Clinical characteristics of patients with epilepsy in a specialist neuropsychiatry service

Neuropsychiatry services provide specialist input into the assessment and management of behavioral symptoms associated with a range of neurological conditions, including epilepsy. Despite the centrality of epilepsy to neuropsychiatry and the recent expansion of neuropsychiatry service provision, little is known about the clinical characteristics of patients with epilepsy who are routinely seen by a specialist neuropsychiatry service. This retrospective study filled this gap by retrospectively evaluating a naturalistic series of 60 consecutive patients with epilepsy referred to and assessed within a neuropsychiatry setting. Fifty-two patients (86.7%) had active epilepsy and were under the ongoing care of the referring neurologist for seizure management. The majority of patients (N = 42; 70.0%) had a diagnosis of localization-related epilepsy, with temporal lobe epilepsy as the most common epilepsy type (N = 37; 61.7%). Following clinical assessment, 39 patients (65.0%) fulfilled formal diagnostic criteria for at least one psychiatric disorder; nonepileptic attack disorder (N = 37; 61.7%), major depression (N = 23; 38.3%), and generalized anxiety disorder (N = 16; 26.7%) were the most commonly diagnosed comorbidities. The clinical characteristics of patients seen in specialist neuropsychiatry settings are in line with the results from previous studies in neurology clinics in terms of both epilepsy and psychiatric comorbidity. Our findings confirm the need for the development and implementation of structured care pathways for the neuropsychiatric aspects of epilepsy, with focus on comorbid nonepileptic attacks and affective and anxiety symptoms. This is of particular importance in consideration of the impact of behavioral symptoms on patients' health-related quality of life.

A szervezeti elkötelezettség és a munka-család viszonyrendszer összefüggései (The relationship between organizational commitment and work-life balance)

376 ügyfélszolgálati dolgozó bevonásával végzett kérdőíves vizsgálatukban a szerzők arra keresték a választ, hogy a szervezeti elkötelezettség profilok hogyan függnek össze a munkahelyi elégedettséggel, a kilépési szándékkal és a munka-család viszonyrendszerre vonatkozó változókkal (munka-család konfliktus, munkacsalád egyensúly, munka-család gazdagítás). Nyolc különböző profilt találtak, amelyek elemzéséből kiderült: az elkötelezettség-komponensek közül az érzelmi elkötelezettségnek kitüntetett szerepe van a kedvező következményeket tekintve, továbbá az elkötelezettségkomponensek együttes hatása szinergikus lehet. ________ In their research that was based on the answers of 376 customer service employees to a questionnaire survey, the authors are looking at the relationship between the organizational commitment profiles and work satisfaction, intention to leave the organization and various subconcepts of work life balance (work-family conflict, work-family balance and work-family enrichment). They have found 8 different profiles, the analysis of which revealed the central role of the affective component regarding the positive outcomes of the above mentioned variables as well as the synergic relations among the different components of organizational commitment.

The effect of a breakfast program on nutritional status, quality of life, and health care use among frail homebound older adults

The population of older adults is rapidly increasing, creating a need for community services that assist vulnerable older adults in maintaining independence and quality of life. Recent evidence confirms the importance of food and nutrition in reaching this objective. The Elderly Nutrition Program (ENP) is part of a system of federally funded community based programs, authorized through the Older Americans Act. ENP services include the home-delivered meals program, which targets frail homebound older adults at nutritional risk. Traditionally, ENP services provide a noon meal 5 days/week. This study evaluated the impact of expanding the home-delivered meals service to include breakfast + lunch, on the nutritional status, quality of life and health care utilization of program participants. ^ This cross-sectional study compared 2 groups. The Breakfast group (n = 167) received a home-delivered breakfast + lunch, 5 days/week. The Comparison group (n = 214) received lunch 5 days/week. Participants, recruited from 5 ENP programs, formed a geographically, racially/ethnically diverse sample. Participants ranged in age from 60–100 years, they were functionally limited, at high nutritional risk, low income, and they lived alone and had difficulty shopping or preparing food. Participant data were collected through in-home interviews and program records. A 24-hour food recall and information on participant demographics, malnutrition risk, functional status, health care use, and applicable quality of life factors were obtained. Service and cost data were collected from program administrators. ^ Breakfast group participants had greater energy/nutrient intakes (p < .05), fewer health care contacts (p < .05), and greater quality of life measured as food security (p < .05) and fewer depressive symptoms (p < .05), than comparison group participants. These benefits were achieved for $1.30/person/day. ^ The study identified links from improvements in nutritional status to enhanced quality of life to diminished health care utilization and expenditures. A model of health, loneliness, food enjoyment, food insecurity, and depression as factors contributing to quality of life for this population, was proposed and tested (p < .01). ^ The breakfast service is an inexpensive addition to traditional home-delivered meals services and can improve the lives of frail homebound older adults. Agencies should be encouraged to expand meals programs to include a breakfast service. ^

Making Life More Satisfying for Hospitality Managers

Because of the considerable amount of time that hospitality managers spend at work, the relationship between life satisfaction and job satisfaction is of particular interest. Dissonance may result when the role at work conflicts with the role at home of with the family. Food service managers indicate that the top inter-role conflicts area is that work time takes up time that they would like to spend with family and others; that they are too tired to do some of the things they would like to do after work; and that the job makes it difficult to be the kind of friend, spouse, or parent that they would like to be.

The Food Service Industry: Beliefs Held by Academics

In his study - The Food Service Industry: Beliefs Held by Academics - by Jack Ninemeier, Associate Professor, School of Hotel, Restaurant and Institutional Management at Michigan State University, Associate Professor Ninemeier initially describes his study this way: “Those in the academic sector exert a great deal of influence on those they are training to enter the food service industry. One author surveyed educational institutions across the country to ascertain attitudes of teachers toward various segments of the industry.” Those essential segments of the industry serve as the underpinnings of this discussion and are four-fold. They are lodging, institutional, multi-unit, and single-unit properties. For each segment the analysis addressed factors relating to Marketing, management and operating concerns: Marketing, operations, fiscal management, innovation, future of the segment Employee-related concerns: quality of work life, training/education opportunities, career opportunities The study uses a survey of academicians as a guide; they point to segments of the food service industry students might be inclined to enter, or even ignore. The survey was done via a questionnaire sent from the campus of the School of Hotel, Restaurant and Institutional Management at Michigan State University to 1850 full-time faculty members in two and four-year hospitality programs in the United States. Through the survey, Ninemeier wishes to reasonably address specific problems now confronting the food service industry. Those problems include but are not limited to: reducing employee turnover, retaining staff, increasing productivity and revenue, and attracting new staff. “Teachers in these programs are, therefore, an important plank in industry's platform designed to recruit students with appropriate background knowledge and interest in their operations,” Ninemeier says. Your author actually illustrates the survey results, in table form. The importance to an employee, of tangibles and intangibles such as morale, ego/esteem, wages, and benefits are each explored through the survey. According to the study, an interesting dichotomy exists in the institutional property element. Although, beliefs the academics hold about the institutional element suggest that it offers low job stress, attractive working conditions, and non-demanding competitive pressures, the survey and Ninemeier also observe: “Academics do not believe that many of their graduates will enter the institutional segment.” “If academic beliefs are incorrect, an educational program to educate academics about management and employee opportunities in the segment may be in order,” Ninemeier waxes philosophically.

Children with special health care needs: Comparison of the effects of home care setting, prescribed pediatric extended care setting, and long-term care setting on child and family health outcomes and health care service use

Technological advances during the past 30 years have dramatically improved survival rates for children with life-threatening conditions (preterm births, congenital anomalies, disease, or injury) resulting in children with special health care needs (CSHCN), children who have or are at increased risk for a chronic physical, developmental, behavioral, or emotional condition and who require health and related services beyond that required by children generally. There are approximately 10.2 million of these children in the United States or one in five households with a child with special health care needs. Care for these children is limited to home care, medical day care (Prescribed Pediatric Extended Care; P-PEC) or a long term care (LTC) facility. There is very limited research examining health outcomes of CSHCN and their families. The purpose of this research was to compare the effects of home care settings, P-PEC settings, and LTC settings on child health and functioning, family health and function, and health care service use of families with CSHCN. Eighty four CSHCN ages 2 to 21 years having a medically fragile or complex medical condition that required continual monitoring were enrolled with their parents/guardians. Interviews were conducted monthly for five months using the PedsQL™ Generic Core Module for child health and functioning, PedsQL™ Family Impact Module for family health and functioning, and Access to Care from the NS-CSHCN survey for health care services. Descriptive statistics, chi square, and ANCOVA were conducted to determine differences across care settings. Children in the P-PEC settings had a highest health care quality of life (HRQL) overall including physical and psychosocial functioning. Parents/guardians with CSHCN in LTC had the highest HRQL including having time and energy for a social life and employment. Parents/guardians with CSHCN in home care settings had the poorest HRQL including physical and psychosocial functioning with cognitive difficulties, difficulties with worry, communication, and daily activities. They had the fewest hours of employment and the most hours providing direct care for their children. Overall health care service use was the same across the care settings.

Recruiting and developing technicians for hotel food service operations

The thesis which follows is a study of recruiting and developing skilled workers for Hotel Food Service Operations in the Miami area. The aim of the study is to bring to the attention of personnel management the role of recruiting and training in providing the skilled people needed for their operation in the short and long run as well. The study was done as a case study of the medium and large size hotels which have a minimum of 250 units each in the Miami area. However, the study has been generalized where it is possible, and when data permitted. The primary data was collected by the use of the questionnaire survey method composed of key questions about recruiting, training and sources of skilled people, turnover reasons, etc. Eight tables have been constructed, analyzed and interpreted. A personal opinion was mentioned in the interpretation of each table's data. It was found that personnel management should provide a better recruiting and developing procedures in order to attract more qualified people, particularly among the youngsters who are potential skilled workers for the future. It was concluded that the quality of work life, the benefits, and the opportunities for advancement in the food and beverage operations play a significant role in an employee's decision to stay with a particular job, and to acquire the necessary skills.

Delay-sensitive service request scheduling for cloud computing

Cloud computing realizes the long-held dream of converting computing capability into a type of utility. It has the potential to fundamentally change the landscape of the IT industry and our way of life. However, as cloud computing expanding substantially in both scale and scope, ensuring its sustainable growth is a critical problem. Service providers have long been suffering from high operational costs. Especially the costs associated with the skyrocketing power consumption of large data centers. In the meantime, while efficient power/energy utilization is indispensable for the sustainable growth of cloud computing, service providers must also satisfy a user's quality of service (QoS) requirements. This problem becomes even more challenging considering the increasingly stringent power/energy and QoS constraints, as well as other factors such as the highly dynamic, heterogeneous, and distributed nature of the computing infrastructures, etc. ^ In this dissertation, we study the problem of delay-sensitive cloud service scheduling for the sustainable development of cloud computing. We first focus our research on the development of scheduling methods for delay-sensitive cloud services on a single server with the goal of maximizing a service provider's profit. We then extend our study to scheduling cloud services in distributed environments. In particular, we develop a queue-based model and derive efficient request dispatching and processing decisions in a multi-electricity-market environment to improve the profits for service providers. We next study a problem of multi-tier service scheduling. By carefully assigning sub deadlines to the service tiers, our approach can significantly improve resource usage efficiencies with statistically guaranteed QoS. Finally, we study the power conscious resource provision problem for service requests with different QoS requirements. By properly sharing computing resources among different requests, our method statistically guarantees all QoS requirements with a minimized number of powered-on servers and thus the power consumptions. The significance of our research is that it is one part of the integrated effort from both industry and academia to ensure the sustainable growth of cloud computing as it continues to evolve and change our society profoundly.^

Delay-Sensitive Service Request Scheduling for Cloud Computing

Cloud computing realizes the long-held dream of converting computing capability into a type of utility. It has the potential to fundamentally change the landscape of the IT industry and our way of life. However, as cloud computing expanding substantially in both scale and scope, ensuring its sustainable growth is a critical problem. Service providers have long been suffering from high operational costs. Especially the costs associated with the skyrocketing power consumption of large data centers. In the meantime, while efficient power/energy utilization is indispensable for the sustainable growth of cloud computing, service providers must also satisfy a user's quality of service (QoS) requirements. This problem becomes even more challenging considering the increasingly stringent power/energy and QoS constraints, as well as other factors such as the highly dynamic, heterogeneous, and distributed nature of the computing infrastructures, etc. In this dissertation, we study the problem of delay-sensitive cloud service scheduling for the sustainable development of cloud computing. We first focus our research on the development of scheduling methods for delay-sensitive cloud services on a single server with the goal of maximizing a service provider's profit. We then extend our study to scheduling cloud services in distributed environments. In particular, we develop a queue-based model and derive efficient request dispatching and processing decisions in a multi-electricity-market environment to improve the profits for service providers. We next study a problem of multi-tier service scheduling. By carefully assigning sub deadlines to the service tiers, our approach can significantly improve resource usage efficiencies with statistically guaranteed QoS. Finally, we study the power conscious resource provision problem for service requests with different QoS requirements. By properly sharing computing resources among different requests, our method statistically guarantees all QoS requirements with a minimized number of powered-on servers and thus the power consumptions. The significance of our research is that it is one part of the integrated effort from both industry and academia to ensure the sustainable growth of cloud computing as it continues to evolve and change our society profoundly.

Applying life cycle assessment to analyze the environmental sustainability of public transit modes for the City of Toronto

One challenge related to transit planning is selecting the appropriate mode: bus, light rail transit (LRT), regional express rail (RER), or subway. This project uses data from life cycle assessment to develop a tool to measure energy requirements for different modes of transit, on a per passenger-kilometer basis. For each of the four transit modes listed, a range of energy requirements associated with different vehicle models and manufacturers was developed. The tool demonstrated that there are distinct ranges where specific transit modes are the best choice. Diesel buses are the clear best choice from 7-51 passengers, LRTs make the most sense from 201-427 passengers, and subways are the best choice above 918 passengers. There are a number of other passenger loading ranges where more than one transit mode makes sense; in particular, LRT and RER represent very energy-efficient options for ridership ranging from 200 to 900 passengers. The tool developed in the thesis was used to analyze the Bloor-Danforth subway line in Toronto using estimated ridership for weekday morning peak hours. It was found that ridership across the line is for the most part actually insufficient to justify subways over LRTs or RER. This suggests that extensions to the existing Bloor-Danforth line should consider LRT options, which could service the passenger loads at the ends of the line with far greater energy efficiency. It was also clear that additional destinations along the entire transit line are necessary to increase the per passenger-kilometer energy efficiency, as the current pattern of commuting to downtown leaves much of the system underutilized. It is hoped that the tool developed in this thesis can be used as an additional resource in the transit mode decision-making process for many developing transportation systems, including the transit systems across the GTHA.

Improving Smartphones Battery Life by Reducing Energy Waste of Background Applications

Smartphones have undergone a remarkable evolution over the last few years, from simple calling devices to full fledged computing devices where multiple services and applications run concurrently. Unfortunately, battery capacity increases at much slower pace, resulting as a main bottleneck for Internet connected smartphones. Several software-based techniques have been proposed in the literature for improving the battery life. Most common techniques include data compression, packet aggregation or batch scheduling, offloading partial computations to cloud, switching OFF interfaces (e.g., WiFi or 3G/4G) periodically for short intervals etc. However, there has been no focus on eliminating the energy waste of background applications that extensively utilize smartphone resources such as CPU, memory, GPS, WiFi, 3G/4G data connection etc. In this paper, we propose an Application State Proxy (ASP) that suppresses/stops the applications on smartphones and maintains their presence on any other network device. The applications are resumed/restarted on smartphones only in case of any event, such as a new message arrival. In this paper, we present the key requirements for the ASP service and different possible architectural designs. In short, the ASP concept can significantly improve the battery life of smartphones, by reducing to maximum extent the usage of its resources due to background applications.

Living conditions in old age: Coexisting disadvantages across life domains

The aim of this thesis was to analyse coexisting disadvantages in the older Swedish population. Coexisting disadvantages are those that occur simultaneously in various life domains. A person who simultaneously experiences several disadvantages may be particularly vulnerable and less well-equipped to manage daily life and may also need support from several different welfare service providers. Concerted actions may be needed for older people who experience not only physical health problems and functional limitations, but also other problems. Research that encompasses a wide range of living conditions provides a basis for setting political priorities and making political decisions. The studies in this thesis used data from two Swedish nationally representative surveys: the Level of Living Survey, which includes people aged 18 through 75, and the Swedish Panel Study of Living Conditions of the Oldest Old, which includes people aged 77 and older. Study I showed that the probability of experiencing coexisting disadvantages was higher in people 77 and older than in those aged 18 through 76. These age differences were partly driven by a high prevalence of physical health problems in older people. In all age groups, coexisting disadvantages were more common in women than men. The longitudinal analyses in Study II indicated that coexisting disadvantages in old age persist in some people but are temporary in others. Moreover, the results suggested a pattern of accumulating disadvantages: reporting one disadvantage in young old age (in particular, psychological health problems) increased the probability of reporting coexisting disadvantages in late old age.   Study III showed that physical health problems were a central component of coexisting disadvantages. The results also showed that being older; female; previously employed as a manual labourer; and divorced/separated, widowed or never married were associated with an increased probability of experiencing coexisting disadvantages. However, the experience of coexisting disadvantages differed: the groups associated with coexisting disadvantages tended to report different combinations of disadvantage. Study IV showed that the prevalence of coexisting disadvantages in those 77 and older increased slightly between 1992 and 2011. Physical health problems became more common over time, whereas limited ability to manage daily activities (ADL limitations), limited financial resources and limited political resources became less common. Associations between different disadvantages were found in all survey years, but certain associations changed over time. The results suggest that in general, the composition of coexisting disadvantages in the older population may have altered over time. In sum, results showed that coexisting disadvantages were associated with specific demographic and socio-economic groups. Physical health problems and psychological health problems were of particular importance to the accumulation and coexistence of disadvantages in old age.

On Queueinginventory Models – product form solution; reservation, Cancellation and common life time

Queueing theory is the mathematical study of ‘queue’ or ‘waiting lines’ where an item from inventory is provided to the customer on completion of service. A typical queueing system consists of a queue and a server. Customers arrive in the system from outside and join the queue in a certain way. The server picks up customers and serves them according to certain service discipline. Customers leave the system immediately after their service is completed. For queueing systems, queue length, waiting time and busy period are of primary interest to applications. The theory permits the derivation and calculation of several performance measures including the average waiting time in the queue or the system, mean queue length, traffic intensity, the expected number waiting or receiving service, mean busy period, distribution of queue length, and the probability of encountering the system in certain states, such as empty, full, having an available server or having to wait a certain time to be served.

Le théâtre éducatif – un outil au service de l'enseignement du FLE en cadre scolaire

L’objectif de ce mémoire est d’étudier le rôle que le théâtre éducatif peut avoir sur le développement de la compétence de communication orale dans l’enseignement du français langue étrangère (en abrégé FLE) en cadre scolaire. La recherche montre que le théâtre éducatif donne aux élèves la possibilité d’utiliser leurs compétences linguistiques en les préparant pour des situations réelles. Il leur donne aussi l’occasion de découvrir toutes les émotions et tous les mouvements physiques qui font partie d’une langue vivante.

Seeking To Understand, Aspiring to Teach: Exploring How Life Shapes Emotional and Personal Development in Global Health Leaders

Thesis (Master's)--University of Washington, 2016-08