Comparison of dynamic balance in adolescent male soccer players from rwanda and the United States.

PURPOSE/BACKGROUND: Dynamic balance is an important component of motor skill development. Poor dynamic balance has previously been associated with sport related injury. However, the vast majority of dynamic balance studies as they relate to sport injury have occurred in developed North American or European countries. Thus, the purpose of this study was to compare dynamic balance in adolescent male soccer players from Rwanda to a matched group from the United States. METHODS: Twenty-six adolescent male soccer players from Rwanda and 26 age- and gender-matched control subjects from the United States were screened using the Lower Quarter Y Balance Test during their pre-participation physical. Reach asymmetry (cm) between limbs was examined for all reach directions. In addition, reach distance in each direction (normalized to limb length, %LL) and the composite reach score (also normalized to %LL) were examined. Dependent samples t-tests were performed with significant differences identified at p<0.05. RESULTS: Twenty-six male soccer players from Rwanda (R) were matched to twenty-six male soccer players from the United States (US). The Rwandan soccer players performed better in the anterior (R: 83.9 ± 3.2 %LL; US: 76.5 ± 6.6 %LL, p<0.01), posterolateral (R: 114.4 ± 8.3 %LL ; US: 106.5 ± 8.2 %LL, p<0.01) and composite (R: 105.6 ± 1.3 %LL; US: 97.8 ± 6.2 %LL, p<0.01) reach scores. No significant differences between groups were observed for reach asymmetry. CONCLUSIONS: Adolescent soccer players from Rwanda exhibit superior performance on a standardized dynamic balance test as comparison to similar athletes from the United States. The examination of movement abilities of athletes from countries of various origins may allow for a greater understanding of the range of true normative values for dynamic balance. LEVELS OF EVIDENCE: 3b.

Characteristics of primary care office visits to nurse practitioners, physician assistants and physicians in United States Veterans Health Administration facilities, 2005 to 2010: a retrospective cross-sectional analysis.

UNLABELLED: BACKGROUND: Primary care, an essential determinant of health system equity, efficiency, and effectiveness, is threatened by inadequate supply and distribution of the provider workforce. The Veterans Health Administration (VHA) has been a frontrunner in the use of nurse practitioners (NPs) and physician assistants (PAs). Evaluation of the roles and impact of NPs and PAs in the VHA is critical to ensuring optimal care for veterans and may inform best practices for use of PAs and NPs in other settings around the world. The purpose of this study was to characterize the use of NPs and PAs in VHA primary care and to examine whether their patients and patient care activities were, on average, less medically complex than those of physicians. METHODS: This is a retrospective cross-sectional analysis of administrative data from VHA primary care encounters between 2005 and 2010. Patient and patient encounter characteristics were compared across provider types (PA, NP, and physician). RESULTS: NPs and PAs attend about 30% of all VHA primary care encounters. NPs, PAs, and physicians fill similar roles in VHA primary care, but patients of PAs and NPs are slightly less complex than those of physicians, and PAs attend a higher proportion of visits for the purpose of determining eligibility for benefits. CONCLUSIONS: This study demonstrates that a highly successful nationwide primary care system relies on NPs and PAs to provide over one quarter of primary care visits, and that these visits are similar to those of physicians with regard to patient and encounter characteristics. These findings can inform health workforce solutions to physician shortages in the USA and around the world. Future research should compare the quality and costs associated with various combinations of providers and allocations of patient care work, and should elucidate the approaches that maximize quality and efficiency.

The Irish hospitals sweepstake in the United States of America, 1930-1939

The Irish hospitals sweepstake was established by statute in the Irish Free State in 1930 to fund the state’s hospital service. The vast majority of tickets were sold outside Ireland, particularly in countries where such gambling was illegal at the time. Initially the largest market was in the United Kingdom, but following the introduction of restrictive legislation there in 1934, the promoters of the sweepstake turned their attentions to North America and after 1936 the United States became the largest source of contributions to the Irish sweep. This article examines a number of factors concerning the relationship of the Irish sweep with the USA, including: an effort to estimate the amount of money contributed to the sweep by Americans; the role of the Irish diaspora and of prominent republicans, including Joseph McGarrity and Connie Neenan, in the illegal ticket distribution network; the efforts of American Federal agencies and government departments to disrupt the sweepstake organisation in America; how the sweep was used by those who sought to legalise gambling in the USA; the attitudes of both the Irish and American governments to the sweep’s activities in America; and how the legalisation of gambling in America brought about the demise of the Irish sweep.

Biological influence on the morphology and micromorphology of selected Podzols (Spodosols) and Cambisols (Inceptisols) from the Eastern United States and Northeast Scotland

Biological activities greatly influence the formation of many soils, especially forest soils under cool humid climates. The objective of this study was to investigate the effects of vegetation and soil biota on the formation of selected soils. Field morphology, micromorphology, and carbon and organic matter analysis were determined on six Podzols (Spodosols) and two Cambisols (Inceptisols) from the eastern United States and north-east Scotland. Humification of plant material by soil fauna and fungi occurs in all organic horizons. Thick organic coatings are observed on soil peds and rock fragments from the E1 to the Bs horizon in a Haplic Podzol from Clingmans Dome Mt., TN. Thin sections reveal large accumulations of root material in different stages of decomposition in the spodic horizons of a Haplic Podzol from Whiteface Mt., NY. Organic carbon ranges from 5.4 to 8.5% in the spodic B horizons of the Whiteface Mt. Podzol. Earthworms and enchytraeids have a great effect on the structure of the surface and subsurface horizons in the Dystric Cambisols from Huntly and Clashindarroch Forests, Scotland and a Cambic Podzol from the Corrie Burn Basin, Scotland. Podzols from Speymouth Forest, Scotland (Gleyic Podzol), Cling-mans Dome Mt., and Whiteface Mt. have thick organic horizons. The Podzols from the Flatwoods in Georgia, the Pine Barrens in New Jersey, the Corrie Burn Basin, and the Cambisol from Huntly Forest have only A horizons at the surface. The Clashindarroch Forest soil has a very thin organic horizon. Warm and humid climates and sandy parent material are responsible for thick E horizons and lack of thick organic horizons in the Flatwoods (Carbic Podzol) and Pine Barrens (Ferric Podzol) soils. Earthworms and enchytraeids thrive in the Corrie Burn Basin and Huntly Forest soils due to the vegetation and the highly weathered basic parent material. The site at Clashindarroch once carried oak, and then birch forest, both of which produce a mild litter and also encourage earthworm and enchytraeids. This fauna is responsible for much mixing of the topsoil. The present conifer vegetation will eventually produce a deep litter and cause podzolization.

An evaluation of an adapted United States model of pharmaceutical care to improve psychoactive prescribing for nursing home residents in Northern Ireland (Fleetwood NI Study).

OBJECTIVES: To test the effect of an adapted U.S. model of pharmaceutical care on prescribing of inappropriate psychoactive (anxiolytic, hypnotic, and antipsychotic) medications and falls in nursing homes for older people in Northern Ireland (NI).

DESIGN: Cluster randomized controlled trial.

SETTING: Nursing homes randomized to intervention (receipt of the adapted model of care; n=11) or control (usual care continued; n=11).

PARTICIPANTS: Residents aged 65 and older who provided informed consent (N=334; 173 intervention, 161 control).

INTERVENTION: Specially trained pharmacists visited intervention homes monthly for 12 months and reviewed residents' clinical and prescribing information, applied an algorithm that guided them in assessing the appropriateness of psychoactive medication, and worked with prescribers (general practitioners) to improve the prescribing of these drugs. The control homes received usual care.

MEASUREMENTS: The primary end point was the proportion of residents prescribed one or more inappropriate psychoactive medicine according to standardized protocols; falls were evaluated using routinely collected falls data mandated by the regulatory body for nursing homes in NI.

RESULTS: The proportion of residents taking inappropriate psychoactive medications at 12 months in the intervention homes (25/128, 19.5%) was much lower than in the control homes (62/124, 50.0%) (odds ratio=0.26, 95% confidence interval=0.14–0.49) after adjustment for clustering within homes. No differences were observed at 12 months in the falls rate between the intervention and control groups.

CONCLUSION: Marked reductions in inappropriate psychoactive medication prescribing in residents resulted from pharmacist review of targeted medications, but there was no effect on falls.

Promoting while checking self-interest : a conflict-based governance approach to rebalance corporate power disequilibria in Canada and the United States

La délégation du pouvoir de gestion aux administrateurs et aux gestionnaires, une caractéristique intrinsèque à la gestion efficace de grandes entreprises dans un contexte de capitalisme, confère une grande discrétion à l’équipe de direction. Cette discrétion, si elle n’est pas surveillée, peut mener à des comportements opportunistes envers la corporation, les actionnaires et les autres fournisseurs de capital qui n’ont pas de pouvoir de gestion. Les conflits entre ces deux classes d’agents peuvent émerger à la fois de décisions de gouvernance générale ou de transactions particulières (ie. offre publique d’achat). Dans les cas extrêmes, ces conflits peuvent mener à la faillite de la firme. Dans les cas plus typiques, ils mènent l’extraction de bénéfices privés pour les administrateurs et gestionnaires, l’expropriation des actionnaires, et des réductions de valeur pour la firme. Nous prenons le point de vue d’un petit actionnaire minoritaire pour explorer les méchanismes de gouvernance disponibles au Canada et aux États‐Unis. Après une synthèse dans la Partie 1 des théories sous‐jacentes à l’étude du pouvoir dans la corporation (séparation de la propriété et du contrôle et les conflits d’agence), nous concentrons notre analyse dans la Partie 2 sur les différents types de méchanismes (1) de gouvernance interne, (2) juridiques et (3) marchands, qui confèrent du pouvoir aux deux classes d’agents. Nous examinons comment les intérêts de ces deux classes peuvent être réalignés afin de prévenir et résoudre les conflits au sein de la firme. La Partie 3 explore un équilibre dynamique de pouvoir corporatif qui cherche à minimiser le potentiel d’opportunisme toute en préservant une quantité de discrétion suffisante pour la gestion efficace de la firme. Nous analysons des moyens pour renforcer les protections des actionnaires minoritaires et proposons un survol des pistes de réforme possibles.

The status and barriers to the implementation and continuation of the school gardening projects in Germany, Nigeria and the United States of America

In drawing a conclusion for this study, care must be taken in generalizing findings since the population of students and teachers investigated were limited to certain levels in the different schools and countries. This study recognized some complexity of the factors underlying the status of school gardening instruction and activities in Germany, Nigeria and the U.S. as inadequate time for decision-making in the process of gardening, motivation of teachers and students. This was seen as the major impediments that influenced the status of gardening in the three countries. However, these factors were considered to have affected students’ mode of participation in the school gardening projects. This research finding suggests that the promotion and encouragement of students in gardening activities will promote vegetable production and increasing the numbers of practical farmers. Gardening has the potential to create opportunities for learning in an environment where children are able to experience nature first hand and to use the shared experience for communication (Bowker & Tearle, 2007). Therefore, the need for students to be encouraged to participate in gardening programs as the benefit will not only reduce the rate of obesity currently spreading among youths, but will contribute to the improve knowledge on science subjects. To build a network between community, parents and schools, a parent’s community approach should be used as the curriculum. The community approach will tighten the link between schools; community members, parents, teachers and students. This will help facilitate a better gardening projects implementation. Through a close collaboration, teachers and students will be able to identify issues affecting communities and undertake action learning in collaboration with community organizations to assess community needs and plan the implementation strategies as parents are part of the community. The sense of efficacy is a central factor in motivational and learning processes that govern educational improvement, standard and performance on complex tasks of both teachers and students. Dedication and willingness are the major stimulator and achievement of a project. Through a stimulator and provision of incentives and facilities, schools can achieve the best in project development. Teachers and principals should be aware that students are the lever for achieving the set goals in schools. Failure to understand what students need will result in achieving zero result. Therefore, it is advised that schools focus more on how to lure students to work through proper collaboration with the parents and community members. Principals and teachers should identify areas where students need to be corrected, helping them to correct the problem will enable them be committed in the schools’ programs.

How children's television networks in the United States have adapted to the changing digital habits of their young audiences: A comparative analysis between the Disney Channel and Nickelodeon

In the contemporary societies, many children are drawn to digital media, using it in ways that were initially unfathomable. Changing digital habits among young children have been affiliated to the rapid development, witnessed in the technological field. Prevalently, new forms of technology are being developed and ingrained into young children’s day-to-day activities. The emergence of new forms of technology has in turn prompted significant changes in digital and media consumption particularly, among young children. Changes in media and digital consumption have in turn instigated linear transition in the analogue media industries. This has resulted in analogue media networks working towards digitalizing their industries in a manner that will befit changing digital habits among young children. This report aims at establishing and analyzing the different ways in which children’s digital habits have changed and revolutionized. To achieve this, the report will critically examine the existing scope of knowledge, with reference to changing digital habits among young audiences. Further, the report also aims at establishing the manner in which children television networks have adapted to the changing digital habits among young audiences. To achieve this, the report will focus on two children television networks, Disney channel, and Nickelodeon. After which, a comparative analysis will be conducted to establish the changes made by each of these television channels, with the aim of adapting to the new digital habits among children.

FIRE ANT MOUND DENSITIES IN THE UNITED-STATES AND BRAZIL (HYMENOPTERA, FORMICIDAE)

To compare fire ant populations (Solenopsis) in North and South America, we surveyed 102 preselected roadside sites, half in the southeastern United States and half in the state of Mato Grosso do Sul, Brazil. Fire ants were considerably more abundant in the United States. They occurred at more sites (100 versus 70%), in higher densities (170 versus 30 mounds/ha), in larger mounds (27.0 versus 13.8 liters), and they constituted a larger fraction of the local ant community (97 versus 13% of occupied baits). These data are consistent with the hypothesis that North American populations of S. invicta have escaped natural biological control; however, cultural and climatic factors are also likely explanations.

Some considerations on the possible effects of the failure of the United States Congress to renew the ATPDEA

Includes bibliography

A comparative study of health care policy in the United States and Canada: what policymakers in Latin America might and might not learn from their neighbors to the North

Includes bibliography

United States v. Steinmetz: The Legal Legacy of the Civil War, Revisited

One of the enduring and yet unresolved issues concerning the Civil War is its legal nature: Was it an insurrection or an international war? During the war and since, the United States courts have repeatedly been called upon to determine the status of property which was under the control of the Confederacy and its agents during the Civil War. In the process of making such determinations, the courts have reopened questions about the war's legal status. United States v. Steinmetz is such a case.

EXTRALIMITAL RECORDS OF THE MEXICAN FREE-TAILED BAT (TADARIDA BRASILIENSIS MEXICANA) IN THE CENTRAL UNITED STATES AND THEIR BIOLOGICAL SIGNIFICANCE

Two new records of Tadarida brasiliensis mexicana are reported from Nebraska. The literature records of this taxon from the central United States are summarized. In this region of North America, these bats occupy a “natal range” where the species carries on regular reproductive activities and the populations are relatively stable, including California, Arizona, New Mexico, Texas, and Oklahoma. To the north of the natal range of T. b. mexicana is a “pioneering zone” where, under favorable conditions, the species is capable of reproducing and conducting its normal activities. The pioneering zone of the Mexican free-tailed bat includes Barber and Comanche counties in Kansas and as far north as Mesa and Saguache counties in southwestern Colorado. Finally, to the north of the pioneering zone, there is a much larger area that is proposed as the “exploring zone” in which only a few individuals of the species are found. Reproductive activities do not occur on any regular basis in the exploring zone, which encompasses the remainder of Colorado and Kansas as well as the states of Wyoming, Nebraska, Iowa, Illinois, Missouri, and southeastern South Dakota.

Outcomes of Epileptic Spasms in Patients Aged Less Than 3 Years: Single-Center United States Experience

Retrospective review was performed of children aged <3 years with epileptic spasms at our center from 2004-2010. Short-term (<6 months) and long-term (>= 6 months) outcomes were assessed. We included 173 children (104 boys; median age of onset, 6.8 months) with epileptic spasms of known (62%) and unknown (38%) etiology. Treatments included adrenocorticotropic hormone (n = 103), vigabatrin (n = 82), phenobarbital (n = 34), and other agents (n = 121). Short-term treatment with adrenocorticotropic hormone and vigabatrin provided better epileptic spasm control in groups with known and unknown etiology than other agents. At follow-up (6-27 months), 54% of children manifested seizures, and 83% manifested developmental delay. Known etiology was a predictor of poor developmental outcome (P = 0.006), whereas bilateral/diffuse brain lesions predicted both poor development and seizures (P = 0.001 and 0.005, respectively). Initial presentations of epileptic spasms with hypotonia or developmental delay most strongly predicted both seizures and neurodevelopmental outcomes (P < 0.001). In a child presenting with epileptic spasms with developmental delay or hypotonia, no specific treatment may offer superior benefit. (c) 2012 Elsevier Inc. All rights reserved.

Accounting for Fetal Death: Vital Statistics and the Medicalization of Pregnancy in the United States

Recent reports by the Centers for Disease Control and Prevention have decried the high rate of fetal mortality in the contemporary United States. Much of the data about fetal and infant deaths, as well as other poor pregnancy outcomes, are tabulated and tracked through vital statistics. In this article, I demonstrate how notions of fetal death became increasingly tied to the surveillance of maternal bodies through the tabulating and tracking of vital statistics in the middle part of the twentieth century. Using a historical analysis of the revisions to the United States Standard Certificate of Live Birth, and the United States Standard Report of Fetal Death, I examine how the categories of analysis utilized in these documents becomes integrally linked to contemporary ideas about fetal and perinatal death, gestational age, and prematurity. While it is evident that there are relationships between maternal behavior and birth outcomes, in this article I interrogate the ways in which the surveillance of maternal bodies through vital statistics has naturalized these relationships. Copyright 2013 Elsevier Ltd. All rights reserved.