Occupational therapists' attitudes toward family -centered care

The purpose of this study was to examine pediatric occupational therapists attitudes towards family-centered care. Specific attributes identified by the literature (professional characteristics, educational experiences and organizational culture) were investigated to determine their influence on these attitudes. Study participants were 250 pediatric occupational therapists who were randomly selected from the American Occupational Therapy Association special interest sections. ^ Participants received a mail packet with three instruments to complete and mail back within 2 weeks. The instruments were (a) the Professional Attitude Scale, (b) the Professional Characteristics Questionnaire, and (c) the Family-Centered Program Rating Scale. There was a 50% return rate. Data analysis was conducted in SPSS using descriptive statistics, correlations and regression analysis. ^ The analysis showed that pediatric occupational therapists working in various practice settings demonstrate favorable attitudes toward family-centered care as measured by the Professional Attitude Scale. There was no correlation between professional characteristics and educational experiences to therapists' attitudes. A moderate correlation (r = .368, p < .05) was found between the occupational therapists attitudes and the organizational culture of their workplaces. A factor analysis was conducted on the organizational culture instrument (FamPRS) as this sample was exclusively pediatric occupational therapists and the original sample was interdisciplinary professionals. Two factors were extracted using a principal components extraction and varimax rotation, in addition to examination of the scree plot. These two factors accounted for 50% of the total variance of the scores on the instrument. Factor 1, called empowerment accounted for 45.6% of the variance, and Factor 2, responsiveness accounted for 4.3% of the variance of the entire instrument. Stepwise regression analysis demonstrated that these two factors accounted for 16% of the variance toward attitudes clinicians hold toward family-centered care. These factors support the tenets of family-centered care; empowering parents to be leaders in their child's health care and helping organizations become more responsive to family needs. ^ These study findings suggest that organizational culture has some influence on occupational therapists attitudes toward family-centered care (R 2 = .16). These findings suggest educators should consider families as valuable resources when considering program planning in family-centered care at preservice and workplace settings. ^

Assessment of silicone polymer composites for the trace extraction of herbicides : a tool for environmental forensics

Passive samplers are not only a versatile tool to integrate environmental concentrations of pollutants, but also to avoid the use of live sentinel organisms for environmental monitoring. This study introduced the use of magnetic silicone polymer composites (Fe-PDMS) as passive sampling media to pre-concentrate a wide range of analytes from environmental settings. The composite samplers were assessed for their accumulation properties by performing lab experiments with two model herbicides (Atrazine and Irgarol 1051) and evaluated for their uptake properties from environmental settings (waters and sediments). The Fe-PDMS composites showed good accumulation of herbicides and pesticides from both freshwater and saltwater settings and the accumulation mechanism was positively correlated with the log Kow value of individual analytes. Results from the studies show that these composites could be easily used for a wide number of applications such as monitoring, cleanup, and/or bioaccumulation modeling, and as a non-intrusive and nondestructive monitoring tool for environmental forensic purposes.

Observation of manganese nodules on the Muir Seamount during Atlantis Cruise 260

Seamounts are very effectively studied by deep-sea photography. Each photograph can be considered as a sample point when used in connection with bathymetric surveys, dredge samples, and cores, thus making it possible to delineate and map geologic and biologic zones on a seamount. Seamounts transcend through a great depth range and are characterized by minimal sedimentation which results in exciting and photogenic differences of environment over a short distance, as typified by our studies of Great Meteor and the New England Seamounts.

A experiência do usuário idoso no design de jogo digital para a reabilitação neural de pacientes com quadro de acidente vascular cerebral (AVC)

Stroke is nowadays one of the main causes of death in Brazil and worldwide. During the rehabilitation process, patients undergo physioterapic exercises based on repetition, which may cause them to feel little progress is being made. Focusing on themes from the areas of Human-Computer Interaction and Motor Imagery, the present work describes the development of a digital game concept aimed at motor rehabilitation to the neural rehabilitation of patients who have suffered a stroke in a playful and engaging way. The research hypothesizes that an interactive digital game based on Motor Imagery contributes to patients' raised commitment in the stroke sequel rehabilitation process. The research process entailed the investigation of 10 subjects who live with sequels caused by stroke - it was further established that subjects were over 60 years old. Using as foundation an initial survey regarding target-users' specificities, where an investigation on subjectrelated aspects was carried out through Focus Group (n=9) and Contextual Analysis (n=3), having as subjects elderly individuals, a list with the necessary requirements for the conceptualization of a digital game was fleshed out. The initial survey also enabled the establishment of preliminary interactions for the formulation of game prototypes. At first, low-resolution prototypes were used, with two distinct interaction models for the game - one with a direct approach to the Motor Imagery concept, and another using a narrative with characters and scene settings. The goal was to verify participants' receptivity regarding the addition of playful activities into game dynamics. Prototypes were analyzed while being used by five patients, through the Cooperative Evaluation technique. The tests indicated a preference for option with elements in a playful narrative. Based on these results high fidelity prototypes were created, where concepts close to the game's final version were elaborated. The High Fidelity prototype was also evaluated with four patients through the Cooperative Evaluation technique. It was concluded that elderly individuals and patients were receptive to the idea of a digital game for the rehabilitation from sequels caused by stroke; that, for the success of devices aimed at these cohorts, their contexts, needs and expectations must be respected above all; and that user-centered design is an essential approach in that regard.

Gravidade do olho seco em pacientes internados em unidade de terapia intensiva: análise de conceito e construção de definições

Dry eye syndrome is a multifactorial disease of the tear film, resulting from the instability of the lacrimal functional unit that produces volume change, up or tear distribution. In patients in intensive care the cause is enhanced due to various risk factors, such as mechanical ventilation, sedation, lagophthalmos, low temperatures, among others. The study's purpose is to build an assessment tool of Dry Eye Severity in patients in intensive care units based on the systematization of nursing care and their classification systems. The aim of this study is to build an assessment tool of Dry Eye Severity in hospitalized patients in Care Unit Intensiva.Trata is a methodological study conducted in three stages, namely: context analysis, concept analysis, construction of operational definitions and magnitudes of nursing outcome. For the first step we used the methodological framework for Hinds, Chaves and Cypress (1992). For the second step we used the model of Walker and Avant and an integrative review Whitemore seconds, Knalf (2005). This step enabled the identification of the concept of attributes, background and consequent ground and the construction of the settings for the result of nursing severity of dry eye. For the construction of settings and operational magnitudes, it was used Psicometria proposed by Pasquali (1999). As a result of context analysis, visualized from the reflection that the matter should be discussed and that nursing needs to pay attention to the problem of eye injury, so minimizing strategies are created this event with a high prevalence. With the integrative review were located from the crosses 19 853 titles, selected 215, and from the abstracts 96 articles were read in full. From reading 10 were excluded culminating in the sample of 86 articles that were used to analyze the concept and construction of settings. Selected articles were found in greater numbers in the Scopus database (55.82%), performed in the United States (39.53%), and published mainly in the last five years (48.82). Regarding the concept of analysis were identified as antecedents: age, lagophthalmos, environmental factors, medication use, systemic diseases, mechanical ventilation and ophthalmic surgery. As attributes: TBUT <10s, Schimer I test <5 mm in Schimer II test <10mm, reduced osmolarity. As consequential: the ocular surface damage, ocular discomfort, visual instability. The settings were built and added indicators such as: decreased blink mechanism and eyestrain.

Global Japanization? The transnational transformation of the labour process

Global Japaniziation? Brings together research from North America, Japan, Europe and Latin America to analyse the influence of Japanese manufacturing investment and Japanese working practices across the global economy. The editors present original case studies of work reorganization and workers' experiences within both Japanese companies and those of their competitors in diverse sectors and national settings. These studies provide a wide-ranging critique of conventional accounts of Japanese models of management and production, and their implications for employees. They offer new evidence and fresh perspectives on the role of "transplants" in disseminating manufacturing innovations, and on the responses of non-Japanese firm in reorganizing production operations and industrial relations.

Cumulon: Simplified Matrix-Based Data Analytics in the Cloud

Cumulon is a system aimed at simplifying the development and deployment of statistical analysis of big data in public clouds. Cumulon allows users to program in their familiar language of matrices and linear algebra, without worrying about how to map data and computation to specific hardware and cloud software platforms. Given user-specified requirements in terms of time, monetary cost, and risk tolerance, Cumulon automatically makes intelligent decisions on implementation alternatives, execution parameters, as well as hardware provisioning and configuration settings -- such as what type of machines and how many of them to acquire. Cumulon also supports clouds with auction-based markets: it effectively utilizes computing resources whose availability varies according to market conditions, and suggests best bidding strategies for them. Cumulon explores two alternative approaches toward supporting such markets, with different trade-offs between system and optimization complexity. Experimental study is conducted to show the efficiency of Cumulon's execution engine, as well as the optimizer's effectiveness in finding the optimal plan in the vast plan space.

Fluid resuscitation practice patterns in intensive care units of the USA: a cross-sectional survey of critical care physicians.

BACKGROUND: Fluid resuscitation is a cornerstone of intensive care treatment, yet there is a lack of agreement on how various types of fluids should be used in critically ill patients with different disease states. Therefore, our goal was to investigate the practice patterns of fluid utilization for resuscitation of adult patients in intensive care units (ICUs) within the USA. METHODS: We conducted a cross-sectional online survey of 502 physicians practicing in medical and surgical ICUs. Survey questions were designed to assess clinical decision-making processes for 3 types of patients who need volume expansion: (1) not bleeding and not septic, (2) bleeding but not septic, (3) requiring resuscitation for sepsis. First-choice fluid used in fluid boluses for these 3 patient types was requested from the respondents. Descriptive statistics were performed using a Kruskal-Wallis test to evaluate differences among the physician groups. Follow-up tests, including t tests, were conducted to evaluate differences between ICU types, hospital settings, and bolus volume. RESULTS: Fluid resuscitation varied with respect to preferences for the factors to determine volume status and preferences for fluid types. The 3 most frequently preferred volume indicators were blood pressure, urine output, and central venous pressure. Regardless of the patient type, the most preferred fluid type was crystalloid, followed by 5 % albumin and then 6 % hydroxyethyl starches (HES) 450/0.70 and 6 % HES 600/0.75. Surprisingly, up to 10 % of physicians still chose HES as the first choice of fluid for resuscitation in sepsis. The clinical specialty and the practice setting of the treating physicians also influenced fluid choices. CONCLUSIONS: Practice patterns of fluid resuscitation varied in the USA, depending on patient characteristics, clinical specialties, and practice settings of the treating physicians.

IL-10-producing Regulatory B Cell Development in Human Autoimmune Disease

B cell abnormalities contribute to the development and progress of autoimmune disease. Traditionally, the role of B cells in autoimmune disease was thought to be predominantly limited to the production of autoantibodies. Nevertheless, in addition to autoantibody production, B cells have other functions potentially relevant to autoimmunity. Such functions include antigen presentation to and activation of T cells, expression of costimulatory molecules and cytokine production. Recently, the ability of B cells to negatively regulate cellular immune responses and inflammation has been described and the concept of “regulatory B cells” has emerged. A variety of cytokines produced by regulatory B cell subsets have been reported with interleukin-10 (IL-10) being the most studied. IL-10-producing regulatory B cells predominantly localize within a rare CD1dhiCD5+ B cell subset in mice and the CD24hiCD27+ B cell subset in adult humans. This specific IL-10-producing subset of regulatory B cells have been named “B10 cells” to highlight that the regulatory function of these rare B cells is primarily mediated by IL-10, and to distinguish them from other regulatory B cell subsets that regulate immune responses through different mechanisms. B10 cells have been studies in a variety of animal models with autoimmune disease and clinical settings of human autoimmunity. There are many unsolved questions related to B10 cells including their surface phenotype, their origin and development in vivo, and their role in autoimmunity.

In Chapter 3 of this dissertation, the role of the B cell receptor (BCR) in B10 cell development is highlighted. First, the BCR repertoire of mouse peritoneal cavity B10 cells is examined by single cell sequencing; peritoneal cavity B10 cells have clonally diverse germline BCRs that are predominantly unmutated. Second, mouse B10 cells are shown to have higher frequencies of λ+ BCRs compared to non-B10 cells which may indicate the involvement of BCR light chain editing early in the process of B10 cell development in vivo. Third, human peripheral blood B10 cells are examined and are also found to express higher frequencies of λ chains compared to non-b10 cells. Therefore, B10 cell BCRs are clonally diverse and enriched for unmutated germline sequences and λ light chains.

In Chapter 4 of this dissertation, B10 cells are examined in the healthy developing human across the entire age range of infancy, childhood and adolescence, and in a large cohort of children with autoimmunity. The study of B10 cells in the developing human documents a massive transient expansion during middle childhood when up to 30% of blood B cells were competent to produce IL-10. The surface phenotype of pediatric B10 cells was variable and reflective of overall B cell development. B10 cells down-regulated CD4+ T cell interferon-gamma (IFN-γ) production through IL-10-dependent pathways and IFN-γ inhibited whereas interleukin-21 (IL-21) promoted B cell IL-10 competency in vitro. Children with autoimmunity had a contracted B10 cell compartment, along with increased IFN-γ and decreased IL-21 serum levels compared to age-matched healthy controls. The decreased B10 cell frequencies and numbers in children with autoimmunity may be partially explained by the differential regulation of B10 cell development by IFN-γ and IL-21 and alterations in serum cytokine levels. The age-related changes of the B10 cell compartment during normal human development provide new insights into immune tolerance mechanisms involved in inflammation and autoimmunity.

These studies collectively demonstrate that BCR signals are the most important early determinant of B10 cell development in vivo, that human B10 cells are not a surface phenotype defined developmental B cell subset but a functionally defined regulatory B cell subset that regulates CD4+ T IFN-γ production through IL-10-dependent pathways and that human B10 cell development can be regulated by soluble factors in vivo such as the cytokine milieu. The findings of these studies provide new insights into immune tolerance mechanisms involved in human autoimmunity and the potent effects of IL-21 on human B cell IL-10 competence in vitro open new horizons in the development of autologous B10 cell-based therapies as an approach to treat human autoimmune disease in the future.

(Table 2) Age determination of Irminger Basin sediment cores

High-resolution records of coarse lithic content and oxygen isotope have been obtained in a piston core from the Irminger Basin. The last glacial period is characterized by numerous periods of increased iceberg discharges originating partly from Iceland and corresponding to millennial-scale instabilities of the coastal ice sheets and ice shelves in the Nordic area. A comparison with midlatitude sediment cores shows that ice-rafted material corresponding to the Heinrich events was deposited synchronously from 40° to 60°N. There are thus two oscillating systems: every 5-10 kyr massive iceberg armadas are released from large continental ice caps, whereas more frequent instabilities of the coastal ice sheets in the high latitude regions occur every 1.2-3.8 kyr. At the time of the Heinrich events the synchroneity of the response from all the northern hemisphere ice sheets attests the existence of strong interactions between the two systems.

Geochemistry on manganese crusts from French Polynesia

The Tuamotu Archipelago in French Polynesia is a Co-rich ferromanganese crust province. The NODCO I survey (1986) provided detailed data on Co-rich crusts in this environment through the exploration of a restricted zone in the vicinity of Niau Island on the southern flank of the archipelago. This flat zone is a fossil atoll which, under the action of subsidence and tectonic movements, has collapsed to a water depth of 1000 m. The plateau is partially filled with coralline sediments. Outcrops of ferromanganese crusts, associated with rare nodules and slabs, are located on the inner side of the coral reef which bounds the ancient lagoon. The successive episodes of plateau history have been recorded in the different growth periods of the ferromanganese crusts. The crusts, nodules and slabs belong to the same morphological, mineralogical and geochemical family. Cobalt contents vary from 0.7 to 1.3%. The highest values belong to the thinnest ferromanganese crusts which are located on the flanks of the plateau. Average Ni contents are about 0.5% and Cu contents about 0.1%; Pt contents vary from 0.2 to 1.3 ppm. Platinum and Co are enriched in the outermost oxide zone of the crusts. Poorly crystallized -MnO2 is the dominant mineralogical phase. Cobalt enrichment seems to be related to -MnO2 particle size. The greatest contents are located in the finest material where the particle size is less than 0.1 m. Cobalt-rich crusts of the Niau Zone have the same characteristics as the Co-rich crusts from the Equatorial North Pacific. They differ in original setting: the reefal environment in the Niau Zone is superficial, overlying a volcanic substrate.

Annotated record of the detailed examination of Mn deposits from BLM Leg Alpha Cruise, R/V Kana Keoki off the south-western coastal area of the Gulf of Mexico off Texas

The BLM-OCS (Bureau of Land Management-Outer Continental Shelf) program was designed to establish chemical, biological, and geological baseline on the South Texas Continental Shelf. The focus for the geological program was to establish the nature and amount of the suspended sediment in the water column, of the Holocene sediments on the shelf, and to identify and locate regions of geology conditions which may be hazardous to OCS operations. To accomplish these goals three cruises were planned. The report constitutes results of the first cruise. The results of these cruises associated with the subsequent laboratory analysis, enabled to establish a detailed baseline in order to provide significant geologic and biologic data for environmental assessment. Dredges recovered are available at University of Texas (see: BLM/OCS South Texas Outer Continental Shelf (STOCS) Project Sediment Data http://www.ngdc.noaa.gov/docucomp/page?xml=NOAA/NESDIS/NGDC/MGG/Geology/iso/xml/G02888.xml&view=getDataView&header=none).

Annotated record of the detailed examination of Mn deposits from BLM Leg Bravo Cruise, R/V Kana Keoki off the south-western coastal area of the Gulf of Mexico off Texas

The BLM-OCS (Bureau of Land Management-Outer Continental Shelf) program was designed to establish chemical, biological, and geological baseline on the South Texas Continental Shelf. The focus for the geological program was to establish the nature and amount of the suspended sediment in the water column, of the Holocene sediments on the shelf, and to identify and locate regions of geology conditions which may be hazardous to OCS operations. To accomplish these goals three cruises were planned. The report constitutes results of the second cruise. The results of these cruises associated with the subsequent laboratory analysis, enabled to establish a detailed baseline in order to provide significant geologic and biologic data for environmental assessment. Dredges recovered are available at University of Texas (see: BLM/OCS South Texas Outer Continental Shelf (STOCS) Project Sediment Data http://www.ngdc.noaa.gov/docucomp/page?xml=NOAA/NESDIS/NGDC/MGG/Geology/iso/xml/G02888.xml&view=getDataView&header=none).

Mediterranean cold-water coral measurements

This study presents aggradation rates supplemented for the first time by carbonate accumulation rates from Mediterranean cold-water coral sites considering three different regional and geomorphological settings: (i) a cold-water coral ridge (eastern Melilla coral province, Alboran Sea), (ii) a cold-water coral rubble talus deposit at the base of a submarine cliff (Urania Bank, Strait of Sicily) and (iii) a cold-water coral deposit rooted on a predefined topographic high overgrown by cold-water corals (Santa Maria di Leuca coral province, Ionian Sea). The mean aggradation rates of the respective cold-water coral deposits vary between 10 and 530 cm kyr?1 and the mean carbonate accumulation rates range between 8 and 396 g cm?2 kyr?1 with a maximum of 503 g cm?2 kyr?1 reached in the eastern Melilla coral province. Compared to other deep-water depositional environments the Mediterranean cold-water coral sites reveal significantly higher carbonate accumulation rates that were even in the range of the highest productive shallow-water Mediterranean carbonate factories (e.g. Cladocora caespitosa coral reefs). Focusing exclusively on cold-water coral occurrences, the carbonate accumulation rates of the Mediterranean cold-water coral sites are in the lower range of those obtained for the prolific Norwegian coral occurrences, but exhibit much higher rates than the cold-water coral mounds off Ireland. This study clearly indicates that cold-water corals have the potential to act as important carbonate factories and regional carbonate sinks within the Mediterranean Sea. Moreover, the data highlight the potential of cold-water corals to store carbonate with rates in the range of tropical shallow-water reefs. In order to evaluate the contribution of the cold-water coral carbonate factory to the regional or global carbonate/carbon cycle, an improved understanding of the temporal and spatial variability in aggradation and carbonate accumulation rates and areal estimates of the respective regions is needed.

THE DESIGN OF A POWER SYSTEM FOR A WIRELESS SENSOR NETWORK FOR LONG-TERM OPERATION

Wireless sensor networks (WSNs) have shown wide applicability to many fields including monitoring of environmental, civil, and industrial settings. WSNs however are resource constrained by many competing factors that span their hardware, software, and networking. One of the central resource constrains is the charge consumption of WSN nodes. With finite energy supplies, low charge consumption is needed to ensure long lifetimes and success of WSNs. This thesis details the design of a power system to support long-term operation of WSNs. The power system’s development occurs in parallel with a custom WSN from the Queen’s MEMS Lab (QML-WSN), with the goal of supporting a 1+ year lifetime without sacrificing functionality. The final power system design utilizes a TPS62740 DC-DC converter with AA alkaline batteries to efficiently supply the nodes while providing battery monitoring functionality and an expansion slot for future development. Testing tools for measuring current draw and charge consumption were created along with analysis and processing software. Through their use charge consumption of the power system was drastically lowered and issues in QML-WSN were identified and resolved including the proper shutdown of accelerometers, and incorrect microcontroller unit (MCU) power pin connection. Controlled current profiling revealed unexpected behaviour of nodes and detailed current-voltage relationships. These relationships were utilized with a lifetime projection model to estimate a lifetime between 521-551 days, depending on the mode of operation. The power system and QML-WSN were tested over a long term trial lasting 272+ days in an industrial testbed to monitor an air compressor pump. Environmental factors were found to influence the behaviour of nodes leading to increased charge consumption, while a node in an office setting was still operating at the conclusion of the trail. This agrees with the lifetime projection and gives a strong indication that a 1+ year lifetime is achievable. Additionally, a light-weight charge consumption model was developed which allows charge consumption information of nodes in a distributed WSN to be monitored. This model was tested in a laboratory setting demonstrating +95% accuracy for high packet reception rate WSNs across varying data rates, battery supply capacities, and runtimes up to full battery depletion.