Selected problems of hazardous waste management in California; report.

Most of the pages of the photocopy, which is in double columns, represent approximately 2 pages of the original.

Survey of the federal government on supervisor practices in employment of people with disabilities /

Shipping list no.: 2003-0007-P.

Report to the secretary and the Congress on immunosuppressive therapies /

"October 1985."

Balancing Cooperation and Competition: A New in Era in U.S.-China Relations

Created as part of the 2016 Jackson School for International Studies SIS 495: Task Force.

Public Land for Affordable Housing: An Evaluation of a HALA Proposal in Seattle

Thesis (Master's)--University of Washington, 2016-06

The relative importance of vascular structure and function in predicting cardiovascular events

OBJECTIVES We sought to assess the prognostic utility of brachial artery reactivity (BAR) in patients at risk of cardiovascular events. BACKGROUND Impaired flow-mediated vasodilation measured by BAR is a marker of endothelial dysfunction. Brachial artery reactivity is influenced by risk factors and is responsive to various pharmacological and other treatments. However, its prognostic importance is uncertain, especially relative to other predictors of outcome. METHODS A total of 444 patients were prospectively enrolled to undergo BAR and follow-up. These patients were at risk of cardiovascular events, based on the presence of risk factors or known or suspected cardiovascular disease. We took a full clinical history, performed BAR, and obtained carotid intima-media thickness (IMT) and left ventricular mass and ejection fraction. Patients were followed up for cardiovascular events and all-cause mortality. Multivariate Cox regression analysis was performed to assess the independent association of investigation variables on outcomes. RESULTS The patients exhibited abnormal BAR (5.2 +/- 6.1% [mean +/- SD]) but showed normal nitrate-mediated dilation (9.9 +/- 7.2%) and normal mean IMT (0.67 +/- 0.12 mm [average]). Forty-nine deaths occurred over the median follow-up period of 24 months (interquartile range 10 to 34). Patients in the lowest tertile group of BAR (<2%) had significantly more events than those in the combined group of highest and mid-tertiles (p = 0.029, log-rank test). However, mean IMT (rather than flow-mediated dilation) was the vascular factor independently associated with mortality, even in the subgroup (n = 271) with no coronary artery disease and low risk. CONCLUSIONS Brachial artery reactivity is lower in patients with events, but is not an independent predictor of cardiovascular outcomes in this cohort of patients. (C) 2004 by the American College of Cardiology Foundation.

A proposed new classification system for whiplash associated disorders - implications for assessment and management

The development of chronic symptoms following whiplash injury is common and contributes substantially to costs associated with this condition. The currently used Quebec Task Force classification system of whiplash associated disorders is primarily based on the severity of signs and symptoms following injury and its usefulness has been questioned. Recent evidence is emerging that demonstrates differences in physical and psychological impairments between individuals who recover from the injury and those who develop persistent pain and disability. Motor dysfunction, local cervical mechanical hyperalgesia and psychological distress are present soon after injury in all whiplash injured persons irrespective of recovery. In contrast those individuals who develop persistent moderate/severe pain and disability show a more complex picture, characterized by additional impairments of widespread sensory hypersensitivity indicative of underlying disturbances in central pain processing as well as acute posttraumatic stress reaction, with these changes present from soon after injury. Based on this heterogeneity a new classification system is proposed that takes into account measurable disturbances in motor, sensory and psychological dysfunction. The implications for the management of this condition are discussed. (C) 2004 Elsevier Ltd. All rights reserved.

Clinical decision-making and myocardial viability: current perspectives

Not all myocardium involved in a myocardial infarction is dead or irreversibly damaged. The balance between the amount of scar and live tissue, and the nature of the live tissue, determine the likelihood that contractile function will improve after revascularisation. This improvement (which defines viability) may be predicted with about 80% accuracy using several techniques. This review examines the determinants of functional recovery and how they may be integrated in making decisions regarding revascularisation. (Intern Med J 2005; 35: 118–125)

Impact of gender on risk stratification by exercise and dobutamine stress echocardiography: long-term mortality in 4234 women and 6898 men

Aims Prior research is limited with regard to the diagnostic and prognostic accuracy of commonplace cardiac imaging modalities in women. The aim of this study was to examine 5-year mortality in 4234 women and 6898 men undergoing exercise or dobutamine stress echocardiography at three hospitals. Methods and results Univariable and multivariable Cox proportional hazards models were used to estimate time to cardiac death in this multi-centre, observational registry. Of the 11 132 patients, women had a greater frequency of cardiac risk factors (P < 0.0001). However, men more often had a history of coronary disease including a greater frequency of echocardiographic wall motion abnormalities (P < 0.0001). During 5 years of follow-up, 103 women and 226 men died from ischaernic heart disease (P < 0.0001). Echocardiographic estimates of left ventricular function (P < 0.0001) and the extent of ischaernic watt motion abnormalities (P < 0.0001) were highly predictive of cardiac death. Risk-adjusted 5-year survival was 99.4, 97.6, and 95% for exercising women with no, single, and multi-vessel ischaemia (P < 0.0001). For women undergoing dobutamine stress, 5-year survival was 95, 89, and 86.6% for those with 0, 1, and 2-3 vessel ischaemia (P < 0.0001). Exercising men had a 2.0-fold higher risk at every level of worsening ischaemia (P < 0.0001). Significantly worsening cardiac survival was noted for the 1568 men undergoing dobutamine stress echocardiography (P < 0.0001); no ischaemia was associated with 92% 5-year survival as compared with death rates of &GE; 16% for men with ischaemia on dobutamine stress echocardiography (P < 0.0001). Conclusion Echocardiographic measures of inducible wall motion abnormalities and global and regional left ventricutar function are highly predictive of long-term outcome for women and men alike.

Rotary atomizer drop size distribution database

Wind tunnel measurements of drop Size distributions from Micronair A U4000 and A U5000 rotary atomizers were collected to develop a database for model use. The measurements varied tank mix, flow rate, air speed, and blade angle conditions, which were correlated by multiple regressions (average R-2 = 0.995 for A U4000 and 0.988 for AU5000). This database replaces an outdated set of rotary atomizer data measured in the 1980s by the USDA Forest Service and fills in a gap in data measured in the 1990s by the Spray Drift Task Force. Since current USDA Forest Service spray projects rely on rotary atomizers, the creation of the database (and its multiple regression interpolation) satisfies a need seen for ten years.

Validity of BMI as a measure of obesity in Australian white Caucasian and Australian Sri lankan children

Background: Body mass index ( BMI) is used to diagnose obesity. However, its ability to predict the percentage fat mass (% FM) reliably is doubtful. Therefore validity of BMI as a diagnostic tool of obesity is questioned. Aim: This study is focused on determining the ability of BMI- based cut- off values in diagnosing obesity among Australian children of white Caucasian and Sri Lankan origin. Subjects and methods: Height and weight was measured and BMI ( W/H-2) calculated. Total body water was determined by deuterium dilution technique and fat free mass and hence fat mass derived using age- and gender- specific constants. A % FM of 30% for girls and 20% for boys was considered as the criterion cut- off level for obesity. BMI- based obesity cut- offs described by the International Obesity Task Force ( IOTF), CDC/ NCHS centile charts and BMI- Z were validated against the criterion method. Results: There were 96 white Caucasian and 42 Sri Lankan children. Of the white Caucasians, 19 ( 36%) girls and 29 ( 66%) boys, and of the Sri Lankans 7 ( 46%) girls and 16 ( 63%) boys, were obese based on % FM. The FM and BMI were closely associated in both Caucasians ( r = 0.81, P < 0.001) and Sri Lankans ( r = 0.92, P< 0.001). Percentage FM and BMI also had a lower but significant association. Obesity cut- off values recommended by IOTF failed to detect a single case of obesity in either group. However, NCHS and BMI- Z cut- offs detected cases of obesity with low sensitivity. Conclusions: BMI is a poor indicator of percentage fat and the commonly used cut- off values were not sensitive enough to detect cases of childhood obesity in this study. In order to improve the diagnosis of obesity, either BMI cut- off values should be revised to increase the sensitivity or the possibility of using other indirect methods of estimating the % FM should be explored.

Incremental cost-effectiveness of exercise echocardiography vs. SPECT imaging for the evaluation of stable chest pain

Aims Technological advances in cardiac imaging have led to dramatic increases in test utilization and consumption of a growing proportion of cardiovascular healthcare costs. The opportunity costs of strategies favouring exercise echocardiography or SPECT imaging have been incompletely evaluated. Methods and results We examined prognosis and cost-effectiveness of exercise echocardiography (n=4884) vs. SPECT (n=4637) imaging in stable, intermediate risk, chest pain patients. Ischaemia extent was defined as the number of vascular territories with echocardiographic wall motion or SPECT perfusion abnormalities. Cox proportional hazard models were employed to assess time to cardiac death or myocardial infarction (MI). Total cardiovascular costs were summed (discounted and inflation-corrected) throughout follow-up. A cost-effectiveness ratio = 2% annual event risk), SPECT ischaemia was associated with earlier and greater utilization of coronary revascularization (P < 0.0001) resulting in an incremental cost-effectiveness ratio of $32 381/LYS. Conclusion Health care policies aimed at allocating limited resources can be effectively guided by applying clinical and economic outcomes evidence. A strategy aimed at cost-effective testing would support using echocardiography in low-risk patients with suspected coronary disease, whereas those higher risk patients benefit from referral to SPECT imaging.

Building Community Coalitions for the Promotion of Physical Activity: 10,000 Steps Rockhampton

The 10,000 Steps Rockhampton project is a multi-strategy community-wide, physical activity intervention based on the simultaneous implementation of five strategies, each identified as 'best practice' for the promotion of physical activity. Several community partners were engaged to develop and implement the strategies during the first eighteen months of the project. These included: the local media (TV, newspaper and radio); the local Division of General Practice and other health professional groups; the Heart Foundation and ‘Just Walk It’; the local council; and several large worksites. A local physical activity task force was also formed to administer a 'micro-grants' scheme, and to guide the development of community based strategies. The presentation will focus on the critical elements involved in developing and maintaining relationships with community partners. These include identification and ‘courting’ of potential partners, strategies for keeping them engaged, and the challenges of maintaining the balance between ‘top-down’ (evidence-based) and ‘bottom-up’ (community-driven) strategies. Data on implementation and uptake of the key strategies will also be presented. These include: 1) process data on the number of health

DOS CABIDES DE EMPREGO AOS CABIDES DO CONHECIMENTO: UM CASO DE PARCERIA ENTRE O INSTITUTO GENERAL MOTORS E A ESCOLAMUNICIPAL DE ENSINO PROFª. ALCINA DANTAS FEIJÃO NO DESENVOLVIMENTO DA RESPONSABILIDADE SOCIAL EMPRESARIAL

O Brasil, até poucos anos atrás, não via em sua agenda de prioridades a educação como foco principal para o crescimento econômico, talvez por não acreditar que com a estabilidade da moeda, abertura da economia e outros fatores necessitassem de pessoal qualificado para poder manter a capacidade produtiva. Assim, o país tenta corrigir esta situação investindo em educação, incorporando novas tecnologias no processo produtivo, necessitando de uma força de trabalho hábil para aprender e desenvolver as novas técnicas. Atualmente o Brasil mantém um dos menores índices de desemprego, no entanto, muitas empresas sofrem com o apagão da qualificação, necessitando realizar treinamentos e por consequência aumento em seus custos. As empresas tentam driblar a falta de pessoal qualificado investindo nos programas de estágio e trainee, realizando contratações de profissionais estrangeiros, criando universidades corporativas, e em alguns casos, as empresas estreitam seus laços junto às redes de ensino, a fim de preparar jovens para o domínio de novas tecnologias, associado ao aprimoramento em sua área de atuação, evitando assim o desequilíbrio entre teoria e prática . As organizações empresariais conscientes de seu papel começam a compreender que a prosperidade tão almejada não se traduz por faturamentos vultosos ou simplesmente pela quantidade de produtos vendidos. Estas despertam para a criação e adaptação de empresas-cidadãs que por meio de suas ações sociais, buscam desenvolver atividades solidárias. Neste contexto, o presente trabalho tem como objetivo geral analisar a Responsabilidade Social Empresarial sob a ótica de parcerias com escolas (parceria entre a General Motors do Brasil, por meio de seu braço social - o Instituto General Motors e a Escola Municipal de Ensino Profª. Alcina Dantas Feijão da Cidade de São Caetano do Sul). A parceria se concretiza, por meio do Programa Jovens Empreendedores ou Fábrica de Cabides . O intuito do Programa é despertar o espírito empreendedor nos estudantes e incentivar a formação de futuros empresários. Com os objetivos específicos determinou-se: a) estudar parcerias entre empresas e escolas no desenvolvimento da RSE; b) entender os motivos que levaram a empresa e a escola a concretizar a parceria e suas expectativas; c) identificar possíveis alterações ocorridas na escola, atribuídas ao processo de parceria. A partir destes objetivos, o procedimento metodológico foi orientado pelo método de estudo de caso, objetivando uma pesquisa mais voltada para abordagem qualitativa, levantando-se referenciais teóricos, bem como, procedimentos de análise de dados por meio de questionário, observação direta e artefatos físicos. A análise compreensiva dos dados foi realizada a partir de dois núcleos temáticos: importância da parceria e mercado de trabalho. Os resultados evidenciam que iniciativas de parcerias podem se reverter em melhoria da qualidade de ensino que permita o desenvolvimento de habilidades e competências necessárias à inserção responsável no mercado de trabalho com uma dimensão cidadã.

Inspiring lecturers: sharing e-learning practice through european case studies

What motivates a university lecturer to consider introducing a new e-learning approach to their educational practice? Accounts of e-learning practice can invite discussion and reflection on the approaches taken, reinforcement of a particular model, connection with the experience of others, vicarious learning opportunities and glimpses into tacit knowledge. If these examples provoke thinking, could they have the ‘sticky qualities’, the memorable inspiration and ideas that move us to action, when we observe the practice of others? (Szulanski, 2003) “Case studies have the capacity to inspire but also to provoke and to challenge.” (JISC, 2004) This paper will discuss a process followed for sharing best practices of e-learning. It will explain how good practices were identified and gathered by the EUNIS E-Learning Task Force collaboration, using a database and a weblog (EUNIC, 2008). It will examine the methods used for the developing and compiling of the practices and the communication of these. Actual examples of some of the case studies gathered will be included in an appendix. Suggestions of ways to develop this process further and the tangible benefits identified will be examined to ask if effective practice can also become embedded practice.