried out with regard to visualization.

A systematic review evaluating the role of nurses and processes for delivering early mobility interventions in the intensive care unit.

Science.gov (United States)

Krupp, Anna; Steege, Linsey; King, Barbara

2018-04-19

To investigate processes for delivering early mobility interventions in adult intensive care unit patients used in research and quality improvement studies and the role of nurses in early mobility interventions. A systematic review was conducted. Electronic databases PubMED, CINAHL, PEDro, and Cochrane were searched for studies published from 2000 to June 2017 that implemented an early mobility intervention in adult intensive care units. Included studies involved progression to ambulation as a component of the intervention, included the role of the nurse in preparing for or delivering the intervention, and reported at least one patient or organisational outcome measure. The System Engineering Initiative for Patient Safety (SEIPS) model, a framework for understanding structure, processes, and healthcare outcomes, was used to evaluate studies. 25 studies were included in the final review. Studies consisted of randomised control trials, prospective, retrospective, or mixed designs. A range of processes to support the delivery of early mobility were found. These processes include forming interdisciplinary teams, increasing mobility staff, mobility protocols, interdisciplinary education, champions, communication, and feedback. Variation exists in the process of delivering early mobility in the intensive care unit. In particular, further rigorous studies are needed to better understand the role of nurses in implementing early mobility to maintain a patient's functional status. Copyright © 2018 Elsevier Ltd. All rights reserved.

Comparisons of auction mechanisms in a multiple unit setting: A consideration for restructuring electric power markets

Science.gov (United States)

Bernard, John Charles

The objective of this study was to compare the performance of five single sided auctions that could be used in restructured electric power markets across different market sizes in a multiple unit setting. Auction selection would profoundly influence an industry over $200 billion in size in the United States, and the consequences of implementing an inappropriate mechanism would be great. Experimental methods were selected to analyze the auctions. Two rounds of experiments were conducted, the first testing the sealed offer last accepted offer (LAO) and first rejected offer (FRO), and the clock English (ENG) and sealed offer English (SOE) in markets of sizes two and six. The FRO, SOE, and ENG used the same pricing rule. Second round testing was on the LAO, FRO, and the nonuniform price multiple unit Vickrey (MUV) in markets of sizes two, four, and six. Experiments lasted 23 and 75 periods for rounds 1 and 2 respectively. Analysis of variance and contrast analysis were used to examine the data. The four performance measures used were price, efficiency, profits per unit, and supply revelation. Five basic principles were also assessed: no sales at losses, all low cost capacity should be offered and sold, no high cost capacity should sell, and the market should clear. It was expected group size and auction type would affect performance. For all performance measures, group size was a significant variable, with smaller groups showing poorer performance. Auction type was significant only for the efficiency performance measure, where clock auctions outperformed the others. Clock auctions also proved superior for the first four principles. The FRO performed poorly in almost all situations, and should not be a preferred mechanism in any market. The ENG was highly efficient, but expensive for the buyer. The SOE appeared superior to the FRO and ENG. The clock improves efficiency over the FRO while less information kept prices under the ENG. The MUV was superior in revealing costs

Implementing standardized, inter-unit communication in an international setting: handoff of patients from emergency medicine to internal medicine.

Science.gov (United States)

Balhara, Kamna S; Peterson, Susan M; Elabd, Mohamed Moheb; Regan, Linda; Anton, Xavier; Al-Natour, Basil Ali; Hsieh, Yu-Hsiang; Scheulen, James; Stewart de Ramirez, Sarah A

2018-04-01

Standardized handoffs may reduce communication errors, but research on handoff in community and international settings is lacking. Our study at a community hospital in the United Arab Emirates characterizes existing handoff practices for admitted patients from emergency medicine (EM) to internal medicine (IM), develops a standardized handoff tool, and assesses its impact on communication and physician perceptions. EM physicians completed a survey regarding handoff practices and expectations. Trained observers utilized a checklist based on the Systems Engineering Initiative for Patient Safety model to observe 40 handoffs. EM and IM physicians collaboratively developed a written tool encouraging bedside handoff of admitted patients. After the intervention, surveys of EM physicians and 40 observations were subsequently repeated. 77.5% of initial observed handoffs occurred face-to-face, with 42.5% at bedside, and in four different languages. Most survey respondents considered face-to-face handoff ideal. Respondents noted 9-13 patients suffering harm due to handoff in the prior month. After handoff tool implementation, 97.5% of observed handoffs occurred face-to-face (versus 77.5%, p = 0.014), with 82.5% at bedside (versus 42.5%, p face-to-face and bedside handoff, positively impacted workflow, and increased perceptions of safety by EM physicians in an international, non-academic setting. Our three-step approach can be applied towards developing standardized, context-specific inter-specialty handoff in a variety of settings.

Emergency residential care settings: A model for service assessment and design.

Science.gov (United States)

Graça, João; Calheiros, Maria Manuela; Patrício, Joana Nunes; Magalhães, Eunice Vieira

2018-02-01

There have been calls for uncovering the "black box" of residential care services, with a particular need for research focusing on emergency care settings for children and youth in danger. In fact, the strikingly scant empirical attention that these settings have received so far contrasts with the role that they often play as gateway into the child welfare system. To answer these calls, this work presents and tests a framework for assessing a service model in residential emergency care. It comprises seven studies which address a set of different focal areas (e.g., service logic model; care experiences), informants (e.g., case records; staff; children/youth), and service components (e.g., case assessment/evaluation; intervention; placement/referral). Drawing on this process-consultation approach, the work proposes a set of key challenges for emergency residential care in terms of service improvement and development, and calls for further research targeting more care units and different types of residential care services. These findings offer a contribution to inform evidence-based practice and policy in service models of residential care. Copyright © 2017 Elsevier Ltd. All rights reserved.

The role of online community from user and firm perspective

DEFF Research Database (Denmark)

Ponnamma Divakaran, Pradeep Kumar

for firm’s benefits. The overall objective of this doctoral dissertation is to provide insights about how online communities as a collective unit can be exploited for solving some of the problems faced by companies in their product development especially in their pre-launch period. This objective is built...... on the community itself and its characteristics, (2) research focussed on studying the off-line consumer or market behaviour using community as the field setting and (3) research focussed on investigating the various functions and roles of online communities as a collective unit. The first two studies...

Transportable GPU (General Processor Units) chip set technology for standard computer architectures

Science.gov (United States)

Fosdick, R. E.; Denison, H. C.

1982-11-01

The USAFR-developed GPU Chip Set has been utilized by Tracor to implement both USAF and Navy Standard 16-Bit Airborne Computer Architectures. Both configurations are currently being delivered into DOD full-scale development programs. Leadless Hermetic Chip Carrier packaging has facilitated implementation of both architectures on single 41/2 x 5 substrates. The CMOS and CMOS/SOS implementations of the GPU Chip Set have allowed both CPU implementations to use less than 3 watts of power each. Recent efforts by Tracor for USAF have included the definition of a next-generation GPU Chip Set that will retain the application-proven architecture of the current chip set while offering the added cost advantages of transportability across ISO-CMOS and CMOS/SOS processes and across numerous semiconductor manufacturers using a newly-defined set of common design rules. The Enhanced GPU Chip Set will increase speed by an approximate factor of 3 while significantly reducing chip counts and costs of standard CPU implementations.

In Silico Testing of an Artificial-Intelligence-Based Artificial Pancreas Designed for Use in the Intensive Care Unit Setting.

Science.gov (United States)

DeJournett, Leon; DeJournett, Jeremy

2016-11-01

Effective glucose control in the intensive care unit (ICU) setting has the potential to decrease morbidity and mortality rates which should in turn lead to decreased health care expenditures. Current ICU-based glucose controllers are mathematically derived, and tend to be based on proportional integral derivative (PID) or model predictive control (MPC). Artificial intelligence (AI)-based closed loop glucose controllers may have the ability to achieve control that improves on the results achieved by either PID or MPC controllers. We conducted an in silico analysis of an AI-based glucose controller designed for use in the ICU setting. This controller was tested using a mathematical model of the ICU patient's glucose-insulin system. A total of 126 000 unique 5-day simulations were carried out, resulting in 107 million glucose values for analysis. For the 7 control ranges tested, with a sensor error of ±10%, the following average results were achieved: (1) time in control range, 94.2%, (2) time in range 70-140 mg/dl, 97.8%, (3) time in hyperglycemic range (>140 mg/dl), 2.1%, and (4) time in hypoglycemic range (artificial pancreas system for use in the ICU setting. © 2016 Diabetes Technology Society.

A Systematic Review of the Liaison Nurse Role on Patient's Outcomes after Intensive Care Unit Discharge.

Science.gov (United States)

Tabanejad, Zeinab; Pazokian, Marzieh; Ebadi, Abbas

2014-10-01

This review focuses on the impact of liaison nurse in nursing care of patient after ICU discharge on patient's outcomes, compared with patients that are not taken care of by liaison nurses. The role of the ICU liaison nurse has transpired to solve the gap between intensive care unit and wards. Therefore, we aimed to review the outcomes of all studies in this field. A systematic review of intervention studies between 2004 and 2013 was undertaken using standard and sensitive keywords such as liaison nurse, intensive care unit, and patient outcomes in the following databases: Science direct, PubMed, Scopus, Ovid, Oxford, Wiley, Scholar, and Mosby. Then, the articles which had the inclusion criteria after quality control were selected for a systematic review. From 662 retrieved articles, six articles were analyzed in a case study and four articles showed a statistically significant effect of the liaison nurse on the patient's outcomes such as reducing delays in patient discharge, effective discharge planning, improvement in survival for patients at the risk for readmission. Liaison nurses have a positive role on the outcomes of patients who are discharged from the ICU and more research should be done to examine the exact function of liaison nurses and other factors that influence outcomes in patients discharged from ICU.

Hadron physics and transfinite set theory

International Nuclear Information System (INIS)

Augenstein, B.W.

1984-01-01

Known results in transfinite set theory appear to anticipate many aspects of modern particle physics. Extensive and powerful analogies exist between the very curious theorems on ''paradoxical'' decompositions in transfinite set theory, and hadron physics with its underlying quark theory. The phenomenon of quark confinement is an example of a topic with a natural explanation via the analogies. Further, every observed strong interaction hadron reaction can be envisaged as a paradoxical decomposition or sequence of paradoxical decompositions. The essential role of non-Abelian groups in both hadron physics and paradoxical decompositions is one mathematical link connecting these two areas. The analogies suggest critical roles in physics for transfinite set theory and nonmeasurable sets. (author)

Role Models and Teachers: medical students perception of teaching-learning methods in clinical settings, a qualitative study from Sri Lanka.

Science.gov (United States)

Jayasuriya-Illesinghe, Vathsala; Nazeer, Ishra; Athauda, Lathika; Perera, Jennifer

2016-02-09

Medical education research in general, and those focusing on clinical settings in particular, have been a low priority in South Asia. This explorative study from 3 medical schools in Sri Lanka, a South Asian country, describes undergraduate medical students' experiences during their final year clinical training with the aim of understanding the teaching-learning experiences. Using qualitative methods we conducted an exploratory study. Twenty eight graduates from 3 medical schools participated in individual interviews. Interview recordings were transcribed verbatim and analyzed using qualitative content analysis method. Emergent themes reveled 2 types of teaching-learning experiences, role modeling, and purposive teaching. In role modelling, students were expected to observe teachers while they conduct their clinical work, however, this method failed to create positive learning experiences. The clinical teachers who predominantly used this method appeared to be 'figurative' role models and were not perceived as modelling professional behaviors. In contrast, purposeful teaching allowed dedicated time for teacher-student interactions and teachers who created these learning experiences were more likely to be seen as 'true' role models. Students' responses and reciprocations to these interactions were influenced by their perception of teachers' behaviors, attitudes, and the type of teaching-learning situations created for them. Making a distinction between role modeling and purposeful teaching is important for students in clinical training settings. Clinical teachers' awareness of their own manifest professional characterizes, attitudes, and behaviors, could help create better teaching-learning experiences. Moreover, broader systemic reforms are needed to address the prevailing culture of teaching by humiliation and subordination.

Athletic Trainers' Roles and Responsibilities Regarding Academic Adjustments as Part of the Concussion-Management Process in the Secondary School Setting.

Science.gov (United States)

Bacon, Cailee E Welch; Kay, Melissa C; McLeod, Tamara C Valovich

2017-10-01

  Athletic trainers (ATs) play a vital role in managing the care of student-athletes after a sport-related concussion, yet little is known about their specific involvement in the implementation of academic adjustments as part of the concussion-management plan.   To explore ATs' perceived roles and responsibilities regarding the implementation of academic adjustments for concussed student-athletes.   Qualitative study.   Individual telephone interviews.   Sixteen ATs employed in the secondary school setting (8 women, 8 men; age = 39.6 ± 7.9 years; athletic training experience = 15.1 ± 5.6 years), representing 12 states, were interviewed.   One telephone interview was conducted with each participant. After the interviews were transcribed, the data were analyzed and coded into themes and categories, which were determined via consensus of a 4-person research team. To decrease researcher bias, triangulation occurred through participant member checking, the inclusion of multiple researchers, and an internal auditor.   Several categories related to participants' perceptions regarding their roles and responsibilities within the academic-adjustments process emerged from data analysis: (1) understanding of academic adjustments, (2) perceptions of their roles in academic adjustments, (3) initiation of academic adjustments, (4) facilitation of academic adjustments, and (5) lack of a role in the academic-adjustments process. Although most ATs perceived that they had a role in the initiation and facilitation of academic adjustments for concussed student-athletes, some reported they did not want a role in the process. Regardless, participants frequently suggested the need for further education.   These findings highlight that ATs either wanted to be involved in the implementation of academic adjustments but felt further education was needed or they did not want to be involved because they felt that it was not in their area of expertise. To create a cohesive

The role of the neuro-astro-vascular unit in the etiology of Ataxia Telangiectasia

Directory of Open Access Journals (Sweden)

Leenoy eMeshulam

2012-09-01

Full Text Available The growing recognition that brain pathologies do not affect neurons only but rather are, to a large extent, pathologies of glial cells as well as of the vasculature opens to new perspectives in our understanding of genetic disorders of the CNS. To validate the role of the neuron-glial-vascular unit in the etiology of genome instability disorders, we report about cell death and morphological aspects of neuro-glia networks and the associated vasculature in a mouse model of Ataxia Telangiectasia (A-T, a human genetic disorder that induces severe motor impairment. We found that AT-mutated protein deficiency was consistent with aberrant astrocytic morphology and alterations of the vasculature, often accompanied by reactive gliosis. Interestingly similar findings could also be reported in the case of other genetic disorders. These observations bolster the notion that astrocyte-specific pathologies, hampered vascularization and astrocyte-endothelium interactions in the CNS could play a crucial role in the etiology of genome instability brain disorders and could underlie neurodegeneration.

Prederivatives of gamma paraconvex set-valued maps and Pareto optimality conditions for set optimization problems.

Science.gov (United States)

Huang, Hui; Ning, Jixian

2017-01-01

Prederivatives play an important role in the research of set optimization problems. First, we establish several existence theorems of prederivatives for γ -paraconvex set-valued mappings in Banach spaces with [Formula: see text]. Then, in terms of prederivatives, we establish both necessary and sufficient conditions for the existence of Pareto minimal solution of set optimization problems.

Spatial and temporal patterns of plantation forests in the United States since the 1930s: an annual and gridded data set for regional Earth system modeling

Science.gov (United States)

Chen, Guangsheng; Pan, Shufen; Hayes, Daniel J.; Tian, Hanqin

2017-08-01

Plantation forest area in the conterminous United States (CONUS) ranked second among the world's nations in the land area apportioned to forest plantation. As compared to the naturally regenerated forests, plantation forests demonstrate significant differences in biophysical characteristics, and biogeochemical and hydrological cycles as a result of more intensive management practices. Inventory data have been reported for multiple time periods on plot, state, and regional scales across the CONUS, but the requisite annual and spatially explicit plantation data set over a long-term period for analysis of the role of plantation management on regional or national scales is lacking. Through synthesis of multiple inventory data sources, this study developed methods to spatialize the time series plantation forest and tree species distribution data for the CONUS over the 1928-2012 time period. According to this new data set, plantation forest area increased from near zero in the 1930s to 268.27 thousand km2 in 2012, accounting for 8.65 % of the total forestland area in the CONUS. Regionally, the South contained the highest proportion of plantation forests, accounting for about 19.34 % of total forestland area in 2012. This time series and gridded data set developed here can be readily applied in regional Earth system modeling frameworks for assessing the impacts of plantation management practices on forest productivity, carbon and nitrogen stocks, and greenhouse gases (e.g., CO2, CH4, and N2O) and water fluxes on regional or national scales. The gridded plantation distribution and tree species maps, and the interpolated state-level annual tree planting area and plantation area during 1928-2012, are available from PANGAEA.873558" target="_blank">https://doi.org/10.1594/PANGAEA.873558.

78 FR 70414 - Pricing for the 2013 Coin and Chronicles Set-Theodore Roosevelt

Science.gov (United States)

2013-11-25

... DEPARTMENT OF THE TREASURY United States Mint Pricing for the 2013 Coin and Chronicles Set--Theodore Roosevelt AGENCY: United States Mint, Department of the Treasury. ACTION: Notice. SUMMARY: The United States Mint is announcing a price of $57.95 for the 2013 Coin and Chronicles Set--Theodore...

Study on the role of the United Nations in the field of verification

International Nuclear Information System (INIS)

1991-01-01

The present report has been prepared pursuant to General Assembly resolution 43/81 B. The Group of Governmental Experts, while taking fully into account the mandate of the resolution, that is, to prepare a study that addresses the role of the United Nations in the field of verification of arms limitation and disarmament, has also taken into consideration approaches, methods, procedures and techniques relating to other arrangements in the area of international peace and security which might otherwise be useful to the process of verification of arms limitation and disarmament agreements. A selected bibliography on technical aspects of verification is given. However, materials published in languages other than English are not adequately reflected. Refs

Associations among unit leadership and unit climates for implementation in acute care: a cross-sectional study.

Science.gov (United States)

Shuman, Clayton J; Liu, Xuefeng; Aebersold, Michelle L; Tschannen, Dana; Banaszak-Holl, Jane; Titler, Marita G

2018-04-25

Nurse managers have a pivotal role in fostering unit climates supportive of implementing evidence-based practices (EBPs) in care delivery. EBP leadership behaviors and competencies of nurse managers and their impact on practice climates are widely overlooked in implementation science. The purpose of this study was to examine the contributions of nurse manager EBP leadership behaviors and nurse manager EBP competencies in explaining unit climates for EBP implementation in adult medical-surgical units. A multi-site, multi-unit cross-sectional research design was used to recruit the sample of 24 nurse managers and 553 randomly selected staff nurses from 24 adult medical-surgical units from 7 acute care hospitals in the Northeast and Midwestern USA. Staff nurse perceptions of nurse manager EBP leadership behaviors and unit climates for EBP implementation were measured using the Implementation Leadership Scale and Implementation Climate Scale, respectively. EBP competencies of nurse managers were measured using the Nurse Manager EBP Competency Scale. Participants were emailed a link to an electronic questionnaire and asked to respond within 1 month. The contributions of nurse manager EBP leadership behaviors and competencies in explaining unit climates for EBP implementation were estimated using mixed-effects models controlling for nurse education and years of experience on current unit and accounting for the variability across hospitals and units. Significance level was set at α < .05. Two hundred sixty-four staff nurses and 22 nurse managers were included in the final sample, representing 22 units in 7 hospitals. Nurse manager EBP leadership behaviors (p < .001) and EBP competency (p = .008) explained 52.4% of marginal variance in unit climate for EBP implementation. Leadership behaviors uniquely explained 45.2% variance. The variance accounted for by the random intercepts for hospitals and units (p < .001) and years of nursing experience in current unit

Perspectives on the Role of Fospropofol in the Monitored Anesthesia Care Setting

Directory of Open Access Journals (Sweden)

Joseph V. Pergolizzi

2011-01-01

Full Text Available Monitored anesthesia care (MAC is a safe, effective, and appropriate form of anesthesia for many minor surgical procedures. The proliferation of outpatient procedures has heightened interest in MAC sedation agents. Among the most commonly used MAC sedation agents today are benzodiazepines, including midazolam, and propofol. Recently approved in the United States is fospropofol, a prodrug of propofol which hydrolyzes in the body by alkaline phosphatase to liberate propofol. Propofol liberated from fospropofol has unique pharmacological properties, but recently retracted pharmacokinetic (PK and pharmacodynamic (PD evaluations make it difficult to formulate clear conclusions with respect to fospropofol's PK/PD properties. In safety and efficacy clinical studies, fospropofol demonstrated dose-dependent sedation with good rates of success at doses of 6.5 mg/kg along with good levels of patient and physician acceptance. Fospropofol has been associated with less pain at injection site than propofol. The most commonly reported side effects with fospropofol are paresthesia and pruritus. Fospropofol is a promising new sedation agent that appears to be well suited for MAC sedation, but further studies are needed to better understand its PK/PD properties as well its appropriate clinical role in outpatient procedures.

75 FR 17832 - Pricing for 2010 Lincoln One-Cent Coin Two-Roll Set

Science.gov (United States)

2010-04-07

... DEPARTMENT OF THE TREASURY United States Mint Pricing for 2010 Lincoln One-Cent Coin Two-Roll Set AGENCY: United States Mint, Department of the Treasury. ACTION: Notice. SUMMARY: The United States Mint is announcing the price of the 2010 Lincoln One-Cent Coin Two-Roll Set. The 2010 Lincoln One-Cent...

77 FR 69548 - Price for the 2012 Limited Edition Silver Proof SetTM

Science.gov (United States)

2012-11-19

... DEPARTMENT OF THE TREASURY United States Mint Price for the 2012 Limited Edition Silver Proof Set TM AGENCY: United States Mint, Department of the Treasury. ACTION: Notice. SUMMARY: The United States Mint is announcing a price of $149.95 for the 2012 Limited Edition Silver Proof Set TM . FOR FURTHER...

The role of consumer satisfaction, consideration set size, variety seeking and convenience orientation in explaining seafood consumption in Vietnam

OpenAIRE

Ninh, Thi Kim Anh

2010-01-01

The study examines the relationship betweens convenience food and seafood consumption in Vietnam through a replication and an extension of studies of Rortveit and Olsen (2007; 2009). The main purpose of this study is to give an understanding of the role of consumers’ satisfaction, consideration set size, variety seeking, and convenience in explaining seafood consumption behavior in Vietnam.

A description of the roles, activities, and skills of clinical nurse specialists in the United States.

Science.gov (United States)

Scott, R A

1999-07-01

Clinical nurse specialists (CNSs) frequently adapt to meet the challenging and changing needs of patients, families, nurses, physicians, and institutions, thus creating an advance practice role that is problematic in definition and description. The two dilemmas associated with CNSs have been role confusion and ambiguity, and the inability to explicate CNSs' value in economic terms. The purpose of this study was to describe the roles, activities, skills, and the cost-saving and revenue-generating activities of Master's-prepared nurses who function in traditional CNS roles in the United States. A descriptive research design was employed, using Role Theory as a framework to guide the study. The tool used to measure CNS practice included a 68-item instrument. It was pretested and used in two pilot studies. Content validity was supported by three experienced CNSs who were, at the time, in a doctoral nursing program. Instrument reliability was 0.89. Surveys were mailed to all individuals who subscribed (n = 2379) to the Clinical Nurse Specialist Journal. From the convenience sample, 724 CNSs participated, providing a margin of error of +/- 4 percentage points with a 99% confidence level. Regarding the five role components, CNSs reported (listed from most frequently to least frequently) spending time in the role of expert practitioner, educator, consultant, administrator, and researcher. Most of the activities listed in each of the roles were typical of CNS practice. Of the advanced practice roles, the two with the most surprising results were the expert practitioner and administrator roles. The results indicated a trend toward performing advanced skills that have been in the past considered solely medical practice and toward increasing administrative responsibilities. A small number of CNSs were able to identify cost-saving and revenue-generating activities, including the monetary value of the activity.

Measuring Men's Gender Norms and Gender Role Conflict/Stress in a High HIV-Prevalence South African Setting.

Science.gov (United States)

Gottert, Ann; Barrington, Clare; Pettifor, Audrey; McNaughton-Reyes, Heath Luz; Maman, Suzanne; MacPhail, Catherine; Kahn, Kathleen; Selin, Amanda; Twine, Rhian; Lippman, Sheri A

2016-08-01

Gender norms and gender role conflict/stress may influence HIV risk behaviors among men; however scales measuring these constructs need further development and evaluation in African settings. We conducted exploratory and confirmatory factor analyses to evaluate the Gender Equitable Men's Scale (GEMS) and the Gender Role Conflict/Stress (GRC/S) scale among 581 men in rural northeast South Africa. The final 17-item GEMS was unidimensional, with adequate model fit and reliability (alpha = 0.79). Factor loadings were low (0.2-0.3) for items related to violence and sexual relationships. The final 24-item GRC/S scale was multidimensional with four factors: Success, power, competition; Subordination to women; Restrictive emotionality; and Sexual prowess. The scale had adequate model fit and good reliability (alpha = 0.83). While GEMS is a good measure of inequitable gender norms, new or revised scale items may need to be explored in the South African context. Adding the GRC/S scale to capture men's strain related to gender roles could provide important insights into men's risk behaviors.

MIL-STD-1553 dynamic bus controller/remote terminal hybrid set

Science.gov (United States)

Friedman, S. N.

This paper describes the performance, physical and electrical requirements of a Dual Redundant BUS Interface Unit (BIU) acting as a BUS Controller Interface Unit (BCIU) or Remote Terminal Unit (RTU) between a Motorola 68000 VME BUS and MIL-STD-1553B Multiplex Data Bus. A discussion of how the BIU Hybrid set is programmed, and operates as a BCIU or RTU, will be included. This paper will review Dynamic Bus Control and other Mode Code capabilities. The BIU Hybrid Set interfaces to a 68000 Microprocessor with a VME Bus using programmed I/O transfers. This special interface will be discussed along with the internal Dual Access Memory (4K x 16) used to support the data exchanges between the CPU and the BIU Hybrid Set. The hybrid set's physical size and power requirements will be covered. This includes the present Double Eurocard the BIU function is presently being offered on.

Rationale set of indicators and prioritize relevant to assess competitive activity of hockey players of high qualification of different roles

Directory of Open Access Journals (Sweden)

A.P. Mikhnov

2015-02-01

Full Text Available Purpose: organize technical and tactical actions and determine their priority importance for high-end players of different roles. Establish their priority importance for the success of competitive activity hockey with the game roles. Material : the study involved 54 experts on hockey coaches and players of high class. The significance of technical and tactical actions evaluated for players of different roles. Results : systematic account of technical and tactical actions of athletes and prioritize them to assess the significance of competitive activity. Three groups of technical and tactical actions: 1 active attacks; 2 - active safety; 3 - organizational and maneuvering. Set priorities for technical and tactical actions for players of different roles. Conclusions : the proposed technical and tactical actions can be recommended for the evaluation of the effectiveness of competitive activity players. In the process of estimating the action game players need to consider their role playing. Identification of priority in the implementation of technical and tactical actions in the game can be used in integrated assessment of actions players different roles.

Accounting for medical communication: Parents’ perceptions of communicative roles and responsibilities in the pediatric intensive care unit

OpenAIRE

GORDON, CYNTHIA; BARTON, ELLEN; MEERT, KATHLEEN L.; EGGLY, SUSAN; POLLACK, MURRAY; ZIMMERMAN, JERRY; ANAND, K. J. S.; CARCILLO, JOSEPH; NEWTH, CHRISTOPHER J. L.; DEAN, J. MICHAEL; WILLSON, DOUGLAS F.; NICHOLSON, CAROL

2009-01-01

Through discourse analysis of transcribed interviews conducted over the phone with parents whose child died in the Pediatric Intensive Care Unit (PICU) (n = 51), this study uncovers parents’ perceptions of clinicians’ and their own communicative roles and responsibilities in the context of team-based care. We examine parents’ descriptions and narratives of communicative experiences they had with PICU clinicians, focusing on how parents use accounts to evaluate the communicative behaviors they...

Addressing Child Poverty: How Does the United States Compare With Other Nations?

Science.gov (United States)

Smeeding, Timothy; Thévenot, Céline

2016-04-01

Poverty during childhood raises a number of policy challenges. The earliest years are critical in terms of future cognitive and emotional development and early health outcomes, and have long-lasting consequences on future health. In this article child poverty in the United States is compared with a set of other developed countries. To the surprise of few, results show that child poverty is high in the United States. But why is poverty so much higher in the United States than in other rich nations? Among child poverty drivers, household composition and parent's labor market participation matter a great deal. But these are not insurmountable problems. Many of these disadvantages can be overcome by appropriate public policies. For example, single mothers have a very high probability of poverty in the United States, but this is not the case in other countries where the provision of work support increases mothers' labor earnings and together with strong public cash support effectively reduces child poverty. In this article we focus on the role and design of public expenditure to understand the functioning of the different national systems and highlight ways for improvements to reduce child poverty in the United States. We compare relative child poverty in the United States with poverty in a set of selected countries. The takeaway is that the United States underinvests in its children and their families and in so doing this leads to high child poverty and poor health and educational outcomes. If a nation like the United States wants to decrease poverty and improve health and life chances for poor children, it must support parental employment and incomes, and invest in children's futures as do other similar nations with less child poverty. Copyright © 2016 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

Assessing students in community settings: the role of peer evaluation

NARCIS (Netherlands)

H.G. Schmidt (Henk); D.H.J.M. Dolmans (Diana); A.A. Abdel-Hameed (Ahmed); M.E.M. Mohi Eldin (Magzoub)

1998-01-01

textabstractThe assessment of students in community settings faces unique difficulties. Since students are usually posted in small groups in different community settings and since the learning (largely) takes place outside the classroom, assessing student performance becomes an intrinsically complex

Supporting the Sexual Intimacy Needs of Patients in a Longer Stay Inpatient Forensic Setting.

Science.gov (United States)

Quinn, Chris; Happell, Brenda

2016-10-01

To explore perceptions of nurses and patients regarding sexual intimacy in a long-term mental health unit. Qualitative exploratory design including in-depth semi-structured individual interviews with 12 registered nurses and 10 long-term patients of a forensic mental health hospital. The theme of supporting sexual intimacy was identified and described in this paper and included the following subthemes for nurses: It depends on the setting, need for guidelines and consent, and for patients-it depends on the setting; and need for support. The findings suggest that current guidelines regarding sexual intimacy in acute inpatient settings may not be appropriate in long-term facilities, with a need for guidelines to specifically address this setting. Furthermore, support for sexual intimacy needs of patients was identified as a strong need for patients and they believed not currently met. Nurses have an important role to play as part of their holistic approach to care and barriers to providing this aspect of care must be overcome to ensure patients' rights are respected. © 2015 Wiley Periodicals, Inc.

The critical role of extreme heat for maize production in the United States

Science.gov (United States)

Lobell, David B.; Hammer, Graeme L.; McLean, Greg; Messina, Carlos; Roberts, Michael J.; Schlenker, Wolfram

2013-05-01

Statistical studies of rainfed maize yields in the United States and elsewhere have indicated two clear features: a strong negative yield response to accumulation of temperatures above 30°C (or extreme degree days (EDD)), and a relatively weak response to seasonal rainfall. Here we show that the process-based Agricultural Production Systems Simulator (APSIM) is able to reproduce both of these relationships in the Midwestern United States and provide insight into underlying mechanisms. The predominant effects of EDD in APSIM are associated with increased vapour pressure deficit, which contributes to water stress in two ways: by increasing demand for soil water to sustain a given rate of carbon assimilation, and by reducing future supply of soil water by raising transpiration rates. APSIM computes daily water stress as the ratio of water supply to demand, and during the critical month of July this ratio is three times more responsive to 2°C warming than to a 20% precipitation reduction. The results suggest a relatively minor role for direct heat stress on reproductive organs at present temperatures in this region. Effects of elevated CO2 on transpiration efficiency should reduce yield sensitivity to EDD in the coming decades, but at most by 25%.

Non-Asymptotic Confidence Sets for Circular Means

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Thomas Hotz

2016-10-01

Full Text Available The mean of data on the unit circle is defined as the minimizer of the average squared Euclidean distance to the data. Based on Hoeffding’s mass concentration inequalities, non-asymptotic confidence sets for circular means are constructed which are universal in the sense that they require no distributional assumptions. These are then compared with asymptotic confidence sets in simulations and for a real data set.

New Roles, New Responsibilities: Examining Training Needs of Repository Staff

Directory of Open Access Journals (Sweden)

Natasha Simons

2012-05-01

Full Text Available INTRODUCTION Institutional repositories play a critical role in the research lifecycle. Funding agencies are increasingly seeking an improved return on their investment in research. Repositories facilitate this process by providing storage of, and access to, institutional research outputs and, more recently, research data. While repositories are generally managed within the academic library, repository staff require different skills and knowledge compared with traditional library roles. This study reports on a survey of Australasian institutional repository staff to identify skills and knowledge sets. METHODS Institutional repository staff working at universities in Australia and New Zealand were invited to participate in an online survey which incorporated both open and closed-ended question types. RESULTS The survey found significant gaps in the current provision of formal training and coursework related to institutional repositories, which echoed findings in the United Kingdom, Italy, and the United States. DISCUSSION There is clearly a need for more and varied training opportunities for repository professionals. Repository work requires a specific set of skills that can be difficult to find and institutions will benefit from investing in training and ongoing development opportunities for repository staff. CONCLUSION The data from this study could be used to facilitate staff recruitment, development, training, and retention strategies.

A Multi-Objective Unit Commitment Model for Setting Carbon Tax to Reduce CO2 Emission: Thailand's Electricity Generation Case

Directory of Open Access Journals (Sweden)

Nuchjarin Intalar

2015-07-01

Full Text Available Carbon tax policy is a cost-effective instrument for emission reduction. However, setting the carbon tax is one of the challenging task for policy makers as it will lead to higher price of emission-intensive sources especially the utility price. In a large-scale power generation system, minimizing the operational cost and the environmental impact are conflicting objectives and it is difficult to find the compromise solution. This paper proposes a methodology of finding a feasible carbon tax rate on strategic level using the operational unit commitment model. We present a multi-objective mixed integer linear programming model to solve the unit commitment problem and consider the environmental impacts. The methodology of analyzing of the effect of carbon tax rates on the power generation, operating cost, and CO2 emission is also provided. The trade-off relationship between total operating cost and total CO2 emission is presented in the Pareto-optimal curve to analyze the feasible carbon tax rate that is influencing on electricity operating cost. The significant outcome of this paper is a modeling framework for the policy makers to determine the possible carbon tax that can be imposed on the electricity generation.

Decision unit program

International Nuclear Information System (INIS)

Madjar, N.; Pastor, C.; Chambon, B.; Drain, D.; Giorni, A.; Dauchy, A.

1981-01-01

A decision unit has been built to simplify the electronic logic set-up in multi-detectors experiments. This unit, designed with fast memories used as decision making tables, replaces conventional logic modules. Nine inputs are provided for receiving the fast detector signals (charged particles, gammas, neutrons, ...). Fifteen independent outputs allow the identification of the choosen events among the 2 9 possible events. A CAMAC interface between the unit and the computer, or a manual control auxiliary module, is used to load, in the memory, the pattern of the choosen events [fr

76 FR 67799 - Pricing for the American Eagle 25th Anniversary Silver Coin Set

Science.gov (United States)

2011-11-02

... DEPARTMENT OF THE TREASURY United States Mint Pricing for the American Eagle 25th Anniversary Silver Coin Set AGENCY: United States Mint, Department of the Treasury. ACTION: Notice. SUMMARY: The United States Mint is announcing the price of the American Eagle 25th Anniversary Silver Coin Set. The...

The role of perfectionism, dichotomous thinking, shape and weight overvaluation, and conditional goal setting in eating disorders.

Science.gov (United States)

Lethbridge, Jessica; Watson, Hunna J; Egan, Sarah J; Street, Helen; Nathan, Paula R

2011-08-01

This study examined the role of perfectionism (self-oriented and socially prescribed), shape and weight overvaluation, dichotomous thinking, and conditional goal setting in eating disorder psychopathology. Perfectionism and shape and weight overvaluation have had longstanding implication in the development and maintenance of eating disorders. A leading evidence-based theory of eating disorders (Fairburn, Cooper & Shafran, 2003) outlines perfectionism as a maintaining mechanism of eating disorder psychopathology and as a proximal risk factor for the development of shape and weight overvaluation. These constructs have been linked to other cognitive processes relevant to eating disorders, specifically, dichotomous thinking and conditional goal setting. Women with DSM-IV eating disorders (N=238) were compared to women in the general community (N=248) and, as hypothesised, scores on measures of these constructs were pronounced in the clinical sample. Hierarchical regression analyses predicting eating disorder psychopathology showed that for both groups, dichotomous thinking and conditional goal setting significantly improved model fit beyond perfectionism and shape and weight overvaluation alone. Self-oriented perfectionism, but not socially prescribed perfectionism, was relevant to eating disorder psychopathology. We discuss the implications for current treatment protocols and early intervention. Crown Copyright © 2011. Published by Elsevier Ltd. All rights reserved.

The Experience and Effectiveness of Nurse Practitioners in Orthopaedic Settings: A Comprehensive Systematic Review.

Science.gov (United States)

Taylor, Anita; Staruchowicz, Lynda

This review asks "What is the experience and effectiveness of nurse practitioners in orthopaedic settings"?The objective of the quantitative component of this review is to synthesise the best available evidence on effectiveness of orthopaedic nurse practitioner specific care on patient outcomes and process indicators.The objective of the qualitative component of this review is to synthesise the best available evidence on the experience of becoming or being an orthopaedic nurse practitioner in relation to role development, role implementation and (ongoing) role evaluation.The objective of the text and opinion component of this review is to synthesise the best available evidence of the contemporary discourse on the effectiveness and experience of nurse practitioners in orthopaedic settings. Nurse practitioner roles have emerged in response to areas of unmet healthcare needs in a variety of settings. Nurse practitioners first evolved in the United States 40 years ago in response to a shortage of primary health care physicians. Nurse practitioners filled the void by providing access to primary health care services where otherwise there was none. Nurse practitioners comprise one branch of advanced nursing practice in the US along with Nurse Anaesthetists (NA), Clinical Nurse Specialists (CNS) and Nurse Midwives (NM). Canada soon followed America's lead by establishing the nurse practitioner role in 1967. Canada has two areas of advanced nursing practice, namely nurse practitioner and clinical nurse specialist; they are moving towards introducing nurse anaesthetists currently. The nurse practitioner role was introduced into the United Kingdom 20 years ago.There is commonality amongst the definition and characteristics of Nurse Practitioner (NP)/Advanced Practice Nurse (APN) role and practice internationally in terms of education, practice standards and regulation; operationally there is variability however. Australia's progress with nurse practitioners is very much

Loss of parental role as a cause of stress in the neonatal intensive care unit.

Science.gov (United States)

Bouet, Kary M; Claudio, Norma; Ramirez, Verónica; García-Fragoso, Lourdes

2012-01-01

Having a baby in the Neonatal Intensive Care Unit (NICU) is a major source of stress for parents. The barriers to parenting and reactions to the environment may negatively influence the parent-infant relationship. To identify NICU-related parental stress and associated factors. Parents (N = 156) of newborns admitted to NICU completed the Parental Stressor Scale. Most of the parents (46%) rated the experience to be extremely stressful. The principal cause of stress was the alteration in parental role and being separated from their baby. Stress was not associated to education, marital status, infants' birth weight, gestational age, congenital anomalies or if the parents expected the baby to be in the NICU. Identification of areas associated to higher levels of stress in parents may help the NICU staff to establish strategies to help parents cope with the stress caused by being unable to start their parenting role immediately after their babies' birth.

[Fear of child/family in pediatric intensive care units: what is the nurse's role?].

Science.gov (United States)

Machado, Cidália; Sousa, Pedro Jácome

2007-01-01

The fear is considered a negative emotion, lived with apprehension, uncertainty and a sense of threat or danger to the personal integrity (Torres & Guerra, 2003). It is often associated with hospitalization of the chid/family, and may be the cause to start an emotional crisis due to the separation from environment and the usual routines, the loss of independence and autonomy, and also due to be with strange people (Bicho, 2006; Festas 1994; Freitas &Freitas, 2005; Hockenberry, 2006). Hospitalization in a Pediatric Intensive Care Unit (PICU) may worsen an already existing crisis not only for the given reasons but also because the child may be in life danger. The environment "aggressive"and stressant characteristic of these units also contributes to this situation. To minimize the fear and his negative effects, the nurse has an important role to play. Because of his/her activities and function he/she is the closest health care professional to the child/family, and therefore in a better position to establish a relationship of trust and empathy that will minimize such effects, as well as to the interventions best suited to achieve this objective.

Fuqing nuclear power of nuclear steam turbine generating unit No.1 at the implementation and feedback

International Nuclear Information System (INIS)

Cao Yuhua; Xiao Bo; He Liu; Huang Min

2014-01-01

The article introduces the Fuqing nuclear power of nuclear steam turbine generating unit no.l purpose, range of experience, experiment preparation, implementation, feedback and response. Turn of nuclear steam turbo-generator set flush, using the main reactor coolant pump and regulator of the heat generated by the electric heating element and the total heat capacity in secondary circuit of reactor coolant system (steam generator secondary side) of saturated steam turbine rushed to 1500 RPM, Fuqing nuclear power of nuclear steam turbine generating unit no.1 implementation of the performance of the inspection of steam turbine and its auxiliary system, through the test problems found in the clean up in time, the nuclear steam sweep turn smooth realization has accumulated experience. At the same time, Fuqing nuclear power of nuclear steam turbine generating unit no.1 at turn is half speed steam turbine generator non-nuclear turn at the first, with its smooth realization of other nuclear power steam turbine generator set in the field of non-nuclear turn play a reference role. (authors)

Future shift of the relative roles of precipitation and temperature in controlling annual runoff in the conterminous United States

Science.gov (United States)

Kai Duan; Ge Sun; Steven G. McNulty; Peter V. Caldwell; Erika C. Cohen; Shanlei Sun; Heather D. Aldridge; Decheng Zhou; Liangxia Zhang; Yang Zhang

2017-01-01

This study examines the relative roles of cli- matic variables in altering annual runoff in the contermi- nous United States (CONUS) in the 21st century, using a monthly ecohydrological model (the Water Supply Stress In- dex model, WaSSI) driven with historical records and future scenarios constructed from 20 Coupled Model Intercompar- ison Project Phase 5 (CMIP5)...

Paediatric cardiac intensive care unit: current setting and organization in 2010.

Science.gov (United States)

Fraisse, Alain; Le Bel, Stéphane; Mas, Bertrand; Macrae, Duncan

2010-10-01

Over recent decades, specialized paediatric cardiac intensive care has emerged as a central component in the management of critically ill, neonatal, paediatric and adult patients with congenital and acquired heart disease. The majority of high-volume centres (dealing with over 300 surgical cases per year) have dedicated paediatric cardiac intensive care units, with the smallest programmes more likely to care for paediatric cardiac patients in mixed paediatric or adult intensive care units. Specialized nursing staff are also a crucial presence at the patient's bedside for quality of care. A paediatric cardiac intensive care programme should have patients (preoperative and postoperative) grouped together geographically, and should provide proximity to the operating theatre, catheterization laboratory and radiology department, as well as to the regular ward. Age-appropriate medical equipment must be provided. An optimal strategy for running a paediatric cardiac intensive care programme should include: multidisciplinary collaboration and involvement with paediatric cardiology, anaesthesia, cardiac surgery and many other subspecialties; a risk-stratification strategy for quantifying perioperative risk; a personalized patient approach; and anticipatory care. Finally, progressive withdrawal from heavy paediatric cardiac intensive care management should be institutionalized. Although the countries of the European Union do not share any common legislation on the structure and organization of paediatric intensive care or paediatric cardiac intensive care, any paediatric cardiac surgery programme in France that is agreed by the French Health Ministry must perform at least '150 major procedures per year in children' and must provide a 'specialized paediatric intensive care unit'. Copyright © 2010 Elsevier Masson SAS. All rights reserved.

The Role of Construct Maps in Standard Setting

Science.gov (United States)

Kane, Michael T.; Tannenbaum, Richard J.

2013-01-01

The authors observe in this commentary that construct maps can help standard-setting panels to make realistic and internally consistent recommendations for performance-level descriptions (PLDs) and cut-scores, but the benefits may not be realized if policymakers do not fully understand the rationale for the recommendations provided by the…

Unit cost of healthcare services at 200-bed public hospitals in Myanmar: what plays an important role of hospital budgeting?

Science.gov (United States)

Than, Thet Mon; Saw, Yu Mon; Khaing, Moe; Win, Ei Mon; Cho, Su Myat; Kariya, Tetsuyoshi; Yamamoto, Eiko; Hamajima, Nobuyuki

2017-09-19

Cost information is important for efficient allocation of healthcare expenditure, estimating future budget allocation, and setting user fees to start new financing systems. Myanmar is in political transition, and trying to achieve universal health coverage by 2030. This study assessed the unit cost of healthcare services at two public hospitals in the country from the provider perspective. The study also analyzed the cost structure of the hospitals to allocate and manage the budgets appropriately. A hospital-based cross-sectional study was conducted at 200-bed Magway Teaching Hospital (MTH) and Pyinmanar General Hospital (PMN GH), in Myanmar, for the financial year 2015-2016. The step-down costing method was applied to calculate unit cost per inpatient day and per outpatient visit. The costs were calculated by using Microsoft Excel 2010. The unit costs per inpatient day varied largely from unit to unit in both hospitals. At PMN GH, unit cost per inpatient day was 28,374 Kyats (27.60 USD) for pediatric unit and 1,961,806 Kyats (1908.37 USD) for ear, nose, and throat unit. At MTH, the unit costs per inpatient day were 19,704 Kyats (19.17 USD) for medicine unit and 168,835 Kyats (164.24 USD) for eye unit. The unit cost of outpatient visit was 14,882 Kyats (14.48 USD) at PMN GH, while 23,059 Kyats (22.43 USD) at MTH. Regarding cost structure, medicines and medical supplies was the largest component at MTH, and the equipment was the largest component at PMN GH. The surgery unit of MTH and the eye unit of PMN GH consumed most of the total cost of the hospitals. The unit costs were influenced by the utilization of hospital services by the patients, the efficiency of available resources, type of medical services provided, and medical practice of the physicians. The cost structures variation was also found between MTH and PMN GH. The findings provided the basic information regarding the healthcare cost of public hospitals which can apply the efficient utilization of the

Society for Assisted Reproductive Technology and assisted reproductive technology in the United States: a 2016 update.

Science.gov (United States)

Toner, James P; Coddington, Charles C; Doody, Kevin; Van Voorhis, Brad; Seifer, David B; Ball, G David; Luke, Barbara; Wantman, Ethan

2016-09-01

The Society for Assisted Reproductive Technology (SART) was established within a few years of assisted reproductive technology (ART) in the United States, and has not only reported on the evolution of infertility care, but also guided it toward improved success and safety. Moving beyond its initial role as a registry, SART has expanded its role to include quality assurance, data validation, practice and advertising guidelines, research, patient education and advocacy, and membership support. The success of ART in this country has greatly benefited from SART's role, as highlighted by a series of graphs. SART continues to set the standard and lead the way. Copyright © 2016 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

Early and total neonatal mortality in relation to birth setting in the United States, 2006-2009.

Science.gov (United States)

Grünebaum, Amos; McCullough, Laurence B; Sapra, Katherine J; Brent, Robert L; Levene, Malcolm I; Arabin, Birgit; Chervenak, Frank A

2014-10-01

We examined neonatal mortality in relation to birth settings and birth attendants in the United States from 2006 through 2009. Data from the Centers for Disease Control and Prevention-linked birth and infant death dataset in the United States from 2006 through 2009 were used to assess early and total neonatal mortality for singleton, vertex, and term births without congenital malformations delivered by midwives and physicians in the hospital and midwives and others out of the hospital. Deliveries by hospital midwives served as the reference. Midwife home births had a significantly higher total neonatal mortality risk than deliveries by hospital midwives (1.26 per 1000 births; relative risk [RR], 3.87 vs 0.32 per 1000; P home births of 41 weeks or longer (1.84 per 1000; RR, 6.76 vs 0.27 per 1000; P home births of women with a first birth (2.19 per 1000; RR, 6.74 vs 0.33 per 1000; P home births, neonatal mortality for first births was twice that of subsequent births (2.19 vs 0.96 per 1000; P home births compared with midwife hospital births was 9.32 per 10,000 births, and the excess early neonatal mortality was 7.89 per 10,000 births. Our study shows a significantly increased total and early neonatal mortality for home births and even higher risks for women of 41 weeks or longer and women having a first birth. These significantly increased risks of neonatal mortality in home births must be disclosed by all obstetric practitioners to all pregnant women who express an interest in such births. Copyright © 2014 Elsevier Inc. All rights reserved.

Benchmarking of protein descriptor sets in proteochemometric modeling (part 2): modeling performance of 13 amino acid descriptor sets

Science.gov (United States)

2013-01-01

Background While a large body of work exists on comparing and benchmarking descriptors of molecular structures, a similar comparison of protein descriptor sets is lacking. Hence, in the current work a total of 13 amino acid descriptor sets have been benchmarked with respect to their ability of establishing bioactivity models. The descriptor sets included in the study are Z-scales (3 variants), VHSE, T-scales, ST-scales, MS-WHIM, FASGAI, BLOSUM, a novel protein descriptor set (termed ProtFP (4 variants)), and in addition we created and benchmarked three pairs of descriptor combinations. Prediction performance was evaluated in seven structure-activity benchmarks which comprise Angiotensin Converting Enzyme (ACE) dipeptidic inhibitor data, and three proteochemometric data sets, namely (1) GPCR ligands modeled against a GPCR panel, (2) enzyme inhibitors (NNRTIs) with associated bioactivities against a set of HIV enzyme mutants, and (3) enzyme inhibitors (PIs) with associated bioactivities on a large set of HIV enzyme mutants. Results The amino acid descriptor sets compared here show similar performance (set differences ( > 0.3 log units RMSE difference and >0.7 difference in MCC). Combining different descriptor sets generally leads to better modeling performance than utilizing individual sets. The best performers were Z-scales (3) combined with ProtFP (Feature), or Z-Scales (3) combined with an average Z-Scale value for each target, while ProtFP (PCA8), ST-Scales, and ProtFP (Feature) rank last. Conclusions While amino acid descriptor sets capture different aspects of amino acids their ability to be used for bioactivity modeling is still – on average – surprisingly similar. Still, combining sets describing complementary information consistently leads to small but consistent improvement in modeling performance (average MCC 0.01 better, average RMSE 0.01 log units lower). Finally, performance differences exist between the targets compared thereby underlining that

The organisational context of nursing care in stroke units: a case study approach.

Science.gov (United States)

Burton, Christopher R; Fisher, Andrea; Green, Theresa L

2009-01-01

Internationally the stroke unit is recognised as the evidence-based model for patient management, although clarity about the effective components of stroke units is lacking. Whilst skilled nursing care has been proposed as one component, the theoretical and empirical basis for stroke nursing is limited. We attempted to explore the organisational context of stroke unit nursing, to determine those features that staff perceived to be important in facilitating high quality care. A case study approach was used, that included interviews with nurses and members of the multidisciplinary teams in two Canadian acute stroke units. A total of 20 interviews were completed, transcribed and analysed thematically using the Framework Approach. Trustworthiness was established through the review of themes and their interpretation by members of the stroke units. Nine themes that comprised an organisational context that supported the delivery of high quality nursing care in acute stroke units were identified, and provide a framework for organisational development. The study highlighted the importance of an overarching service model to guide the organisation of care and the development of specialist and advanced nursing roles. Whilst multidisciplinary working appears to be a key component of stroke unit nursing, various organisational challenges to its successful implementation were highlighted. In particular the consequence of differences in the therapeutic approach of nurses and therapy staff needs to be explored in greater depth. Successful teamwork appears to depend on opportunities for the development of relationships between team members as much as the use of formal communication systems and structures. A co-ordinated approach to education and training, clinical leadership, a commitment to research, and opportunities for role and practice development also appear to be key organisational features of stroke unit nursing. Recommendations for the development of stroke nursing

Set-up of a pre-test mock-up experiment in preparation for the HCPB Breeder Unit mock-up experimental campaign

Energy Technology Data Exchange (ETDEWEB)

Hernández, F., E-mail: francisco.hernandez@kit.edu [Karlsruhe Institute of Technology (KIT), Institute for Neutron Physics and Reactor Technology (INR) (Germany); Kolb, M. [Karlsruhe Institute of Technology (KIT), Institute for Applied Materials (IAM-WPT) (Germany); Ilić, M.; Kunze, A. [Karlsruhe Institute of Technology (KIT), Institute for Neutron Physics and Reactor Technology (INR) (Germany); Németh, J. [KFKI Research Institute for Particle and Nuclear Physics (Hungary); Weth, A. von der [Karlsruhe Institute of Technology (KIT), Institute for Neutron Physics and Reactor Technology (INR) (Germany)

2013-10-15

Highlights: ► As preparation for the HCPB-TBM Breeder Unit out-of-pile testing campaign, a pre-test experiment (PREMUX) has been prepared and described. ► A new heater system based on a wire heater matrix has been developed for imitating the neutronic volumetric heating and it is compared with the conventional plate heaters. ► The test section is described and preliminary thermal results with the available models are presented and are to be benchmarked with PREMUX. ► The PREMUX integration in the air cooling loop L-STAR/LL in the Karlsruhe Institute for Technology is shown and future steps are discussed. -- Abstract: The complexity of the experimental set-up for testing a full-scaled Breeder Unit (BU) mock-up for the European Helium Cooled Pebble Bed Test Blanket Module (HCPB-TBM) has motivated to build a pre-test mock-up experiment (PREMUX) consisting of a slice of the BU in the Li{sub 4}SiO{sub 4} region. This pre-test aims at verifying the feasibility of the methods to be used for the subsequent testing of the full-scaled BU mock-up. Key parameters needed for the modeling of the breeder material is also to be determined by the Hot Wire Method (HWM). The modeling tools for the thermo-mechanics of the pebble beds and for the mock-up structure are to be calibrated and validated as well. This paper presents the setting-up of PREMUX in the L-STAR/LL facility at the Karlsruhe Institute of Technology. A key requirement of the experiments is to mimic the neutronic volumetric heating. A new heater concept is discussed and compared to several conventional heater configurations with respect to the estimated temperature distribution in the pebble beds. The design and integration of the thermocouple system in the heater matrix and pebble beds is also described, as well as other key aspects of the mock-up (dimensions, layout, cooling system, purge gas line, boundary conditions and integration in the test facility). The adequacy of these methods for the full-scaled BU

The Role of Music in Speech Intelligibility of Learners with Post Lingual Hearing Impairment in Selected Units in Lusaka District

Science.gov (United States)

Katongo, Emily Mwamba; Ndhlovu, Daniel

2015-01-01

This study sought to establish the role of music in speech intelligibility of learners with Post Lingual Hearing Impairment (PLHI) and strategies teachers used to enhance speech intelligibility in learners with PLHI in selected special units for the deaf in Lusaka district. The study used a descriptive research design. Qualitative and quantitative…

The role of procalcitonin in neonatal intensive care unit patients with candidemia.

Science.gov (United States)

Montagna, Maria Teresa; Coretti, Caterina; Rella, Antonella; Barbuti, Giovanna; Manca, Fabio; Montagna, Osvaldo; Laforgia, Nicola; Caggiano, Giuseppina

2013-01-01

Candidemia is a major infectious complication in neonatal patients. The isolation of yeasts from blood is still the "gold standard" for its diagnosis, but other laboratory markers (i.e., circulating antigens) have been studied with varying specificities and sensitivities. The aim of this study was to evaluate the role of procalcitonin for the diagnosis of candidemia in neonatal patients at high risk. To verify if the use of different commercial methods can highlight dissimilar results of sensitivity and/or specificity, the determination of procalcitonin serum levels was estimated by two systems. Overall, 90 patients from a Neonatal Intensive Care Units were enrolled, of whom six developed Candida bloodstream infection. Four of six infants with candidemia had slight increase of procalcitonin values (0.5-1 ng/mL). Only one baby showed very high levels but he had fungal and bacterial sepsis at the same time, while no elevation was observed in the sixth patient. No statistically significant difference was observed between two different methods at the time of monitoring (p>0.643). Both methods showed a sensitivity of 83.3 % at diagnosis, while the specificity was 73.8 and 63.1 % by methods A and B, respectively. In the light of the low sensibility and specificity of this assay, we can assume that the determination of procalcitonin would not seem to play a significant role in the diagnosis of fungal infection in neonatal patients.

Fostering New Roles for Librarians: Skills Set for Repository Managers — Results of a Survey in Italy

Directory of Open Access Journals (Sweden)

Maria Cassella

2012-04-01

Full Text Available The open access movement in scholarly communication has grown considerably over the last ten years and it has driven an increase in the number of institutional repositories (IRs. New professional roles and skills had to be developed to secure effective IR management. Collection developmente expertise and metadata curation are regarded as strategic roles for repositories and therefore it is only logical for the library and information community to take on the responsibility for managing these digital archives. However, it has become clear that traditional librarian skills do not suffice anymore to run successful repositories. A richer set of skills is needed, including management and communication skills, technical skills, and expertise with regard to access rights and preservation of digital content. Referring to the work carried out by the SHERPA Project in the UK with regard to the skills set for repository staff, the authors performed a survey among repository managers in Italy to assess the educational and professional background of the repository managers and the skills set required to implement successful institutional repositories. The survey findings show that the professional profile of the repository manager is a multiform and complex one. It requires cross-functional and highly specialised competencies. Italian repository managers are of the opinion that the skills required to promote the repository within the institution and those required to deal with copyright issues as the most essential skills repository managers should acquire and be trained for. Collection development and metadata expertise, familiarity with project management and expertise in repository workflow design are also highly rated. Technical skills are needed to deal with interoperability standards and protocols. In Italy academic curricula do not meet the repository managers’ educational needs. Academic programmes should be developed to include communication

A Systematic Review of the Liaison Nurse Role on Patient’s Outcomes after Intensive Care Unit Discharge

OpenAIRE

Tabanejad, Zeinab; Pazokian, Marzieh; Ebadi, Abbas

2014-01-01

Background: This review focuses on the impact of liaison nurse in nursing care of patient after ICU discharge on patient’s outcomes, compared with patients that are not taken care of by liaison nurses. The role of the ICU liaison nurse has transpired to solve the gap between intensive care unit and wards. Therefore, we aimed to review the outcomes of all studies in this field. Methods: A systematic review of intervention studies between 2004 and 2013 was undertaken using standard and sensitiv...

78 FR 24816 - Pricing for the 2013 American Eagle West Point Two-Coin Silver Set

Science.gov (United States)

2013-04-26

... DEPARTMENT OF THE TREASURY United States Mint Pricing for the 2013 American Eagle West Point Two-Coin Silver Set AGENCY: United States Mint, Department of the Treasury. ACTION: Notice. SUMMARY: The United States Mint is announcing the price of the 2013 American Eagle West Point Two-Coin Silver Set. The...

Barriers to the Role of the Head Athletic Trainer for Women in National Collegiate Athletic Association Division II and III Settings.

Science.gov (United States)

Mazerolle, Stephanie M; Eason, Christianne M

2016-07-01

Very few women assume the role of head athletic trainer (AT). Reasons for this disparity include discrimination, motherhood, and a lack of interest in the position. However, data suggest that more women seek the head AT position in National Collegiate Athletic Association Division II and III settings. To examine the barriers female ATs face as they transition to the role of head AT. Qualitative study. Divisions II and III. In total, 77 female ATs participated in our study. Our participants (38 ± 9 years old) were employed as head ATs at the Division II or III level. We conducted online interviews with all participants. They journaled their reflections to a series of open-ended questions pertaining to their experiences as head ATs. Data were analyzed following a general inductive approach. Credibility was secured by peer review and researcher triangulation. Organizational and personal factors emerged as the 2 major themes that described challenges for women assuming the role of the head AT. Organizational barriers were defined by gender stereotyping and the "good old boys" network. Personal influences included a lack of leadership aspirations, motherhood and family, and a lack of mentors. Female ATs working in Divisions II or III experienced similar barriers to assuming the role of the head AT as those working in the Division I setting. Stereotyping still exists within collegiate athletics, which limits the number of women in higher-ranking positions; however, a lack of desire to assume a higher position and the desire to balance work and home inhibit some women from moving up.

78 FR 38452 - Price for the 2013 Girl Scouts of the USA Young Collector Set

Science.gov (United States)

2013-06-26

... DEPARTMENT OF THE TREASURY United States Mint Price for the 2013 Girl Scouts of the USA Young Collector Set AGENCY: United States Mint, Department of the Treasury. ACTION: Notice. SUMMARY: The United States Mint is announcing a price of $54.95 for the 2013 Girl Scouts of the USA Young Collector Set. FOR...

Dementia Special Care Units in Residential Care Communities: United States, 2010

Science.gov (United States)

... on Vital and Health Statistics Annual Reports Health Survey Research Methods Conference Reports from the National Medical Care Utilization ... dementia special care units, or in a more traditional setting where these residents are integrated with residents ...

An Investigation of the Role of Grapheme Units in Word Recognition

Science.gov (United States)

Lupker, Stephen J.; Acha, Joana; Davis, Colin J.; Perea, Manuel

2012-01-01

In most current models of word recognition, the word recognition process is assumed to be driven by the activation of letter units (i.e., that letters are the perceptual units in reading). An alternative possibility is that the word recognition process is driven by the activation of grapheme units, that is, that graphemes, rather than letters, are…

EU Research and Innovation (R and I) in renewable energies: The role of the Strategic Energy Technology Plan (SET-Plan)

Energy Technology Data Exchange (ETDEWEB)

Hervas Soriano, Fernando [Joint Research Centre, Institute for Prospective Technological Studies, Edificio EXPO, c/ Inca Garcilaso 3, E-41092 Seville (Spain); Mulatero, Fulvio, E-mail: fulvio.mulatero@ec.europa.eu [Joint Research Centre, Institute for Prospective Technological Studies, Edificio EXPO, c/ Inca Garcilaso 3, E-41092 Seville (Spain)

2011-06-15

The SET-Plan established a strategy to use Research and Innovation (R and I) to green the EU energy sector while ensuring a secure supply and increasing EU competitiveness. The strategy sets clear objectives and programming plans and takes stock of existing initiatives in the energy sector, fosters a cooperative approach to R and I, introduces a high-level steering group (the SET-Plan Steering Group) to monitor progress, creates a dedicated information system (the SETIS) to fill the void in policy information and produces estimates of financial needs over the programming period. In this respect, the SET-Plan could serve as a blueprint for R and I strategies to tackle other societal challenges. To be effective, such strategies should further clarify the hierarchy of existing objectives and instruments, introduce specific instruments to pull the demand of new technologies, strengthen links with education and training policies and formalize links with the governance structures of existing initiatives. - Highlights: > This paper assesses the impact of the SET-Plan on EU renewable energy policy. > We analyze the degree of complementarity and duplication with existing initiatives. > We discuss the role of a new system of indicators (SETIS). > The analysis of financing reveals the existence of sizeable shortfalls. > Lessons for future similar initiatives are sketched.

EU Research and Innovation (R and I) in renewable energies: The role of the Strategic Energy Technology Plan (SET-Plan)

International Nuclear Information System (INIS)

Hervas Soriano, Fernando; Mulatero, Fulvio

2011-01-01

The SET-Plan established a strategy to use Research and Innovation (R and I) to green the EU energy sector while ensuring a secure supply and increasing EU competitiveness. The strategy sets clear objectives and programming plans and takes stock of existing initiatives in the energy sector, fosters a cooperative approach to R and I, introduces a high-level steering group (the SET-Plan Steering Group) to monitor progress, creates a dedicated information system (the SETIS) to fill the void in policy information and produces estimates of financial needs over the programming period. In this respect, the SET-Plan could serve as a blueprint for R and I strategies to tackle other societal challenges. To be effective, such strategies should further clarify the hierarchy of existing objectives and instruments, introduce specific instruments to pull the demand of new technologies, strengthen links with education and training policies and formalize links with the governance structures of existing initiatives. - Highlights: → This paper assesses the impact of the SET-Plan on EU renewable energy policy. → We analyze the degree of complementarity and duplication with existing initiatives. → We discuss the role of a new system of indicators (SETIS). → The analysis of financing reveals the existence of sizeable shortfalls. → Lessons for future similar initiatives are sketched.

77 FR 3035 - Pricing for 2012 Annual Sets and America the Beautiful Quarters® Bags & Rolls

Science.gov (United States)

2012-01-20

... DEPARTMENT OF THE TREASURY United States Mint Pricing for 2012 Annual Sets and America the Beautiful Quarters[supreg] Bags & Rolls AGENCY: United States Mint, Department of the Treasury. ACTION: Notice. SUMMARY: The United States Mint is announcing 2012 pricing for annual sets and the America the...

Maximizing Success by Work Setting Diagnosis.

Science.gov (United States)

Sturner, William F.

1990-01-01

This article confronts the tension between creative expression and organizational realities in the workplace. It offers tips on diagnosing such components of the work setting as personal potential and ambition, supervisors' roles, colleagues' roles, organizational culture, and other variables that may influence the success of one's innovations in…

1:250,000-scale Hydrologic Units of the United States

Science.gov (United States)

Steeves, Peter; Nebert, Douglas

1994-01-01

The Geographic Information Retrieval and Analysis System (GIRAS) was developed in the mid 70s to put into digital form a numberof data layers which were of interest to the USGS. One of these data layers was the Hydrologic Units. The map is based on the Hydrologic Unit Maps published by the U.S. Geological Survey Office of Water Data Coordination, together with the list descriptions and name of region, subregion, accounting units, and cataloging unit. The hydrologic units are encoded with an eight-digit number that indicates the hydrologic region (first two digits), hydrologic subregion (second two digits), accounting unit (third two digits), and cataloging unit (fourth two digits). The data produced by GIRAS was originally collected at a scale of 1:250K. Some areas, notably major cities in the west, were recompiled at a scale of 1:100K. In order to join the data together and use the data in a geographic information system (GIS) the data were processed in the ARC/INFO GUS software package. Within the GIS, the data were edgematched and the neatline boundaries between maps were removed to create a single data set for the conterminous

Optimization of the primary collimator settings for fractionated IMRT stereotactic radiotherapy

International Nuclear Information System (INIS)

Tobler, Matt; Leavitt, Dennis D.; Watson, Gordon

2004-01-01

Advances in field-shaping techniques for stereotactic radiosurgery/radiotherapy have allowed dynamic adjustment of field shape with gantry rotation (dynamic conformal arc) in an effort to minimize dose to critical structures. Recent work evaluated the potential for increased sparing of dose to normal tissues when the primary collimator setting is optimized to only the size necessary to cover the largest shape of the dynamic micro multi leaf field. Intensity-modulated radiotherapy (IMRT) is now a treatment option for patients receiving stereotactic radiotherapy treatments. This multisegmentation of the dose delivered through multiple fixed treatment fields provides for delivery of uniform dose to the tumor volume while allowing sparing of critical structures, particularly for patients whose tumor volumes are less suited for rotational treatment. For these segmented fields, the total number of monitor units (MUs) delivered may be much greater than the number of MUs required if dose delivery occurred through an unmodulated treatment field. As a result, undesired dose delivered, as leakage through the leaves to tissues outside the area of interest, will be proportionally increased. This work will evaluate the role of optimization of the primary collimator setting for these IMRT treatment fields, and compare these results to treatment fields where the primary collimator settings have not been optimized

Floating point only SIMD instruction set architecture including compare, select, Boolean, and alignment operations

Science.gov (United States)

Gschwind, Michael K [Chappaqua, NY

2011-03-01

Mechanisms for implementing a floating point only single instruction multiple data instruction set architecture are provided. A processor is provided that comprises an issue unit, an execution unit coupled to the issue unit, and a vector register file coupled to the execution unit. The execution unit has logic that implements a floating point (FP) only single instruction multiple data (SIMD) instruction set architecture (ISA). The floating point vector registers of the vector register file store both scalar and floating point values as vectors having a plurality of vector elements. The processor may be part of a data processing system.

The role of resting duration in the kinematic pattern of two consecutive bench press sets to failure in elite sprint kayakers.

Science.gov (United States)

García-López, D; Herrero, J A; Abadía, O; García-Isla, F J; Ualí, I; Izquierdo, M

2008-09-01

This study aimed to investigate the role of rest period duration (RP) on the time course of the acceleration portion (AP) and mean velocity of the concentric phase across two bench press sets to failure with a submaximal load (60% of the 1RM) using different RP. Ten elite junior kayakers performed, on four different days, two consecutive bench press sets to failure, allowing randomly 1-, 2-, 3- and 4-min RP between sets. AP reached a maximal value of 66% of the concentric movement time. This maximal AP was observed in repetition number 2 or 3, and then AP declined during the set, with a significant decrease when the number of repetitions was over 80% of the total number of repetitions performed. AP and lifting velocity patterns of the concentric phase were not altered during a second set to failure, regardless of RP. However, when velocity was expressed in absolute terms, 1-min RP was insufficient to maintain the average lifting velocity during the second set, compared to the first one. These results may be of use in selecting number of repetitions and resting duration in order to ensure optimal maintenance of the accelerative portion of concentric movement time with different resting-period durations.

Food systems in correctional settings

DEFF Research Database (Denmark)

Smoyer, Amy; Kjær Minke, Linda

management of food systems may improve outcomes for incarcerated people and help correctional administrators to maximize their health and safety. This report summarizes existing research on food systems in correctional settings and provides examples of food programmes in prison and remand facilities......Food is a central component of life in correctional institutions and plays a critical role in the physical and mental health of incarcerated people and the construction of prisoners' identities and relationships. An understanding of the role of food in correctional settings and the effective......, including a case study of food-related innovation in the Danish correctional system. It offers specific conclusions for policy-makers, administrators of correctional institutions and prison-food-service professionals, and makes proposals for future research....

The ASN imposes on EDF complementary requirements for the setting of the hard-core unit

International Nuclear Information System (INIS)

Anon.

2014-01-01

In January 2014, the ASN (French Authority for Nuclear Safety) published a list of 19 decisions concerning the implementation of a 'post-Fukushima' hard-core unit in each EDF nuclear power plant. The purpose of the hard-core unit is to have structures and equipment able to resist very extreme events and able to assure the vital functions necessary for the reactor safety. The 19 decisions detail the rules for the design of the hard-core unit. For example the hard-core unit will have to resist earthquakes for which the probability of occurrence is about 1 every 20.000 years while the probability taking into account for the design of the reactor is only 1 every 1000 or 10.000 years

The Role of Feedback in the Bologna Process, According to Goal Setting Theory: An Exploratory Study of Students' Perceptions

OpenAIRE

Puig Terrón, Miriam; Balagué i Canadell, Jordi; Solé Pla, Joan

2016-01-01

This study has been carried out while The Bologna Process was implemented in the European Higher Education Area (EHEA). One of the main features of TBP is Lifelong Learning (LLL), introduced to improve student learning, by emphasizing the role of feedback. The Goal Setting Theory of Motivation (GST) considers feedback as a mechanism to enhance performance. Starting from this theoretical framework, our objective is to analyse whether, for those students with specific and challenging goals, fee...

Collimator setting optimization in intensity modulated radiotherapy

International Nuclear Information System (INIS)

Williams, M.; Hoban, P.

2001-01-01

Full text: The aim of this study was to investigate the role of collimator angle and bixel size settings in IMRT when using the step and shoot method of delivery. Of particular interest is minimisation of the total monitor units delivered. Beam intensity maps with bixel size 10 x 10 mm were segmented into MLC leaf sequences and the collimator angle optimised to minimise the total number of MU's. The monitor units were estimated from the maximum sum of positive-gradient intensity changes along the direction of leaf motion. To investigate the use of low resolution maps at optimum collimator angles, several high resolution maps with bixel size 5 x 5 mm were generated. These were resampled into bixel sizes, 5 x 10 mm and 10 x 10 mm and the collimator angle optimised to minimise the RMS error between the original and resampled map. Finally, a clinical IMRT case was investigated with the collimator angle optimised. Both the dose distribution and dose-volume histograms were compared between the standard IMRT plan and the optimised plan. For the 10 x 10 mm bixel maps there was a variation of 5% - 40% in monitor units at the different collimator angles. The maps with a high degree of radial symmetry showed little variation. For the resampled 5 x 5 mm maps, a small RMS error was achievable with a 5 x 10 mm bixel size at particular collimator positions. This was most noticeable for maps with an elongated intensity distribution. A comparison between the 5 x 5 mm bixel plan and the 5 x 10 mm showed no significant difference in dose distribution. The monitor units required to deliver an intensity modulated field can be reduced by rotating the collimator and aligning the direction of leaf motion with the axis of the fluence map that has the least intensity. Copyright (2001) Australasian College of Physical Scientists and Engineers in Medicine

The prospective United Kingdom nuclear energy programme up to 2000 AD and the UKAEA's role and manpower requirements

International Nuclear Information System (INIS)

Simeone, R.N.; Hodgkinson, I.A.

1980-01-01

This paper begins by surveying the development of the United Kingdom nuclear industry, its organization in both the public and private sectors of the economy, and changes in the numbers employed up to the present day. The possible future nuclear programme and overall manpower needs, and the UKAEA's role and manpower requirements within this programme, are outlined. Manpower problems arising from national shortages of engineers and technicians and reviews of arrangements for their education and training, and also from the pattern of historical development of the UKAEA, are described. UKAEA arrangements for formulating and implementing personnel policies, current policies for recruitment, carrier management and in-service training and their relationship to present and future needs are then discussed. The final section draws attention to UKAEA facilities for the training of staff from other organizations in the United Kingdom and from overseas. (author)

Collaborative Memory and Part-Set Cuing Impairments: The Role of Executive Depletion in Modulating Retrieval Disruption

Science.gov (United States)

Barber, Sarah J.; Rajaram, Suparna

2011-01-01

When people are exposed to a subset of previously studied list items they recall fewer of the remaining items compared to a condition where none of the studied items are provided during recall. This occurs both when the subset of items is provided by the experimenter (i.e., the part-set cuing deficit in individual recall) and when they are provided during the course of a collaborative discussion (i.e., the collaborative inhibition effect in group recall). Previous research has identified retrieval disruption as a common mechanism underlying both effects; however, less is known about the factors that may make individuals susceptible to such retrieval disruption. In the current studies we tested one candidate factor, namely, executive control. Using an executive depletion paradigm we directly manipulated an individual’s level of executive control during retrieval. Results revealed no direct role of executive depletion in modulating retrieval disruption. In contrast, executive control abilities were indirectly related to retrieval disruption through their influence at encoding. Together, these results suggest that executive control does not directly affect retrieval disruption at the retrieval stage, and that the role of this putative mechanism may be limited to the encoding stage. PMID:21678155

The role of experience curves for setting MEPS for appliances

International Nuclear Information System (INIS)

Siderius, Hans-Paul

2013-01-01

Minimum efficiency performance standards (MEPS) are an important policy instrument to raise the efficiency of products. In most schemes the concept of life cycle costs (LCC) is used to guide setting the MEPS levels. Although a large body of literature shows that product cost is decreasing with increasing cumulative production, the experience curve, this is currently not used for setting MEPS. This article shows how to integrate the concept of the experience curve into LCC calculations for setting MEPS in the European Union and applies this to household laundry driers, refrigerator-freezers and televisions. The results indicate that for driers and refrigerator-freezers at least twice the energy savings compared to the current approach can be achieved. These products also show that energy label classes can successfully be used for setting MEPS. For televisions an experience curve is provided, showing a learning rate of 29%. However, television prices do not show a relation with energy efficiency but are to a large extent determined by the time the product is placed on the market. This suggests to policy makers that for televisions and other products with a short (re)design and market cycle timing is more important than the MEPS levels itself. - Highlights: • We integrate experience curves into life cycle cost calculations for MEPS. • For driers and refrigerators this results in at least twice the energy savings. • For flat panel televisions an experience curve is provided

On the role of phraseological units in nowadays English periodicals

Directory of Open Access Journals (Sweden)

Osipova I. A.

2016-09-01

Full Text Available the current study is aimed at functional analysis of phraseological units in today’s English periodicals. An everlasting interest of contemporary researches to the above mentioned object of studies stems from the thesis that phraseological units are a potent linguistic means to convey emotional potential and vivid images of texts belonging to the publicistic genre.

The Role of Parliaments in Times of Transition: The Impact of Participatory Politics on Social Cohesion and the Quality of Governance in Post-Authoritarian Settings

DEFF Research Database (Denmark)

Afsah, Ebrahim

The Role of Parliaments in Times of Transition: The Impact of Participatory Politics on Social Cohesion and the Quality of Governance in Post-Authoritarian Settings This contribution presents the theoretical basis for the normative preference given to electoral politics and investigates the insti......The Role of Parliaments in Times of Transition: The Impact of Participatory Politics on Social Cohesion and the Quality of Governance in Post-Authoritarian Settings This contribution presents the theoretical basis for the normative preference given to electoral politics and investigates...... the institutional prerequisites if competitive electoral politics are to lead to better governance outcomes and greater social stability. Examining why these preconditions are largely lacking in the Arab world, this contribution investigates what could be done to redress these shortcomings....

The Role of Nuclear Receptor-Binding SET Domain Family Histone Lysine Methyltransferases in Cancer.

Science.gov (United States)

Bennett, Richard L; Swaroop, Alok; Troche, Catalina; Licht, Jonathan D

2017-06-01

The nuclear receptor-binding SET Domain (NSD) family of histone H3 lysine 36 methyltransferases is comprised of NSD1, NSD2 (MMSET/WHSC1), and NSD3 (WHSC1L1). These enzymes recognize and catalyze methylation of histone lysine marks to regulate chromatin integrity and gene expression. The growing number of reports demonstrating that alterations or translocations of these genes fundamentally affect cell growth and differentiation leading to developmental defects illustrates the importance of this family. In addition, overexpression, gain of function somatic mutations, and translocations of NSDs are associated with human cancer and can trigger cellular transformation in model systems. Here we review the functions of NSD family members and the accumulating evidence that these proteins play key roles in tumorigenesis. Because epigenetic therapy is an important emerging anticancer strategy, understanding the function of NSD family members may lead to the development of novel therapies. Copyright © 2017 Cold Spring Harbor Laboratory Press; all rights reserved.

Uniform Facility Data Set US (UFDS-1998)

Data.gov (United States)

U.S. Department of Health & Human Services — The Uniform Facility Data Set (UFDS) was designed to measure the scope and use of drug abuse treatment services in the United States. The survey collects information...

Leaf transpiration plays a role in phosphorus acquisition among a large set of chickpea genotypes.

Science.gov (United States)

Pang, Jiayin; Zhao, Hongxia; Bansal, Ruchi; Bohuon, Emilien; Lambers, Hans; Ryan, Megan H; Siddique, Kadambot H M

2018-01-09

Low availability of inorganic phosphorus (P) is considered a major constraint for crop productivity worldwide. A unique set of 266 chickpea (Cicer arietinum L.) genotypes, originating from 29 countries and with diverse genetic background, were used to study P-use efficiency. Plants were grown in pots containing sterilized river sand supplied with P at a rate of 10 μg P g -1 soil as FePO 4 , a poorly soluble form of P. The results showed large genotypic variation in plant growth, shoot P content, physiological P-use efficiency, and P-utilization efficiency in response to low P supply. Further investigation of a subset of 100 chickpea genotypes with contrasting growth performance showed significant differences in photosynthetic rate and photosynthetic P-use efficiency. A positive correlation was found between leaf P concentration and transpiration rate of the young fully expanded leaves. For the first time, our study has suggested a role of leaf transpiration in P acquisition, consistent with transpiration-driven mass flow in chickpea grown in low-P sandy soils. The identification of 6 genotypes with high plant growth, P-acquisition, and P-utilization efficiency suggests that the chickpea reference set can be used in breeding programmes to improve both P-acquisition and P-utilization efficiency under low-P conditions. © 2018 John Wiley & Sons Ltd.

Set theory and physics

Energy Technology Data Exchange (ETDEWEB)

Svozil, K. [Univ. of Technology, Vienna (Austria)

1995-11-01

Inasmuch as physical theories are formalizable, set theory provides a framework for theoretical physics. Four speculations about the relevance of set theoretical modeling for physics are presented: the role of transcendental set theory (i) in chaos theory, (ii) for paradoxical decompositions of solid three-dimensional objects, (iii) in the theory of effective computability (Church-Turing thesis) related to the possible {open_quotes}solution of supertasks,{close_quotes} and (iv) for weak solutions. Several approaches to set theory and their advantages and disadvantages for physical applications are discussed: Cantorian {open_quotes}naive{close_quotes} (i.e., nonaxiomatic) set theory, contructivism, and operationalism. In the author`s opinion, an attitude, of {open_quotes}suspended attention{close_quotes} (a term borrowed from psychoanalysis) seems most promising for progress. Physical and set theoretical entities must be operationalized wherever possible. At the same time, physicists should be open to {open_quotes}bizarre{close_quotes} or {open_quotes}mindboggling{close_quotes} new formalisms, which need not be operationalizable or testable at the time of their creation, but which may successfully lead to novel fields of phenomenology and technology.

Intervention Techniques Used With Autism Spectrum Disorder by Speech-Language Pathologists in the United States and Taiwan: A Descriptive Analysis of Practice in Clinical Settings.

Science.gov (United States)

Hsieh, Ming-Yeh; Lynch, Georgina; Madison, Charles

2018-04-27

This study examined intervention techniques used with children with autism spectrum disorder (ASD) by speech-language pathologists (SLPs) in the United States and Taiwan working in clinic/hospital settings. The research questions addressed intervention techniques used with children with ASD, intervention techniques used with different age groups (under and above 8 years old), and training received before using the intervention techniques. The survey was distributed through the American Speech-Language-Hearing Association to selected SLPs across the United States. In Taiwan, the survey (Chinese version) was distributed through the Taiwan Speech-Language Pathologist Union, 2018, to certified SLPs. Results revealed that SLPs in the United States and Taiwan used 4 common intervention techniques: Social Skill Training, Augmentative and Alternative Communication, Picture Exchange Communication System, and Social Stories. Taiwanese SLPs reported SLP preparation program training across these common intervention strategies. In the United States, SLPs reported training via SLP preparation programs, peer therapists, and self-taught. Most SLPs reported using established or emerging evidence-based practices as defined by the National Professional Development Center (2014) and the National Standards Report (2015). Future research should address comparison of SLP preparation programs to examine the impact of preprofessional training on use of evidence-based practices to treat ASD.

Potential role of a pharmacist to enhance medication-related aspects of clinical trials conducted in a dedicated clinical research unit

Directory of Open Access Journals (Sweden)

Kimberly A. Redic, PharmD

2017-06-01

Conclusions: This pilot study showed potential roles for pharmacy personnel involvement in medication reconciliation in the clinical research setting. Pharmacists have the opportunity to ensure that IDs are accurately included in patient medication lists and to identify the use of potential protocol prohibited concomitant medications.

Parameters in fractional laser assisted delivery of topical anesthetics: Role of laser type and laser settings.

Science.gov (United States)

Meesters, Arne A; Nieboer, Marilin J; Kezic, Sanja; de Rie, Menno A; Wolkerstorfer, Albert

2018-05-07

Efficacy of topical anesthetics can be enhanced by pretreatment of the skin with ablative fractional lasers. However, little is known about the role of parameters such as laser modality and laser density settings in this technique. Aims of this study were to compare the efficacy of pretreatment with two different ablative fractional laser modalities, a CO 2 laser and an Er:YAG laser, and to assess the role of laser density in ablative fractional laser assisted topical anesthesia. In each of 15 healthy subjects, four 10 × 10 mm test regions on the back were randomized to pretreatment (70-75 μm ablation depth) with CO 2 laser at 5% density, CO 2 laser at 15% density, Er:YAG laser at 5% density or Er:YAG laser at 15% density. Articaine hydrochloride 40 mg/ml + epinephrine 10 μg/ml solution was applied under occlusion to all four test regions. After 15 minutes, a pass with the CO 2 laser (1,500 μm ablation depth) was administered as pain stimulus to each test region. A reference pain stimulus was given on unanesthetized skin. The main outcome parameter, pain, was scored on a 0-10 visual analogue scale (VAS) after each pain stimulus. Median VAS scores were 1.50 [CO 2 5%], 0.50 [CO 2 15%], 1.50 [Er:YAG 5%], 0.43 [Er:YAG 15%], and 4.50 [unanesthetized reference]. VAS scores for all pretreated test regions were significantly lower compared to the untreated reference region (P laser pretreated regions. However, VAS scores were significantly lower at 15% density compared to 5% density for both for the CO 2 laser (P laser (P laser was considered slightly more painful than pretreatment with Er:YAG laser by the subjects. Fractional laser assisted topical anesthesia is effective even with very low energy settings and an occlusion time of only 15 minutes. Both the CO 2 laser and the Er:YAG laser can be used to assist topical anesthesia although the CO 2 laser pretreatment is experienced as more painful. In our study settings, using articaine

Transformational leadership and group potency in small military units: The mediating role of group identification and cohesion

Directory of Open Access Journals (Sweden)

Carlos García-Guiu

2016-12-01

Full Text Available In the present study, we examined an exploratory model to assess the relationship between transformational leadership and group potency and analyze the mediating role of group identification and cohesion. The research was conducted with squads of the Spanish Army. The sample was composed of 243 members of 51 squads of operational units. Our findings highlighted the importance of the transformational leadership style of command of non-commissioned officers (NCOs due to its positive relationship with the group potency of the squad. We also analyzed the indirect relationships between transformational leadership and group identification and group cohesion and found that the latter variables played a mediating role between transformational leadership and group potency. The conclusions of this study are relevant due to the growing importance of transformational leadership and actions implemented at lower levels of the command chain for the success of missions of security organizations and defense.

Association of medication errors with drug classifications, clinical units, and consequence of errors: Are they related?

Science.gov (United States)

Muroi, Maki; Shen, Jay J; Angosta, Alona

2017-02-01

Registered nurses (RNs) play an important role in safe medication administration and patient safety. This study examined a total of 1276 medication error (ME) incident reports made by RNs in hospital inpatient settings in the southwestern region of the United States. The most common drug class associated with MEs was cardiovascular drugs (24.7%). Among this class, anticoagulants had the most errors (11.3%). The antimicrobials was the second most common drug class associated with errors (19.1%) and vancomycin was the most common antimicrobial that caused errors in this category (6.1%). MEs occurred more frequently in the medical-surgical and intensive care units than any other hospital units. Ten percent of MEs reached the patients with harm and 11% reached the patients with increased monitoring. Understanding the contributing factors related to MEs, addressing and eliminating risk of errors across hospital units, and providing education and resources for nurses may help reduce MEs. Copyright © 2016 Elsevier Inc. All rights reserved.

Uniform Facility Data Set US (UFDS-1997)

Data.gov (United States)

U.S. Department of Health & Human Services — The Uniform Facility Data Set (UFDS), formerly the National Drug and Alcohol Treatment Unit Survey or NDATUS, was designed to measure the scope and use of drug abuse...

19 CFR 24.72 - Claims; set-off.

Science.gov (United States)

2010-04-01

... CUSTOMS FINANCIAL AND ACCOUNTING PROCEDURE § 24.72 Claims; set-off. When an importer of record or other... indebted to the United States, either as principal or surety, for an amount which is legally fixed and...

Assisting role redesign: a qualitative evaluation of the implementation of a podiatry assistant role to a community health setting utilising a traineeship approach.

Science.gov (United States)

Moran, Anna M; Nancarrow, Susan A; Wiseman, Leah; Maher, Kerryn; Boyce, Rosalie A; Borthwick, Alan M; Murphy, Karen

2012-11-27

Increasing demands for podiatry combined with workforce shortages due to attrition, part-time working practices and rural healthcare shortages means that in some geographic areas in Australia there are insufficient professionals to meet service demand. Although podiatry assistants have been introduced to help relieve workforce shortages there has been little evaluation of their impact on patient, staff and/or service outcomes. This research explores the processes and outcomes of a 'trainee' approach to introducing a podiatry assistant (PA) role to a community setting in the Australian Capital Territory (ACT) Government Health Service Directorate. A qualitative methodology was employed involving interviews and focus groups with service managers, qualified practitioners, the assistant, service users and consumer representatives. Perspectives of the implementation process; the traineeship approach; the underlying mechanisms that help or hinder the implementation process; and the perceived impact of the role were explored. Data were analysed using the Richie and Spencer Framework approach. Although the impact of the PA role had not been measured at the time of the evaluation, the implementation of the PA traineeship was considered a success in terms of enabling the transfer of a basic foot-care service from nursing back to podiatry; releasing Enrolled Nurses (ENs) from foot-care duties; an increase in the number of treatments delivered by the podiatry service; and high levels of stakeholder satisfaction with the role. It was perceived that the transfer of the basic foot-care role from nursing to podiatry through the use of a PA impacted on communication and feedback loops between the PA and the podiatry service; the nursing-podiatry relationship; clinical governance around the foot-care service; and continuity of care for clients through the podiatry service. The traineeship was considered successful in terms of producing a PA whose skills were shaped by and directly

Assisting role redesign: a qualitative evaluation of the implementation of a podiatry assistant role to a community health setting utilising a traineeship approach

Directory of Open Access Journals (Sweden)

Moran Anna M

2012-11-01

Full Text Available Abstract Background Increasing demands for podiatry combined with workforce shortages due to attrition, part-time working practices and rural healthcare shortages means that in some geographic areas in Australia there are insufficient professionals to meet service demand. Although podiatry assistants have been introduced to help relieve workforce shortages there has been little evaluation of their impact on patient, staff and/or service outcomes. This research explores the processes and outcomes of a ‘trainee’ approach to introducing a podiatry assistant (PA role to a community setting in the Australian Capital Territory (ACT Government Health Service Directorate. Method A qualitative methodology was employed involving interviews and focus groups with service managers, qualified practitioners, the assistant, service users and consumer representatives. Perspectives of the implementation process; the traineeship approach; the underlying mechanisms that help or hinder the implementation process; and the perceived impact of the role were explored. Data were analysed using the Richie and Spencer Framework approach. Results Although the impact of the PA role had not been measured at the time of the evaluation, the implementation of the PA traineeship was considered a success in terms of enabling the transfer of a basic foot-care service from nursing back to podiatry; releasing Enrolled Nurses (ENs from foot-care duties; an increase in the number of treatments delivered by the podiatry service; and high levels of stakeholder satisfaction with the role. It was perceived that the transfer of the basic foot-care role from nursing to podiatry through the use of a PA impacted on communication and feedback loops between the PA and the podiatry service; the nursing-podiatry relationship; clinical governance around the foot-care service; and continuity of care for clients through the podiatry service. The traineeship was considered successful in terms of

Predicting race performance in triathlon: the role of perfectionism, achievement goals, and personal goal setting.

Science.gov (United States)

Stoeber, Joachim; Uphill, Mark A; Hotham, Sarah

2009-04-01

The question of how perfectionism affects performance is highly debated. Because empirical studies examining perfectionism and competitive sport performance are missing, the present research investigated how perfectionism affected race performance and what role athletes' goals played in this relationship in two prospective studies with competitive triathletes (Study 1: N = 112; Study 2: N = 321). Regression analyses showed that perfectionistic personal standards, high performance-approach goals, low performance-avoidance goals, and high personal goals predicted race performance beyond athletes' performance level. Moreover, the contrast between performance-avoidance and performance-approach goals mediated the relationship between perfectionistic personal standards and performance, whereas personal goal setting mediated the relationship between performance-approach goals and performance. The findings indicate that perfectionistic personal standards do not undermine competitive performance, but are associated with goals that help athletes achieve their best possible performance.

An Agent Framework for Recognition of Graphic Units in Drawings

NARCIS (Netherlands)

Achten, H.H.; Jessurun, A.J.; Koszewski, K.; Wrona, S.

2002-01-01

Architects use graphic conventions in their drawings that have meaningful content to the design task. In previous work, such well-defined sets of graphic entities have been identified and defined. These sets are called graphic units. In this paper, we discuss how graphic unit recognition in drawings

Theoretical review and framework : The roles of controllers

NARCIS (Netherlands)

Rouwelaar, ten J.A. (Hans)

2007-01-01

In the last decades, the position of the business unit controller has grown in importance. This study gives a review of the research behind the two roles, which business unit-controllers can fulfill in business life: the support role and the control role. The support role is associated with

Realtime ultrasound guided percutaneous tracheostomy in emergency setting: the glass ceiling has been broken.

Science.gov (United States)

Ravi, Parli Raghavan; Vijai, M N; Shouche, Sachin

2017-01-01

In recent years ultrasound guided percutaneous tracheostomy (USPCT) has become a routine practice in critical care units. Its safety and superiority over conventional percutaneous tracheostomy and bronchoscopic guided PCT is proven to be non-inferior in elective cases. However its role in emergency percutaneous tracheostomy has never been studied, since percutaneous tracheostomy itself remains an enigma in accessing emergency airway. There is no report of use of ultrasound guided percutaneous tracheostomy in emergency setting so far in the literature. We report our early experience with USPCT in emergency setting. Sixteen adult patients who required access to an emergency surgical airway after failure to accomplish emergency oro-tracheal intubation were the study population. Their airway was accessed by USPCT. Recorded data included clinical and demographic data including time taken to perform the procedure and complications. Short term and long term follow ups for a period of 2 years were done for the survivors. Twelve male and four female patients underwent the procedure and the average time of the procedure was 3.6 min with no failures nor conversions to surgical tracheostomy and no complications. The average oxygen saturation was 86% and average Glasgow coma scale was 8.4. This time period included the oxygen insufflation time. 10 patients were decannulated while six patients died due to the pathology of the disease itself. There were no complications in either short term or long term follow up. USPCT has a definitive role in emergency both in trauma and non-trauma setting. It is safe, feasible and faster in experienced hands. Use of USPCT in emergency setting has further narrowed the list of contraindications of percutaneous tracheostomy.

Deciphering the Role of Sulfonated Unit in Heparin-Mimicking Polymer to Promote Neural Differentiation of Embryonic Stem Cells.

Science.gov (United States)

Lei, Jiehua; Yuan, Yuqi; Lyu, Zhonglin; Wang, Mengmeng; Liu, Qi; Wang, Hongwei; Yuan, Lin; Chen, Hong

2017-08-30

Glycosaminoglycans (GAGs), especially heparin and heparan sulfate (HS), hold great potential for inducing the neural differentiation of embryonic stem cells (ESCs) and have brought new hope for the treatment of neurological diseases. However, the disadvantages of natural heparin/HS, such as difficulty in isolating them with a sufficient amount, highly heterogeneous structure, and the risk of immune responses, have limited their further therapeutic applications. Thus, there is a great demand for stable, controllable, and well-defined synthetic alternatives of heparin/HS with more effective biological functions. In this study, based upon a previously proposed unit-recombination strategy, several heparin-mimicking polymers were synthesized by integrating glucosamine-like 2-methacrylamido glucopyranose monomers (MAG) with three sulfonated units in different structural forms, and their effects on cell proliferation, the pluripotency, and the differentiation of ESCs were carefully studied. The results showed that all the copolymers had good cytocompatibility and displayed much better bioactivity in promoting the neural differentiation of ESCs as compared to natural heparin; copolymers with different sulfonated units exhibited different levels of promoting ability; among them, copolymer with 3-sulfopropyl acrylate (SPA) as a sulfonated unit was the most potent in promoting the neural differentiation of ESCs; the promoting effect is dependent on the molecular weight and concentration of P(MAG-co-SPA), with the highest levels occurring at the intermediate molecular weight and concentration. These results clearly demonstrated that the sulfonated unit in the copolymers played an important role in determining the promoting effect on ESCs' neural differentiation; SPA was identified as the most potent sulfonated unit for copolymer with the strongest promoting ability. The possible reason for sulfonated unit structure as a vital factor influencing the ability of the copolymers

Inpatient Peripherally Inserted Central Venous Catheter Complications: Should Peripherally Inserted Central Catheter Lines Be Placed in the Intensive Care Unit Setting?

Science.gov (United States)

Martyak, Michael; Kabir, Ishraq; Britt, Rebecca

2017-08-01

Peripherally inserted central venous catheters (PICCs) are now commonly used for central access in the intensive care unit (ICU) setting; however, there is a paucity of data evaluating the complication rates associated with these lines. We performed a retrospective review of all PICCs placed in the inpatient setting at our institution during a 1-year period from January 2013 to December 2013. These were divided into two groups: those placed at the bedside in the ICU and those placed by interventional radiology in non-ICU patients. Data regarding infectious and thrombotic complications were collected and evaluated. During the study period, 1209 PICC line placements met inclusion criteria and were evaluated; 1038 were placed by interventional radiology in non-ICU patients, and 171 were placed at the bedside in ICU patients. The combined thrombotic and central line associated blood stream infection rate was 6.17 per cent in the non-ICU group and 10.53 per cent in the ICU group (P = 0.035). The thrombotic complication rate was 5.88 per cent in the non-ICU group and 7.60 per cent in the ICU group (P = 0.38), whereas the central line associated blood stream infection rate was 0.29 per cent in the non-ICU group and 2.92 per cent in the ICU group (P = 0.002). This study seems to suggest that PICC lines placed at the bedside in the ICU setting are associated with higher complication rates, in particular infectious complications, than those placed by interventional radiology in non-ICU patients. The routine placement of PICC lines in the ICU settings needs to be reevaluated given these findings.

Articulating the Role of the Development Specialist in Large Organisational Settings.

Science.gov (United States)

Dennis, Dell

1997-01-01

Workplace educators play a more holistic role of development specialists who plan, implement, and manage human resource development. This role requires skills in communication, employee relations, program development, change agency, and budget management. (SK)

Intensive symptom control of opioid-refractory dyspnea in congestive heart failure: Role of milrinone in the palliative care unit.

Science.gov (United States)

Silvestre, Julio; Montoya, Maria; Bruera, Eduardo; Elsayem, Ahmed

2015-12-01

We describe an exemplary case of congestive heart failure (CHF) symptoms controlled with milrinone. We also analyze the benefits and risks of milrinone administration in an unmonitored setting. We describe the case of a patient with refractory leukemia and end-stage CHF who developed severe dyspnea after discontinuation of milrinone. At that point, despite starting opioids, she had been severely dyspneic and anxious, requiring admission to the palliative care unit (PCU) for symptom control. After negotiation with hospital administrators, milrinone was administered in an unmonitored setting such as the PCU. A multidisciplinary team approach was also provided. Milrinone produced a dramatic improvement in the patient's symptom scores and performance status. The patient was eventually discharged to home hospice on a milrinone infusion with excellent symptom control. This case suggests that milrinone may be of benefit for short-term inpatient administration for dyspnea management, even in unmonitored settings and consequently during hospice in do-not-resuscitate (DNR) patients. This strategy may reduce costs and readmissions to the hospital related to end-stage CHF.

Leadership and priority setting: the perspective of hospital CEOs.

Science.gov (United States)

Reeleder, David; Goel, Vivek; Singer, Peter A; Martin, Douglas K

2006-11-01

The role of leadership in health care priority setting remains largely unexplored. While the management leadership literature has grown rapidly, the growing literature on priority setting in health care has looked in other directions to improve priority setting practices--to health economics and ethical approaches. Consequently, potential for improvement in hospital priority setting practices may be overlooked. A qualitative study involving interviews with 46 Ontario hospital CEOs was done to describe the role of leadership in priority setting through the perspective of hospital leaders. For the first time, we report a framework of leadership domains including vision, alignment, relationships, values and process to facilitate priority setting practices in health services' organizations. We believe this fledgling framework forms the basis for the sharing of good leadership practices for health reform. It also provides a leadership guide for decision makers to improve the quality of their leadership, and in so doing, we believe, the fairness of their priority setting.

The role of Nuclear Energy Unit in gathering, organizing and disseminating of nuclear information

International Nuclear Information System (INIS)

Samsurdin Ahamad

1986-01-01

The Nuclear Energy Unit (UTN) was established with an aim to promote the application of Nuclear Science and Technology in industries, agriculture and medicine in Malaysia. Therefore UTN represents Malaysia in INIS so as to share the available information for collection, merging and dissemination of information. In UTN a variety of activities are being carried out, especially by the Information Science Department whereby a library, equipped with reading materials and a computerized information system (SMBK) is set up as the information centre. A number of publications have also been made so as to keep the technical officers and other staff aware of the developments in Nuclear Science and Technology. To provide a better understanding of the latest techniques and nuclear technological procedures, courses, seminars and workshops for officers involved are carried out. Talks and exhibitions are also organized in order to promote Nuclear Science and Technology amongst the layman. (author)

CzEngClass – Towards a Lexicon of Verb Synonyms with Valency Linked to Semantic Roles

Directory of Open Access Journals (Sweden)

Urešová Zdeňka

2017-12-01

Full Text Available In this paper, we introduce our ongoing project about synonymy in bilingual context. This project aims at exploring semantic ‘equivalence’ of verb senses of generally different verbal lexemes in a bilingual (Czech-English setting. Specifically, it focuses on their valency behavior within such equivalence groups. We believe that using bilingual context (translation as an important factor in the delimitation of classes of synonymous lexical units (verbs, in our case may help to specify the verb senses, also with regard to the (semantic roles relation to other verb senses and roles of their arguments more precisely than when using monolingual corpora. In our project, we work “bottom-up”, i.e., from an evidence as recorded in our corpora and not “top-down”, from a predefined set of semantic classes.

A test of the California competency-based differentiated role model.

Science.gov (United States)

Keating, Sarah B; Rutledge, Dana N; Sargent, Arlene; Walker, Polly

2003-01-01

To address the incongruence between the expectations of nursing service and education in California, the Education Industry Interface Task Force of the California Strategic Planning Committee for Nursing developed descriptions to assist employers and educators in clearly differentiating practice and educational competencies. The completion of the Competency-Based Role Differentiation Model resulted in the need to test the model for its utility in the service setting, in education, and for career planning for nurses. Three alpha demonstration sites were selected based on representative geographical regions of California. The sites were composed of tri-partnerships consisting of a medical center, an associate degree in nursing program, and a baccalaureate nursing program. Observers rated senior students and new graduates in medical-surgical units on their behaviors in teacher and leadership care provider and care coordinator roles. The alpha demonstration study results were as expected. That is, senior students practice predominantly at a novice level in teacher and management/leadership care provider functions and new graduates practice predominately at the competent level. New graduates are more likely to take on novice and competent care coordinator roles. The CBRDM may be useful for practice and education settings to evaluate student and nurse performance, to define role expectations, and to identify the preparation necessary for the roles. It is useful for all of nursing as it continues to define its levels of practice and their relationship to on-the-job performance, curriculum development, and carrier planning.

Evaluation of a pilot training program in alcohol screening, brief intervention, and referral to treatment for nurses in inpatient settings.

Science.gov (United States)

Broyles, Lauren M; Gordon, Adam J; Rodriguez, Keri L; Hanusa, Barbara H; Kengor, Caroline; Kraemer, Kevin L

2013-01-01

Alcohol screening, brief intervention, and referral to treatment (SBIRT) is a set of clinical strategies for reducing the burden of alcohol-related injury, disease, and disability. SBIRT is typically considered a physician responsibility but calls for interdisciplinary involvement requiring basic SBIRT knowledge and skills training for all healthcare disciplines. The purpose of this pilot study was to design, implement, and evaluate a theory-driven SBIRT training program for nurses in inpatient settings (RN-SBIRT) that was developed through an interdisciplinary collaboration of nursing, medical, and public health professionals and tailored for registered nurses in the inpatient setting. In this three-phase study, we evaluated (1) RN-SBIRT's effectiveness for changing nurses' alcohol-related knowledge, clinical practice, and attitudes and (2) the feasibility of implementing the inpatient curriculum. In a quasi-experimental design, two general medical units at our facility were randomized to receive RN-SBIRT or a self-directed Web site on alcohol-related care. We performed a formative evaluation of RN-SBIRT, guided by the RE-AIM implementation framework. After training, nurses in the experimental condition had significant increases in Role Adequacy for working with drinkers and reported increased performance and increased competence for a greater number of SBIRT care tasks. Despite some scheduling challenges for the nurses to attend RN-SBIRT, nurse stakeholders were highly satisfied with RN-SBIRT. Results suggest that with adequate training and ongoing role support, nurses in inpatient settings could play active roles in interdisciplinary initiatives to address unhealthy alcohol use among hospitalized patients.

Radiologic assessment in the pediatric intensive care unit

International Nuclear Information System (INIS)

Markowitz, R.I.

1984-01-01

The severely ill infant or child who requires admission to a pediatric intensive care unit (PICU) often presents with a complex set of problems necessitating multiple and frequent management decisions. Diagnostic imaging plays an important role, not only in the initial assessment of the patient's condition and establishing a diagnosis, but also in monitoring the patient's progress and the effects of interventional therapeutic measures. Bedside studies obtained using portable equipment are often limited but can provide much useful information when a careful and detailed approach is utilized in producing the radiograph and interpreting the examination. This article reviews some of the basic principles of radiographic interpretation and details some of the diagnostic points which, when promptly recognized, can lead to a better understanding of the patient's condition and thus to improved patient care and management. While chest radiography is stressed, studies of other regions including the upper airway, abdomen, skull, and extremities are discussed. A brief consideration of the expanding role of new modality imaging (i.e., ultrasound, CT) is also included. Multiple illustrative examples of common and uncommon problems are shown

A qualitative interpretive study exploring parents' perception of the parental role in the paediatric intensive care unit.

Science.gov (United States)

Ames, Kaitlin E; Rennick, Janet E; Baillargeon, Sophie

2011-06-01

The purpose of this study was to explore parents' perception of the parental role in a tertiary care Canadian university affiliated hospital's paediatric intensive care unit (PICU). A descriptive interpretive design was used with a purposive heterogeneous sample to reflect the range of children and parents normally admitted to the PICU. Semi-structured interviews were conducted with seven parents. Interview data were collected and analysed using the constant comparative method. Three main themes emerged: (1) being present and participating in the child's care; (2) forming a partnership of trust with the PICU health care team; and (3) being informed of the child's progress and treatment plan as the person who "knows" the child best. Enhanced understanding of the parental role in the PICU from the perspective of parents can help guide the development of strategies to more effectively support parents and promote parenting during this extremely stressful time. Copyright © 2011 Elsevier Ltd. All rights reserved.

Against the odds: experiences of nurse leaders in Clinical Development Units (Nursing) in Australia.

Science.gov (United States)

Atsalos, Christine; O'Brien, Louise; Jackson, Debra

2007-06-01

This paper is a report of a longitudinal study to develop an understanding of the phenomena of Clinical Development Unit (Nursing) leadership by exploring the experiences of the nurse leaders of nine Australian units as they attempted to develop their existing wards or units into recognized centres of nursing excellence. The concept of Clinical Development Unit (Nursing) in Australia originated in the British Nursing Development Unit movement, which has been widely credited with introducing innovative approaches to developing nurses and nursing. A network of nine Clinical Development Units (Nursing) was set up in a suburban area health service in Australia. The aim was to develop existing wards or units into centres of excellence by disseminating a new vision for Australian nurses that was based on the pioneering work of the British Nursing Development Unit movement. Principles of Heideggerian hermeneutic phenomenology provided a framework for the study. Nine Clinical Development Unit (Nursing) leaders participated in qualitative interviews from 1998 to 2002. These interviews were transcribed into text and thematically analysed. Despite attempts to implement a variety of measures to nurture these Clinical Development Units (Nursing) until they had become well established, the new Clinical Development Unit (Nursing) leaders were unable to maintain the Clinical Development Unit (Nursing) vision with which they had been entrusted. This paper discusses their reactions to the problems they faced and the new understandings they developed of their Clinical Development Unit (Nursing) role over time. The findings illuminate the difficulties involved in maintaining the commitment of all levels of staff and management when attempting to introduce new nursing projects.

Oversight Institutions Within the United Nations

DEFF Research Database (Denmark)

Pontoppidan, Caroline Aggestam

2015-01-01

This article will give a description of the role of internal audit and governance functions within the United Nations system. The United Nations has, during the last 10 years, worked to establish effective oversight services. Oversight, governance and hereunder the internal audit function has been...

The Unitality of Quantum B-algebras

Science.gov (United States)

Han, Shengwei; Xu, Xiaoting; Qin, Feng

2018-02-01

Quantum B-algebras as a generalization of quantales were introduced by Rump and Yang, which cover the majority of implicational algebras and provide a unified semantic for a wide class of substructural logics. Unital quantum B-algebras play an important role in the classification of implicational algebras. The main purpose of this paper is to construct unital quantum B-algebras from non-unital quantum B-algebras.

77 FR 61475 - Price for the 2012 Annual Uncirculated Dollar Coin Set

Science.gov (United States)

2012-10-09

... DEPARTMENT OF THE TREASURY United States Mint Price for the 2012 Annual Uncirculated Dollar Coin Set AGENCY: United States Mint, Department of the Treasury. ACTION: Notice. SUMMARY: Because of the recent increase in the market price of silver, the United States Mint is announcing a new price of $59.95...

Serratia marcescens outbreak in a neonatal intensive care unit: crucial role of implementing hand hygiene among external consultants.

Science.gov (United States)

Montagnani, Carlotta; Cocchi, Priscilla; Lega, Laura; Campana, Silvia; Biermann, Klaus Peter; Braggion, Cesare; Pecile, Patrizia; Chiappini, Elena; de Martino, Maurizio; Galli, Luisa

2015-01-13

Serratia marcescens represents an important pathogen involved in hospital acquired infections. Outbreaks are frequently reported and are difficult to eradicate. The aim of this study is to describe an outbreak of Serratia marcescens occurred from May to November 2012 in a neonatal intensive care unit, to discuss the control measures adopted, addressing the role of molecular biology in routine investigations during the outbreak. After an outbreak of Serratia marcescens involving 14 neonates, all admitted patients were screened for rectal and ocular carriage every two weeks. Extensive environmental sampling procedure and hand sampling of the staff were performed. Antimicrobial susceptibility pattern and molecular analysis of isolates were carried out. Effective hand hygiene measures involving all the external consultants has been implemented. Colonized and infected babies were cohorted. Dedicated staff was established to care for the colonized or infected babies. During the surveillance, 65 newborns were sampled obtaining 297 ocular and rectal swabs in five times. Thirty-four Serratia marcescens isolates were collected: 11 out of 34 strains were isolated from eyes, being the remaining 23 isolated from rectal swabs. Two patients presented symptomatic conjunctivitis. Environmental and hand sampling resulted negative. During the fifth sampling procedure no colonized or infected patients have been identified. Two different clones have been identified. Ocular and rectal colonization played an important role in spread of infections. Implementation of infection control measures, involving also external specialists, allowed to control a serious Serratia marcescens outbreak in a neonatal intensive care unit.

THE ROLE OF THE UNITED STATES OF AMERICA IN THE POST-COLD WAR WORLD: A GLOBAL LEADER OR HEGEMON?

Directory of Open Access Journals (Sweden)

Katarina Jonev

2016-09-01

Full Text Available The authors of this paper deal with the role of the USA in the post-Cold War world and their position from the standpoint of relevant indicators and theoretical considerations. This work also refers to path that the United States took from isolationism to the world domination and considers justification of the position of the USA in the period after the Cold War from the point of hegemonic stability theories, while at the end indicates the diversity of understanding of contemporary thinkers regarding the position of the United States as the hegemon or rather “just” a global leader. This paper does not prejudge the final definition of the position of the USA in international relations, but aims to launch discussions on the necessity and justification of the existence of such vision on a global scale.

Dissecting random and systematic differences between noisy composite data sets.

Science.gov (United States)

Diederichs, Kay

2017-04-01

Composite data sets measured on different objects are usually affected by random errors, but may also be influenced by systematic (genuine) differences in the objects themselves, or the experimental conditions. If the individual measurements forming each data set are quantitative and approximately normally distributed, a correlation coefficient is often used to compare data sets. However, the relations between data sets are not obvious from the matrix of pairwise correlations since the numerical value of the correlation coefficient is lowered by both random and systematic differences between the data sets. This work presents a multidimensional scaling analysis of the pairwise correlation coefficients which places data sets into a unit sphere within low-dimensional space, at a position given by their CC* values [as defined by Karplus & Diederichs (2012), Science, 336, 1030-1033] in the radial direction and by their systematic differences in one or more angular directions. This dimensionality reduction can not only be used for classification purposes, but also to derive data-set relations on a continuous scale. Projecting the arrangement of data sets onto the subspace spanned by systematic differences (the surface of a unit sphere) allows, irrespective of the random-error levels, the identification of clusters of closely related data sets. The method gains power with increasing numbers of data sets. It is illustrated with an example from low signal-to-noise ratio image processing, and an application in macromolecular crystallography is shown, but the approach is completely general and thus should be widely applicable.

Sets in Excess Demand in Ascending Auctions with Unit-Demand Bidders

NARCIS (Netherlands)

Andersson, T.D.; Andersson, C.; Talman, A.J.J.

2010-01-01

This paper analyzes the problem of selling a number of indivisible items to a set of unitdemand bidders. An ascending auction mechanism called the Excess Demand Ascending Auction (EDAA) is defined. The main results demonstrate that EDAA terminates in a finite number of iterations and that the exact

Predecessor queries in dynamic integer sets

DEFF Research Database (Denmark)

Brodal, Gerth Stølting

1997-01-01

We consider the problem of maintaining a set of n integers in the range 0.2w–1 under the operations of insertion, deletion, predecessor queries, minimum queries and maximum queries on a unit cost RAM with word size w bits. Let f (n) be an arbitrary nondecreasing smooth function satisfying n...

Assessment of physiological performance and perception of pushing different wheelchairs on indoor modular units simulating a surface roughness often encountered in under-resourced settings.

Science.gov (United States)

Sasaki, Kotaro; Rispin, Karen

2017-01-01

In under-resourced settings where motorized wheelchairs are rarely available, manual wheelchair users with limited upper-body strength and functionalities need to rely on assisting pushers for their mobility. Because traveling surfaces in under-resourced settings are often unpaved and rough, wheelchair pushers could experience high physiological loading. In order to evaluate pushers' physiological loading and to improve wheelchair designs, we built indoor modular units that simulate rough surface conditions, and tested a hypothesis that pushing different wheelchairs would result in different physiological performances and pushers' perception of difficulty on the simulated rough surface. Eighteen healthy subjects pushed two different types of pediatric wheelchairs (Moti-Go manufactured by Motivation, and KidChair by Hope Haven) fitted with a 50-kg dummy on the rough and smooth surfaces at self-selected speeds. Oxygen uptake, traveling distance for 6 minutes, and the rating of difficulty were obtained. The results supported our hypothesis, showing that pushing Moti-Go on the rough surface was physiologically less loading than KidChair, but on the smooth surface, the two wheelchairs did not differ significantly. These results indicate wheelchair designs to improve pushers' performance in under-resourced settings should be evaluated on rough surfaces.

Intensive-care unit lung infections: The role of imaging with special emphasis on multi-detector row computed tomography

International Nuclear Information System (INIS)

Romano, Luigia; Pinto, Antonio; Merola, Stefanella; Gagliardi, Nicola; Tortora, Giovanni; Scaglione, Mariano

2008-01-01

Nosocomial pneumonia is the most frequent hospital-acquired infection. In mechanically ventilated patients admitted to an intensive-care unit as many as 7-41% may develop pneumonia. The role of imaging is to identify the presence, location and extent of pulmonary infection and the presence of complications. However, the poor resolution of bedside plain film frequently limits the value of radiography as an accurate diagnostic tool. To date, multi-detector row computed tomography with its excellent contrast resolution is the most sensitive modality for evaluating lung parenchyma infections

Portable Power And Digital-Communication Units

Science.gov (United States)

Levin, Richard R.; Henry, Paul K.; Rosenberg, Leigh S.

1992-01-01

Conceptual network of electronic-equipment modules provides electrical power and digital radio communications at multiple sites not served by cables. System includes central communication unit and portable units powered by solar photovoltaic arrays. Useful to serve equipment that must be set up quickly at remote sites or buildings that cannot be modified to provide cable connections.

Healthcare professionals’ hand hygiene knowledge and beliefs in the United Arab Emirates

Science.gov (United States)

Ng, Wai Khuan; Shaban, Ramon Z.; van de Mortel, Thea

2016-01-01

Background: Hand hygiene at key moments during patient care is considered an important infection prevention and control measure to reduce healthcare-associated infections. While there is extensive research in Western settings, there is little in the United Arab Emirates where particular cultural and religious customs are thought to influence hand hygiene behaviour. Aim: To examine the hand hygiene knowledge and beliefs of health professionals at a tertiary care hospital in the United Arab Emirates. Methods: A mixed methods design employed a survey followed by focus groups with nurses and doctors. Findings: A total of 109 participants (13.6%) completed the survey: 96 nurses (88%) and 13 doctors (12%). Doctors’ hand hygiene knowledge was slightly higher than that of nurses (78.5% versus 73.5%). There was no significant difference in scores on the hand hygiene beliefs scale between nurses (M = 103.06; SD = 8.0) and doctors (M = 99.00; SD = 10.53; t (80) = 1.55; p = 0.13, two-tailed). Seven categories emerged following transcript analysis. Discussion: Hand hygiene knowledge scores suggest further hand hygiene education is required, especially on alcohol-based hand rub use. Addressing doctors’ beliefs is particularly important given the leadership roles that doctors play in healthcare settings. PMID:28989517

7 CFR 28.107 - Original cotton standards and reserve sets.

Science.gov (United States)

2010-01-01

... 7 Agriculture 2 2010-01-01 2010-01-01 false Original cotton standards and reserve sets. 28.107... Standards Act Practical Forms of Cotton Standards § 28.107 Original cotton standards and reserve sets. (a) The containers of the original Universal Standards and other official cotton standards of the United...

Simple Economics of the Price-Setting Newsvendor Problem

OpenAIRE

Michael Salinger; Miguel Ampudia

2011-01-01

The Lerner relationship linking the profit-maximizing price to marginal cost and the elasticity of demand generalizes to the price-setting newsvendor, and the result resolves the puzzle over the different effects of additive and multiplicative uncertainty on the solution. Multiplicative uncertainty increases the optimal price because it increases the marginal cost of a unit sold and does not affect the markup factor. Additive uncertainty has no effect on the marginal cost of a unit sold and l...

The communication process in clinical settings.

Science.gov (United States)

Mathews, J J

1983-01-01

The communication of information in clinical settings is fraught with problems despite avowed common aims of practitioners and patients. Some reasons for the problematic nature of clinical communication are incongruent frames of reference about what information ought to be shared, sociolinguistic differences and social distance between practitioners and patients. Communication between doctors and nurses is also problematic, largely due to differences in ideology between the professions about what ought to be communicated to patients about their illness and who is ratified to give such information. Recent social changes, such as the Patient Bill of Rights and informed consent which assure access to information, and new conceptualizations of the nurse's role, warrant continued study of the communication process especially in regard to what constitutes appropriate and acceptable information about a patient's illness and who ought to give such information to patients. The purpose of this paper is to outline characteristics of communication in clinical settings and to provide a literature review of patient and practitioner interaction studies in order to reflect on why information exchange is problematic in clinical settings. A framework for presentation of the problems employs principles from interaction and role theory to investigate clinical communication from three viewpoints: (1) the level of shared knowledge between participants; (2) the effect of status, role and ideology on transactions; and (3) the regulation of communication imposed by features of the institution.

METRIC context unit architecture

Energy Technology Data Exchange (ETDEWEB)

Simpson, R.O.

1988-01-01

METRIC is an architecture for a simple but powerful Reduced Instruction Set Computer (RISC). Its speed comes from the simultaneous processing of several instruction streams, with instructions from the various streams being dispatched into METRIC's execution pipeline as they become available for execution. The pipeline is thus kept full, with a mix of instructions for several contexts in execution at the same time. True parallel programming is supported within a single execution unit, the METRIC Context Unit. METRIC's architecture provides for expansion through the addition of multiple Context Units and of specialized Functional Units. The architecture thus spans a range of size and performance from a single-chip microcomputer up through large and powerful multiprocessors. This research concentrates on the specification of the METRIC Context Unit at the architectural level. Performance tradeoffs made during METRIC's design are discussed, and projections of METRIC's performance are made based on simulation studies.

Intensive Care Unit Structure Variation and Implications for Early Mobilization Practices. An International Survey.

Science.gov (United States)

Bakhru, Rita N; McWilliams, David J; Wiebe, Douglas J; Spuhler, Vicki J; Schweickert, William D

2016-09-01

Early mobilization (EM) improves outcomes for mechanically ventilated patients. Variation in structure and organizational characteristics may affect implementation of EM practices. We queried intensive care unit (ICU) environment and standardized ICU practices to evaluate organizational characteristics that enable EM practice. We recruited 151 ICUs in France, 150 in Germany, 150 in the United Kingdom, and 500 in the United States by telephone. Survey domains included respondent characteristics, hospital and ICU characteristics, and ICU practices and protocols. We surveyed 1,484 ICU leaders and received a 64% response rate (951 ICUs). Eighty-eight percent of respondents were in nursing leadership roles; the remainder were physiotherapists. Surveyed ICUs were predominantly mixed medical-surgical units (67%), and 27% were medical ICUs. ICU staffing models differed significantly (P equipment were highly variable among respondents. International ICU structure and practice is quite heterogeneous, and several factors (multidisciplinary rounds, setting daily goals for patients, presence of a dedicated physiotherapist, country, and nurse/patient staffing ratio) are significantly associated with the practice of EM. Practice and barriers may be far different based upon staffing structure. To achieve successful implementation, whether through trials or quality improvement, ICU staffing and practice patterns must be taken into account.

Measurement units of physical values

International Nuclear Information System (INIS)

Debraine, P.

1955-01-01

The aim of this paper is twofold: 1) to give an analysis of the formation conditions of the various systems of units, 2) to show how the practical problems involving changes of units can be solved. This analysis leads to the conception of 'types' of systems, which is very useful to clarity the question of rationalized and non rationalized systems. The second point which consists essentially in: 1) finding the relationship between the measures of a given quantity in different systems, 2) deriving practical formulas, 3) deriving formulas in various 'types' of systems, is made easier by use of sets of: * definition formulas, * transformation formulas, * units of the various practical systems with useful numerical information covering the following fields: ** geometry, ** kinematics, ** mechanics, ** electricity and magnetism, ** thermodynamics, ** radiation, ** photometry, These sets being printed on coloured paper can be easily found. A number of numerical examples (21) show in a detailed way how to solve the various problems likely to occur. A chapter is particularly devoted to the Giorgi MKS system. (author) [fr

Entry into Nursing: An Ethnographic Study of Newly Qualified Nurses Taking on the Nursing Role in a Hospital Setting

Directory of Open Access Journals (Sweden)

Mari Skancke Bjerknes

2012-01-01

Full Text Available The transition from student to working nurse has long been recognized as challenging. This paper presents the findings of research into the opportunities and limitations encountered by newly qualified nurses when taking on the nursing role. The study had an ethnographic design. Observation, interviews, and document analysis were used to gain insight into nurses' daily work from the perspective of recently graduated nurses. Thirteen nurses were monitored closely during their first year in a hospital setting in Norway. These new nurses generally entered the field with empathy for their patients, enthusiasm for the profession, and readiness to learn more about being a good nurse. However, their more experienced colleagues seemed to neither respect nor nurture this attitude. The new nurses experienced heavier responsibilities than expected, fragmentation of patient care, and stressful interactions with colleagues. The lack of a supportive work environment and role models increased the new nurses' experience of overwhelming responsibility in their daily work situations. The nurses learned to cope the hard way, despite the organizational culture, not because of it. Adjusting the profession's expectations of new nurses, and offering good role models and more comprehensive support programmes, would markedly ease the transition for new nurses.

Radiation processing of food: role in national development

International Nuclear Information System (INIS)

Sharma, Arun

2002-01-01

Radiation technology can be harnessed in several ways depending on the needs. With adequate storage and packaging regimes it increases the possibilities of handling and distribution of farm produce, thereby improving its supply and management. It can add value to the product by improving its hygiene and quarantine. This is becoming increasingly important for ensuring biosecurity in international trade. Being a newly emerging technology from laboratory to market place, it may face several hurdles. These hurdles may involve engineering or technological challenges during scale-up, post-processing handling and management, problems of security of facilities, consumer attitudes and other unforeseen factors. A small beginning has been made in this direction with a setting up of two technology demonstration units, one for spices and other for onion, by the department. The experience of running these two units and a few more that are contemplated the private sector would probably determine the role the technology would play in future in the national development

Freestanding midwifery unit versus obstetric unit

DEFF Research Database (Denmark)

Overgaard, Charlotte; Møller, Anna Margrethe; Fenger-Grøn, Morten

2011-01-01

low-risk women intending FMU birth and a matched control group of 839 low-risk women intending OU birth were included at the start of care in labour. OU women were individually chosen to match selected obstetric/socio-economic characteristics of FMU women. Analysis was by intention to treat. Main......Objective To compare perinatal and maternal morbidity and birth interventions in low-risk women giving birth in two freestanding midwifery units (FMUs) and two obstetric units (OUs). Design A cohort study with a matched control group. Setting The region of North Jutland, Denmark. Participants 839...... women were significantly less likely to experience an abnormal fetal heart rate (RR: 0.3, 95% CI 0.2 to 0.5), fetal–pelvic complications (0.2, 0.05 to 0.6), shoulder dystocia (0.3, 0.1 to 0.9), occipital–posterior presentation (0.5, 0.3 to 0.9) and postpartum haemorrhage >500 ml (0.4, 0.3 to 0...

A Unit-Test Framework for Database Applications

DEFF Research Database (Denmark)

Christensen, Claus Abildgaard; Gundersborg, Steen; de Linde, Kristian

The outcome of a test of an application that stores data in a database naturally depends on the state of the database. It is therefore important that test developers are able to set up and tear down database states in a simple and efficient manner. In existing unit-test frameworks, setting up...... test can be minimized. In addition, the reuse between unit tests can speed up the execution of test suites. A performance test on a medium-size project shows a 40% speed up and an estimated 25% reduction in the number of lines of test code....

Recovery-Oriented Practice in Mental Health Inpatient Settings

DEFF Research Database (Denmark)

Waldemar, Anna Kristine; Arnfred, Sidse M; Petersen, Lone

2016-01-01

OBJECTIVE: Implementation of recovery-oriented practice has proven to be challenging, and little is known about the extent to which recovery-oriented principles are integrated into mental health inpatient settings. This review of the literature examined the extent to which a recovery......-oriented approach is an integrated part of mental health inpatient settings. METHODS: A systematic search (2000-2014) identified quantitative and qualitative studies that made explicit reference to the concept of recovery and that were conducted in adult mental health inpatient settings or that used informants from......, the United States, Australia, and Ireland were included. The results highlight the limited number of studies of recovery-oriented practice in mental health inpatient settings and the limited extent to which such an approach is integrated into these settings. Findings raise the question of whether recovery...

Fishing for meaningful units in connected speech

DEFF Research Database (Denmark)

Henrichsen, Peter Juel; Christiansen, Thomas Ulrich

2009-01-01

In many branches of spoken language analysis including ASR, the set of smallest meaningful units of speech is taken to coincide with the set of phones or phonemes. However, fishing for phones is difficult, error-prone, and computationally expensive. We present an experiment, based on machine...

Prospects of Nuclear Energy in the United States in the 21st Century

International Nuclear Information System (INIS)

Newman, R. E.

1988-01-01

The Nuclear Industry is now over 40 years old and a proven, mature product has been developed. That proven mature product has evolve into a small set of standardized designs - designs based on evolution of the best and safest features, not revolutionary changes. Just as the product design must be standardized, the regulatory process must also be standardized. With a predictable regulatory environment and rate structure the economic advantages of Nuclear Power will be self-evident. The Nuclear Industry in the United States has had a history of cycles as the economy and need for power has changed. The need for electricity to support growth is a given. With a strong focus on the standardization of the process and the product, a competent engineering approach to safety, and improved economies, the 21st century will see nuclear power assume its appropriate role as a key source in the energy mix in the United States. Presenting a discussion dealing with the future is always a risky thing. One man's prognosis is another mans wild guess. Today, I would like to talk briefly on my views of the future, and especially my views on the Prospects for Nuclear Energy in the U. S. in that future. Though it is clear that nuclear energy will play a key role in fulfilling the energy needs of the world, the future of nuclear energy in the United States is not as clear. A discussion of the future of the U. S. Nuclear Industry is especially appropriate here today because I am firmly confident that the Republic of Korea will play a major role in that future. The world energy situation and the role of nuclear power has undergone a number of upsets in the last decade. Often we tend to dwell on the gloom of the past and overlook the strengths that the Nuclear Industry has developed. Presently over 437 gigawatts of electricity in the world is planned to be produced by 564 nuclear units. There are over 32 countries with commercial nuclear programs. One of the brightest of these being here in

Does Competency-Based Education Have a Role in Academic Pharmacy in the United States?

Science.gov (United States)

Medina, Melissa S.

2017-01-01

Competency-based Education (CBE) is an educational model that allows students to learn and demonstrate their abilities at their own pace. CBE is growing in popularity in undergraduate educational programs and its role in pharmacy education in the United States (US) is under review. In comparison, medical education is utilizing competency-based approaches (such as competencies and Entrustable Professional Activities) to ensure that students possess the required knowledge, skills, and attitudes prior to graduation or program completion. The concept of competency-based approaches is growing in use in pharmacy education in the US, but the future related to aspects of this concept (e.g., mandatory Entrustable Professional Activities) is not certain. A review of pharmacy education’s evolution in the US and a comparison of competency-related terms offers insight into the future use of competency-based approaches and CBE in pharmacy education in the US through the lens of benefits and challenges. PMID:28970425

Does Competency-Based Education Have a Role in Academic Pharmacy in the United States?

Directory of Open Access Journals (Sweden)

Melissa S. Medina

2017-02-01

Full Text Available Competency-based Education (CBE is an educational model that allows students to learn and demonstrate their abilities at their own pace. CBE is growing in popularity in undergraduate educational programs and its role in pharmacy education in the United States (US is under review. In comparison, medical education is utilizing competency-based approaches (such as competencies and Entrustable Professional Activities to ensure that students possess the required knowledge, skills, and attitudes prior to graduation or program completion. The concept of competency-based approaches is growing in use in pharmacy education in the US, but the future related to aspects of this concept (e.g., mandatory Entrustable Professional Activities is not certain. A review of pharmacy education’s evolution in the US and a comparison of competency-related terms offers insight into the future use of competency-based approaches and CBE in pharmacy education in the US through the lens of benefits and challenges.

A full ranking for decision making units using ideal and anti-ideal points in DEA.

Science.gov (United States)

Barzegarinegad, A; Jahanshahloo, G; Rostamy-Malkhalifeh, M

2014-01-01

We propose a procedure for ranking decision making units in data envelopment analysis, based on ideal and anti-ideal points in the production possibility set. Moreover, a model has been introduced to compute the performance of a decision making unit for these two points through using common set of weights. One of the best privileges of this method is that we can make ranking for all decision making units by solving only three programs, and also solving these programs is not related to numbers of decision making units. One of the other advantages of this procedure is to rank all the extreme and nonextreme efficient decision making units. In other words, the suggested ranking method tends to seek a set of common weights for all units to make them fully ranked. Finally, it was applied for different sets holding real data, and then it can be compared with other procedures.

The role of the negative selection activities in securing the competence of an organization belonging to SEN units

International Nuclear Information System (INIS)

Boruga, Carmen

2008-01-01

The transformation and the accommodation of National Power System (SEN) units to a new management system, own to a decentralized economy and having financial support from both native capital and foreign capital, in uncertain proportion at the moment and being in a continuous adjustment determined by the reasons and the motivations first of all political, generated conceptual changes in the so-called modern management theory. The accommodation of this theory to the concrete situation from SEN units imposed the concept of negative selection. It is a concept which represents author's desire to be created as an original contribution to the contemporary management theory. Unlike the selection at the hiring (or positive selection), the negative selection is achieved on personal already employed, in the conditions of activities of a decreased number of personnel and also of a redistribution of personnel on the other side. The negative selection, much more than the positive selection activity in this period in the SEN units (recording a drastic decrease from 90.000 employees counted by the energetic system at the end of 9th decade of the past century, to a little over 30.000 who at the moment work in the societies became independent), determines the specialist in human resources to ensure a judicious training and high competence. It concerns the knowledge of the standard systems and is also related to the method of knowledge and valuation of behavior of the organizational employees. This subject was developed on basis of the documentation and the analyses of documents but also on the basis of a set of studies and researches that were made during 1996-2006 in the SEN units. The work methods and models of negative selection used in the SEN units were analysed. This work concerns four companies which constitute currently the SEN nucleus at present at which the nuclear units with a particular status were added. One finds out that these methods and models of negative selection

Executive Functioning: Relationship with High School Student Role Performance

Directory of Open Access Journals (Sweden)

Donna P. Mann

2015-10-01

Full Text Available BACKGROUND. Student role performance for academic success in secondary education is under represented in the occupational therapy literature, despite the persistently high dropout rate in the United States (Stillwell & Sable, 2013. Executive dysfunction is one of many possible contributors to difficulties in the classroom (Dirette & Kolak, 2004 and is a better indicator of school performance than IQ (Diamond, 2012. This research examined executive functioning of both alternative and traditional high school students to determine if there is a relationship between executive function and academic success as measured by cumulative grade point average. METHOD. 132 high school students from three different school settings were given the Behavioral Rating Inventory of Executive Function-Self Report (BRIEF-SR. The Global Executive Composite (GEC and individual subscale scores were compared to GPA. RESULTS. No significant difference in GEC scores was found among settings. Subscale scores for “inhibition” and “task completion” were significantly different in the alternative school setting. A weak negative correlation was seen between the GEC and GPA. However, academically unsuccessful students scored statistically lower on the GEC. CONCLUSION. Global executive dysfunction was not predicted by setting but was seen in academically unsuccessful students.

University research reactors in the United States: Their role and value

International Nuclear Information System (INIS)

1988-01-01

This report is primarily addressed to the people who make decisions affecting the levels of future university reactor programs URR: university administrators, department heads, federal policy makers, state and local policy makers, those in industry and government who depend upon a supply of nuclear-trained personnel, and those who are concerned with the future of the many sciences that benefit from the unique capabilities of nuclear-based techniques as well as from the nuclear sciences themselves. The major thrust of this report is to illustrate the scientific and social benefits and contributions associated with well-managed and well-funded university reactor programs. The intent is to help a decision maker gain a perspective and appreciation of the scientific, academic, social, and technical values of URR programs. The report also examines the role of university-like reactors in Europe, where a productive community of researchers is apparently served in an exemplary manner. The committee, assesses the security and safeguard needs at small reactors in a university setting in order to help gain a perspective on the potential hazards and relative risks involved. The last chapter discusses the kind of commitment and support needed if a significant population of URRs is to remain productive. 83 refs., 11 figs., 2 tabs

This is my neighborhood: comparing United States and Australian Oxford House Neighborhoods.

Science.gov (United States)

Ferrari, Joseph R; Jason, Leonard A; Blake, Ron; Davis, Margaret I; Olson, Bradley D

2006-01-01

The number of Oxford Houses, communal-living, mutual help settings for persons in recovery of alcohol and substance abuse, has spread across the United States and recently in and around Melbourne, Australia. In this study 55 US and 6 AU Houses were compared descriptively for their neighborhood characteristics. Across settings, there were greater similarities than significant differences in the locations. Results imply that Australian Oxford Houses are "safe and sober" settings for persons in recovery consistent with the original United States model in physical dwelling settings.

Challenges and Benefits of Early Bilingualism in the United States' Context

Science.gov (United States)

Espinosa, Linda M.

2015-01-01

The population of young dual language learners (DLL) in the United States has tripled in the last several decades and now accounts for 25% of all children in the United States (Migration Policy Institute, June 2014). Many of these children are exposed to multiple languages in the home and the early childhood setting (ECE) setting, and the vast…

77 FR 32716 - Price for the 2012 American Eagle San Francisco Two-Coin Silver Proof Set

Science.gov (United States)

2012-06-01

... DEPARTMENT OF THE TREASURY United States Mint Price for the 2012 American Eagle San Francisco Two...: The United States Mint is announcing the price of the 2012 American Eagle San Francisco Two-Coin Silver Proof Set. The coin set will be offered for sale at a price of $149.95. FOR FURTHER INFORMATION...

Installation, Operation, and Operator's Maintenance of Diesel-Engine-Driven Generator Sets.

Science.gov (United States)

Marine Corps Inst., Washington, DC.

This student guide, one of a series of correspondence training courses designed to improve the job performance of members of the Marine Corps, contains three study units dealing with the skills needed by individuals responsible for the installation, operation, and maintenance of diesel engine-driven generator sets. The first two units cover…

Legal Teaching Methods to Diverse Student Cohorts: A Comparison between the United Kingdom, the United States, Australia and New Zealand

Science.gov (United States)

Kraal, Diane

2017-01-01

This article makes a comparison across the unique educational settings of law and business schools in the United Kingdom, the United States, Australia and New Zealand to highlight differences in teaching methods necessary for culturally and ethnically mixed student cohorts derived from high migration, student mobility, higher education rankings…

Effect of the clinical support nurse role on work-related stress for nurses on an inpatient pediatric oncology unit.

Science.gov (United States)

Chang, Ann; Kicis, Jennifer; Sangha, Gurjit

2007-01-01

High patient acuity, heavy workload, and patient deaths can all contribute to work-related stress for pediatric oncology nurses. A new leadership role, the clinical support nurse (CSN), was recently initiated on the oncology unit of a large Canadian pediatric hospital to support frontline staff and reduce some of the stresses related to clinical activity. The CSN assists nurses with complex patient care procedures, provides hands-on education at the bedside, and supports staff in managing challenging family situations. This study explores the effect of the CSN role on the nurses' work-related stress using the Stressor Scale for Pediatric Oncology Nurses. A total of 58 nurses participated in this study for a response rate of 86%. The results show that the intensity of work-related stress experienced by nurses in this study is significantly less (P < .001) on shifts staffed with a CSN compared with shifts without a CSN.

Study Drugs and Academic Integrity: The Role of Beliefs about an Academic Honor Code in the Prediction of Nonmedical Prescription Drug Use for Academic Enhancement

Science.gov (United States)

Reisinger, Kelsy B.; Rutledge, Patricia C.; Conklin, Sarah M.

2016-01-01

The role of beliefs about academic integrity in college students' decisions to use nonmedical prescription drugs (NMPDs) in academic settings was examined. In Spring 2012 the authors obtained survey data from 645 participants at a small, undergraduate, private liberal arts institution in the Northeastern United States. A broadcast e-mail message…

School-based Yoga Programs in the United States: A Survey

Science.gov (United States)

Butzer, Bethany; Ebert, Marina; Telles, Shirley; Khalsa, Sat Bir S.

2016-01-01

Context Substantial interest has begun to emerge around the implementation of yoga interventions in schools. Researchers have found that yoga practices may enhance skills such as self-regulation and prosocial behavior, and lead to improvements in students’ performance. These researchers, therefore, have proposed that contemplative practices have the potential to play a crucial role in enhancing the quality of US public education. Objective The purpose of the present study was to provide a summary and comparison of school-based yoga programs in the United States. Design Online, listserv, and database searches were conducted to identify programs, and information was collected regarding each program’s scope of work, curriculum characteristics, teacher-certification and training requirements, implementation models, modes of operation, and geographical regions. Setting The online, listserv, and database searches took place in Boston, MA, USA, and New Haven, CT, USA. Results Thirty-six programs were identified that offer yoga in more than 940 schools across the United States, and more than 5400 instructors have been trained by these programs to offer yoga in educational settings. Despite some variability in the exact mode of implementation, training requirements, locations served, and grades covered, the majority of the programs share a common goal of teaching 4 basic elements of yoga: (1) physical postures, (2) breathing exercises, (3) relaxation techniques, and (4) mindfulness and meditation practices. The programs also teach a variety of additional educational, social-emotional, and didactic techniques to enhance students’ mental and physical health and behavior. Conclusions The fact that the present study was able to find a relatively large number of formal, school-based yoga programs currently being implemented in the United States suggests that the programs may be acceptable and feasible to implement. The results also suggest that the popularity of school

Distributed Large Independent Sets in One Round On Bounded-independence Graphs

OpenAIRE

Halldorsson , Magnus M.; Konrad , Christian

2015-01-01

International audience; We present a randomized one-round, single-bit messages, distributed algorithm for the maximum independent set problem in polynomially bounded-independence graphs with poly-logarithmic approximation factor. Bounded-independence graphs capture various models of wireless networks such as the unit disc graphs model and the quasi unit disc graphs model. For instance, on unit disc graphs, our achieved approximation ratio is O((log(n)/log(log(n)))^2).A starting point of our w...

The simplifying role of pure and stable sets in induced possibilities and necessities

International Nuclear Information System (INIS)

Tsiporkova, E.

1996-01-01

The behaviour of upper and lower (conditional) possibilities and necessities induced by a multivalued mapping is investigated in case pure and stable sets with respect to this multivalued mapping are involved. It is obtained that the upper and lower possibilities (resp. necessities) and the upper and lower conditional possibilities (resp. necessities) of a pure set with respect to the original (non-restricted) mapping coincide. Simplified expressions for the lower conditional possibilities and necessities induced by a multivalued mapping are established in case of a restricting set that is pure with respect to this multivalued mapping. Moreover, if the multivalued mapping involved is non-void and surjective then the interaction of stable sets with the upper and lower (conditional) possibilities and necessities is also studied

Patient Preferences and Surrogate Decision Making in Neuroscience Intensive Care Units

Science.gov (United States)

Cai, Xuemei; Robinson, Jennifer; Muehlschlegel, Susanne; White, Douglas B.; Holloway, Robert G.; Sheth, Kevin N.; Fraenkel, Liana; Hwang, David Y.

2016-01-01

In the neuroscience intensive care unit (NICU), most patients lack the capacity to make their own preferences known. This fact leads to situations where surrogate decision makers must fill the role of the patient in terms of making preference-based treatment decisions, oftentimes in challenging situations where prognosis is uncertain. The neurointensivist has a large responsibility and role to play in this shared decision making process. This review covers how NICU patient preferences are determined through existing advance care documentation or surrogate decision makers and how the optimum roles of the physician and surrogate decision maker are addressed. We outline the process of reaching a shared decision between family and care team and describe a practice for conducting optimum family meetings based on studies of ICU families in crisis. We review challenges in the decision making process between surrogate decision makers and medical teams in neurocritical care settings, as well as methods to ameliorate conflicts. Ultimately, the goal of shared decision making is to increase knowledge amongst surrogates and care providers, decrease decisional conflict, promote realistic expectations and preference-centered treatment strategies, and lift the emotional burden on families of neurocritical care patients. PMID:25990137

upSET, the Drosophila homologue of SET3, Is Required for Viability and the Proper Balance of Active and Repressive Chromatin Marks

Directory of Open Access Journals (Sweden)

Kyle A. McElroy

2017-02-01

Full Text Available Chromatin plays a critical role in faithful implementation of gene expression programs. Different post-translational modifications (PTMs of histone proteins reflect the underlying state of gene activity, and many chromatin proteins write, erase, bind, or are repelled by, these histone marks. One such protein is UpSET, the Drosophila homolog of yeast Set3 and mammalian KMT2E (MLL5. Here, we show that UpSET is necessary for the proper balance between active and repressed states. Using CRISPR/Cas-9 editing, we generated S2 cells that are mutant for upSET. We found that loss of UpSET is tolerated in S2 cells, but that heterochromatin is misregulated, as evidenced by a strong decrease in H3K9me2 levels assessed by bulk histone PTM quantification. To test whether this finding was consistent in the whole organism, we deleted the upSET coding sequence using CRISPR/Cas-9, which we found to be lethal in both sexes in flies. We were able to rescue this lethality using a tagged upSET transgene, and found that UpSET protein localizes to transcriptional start sites (TSS of active genes throughout the genome. Misregulated heterochromatin is apparent by suppressed position effect variegation of the wm4 allele in heterozygous upSET-deleted flies. Using nascent-RNA sequencing in the upSET-mutant S2 lines, we show that this result applies to heterochromatin genes generally. Our findings support a critical role for UpSET in maintaining heterochromatin, perhaps by delimiting the active chromatin environment.

Neural set point for the control of arterial pressure: role of the nucleus tractus solitarius

Directory of Open Access Journals (Sweden)

Valentinuzzi Max E

2010-01-01

the baroreflex would stabilize the short term pressure value to the prevailing carotid MAP. The discharge rates of rostral neural projections to the NTS would function as the set point of the closed and open loops of cardiovascular control. No doubt, then, the RNS play a functional role not only under steady-state conditions, but also in different behaviors and pathologies.

Measurement units of physical values; Unites de mesure des grandeurs physiques

Energy Technology Data Exchange (ETDEWEB)

Debraine, P [Commissariat a l' Energie Atomique, Saclay(France). Centre d' Etudes Nucleaires

1955-07-01

The aim of this paper is twofold: 1) to give an analysis of the formation conditions of the various systems of units, 2) to show how the practical problems involving changes of units can be solved. This analysis leads to the conception of 'types' of systems, which is very useful to clarity the question of rationalized and non rationalized systems. The second point which consists essentially in: 1) finding the relationship between the measures of a given quantity in different systems, 2) deriving practical formulas, 3) deriving formulas in various 'types' of systems, is made easier by use of sets of: * definition formulas, * transformation formulas, * units of the various practical systems with useful numerical information covering the following fields: ** geometry, ** kinematics, ** mechanics, ** electricity and magnetism, ** thermodynamics, ** radiation, ** photometry, These sets being printed on coloured paper can be easily found. A number of numerical examples (21) show in a detailed way how to solve the various problems likely to occur. A chapter is particularly devoted to the Giorgi MKS system. (author) [French] Le but de cet expose est double: 1) donner une analyse des conditions de formation des differents systemes d'unites, 2) montrer comment peuvent se resoudre les problemes pratiques de changement d'unites. Cette analyse amene a 1a conception de ''types'' de systemes, conception tres utile pour eclairer la question des systemes rationalises et non rationalises. La seconde partie du programme qui consiste essentiellement: 1) a determiner les relations entre les mesures d'une meme grandeur dans differents systemes, 2) a etablir des formules pratiques, 3) a etablir les formules valables dans un ''type'' de systeme donne est facilitee par l'utilisation de listes classees de 1) formules de definition, 2) equations de transformation, 3) unites des differents systemes accompagnees de relations numeriques utiles, couvrant les domaines suivants: 1) geometrie, 5

ORGANIZATION MANAGEMENT TODAY: SETTING THE HUMAN ...

African Journals Online (AJOL)

CIU

... paper attempted to articulate the new roles by outlining the basic ingredients for setting an agenda for the ... The removal of traditional restrictive rules has opened up .... The human resource is identified as the most critical factor in the work.

The role of anaesthetists in paediatric intensive care units

African Journals Online (AJOL)

Adele

to various surgical and critical care disciplines, the usefulness of a paediatric intensive care unit (PICU) rotation was investigated. A brief overview of the experiences of anaesthetic registrars at a. South African teaching hospital rotating through a PICU is pre- sented, as well as the potential advantages for both trainees and.

IceBridge IMU L0 Raw Inertial Measurement Unit Data

Data.gov (United States)

National Aeronautics and Space Administration — The NASA IceBridge IMU L0 Raw Inertial Measurement Unit Data (IPUTI0) data set contains Inertial Measurement Unit (IMU) readings, including latitude, longitude,...

End of the nuclear dream. The UKAEA and its role in nuclear research and development

Energy Technology Data Exchange (ETDEWEB)

Flood, M

1988-01-01

The study sets out to assess the performance of the United Kingdom Atomic Energy Authority (UKAEA) and to make recommendations for its role in the future within the overall energy needs of the United Kingdom. It assumes that the Magnox stations will be phased out after 20-25 years service, that the Advanced Gas-Cooled reactors will be shut down after 20-25 years service and no more built and that perhaps five or so Pressurized Water reactors will be built by the year 2000, including the Sizewell-B station. The first part of the report traces the institutional changes that have taken place in the UKAEA from its formation in 1954 up to the late 1980s. The current structure of the UKAEA is described in part 2. Questions of accountability are raised and its dual role of assessor and promoter of nuclear power is questioned. Part three looks at the UKAEA's role in developing nuclear power, especially the economic implications. In part four fundamental errors of judgement by the UKAEA are blamed for the failure of the UK nuclear industry to provide cheap, abundant, electricity. Practical recommendations for a major restructuring of the Authority are made.

Towards A Model of Identity and Role Exit

Directory of Open Access Journals (Sweden)

Jason S. Milne

2011-11-01

Full Text Available Explanations of role exit often focus on how factors associated with a specific role that affect whether the individual will exit a role or not. Other research explains how identities affect our performance in a role. However, no one has yet to demonstrate the connection between role-set factors and identities, and role exit. Using data from a survey of 940 current and former soccer referees, this paper provides a model of role exit that involves a complex of processes that include role-set factors (structural and cultural factors associated with a specific role and identity processes. Specifically, this paper demonstrates that, other than role conflict, identity processes explain the relationship between role-set factors and role exit. The model provides a beginning method for understanding the connection between identities and role exit.

Fractal Dimension and the Cantor Set

Indian Academy of Sciences (India)

IAS Admin

S Smith. dimension'). We now give two examples of such objects to show that this notion is not vacuous. Cantor Set. Start with the unit interval [0, 1]. Delete the open mid- dle third of the segment, leaving behind two closed seg- ments: [0, 1/3] and [2/3, 1]. Note that, each has length. 1/3. Repeat the same construction for each ...

78 FR 5245 - Pricing for New Product-America the Beautiful Quarters® Three-Roll Set

Science.gov (United States)

2013-01-24

... DEPARTMENT OF THE TREASURY United States Mint Pricing for New Product--America the Beautiful Quarters[supreg] Three-Roll Set AGENCY: United States Mint, Department of the Treasury. ACTION: Notice. SUMMARY: The United States Mint is announcing pricing for a new product, the America the Beautiful...

The nursing role during end-of-life care in the intensive care unit related to the interaction between patient, family and professional: an integrative review

NARCIS (Netherlands)

Noome, M.; Beneken genaamd Kolmer, D.M.; Leeuwen, E. van; Dijkstra, B.M.; Vloet, L.C.M.

2016-01-01

AIM: The aim of this study was to explore how intensive care unit (ICU) nurses describe their role during End-of-Life Care (EOLC) in the ICU, related to the interaction between patient, family and professionals (care triad). METHOD: Three electronic databases, PubMed, CINAHL and EMBASE, and

The nursing role during end-of-life care in the intensive care unit related to the interaction between patient, family and professional : An integrative review

NARCIS (Netherlands)

Noome, M.; Beneken genaamd Kolmer, D.M.; van Leeuwen, E.; Dijkstra, B.M.; Vloet, L.

2016-01-01

Aim The aim of this study was to explore how intensive care unit (ICU) nurses describe their role during End-of-Life Care (EOLC) in the ICU, related to the interaction between patient, family and professionals (care triad). Method Three electronic databases, PubMed, CINAHL and EMBASE, and reference

The role of heat pipes in intensified unit operations

International Nuclear Information System (INIS)

Reay, David; Harvey, Adam

2013-01-01

Heat pipes are heat transfer devices that rely, most commonly, on the evaporation and condensation of a working fluid contained within them, with passive pumping of the condensate back to the evaporator. They are sometimes referred to as ‘thermal superconductors’ because of their exceptionally high effective thermal conductivity (substantially higher than any metal). This, together with several other characteristics make them attractive to a range of intensified unit operations, particularly reactors. The majority of modern computers deploy heat pipes for cooling of the CPU. The application areas of heat pipes come within a number of broad groups, each of which describes a property of the heat pipe. The ones particularly relevant to chemical reactors are: i. Separation of heat source and sink. ii. Temperature flattening, or isothermalisation. iii. Temperature control. Chemical reactors, as a heat pipe application area, highlight the benefits of the heat pipe based on isothermalisation/temperature flattening device and on being a highly effective heat transfer unit. Temperature control, done passively, is also of relevance. Heat pipe technology offers a number of potential benefits to reactor performance and operation. The aim of increased yield of high purity, high added value chemicals means less waste and higher profitability. Other intensified unit operations, such as those employing sorption processes, can also profit from heat pipe technology. This paper describes several variants of heat pipe and the opportunities for their use in intensified plant, and will give some current examples. -- Highlights: ► Heat pipes – thermal superconductors – can lead to improved chemical reactor performance. ► Isothermalisation within a reactor vessel is an ideal application. ► The variable conductance heat pipe can control reaction temperatures within close limits. ► Heat pipes can be beneficial in intensified reactors

Malnutrition in healthcare settings and the role of gastrostomy feeding.

Science.gov (United States)

Kurien, Matthew; Williams, Jake; Sanders, David S

2017-08-01

Malnutrition can adversely affect physical and psychological function, influencing both morbidity and mortality. Despite the prevalence of malnutrition and its associated health and economic costs, malnutrition remains under-detected and under-treated in differing healthcare settings. For a subgroup of malnourished individuals, a gastrostomy (a feeding tube placed directly into the stomach) may be required to provide long-term nutritional support. In this review we explore the spectrum and consequences of malnutrition in differing healthcare settings. We then specifically review gastrostomies as a method of providing nutritional support. The review highlights the origins of gastrostomies, and discusses how endoscopic and radiological advances have culminated in an increased demand and placement of gastrostomy feeding tubes. Several studies have raised concerns about the benefits derived following this intervention and also about the patients selected to undergo this procedure. These studies are discussed in detail in this review, alongside suggestions for future research to help better delineate those who will benefit most from this intervention, and improve understanding about how gastrostomies influence nutritional outcomes.

Challenges encountered by critical care unit managers in the large intensive care units.

Science.gov (United States)

Matlakala, Mokgadi C; Bezuidenhout, Martie C; Botha, Annali D H

2014-04-04

Nurses in intensive care units (ICUs) are exposed regularly to huge demands interms of fulfilling the many roles that are placed upon them. Unit managers, in particular, are responsible for the efficient management of the units and have the responsibilities of planning, organising, leading and controlling the daily activities in order to facilitate the achievement of the unit objectives. The objective of this study was to explore and present the challenges encountered by ICU managers in the management of large ICUs. A qualitative, exploratory and descriptive study was conducted at five hospital ICUs in Gauteng province, South Africa. Data were collected through individual interviews from purposively-selected critical care unit managers, then analysed using the matic coding. Five themes emerged from the data: challenges related to the layout and structure of the unit, human resources provision and staffing, provision of material resources, stressors in the unit and visitors in the ICU. Unit managers in large ICUs face multifaceted challenges which include the demand for efficient and sufficient specialised nurses; lack of or inadequate equipment that goes along with technology in ICU and supplies; and stressors in the ICU that limit the efficiency to plan, organise, lead and control the daily activities in the unit. The challenges identified call for multiple strategies to assist in the efficient management of large ICUs.

Challenges encountered by critical care unit managers in the large intensive care units

Directory of Open Access Journals (Sweden)

Mokgadi C. Matlakala

2014-04-01

Full Text Available Background: Nurses in intensive care units (ICUs are exposed regularly to huge demands interms of fulfilling the many roles that are placed upon them. Unit managers, in particular, are responsible for the efficient management of the units and have the responsibilities of planning, organising, leading and controlling the daily activities in order to facilitate the achievement of the unit objectives. Objectives: The objective of this study was to explore and present the challenges encountered by ICU managers in the management of large ICUs. Method: A qualitative, exploratory and descriptive study was conducted at five hospital ICUs in Gauteng province, South Africa. Data were collected through individual interviews from purposively-selected critical care unit managers, then analysed using the matic coding. Results: Five themes emerged from the data: challenges related to the layout and structure of the unit, human resources provision and staffing, provision of material resources, stressors in the unit and visitors in the ICU. Conclusion: Unit managers in large ICUs face multifaceted challenges which include the demand for efficient and sufficient specialised nurses; lack of or inadequate equipment that goes along with technology in ICU and supplies; and stressors in the ICU that limit the efficiency to plan, organise, lead and control the daily activities in the unit. The challenges identified call for multiple strategies to assist in the efficient management of large ICUs.

Effect of study design and setting on tuberculosis clustering estimates using Mycobacterial Interspersed Repetitive Units-Variable Number Tandem Repeats (MIRU-VNTR): a systematic review.

Science.gov (United States)

Mears, Jessica; Abubakar, Ibrahim; Cohen, Theodore; McHugh, Timothy D; Sonnenberg, Pam

2015-01-21

To systematically review the evidence for the impact of study design and setting on the interpretation of tuberculosis (TB) transmission using clustering derived from Mycobacterial Interspersed Repetitive Units-Variable Number Tandem Repeats (MIRU-VNTR) strain typing. MEDLINE, EMBASE, CINHAL, Web of Science and Scopus were searched for articles published before 21st October 2014. Studies in humans that reported the proportion of clustering of TB isolates by MIRU-VNTR were included in the analysis. Univariable meta-regression analyses were conducted to assess the influence of study design and setting on the proportion of clustering. The search identified 27 eligible articles reporting clustering between 0% and 63%. The number of MIRU-VNTR loci typed, requiring consent to type patient isolates (as a proxy for sampling fraction), the TB incidence and the maximum cluster size explained 14%, 14%, 27% and 48% of between-study variation, respectively, and had a significant association with the proportion of clustering. Although MIRU-VNTR typing is being adopted worldwide there is a paucity of data on how study design and setting may influence estimates of clustering. We have highlighted study design variables for consideration in the design and interpretation of future studies. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Melding Research and Education in a Zoological Setting

Science.gov (United States)

Foote, Dustin

The first zoo was opened in London in 1828 and was intended for scientific study, but was eventually opened to the public in 1847. Since then, public dogma has dictated the development, role, and standards concerning the use of animals across the zoological community. Too often there is disconnect between research programs, captive propagation, and public education. In the fight against human driven extinction of earth's flora and fauna, it is vital that these areas be aligned. Thus in an effort to unite research and education in a zoological setting, East Carolina University (ECU) and Sylvan Heights Bird Park (SHBP) have partnered for a collaborative project involving the study of evolution in the African brood parasitic finches (Viduidae), specifically he Pin-tailed Whydah (Vidua macroura). I attempt to quantify the educational impact of Avian Pirates and SHBP, and assess basic demographic factors that will allow insights into what areas of exhibit design pertain to education. It is important to understand what aspects of zoos facilitate visitor learning in areas of conservation and biodiversity. This is vital as Zoos are under new pressure to substantiate claims of education during visits.

Managing Asthma in the Early Childhood Setting

Science.gov (United States)

Graville, Iris

2011-01-01

Asthma, one of the most common chronic disorders in childhood, affects more than seven million children in the United States, and is the third leading cause of hospitalization for children. Statistics like these make planning and preparing for asthma in the early childhood setting a high priority. With the high rates of asthma in the U.S. today,…

EPA's Role in the United Nations Economic and Social Council

Science.gov (United States)

The United Nations Economic and Social Council (ECOSOC) considers the world’s economic, social, and environmental challenges. ECOSOC is composed of subsidiary bodies, including the recently concluded Commission on Sustainable Development (CSD).

The role of a palliative care inpatient unit in disease management of ...

African Journals Online (AJOL)

Objectives. To monitor the success of an inpatient palliative care unit combining private and state patients, and accessible to patients with cancer and AIDS. Design. An observational study was conducted of patients admitted to the unit in the first 3 months following opening of the ward (1 March - 31 May 2006). Methods.

Competing perspectives during organizational socialization on the role of certified athletic trainers in high school settings.

Science.gov (United States)

Mensch, James; Crews, Candice; Mitchell, Murray

2005-01-01

When certified athletic trainers (ATCs) enter a workplace, their potential for professional effectiveness is affected by a number of factors, including the individual's ability to put acquired knowledge, skills, and attitudes into practice. This ability may be influenced by the preconceived attitudes and expectations of athletes, athletes' parents, athletic directors, physical therapists, physicians, and coaches. To examine the perspectives of high school coaches and ATCs toward the ATC's role in the high school setting by looking at 3 questions: (1) What are coaches' expectations of ATCs during different phases of a sport season? (2) What do ATCs perceive their role to be during different phases of a season? and (3) How do coaches' expectations compare with ATCs' expectations? Qualitative research design involving semistructured interviews. High schools. Twenty high school varsity basketball coaches from 10 high schools in 2 states and the ATCs assigned to these teams. For the coaches, 12 questions focused on 3 specific areas: (1) the athletic training services they received as high school basketball coaches, (2) each coach's expectations of the ATC with whom he or she was working during various phases of the season, and (3) coaches' levels of satisfaction with the athletic training services provided to their team. For the ATCs, 17 questions focused on 3 areas: (1) the ATC's background, (2) the ATC's perceived duties at different phases of the basketball season and his or her relationship with the coach, and (3) other school factors that enhanced or interfered with the ATC's ability to perform duties. Three themes emerged. Coaches had limited knowledge and understanding of ATCs' qualifications, training, professional preparation, and previous experience. Coaches simply expected ATCs to be available to complement their roles. Positive communication was identified as a critical component to a good coach-ATC relationship. Although all participants valued good

Physical health monitoring in mental health settings: a study exploring mental health nurses' views of their role.

Science.gov (United States)

Mwebe, Herbert

2017-10-01

To explore nurses' views of their role in the screening and monitoring of the physical care needs of people with serious mental illness in a mental health service provider. There is increasing awareness through research that people with serious mental illness disproportionately experience and die early from physical health conditions. Mental health nurses are best placed as front-line workers to offer screening, monitoring and interventions; however, their views on physical care interventions are not studied often. Qualitative exploratory study. The study was carried out in a mental health inpatient centre in England. Volunteer sampling was adopted for the study with a total target sample of (n = 20) nurses from three inpatient wards. Semistructured interviews were conducted with (n = 10) registered mental health nurses who had consented to take part in the study. Inductive data analysis and theme development were guided by a thematic analytic framework. Participants shared a clear commitment regarding their role regarding physical health screening and monitoring in mental health settings. Four themes emerged as follows: features of current practice and physical health monitoring; perceived barriers to physical health monitoring; education and training needs; and strategies to improve physical health monitoring. Nurses were unequivocal in their resolve to ensure good standard physical health monitoring and screening interventions in practice. However, identified obstacles have to be addressed to ensure that physical health screening and monitoring is integrated adequately in everyday clinical activities. Achieving this would require improvements in nurses' training, and an integrated multiservice and team-working approach. Attending to the physical health needs of people with serious mental illness has been associated with multiple improvements in both mental and physical health; nurses have a vital role to play in identifying and addressing causes of poor

Power from Perspective: Potential future United States energy portfolios

International Nuclear Information System (INIS)

Tonn, Bruce; Healy, K.C.; Gibson, Amy; Ashish, Ashutosh; Cody, Preston; Beres, Drew; Lulla, Sam; Mazur, Jim; Ritter, A.J.

2009-01-01

This paper presents United States energy portfolios for the year 2030, developed from seven different Perspectives. The Perspectives are characterized by different weights placed on fourteen defining values (e.g., cost, social acceptance). The portfolios were constructed to achieve three primary goals, energy independence, energy security, and greenhouse gas reductions. The portfolios are also evaluated over a comprehensive set of secondary criteria (e.g., economic growth, technical feasibility). It is found that very different portfolios based on very different defining values can achieve the three primary goals. Commonalities among the portfolios include reliance upon cellulosic ethanol, nuclear power, and energy efficiency to meet year 2030 energy demands. It is concluded that the US energy portfolio must be diverse and to achieve national energy goals will require an explicit statement of goals, a strong role for government, and coordinated action across society

The use of supplements and performance and image enhancing drugs in fitness settings: A exploratory cross-sectional investigation in the United Kingdom.

Science.gov (United States)

Mooney, Roisin; Simonato, Pierluigi; Ruparelia, Risha; Roman-Urrestarazu, Andres; Martinotti, Giovanni; Corazza, Ornella

2017-05-01

The strive for perfection is prevalent in the fitness industry. This study aimed to explore the use of products to enhance performance alongside exposure to exercise addiction, appearance anxiety and self-esteem in fitness settings. An online survey was prepared and piloted before wider dissemination in fitness clubs via snowballing and selected mailing lists. A list of commonly used products, including Performance and Image Enhancing Drugs (PIEDs) was provided. Exercise addiction (Exercise Addiction Inventory; EAI), anxiety levels (Appearance Anxiety Inventory; AAI) and their self-esteem (Rosenberg's Self-Esteem Scale; RSE) were also measured. 377 questionnaires were completed. A significant number of participants declared the use products either to lose weight (16%) or to reach their fitness goals (41%). The Internet played a major role in both the supply of information and the provision of the enhancement products (33.7%) and side effects were reported (10.5%). Only a limited number of participants sought a medical opinion about taking products (5.1%). EAI scores were high (m=20.02 ± 4.1), AAI (m=15.98 ± 4.8) showed an intermediate level of anxiety, while self-esteem was low (RSE m=12.59 ± 2.2). This pilot study identified the emergence of a new drug trend in fitness settings and showed a potential relationship to exercise addiction, anxiety disorders and low self-esteem. The Internet played a crucial role in disseminating often untested products, including PIEDs without medical supervision and unwanted side-effects were reported. More studies in the field are required in order to safeguard public health and inform policy making. Copyright © 2017 John Wiley & Sons, Ltd.

Unit 1203: The Social and Psychological Implications of Language.

Science.gov (United States)

Minnesota Univ., Minneapolis. Center for Curriculum Development in English.

Designed as a synthesis of concepts familiar to students having studied the earlier Minnesota Project English units or as an introduction for other students, this unit for grade 12 treats the role of language in the social and psychological development of man. Alternative introductions to the unit are provided: one concentrating on definitions of…

Achieving Work-Life Balance in the National Collegiate Athletic Association Division I Setting, Part I: The Role of the Head Athletic Trainer

Science.gov (United States)

Mazerolle, Stephanie M.; Goodman, Ashley; Pitney, William A.

2015-01-01

Context: Supervisor support has been identified as key to the fulfillment of work-life balance for the athletic trainer (AT), yet limited literature exists on the perspectives of supervisors. Objective: To investigate how the head AT facilitates work-life balance among staff members within the National Collegiate Athletic Association Division I setting. Design: Qualitative study. Setting: Web-based management system. Patients or Other Participants: A total of 18 head ATs (13 men, 5 women; age = 44 ± 8 years, athletic training experience = 22 ± 7 years) volunteered for an asynchronous, Web-based interview. Data Collection and Analysis: Participants responded to a series of questions by journaling their thoughts and experiences. We included multiple-analyst triangulation, stakeholder checks, and peer review to establish data credibility. We analyzed the data via a general inductive approach. Results: Four prevailing themes emerged from the data: modeling work-life balance, encouraging disengagement from the AT role, cooperation and community workplace, and administrative support and understanding. Conclusions: Head ATs at the Division I level recognized the need to promote work-life balance among their staffs. They not only were supportive of policies that promote work-life balance, including spending time away from the role of the AT and teamwork among staff members, but also modeled and practiced the strategies that they promoted. PMID:25343530

Pioneering a new role: the beginning, current practice and future of the Clinical Nurse Leader.

Science.gov (United States)

Poulin-Tabor, Danielle; Quirk, Rebecca L; Wilson, Lauri; Orff, Sonja; Gallant, Paulette; Swan, Nina; Manchester, Nicole

2008-07-01

To discuss the development of a new nursing role in response to the health care crisis in the United States. The nursing shortage and fragmentation of care has contributed to the need for nurses who are prepared to laterally integrate care, bring evidence-based practice to the bedside and provide continuity of care to patients and families. The CNLs review the literature, share their experiences, and discuss outcomes related to improved quality of care. Having clinical nurses with a global perspective acting as facilitators and integrators of care is essential to maintaining a high standard of care. Organizational and management support is critical. The more CNLs that can be embedded in an institution, the more successful the role can be. The varied utilization of the CNLs in this practice setting has proven its value in a short period of time and facilitated better communication and collaboration among patients and their health care team. The flexibility and broad scope of this role allows for its use in any practice setting to realize gains in quality outcomes, cost savings, improved patient flow, increased safety, nurse satisfaction and increasing organizational capacity.

The role of personnel marketing in the process of building corporate social responsibility strategy of a scientific unit

Directory of Open Access Journals (Sweden)

Sylwia Jarosławska-Sobór

2015-09-01

Full Text Available The goal of this article is to discuss the significance of human capital in the process of building the strategy of social responsibility and the role of personnel marketing in the process. Dynamically changing social environment has enforced a new way of looking at non-material resources. Organizations have understood that it is human capital and social competences that have a significant impact on the creation of an organization’s value, generating profits, as well as gaining competitive advantage in the 21st century. Personnel marketing is now a key element in the process of implementation of the CSR concept and building the value of contemporary organizations, especially such unique organizations as scientific units. In this article you will find a discussion concerning the basic values regarded as crucial by the Central Mining Institute in the context of their significance for the paradigm of social responsibility. Such an analysis was carried out on the basis of the experiences of Central Mining Institute (GIG in the development of strategic CSR, which takes into consideration the specific character of the Institute as a scientific unit.

Protein folding: Defining a standard set of experimental conditions and a preliminary kinetic data set of two-state proteins

DEFF Research Database (Denmark)

Maxwell, Karen L.; Wildes, D.; Zarrine-Afsar, A.

2005-01-01

Recent years have seen the publication of both empirical and theoretical relationships predicting the rates with which proteins fold. Our ability to test and refine these relationships has been limited, however, by a variety of difficulties associated with the comparison of folding and unfolding ...... efforts is to set uniform standards for the experimental community and to initiate an accumulating, self-consistent data set that will aid ongoing efforts to understand the folding process....... constructs. The lack of a single approach to data analysis and error estimation, or even of a common set of units and reporting standards, further hinders comparative studies of folding. In an effort to overcome these problems, we define here a consensus set of experimental conditions (25°C at pH 7.0, 50 m...... rates, thermodynamics, and structure across diverse sets of proteins. These difficulties include the wide, potentially confounding range of experimental conditions and methods employed to date and the difficulty of obtaining correct and complete sequence and structural details for the characterized...

Unit III: International Conflict.

Science.gov (United States)

Maxey, Phyllis

1983-01-01

This lesson helps students understand the global network involved in international events. Students have an opportunity to examine the impact of international law and the role of international organizations, national governments, and private individuals in the effort to secure the release of United States hostages in Iran. (AM)

Preconstructing Suspicion and Recasting Masculinity in Preschool Settings

Directory of Open Access Journals (Sweden)

John C. Pruit

2014-10-01

Full Text Available Although there is literature explaining how female ethnographers negotiate maledominated research settings, there is a lack of literature explaining how male ethnographers negotiate female-dominated settings. It is, more or less, taken for granted the research settings males choose will be suitable for them. The field of early childhood education, and preschools in particular, would benefit from a basic explanation of male fieldworker practices and why they are necessary for men in early childhood education settings. Drawing on personal experiences from two years of ethnographic research, I turn to a Montessori preschool in the Midwestern United States to address the complexities of being a male fieldworker in a femaledominated setting. I first explicate some dimensions of preconstructing suspicion of males in ECE. I then develop a gender recasting strategy with the goal of recasting masculinity. Recasting masculinity is a reflexive self-presentation strategy using personal characteristics as resources to build trust and rapport with research participants.

Nurses’ workarounds in acute healthcare settings: a scoping review

Science.gov (United States)

2013-01-01

Background Workarounds circumvent or temporarily ‘fix’ perceived workflow hindrances to meet a goal or to achieve it more readily. Behaviours fitting the definition of workarounds often include violations, deviations, problem solving, improvisations, procedural failures and shortcuts. Clinicians implement workarounds in response to the complexity of delivering patient care. One imperative to understand workarounds lies in their influence on patient safety. This paper assesses the peer reviewed empirical evidence available on the use, proliferation, conceptualisation, rationalisation and perceived impact of nurses’ use of workarounds in acute care settings. Methods A literature assessment was undertaken in 2011–2012. Snowballing technique, reference tracking, and a systematic search of twelve academic databases were conducted to identify peer reviewed published studies in acute care settings examining nurses’ workarounds. Selection criteria were applied across three phases. 58 studies were included in the final analysis and synthesis. Using an analytic frame, these studies were interrogated for: workarounds implemented in acute care settings by nurses; factors contributing to the development and proliferation of workarounds; the perceived impact of workarounds; and empirical evidence of nurses’ conceptualisation and rationalisation of workarounds. Results The majority of studies examining nurses’ workarounds have been published since 2008, predominantly in the United States. Studies conducted across a variety of acute care settings use diverse data collection methods. Nurses’ workarounds, primarily perceived negatively, are both individually and collectively enacted. Organisational, work process, patient-related, individual, social and professional factors contribute to the proliferation of workarounds. Group norms, local and organisational culture, ‘being competent’, and collegiality influence the implementation of workarounds. Conclusion

Nurses' workarounds in acute healthcare settings: a scoping review.

Science.gov (United States)

Debono, Deborah S; Greenfield, David; Travaglia, Joanne F; Long, Janet C; Black, Deborah; Johnson, Julie; Braithwaite, Jeffrey

2013-05-11

Workarounds circumvent or temporarily 'fix' perceived workflow hindrances to meet a goal or to achieve it more readily. Behaviours fitting the definition of workarounds often include violations, deviations, problem solving, improvisations, procedural failures and shortcuts. Clinicians implement workarounds in response to the complexity of delivering patient care. One imperative to understand workarounds lies in their influence on patient safety. This paper assesses the peer reviewed empirical evidence available on the use, proliferation, conceptualisation, rationalisation and perceived impact of nurses' use of workarounds in acute care settings. A literature assessment was undertaken in 2011-2012. Snowballing technique, reference tracking, and a systematic search of twelve academic databases were conducted to identify peer reviewed published studies in acute care settings examining nurses' workarounds. Selection criteria were applied across three phases. 58 studies were included in the final analysis and synthesis. Using an analytic frame, these studies were interrogated for: workarounds implemented in acute care settings by nurses; factors contributing to the development and proliferation of workarounds; the perceived impact of workarounds; and empirical evidence of nurses' conceptualisation and rationalisation of workarounds. The majority of studies examining nurses' workarounds have been published since 2008, predominantly in the United States. Studies conducted across a variety of acute care settings use diverse data collection methods. Nurses' workarounds, primarily perceived negatively, are both individually and collectively enacted. Organisational, work process, patient-related, individual, social and professional factors contribute to the proliferation of workarounds. Group norms, local and organisational culture, 'being competent', and collegiality influence the implementation of workarounds. Workarounds enable, yet potentially compromise, the execution of

Configurations of Leadership Practices in Hospital Units

DEFF Research Database (Denmark)

Meier, Ninna

2015-01-01

configurations of leadership practices varied in four different clinical settings, thus contributing with contextual accounts of leadership as practice, and suggested “configurations of practice” as a way to carve out similarities and differences in leadership practices across settings....... and interviews with ten interdisciplinary clinical managers. Findings: – Comparing leadership as configurations of practices across four different clinical settings, the author shows how flexible and often shared leadership practices were embedded in and central to the core clinical work in all units studied...

Reduction of standby energy use in set-top boxes in the United States and the European Union

Energy Technology Data Exchange (ETDEWEB)

Zandelin, S.

2000-06-01

In the US, there were over 110 million set-top boxes in 1999. About half of these boxes were game consoles. In the EU, the number of set-top boxes was estimated to be about 71 millions in 1999. The most common set-top boxes in the EU were analog satellite receivers. That is quite a difference from the US, where almost no analog satellite receivers exist. It is expected that the amount of set-top boxes will increase rapidly when the broadcasts switch to digital. Set-top boxes in the US consume 7.9 TWh of electricity every year. Of this 5.5 TWh, or 70 %, are consumed while in standby mode. The amount of energy used in standby in the US would be enough to heat about 220,000 Swedish houses. Even though almost half of the set-top boxes in the US are game consoles, they only use 30 % of the set-top energy. This is because they have low standby power. Since most analog cable boxes have a very high standby power, 46 % of the set-top energy come from analog cable boxes. Analog cable boxes use 76 % of the energy in standby mode. The set-top electricity consumption in the US is 0.70 % of the residential electricity use. In the EU the total amount of energy used by set-top boxes is 5.1 TWh every year. The fraction used in standby mode in the EU, 60 %, is smaller than in the US. In the EU, the most common boxes are the analog satellite receivers. They use 59 % of the total set-top energy, or 3.0 TWh. The set-top energy share of the residential electricity use in the EU is about 0.85 %. Sweden has a share that is less than half of the EU share. One reason for that could be that a lot of electricity is used for heating in Sweden. In most set-top boxes, high standby power is because most circuitry and components are still powered when they are not in use. By making modest redesigns and changes of communications protocols between the service provider and the user, the energy efficiency could be increased and the standby power consumption reduced significantly. If nothing is done to

[Primary care in the United Kingdom].

Science.gov (United States)

Sánchez-Sagrado, T

2016-03-01

The inadequate planning of health professionals in Spain has boosted the way out of doctors overseas. The United Kingdom is one of the countries chosen by Spanish doctors to develop their job. The National Health Service is a health system similar to the Spanish one. Health care services are financing mainly through taxes. The right to health care is linked to the citizen condition. The provision of health care is a mix-up of public and private enterprises. Primary Care is much closed to Spanish Primary Care. Doctors are "self-employed like" professionals. They can set their surgeries in a free area previously designed by the government. They have the right to make their own team and to manage their own budget. Medical salary is linked to professional capability and curriculum vitae. The main role of a General Practitioner is the prevention. Team work and coordination within primary and specialised care is more developed than in Spain. The access to diagnostic tests and to the specialist is controlled through waiting lists. General Practitioners work as gate-keepers. Patients may choose freely their doctor and consultations and hospital care are free at the point of use. Within the United Kingdom there are also health regions with problems due to inequalities to access and to treatment. There is a training path and the access to it is by Curricula. The number of training jobs is regulated by the local needs. Continuing education is compulsory and strictly regulated local and nationally. The National Health Service was the example for the Spanish health reform in 1986. While Spanish Primary health care is of quality, the efficiency of the health system would improve if staff in Primary Care settings were managed in a similar way to the British's. Copyright © 2015 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

Ageing prisoners' health care: analysing the legal settings in Europe and the United States.

Science.gov (United States)

Bretschneider, Wiebke; Elger, Bernice; Wangmo, Tenzin

2013-01-01

Relatively little is known about the current health care situation and the legal rights of ageing prisoners worldwide. To date, only a few studies have investigated their rights to health care. However, elderly prisoners need special attention. The aim of this article is to critically review the health care situation of older prisoners by analysing the relevant national and international legal frameworks with a particular focus on Switzerland, England and Wales, and the United States (U.S.). Publications on legal frameworks were searched using Web of Science, PubMed, MEDLINE, HeinOnline, and the National Criminal Justice Reference Service. Searches utilizing combinations of keywords relating to ageing prisoners were performed. Relevant reports and policy documents were obtained in order to understand the legal settings in Switzerland, England and Wales, and the U.S. All articles, reports, and policy documents published in English and German between 1774 to June 2012 were included for analysis. Using a comparative approach, an outline was completed to distinguish positive policies in this area. Regulatory approaches were investigated through evaluations of soft laws applicable in Europe and U.S. Supreme Court judgements. Even though several documents could be interpreted as guaranteeing adequate health care for ageing prisoners, there is no specific regulation that addresses this issue completely. The Vienna International Plan of Action on Ageing contributes the most by providing an in-depth analysis of the health care needs of older persons. Still, critical analysis of retrieved documents reveals the lack of specific legislation regarding the health care for ageing prisoners. No consistent regulation delineates the provision of health care for ageing prisoners. Neither national nor international institutions have enforceable laws that secure the precarious situation of older adults in prisons. To initiate a change, this work presents critical issues that must be

Optimizing enactment of nursing roles: redesigning care processes and structures

Directory of Open Access Journals (Sweden)

Jackson K

2014-02-01

Full Text Available Karen Jackson,1 Deborah E White,2 Jeanne Besner,1 Jill M Norris21Health Systems and Workforce Research Unit, Alberta Health Services, Calgary, Alberta, Canada; 2Faculty of Nursing, University of Calgary, Calgary, Alberta, CanadaBackground: Effective and efficient use of nursing human resources is critical. The Nursing Role Effectiveness Model conceptualizes nursing practice in terms of key clinical role accountabilities and has the potential to inform redesign efforts. The aims of this study were to develop, implement, and evaluate a job redesign intended to optimize the enactment of registered nurse (RN clinical role accountabilities.Methods: A job redesign was developed and implemented in a single medical patient care unit, the redesign unit. A mixed-methods design was used to evaluate the job redesign; a second medical patient care unit served as a control unit. Data from administrative databases, observations, interviews, and demographic surveys were collected pre-redesign (November 2005 and post-redesign (October 2007.Results: Several existing unit structures and processes (eg, model of care delivery influenced RNs' ability to optimally enact their role accountabilities. Redesign efforts were hampered by contextual issues, including organizational alignment, leadership, and timing. Overall, optimized enactment of RN role accountabilities and improvements to patient outcomes did not occur, yet this was predictable, given that the redesign was not successful. Although the results were disappointing, much was learned about job redesign.Conclusion: Potential exists to improve the utilization of nursing providers by situating nurses' work in a clinical role accountability framework and attending to a clear organizational vision and well-articulated strategic plan that is championed by leaders at all levels of the organization. Health care leaders require a clear understanding of nurses' role accountabilities, support in managing change, and

Geometric fit of a point set by generalized circles

DEFF Research Database (Denmark)

Körner, Mark-Christopher; Brimberg, Jack; Juel, Henrik

2010-01-01

In our paper we approximate a set of given points by a general circle. More precisely, given two norms k 1 and k 2 and a set of points in the plane, we consider the problem of locating and scaling the unit circle of norm k 1 such that the sum of weighted distances between the circumference...... of the circle and the given points is minimized, where the distance is measured by a norm k 2. We present results for the general case. In the case that k 1 and k 2 are both polyhedral norms, we are able to solve the problem by investigating a finite candidate set....

77 FR 42365 - Price for the Making American History Coin and Currency Set

Science.gov (United States)

2012-07-18

... DEPARTMENT OF THE TREASURY United States Mint Price for the Making American History Coin and... States Mint is announcing a price of $72.95 for the Making American History Coin and Currency Set. FOR FURTHER INFORMATION CONTACT: B.B. Craig, Associate Director for Sales and Marketing; United States Mint...

Exploring the relationship between social identity and workplace jurisdiction for new nursing roles: a case study approach.

Science.gov (United States)

Maxwell, E; Baillie, L; Rickard, W; McLaren, S M

2013-05-01

The introduction of new healthcare roles internationally has had mixed results with some evidence that variations can be accounted for by the manner of their introduction rather than role content. Explanation may be found partly in the ways in which new roles establish a workplace jurisdiction; that is, recognition in the workplace of a role's legitimate rights to undertake a particular scope of practice. To explore the factors that influence the development of workplace jurisdiction of new nursing roles. Critical realist multiple case study design within two NHS Acute Hospital Trusts in England and two new nursing roles as embedded units of analysis in each case (n=4 roles). In Phase 1, data were collected through semi-structured interviews (n=21), non-participant observation of committees (n=11), partial participant observation and shadowing of the role holders' working day (n=9), together with analysis of organisational documents (n=33). In Phase 2, follow up interviews with role-holders (n=4) were conducted. Participants Staff in new nursing roles (n=4) were selected purposively as embedded units according to the theoretical framework and other informants (n=17) were selected according to the study propositions. Qualitative analysis demonstrated that different role drivers produced two different role types, each of whom faced different challenges in negotiating the implementation of the role in the workplace. Negotiation of workplace jurisdiction was shown to be dependent on sharing social identities with co-workers. Four major workplace identities were found: professional, speciality, organisational and relational. The current focus on setting legal and public jurisdictions for new nursing roles through national standards and statutory registration needs to be complemented by a better understanding of how workplace jurisdiction is achieved. This study suggests that social identity is a significant determinant. Copyright © 2012 Elsevier Ltd. All rights

Evaluating the use of the Cleo 90 infusion set for patients on a palliative care unit.

Science.gov (United States)

Schneider, Michael; Hoffmann, Martin; Lorenzl, Stefan

2009-08-01

Although the use of subcutaneous infusion is common in palliative care, problems can occur. Normally, butterfly needles are used; however, there are occasional issues with patients being able to walk around or with restless patients who suffer from delirium. In these cases, needles often dislocate; therefore, a small observational study was undertaken to evaluate the use of the Cleo 90 infusion set. The use of this needle system has been well established in diabetic patients who require continuous subcutaneous infusion of insulin, but has never been tested in a wider range of patients with other medications. In this 6-month study, 45 patients were identified for subcutaneous infusion and a total of 112 needles were used for this study, since we initially changed each site after 2 days to control the local site for adverse reactions. We have not observed any complications with drug combinations delivered via the attached tube and the needle, and have used up to five different drugs mixed together in a single syringe. Needles could be used for a mean time of 5 +/- 2 days (range 2-12 days). Local site reactions have been observed only with sodium chloride infusions, which were not delivered via a pump system. Reddening and induration of the skin occurred, but they were reversible after removing the needle. As this was a small study in only one unit, without standardization the results can only be observational. However, it has shown, for the first time, that the Cleo 90 needle can be safe and comfortable.

Counting SET-free sets

OpenAIRE

Harman, Nate

2016-01-01

We consider the following counting problem related to the card game SET: How many $k$-element SET-free sets are there in an $n$-dimensional SET deck? Through a series of algebraic reformulations and reinterpretations, we show the answer to this question satisfies two polynomiality conditions.

Pakinggan at Unawain: Comprehending Intermediate Filipino. [DVD Set

Science.gov (United States)

Ramos, Teresita V.

2004-01-01

Watching while listening promotes understanding and makes learning Filipino a lively and engaging experience. This set of two DVDs presents 42 video dialogs to help students move beyond the beginning level in mastering Filipino structures and functions. The units cover nine thematic areas: (1) meeting people; (2) food; (3) household activities;…

United Nations opens gender coordinating unit for Afghanistan.

Science.gov (United States)

Morris, K

1999-02-06

The UN has created a gender coordinating unit for Afghanistan in an effort to combat some problems encountered by women and girls in the country. Reports continue to come in of women in Afghanistan being denied the right to work, to be educated, and to have access to medical care. The gap in education between men and women continues to widen as a result of edicts issued by Taliban authorities banning girls from attending formal schools and female teachers from working. The situation has grown worse since the UN and nongovernmental organizations (NGOs) withdrew international workers last year due to security concerns. Although a UN mission will travel to the country this week to discuss the return of international staff, the gender coordinating unit will for now have to work out of Islamabad, Pakistan. The unit will create guidelines for gender mainstreaming, a strategy in which mainstream policies and resource allocations are changed to reflect the principle of gender equality. Other goals include setting realistic objectives for gender activities, working with partners on pilot projects, and establishing minimum standards for best practices. MERLIN, a NGO with a primary health care program run by local staff in the Taliban-controlled province of Farah, welcomes the move.

Evaluation of setting time and flow properties of self-synthesize alginate impressions

Science.gov (United States)

Halim, Calista; Cahyanto, Arief; Sriwidodo, Harsatiningsih, Zulia

2018-02-01

Alginate is an elastic hydrocolloid dental impression materials to obtain negative reproduction of oral mucosa such as to record soft-tissue and occlusal relationships. The aim of the present study was to synthesize alginate and to determine the setting time and flow properties. There were five groups of alginate consisted of fifty samples self-synthesize alginate and commercial alginate impression product. Fifty samples were divided according to two tests, each twenty-five samples for setting time and flow test. Setting time test was recorded in the s unit, meanwhile, flow test was recorded in the mm2 unit. The fastest setting time result was in the group three (148.8 s) and the latest was group fours). The highest flow test result was in the group three (69.70 mm2) and the lowest was group one (58.34 mm2). Results were analyzed statistically by one way ANOVA (α= 0.05), showed that there was a statistical significance of setting time while no statistical significance of flow properties between self-synthesize alginate and alginate impression product. In conclusion, the alginate impression was successfully self-synthesized and variation composition gives influence toward setting time and flow properties. The most resemble setting time of control group is group three. The most resemble flow of control group is group four.

Goal setting practice in services delivering community-based stroke rehabilitation: a United Kingdom (UK) wide survey.

Science.gov (United States)

Scobbie, Lesley; Duncan, Edward A; Brady, Marian C; Wyke, Sally

2015-01-01

We investigated the nature of services providing community-based stroke rehabilitation across the UK, and goal setting practice used within them, to inform evaluation of a goal setting and action planning (G-AP) framework. We designed, piloted and electronically distributed a survey to health professionals working in community-based stroke rehabilitation settings across the UK. We optimised recruitment using a multi-faceted strategy. Responses were analysed from 437 services. Services size, composition and input was highly variable; however, most were multi-disciplinary (82%; n = 335/407) and provided input to a mixed diagnostic group of patients (71%; n = 312/437). Ninety one percent of services (n = 358/395) reported setting goals with "all" or "most" stroke survivors. Seventeen percent (n = 65/380) reported that no methods were used to guide goal setting practice; 47% (n = 148/315) reported use of informal methods only. Goal setting practice varied, e.g. 98% of services (n = 362/369) reported routinely asking patients about goal priorities; 39% (n = 141/360) reported routinely providing patients with a copy of their goals. Goal setting is embedded within community-based stroke rehabilitation; however, practice varies and is potentially sub-optimal. Further evaluation of the G-AP framework is warranted to inform optimal practice. Evaluation design will take account of the diverse service models that exist. Implications for Rehabilitation Community-based stroke rehabilitation services across the UK are diverse and tend to see a mixed diagnostic group of patients. Goal setting is implemented routinely within community-based stroke rehabilitation services; however, practice is variable and potentially sub-optimal. Further evaluation of the G-AP framework is warranted to assess its effectiveness in practice.

The Proximate Unit in Chinese Handwritten Character Production

Directory of Open Access Journals (Sweden)

Jenn-Yeu eChen

2013-08-01

Full Text Available In spoken word production, a proximate unit is the first phonological unit at the sublexical level that is selectable for production (O’Seaghdha, Chen, & Chen, 2010. The present study investigated whether the proximate unit in Chinese handwritten word production is the stroke, the radical, or something in between. A written version of the form preparation task was adopted. Chinese participants learned sets of two-character words, later were cued with the first character of each word, and had to write down the second character (the target. Response times were measured from the onset of a cue character to the onset of a written response. In Experiment 1, the target characters within a block shared (homogeneous or did not share (heterogeneous the first stroke. In Experiment 2, the first two strokes were shared in the homogeneous blocks. Response times in the homogeneous blocks and in the heterogeneous blocks were comparable in both experiments (Exp. 1: 687 ms vs. 684 ms, Exp. 2: 717 vs. 716. In Experiment 3 and 4, the target characters within a block shared or did not share the first radical. Response times in the homogeneous blocks were significantly faster than those in the heterogeneous blocks (Exp. 3: 685 vs. 704, Exp. 4: 594 vs. 650. In Experiment 5 and 6, the shared component was a Gestalt-like form that is more than a stroke, constitutes a portion of the target character, can be a stand-alone character itself, can be a radical of another character but is not a radical of the target character (e.g., 士in聲, 鼓, 穀, 款; called a logographeme. Response times in the homogeneous blocks were significantly faster than those in the heterogeneous blocks (Exp. 5: 576 vs. 625, Exp. 6: 586 vs. 620. These results suggest a model of Chinese handwritten character production in which the stroke is not a functional unit, the radical plays the role of a morpheme, and the logographeme is the proximate unit.

Candidate sites for future hot-dry-rock development in the United States

Energy Technology Data Exchange (ETDEWEB)

Goff, F.; Decker, E.R.

1982-12-01

Generalized geologic and other data are tabulated for 24 potential hot dry rock (HDR) sites in the contiguous United States. The data show that HDR resources occur in many geologic and tectonic settings. Potential reservoir rocks at each prospect are described and each system is cateogrized accoridng to inferred heat sources. The Fenton Hill area in New Mexico is discussed in detail because this region may be considered ideal for HDR development. Three other prospectively valuable localities are described: The Geysers-Clear lake region in California, the Roosevelt Hot Springs area in Utah, and the White Mountains region in New Hampshire. These areas are singled out to illustrate the roles of significantly different geology and geophysics, reservoir rocks, and reservoir heat contents in possible HDR developments.

Improving clinical research and cancer care delivery in community settings: evaluating the NCI community cancer centers program.

Science.gov (United States)

Clauser, Steven B; Johnson, Maureen R; O'Brien, Donna M; Beveridge, Joy M; Fennell, Mary L; Kaluzny, Arnold D

2009-09-26

In this article, we describe the National Cancer Institute (NCI) Community Cancer Centers Program (NCCCP) pilot and the evaluation designed to assess its role, function, and relevance to the NCI's research mission. In doing so, we describe the evolution of and rationale for the NCCCP concept, participating sites' characteristics, its multi-faceted aims to enhance clinical research and quality of care in community settings, and the role of strategic partnerships, both within and outside of the NCCCP network, in achieving program objectives. The evaluation of the NCCCP is conceptualized as a mixed method multi-layered assessment of organizational innovation and performance which includes mapping the evolution of site development as a means of understanding the inter- and intra-organizational change in the pilot, and the application of specific evaluation metrics for assessing the implementation, operations, and performance of the NCCCP pilot. The assessment of the cost of the pilot as an additional means of informing the longer-term feasibility and sustainability of the program is also discussed. The NCCCP is a major systems-level set of organizational innovations to enhance clinical research and care delivery in diverse communities across the United States. Assessment of the extent to which the program achieves its aims will depend on a full understanding of how individual, organizational, and environmental factors align (or fail to align) to achieve these improvements, and at what cost.

Accounting for medical communication: parents' perceptions of communicative roles and responsibilities in the pediatric intensive care unit.

Science.gov (United States)

Gordon, Cynthia; Barton, Ellen; Meert, Kathleen L; Eggly, Susan; Pollacks, Murray; Zimmerman, Jerry; Anand, K J S; Carcillo, Joseph; Newth, Christopher J L; Dean, J Michael; Willson, Douglas F; Nicholson, Carol

2009-01-01

Through discourse analysis of transcribed interviews conducted over the phone with parents whose child died in the Pediatric Intensive Care Unit (PICU) (n = 51), this study uncovers parents' perceptions of clinicians' and their own communicative roles and responsibilities in the context of team-based care. We examine parents' descriptions and narratives of communicative experiences they had with PICU clinicians, focusing on how parents use accounts to evaluate the communicative behaviors they report (n = 47). Findings indicate that parental perceptions of communicative responsibilities are more nuanced than assumed in previous research: Parents identified their own responsibilities as participating as part of the team of care, gathering information, interacting with appropriate affect, and working to understand complex and uncertain medical information. Complementarily, parents identified clinician responsibilities as communicating professionally, providing medical information clearly, managing parents' hope responsibly, and communicating with appropriate affect. Through the accounts they provide, parents evaluate both parental and clinician role-responsibilities as fulfilled and unfulfilled. Clinicians' management of prognostic uncertainty and parents' struggles to understand that uncertainty emerged as key, complementary themes with practical implications for incorporating parents into the PICU care team. The study also highlights insights retrospective interview data bring to the examination of medical communication.

Some Aspects of -Units in BCK-Algebras

Directory of Open Access Journals (Sweden)

Hee Sik Kim

2012-01-01

Full Text Available We explore properties of the set of d-units of a -algebra. A property of interest in the study of -units in -algebras is the weak associative property. It is noted that many other -algebras, especially -algebras, are in fact weakly associative. The existence of -algebras which are not weakly associative is demonstrated. Moreover, the notions of a -integral domain and a left-injectivity are discussed.

An Investigation of Mathematical Knowledge Related to Mathematics Teachers' Basic Concepts in Sets Unit

Directory of Open Access Journals (Sweden)

Nurullah YAZICI

2017-05-01

Full Text Available This research was conducted in order to examine the subject matter of Mathematics teachers in the context of "Mathematical Knowledge For Teaching" (MKT model of "Basic Concepts in Sets" which is the first topic of the 9th class "Sets". The study group, which is one of the qualitative research methods, used the case study design, constitutes 5 mathematics teachers who work in different education levels (primary and secondary education in the academic year of 2015-2016. Open-ended questions and semi-structured interview form developed by the researcher were used for data collection. A descriptive analysis technique was used to analyze the data obtained through interviews. While analyzing the data, teacher and student textbooks, which were prepared by the Ministry of National Education for the purpose of teaching in 2015-2016 academic year, were taken as a reference. According to the research findings, it was determined that the teachers had deficiencies in the subject field of "Basic Concepts in the Sets" and had superficial knowledge rather than in depth knowledge.

Causal asymmetry across cultures: Assigning causal roles in symmetric physical settings

Directory of Open Access Journals (Sweden)

Andrea eBender

2011-09-01

Full Text Available In the cognitive sciences, causal cognition in the physical domain has featured as a core research topic, but the impact of culture has been rarely ever explored. One case in point for a topic on which this neglect is pronounced is the pervasive tendency of people to consider one of two (equally important entities as more important for bringing about an effect. In order to scrutinize how robust such tendencies are across cultures, we asked German and Tongan participants to assign prime causality in nine symmetric settings. For most settings, strong asymmetries in both cultures were found, but not always in the same direction, depending on the task content. This indicates that causal asymmetries, while indeed being a robust phenomenon across cultures, are also subject to culture-specific concepts. Moreover, the asymmetries were found to be modulated by figure-ground relations, but not by marking agency.

Identification of unmeasured variables in the set of model constraints of the data reconciliation in a power unit

Science.gov (United States)

Szega, Marcin; Nowak, Grzegorz Tadeusz

2013-12-01

In generalized method of data reconciliation as equations of conditions beside substance and energy balances can be used equations which don't have precisely the status of conservation lows. Empirical coefficients in these equations are traded as unknowns' values. To this kind of equations, in application of the generalized method of data reconciliation in supercritical power unit, can be classified: steam flow capacity of a turbine for a group of stages, adiabatic internal efficiency of group of stages, equations for pressure drop in pipelines and equations for heat transfer in regeneration heat exchangers. Mathematical model of a power unit was developed in the code Thermoflex. Using this model the off-design calculation has been made in several points of loads for the power unit. Using these calculations identification of unknown values and empirical coefficients for generalized method of data reconciliation used in power unit has been made. Additional equations of conditions will be used in the generalized method of data reconciliation which will be used in optimization of measurement placement in redundant measurement system in power unit for new control systems

Western United States Dams Challenges Faced, Options, and Opportunities

Science.gov (United States)

Raff, D.

2017-12-01

Water management in the Western United States relies significantly upon a fleet of small to very large engineered dams to store water during times of runoff and distribute that water during times of need. Much of this infrastructure is Federally owned and/or operated, and was designed and funded during the first half of the twentieth century through a complex set of repayment contracts for Federally authorized purposes addressing water supply, recreation, and hydropower, and other water management objectives. With environmental laws, namely the Endangered Species Act, and other environmental concerns taking a more active role in water resources in the mid to latter half of the twentieth century, this infrastructure is being stressed even greater than anticipated to provide authorized purposes. Additionally, weather and climate norms being experienced are certainly near the edges, if not outside, of anticipated variability in the climate and hydrology scenarios for which the infrastructure was designed. And, finally, these dams, economically designed for a lifespan of 50 - 100 years, are experiencing maintenance challenges from routine to significant. This presentation will focus on identifying some of the history and challenges facing the water infrastructure in the Western United States. Additionally, some perspectives on future paths to meet the needs of western irrigation and hydropower production will be provided.

Psychiatric diagnosis in legal settings

Directory of Open Access Journals (Sweden)

Alfred Allan

2005-12-01

Full Text Available When asked to give a diagnosis in legal settings practitioners should be mindful of the tentative nature of psychiatric diag- noses and that courts require that such a diagnosis must have scientific credibility. South African courts are not explicit about the test they will apply to determine whether a diagno- sis is scientifically credible, but some guidance can be found in United States case law. This paper examines these criteria with reference to the disorders included in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR.

Effect on moisture permeability of typewriting on unit dose package surfaces.

Science.gov (United States)

Rackson, J T; Zellhofer, M J; Birmingham, P H

1984-10-01

The effects of typewriting on labels of two unit dose packages with respect to moisture permeability were examined. Using an electric typewriter, a standard label format was imprinted on two different types of class A unit dose packages: (1) a heat-sealed paper-backed foil and cellofilm strip pouch, and (2) a copolyester and polyethylene multiple-cup blister with a heat-sealed paper-backed foil and cellofilm cover. The labels were typed at various typing-element impact settings. The official USP test for water permeation was then performed on typed packages and untyped control packages. The original untyped packages were confirmed to be USP class A quality. The packages for which successively harder impact settings were used showed a corresponding increase in moisture permeability. This resulted in a lowering of USP package ratings from class A to class B and D, some of which would be unsuitable for use in any unit dose system under current FDA repackaging standards. Typing directly onto the label of a unit dose package before it is sealed will most likely damage the package and possibly make it unfit for use. Pharmacists who must type labels for the unit dose packages studied should use the lowest possible typewriter impact setting and test for damage using the USP moisture-permeation test.

Courageous Voices: Using Text Sets to Inspire Change

Science.gov (United States)

Tracy, Kelly N.; Menickelli, Kristin; Scales, Roya Q.

2017-01-01

This article describes how one teacher immersed her sixth graders in an intensive three-week thematic text set unit centered on courage. Her aim was to help students discover and take action on issues that mattered to them as they learned important literacy skills and strategies. Students engaged in significant reading, writing, and discussion as…

An audit of patient aggression in an adult psychiatric unit: 2013-2014.

Science.gov (United States)

Ewing, Claire; Phillipou, Andrea; Castle, David

2018-02-01

The aim of this study was to determine the rates of patient aggression in a psychiatric unit over 12 months and to determine underlying causes, notably the role of substances. A retrospective file audit was undertaken of all patients admitted to St Vincent's psychiatric unit (Melbourne, Australia) in the first half of 2013 and 2014 involved in an aggressive incident. Patient information included demographics, psychiatric, substance and aggression history. The setting and context of aggression and associated mental state findings were also reviewed. There were 26 aggressive incidents in 2013 and 63 in 2014, perpetrated by 11 and 34 patients respectively. No significant differences were found between the groups' baseline demographics. The 2014 cohort was significantly more likely to have substance use history (odds ratio (OR) 4.83) and have made threats to staff (OR 4.07) but significantly less likely to be distracted by internal stimuli (OR 0.05). There were also (not statistically significant) trends for the 2014 cohort; they were more likely to report a history of alcohol use (OR 3.9); be accompanied to emergency department by police (OR 2.95) and have leave prior to aggression ( χ 2 = 7.37). Aggressive incidents more than doubled over 12 months. Substance use appeared to be a major factor associated with aggression. These findings have implications for service provision and training. Further research is needed to better understand and manage substances in psychiatric settings.

Unconventional wisdom [Entergy's economic management of five disparate nuclear units

International Nuclear Information System (INIS)

Wood, J.

1996-01-01

The conventional wisdom is that a competitive nuclear power programme requires standard plants, multi-unit sites and economies of scale. Entergy Operations, Inc (EOI) in the USA has five nuclear units of two reactor types, acquired from five vendors and located on four sites separated by hundreds of miles. EOI set two bench marks in its aim to deliver electricity at the market price from each of its nuclear units while meeting the costs of O and M, fuel, capital investment and overheads. The first was to become the best operator of each type of its differently designed units. The second was to combine the sense of ownership and expertise of single unit operators with the flexibility and efficiency of multi-unit sites. In order to achieve this, EOI aims to operate the five units as though they were on one site. Central to this plan is a set of peer groups, each of which deals with an aspect of plant operation, sharing good practice across all the units. Building on this, increasingly during outages, employees are brought in from other units rather than employing outside contractors. Although EOI employees are more expensive on an hourly basis they are two to three times more efficient than outside contractors. The peer group concept is also leading to rationalisation of expertise as groups become identified with particular specialisations which back-up teams working on other units. (U.K.)

Preparation of School Psychologists in the United States

Science.gov (United States)

Joyce-Beaulieu, Diana; Rossen, Eric

2014-01-01

School psychology in the United States continues to evolve in response to shifts in the country's demographic characteristics, an increasing focus on the importance of child mental health, together with health and education reforms. The landscape of school psychological services in the United States also is shaped through the changing roles and…

75 FR 10561 - Pricing for 2010 United States Mint America the Beautiful QuartersTM

Science.gov (United States)

2010-03-08

... DEPARTMENT OF THE TREASURY United States Mint Pricing for 2010 United States Mint America the Beautiful Quarters\\TM\\ Two-Roll Set, etc. AGENCY: United States Mint, Department of the Treasury. ACTION: Notice. SUMMARY: The United States Mint is announcing the price of the 2010 United States Mint America...

EEA core set of indicators. Guide

Energy Technology Data Exchange (ETDEWEB)

NONE

2005-07-01

This guide provides information on the quality of the 37 indicators in the EEA core set. Its primary role is to support improved implementation of the core set in the EEA, European topic centres and the European environment information and observation network (Eionet). In parallel, it is aimed at helping users outside the EEA/Eionet system make best use of the indicators in their own work. It is hoped that the guide will promote cooperation on improving indicator methodologies and data quality as part of the wider process to streamline and improve environmental reporting in the European Union and beyond. (au)

An inventory of United States and Canadian growth record sets: preliminary report.

Science.gov (United States)

Hunter, W S; Baumrind, S; Moyers, R E

1993-06-01

A listing and description of longitudinal craniofacial growth record sets currently extant on the North American continent is provided. An argument is made for the preservation of these resources and for the generation of a pooled or shared image base of duplicate craniofacial physical records. This is a preliminary report and is assumed to be incomplete. In an effort to improve our accuracy and completeness, we invite corrections and additions.

Surveillance Monitoring Management for General Care Units: Strategy, Design, and Implementation.

Science.gov (United States)

McGrath, Susan P; Taenzer, Andreas H; Karon, Nancy; Blike, George

2016-07-01

The growing number of monitoring devices, combined with suboptimal patient monitoring and alarm management strategies, has increased "alarm fatigue," which have led to serious consequences. Most reported alarm man- agement approaches have focused on the critical care setting. Since 2007 Dartmouth-Hitchcock (Lebanon, New Hamp- shire) has developed a generalizable and effective design, implementation, and performance evaluation approach to alarm systems for continuous monitoring in general care settings (that is, patient surveillance monitoring). In late 2007, a patient surveillance monitoring system was piloted on the basis of a structured design and implementation approach in a 36-bed orthopedics unit. Beginning in early 2009, it was expanded to cover more than 200 inpatient beds in all medicine and surgical units, except for psychiatry and labor and delivery. Improvements in clinical outcomes (reduction of unplanned transfers by 50% and reduction of rescue events by more than 60% in 2008) and approximately two alarms per patient per 12-hour nursing shift in the original pilot unit have been sustained across most D-H general care units in spite of increasing patient acuity and unit occupancy. Sample analysis of pager notifications indicates that more than 85% of all alarm conditions are resolved within 30 seconds and that more than 99% are resolved before escalation is triggered. The D-H surveillance monitoring system employs several important, generalizable features to manage alarms in a general care setting: alarm delays, static thresholds set appropriately for the prevalence of events in this setting, directed alarm annunciation, and policy-driven customization of thresholds to allow clinicians to respond to needs of individual patients. The systematic approach to design, implementation, and performance management has been key to the success of the system.

Ultrasonic unit for line-by-line ultrasonic scanning of bodies

International Nuclear Information System (INIS)

Soldner, R.

1978-01-01

The ultrasonic unit for medical diagnostics operates by the sectorial scanning principle, which avoids direct coupling of the transducer head to the surface of the body. For this purpose, several transmitter/receiver units (approx. 100) are arranged on a partial ring of a circular arc and the ultrasonic beams, which can be triggered sequentially in time, are directed at a common intersection behind the ultrasonic window of the unit, i.e., outside the unit. A mechanical system is employed to set and adjust the partial ring carrying the transmitter/receiver units. (DG) [de

Testing a "content meets process" model of depression vulnerability and rumination: Exploring the moderating role of set-shifting deficits.

Science.gov (United States)

Vergara-Lopez, Chrystal; Lopez-Vergara, Hector I; Roberts, John E

2016-03-01

MacCoon and Newman's (2006) "content meets process" model posits that deficits in cognitive control make it difficult to disengage from negative cognitions caused by a negative cognitive style (NCS). The present study examined if the interactive effect of cognitive set-shifting abilities and NCS predicts rumination and past history of depression. Participants were 90 previously depressed individuals and 95 never depressed individuals. We administered three laboratory tasks that assess set-shifting: the Wisconsin Card-Sorting Task, the Emotional Card-Sorting Task, and the Internal Switch Task, and self-report measures of NCS and rumination. Shifting ability in the context of emotional distractors moderated the association between NCS and depressive rumination. Although previously depressed individuals had more NCS and higher trait rumination relative to never depressed individuals, shifting ability did not moderate the association between NCS and depression history. The cross-sectional correlational design cannot address the causal direction of effects. It is also not clear whether findings will generalize beyond college students. NCS was elevated in previously depressed individuals consistent with its theoretical role as trait vulnerability to the disorder. Furthermore, NCS may be particularly likely to trigger rumination among individuals with poor capacity for cognitive control in the context of emotional distraction. Copyright © 2015 Elsevier Ltd. All rights reserved.

Traction sheave elevator, hoisting unit and machine space

Science.gov (United States)

Hakala, Harri; Mustalahti, Jorma; Aulanko, Esko

2000-01-01

Traction sheave elevator consisting of an elevator car moving along elevator guide rails, a counterweight moving along counterweight guide rails, a set of hoisting ropes (3) on which the elevator car and counterweight are suspended, and a drive machine unit (6) driving a traction sheave (7) acting on the hoisting ropes (3) and placed in the elevator shaft. The drive machine unit (6) is of a flat construction. A wall of the elevator shaft is provided with a machine space with its open side facing towards the shaft, the essential parts of the drive machine unit (6) being placed in the space. The hoisting unit (9) of the traction sheave elevator consists of a substantially discoidal drive machine unit (6) and an instrument panel (8) mounted on the frame (20) of the hoisting unit.

On the Degree of Participant Commitment in Non-Work Settings

DEFF Research Database (Denmark)

Klokmose, Clemens Nylandsted; Korn, Matthias

-work. In work settings the role of peers is well defined, whereas in non-work settings participating peers are more elusive—like the familiar stranger at the parents’ evening at school. Furthermore, work practices are institutionalized and it is possible to enforce people to become aware of the participation...

Role of levosimendan in the management of subarachnoid hemorrhage.

Science.gov (United States)

Varvarousi, Giolanda; Xanthos, Theodoros; Sarafidou, Pavlina; Katsioula, Ellisavet; Georgiadou, Marianthi; Eforakopoulou, Maria; Pavlou, Hlias

2016-02-01

Aneurysmal subarachnoid hemorrhage (aSAH) is one of the leading causes of neurologic disability accounting for dismal long term survival rates. aSAH leads to a sudden increase in intracranial pressure and a massive sympathetic discharge. Excessive sympathetic stimulation leads to catecholamine mediated myocardial dysfunction and hemodynamic instability which may critically hamper brain perfusion and oxygenation. In the setting of acute aSAH, administration of vasoactive drugs aims at stabilizing impaired hemodynamics. However, studies have shown that conventional treatment with vasoactive drugs that lead to Ca(+2) overload and increase myocardial oxygen consumption, fail to restore hemodynamics and decrease cerebral blood flow. Levosimendan is a non-adrenergic inotropic Ca(+2) sensitizer with not only beneficial hemodynamic properties but also pleiotropic effects, contributing to its cardioprotective and neuroprotective role. Although there have been limited data available regarding the use of levosimendan in patients with aSAH, current evidence suggests that levosimendan may have a role in the setting of post-aSAH cardiomyopathy and decreased cerebral blood flow both in the emergency departments and in intensive care units. The purpose of this review is to provide an overview of studies of levosimendan therapy for aSAH, and describe current knowledge about the effects of levosimendan in the management of aSAH. Copyright © 2015 Elsevier Inc. All rights reserved.

The Role of Oncology Nurses in Discussing Clinical Trials.

Science.gov (United States)

Flocke, Susan A; Antognoli, Elizabeth; Daly, Barbara J; Jackson, Brigid; Fulton, Sarah E; Liu, Tasnuva M; Surdam, Jessica; Manne, Sharon; Meropol, Neal J

2017-09-01

To describe oncology nurses' experiences discussing clinical trials with their patients, and to assess barriers to these discussions.
. A qualitative study designed to elicit narratives from oncology nurses. 
. Community- and academic-based oncology clinics throughout the United States.
. 33 oncology nurses involved in direct patient care in community-based and large hospital-based settings. The sample was drawn from members of the Oncology Nursing Society. 
. In-depth interviews were conducted and analyzed using a 
immersion/crystallization approach to identify themes and patterns. The analyses highlight specific issues, examples, and contexts that present challenges to clinical trial discussions with patients.
. Oncology nurses view their roles as patient educators and advocates to be inclusive of discussion of clinical trials. Barriers to such discussions include lack of knowledge and strategies for addressing patients' common misconceptions and uncertainty about the timing of discussions.
. These data indicate that enabling nurses to actively engage patients in discussions of clinical trials requires educational interventions to build self-efficacy and close knowledge gaps. 
. Oncology nurses can play a critical role in advancing cancer care by supporting patients in decision making about clinical trial participation. This will require training and education to build their knowledge, reduce barriers, and increase their self-efficacy to fulfill this responsibility in various clinical settings.

Dedicated education unit: student perspectives.

Science.gov (United States)

Nishioka, Vicki M; Coe, Michael T; Hanita, Makoto; Moscato, Susan R

2014-01-01

The study compared students' perceptions of their clinical learning experiences in a dedicated education unit (DEU) with their experiences in traditional clinical education. Unlike traditional academic-instructor models, expert nurses in the DEU provide clinical education to students with faculty support. This repeated measures design used student surveys, supplemented by focus group data. Students were more likely to agree that their clinical learning experience was high quality and they had a consistent mentoring relationship during DEU rotations. Students also reported the quality of the unit's learning environment, the leadership style of the nurse manager, and the nursing care on the unit was more favorable in DEUs than traditional units. Consistent with their changed role in DEUs, faculty members were less active in helping students integrate theory and practice. These findings provide additional evidence of the value that the DEU model contributes to high-quality clinical education.

The United States and Europe: Current Issues

National Research Council Canada - National Science Library

Archick, Kristin; Morelli, Vince L

2006-01-01

The United States and Europe share a long and intertwined history. Both sides of the Atlantic face a common set of international concerns, have few other comparable partners, and share a deep economic relationship...

Role of parents in the promotion of hand hygiene in the paediatric setting: a systematic literature review.

Science.gov (United States)

Bellissimo-Rodrigues, F; Pires, D; Zingg, W; Pittet, D

2016-06-01

When a child is hospitalized, parents have to share their role to protect the child with the hospital, and establish a partnership with healthcare workers to deliver safe care to the child, including undertaking good hand hygiene practices. To review the scientific evidence about the participation of parents in the promotion of hand hygiene in paediatric settings. A systematic search of MEDLINE, EMBASE and SciELO databases was undertaken using the following terms: ('hand hygiene'[MeSH] OR 'hand hygiene' OR 'hand disinfection'[MeSH] OR hand disinf* OR hand wash* OR handwash* OR hand antisep*) AND (parent OR caregiver OR mother OR father OR family OR families OR relatives). The Integrated Quality Criteria for Review of Multiple Study Designs tool was used for quality assessment. The literature search yielded 1645 articles, and 11 studies met the inclusion criteria for the final analysis. Most studies were observational, and were based on questionnaires or interviews. Most parents had little knowledge about the indications to perform hand hygiene, but recognized hand hygiene as a relevant tool for the prevention of healthcare-associated infections. Their willingness to remind healthcare workers about a failed opportunity to perform hand hygiene was variable and, overall, rather low. Parents felt more comfortable about reminding healthcare workers about hand hygiene if they had previously been invited to do so. Literature on the subject is scarce. The promotion of hand hygiene by parents should be further explored by research as a potential intervention for enhancing patient safety in paediatric settings. Copyright © 2016. Published by Elsevier Ltd.

Integrative analysis of survival-associated gene sets in breast cancer.

Science.gov (United States)

Varn, Frederick S; Ung, Matthew H; Lou, Shao Ke; Cheng, Chao

2015-03-12

Patient gene expression information has recently become a clinical feature used to evaluate breast cancer prognosis. The emergence of prognostic gene sets that take advantage of these data has led to a rich library of information that can be used to characterize the molecular nature of a patient's cancer. Identifying robust gene sets that are consistently predictive of a patient's clinical outcome has become one of the main challenges in the field. We inputted our previously established BASE algorithm with patient gene expression data and gene sets from MSigDB to develop the gene set activity score (GSAS), a metric that quantitatively assesses a gene set's activity level in a given patient. We utilized this metric, along with patient time-to-event data, to perform survival analyses to identify the gene sets that were significantly correlated with patient survival. We then performed cross-dataset analyses to identify robust prognostic gene sets and to classify patients by metastasis status. Additionally, we created a gene set network based on component gene overlap to explore the relationship between gene sets derived from MSigDB. We developed a novel gene set based on this network's topology and applied the GSAS metric to characterize its role in patient survival. Using the GSAS metric, we identified 120 gene sets that were significantly associated with patient survival in all datasets tested. The gene overlap network analysis yielded a novel gene set enriched in genes shared by the robustly predictive gene sets. This gene set was highly correlated to patient survival when used alone. Most interestingly, removal of the genes in this gene set from the gene pool on MSigDB resulted in a large reduction in the number of predictive gene sets, suggesting a prominent role for these genes in breast cancer progression. The GSAS metric provided a useful medium by which we systematically investigated how gene sets from MSigDB relate to breast cancer patient survival. We used

Global digital data sets of soil type, soil texture, surface slope and other properties: Documentation of archived data tape

Science.gov (United States)

Staub, B.; Rosenzweig, C.; Rind, D.

1987-01-01

The file structure and coding of four soils data sets derived from the Zobler (1986) world soil file is described. The data were digitized on a one-degree square grid. They are suitable for large-area studies such as climate research with general circulation models, as well as in forestry, agriculture, soils, and hydrology. The first file is a data set of codes for soil unit, land-ice, or water, for all the one-degree square cells on Earth. The second file is a data set of codes for texture, land-ice, or water, for the same soil units. The third file is a data set of codes for slope, land-ice, or water for the same units. The fourth file is the SOILWRLD data set, containing information on soil properties of land cells of both Matthews' and Food and Agriculture Organization (FAO) sources. The fourth file reconciles land-classification differences between the two and has missing data filled in.

Assistance at mealtimes in hospital settings and rehabilitation units for older adults from the perspective of patients, families and healthcare professionals: a mixed methods systematic review protocol.

Science.gov (United States)

Edwards, Deborah; Carrier, Judith; Hopkinson, Jane

2015-11-01

The review question is: assistance at mealtimes for older adults in hospital settings and rehabilitation units: what goes on, what works and what do patients, families and healthcare professionals think about it?The specific objectives are:This mixed methods review seeks to develop an aggregated synthesis of quantitative and qualitative data on assistance at mealtimes for older adults in hospital settings and rehabilitation units in order to derive conclusions and recommendations useful for clinical practice and policy decision making. Worldwide, it is estimated that between 20% and 50% of all adult patients admitted to hospital wards are malnourished. Reported prevalence occurs, depending on the specific patient group of interest, type of healthcare setting, disease state and criteria used to assess malnutrition. For older adults in hospital (over 65 years) the prevalence of malnutrition has been reported as being as high as 60% and can continue to deteriorate during the hospital stay. This is an area of concern as it is associated with prolonged hospital stays and increased morbidity (pressure ulcers, infections and falls) and mortality, especially for those with chronic conditions.Malnutrition in adults in developed countries is frequently associated with disease and may occur because of reduced dietary intake, malabsorption, increased nutrient losses or altered metabolic demands, with reduced dietary intake being considered the single most important aetiological factor. For the hospitalized older adult patient with pre-existing malnutrition, further nutritional problems are often encountered due to a reduced dietary intake. Poor food intake for older patients in hospital may be due to the effects of acute illness, poor appetite, nausea or vomiting, "nil by mouth" orders, medication side effects, catering limitations, swallowing and/or oral problems, difficulty with vision and opening containers, the placement of food out of the patients' reach, limited access

Spatial occupancy models for large data sets

Science.gov (United States)

Johnson, Devin S.; Conn, Paul B.; Hooten, Mevin B.; Ray, Justina C.; Pond, Bruce A.

2013-01-01

Since its development, occupancy modeling has become a popular and useful tool for ecologists wishing to learn about the dynamics of species occurrence over time and space. Such models require presence–absence data to be collected at spatially indexed survey units. However, only recently have researchers recognized the need to correct for spatially induced overdisperison by explicitly accounting for spatial autocorrelation in occupancy probability. Previous efforts to incorporate such autocorrelation have largely focused on logit-normal formulations for occupancy, with spatial autocorrelation induced by a random effect within a hierarchical modeling framework. Although useful, computational time generally limits such an approach to relatively small data sets, and there are often problems with algorithm instability, yielding unsatisfactory results. Further, recent research has revealed a hidden form of multicollinearity in such applications, which may lead to parameter bias if not explicitly addressed. Combining several techniques, we present a unifying hierarchical spatial occupancy model specification that is particularly effective over large spatial extents. This approach employs a probit mixture framework for occupancy and can easily accommodate a reduced-dimensional spatial process to resolve issues with multicollinearity and spatial confounding while improving algorithm convergence. Using open-source software, we demonstrate this new model specification using a case study involving occupancy of caribou (Rangifer tarandus) over a set of 1080 survey units spanning a large contiguous region (108 000 km2) in northern Ontario, Canada. Overall, the combination of a more efficient specification and open-source software allows for a facile and stable implementation of spatial occupancy models for large data sets.

Aiming for a holistic integrated service for men diagnosed with prostate cancer - Definitions of standards and skill sets for nurses and allied healthcare professionals.

Science.gov (United States)

Lamb, Alastair D; Thompson, Sue; Kinsella, Netty; Gerbitz, Ingmar; Chapman, Elaine; Putt, Lisa; Bennett, Sophie; Thankappannair, Vineetha; Geoghegan, Lisa; Wright, Naomi; Stirton-Croft, Alison; Nixon, Penny; Styling, Andrew; Whitney, Diane; Hodgson, Lindsay; Punt, Lisa; Longmore, Jenny; Carter, Mike; Petch, Bill; Rimmer, Yvonne; Russell, Simon; Hughes-Davies, Luke; Mazhar, Danish; Shah, Nimish C; Gnanapragasam, Vincent J; Doble, Andrew; Bratt, Ola; Kastner, Christof

2017-08-01

To establish a comprehensive set of recommendations for the service structure and skill set of nurses and allied healthcare professionals in prostate cancer care. Using components of formal consensus methodology, a 30-member multidisciplinary panel produced 53 items for discussion relating to the provision of care for prostate cancer patients by specialist nurses and allied healthcare professionals. Items were developed by two rounds of email correspondence in which, first, items were generated and, second, items refined to form the basis of a consensus meeting which constituted the third round of review. The fourth and final round was an email review of the consensus output. The panel agreed on 33 items that were appropriate for recommendations to be made. These items were grouped under categories of "Environment" and "Patient Pathway" and included comments on training, leadership, communication and quality assessment as well as specific items related to prostate diagnosis clinics, radical treatment clinics and follow-up survivor groups. Specialist nurses and allied healthcare professionals play a vital role alongside urologists and oncologists to provide care to men with prostate cancer and their families. We present a set of standards and consensus recommendations for the roles and skill-set required for these practitioners to provide gold-standard prostate cancer care. These recommendations could form the basis for development of comprehensive integrated prostate cancer pathways in prostate cancer centres as well as providing guidance for any units treating men with prostate cancer. Copyright © 2017. Published by Elsevier Ltd.

Nurse-led implementation of a ventilator-associated pneumonia care bundle in a children's critical care unit.

Science.gov (United States)

Hill, Charlotte

2016-05-09

Ventilator-associated pneumonia (VAP) is the leading cause of death with hospital-acquired infections, and preventing it is one of the Saving Lives initiatives ( Department of Health 2007 ). This article discusses the implementation of a purpose-designed VAP care bundle in a children's intensive care unit and examines the unique role of nurses in the management of the change process. A nurse-led VAP education, implementation and surveillance programme was set up. Nurse education was paramount, as nursing staff acceptance and involvement was a key feature. A multi-method training strategy was implemented, providing staff with multiple training opportunities and introducing VAP project education as a routine part of staff induction. Bundle compliance was monitored regularly and graphs of the results produced quarterly; feedback proved to be useful in keeping staff informed and engaged in VAP reduction. Comparison of VAP incidence before and after introduction of the care bundle showed a reduction after its implementation. With a co-ordinated, multidisciplinary approach, VAP care bundles can result in significant and sustained reductions in VAP rates in the paediatric intensive care unit. Effective co-ordination and leadership is crucial to successful implementation of the VAP bundle, and nurses are well placed to undertake this role.

Report on the International Workshop on Drug Prevention and Treatment in Rural Settings Organized by United Nation Office on Drugs and Crime (UNODC) and World Health Organization (WHO).

Science.gov (United States)

Milano, Giulia; Saenz, Elizabeth; Clark, Nicolas; Busse, Anja; Gale, John; Campello, Giovanna; Mattfeld, Elizabeth; Maalouf, Wadih; Heikkila, Hanna; Martelli, Antonietta; Morales, Brian; Gerra, Gilberto

2017-11-10

Very little evidence has been reported in literature regarding the misuse of substances in rural areas. Despite the common perception of rural communities as a protective and risk-mitigating environment, the scientific literature demonstrated the existence of many risk factors in rural communities. The Drug Prevention and Health Branch (DHB) of the United Nations Office on Drugs and Crime (UNODC), and the World Health Organization (WHO), in June 2016, organized a meeting of experts in treatment and prevention of SUDs in rural settings. The content presented during the meeting and the related discussion have provided materials for the preparation of an outline document, which is the basis to create a technical tool on SUDs prevention and treatment in rural settings. The UNODC framework for interventions in rural settings is a technical tool aimed to assist policy makers and managers at the national level. This paper is a report on UNODC/WHO efforts to improve the clinical conditions of people affected by SUDs and living in rural areas. The purpose of this article is to draw attention on a severe clinical and social problem in a reality forgotten by everyone.

Practical unit testing with JUnit and Mockito

CERN Document Server

Kaczanowski, Tomek

2013-01-01

This book explains in detail how to implement unit tests using two very popular open source Java technologies: JUnit and Mockito. It presents a range of techniques necessary to write high quality unit tests - e.g. mocks, parametrized tests and matchers. It also discusses trade-offs related to the choices we have to make when dealing with some real-life code issues. The book stresses the importance of writing readable and maintainable unit tests, and puts a lot of stress on code quality. It shows how to achieve testable code and to eliminate common mistakes by following the Test Driven Development approach. Every topic discussed in the book is illustrated with code examples, and each chapter is accompanied by some exercises. By reading this book you will: Grasp the role and purpose of unit tests Write high-quality, readable and maintainable unit tests Learn how to use JUnit and Mockito (but also other useful tools) Avoid common pitfalls when writing unit tests Recognize bad unit tests, a...

Matched pairs approach to set theoretic solutions of the Yang-Baxter equation

International Nuclear Information System (INIS)

Gateva-Ivanova, T.; Majid, S.

2005-08-01

We study set-theoretic solutions (X,r) of the Yang-Baxter equations on a set X in terms of the induced left and right actions of X on itself. We give a characterization of involutive square-free solutions in terms of cyclicity conditions. We characterise general solutions in terms of an induced matched pair of unital semigroups S(X,r) and construct (S,r S ) from the matched pair. Finally, we study extensions of solutions in terms of matched pairs of their associated semigroups. We also prove several general results about matched pairs of unital semigroups of the required type, including iterated products S bowtie S bowtie S underlying the proof that r S is a solution, and extensions (S bowtie T, r Sb owtie T ). Examples include a general 'double' construction (S bowtie S,r Sb owtie S ) and some concrete extensions, their actions and graphs based on small sets. (author)

Perception of community pharmacists toward their current professional role in the healthcare system of Dubai, United Arab Emirates.

Science.gov (United States)

Rayes, Ibrahim Khalid; Hassali, Mohamed Azmi; Abduelkarem, Abduelmula R

2015-07-01

The new paradigm to pharmacy profession has changed the focus of pharmacists from product-centered to patient-oriented. This change has brought new set of beliefs and assumptions on the way services should be delivered to pharmacy clients. The main aim of this study was to explore the perception of community pharmacists on their current professional role in Dubai. Key findings show that community pharmacists are more directed toward business than patients. They almost dispense all categories of medicines over-the-counter without the need of prescriptions. However, a new trend of pharmacists in Dubai is to provide enhanced pharmacy services such as consultation to patients upon request.

31 CFR Appendix C to Subpart C of... - United States Customs Service

Science.gov (United States)

2010-07-01

... 31 Money and Finance: Treasury 1 2010-07-01 2010-07-01 false United States Customs Service C... Customs Service 1. In general. This appendix applies to the United States Customs Service. It sets forth... records and accounting of disclosures. (a) For records which are maintained at the United States Customs...

Defining role models for staff orientation.

Science.gov (United States)

Kinley, H

This article examines the need for a formal role model to help integrate new staff within a unit. While acknowledging the range of titles and functions ascribed to such a role in the literature, the author suggests that the essence of the role and its formal recognition has benefits for experienced staff and orientees alike.

An Analysis of Unit Costs at a Consolidated Supply Depot

Science.gov (United States)

1990-12-01

Not-For-Profit Setting,"The Accounting Review,July 1990. Horngren , C. T., Cost Accountinq:A Managerial Emphasis,3rd ed, Prentice-Hall Inc.,1972...sector has used concepts of unit costs for 4 decades. Any managerial or cost accounting text discusses in some length unit costs . For Defense contractors...the Cost Accounting Standards Board (CASB) provides guidance for contract costs . Unit costs include direct, indirect, and general and administrative

Work-Identity in Ethnographic Research: Developing Field Roles in a Demanding Workplace Setting

Directory of Open Access Journals (Sweden)

Gunilla Jansson PhD

2013-02-01

Full Text Available In this article we problematize our field roles as two linguistic ethnographers who aim to study the communication and documentation practices drawn upon by care workers in elderly care facilities in Sweden. Our field roles are discussed in relation to the complex nature of care workers' knowledge and competence, which results from three different aspects of their work-identities: institutional, professional, and individual. As researchers, we found ourselves in constant dialogue with the research participants, and our field roles were continuously shaped and reshaped according to the individuals and the situations in which we became involved. Even aspects of our own identities taken into the field, such as our background and personal qualities, proved to be important in establishing good relations with the care staff. Coming closer to the participants' professional identity proved to be of utmost importance for interpreting their choices and decisions in the workplace. Identity negotiation is presented here as a constructive way of discussing ethnographic field roles in the research field.

The role of familiarity in associative recognition of unitized compound word pairs.

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Ahmad, Fahad N; Hockley, William E

2014-01-01

This study examined the effect of unitization and contribution of familiarity in the recognition of word pairs. Compound words were presented as word pairs and were contrasted with noncompound word pairs in an associative recognition task. In Experiments 1 and 2, yes-no recognition hit and false-alarm rates were significantly higher for compound than for noncompound word pairs, with no difference in discrimination in both within- and between-subject comparisons. Experiment 2 also showed that item recognition was reduced for words from compound compared to noncompound word pairs, providing evidence of the unitization of the compound pairs. A two-alternative forced-choice test used in Experiments 3A and 3B provided evidence that the concordant effect for compound word pairs was largely due to familiarity. A discrimination advantage for compound word pairs was also seen in these experiments. Experiment 4A showed that a different pattern of results is seen when repeated noncompound word pairs are compared to compound word pairs. Experiment 4B showed that memory for the individual items of compound word pairs was impaired relative to items in repeated and nonrepeated noncompound word pairs, and Experiment 5 demonstrated that this effect is eliminated when the elements of compound word pairs are not unitized. The concordant pattern seen in yes-no recognition and the discrimination advantage in forced-choice recognition for compound relative to noncompound word pairs is due to greater reliance on familiarity at test when pairs are unitized.

Engaging the expert in public dialogue: Developing the role of performance assessment

International Nuclear Information System (INIS)

Littleboy, Anna; Hodgkinson, David

2001-01-01

Participatory approaches to decision-making call for two-way dialogue with a wide range of stakeholders. In the United Kingdom, probabilistic performance assessments of a potential deep geological disposal facility have typically been undertaken by experts to meet regulations set by other experts. However, there is potential for performance assessments to fulfil the additional role of enabling dialogue with other stakeholder groups. This paper suggests developments in the focus and presentation of performance assessments to foster such dialogue. It reflects issues relevant to performance assessment that arise as waste management organisations consider the consequences of involving wider stakeholder groups in decision making about repository development

Engaging the expert in public dialogue: Developing the role of performance assessment

Energy Technology Data Exchange (ETDEWEB)

Littleboy, Anna [United Kingdom Nirex Ltd., Harwell (United Kingdom); Hodgkinson, David [Quintessa Ltd., Henley-on-Thames (United Kingdom)

2001-07-01

Participatory approaches to decision-making call for two-way dialogue with a wide range of stakeholders. In the United Kingdom, probabilistic performance assessments of a potential deep geological disposal facility have typically been undertaken by experts to meet regulations set by other experts. However, there is potential for performance assessments to fulfil the additional role of enabling dialogue with other stakeholder groups. This paper suggests developments in the focus and presentation of performance assessments to foster such dialogue. It reflects issues relevant to performance assessment that arise as waste management organisations consider the consequences of involving wider stakeholder groups in decision making about repository development.

Climate change indicators in the United States

Science.gov (United States)

2010-04-01

The U.S. Environmental Protection Agency (EPA) has published this report, Climate Change Indicators in the United States, to help readers interpret a set of important indicators to better understand climate change. The report presents 24 indicators, ...

Investigation of The regularities of the process and development of method of management of technological line operation within the process of mass raw mate-rials supply in terms of dynamics of inbound traffic of unit trains

Directory of Open Access Journals (Sweden)

Катерина Ігорівна Сізова

2015-03-01

Full Text Available Large-scale sinter plants at metallurgical enterprises incorporate highly productive transport-and-handling complexes (THC that receive and process mass iron-bearing raw materials. Such THCs as a rule include unloading facilities and freight railway station. The central part of the THC is a technological line that carries out operations of reception and unloading of unit trains with raw materials. The technological line consists of transport and freight modules. The latter plays a leading role and, in its turn, consists of rotary car dumpers and conveyor belts. This module represents a determinate system that carries out preparation and unloading operations. Its processing capacity is set in accordance with manufacturing capacity of the sinter plant. The research has shown that in existing operating conditions, which is characterized by “arrhythmia” of interaction between external transport operation and production, technological line of THC functions inefficiently. Thus, it secures just 18-20 % of instances of processing of inbound unit trains within set standard time. It was determined that duration of the cycle of processing of inbound unit train can play a role of regulator, under stochastic characteristics of intervals between inbound unit trains with raw materials on the one hand, and determined unloading system on the other hand. That is why evaluation of interdependence between these factors allows determination of duration of cycle of processing of inbound unit trains. Basing on the results of the study, the method of logistical management of the processing of inbound unit trains was offered. At the same time, real duration of processing of inbound unit train is taken as the regulated value. The regulation process implies regular evaluation and comparison of these values, and, taking into account different disturbances, decision-making concerning adaptation of functioning of technological line. According to the offered principles

The nursing professorial unit: translating acute and critical care nursing research

Directory of Open Access Journals (Sweden)

Martin Christensen

2017-11-01

Full Text Available Background and context: Implementation of current research in practice is challenging for ward-based nursing staff. However, university-based nursing academics are seen as the research experts and are perhaps well placed to support clinical nursing research. The problem lies with the divide between practice and academia; universities often use the clinical environment as the place to conduct research but this is often not translated effectively into practice. The development of a nursing professorial unit for acute and critical care was undertaken to meet this challenge. The unit’s key aim is to develop, mentor and support a nursing research culture that is wholly situated within and driven by the requirements of the clinical environment. Aim: The aim of this article is to offer some insights as to how staff set about engaging with and developing the nursing professorial unit to support nursing research in our local hospital. Conclusions: The article highlights how an effective and coordinated approach to supporting clinical nursing research is possible. The nursing professorial unit has been successful in bridging the divide between academia and practice by using a non-university approach to supporting nursing research. Instead we have adopted the philosophy that practice is the sole driver for research and as academics our role is to support that position. Implications for practice: The adoption of the nursing professorial unit model for supporting clinical nursing research is beneficial in closing the divide between clinical practice and the university The continual presence of the academics in the clinical environment has had a positive impact on research development and implementation in practice The nursing professorial unit has become an integral part of the nursing culture in the hospital environment

Enhancing Productivity Through Feedback and Goal Setting. Final Report.

Science.gov (United States)

Pritchard, Robert D.; And Others

A field test was conducted to research the effects of feedback and goal-setting techniques on increasing productivity. Subjects were regular employees of two autonomous clerical-type units in a credit card and payment processing center of a Southwestern oil company. The study desiqn had three phases--baseline period and two experimental conditions…

The development and validation of an interprofessional scale to assess teamwork in mental health settings.

Science.gov (United States)

Tomizawa, Ryoko; Yamano, Mayumi; Osako, Mitue; Misawa, Takeshi; Hirabayashi, Naotugu; Oshima, Nobuo; Sigeta, Masahiro; Reeves, Scott

2014-09-01

Currently, no evaluative scale exists to assess the quality of interprofessional teamwork in mental health settings across the globe. As a result, little is known about the detailed process of team development within this setting. The purpose of this study is to develop and validate a global interprofessional scale that assesses teamwork in mental health settings using an international comparative study based in Japan and the United States. This report provides a description of this study and reports progress made to date. Specifically, it outlines work on literature reviews to identify evaluative teamwork tools as well as identify relevant teamwork models and theories. It also outlines plans for empirical work that will be undertaken in both Japan and the United States.

The Present and Future State of Blended Learning in Workplace Learning Settings in the United States

Science.gov (United States)

Bonk, Curtis J.; Kim, Kyong-Jee; Oh, Eun Jung; Teng, Ya-Ting; Son, Su Jin

2007-01-01

This paper reports survey findings related to the present and future state of blended learning in workplace learning settings across the U.S. Surveyed in this study are 118 practitioners in corporate training or elearning in various workplace settings. The findings reveal interesting perceptions by respondents regarding the benefits of and…

Coping with information style and family burden: Possible roles of self-stigma and hope among parents of children in a psychiatric inpatient unit.

Science.gov (United States)

Hasson-Ohayon, I; Pijnenborg, G H M; Ben-Pazi, A; Taitel, S; Goldzweig, G

2017-05-01

Parents of children who are hospitalized in inpatient psychiatric units must cope with significant challenges. One of these challenges relates to the way in which they cope with illness-related information. The current study examined the relationship between two such coping styles - monitoring and blunting - and family burden among parents of children in a psychiatric inpatient unit. Moreover, the possible moderating roles played by hope and self-stigma in these associations were also examined. Questionnaires regarding coping with information style, self-stigma, hope and family burden were administered to 70 parents. A main positive effect of hope and a main negative effect of self-stigma were uncovered. An interaction between self-stigma and monitoring was also revealed, suggesting that for parents with high self-stigma, compared to those with low self-stigma, more monitoring was related to more burden. Tailoring family interventions according to coping style and self-stigma is highly recommended as a mean to reduce the family burden of parents whose child is hospitalized in a psychiatric inpatient unit. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

NATURAL GAS LIQUEFACTION UNITS ON THE BASE OF EXPANDER NITROGEN CYCLES

OpenAIRE

Кузьменко, И. Ф.; Передельский, В. А.; Довбиш, А. Л.

2014-01-01

It is necessary to create large-capacity LNG-units for natural gas peaks consumption shaving and also to expand liquefied natural gas (LNG) marketing. It is proposed to create such natural gas liquefaction units with the use of outer nitrogen cryogenic thermodynamic cycles. It is necessary to use turboexpander-compressor sets (TECS) in them for maximizing cycles efficiency. Different technological schemes of LNG-units including nitrogen cryogenic units with TECS from one to four have been exa...

Spiritual Care in the Intensive Care Unit: A Narrative Review.

Science.gov (United States)

Ho, Jim Q; Nguyen, Christopher D; Lopes, Richard; Ezeji-Okoye, Stephen C; Kuschner, Ware G

2018-05-01

Spiritual care is an important component of high-quality health care, especially for critically ill patients and their families. Despite evidence of benefits from spiritual care, physicians and other health-care providers commonly fail to assess and address their patients' spiritual care needs in the intensive care unit (ICU). In addition, it is common that spiritual care resources that can improve both patient outcomes and family member experiences are underutilized. In this review, we provide an overview of spiritual care and its role in the ICU. We review evidence demonstrating the benefits of, and persistent unmet needs for, spiritual care services, as well as the current state of spiritual care delivery in the ICU setting. Furthermore, we outline tools and strategies intensivists and other critical care medicine health-care professionals can employ to support the spiritual well-being of patients and families, with a special focus on chaplaincy services.

Fundamental about energy-efficient set-top boxes; Grundlagen zur Energieeffizienz von Set-Top Boxen

Energy Technology Data Exchange (ETDEWEB)

Grieder, T.; Huser, A.

2004-07-01

In various countries within Europe, digital television has already achieved a wide distribution. All types of reception are affected by this new technology, cable television, satellite reception and reception with a conventional roof or room aerial. In addition to the television set itself, a separate receiver is required for the digital signals, a so-called set-top box. Instead of one analogue programme, at least 3, or, in extreme cases more than 10, digital programmes are received, with interactive ser-vices also being possible. Up to now, very little of this development has been seen in Switzerland. Thanks to the wide range of programmes available over the cable networks, there is virtually no demand for an improved offer via a conventional aerial. Only in the case of satellite reception has the changeover already taken place in the majority of cases. Attractive additional services, as well as the integration into the international environment, will result in an increasing number of set-top boxes also being used in Switzerland. Over the next 10 to 15 years, the current number of approximately 420,000 units will increase to over 3 million, whereby the total electricity demand within Switzerland will increase by a further 0.5 to 1%. In order to check this increase, the European Union has taken the path of a voluntary agreement with the appliance manufacturers and service providers, and a similar procedure is also recommended for Switzerland. In addition, this study also draws up various recommendations for the importers of set-top boxes and for the service providers. (author)

The Role of Parenting Practices in the Home Environment among Underserved Youth.

Science.gov (United States)

Conlon, Beth A; McGinn, Aileen P; Lounsbury, David W; Diamantis, Pamela M; Groisman-Perelstein, Adriana E; Wylie-Rosett, Judith; Isasi, Carmen R

2015-08-01

The home environment, which includes parenting practices, is an important setting in which children develop their health behaviors. We examined the role of parenting practices in the home environment among underserved youth. We examined baseline data of a family-focused pediatric obesity intervention. Parenting practices (monitoring, discipline, limit setting of soda/snacks [SS] and screen media [SM], pressure to eat, and reinforcement) and availability of fruits/vegetables (FV) and sugar-sweetened beverages (SSBs), family meals, television (TV) watching during meals, TVs in the home, owning active video games/sports equipment, and household food security were assessed in 301 parent/caregivers of overweight/obese children (ages 7-12 years; BMI≥85th percentile). Associations were evaluated using Spearman's rank correlation coefficients and logistic regression models adjusted for potential confounders. Parents/caregivers (ages 22-67 years) were largely Hispanic/Latino (74.1%), female (92.4%), and reported high levels of limit setting SS and low levels of pressure to eat. Parent age, gender, country of birth, and years living in the United States accounted for differences among several parenting practices. Adjusted logistic regression models identified several statistically significant associations, including: Monitoring was positively associated with availability FV (odds ratio [OR]=2.19; 95% confidence interval [CI], 1.25, 3.82); limit setting SS was inversely associated with availability of SSBs (OR=0.40; 95% CI, 0.21, 0.75); and limit setting SM was inversely associated with TV viewing during family meals (OR=0.51; 95% CI, 0.31, 0.85). Nearly 40% of our population was food insecure, and food insecurity was positively associated with pressure to eat (OR=1.77; 95% CI, 1.01, 3.15). Parenting practices play an important role in the home environment, and longitudinal studies are needed to examine these associations in the context of family-focused pediatric obesity

Development of a transient, lumped hydrologic model for geomorphologic units in a geomorphology based rainfall-runoff modelling framework

Science.gov (United States)

Vannametee, E.; Karssenberg, D.; Hendriks, M. R.; de Jong, S. M.; Bierkens, M. F. P.

2010-05-01

We propose a modelling framework for distributed hydrological modelling of 103-105 km2 catchments by discretizing the catchment in geomorphologic units. Each of these units is modelled using a lumped model representative for the processes in the unit. Here, we focus on the development and parameterization of this lumped model as a component of our framework. The development of the lumped model requires rainfall-runoff data for an extensive set of geomorphological units. Because such large observational data sets do not exist, we create artificial data. With a high-resolution, physically-based, rainfall-runoff model, we create artificial rainfall events and resulting hydrographs for an extensive set of different geomorphological units. This data set is used to identify the lumped model of geomorphologic units. The advantage of this approach is that it results in a lumped model with a physical basis, with representative parameters that can be derived from point-scale measurable physical parameters. The approach starts with the development of the high-resolution rainfall-runoff model that generates an artificial discharge dataset from rainfall inputs as a surrogate of a real-world dataset. The model is run for approximately 105 scenarios that describe different characteristics of rainfall, properties of the geomorphologic units (i.e. slope gradient, unit length and regolith properties), antecedent moisture conditions and flow patterns. For each scenario-run, the results of the high-resolution model (i.e. runoff and state variables) at selected simulation time steps are stored in a database. The second step is to develop the lumped model of a geomorphological unit. This forward model consists of a set of simple equations that calculate Hortonian runoff and state variables of the geomorphologic unit over time. The lumped model contains only three parameters: a ponding factor, a linear reservoir parameter, and a lag time. The model is capable of giving an appropriate

Improving clinical research and cancer care delivery in community settings: evaluating the NCI community cancer centers program

Directory of Open Access Journals (Sweden)

Fennell Mary L

2009-09-01

Full Text Available Abstract Background In this article, we describe the National Cancer Institute (NCI Community Cancer Centers Program (NCCCP pilot and the evaluation designed to assess its role, function, and relevance to the NCI's research mission. In doing so, we describe the evolution of and rationale for the NCCCP concept, participating sites' characteristics, its multi-faceted aims to enhance clinical research and quality of care in community settings, and the role of strategic partnerships, both within and outside of the NCCCP network, in achieving program objectives. Discussion The evaluation of the NCCCP is conceptualized as a mixed method multi-layered assessment of organizational innovation and performance which includes mapping the evolution of site development as a means of understanding the inter- and intra-organizational change in the pilot, and the application of specific evaluation metrics for assessing the implementation, operations, and performance of the NCCCP pilot. The assessment of the cost of the pilot as an additional means of informing the longer-term feasibility and sustainability of the program is also discussed. Summary The NCCCP is a major systems-level set of organizational innovations to enhance clinical research and care delivery in diverse communities across the United States. Assessment of the extent to which the program achieves its aims will depend on a full understanding of how individual, organizational, and environmental factors align (or fail to align to achieve these improvements, and at what cost.

The Association of Workplace Social Capital With Work Engagement of Employees in Health Care Settings: A Multilevel Cross-Sectional Analysis.

Science.gov (United States)

Fujita, Sumiko; Kawakami, Norito; Ando, Emiko; Inoue, Akiomi; Tsuno, Kanami; Kurioka, Sumiko; Kawachi, Ichiro

2016-03-01

The aim of the study was to examine the cross-sectional multilevel association between unit-level workplace social capital and individual-level work engagement among employees in health care settings. The data were collected from employees of a Japanese health care corporation using a questionnaire. The analyses were limited to 440 respondents from 35 units comprising five or more respondents per unit. Unit-level workplace social capital was calculated as an average score of the Workplace Social Capital Scale for each unit. Multilevel regression analysis with a random intercept model was conducted. After adjusting for demographic variables, unit-level workplace social capital was significantly and positively associated with respondents' work engagement (P capital (P capital might exert a positive contextual effect on work engagement of employees in health care settings.

The association between social stressors and home smoking rules among women with infants in the United States.

Science.gov (United States)

Saint Onge, Jarron M; Gurley-Calvez, Tami; Orth, Teresa A; Okah, Felix A

2014-12-01

We examined the role of social stressors on home-smoking rules (HSRs) among women with infants in the United States, with attention on the moderating role of smoking status and depression. We analyzed data for 118 062 women with recent births in the United States who participated in the Pregnancy Risk Assessment Monitoring System (2004-2010), which is a population-based surveillance data set. We fit multinomial logistic models to predict the odds of partial or no HSRs by a cumulative index of prenatal social stressors. Compared with those with no stressors, mothers with high levels of social stressors had 2.5 times higher odds of partial or no HSRs. Smokers in the 1-2, 3-5, and ≥ 6 stressor categories were 9.0%, 9.6%, and 10.8% more likely to have partial or no HSRs, respectively. Under the highest levels of stress (≥ 6), nonsmokers were almost as likely as smokers to have partial or no HSRs. In addition, the effects of stress on HSRs were more pronounced for nonsmoker, nondepressed mothers. Increases in social stressors represented an important risk factor for partial or no HSRs and might have potential negative implications for infants.

Advertising Representations of Older People in the United Kingdom and Taiwan: A Comparative Analysis.

Science.gov (United States)

Chen, Chin-Hui

2015-01-01

Cross-cultural studies of advertising representations of older people are relatively scarce. This article aims to fill in this gap via a comparison between Taiwan and the United Kingdom, employing a combination of quantitative content analysis and the qualitative grounded theory method. The content-analysis phase reveals underrepresentation of older people in both countries' advertising contexts, as well as representational differences between Taiwan and the United Kingdom in terms of older characters' role salience, the products, physical settings, and social networks they are associated with. The grounded-theory phase yields nine prototypes of older people along with subcategories to conceptualize the qualities of older people as they appear in TV ads in these countries. The findings are discussed in relation to the stereotyping of older people and transformed into hypothetical statements to be modified in future research. In conclusion, the Confucian tradition of filial piety is still found to be important in explaining the observed cross-cultural differences, but the emergence of new norms about aging in Taiwanese advertising also suggests that this tradition may be in decline. © The Author(s) 2015.

Early visual cortex reflects initiation and maintenance of task set

Science.gov (United States)

Elkhetali, Abdurahman S.; Vaden, Ryan J.; Pool, Sean M.

2014-01-01

The human brain is able to process information flexibly, depending on a person's task. The mechanisms underlying this ability to initiate and maintain a task set are not well understood, but they are important for understanding the flexibility of human behavior and developing therapies for disorders involving attention. Here we investigate the differential roles of early visual cortical areas in initiating and maintaining a task set. Using functional Magnetic Resonance Imaging (fMRI), we characterized three different components of task set-related, but trial-independent activity in retinotopically mapped areas of early visual cortex, while human participants performed attention demanding visual or auditory tasks. These trial-independent effects reflected: (1) maintenance of attention over a long duration, (2) orienting to a cue, and (3) initiation of a task set. Participants performed tasks that differed in the modality of stimulus to be attended (auditory or visual) and in whether there was a simultaneous distractor (auditory only, visual only, or simultaneous auditory and visual). We found that patterns of trial-independent activity in early visual areas (V1, V2, V3, hV4) depend on attended modality, but not on stimuli. Further, different early visual areas play distinct roles in the initiation of a task set. In addition, activity associated with maintaining a task set tracks with a participant's behavior. These results show that trial-independent activity in early visual cortex reflects initiation and maintenance of a person's task set. PMID:25485712

The relationship between healthy work environments and retention of nurses in a hospital setting.

Science.gov (United States)

Ritter, Desiree

2011-01-01

The purpose of the present paper was to determine the effect a healthy work environment has on the retention of nurses in a hospital setting. There is a nursing shortage that has been ongoing and is expected to continue, resulting in challenges for the healthcare system in the United States. The significance of this issue is the impact the nursing shortage will have on healthcare organizations and patients. The present paper included an extensive review of the current literature. The literature reviewed encompassed scholarly peer-reviewed journal articles. This article focused on nurses, work environments and the impact of the work environments on retention. Important issues that emerged from this analysis were the dangers of an unhealthy environment, the impact a healthy work environment has on patient outcomes and retention, the Magnet link to healthy work environments and the manager's role in creating and sustaining a healthy work environment. The literature provided evidence of the link between healthy work environments and the retention of nurses in a hospital setting. The implications for management are to implement changes now to create a healthy work environment that will recruit and retain nurses to secure their position in the future. © 2010 The Author. Journal compilation © 2010 Blackwell Publishing Ltd.

Relationships between college settings and student alcohol use before, during and after events: a multi-level study.

Science.gov (United States)

Paschall, Mallie J; Saltz, Robert F

2007-11-01

We examined how alcohol risk is distributed based on college students' drinking before, during and after they go to certain settings. Students attending 14 California public universities (N=10,152) completed a web-based or mailed survey in the fall 2003 semester, which included questions about how many drinks they consumed before, during and after the last time they went to six settings/events: fraternity or sorority party, residence hall party, campus event (e.g. football game), off-campus party, bar/restaurant and outdoor setting (referent). Multi-level analyses were conducted in hierarchical linear modeling (HLM) to examine relationships between type of setting and level of alcohol use before, during and after going to the setting, and possible age and gender differences in these relationships. Drinking episodes (N=24,207) were level 1 units, students were level 2 units and colleges were level 3 units. The highest drinking levels were observed during all settings/events except campus events, with the highest number of drinks being consumed at off-campus parties, followed by residence hall and fraternity/sorority parties. The number of drinks consumed before a fraternity/sorority party was higher than other settings/events. Age group and gender differences in relationships between type of setting/event and 'before,''during' and 'after' drinking levels also were observed. For example, going to a bar/restaurant (relative to an outdoor setting) was positively associated with 'during' drinks among students of legal drinking age while no relationship was observed for underage students. Findings of this study indicate differences in the extent to which college settings are associated with student drinking levels before, during and after related events, and may have implications for intervention strategies targeting different types of settings.

Environmental setting and factors that affect water quality in the Georgia-Florida Coastal Plain study unit

Science.gov (United States)

Berndt, M.P.; Oaksford, E.T.; Darst, M.R.; Marella, R.L.

1996-01-01

The Georgia-Florida Coastal Plain study unit covers an area of nearly 62,000 square miles in the southeastern United States, mostly in the Coastal Plain physiographic province. Land resource provinces have been designated based on generalized soil classifications. Land resource provinces in the study area include: the Coastal Flatwoods, the Southern Coastal Plain, the Central Florida Ridge, the Sand Hills, and the Southern Piedmont. The study area includes all or parts of seven hydrologic subregions: the Ogeechee-Savannah, the Altamaha- St.Marys, the Suwannee, the Ochlockonee, the St. Johns, the Peace-Tampa Bay, and the Southern Florida. The primary source of water for public supply in the study area is ground water from the Upper Floridan aquifer. In 1990, more than 90 percent of the 2,888 million gallons per day of ground water used came from this aquifer. The population of the study area was 9.3 million in 1990. The cities of Jacksonville, Orlando, St. Petersburg, Tallahassee, and Tampa, Florida, and parts of Atlanta and Savannah, Georgia, are located in the study area. Forest and agricultural areas are the most common land uses in the study area, accounting for 48 percent and 25 percent of the study area, respectively. Climatic conditions range from temperate in Atlanta, Georgia, where mean annual temperature is about 61.3 degrees Fahrenheit, to subtropical in Tampa, Florida, where mean annual temperature is about 72.4 degrees Fahrenheit. Long-term average precipitation (1961-90) ranges from 43.9 inches per year in Tampa, Florida, and 44.6 in Macon, Georgia, to 65.7 inches per year in Tallahassee, Florida. Floods in the study area result from frontal systems, hurricanes, tropical storms, or severe thunderstorms. Droughts are not common in the study area,especially in the Florida part of the study area due to extensive maritime exposure. The primary physical and cultural characteristics in the study area include physiography, soils and land resource provinces

Clinical nurse leader and clinical nurse specialist role delineation in the acute care setting.

Science.gov (United States)

Thompson, Patricia; Lulham, Kevin

2007-10-01

More than 90 members of the American Association of Colleges of Nursing and 190 practice sites have partnered to develop the clinical nurse leader (CNL) role. The partnership has created synergy between education and practice and nurtured innovation and diffusion of learning on a national basis. In this ongoing department, the editor, Jolene Tornabeni, MA, RN, FAAN, FACHE, showcases a variety of nurse leaders who discuss their new patient care delivery models in preparation for the CNL role and CNLs who highlight partnerships with their clinical colleagues to improve patient care. In this article, the authors explore differences and similarities between the CNL and the clinical nurse specialist roles, describing the working strategies between a CNL and clinical nurse specialist, and role delineations that have resulted from their cooperation, collaboration, and planning.

Observations of the role of science in the United States medical cannabis state policies: Lessons learnt.

Science.gov (United States)

Grbic, Jelica; Goddard, Perilou; Ryder, David

2017-04-01

Clinical trials have shown cannabis to be effective in the treatment of some medical conditions and there is mounting public and political pressure to enact laws enabling the use of cannabis for medicinal purposes. To date, 28 United States (U.S.) states and the District of Columbia have enacted medical cannabis laws. This study sought to identify the main issues pertaining to the development of medical cannabis laws in the U.S, including the role of scientific evidence. Data were collected from three groups of participants: government officials, lobbyists and medical professionals involved in the medical cannabis debate in five selected states in the U.S.; researchers from the same five states conducting funded research in the alcohol and other drugs field; and members of the International Society for the Study of Drug Policy. The data were analysed using thematic analysis. Six major themes emerged in relation to the factors influencing policy: scientific evidence plays a limited role in the development of policy; the available research is limited and mixed; there is a need for clearer communication and active dissemination of evidence to policy makers; researchers need to consider what research is likely to impact on policy; scientific evidence is not a major factor in policy development; and there is a need to consider evidence within a political context. Researchers need to be aware of the political context in which medical cannabis laws are or are not enacted and consider ways in which research findings can achieve a higher profile within this context. Copyright © 2016. Published by Elsevier B.V.

Management of persistent occiput posterior position: a substantial role of instrumental rotation in the setting of failed manual rotation.

Science.gov (United States)

Guerby, Paul; Allouche, Mickael; Simon-Toulza, Caroline; Vayssiere, Christophe; Parant, Olivier; Vidal, Fabien

2018-01-01

To compare the maternal and neonatal outcomes associated with Instrumental Rotation (IR) to operative vaginal delivery in occiput posterior (OP) position with Thierry's spatulas (TS), in the setting of failed manual rotation (MR). We led a prospective observational cohort study in a tertiary referral hospital in Toulouse, France. All women presenting in labor with persistent OP position at full cervical dilatation and who delivered vaginally after failed MR and with IR or OP assisted delivery were included from January 2014 to December 2015. The main outcomes measured were maternal morbidity parameters including episiotomy rate, incidence and severity of perineal lacerations, perineal hematomas and postpartum hemorrhage. Severe perineal tears corresponded to third and fourth degree lacerations. Fetal morbidity outcomes comprised neonatal Apgar scores, acidemia, fetal injuries, birth trauma and neonatal intensive care unit admissions. Among 9762 women, 910 (9.3%) presented with persistent OP position at full cervical dilatation and 222 deliveries were enrolled. Of 111 attempted IR, 97 were successful (87.4%). The incidence of anal sphincter injuries was significantly reduced after IR attempt (1.8% vs. 12.6%; p manual rotation.

The Work-Family Support Roles of Child Care Providers across Settings

Science.gov (United States)

Bromer, Juliet; Henly, Julia R.

2009-01-01

This paper presents a qualitative investigation of the work-family support roles of a sample of 29 child care providers serving low-income families in the Chicago area (16 family, friend, and neighbor providers (FFN), 7 licensed family child care providers (FCC), and 6 center-based teachers). Providers report offering low-income parents…

Interprofessional Simulations Promote Knowledge Retention and Enhance Perceptions of Teamwork Skills in a Surgical-Trauma-Burn Intensive Care Unit Setting.

Science.gov (United States)

George, Katie L; Quatrara, Beth

The current state of health care encompasses highly acute, complex patients, managed with ever-changing technology. The ability to function proficiently in critical care relies on knowledge, technical skills, and interprofessional teamwork. Integration of these factors can improve patient outcomes. Simulation provides "hands-on" practice and allows for the integration of teamwork into knowledge/skill training. However, simulation can require a significant investment of time, effort, and financial resources. The Institute of Medicine recommendations from 2015 include "strengthening the evidence base for interprofessional education (IPE)" and "linking IPE with changes in collaborative behavior." In one surgical-trauma-burn intensive care unit (STBICU), no IPE existed. The highly acute and diverse nature of the patients served by the unit highlights the importance of appropriate training. This is heightened during critical event situations where patients deteriorate rapidly and the team intervenes swiftly. The aims of this study were to (1) evaluate knowledge retention and analyze changes in perceptions of teamwork among nurses and resident physicians in a STBICU setting after completion of an interprofessional critical event simulation and (2) provide insight for future interprofessional simulations (IPSs), including the ideal frequency of such training, associated cost, and potential effect on nursing turnover. A comparison-cohort pilot study was developed to evaluate knowledge retention and analyze changes in perceptions of teamwork. A 1-hour critical event IPS was held for nurses and resident physicians in a STBICU setting. A traumatic brain injury patient with elevated intracranial pressure, rapid deterioration, and cardiac arrest was utilized for the simulation scenario. The simulation required the team to use interventions to reduce elevated intracranial pressure and then perform cardiac resuscitation according to Advanced Cardiac Life Support guidelines. A

The Sport Education Model: A Track and Field Unit Application

Science.gov (United States)

O'Neil, Kason; Krause, Jennifer M.

2016-01-01

Track and field is a traditional instructional unit often taught in secondary physical education settings due to its history, variety of events, and potential for student interest. This article provides an approach to teaching this unit using the sport education model (SEM) of instruction, which has traditionally been presented as a model for team…

Information about the new 8-group delayed neutron set preparation

International Nuclear Information System (INIS)

Svarny, J.

1998-01-01

Some comments to the present state concerning delayed neutron data preparation is given and preliminary analysis of the new 8-group delayed data (relative abundances) is presented. Comparisons of the 8-group to 6-group set is given for rod drop experiment (Unit 1, Cycle 14, NPP Dukovany).(Author)

Automatic sets and Delone sets

International Nuclear Information System (INIS)

Barbe, A; Haeseler, F von

2004-01-01

Automatic sets D part of Z m are characterized by having a finite number of decimations. They are equivalently generated by fixed points of certain substitution systems, or by certain finite automata. As examples, two-dimensional versions of the Thue-Morse, Baum-Sweet, Rudin-Shapiro and paperfolding sequences are presented. We give a necessary and sufficient condition for an automatic set D part of Z m to be a Delone set in R m . The result is then extended to automatic sets that are defined as fixed points of certain substitutions. The morphology of automatic sets is discussed by means of examples

Interval neutrosophic sets and their application in multicriteria decision making problems.

Science.gov (United States)

Zhang, Hong-yu; Wang, Jian-qiang; Chen, Xiao-hong

2014-01-01

As a generalization of fuzzy sets and intuitionistic fuzzy sets, neutrosophic sets have been developed to represent uncertain, imprecise, incomplete, and inconsistent information existing in the real world. And interval neutrosophic sets (INSs) have been proposed exactly to address issues with a set of numbers in the real unit interval, not just a specific number. However, there are fewer reliable operations for INSs, as well as the INS aggregation operators and decision making method. For this purpose, the operations for INSs are defined and a comparison approach is put forward based on the related research of interval valued intuitionistic fuzzy sets (IVIFSs) in this paper. On the basis of the operations and comparison approach, two interval neutrosophic number aggregation operators are developed. Then, a method for multicriteria decision making problems is explored applying the aggregation operators. In addition, an example is provided to illustrate the application of the proposed method.

Aging in a cultural context: cross-national differences in disability and the moderating role of personal control among older adults in the United States and England.

Science.gov (United States)

Clarke, Philippa; Smith, Jacqui

2011-07-01

We investigate cross-national differences in late-life health outcomes and focus on an intriguing difference in beliefs about personal control found between older adult populations in the U.K. and United States. We examine the moderating role of control beliefs in the relationship between physical function and self-reported difficulty with daily activities. Using national data from the United States (Health and Retirement Study) and England (English Longitudinal Study on Ageing), we examine the prevalence in disability across the two countries and show how it varies according to the sense of control. Poisson regression was used to examine the relationship between objective measures of physical function (gait speed) and disability and the modifying effects of control. Older Americans have a higher sense of personal control than the British, which operates as a psychological resource to reduce disability among older Americans. However, the benefits of control are attenuated as physical impairments become more severe. These results emphasize the importance of carefully considering cross-national differences in the disablement process as a result of cultural variation in underlying psychosocial resources. This paper highlights the role of culture in shaping health across adults aging in different sociopolitical contexts.

The 1990 conterminous U.S. AVHRR data set

International Nuclear Information System (INIS)

Eidenshink, J.C.

1992-01-01

The U.S. Geological Survey, using NOAA-11 Advanced Very High Resolution Radiometer (AVHRR) 1-km data, has produced a time series of 19 biweekly maximum normalized difference vegetation index (NDVI) composites of the conterminous United States for the 1990 growing season. Each biweekly composite included data from approximately 20 calibrated and georegistered daily overpasses. The output is a data set which includes all five calibrated AVHRR channels, NDVI values, three satellite/solar viewing angles, and date of observation pointer for each biweekly composite. The data set is intended for assessing seasonal variations in vegetation condition and provides a foundation for studying long-term changes in vegetation resulting from human interactions or global climate alterations. 12 refs

Food irradiation in the United States

International Nuclear Information System (INIS)

Pauli, G.H.

1991-01-01

Since 1963, some irradiated foods have been permitted for sale in the United States. Yet, at this time, commercial application has been limited to irradiation of a relatively small fraction of the spices and seasonings used as ingredients in other foods. The current situation regarding irradiated foods in the United States and how it developed is discussed. The author writes from experience gained as a Government regulator concerned primarily with ensuring safety of food and therefore this is stressed together with the crucial role played by consumers and industry. (author)

Unit and ubiquitous Internet of Things

CERN Document Server

Ning, Huansheng

2013-01-01

Although the Internet of Things (IoT) will play a key role in the development of next generation information, network, and communication technologies, many are still unclear about what makes IoT different from similar concepts. Answering fundamental questions about IoT architectures and models, Unit and Ubiquitous Internet of Things introduces essential IoT concepts from the perspectives of mapping and interaction between the physical world and the cyber world. It addresses key issues such as strategy and education, particularly around unit and ubiquitous IoT technologies. Supplying a new pers

Study on role structure in social planning systems

International Nuclear Information System (INIS)

Kimata, Noboru

1984-01-01

New proposals are attended with a new set of role-expectation. If we lack attention to this aspect of any proposal, we face a serious difficulty in its implementation stage. The system called as Public Hearring shows us this fact. In this paper, introducing ABC model of communication by Westley and Maclean, we try to describe a set of role-expectation for particitants in social planning systems. And also introducing analytical concepts of role enactment process, we reveal two important problems for any proposal as a subsystem of social planning systems: (i) importance of role negotiation process for role-consensus, and (ii) necessity of supporting systems for role-adaptation. Especially for role-adaptation to Channel-Roles, we indicate the potential of VISMS as its supporting system. (author)

Leadership style and culturally competent care: Nurse leaders' views of their practice in the multicultural care settings of the United Arab Emirates.

Science.gov (United States)

El Amouri, Souher; O'Neill, Shirley

2014-01-01

Abstract It is well recognized that nurse-leader-managers play an important role in facilitating the quality and nature of hospital care, the improvement of work performance and work satisfaction. In the United Arab Emirates they face the additional challenge of working within a context of significant linguistic and cultural diversity where leadership in the provision of culturally competent care is a major requirement. With this goal at the fore, a sample of 153 nurse-leader-managers, including matrons, nursing directors, supervisors, nurses-in-charge and in-service education staff from 4 private and 6 government hospitals completed the multifactor leadership questionnaire (Bass & Avolio, 2004). The survey also explored participants' perceptions of the characteristics of good leaders and what they needed to do in their particular work place to enhance culturally competent care. The results showed nurse-leader-managers used both transformational and transactional leadership attributes but in different combinations across the two hospital types.

Hand held control unit for controlling a display screen-oriented computer game, and a display screen-oriented computer game having one or more such control units

NARCIS (Netherlands)

2001-01-01

A hand-held control unit is used to control a display screen-oriented computer game. The unit comprises a housing with a front side, a set of control members lying generally flush with the front side for through actuating thereof controlling actions of in-game display items, and an output for

Perspectives on Inclusive Education with Reference to United Nations

Science.gov (United States)

Sharma, Arvind

2015-01-01

This essay explores inclusive education and explains the role of United Nations for imparting it to different nations. Undoubtedly, the UN and the United Nations Children's Fund (UNICEF) strive for all children to have equitable access to education as a basic human right. The Convention on the Rights of the Child (CRC) combined with the Convention…

Evaluating Speed Enforcement Field Set-Ups Used by Regional Police in Belgium: An Analysis of Speed Outcome Indicators

Directory of Open Access Journals (Sweden)

Brenda Wilmots

2016-12-01

Full Text Available In this paper the results from a field experiment (conducted in 2012 are presented, in which 3 regional police units in the Flemish region of Belgium each tested a particular combination of a speed control (with mobile radar in an anonymous car with communicative signage. The goal of this paper was to scientifically evaluate frequently used field set-ups. The following set-ups were tested in one week: (1 police unit 1: speed control with and without a static feedback sign placed after the control; (2 police unit 2: speed control with and without a digital feedback sign placed after the control; (3 police unit 3: speed display followed by a second speed display further along the road section. During certain time frames, speed control took place in between both signs. All tested field set-ups generated significant reductions in the speed level. Studying the effect of the different variations for each set-up reveals that the effect of the speed control is generally larger in combination with the signage alongside the road. After the period during which the police activities took place, speed levels again reached their initial level. Based on the before–after analysis, only in police area 2 was a small ‘time halo-effect’ found. To generalize results from this pilot study, repetition of tested set-ups in the field is recommended as well as testing on a larger scale.

Participants' engagement with and reactions to the use of on-line action learning sets to support advanced nursing role development.

Science.gov (United States)

Currie, Kay; Biggam, John; Palmer, Janette; Corcoran, Terry

2012-04-01

Professional role development in nursing is occurring at a rapid pace in the UK as elsewhere. Internationally, finding relevant, flexible, sustainable educational solutions to support the preparation of nurses for new roles presents significant challenges for Higher Education Institutions, health service managers and the clinical practitioners who are would-be students. The use of on-line learning is frequently advocated as one means of resolving these difficulties. This paper discusses participants' engagement with, and reactions to, the use of on-line Action Learning Sets (ALS) as part of a national pilot development pathway for Advanced Nursing Practice in Scotland. Data collection included: survey of participants' views of on-line ALS; survey comparing perceptions of ALS with other educational experiences within the pathway; in-depth interviews with case-site participants. A range of benefits and limitations of on-line ALS was identified. The benefit of flexible access and sharing experiences with others was emphasised. Conversely, multiple commitments and lack of group cohesiveness significantly interfered with the effectiveness of this process. Key recommendations for future implementation acknowledge participants' preference for a blended approach, with face-to-face sessions to provide 'getting-to-know-you' opportunities, enhancing commitment to the group process. Copyright © 2011 Elsevier Ltd. All rights reserved.

Precipitation Frequency Atlas of the Western United States

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — The Precipitation Frequency of the Western United States publication is an eleven volume set held in the archives. It was the culmination of many years of...

Set size and culture influence children's attention to number.

Science.gov (United States)

Cantrell, Lisa; Kuwabara, Megumi; Smith, Linda B

2015-03-01

Much research evidences a system in adults and young children for approximately representing quantity. Here we provide evidence that the bias to attend to discrete quantity versus other dimensions may be mediated by set size and culture. Preschool-age English-speaking children in the United States and Japanese-speaking children in Japan were tested in a match-to-sample task where number was pitted against cumulative surface area in both large and small numerical set comparisons. Results showed that children from both cultures were biased to attend to the number of items for small sets. Large set responses also showed a general attention to number when ratio difficulty was easy. However, relative to the responses for small sets, attention to number decreased for both groups; moreover, both U.S. and Japanese children showed a significant bias to attend to total amount for difficult numerical ratio distances, although Japanese children shifted attention to total area at relatively smaller set sizes than U.S. children. These results add to our growing understanding of how quantity is represented and how such representation is influenced by context--both cultural and perceptual. Copyright © 2014 Elsevier Inc. All rights reserved.

Comparison of temperature rise in the pulp chamber with different light curing units: An in-vitro study

OpenAIRE

Rajesh Ebenezar, A V; Anilkumar, R; Indira, R; Ramachandran, S; Srinivasan, M R

2010-01-01

Aims/Objectives: This in vitro study was designed to measure and compare the temperature rise in the pulp chamber with different light curing units. Materials and Methods: The study was done in two settings-in-vitro and in-vivo simulation. In in-vitro setting, 3mm and 6mm acrylic spacers with 4mm tip diameter thermocouple was used and six groups were formed according to the light curing source- 3 Quartz-Tungsten-Halogen (QTH) units and 3 Light-Emitting-Diode (LED) units. For the LED units, th...

Brucellosis in the United States: Role and Significance of Wildlife Reservoirs

Science.gov (United States)

Regulatory programs for brucellosis in domestic livestock have been active in the United States for almost 80 years. Wildlife reservoirs of brucellosis include bison (Bison bison) and elk (Cervus elaphus nelsonii) for B. abortus whereas B. suis is the predominant species infecting feral swine. The...

Identification of different geologic units using fuzzy constrained resistivity tomography

Science.gov (United States)

Singh, Anand; Sharma, S. P.

2018-01-01

Different geophysical inversion strategies are utilized as a component of an interpretation process that tries to separate geologic units based on the resistivity distribution. In the present study, we present the results of separating different geologic units using fuzzy constrained resistivity tomography. This was accomplished using fuzzy c means, a clustering procedure to improve the 2D resistivity image and geologic separation within the iterative minimization through inversion. First, we developed a Matlab-based inversion technique to obtain a reliable resistivity image using different geophysical data sets (electrical resistivity and electromagnetic data). Following this, the recovered resistivity model was converted into a fuzzy constrained resistivity model by assigning the highest probability value of each model cell to the cluster utilizing fuzzy c means clustering procedure during the iterative process. The efficacy of the algorithm is demonstrated using three synthetic plane wave electromagnetic data sets and one electrical resistivity field dataset. The presented approach shows improvement on the conventional inversion approach to differentiate between different geologic units if the correct number of geologic units will be identified. Further, fuzzy constrained resistivity tomography was performed to examine the augmentation of uranium mineralization in the Beldih open cast mine as a case study. We also compared geologic units identified by fuzzy constrained resistivity tomography with geologic units interpreted from the borehole information.

Psychological effects of dog ownership: role strain, role enhancement, and depression.

Science.gov (United States)

Cline, Krista Marie Clark

2010-01-01

The purpose of this study is to examine the link between multiple roles and depression and to attempt to provide a clearer answer to the question of what effect, if any, the role of dog ownership plays. Role strain and role enhancement theories are drawn upon to study this relationship. Ordinary least squares regression is used to examine a national sample of 201 adults in the United States. Findings revealed sex and marital status differences in the relationship between dog ownership and well-being, with women and single adults more likely to benefit from dog ownership. The findings presented here suggest that inattention to variations in marital status and sex may have been one factor in the inconsistency in the literature on pets and well-being.

Collaborative teacher learning in different primary school settings

NARCIS (Netherlands)

Doppenberg, J.J.; Bakx, A.W.E.A.; Brok, den P.J.

2012-01-01

During the last two decades there has been a growing awareness of the potentially strong role teacher collaboration can play in relation to teacher and team learning. Teachers collaborate with their colleagues in different formal and informal settings. Because most studies have focused on teacher

Building a Practically Useful Theory of Goal Setting and Task Motivation.

Science.gov (United States)

Locke, Edwin A.; Latham, Gary P.

2002-01-01

Summarizes 35 years of empirical research on goal-setting theory, describing core findings of the theory, mechanisms by which goals operate, moderators of goal effects, the relation of goals and satisfaction, and the role of goals as mediators of incentives. Explains the external validity and practical significance of goal setting theory,…

Performance measures for a dialysis setting.

Science.gov (United States)

Gu, Xiuzhu; Itoh, Kenji

2018-03-01

This study from Japan extracted performance measures for dialysis unit management and investigated their characteristics from professional views. Two surveys were conducted using self-administered questionnaires, in which dialysis managers/staff were asked to rate the usefulness of 44 performance indicators. A total of 255 managers and 2,097 staff responded. Eight performance measures were elicited from dialysis manager and staff responses: these were safety, operational efficiency, quality of working life, financial effectiveness, employee development, mortality, patient/employee satisfaction and patient-centred health care. These performance measures were almost compatible with those extracted in overall healthcare settings in a previous study. Internal reliability, content and construct validity of the performance measures for the dialysis setting were ensured to some extent. As a general trend, both dialysis managers and staff perceived performance measures as highly useful, especially for safety, mortality, operational efficiency and patient/employee satisfaction, but showed relatively low concerns for patient-centred health care and employee development. However, dialysis managers' usefulness perceptions were significantly higher than staff. Important guidelines for designing a holistic hospital/clinic management system were yielded. Performance measures must be balanced for outcomes and performance shaping factors (PSF); a common set of performance measures could be applied to all the healthcare settings, although performance indicators of each measure should be composed based on the application field and setting; in addition, sound causal relationships between PSF and outcome measures/indicators should be explored for further improvement. © 2017 European Dialysis and Transplant Nurses Association/European Renal Care Association.

Vitamin D Deficiency and Its Determinants in Adults: A Sample from Community-Based Settings in the United Arab Emirates

Science.gov (United States)

Eldeirawi, Kamal; Harfil, Sondos; Fakhry, Randa

2017-01-01

Background. Vitamin D deficiency (VDD) is a public health concern in adults worldwide. This study aims to explore the extent of VDD and its associated factors among adults in the United Arab Emirates (UAE). Subjects and Methods. Quantitative, cross-sectional research was used to assess VDD and its associated factors in 216 adults recruited from randomly selected community-based healthcare settings over a six-month period. Recent values of vitamin D and glycated hemoglobin (HbA1c) were abstracted from medical records, followed by interviews with participants to obtain information on factors related to VDD and other covariates and to measure their heights and weights. Results. A total of 74% of participants demonstrated VDD (vitamin D serum level ≤ 30 nmol/L). Emirati participants had higher odds of having VDD compared to non-Emiratis (OR: 2.95; 95% CI: 1.58–5.52), with also significantly increased odds of the condition appearing in older, less educated, and employed adults. Diabetes type 2 (HbA1c ≥ 6.5%), depression, and obesity were significantly associated with an increased likelihood of VDD after accounting for other covariates. Conclusion. VDD is a significant problem for UAE adults and requires attention by public health policy makers. Diabetes, obesity, and depression need to be considered when screening for vitamin D. PMID:28352281

AN INTRODUCTION TO EXPLORING LAW, DISABILITY, AND THE CHALLENGE OF EQUALITY IN CANADA AND THE UNITED STATES: PAPERS FROM THE BERKELEY SYMPOSIUM

Directory of Open Access Journals (Sweden)

Laverne Jacobs

2015-10-01

Full Text Available It brings me great pleasure to write this Introduction to Exploring Law, Disability, and the Challenge of Equality in Canada and the United States. This special collection of articles in the Windsor Yearbook of Access to Justice [WYAJ] stems from a symposium of the same name held at the Berkeley Law School at the University of California on 5 December 2014. Writing this introduction allows me to bring together my identities as a law and disability scholar, the principal organizer and convener of the Berkeley Symposium, and editor-in-chief of the WYAJ. In these roles, I have had the opportunity to engage with this set of articles and their authors in a distinct way – from the early versions of these articles through to the final peer-reviewed publications. The Berkeley Symposium is the first conference, of which we are aware, to bring together scholars and experts from both Canada and the United States to present research and exchange ideas on equality issues affecting persons with disabilities in both countries.1 Each academic was invited to write about an equality issue of their choice that is of contemporary concern to persons with disabilities, and to focus on Canada, the United States,or both, at their  option. The result is a set of articles that is simultaneously introspective and comparative.

Treatment of Obesity among Youth with Intellectual and Developmental Disabilities: An Emerging Role for Telenursing

Science.gov (United States)

Bennett, Elizabeth Anne; Kolko, Rachel; Chia, Lichun; Elliott, Jennifer Padden; Kalarchian, Melissa Ann

2018-01-01

Childhood obesity is a serious health issue, associated with medical comorbidity and psychosocial impairment that can persist into adulthood. In the United States, youth with intellectual and developmental disabilities are more likely to be obese than youth without disabilities. A large body of evidence supports the efficacy of family-based treatment of childhood obesity, including diet, physical activity, and behavior modification, but few interventions have been developed and evaluated specifically for this population. We highlight studies on treatment of obesity among youth with intellectual and developmental disabilities, including both residential/educational settings as well as outpatient/hospital settings. All interventions were delivered in-person, and further development of promising approaches and delivery via telenursing may increase access by youth and families. Nursing scientists can assume an important role in overcoming barriers to care for this vulnerable and underserved population. PMID:28349744

Does culture affect divorce? evidence from European immigrants in the United States.

Science.gov (United States)

Furtado, Delia; Marcén, Miriam; Sevilla, Almudena

2013-06-01

This article explores the role of culture in determining divorce by examining country-of-origin differences in divorce rates of immigrants in the United States. Because childhood-arriving immigrants are all exposed to a common set of U.S. laws and institutions, we interpret relationships between their divorce tendencies and home-country divorce rates as evidence of the effect of culture. Our results are robust to controlling for several home-country variables, including average church attendance and gross domestic product (GDP). Moreover, specifications with country-of-origin fixed effects suggest that immigrants from countries with low divorce rates are especially less likely to be divorced if they reside among a large number of coethnics. Supplemental analyses indicate that divorce culture has a stronger impact on the divorce decisions of females than of males, pointing to a potentially gendered nature of divorce taboos.

Need for screening for alcohol and drugs in Emergency Trauma Units

African Journals Online (AJOL)

Objectives: To examine the prevalence of alcohol and drug use and abuse, to identify socio-demographic characteristics that correlated with injury and to identify risk factors for injury in a Nigerian Trauma unit. Design: Descriptive cross sectional study. Setting: The study was carried out a general hospital trauma unit in ...

A free church perspective on military chaplains role in its historical context

Directory of Open Access Journals (Sweden)

Neil E. Allison

2016-12-01

Full Text Available The waning influence of Christianity in the United Kingdom’s armed forces since 1960 and the growing ignorance of personnel who have ties to a particular denomination, gave rise to a new assessment of the military chaplain in a modern and postmodern context. This article gives an overview of the practice during the two world wars and after the 1960s. It also gives an overview of the debate on the current role of the military chaplain, especially the beliefs of Herspring, Zahn, Coleman and McCormack, and eventually set up a role model from a Free Church perspective. It is shown that an operating model that is only defined in pastoral terms does not satisfy. The pastoral and spiritual definition, in terms of a liminal serving as an alternative, is suggested because it frees the chaplain to act more independent and also describes the best practice that has always prevailed in the British army.

Making things happen through challenging goals: leader proactivity, trust, and business-unit performance.

Science.gov (United States)

Crossley, Craig D; Cooper, Cecily D; Wernsing, Tara S

2013-05-01

Building on decades of research on the proactivity of individual performers, this study integrates research on goal setting and trust in leadership to examine manager proactivity and business unit sales performance in one of the largest sales organizations in the United States. Results of a moderated-mediation model suggest that proactive senior managers establish more challenging goals for their business units (N = 50), which in turn are associated with higher sales performance. We further found that employees' trust in the manager is a critical contingency variable that facilitates the relationship between challenging sales goals and subsequent sales performance. This research contributes to growing literatures on trust in leadership and proactivity by studying their joint effects at a district-unit level of analysis while identifying district managers' tendency to set challenging goals as a process variable that helps translate their proactivity into the collective performance of their units. PsycINFO Database Record (c) 2013 APA, all rights reserved.

A Novel Implementation Strategy in Residential Care Settings to Promote EBP: Direct Care Provider Perceptions and Development of a Conceptual Framework.

Science.gov (United States)

Slaughter, Susan E; Bampton, Erin; Erin, Daniel F; Ickert, Carla; Jones, C Allyson; Estabrooks, Carole A

2017-06-01

Innovative approaches are required to facilitate the adoption and sustainability of evidence-based care practices. We propose a novel implementation strategy, a peer reminder role, which involves offering a brief formal reminder to peers during structured unit meetings. This study aims to (a) identify healthcare aide (HCA) perceptions of a peer reminder role for HCAs, and (b) develop a conceptual framework for the role based on these perceptions. In 2013, a qualitative focus group study was conducted in five purposively sampled residential care facilities in western Canada. A convenience sample of 24 HCAs agreed to participate in five focus groups. Concurrent with data collection, two researchers coded the transcripts and identified themes by consensus. They jointly determined when saturation was achieved and took steps to optimize the trustworthiness of the findings. Five HCAs from the original focus groups commented on the resulting conceptual framework. HCAs were cautious about accepting a role that might alienate them from their co-workers. They emphasized feeling comfortable with the peer reminder role and identified circumstances that would optimize their comfort including: effective implementation strategies, perceptions of the role, role credibility and a supportive context. These intersecting themes formed a peer reminder conceptual framework. We identified HCAs' perspectives of a new peer reminder role designed specifically for them. Based on their perceptions, a conceptual framework was developed to guide the implementation of a peer reminder role for HCAs. This role may be a strategic implementation strategy to optimize the sustainability of new practices in residential care settings, and the related framework could offer guidance on how to implement this role. © 2017 Sigma Theta Tau International.

Auditory proactive interference in monkeys: the roles of stimulus set size and intertrial interval.

Science.gov (United States)

Bigelow, James; Poremba, Amy

2013-09-01

We conducted two experiments to examine the influences of stimulus set size (the number of stimuli that are used throughout the session) and intertrial interval (ITI, the elapsed time between trials) in auditory short-term memory in monkeys. We used an auditory delayed matching-to-sample task wherein the animals had to indicate whether two sounds separated by a 5-s retention interval were the same (match trials) or different (nonmatch trials). In Experiment 1, we randomly assigned stimulus set sizes of 2, 4, 8, 16, 32, 64, or 192 (trial-unique) for each session of 128 trials. Consistent with previous visual studies, overall accuracy was consistently lower when smaller stimulus set sizes were used. Further analyses revealed that these effects were primarily caused by an increase in incorrect "same" responses on nonmatch trials. In Experiment 2, we held the stimulus set size constant at four for each session and alternately set the ITI at 5, 10, or 20 s. Overall accuracy improved when the ITI was increased from 5 to 10 s, but it was the same across the 10- and 20-s conditions. As in Experiment 1, the overall decrease in accuracy during the 5-s condition was caused by a greater number of false "match" responses on nonmatch trials. Taken together, Experiments 1 and 2 showed that auditory short-term memory in monkeys is highly susceptible to proactive interference caused by stimulus repetition. Additional analyses of the data from Experiment 1 suggested that monkeys may make same-different judgments on the basis of a familiarity criterion that is adjusted by error-related feedback.

Technical specifications: Seabrook Station, Unit 1 (Docket No. 50-443)

International Nuclear Information System (INIS)

1990-03-01

The Seabrook Station, Unit 1 Technical Specifications were prepared by the US Nuclear Regulatory Commission to set forth the limits, operating conditions, and other requirements applicable to a nuclear reactor facility as set forth in Section 50.36 of 10 CFR Part 50 for the protection of the health and safety of the public

Nature or Nurture? Gender Roles Scavenger Hunt

Science.gov (United States)

Whalen, Shannon; Maurer-Starks, Suanne

2008-01-01

The examination of gender roles and stereotypes and their subsequent impact on sexual behavior is a concept for discussion in many sex education courses in college and sex education units in high school. This analysis often leads to a discussion of the impact of nature vs. nurture on gender roles. The gender roles scavenger hunt is an interactive…

The role of therapeutic optimism in recruitment to a clinical trial in a peripartum setting: balancing hope and uncertainty.

Science.gov (United States)

Hallowell, Nina; Snowdon, Claire; Morrow, Susan; Norman, Jane E; Denison, Fiona C; Lawton, Julia

2016-06-01

Hope has therapeutic value because it enables people to cope with uncertainty about their future health. Indeed, hope, or therapeutic optimism (TO), is seen as an essential aspect of the provision and experience of medical care. The role of TO in clinical research has been briefly discussed, but the concept, and whether it can be transferred from care to research and from patients to clinicians, has not been fully investigated. The role played by TO in research emerged during interviews with staff involved in a peripartum trial. This paper unpacks the concept of TO in this setting and considers the role it may play in the wider delivery of clinical trials. The Got-it trial is a UK-based, randomised placebo-controlled trial that investigates the use of sublingual glyceryl trinitrate (GTN) spray to treat retained placenta. Qualitative data were collected in open-ended interviews with obstetricians, research and clinical midwives (n =27) involved in trial recruitment. Data were analysed using the method of constant comparison. TO influenced staff engagement with Got-it at different points in the trial and in different ways. Prior knowledge of, and familiarity with, GTN meant that from the outset staff perceived the trial as low risk. TO facilitated staff involvement in the trial; staff who already understood GTN's effects were optimistic that it would work, and staff collaborated because they hoped that the trial would address what they identified as an important clinical need. TO could fluctuate over the course of the trial, and was sustained or undermined by unofficial observation of clinical outcomes and speculations about treatment allocation. Thus, TO appeared to be influenced by key situational factors: prior knowledge and experience, clinical need and observed participant outcomes. Situational TO plays a role in facilitating staff engagement with clinical research. TO may affect trial recruitment by enabling staff to sustain the levels of uncertainty, or

Midwives' experiences of facilitating normal birth in an obstetric-led unit: a feminist perspective.

LENUS (Irish Health Repository)

Keating, Annette

2012-01-31

OBJECTIVE: to explore midwives\\' experiences of facilitating normal birth in an obstetric-led unit. DESIGN: a feminist approach using semi-structured interviews focusing on midwives\\' perceptions of normal birth and their ability to facilitate this birth option in an obstetric-led unit. SETTING: Ireland. PARTICIPATION: a purposeful sample of 10 midwives with 6-30 years of midwifery experience. All participants had worked for a minimum of 6 years in a labour ward setting, and had been in their current setting for the previous 2 years. FINDINGS: the midwives\\' narratives related to the following four concepts of patriarchy: \\'hierarchical thinking\\

Interval Neutrosophic Sets and Their Application in Multicriteria Decision Making Problems

Directory of Open Access Journals (Sweden)

Hong-yu Zhang

2014-01-01

Full Text Available As a generalization of fuzzy sets and intuitionistic fuzzy sets, neutrosophic sets have been developed to represent uncertain, imprecise, incomplete, and inconsistent information existing in the real world. And interval neutrosophic sets (INSs have been proposed exactly to address issues with a set of numbers in the real unit interval, not just a specific number. However, there are fewer reliable operations for INSs, as well as the INS aggregation operators and decision making method. For this purpose, the operations for INSs are defined and a comparison approach is put forward based on the related research of interval valued intuitionistic fuzzy sets (IVIFSs in this paper. On the basis of the operations and comparison approach, two interval neutrosophic number aggregation operators are developed. Then, a method for multicriteria decision making problems is explored applying the aggregation operators. In addition, an example is provided to illustrate the application of the proposed method.

Management of encopresis in early adolescence in a medical-psychiatric unit.

Science.gov (United States)

Fennig, S; Fennig, S

1999-01-01

The aim of this work is to present the role of a medical-psychiatric unit in the treatment of chronic resistant encopresis in adolescence as an effective alternative to the standard approach. Four case reports are presented. The integrative program is based on full patient cooperation and involves separating the patient from the family environment and the use of medical intervention combined with modified behavioral therapy and parental education and guidance. The patient is given full responsibility for the cure. The median full hospital stay for our patients was 2 weeks, and outcome in all cases was complete remission. This experience suggests that chronic resistant encopresis in adolescents requires a different approach from the standard because of the patient's developmental stage and the often hostile family dynamics. A medical-psychiatric setting provides an excellent management milieu and can lead to a dramatic improvement in this chronic disabling condition.

Eleanor Roosevelt, the United Nations and the Role of Radio Communications

NARCIS (Netherlands)

Luscombe, Anya

Eleanor Roosevelt communicated with the public through a variety of media, both before, during and following her time in the White House. In 1946 she became part of the US delegation to the newly formed United Nations and she used newspaper columns, speeches and radio broadcasts to converse with

The role of Health Impact Assessment in the setting of air quality standards: An Australian perspective

Energy Technology Data Exchange (ETDEWEB)

Spickett, Jeffery, E-mail: J.Spickett@curtin.edu.au [WHO Collaborating Centre for Environmental Health Impact Assessment (Australia); Faculty of Health Sciences, School of Public Health, Curtin University, Perth, Western Australia (Australia); Katscherian, Dianne [WHO Collaborating Centre for Environmental Health Impact Assessment (Australia); Faculty of Health Sciences, School of Public Health, Curtin University, Perth, Western Australia (Australia); Harris, Patrick [CHETRE — UNSW Research Centre for Primary Health Care and Equity, University of New South Wales (Australia)

2013-11-15

The approaches used for setting or reviewing air quality standards vary from country to country. The purpose of this research was to consider the potential to improve decision-making through integration of HIA into the processes to review and set air quality standards used in Australia. To assess the value of HIA in this policy process, its strengths and weaknesses were evaluated aligned with review of international processes for setting air quality standards. Air quality standard setting programmes elsewhere have either used HIA or have amalgamated and incorporated factors normally found within HIA frameworks. They clearly demonstrate the value of a formalised HIA process for setting air quality standards in Australia. The following elements should be taken into consideration when using HIA in standard setting. (a) The adequacy of a mainly technical approach in current standard setting procedures to consider social determinants of health. (b) The importance of risk assessment criteria and information within the HIA process. The assessment of risk should consider equity, the distribution of variations in air quality in different locations and the potential impacts on health. (c) The uncertainties in extrapolating evidence from one population to another or to subpopulations, especially the more vulnerable, due to differing environmental factors and population variables. (d) The significance of communication with all potential stakeholders on issues associated with the management of air quality. In Australia there is also an opportunity for HIA to be used in conjunction with the NEPM to develop local air quality standard measures. The outcomes of this research indicated that the use of HIA for air quality standard setting at the national and local levels would prove advantageous. -- Highlights: • Health Impact Assessment framework has been applied to a policy development process. • HIA process was evaluated for application in air quality standard setting. �

Supervisors' pedagogical role at a clinical education ward - an ethnographic study.

Science.gov (United States)

Manninen, Katri; Henriksson, Elisabet Welin; Scheja, Max; Silén, Charlotte

2015-01-01

Clinical practice is essential for health care students. The supervisor's role and how supervision should be organized are challenging issues for educators and clinicians. Clinical education wards have been established to meet these challenges and they are units with a pedagogical framework facilitating students' training in real clinical settings. Supervisors support students to link together theoretical and practical knowledge and skills. From students' perspectives, clinical education wards have shown potential to enhance students' learning. Thus there is a need for deeper understanding of supervisors' pedagogical role in this context. We explored supervisors' approaches to students' learning at a clinical education ward where students are encouraged to independently take care of patients. An ethnographic approach was used to study encounters between patients, students and supervisors. The setting was a clinical education ward for nursing students at a university hospital. Ten observations with ten patients, 11 students and five supervisors were included in the study. After each observation, individual follow-up interviews with all participants and a group interview with supervisors were conducted. Data were analysed using an ethnographic approach. Supervisors' pedagogical role has to do with balancing patient care and student learning. The students were given independence, which created pedagogical challenges for the supervisors. They handled these challenges by collaborating as a supervisory team and taking different acts of supervision such as allowing students their independence, being there for students and by applying patient-centredness. The supervisors' pedagogical role was perceived as to facilitate students' learning as a team. Supervisors were both patient- and student-centred by making a nursing care plan for the patients and a learning plan for the students. The plans were guided by clinical and pedagogical guidelines, individually adjusted and

The role of the hospice social worker in the nursing home setting.

Science.gov (United States)

Amar, D F

1994-01-01

Data and case examples from two major metropolitan hospice programs are examined in order to arrive at a definition of the hospice social worker's role in the nursing home, and how it differs from that of the hospice social worker in home care. The nursing home population tends to be older, frailer, and with poorer mental status, making them less available to "talk therapies". The nursing home environment itself needs to be assessed as a significant part of the patient/family system. Social work interventions may focus on the patient, the family, the nursing home staff, or any combination of these elements. The hospice social worker on a nursing home team may do less counseling with patients, but the role draws on diverse other skills such as groupwork, negotiation, education, and advocacy.

[Work quota setting and man-hour productivity estimation in pathologists].

Science.gov (United States)

Svistunov, V V; Makarov, S V; Makarova, A E

The paper considers the development and current state of the regulation of work quota setting and remuneration in pathologists. Reasoning from the current staff standards for morbid anatomy departments (units), the authors present a method to calculate the load of pathologists. The essence of the proposed method is demonstrated using a specific example.

Computing half-plane and strip discrepancy of planar point sets

NARCIS (Netherlands)

Berg, de M.

1996-01-01

We present efficient algorithms for two problems concerning the discrepancy of a set S of n points in the unit square in the plane. First, we describe an algorithm for maintaining the half-plane discrepancy of S under insertions and deletions of points. The algorithm runs in O(nlogn) worst-case time

The intersection between cannabis and cancer in the United States.

Science.gov (United States)

Bowles, Daniel W; O'Bryant, Cindy L; Camidge, D Ross; Jimeno, Antonio

2012-07-01

In the last 15 years there has been a major shift in the laws governing medical use of cannabis in the United States. Corresponding with this change there has been escalating interest in the role that cannabis, commonly referred to as marijuana, and cannabinoids play in the care of patients with cancer. This review will examine cannabis' and cannabinoids' current and potential roles in cancer care. Specifically, we will examine five areas of cannabis medicine: (1) pharmacologic properties of cannabis; (2) its potential role in the development of human cancers, particularly smoking-related malignancies; (3) cannabinoids' potential as anti-cancer therapies; (4) cannabis and cannabinoids in the palliation of common cancer-associated symptoms; (5) current legal status of cannabis for medical purposes in the United States. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

Role of the urate transporter SLC2A9 gene in susceptibility to gout in New Zealand Māori, Pacific Island, and Caucasian case-control sample sets.

Science.gov (United States)

Hollis-Moffatt, Jade E; Xu, Xin; Dalbeth, Nicola; Merriman, Marilyn E; Topless, Ruth; Waddell, Chloe; Gow, Peter J; Harrison, Andrew A; Highton, John; Jones, Peter B B; Stamp, Lisa K; Merriman, Tony R

2009-11-01

To examine the role of genetic variation in the renal urate transporter SLC2A9 in gout in New Zealand sample sets of Māori, Pacific Island, and Caucasian ancestry and to determine if the Māori and Pacific Island samples could be useful for fine-mapping. Patients (n= 56 Māori, 69 Pacific Island, and 131 Caucasian) were recruited from rheumatology outpatient clinics and satisfied the American College of Rheumatology criteria for gout. The control samples comprised 125 Māori subjects, 41 Pacific Island subjects, and 568 Caucasian subjects without arthritis. SLC2A9 single-nucleotide polymorphisms rs16890979 (V253I), rs5028843, rs11942223, and rs12510549 were genotyped (possible etiologic variants in Caucasians). Association of the major allele of rs16890979, rs11942223, and rs5028843 with gout was observed in all sample sets (P = 3.7 x 10(-7), 1.6 x 10(-6), and 7.6 x 10(-5) for rs11942223 in the Māori, Pacific Island, and Caucasian samples, respectively). One 4-marker haplotype (1/1/2/1; more prevalent in the Māori and Pacific Island control samples) was not observed in a single gout case. Our data confirm a role of SLC2A9 in gout susceptibility in a New Zealand Caucasian sample set, with the effect on risk (odds ratio >2.0) greater than previous estimates. We also demonstrate association of SLC2A9 with gout in samples of Māori and Pacific Island ancestry and a consistent pattern of haplotype association. The presence of both alleles of rs16890979 on susceptibility and protective haplotypes in the Māori and Pacific Island sample is evidence against a role for this nonsynonymous variant as the sole etiologic agent. More extensive linkage disequilibrium in Māori and Pacific Island samples suggests that Caucasian samples may be more useful for fine-mapping.

A High-Performance Parallel FDTD Method Enhanced by Using SSE Instruction Set

Directory of Open Access Journals (Sweden)

Dau-Chyrh Chang

2012-01-01

Full Text Available We introduce a hardware acceleration technique for the parallel finite difference time domain (FDTD method using the SSE (streaming (single instruction multiple data SIMD extensions instruction set. The implementation of SSE instruction set to parallel FDTD method has achieved the significant improvement on the simulation performance. The benchmarks of the SSE acceleration on both the multi-CPU workstation and computer cluster have demonstrated the advantages of (vector arithmetic logic unit VALU acceleration over GPU acceleration. Several engineering applications are employed to demonstrate the performance of parallel FDTD method enhanced by SSE instruction set.

Testing the Birth Unit Design Spatial Evaluation Tool (BUDSET) in Australia: a pilot study.

Science.gov (United States)

Foureur, Maralyn J; Leap, Nicky; Davis, Deborah L; Forbes, Ian F; Homer, Caroline E S

2011-01-01

To pilot test the Birth Unit Design Spatial Evaluation Tool (BUDSET) in an Australian maternity care setting to determine whether such an instrument can measure the optimality of different birth settings. Optimally designed spaces to give birth are likely to influence a woman's ability to experience physiologically normal labor and birth. This is important in the current industrialized environment, where increased caesarean section rates are causing concerns. The measurement of an optimal birth space is currently impossible, because there are limited tools available. A quantitative study was undertaken to pilot test the discriminant ability of the BUDSET in eight maternity units in New South Wales, Australia. Five auditors trained in the use of the BUDSET assessed the birth units using the BUDSET, which is based on 18 design principles and is divided into four domains (Fear Cascade, Facility, Aesthetics, and Support) with three to eight assessable items in each. Data were independently collected in eight birth units. Values for each of the domains were aggregated to provide an overall Optimality Score for each birth unit. A range of Optimality Scores was derived for each of the birth units (from 51 to 77 out of a possible 100 points). The BUDSET identified units with low-scoring domains. Essentially these were older units and conventional labor ward settings. The BUDSET provides a way to assess the optimality of birth units and determine which domain areas may need improvement. There is potential for improvements to existing birth spaces, and considerable improvement can be made with simple low-cost modifications. Further research is needed to validate the tool.

UpSet: Visualization of Intersecting Sets

Science.gov (United States)

Lex, Alexander; Gehlenborg, Nils; Strobelt, Hendrik; Vuillemot, Romain; Pfister, Hanspeter

2016-01-01

Understanding relationships between sets is an important analysis task that has received widespread attention in the visualization community. The major challenge in this context is the combinatorial explosion of the number of set intersections if the number of sets exceeds a trivial threshold. In this paper we introduce UpSet, a novel visualization technique for the quantitative analysis of sets, their intersections, and aggregates of intersections. UpSet is focused on creating task-driven aggregates, communicating the size and properties of aggregates and intersections, and a duality between the visualization of the elements in a dataset and their set membership. UpSet visualizes set intersections in a matrix layout and introduces aggregates based on groupings and queries. The matrix layout enables the effective representation of associated data, such as the number of elements in the aggregates and intersections, as well as additional summary statistics derived from subset or element attributes. Sorting according to various measures enables a task-driven analysis of relevant intersections and aggregates. The elements represented in the sets and their associated attributes are visualized in a separate view. Queries based on containment in specific intersections, aggregates or driven by attribute filters are propagated between both views. We also introduce several advanced visual encodings and interaction methods to overcome the problems of varying scales and to address scalability. UpSet is web-based and open source. We demonstrate its general utility in multiple use cases from various domains. PMID:26356912

Inching toward incrementalism: federalism, devolution, and health policy in the United States and the United Kingdom.

Science.gov (United States)

Sparer, Michael S; France, George; Clinton, Chelsea

2011-02-01

In the United States, the recently enacted Patient Protection and Affordable Care Act of 2010 envisions a significant increase in federal oversight over the nation's health care system. At the same time, however, the legislation requires the states to play key roles in every aspect of the reform agenda (such as expanding Medicaid programs, creating insurance exchanges, and working with providers on delivery system reforms). The complicated intergovernmental partnerships that govern the nation's fragmented and decentralized system are likely to continue, albeit with greater federal oversight and control. But what about intergovernmental relations in the United Kingdom? What impact did the formal devolution of power in 1999 to Scotland, Wales, and Northern Ireland have on health policy in those nations, and in the United Kingdom more generally? Has devolution begun a political process in which health policy in the United Kingdom will, over time, become increasingly decentralized and fragmented, or will this "state of unions" retain its long-standing reputation as perhaps the most centralized of the European nations? In this article, we explore the federalist and intergovernmental implications of recent reforms in the United States and the United Kingdom, and we put forward the argument that political fragmentation (long-standing in the United States and just emerging in the United Kingdom) produces new intergovernmental partnerships that, in turn, produce incremental growth in overall government involvement in the health care arena. This is the impact of what can be called catalytic federalism.

An exploration of risk for recurrent falls in two geriatric care settings

Science.gov (United States)

2013-01-01

Background Fall events were examined in two distinct geriatric populations to identify factors associated with repeat fallers, and to examine whether patients who use gait aids, specifically a walker, were more likely to experience repeat falls. Each unit already had a generic program for falls prevention in place. Methods Secondary data analysis was conducted on information collected during the pilot testing of a new quality assurance Incident Reporting Tool between October 2006 and September 2008. The study settings included an in-patient geriatric rehabilitation unit (GRU) and a long stay veterans’ unit (LSVU) in a rehabilitation and long-stay hospital in Ontario. Participants were two hundred and twenty three individuals, aged 65 years or older on these two units, who experienced one or more fall incidents during the study period. Results Logistic regression analyses showed that on the GRU age was significantly associated with repeat falls. On the LSVU first falls in the morning or late evening were associated with repeat falling. Walker as a gait aid listed at time of first fall was not associated with repeat falls. Conclusions This study suggests that different intervention may be necessary in different geriatric settings to identify, for secondary prevention, certain individuals for which the generic programs prove inadequate. Information collection with a specific focus on the issue of repeat falls may be necessary for greater insight. PMID:24106879

Managing Forest Conflicts: Perspectives of Indonesia’s Forest Management Unit Directors

Directory of Open Access Journals (Sweden)

Larry A. Fisher

2017-04-01

Full Text Available Recent expansion of the forestry and plantation sectors in Indonesia has intensified agrarian and natural resource conflicts, and created increased awareness of the social, economic and environmental impacts of these disputes. Addressing these disputes is a critical issue in advancing Indonesia’s commitment to sustainable forest management. The Forest Management Units (Kesatuan Pengelolaan Hutan, or KPH, have become the pivotal structural element for managing all state forests at the local level, with responsibility for conventional forest management and policy implementation (establishing management boundaries, conducting forest inventory, and developing forest management plans, as well as the legal mandate to communicate and work with indigenous people and local communities. This paper presents the results of a national survey of all currently functioning KPH units, the first of its kind ever conducted with KPH leadership, to obtain a system-wide perspective of the KPHs’ role, mandate, and capacity for serving as effective intermediaries in managing forest conflicts in Indonesia. The survey results show that the KPHs are still in a very initial stage of development, and are struggling with a complex and rapidly evolving policy and institutional framework. The most common conflicts noted by respondents included forest encroachment, tenure disputes, boundary conflicts, and illegal logging and land clearing. KPH leadership views conflict resolution as among their primary duties and functions, and underscored the importance of more proactive and collaborative approaches for addressing conflict, many seeing themselves as capable facilitators and mediators. Overall, these results juxtapose a generally constructive view by KPH leadership over their role and responsibility in addressing forest management conflicts, with an extremely challenging social, institutional, and political setting. The KPHs can certainly play an important role as local

New set of Chemical Safety rules

CERN Multimedia

HSE Unit

2011-01-01

A new set of four Safety Rules was issued on 28 March 2011: Safety Regulation SR-C ver. 2, Chemical Agents (en); General Safety Instruction GSI-C1, Prevention and Protection Measures (en); General Safety Instruction GSI-C2, Explosive Atmospheres (en); General Safety Instruction GSI-C3, Monitoring of Exposure to Hazardous Chemical Agents in Workplace Atmospheres (en). These documents form part of the CERN Safety Rules and are issued in application of the “Staff Rules and Regulations” and of document SAPOCO 42. These documents set out the minimum requirements for the protection of persons from risks to their occupational safety and health arising, or likely to arise, from the effects of hazardous chemical agents that are present in the workplace or used in any CERN activity. Simultaneously, the HSE Unit has published seven Safety Guidelines and six Safety Forms. These documents are available from the dedicated Web page “Chemical, Cryogenic and Biological Safety&...

[Continuing training plan in a clinical management unit].

Science.gov (United States)

Gamboa Antiñolo, Fernando Miguel; Bayol Serradilla, Elia; Gómez Camacho, Eduardo

2011-01-01

Continuing Care Unit (UCA) focused the attention of frail patients, polypathological patients and palliative care. UCA attend patients at home, consulting, day unit, telephone consulting and in two hospitals of the health area. From 2002 UCA began as a management unit, training has been a priority for development. Key elements include: providing education to the workplace, including key aspects of the most prevalent health care problems in daily work, directing training to all staff including organizational aspects of patient safety and the environment, improved working environment, development of new skills and knowledge supported by the evidence-based care for the development of different skills. The unit can be the ideal setting to undertake the reforms necessary conceptual training of professionals to improve the quality of care. 2010 SESPAS. Published by Elsevier Espana. All rights reserved.

Data resource profile: United Nations Children's Fund (UNICEF).

Science.gov (United States)

Murray, Colleen; Newby, Holly

2012-12-01

The United Nations Children's Fund (UNICEF) plays a leading role in the collection, compilation, analysis and dissemination of data to inform sound policies, legislation and programmes for promoting children's rights and well-being, and for global monitoring of progress towards the Millennium Development Goals. UNICEF maintains a set of global databases representing nearly 200 countries and covering the areas of child mortality, child health, maternal health, nutrition, immunization, water and sanitation, HIV/AIDS, education and child protection. These databases consist of internationally comparable and statistically sound data, and are updated annually through a process that draws on a wealth of data provided by UNICEF's wide network of >150 field offices. The databases are composed primarily of estimates from household surveys, with data from censuses, administrative records, vital registration systems and statistical models contributing to some key indicators as well. The data are assessed for quality based on a set of objective criteria to ensure that only the most reliable nationally representative information is included. For most indicators, data are available at the global, regional and national levels, plus sub-national disaggregation by sex, urban/rural residence and household wealth. The global databases are featured in UNICEF's flagship publications, inter-agency reports, including the Secretary General's Millennium Development Goals Report and Countdown to 2015, sector-specific reports and statistical country profiles. They are also publicly available on www.childinfo.org, together with trend data and equity analyses.

The role of surgery in global health: analysis of United States inpatient procedure frequency by condition using the Global Burden of Disease 2010 framework.

Directory of Open Access Journals (Sweden)

John Rose

Full Text Available The role of surgical care in promoting global health is the subject of much debate. The Global Burden of Disease 2010 study (GBD 2010 offers a new opportunity to consider where surgery fits amongst global health priorities. The GBD 2010 reinforces the DALY as the preferred methodology for determining the relative contribution of disease categories to overall global burden of disease without reference to the likelihood of each category requiring surgery. As such, we hypothesize that the GBD framework underestimates the role of surgery in addressing the global burden of disease.We compiled International Classification of Diseases, Version 9, codes from the United States Nationwide Inpatient Sample from 2010. Using the primary diagnosis code for each hospital admission, we aggregated admissions into GBD 2010 disease sub-categories. We queried each hospitalization for a major operation to determine the frequency of admitted patients whose care required surgery. Major operation was defined according to the Agency for Healthcare Research and Quality (AHRQ. In 2010, 10 million major inpatient operations were performed in the United States, associated with 28.6% of all admissions. Major operations were performed in every GBD disease subcategory (range 0.2%-84.0%. The highest frequencies of operation were in the subcategories of Musculoskeletal (84.0%, Neoplasm (61.4%, and Transport Injuries (43.2%. There was no disease subcategory that always required an operation; nor was there any disease subcategory that never required an operation.Surgical care cuts across the entire spectrum of GBD disease categories, challenging dichotomous traditional classifications of 'surgical' versus 'nonsurgical' diseases. Current methods of measuring global burden of disease do not reflect the fundamental role operative intervention plays in the delivery of healthcare services. Novel methodologies should be aimed at understanding the integration of surgical services into

Data acquisition for a patient-directed intervention protocol in the dynamic intensive care unit setting.

Science.gov (United States)

Chlan, Linda; Patterson, Robert P; Heiderscheit, Annie

2011-07-01

Methods to easily, accurately, and efficiently obtain data in an ICU-based clinical trial can be challenging in this high-tech setting. Patient medical status and the dynamic nature of this clinical setting further complicate data collection. The purpose of this paper is to describe the modifications of commercially available headphones and the application of a data logging device to capture frequency and length of protocol use (music listening or headphones only for noise cancellation) without burdening participants or busy ICU nurses. With the automatic capture of protocol use by research participants, there have been no instances of lost data for this clinical trial. Copyright © 2011 Elsevier Inc. All rights reserved.

Tomography system having an ultrahigh-speed processing unit

International Nuclear Information System (INIS)

Brunnett, C.J.; Gerth, V.W. Jr.

1977-01-01

A transverse section tomography system has an ultrahigh-speed data processing unit for performing back projection and updating. An x-ray scanner directs x-ray beams through a planar section of a subject from a sequence of orientations and positions. The data processing unit includes a scan storage section for retrievably storing a set of filtered scan signals in scan storage locations corresponding to predetermined beam orientations. An array storage section is provided for storing image signals as they are generated

The Role of the Company Officer at the United States Naval Academy

National Research Council Canada - National Science Library

Moxey, Tyrel

2001-01-01

... contributing or not contributing to the mission of the United States Naval Academy. The author conducted 30 questionnaires on the 30 Company Officers stationed at the Naval Academy during this period...

Computerised cardio- tocography in a high-risk unit in a developing ...

African Journals Online (AJOL)

To determine the role of computer-assisted cardiotocography in an obstetric special care unit and its ... standard and computer-assisted cardiotocographs. Main outcome measures. The influence of method of ... obstetric high-risk unit. Among the major reported advantages of this system, the Sonicaid System 8000, are.

Managing a work-life balance: the experiences of midwives working in a group practice setting.