Bioelectrical impedance with different equations versus deuterium oxide dilution method for the inference of body composition in healthy older persons

There is no consensus regarding the accuracy of bioimpedance for the determination of body composition in older persons. This study aimed to compare the assessment of lean body mass of healthy older volunteers obtained by the deuterium dilution method (reference) with those obtained by two frequently used bioelectrical impedance formulas and one formula specifically developed for a Latin-American population. A cross-sectional study. Twenty one volunteers were studied, 12 women, with mean age 72 +/- 6.7 years. Urban community, Ribeiro Preto, Brazil. Fat free mass was determined, simultaneously, by the deuterium dilution method and bioelectrical impedance; results were compared. In bioelectrical impedance, body composition was calculated by the formulas of Deuremberg, Lukaski and Bolonchuck and Valencia et al. Lean body mass of the studied volunteers, as determined by bioelectrical impedance was 37.8 +/- 9.2 kg by the application of the Lukaski e Bolonchuk formula, 37.4 +/- 9.3 kg (Deuremberg) and 43.2 +/- 8.9 kg (Valencia et. al.). The results were significantly correlated to those obtained by the deuterium dilution method (41.6 +/- 9.3 Kg), with r=0.963, 0.932 and 0.971, respectively. Lean body mass obtained by the Valencia formula was the most accurate. In this study, lean body mass of older persons obtained by the bioelectrical impedance method showed good correlation with the values obtained by the deuterium dilution method. The formula of Valencia et al., developed for a Latin-American population, showed the best accuracy.

The epidemiology of chronic fatigue in San Francisco

Chronic fatigue syndrome (CFS) is a recently defined condition characterized by severe disabling fatigue that persists for a minimum of six months, and a host of somatic and neurocognitive symptoms. Although conditions similar to CFS have been described in the medical literature for over 100 years, little is known about the epidemiology of CFS or of chronic fatigue generally. The San Francisco Fatigue Study was undertaken to describe the prevalence and characteristics of self-reported chronic fatigue and associated conditions in a diverse urban community. The study utilized a cross-sectional telephone survey of a random sample of households in San Francisco, followed by case/control interviews of fatigued and nonfatigued subjects. Respondents were classified as chronically fatigued (CF) if they reported severe fatigue lasting six months or longer, then further classified as having CFS-like illness if, based on self-reported information, their condition appeared to meet CFS case definition criteria. Subjects who reported idiopathic chronic fatigue that did not meet CFS criteria were classified as having ICF-like illness.^ 8004 households were screened, yielding fatigue and demographic information on 16970 residents. CF was reported by 635 persons, 3.7% of the study population. CFS-like illness was identified in 34 subjects (0.2%), and ICF-like illness in 259 subjects (1.6%). Logistic regression analysis indicated that prevalence odds ratios for CFS-like illness were significantly elevated for females compared to males (OR = 2.9), and in Blacks (OR = 2.9) and Native Americans (OR = 13.2) relative to Whites, but significantly lower in Asians (OR = 0.12). Above-average household income was protective for all categories of CF. CFS-like subjects reported more symptoms and were more severely disabled than ICF-like subjects, but the pattern of symptoms experienced by both groups was similar. In conclusion, unexplained chronic fatigue, including CFS-like illness, occurs in all sociodemographic groups, but may be most prevalent among persons with lower incomes and in some racial minorities. Future studies that include clinical evaluation of incident cases of CFS and ICF are required to further clarify the epidemiology of unexplained chronic fatigue in the population. ^

Territorial assemblages and Governance : The example of the Taonaba project [Town of Abymes, Guadeloupe]

This article reports on an action research to support the urban community of Cap Excellence in Guadaloupe in its local sustainable development project. After summarizing the terms of the debate around sustainable development, and presenting the region, the search will be put back into the context of a more general approach of territorial* intelligence (TI). The limits of a local Agenda 21 in the form of a 'programmed action plan' is the chance to enhance the concept of TI with that of territorial assemblage. Our study area is the natural reserve of the Grand Cul-de-Sac Marin of Guadeloupe, the second largest biosphere reserve designated by UNESCO in the archipelago of the Petites Antilles, more specifically the implementation of the Taonaba project, whose goal is to launch an ecotourism visitors' centre, operational at the end of 2012. Based on the analysis of a large amount of data, the article describes an evaluation tool for territorial assemblages for participative territorial governance. Our results were presented to local government officials in the Urban Sustainable Development Forum, which our group organised from 2 to 4 April 2012, in the district of Abymes/Pointe-à-Pitre

Territorial assemblages and Governance : The example of the Taonaba project [Town of Abymes, Guadeloupe]

This article reports on an action research to support the urban community of Cap Excellence in Guadaloupe in its local sustainable development project. After summarizing the terms of the debate around sustainable development, and presenting the region, the search will be put back into the context of a more general approach of territorial* intelligence (TI). The limits of a local Agenda 21 in the form of a 'programmed action plan' is the chance to enhance the concept of TI with that of territorial assemblage. Our study area is the natural reserve of the Grand Cul-de-Sac Marin of Guadeloupe, the second largest biosphere reserve designated by UNESCO in the archipelago of the Petites Antilles, more specifically the implementation of the Taonaba project, whose goal is to launch an ecotourism visitors' centre, operational at the end of 2012. Based on the analysis of a large amount of data, the article describes an evaluation tool for territorial assemblages for participative territorial governance. Our results were presented to local government officials in the Urban Sustainable Development Forum, which our group organised from 2 to 4 April 2012, in the district of Abymes/Pointe-à-Pitre

Territorial assemblages and Governance : The example of the Taonaba project [Town of Abymes, Guadeloupe]

This article reports on an action research to support the urban community of Cap Excellence in Guadaloupe in its local sustainable development project. After summarizing the terms of the debate around sustainable development, and presenting the region, the search will be put back into the context of a more general approach of territorial* intelligence (TI). The limits of a local Agenda 21 in the form of a 'programmed action plan' is the chance to enhance the concept of TI with that of territorial assemblage. Our study area is the natural reserve of the Grand Cul-de-Sac Marin of Guadeloupe, the second largest biosphere reserve designated by UNESCO in the archipelago of the Petites Antilles, more specifically the implementation of the Taonaba project, whose goal is to launch an ecotourism visitors' centre, operational at the end of 2012. Based on the analysis of a large amount of data, the article describes an evaluation tool for territorial assemblages for participative territorial governance. Our results were presented to local government officials in the Urban Sustainable Development Forum, which our group organised from 2 to 4 April 2012, in the district of Abymes/Pointe-à-Pitre

April 4, 1968: Death, Difference, and Dialogue

Robert Kennedy's announcement of the assassination of Martin Luther King, Jr., in an Indianapolis urban community that did not revolt in riots on April 4, 1968, provides one significant example in which feelings, energy, and bodily risk resonate alongside the articulated message. The relentless focus on Kennedy's spoken words, in historical biographies and other critical research, presents a problem of isolated effect because the power really comes from elements outside the speech act. Thus, this project embraces the complexities of rhetorical effectivity, which involves such things as the unique situational context, all participants (both Kennedy and his audience) of the speech act, aesthetic argument, and the ethical implications. This version of the story embraces the many voices of the participants through first hand interviews and new oral history reports. Using evidence provided from actual participants in the 1968 Indianapolis event, this project reflects critically upon the world disclosure of the event as it emerges from those remembrances. Phenomenology provides one answer to the constitutive dilemma of rhetorical effectivity that stems from a lack of a framework that gets at questions of ethics, aesthetics, feelings, energy, etc. Thus, this work takes a pedagogical shift away from discourse (verbal/written) as the primary place to render judgments about the effects of communication interaction. With a turn to explore extra-sensory reasoning, by way of the physical, emotional, and numinous, a multi-dimensional look at public address is delivered. The rhetorician will be interested in new ways of assessing effects. The communication ethicist will appreciate the work as concepts like answerability, emotional-volitional tone, and care for the other, come to life via application and consideration of Kennedy's appearance. For argumentation scholars, the interest comes forth in a re-thinking of how we do argumentation. And the critical cultural scholar will find this story ripe with opportunities to uncover the politics of representation, racialized discourse, privilege, power, ideological hegemony, and reconciliation. Through an approach of multiple layers this real-life tale will expose the power of the presence among audience and speaker, emotive argument, as well as the magical turn of fate which all contributes the possibility of a dialogic rhetoric.

The theory of margin as a predictor of success on the National Council Licensure Examination for Registered Nurses

The National Council Licensure Examination for Registered Nurses (NCLEX-RN) is the examination that all graduates of nursing education programs must pass to attain the title of registered nurse. Currently the NCLEX-RN passing rate is at an all-time low (81%) for first-time test takers (NCSBN, 2004); amidst a nationwide shortage of registered nurses (Glabman, 2001). Because of the critical need to supply greater numbers of professional nurses, and the potential accreditation ramifications that low NCLEX-RN passing rates can have on schools of nursing and graduates, this research study tests the effectiveness of a predictor model. This model is based upon the theoretical framework of McClusky's (1959) theory of margin (ToM), with the hope that students found to be at-risk for NCLEX-RN failure can be identified and remediated prior to taking the actual licensure examination. To date no theory based predictor model has been identified that predicts success on the NCLEX-RN. ^ The model was tested using prerequisite course grades, nursing course grades and scores on standardized examinations for the 2003 associate degree nursing graduates at a urban community college (N = 235). Success was determined through the reporting of pass on the NCLEX-RN examination by the Florida Board of Nursing. Point biserial correlations tested model assumptions regarding variable relationships, while logistic regression was used to test the model's predictive power. ^ Correlations among variables were significant and the model accounted for 66% of variance in graduates' success on the NCLEX-RN with 98% prediction accuracy. Although certain prerequisite course grades and nursing course grades were found to be significant to NCLEX-RN success, the overall model was found to be most predictive at the conclusion of the academic program of study. The inclusion of the RN Assessment Examination, taken during the final semester of course work, was the most significant predictor of NCLEX-RN success. Success on the NCLEX-RN allows graduates to work as registered nurses, reflects positively on a school's academic performance record, and supports the appropriateness of the educational program's goals and objectives. The study's findings support potential other uses of McClusky's theory of margin as a predictor of program outcome in other venues of adult education. ^

Explaining the effects of class size on faculty and students

This study explored the effects of class size on faculty and students. Specifically, it examined the relationship of class size and students' participation in class, faculty interactive styles, and academic environment and how these behaviors affected student achievement (percentage of students passing). The sample was composed of 629 students in 30 sections of Algebra I at a large, urban community college. A survey was administered to the students to solicit their perceptions on their participation in class, their faculty interaction style, and the academic environment in their classes. Selected classes were observed to triangulate the findings. The relationship of class size to student participation, faculty interactive styles, and academic environment was determined by using hierarchical linear modeling (HLM). A significant difference was found on the participation of students related to class size. Students in smaller classes participated more and were more engaged than students in larger classes. Regression analysis using the same variables in small and large classes showed that faculty interactive styles significantly predicted student achievement. Stepwise regression analyses of student and faculty background variables showed that (a) students' estimate of GPA was significantly related to their achievement (r = .63); (b) older students reported more participation than did younger ones, (c) students in classes taught by female, Hispanic faculty earned higher passing grades, and (d) students' participation was greater with adjunct professors. Class observations corroborated these findings. The analysis and observational data provided sufficient evidence to warrant the conclusion that small classes were not always most effective in promoting achievement. It was found that small classes may be an artifact of ineffectual teaching, actual or by reputation. While students in small classes participate and are more engaged than students in larger classes, the class-size effect is essentially due to what happens in instruction to promote learning. The interaction of the faculty with students significantly predicted students' achievement regardless of class size. Since college students select their own classes, students do not register for classes taught by faculty with poor teaching reputation, thereby leading to small classes. Further studies are suggested to determine reasons why classes differ in size.

The effects of student -centered and traditional models of teaching on reading skills

A pre-test, post-test, quasi-experimental design was used to examine the effects of student-centered and traditional models of reading instruction on outcomes of literal comprehension and critical thinking skills. The sample for this study consisted of 101 adult students enrolled in a high-level developmental reading course at a large, urban community college in the Southeastern United States. The experimental group consisted of 48 students, and the control group consisted of 53 students. Students in the experimental group were limited in the time spent reading a course text of basic skills, with instructors using supplemental materials such as poems, news articles, and novels. Discussions, the reading-writing connection, and student choice in material selection were also part of the student-centered curriculum. Students in the control group relied heavily on a course text and vocabulary text for reading material, with great focus placed on basic skills. Activities consisted primarily of multiple-choice questioning and quizzes. The instrument used to collect pre-test data was Descriptive Tests of Language Skills in Reading Comprehension; post-test data were taken from the Florida College Basic Skills Exit Test. A MANCOVA was used as the statistical method to determine if either model of instruction led to significantly higher gains in literal comprehension skills or critical thinking skills. A paired samples t-test was also used to compare pre-test and post-test means. The results of the MANCOVA indicated no significant difference between instructional models on scores of literal comprehension and critical thinking. Neither was there any significant difference in scores between subgroups of age (under 25 and 25 and older) and language background (native English speaker and second-language learner). The results of the t-test indicated, however, that students taught under both instructional models made significant gains in on both literal comprehension and critical thinking skills from pre-test to post-test.

Understanding Immigrants' Travel Behavior in Florida: Neighborhood Effects and Behavioral Assimilation

The goal of this study was to develop Multinomial Logit models for the mode choice behavior of immigrants, with key focuses on neighborhood effects and behavioral assimilation. The first aspect shows the relationship between social network ties and immigrants’ chosen mode of transportation, while the second aspect explores the gradual changes toward alternative mode usage with regard to immigrants’ migrating period in the United States (US). Mode choice models were developed for work, shopping, social, recreational, and other trip purposes to evaluate the impacts of various land use patterns, neighborhood typology, socioeconomic-demographic and immigrant related attributes on individuals’ travel behavior. Estimated coefficients of mode choice determinants were compared between each alternative mode (i.e., high-occupancy vehicle, public transit, and non-motorized transport) with single-occupant vehicles. The model results revealed the significant influence of neighborhood and land use variables on the usage of alternative modes among immigrants. Incorporating these indicators into the demand forecasting process will provide a better understanding of the diverse travel patterns for the unique composition of population groups in Florida.

Is there really "nothing you can do"? Pathways to enhanced flood-risk preparedness

Whilst policy makers have tended to adopt an ‘information-deficit model’ to bolster levels of flood-risk preparedness primarily though communication strategies promoting awareness, the assumed causal relation between awareness and preparedness is empirically weak. As such, there is a growing interest amongst scholars and policy makers alike to better understand why at-risk individuals are underprepared. In this vein, empirical studies, typically employing quantitative methods, have tended to focus on exploring the extent to which flood-risk preparedness levels vary depending not only on socio-demographic variables, but also (and increasingly so) the perceptual factors that influence flood risk preparedness. This study builds upon and extends this body of research by offering a more solution-focused approach that seeks to identify how pathways to flood-risk preparedness can be opened up. Specifically, through application of a qualitative methodology, we seek to explore how the factors that negatively influence flood-risk preparedness can be addressed to foster a shift towards greater levels of mitigation behaviour. In doing so, we focus our analysis on an urban community in Ireland that is identified as ‘at risk’ of flash flooding and is currently undergoing significant flood relief works. In this regard, the case study offers an interesting laboratory to explore how attitudes towards flood-risk preparedness at the individual level are being influenced within the context of a flood relief scheme that is only partially constructed. In order to redress the dearth of theoretically informed qualitative studies in this field, we draw on Protection Motivation Theory (PMT) to help guide our analysis and make sense of our results. Our findings demonstrate that flood-risk preparedness can be undermined by low levels of efficacy amongst individuals in terms of the preparedness measures available to them and their own personal capacity to implement them. We also elucidate that the ‘levee effect’ can occur before engineered flood defences are fully constructed as the flood relief works within our case study are beginning to affect people’s perception of flood risk in the case study area. We conclude by arguing that 1) individuals’ coping appraisals need to be enhanced through communication strategies and other interventions which highlight that future floods may not replicate past events; and 2) the concept of residual risk needs to be communicated at all stages of a flood relief scheme, not just upon completion.

Resilience and the cultural landscape : the case of the Lower Ninth Ward after Hurricane Katrina

Le but de cette recherche est d’évaluer l’importance du paysage culturel dans la résilience des communautés urbaines post-catastrophes. Ce travail se concentre sur le quartier du Lower Ninth Ward dans la ville de La Nouvelle-Orléans (États-Unis) après le passage de l’ouragan Katrina en 2005. Les catastrophes naturelles prennent une envergure et causent des dommages considérables lorsqu’elles touchent des villes. La reconstruction post -désastre est donc très dispendieuse pour les villes et les gouvernements, d’autant que certaines régions sont dévastées au point qu’elles doivent être reconstruites au complet. Cependant, le coût le plus lourd à assumer reste celui en vies humaines et si rebâtir les éléments concrets d’une ville est une tâche difficile à entreprendre, reconstruire une communauté est considérablement plus complexe. Dans le but de comprendre une telle démarche, cette recherche se concentre sur les éléments intangibles, comme l’attachement au lieu et les réseaux sociaux, dont une communauté a besoin pour se reconstituer de façon durable et résiliente. Le concept de résilience est très contesté dans la littérature et plusieurs chercheurs se sont essayés à le mesurer. Cette recherche adopte une perspective critique sur le concept et le revisite d’un point de vue holistique pour mettre en lumière sa complexité. Cette démarche permet de remettre en question l’importance de mesurer un concept finalement en perpétuelle redéfinition dans le temps et selon les échelles géographiques. De plus, en établissant une relation entre résilience et paysage culturel, il a été possible de mieux comprendre la complexité de la résilience. Touchant à plusieurs disciplines (architecture de paysage, urbanisme et sociologie), cette recherche utilise une méthodologie qui reflète son aspect multidisciplinaire : les méthodes mixtes. Ces dernières permettent la collecte de données quantitatives et qualitatives qui produisent une vue globale de la situation post-Katrina à travers le regroupement de recensions statistiques, d’observations de terrain et d’articles de journaux. Parallèlement, des entretiens ont été réalisés avec des résidents du quartier ainsi qu’avec des professionnels pour mieux comprendre les différents points de vue. Cette méthodologie a permis de produire des résultats au niveau du cas d’étude autant qu’au niveau théorique. La recherche valide l’importance de prendre en compte le paysage culturel dans les situations post-catastrophes, (en particulier) dans la mesure où il s’agit d’un élément souvent négligé par les urbanistes et les acteurs locaux. En effet, les éléments constitutifs du paysage culturel tels que l’attachement au lieu et les réseaux sociaux, participent d’un sentiment d'appartenance (« home ») et d’une volonté, pour les résidents, de reconstruire leurs habitations, leur communauté ainsi que leur quartier. Toutefois, il faut reconnaître que ces éléments ne suffisent pas à retrouver ce qu’ils ont perdu. Ainsi, l’étude du paysage culturel permet non seulement de mieux comprendre la complexité de la résilience, mais démontre également que cette dernière est une construction sociale.

Resilience and the cultural landscape : the case of the Lower Ninth Ward after Hurricane Katrina

Le but de cette recherche est d’évaluer l’importance du paysage culturel dans la résilience des communautés urbaines post-catastrophes. Ce travail se concentre sur le quartier du Lower Ninth Ward dans la ville de La Nouvelle-Orléans (États-Unis) après le passage de l’ouragan Katrina en 2005. Les catastrophes naturelles prennent une envergure et causent des dommages considérables lorsqu’elles touchent des villes. La reconstruction post -désastre est donc très dispendieuse pour les villes et les gouvernements, d’autant que certaines régions sont dévastées au point qu’elles doivent être reconstruites au complet. Cependant, le coût le plus lourd à assumer reste celui en vies humaines et si rebâtir les éléments concrets d’une ville est une tâche difficile à entreprendre, reconstruire une communauté est considérablement plus complexe. Dans le but de comprendre une telle démarche, cette recherche se concentre sur les éléments intangibles, comme l’attachement au lieu et les réseaux sociaux, dont une communauté a besoin pour se reconstituer de façon durable et résiliente. Le concept de résilience est très contesté dans la littérature et plusieurs chercheurs se sont essayés à le mesurer. Cette recherche adopte une perspective critique sur le concept et le revisite d’un point de vue holistique pour mettre en lumière sa complexité. Cette démarche permet de remettre en question l’importance de mesurer un concept finalement en perpétuelle redéfinition dans le temps et selon les échelles géographiques. De plus, en établissant une relation entre résilience et paysage culturel, il a été possible de mieux comprendre la complexité de la résilience. Touchant à plusieurs disciplines (architecture de paysage, urbanisme et sociologie), cette recherche utilise une méthodologie qui reflète son aspect multidisciplinaire : les méthodes mixtes. Ces dernières permettent la collecte de données quantitatives et qualitatives qui produisent une vue globale de la situation post-Katrina à travers le regroupement de recensions statistiques, d’observations de terrain et d’articles de journaux. Parallèlement, des entretiens ont été réalisés avec des résidents du quartier ainsi qu’avec des professionnels pour mieux comprendre les différents points de vue. Cette méthodologie a permis de produire des résultats au niveau du cas d’étude autant qu’au niveau théorique. La recherche valide l’importance de prendre en compte le paysage culturel dans les situations post-catastrophes, (en particulier) dans la mesure où il s’agit d’un élément souvent négligé par les urbanistes et les acteurs locaux. En effet, les éléments constitutifs du paysage culturel tels que l’attachement au lieu et les réseaux sociaux, participent d’un sentiment d'appartenance (« home ») et d’une volonté, pour les résidents, de reconstruire leurs habitations, leur communauté ainsi que leur quartier. Toutefois, il faut reconnaître que ces éléments ne suffisent pas à retrouver ce qu’ils ont perdu. Ainsi, l’étude du paysage culturel permet non seulement de mieux comprendre la complexité de la résilience, mais démontre également que cette dernière est une construction sociale.

A spatial approach for the epidemiology of antibiotic use and resistance in community-based studies: the emergence of urban clusters of Escherichia coli quinolone resistance in Sao Paulo, Brasil

Background: Population antimicrobial use may influence resistance emergence. Resistance is an ecological phenomenon due to potential transmissibility. We investigated spatial and temporal patterns of ciprofloxacin (CIP) population consumption related to E. coli resistance emergence and dissemination in a major Brazilian city. A total of 4,372 urinary tract infection E. coli cases, with 723 CIP resistant, were identified in 2002 from two outpatient centres. Cases were address geocoded in a digital map. Raw CIP consumption data was transformed into usage density in DDDs by CIP selling points influence zones determination. A stochastic model coupled with a Geographical Information System was applied for relating resistance and usage density and for detecting city areas of high/low resistance risk. Results: E. coli CIP resistant cluster emergence was detected and significantly related to usage density at a level of 5 to 9 CIP DDDs. There were clustered hot-spots and a significant global spatial variation in the residual resistance risk after allowing for usage density. Conclusions: There were clustered hot-spots and a significant global spatial variation in the residual resistance risk after allowing for usage density. The usage density of 5-9 CIP DDDs per 1,000 inhabitants within the same influence zone was the resistance triggering level. This level led to E. coli resistance clustering, proving that individual resistance emergence and dissemination was affected by antimicrobial population consumption.