Health outcomes, quality improvement and cost-effectiveness of the Community Diabetes Education (CoDE) program: Results of a randomized controlled trial

The objectives of this dissertation were to evaluate health outcomes, quality improvement measures, and the long-term cost-effectiveness and impact on diabetes-related microvascular and macrovascular complications of a community health worker-led culturally tailored diabetes education and management intervention provided to uninsured Mexican Americans in an urban faith-based clinic. A prospective, randomized controlled repeated measures design was employed to compare the intervention effects between: (1) an intervention group (n=90) that participated in the Community Diabetes Education (CoDE) program along with usual medical care; and (2) a wait-listed comparison group (n=90) that received only usual medical care. Changes in hemoglobin A1c (HbA1c) and secondary outcomes (lipid status, blood pressure and body mass index) were assessed using linear mixed-models and an intention-to-treat approach. The CoDE group experienced greater reduction in HbA1c (-1.6%, p<.001) than the control group (-.9%, p<.001) over the 12 month study period. After adjusting for group-by-time interaction, antidiabetic medication use at baseline, changes made to the antidiabetic regime over the study period, duration of diabetes and baseline HbA1c, a statistically significant intervention effect on HbA1c (-.7%, p=.02) was observed for CoDE participants. Process and outcome quality measures were evaluated using multiple mixed-effects logistic regression models. Assessment of quality indicators revealed that the CoDE intervention group was significantly more likely to have received a dilated retinal examination than the control group, and 53% achieved a HbA1c below 7% compared with 38% of control group subjects. Long-term cost-effectiveness and impact on diabetes-related health outcomes were estimated through simulation modeling using the rigorously validated Archimedes Model. Over a 20 year time horizon, CoDE participants were forecasted to have less proliferative diabetic retinopathy, fewer foot ulcers, and reduced numbers of foot amputations than control group subjects who received usual medical care. An incremental cost-effectiveness ratio of $355 per quality-adjusted life-year gained was estimated for CoDE intervention participants over the same time period. The results from the three areas of program evaluation: impact on short-term health outcomes, quantification of improvement in quality of diabetes care, and projection of long-term cost-effectiveness and impact on diabetes-related health outcomes provide evidence that a community health worker can be a valuable resource to reduce diabetes disparities for uninsured Mexican Americans. This evidence supports formal integration of community health workers as members of the diabetes care team.^

Element concentrations and isotopic composition of tholeiite and whole rocks samples from the east Mariana Basin

Studies of seafloor magnetic anomaly patterns suggest the presence of Jurassic oceanic crust in a large area in the western Pacific that includes the East Mariana, Nauru and Pigafetta Basins. Sampling of the igneous crust in this area by the Deep Sea Drilling Program (DSDP) and the Ocean Drilling Program (ODP) allows direct evaluation of the age and petrogenesis of this crust. ODP Leg 129 drilled a 51 m sequence of basalt pillows and massive flows in the central East Mariana Basin. 40Ar/39Ar ages determined in this study for two Leg 129 basalts average 114.6 +/- 3.2 Ma. This age is in agreement with the Albian-late Aptian paleontologic age of the overlying sediments, but is distinctively younger than the Jurassic age predicted by magnetic anomaly patterns in the basin. Compositionally, the East Mariana Basin basalts are uniformly low-K tholeiites that are depleted in highly incompatible elements compared to moderately incompatible ones, which is typical of mid-ocean ridge basalts (MORB) erupted near hotspots. The Sr, Nd and Pb isotopic compositions of the tholeiites (87Sr/86Sr init = 0.70360-0.70374; 143Nd/144Nd init = 0.512769-0.512790; 206Pb/204Pb meas = 18.355-18.386) also overlap with some Indian Ocean Ridge MORB, although they are distinct from the isotopic compositions of Jurassic basalts drilled in the Pigafetta Basin, the oldest Pacific MORB. The isotopic compositions of the East Mariana Basin tholeiites are also similar to those of intraplate basalts, and in particular, to the isotopic signature of basalts from the nearby Ontong Java and Manihiki Plateaus. The East Mariana Basin tholeiites also share many petrologic and isotopic characteristics with the oceanic basement drilled in the Nauru Basin at DSDP Site 462. In addition, the new 110.8 +/- 1.0 Ma 40Ar/39Ar age for two flows from the bottom of Site 462 in the Nauru Basin is indistinguishable from the age of the East Mariana Basin flows. Thus, while magnetic anomaly patterns predict that the igneous basement in the Nauru and East Mariana Basins is Jurassic in age, the geochemical and chronological results discussed here suggest that the basement formed during a Cretaceous rifting event within the Jurassic crust. This magmatic and tectonic event was created by the widespread volcanism responsible for the genesis of the large oceanic plateaus of the western Pacific.

Geochemistry of oceanic crust of the North Atlantic

87Sr/a6Sr ratios, Sr, K, Rb and Cs contents and the petrology of basalts and secondary phases recovered from deep basement drilling at DSDP Sites 332B, 417A, 417D and 418A show that the oceanic crust alters in four distinct stages characterized by formation of palagonite, smectite and calcite (Stages I, II and III, respectively). Stage IV represents the final compaction of the crust, including a dehydration of the crust without major chemical changes. Isotopic age determinations by Hart and Staudigel (1978, doi:10.1029/GL005i012p01009) and Richardson et al. (doi:10.1029/JB085iB12p07195), show that, at least for Atlantic-type crustal regimes, Stage I and II last for a maximum of 3 m.y., and Stage III lasts beyond Stage I and II, but is probably completed in significantly less than 10 m.y. Stage IV is long-lived and may still be active at 100 m.y. Stages I and II, the phase of halmyrolysis, include geochemically significant interactions between seawater and basalt for the upper 500 m of layer II and involve volumes of seawater containing a large basaltic component. Stage III solutions show evidence of less seawater-basalt interaction, at least to depths of 500 m; calcites deposited from these solutions have Sr isotopic ratios close to seawater values; but also have very low Sr/Ca ratios indicating a large basalt Ca component in the solutions. Smectite formation is the result of the interaction of seawater and basalt. The initial 87Sr/a6Sr ratios of smectites represent the Sr isotopic composition of the solution when the smectite is being formed. Thereafter, alkalies may be continuously added to interlayer positions in the smectite in order of decreasing hydration energy (Cs is more enriched than Rb, Rb more than K). The later-formed carbonates have very low alkali concentrations, and 87Sr/86Sr ratios identical to contemporaneous seawater. Therefore, since the alkali concentrations in a whole rock sample are affected by different alteration processes, the alkali concentrations alone are not reliable indicators of the degree of alteration.

Hydrochemical Atlas of the Arctic Ocean

Introduction: Chemical composition of water determines its physical properties and character of processes proceeding in it: freezing temperature, volume of evaporation, density, color, transparency, filtration capacity, etc. Presence of chemical elements in water solution confers waters special physical properties exerting significant influence on their circulation, creates necessary conditions for development and inhabitance of flora and fauna, and imparts to the ocean waters some chemical features that radically differ them from the land waters (Alekin & Liakhin, 1984). Hydrochemical information helps to determine elements of water circulation, convection depth, makes it easier to distinguish water masses and gives additional knowledge of climatic variability of ocean conditions. Hydrochemical information is a necessary part of biological research. Water chemical composition can be the governing characteristics determining possibility and limits of use of marine objects, both stationary and moving in sea water. Subject of investigation of hydrochemistry is study of dynamics of chemical composition, i.e. processes of its formation and hydrochemical conditions of water bodies (Alekin & Liakhin 1984). The hydrochemical processes in the Arctic Ocean are the least known. Some information on these processes can be obtained in odd publications. A generalizing study of hydrochemical conditions in the Arctic Ocean based on expeditions conducted in the years 1948-1975 has been carried out by Rusanov et al. (1979). The "Atlas of the World Ocean: the Arctic Ocean" contains a special section "Hydrochemistry" (Gorshkov, 1980). Typical vertical profiles, transects and maps for different depths - 0, 100, 300, 500, 1000, 2000, 3000 m are given in this section for the following parameters: dissolved oxygen, phosphate, silicate, pH and alkaline-chlorine coefficient. The maps were constructed using the data of expeditions conducted in the years 1948-1975. The illustrations reflect main features of distribution of the hydrochemical elements for multi-year period and represent a static image of hydrochemical conditions. Distribution of the hydrochemical elements on the ocean surface is given for two seasons - winter and summer, for the other depths are given mean annual fields. Aim of the present Atlas is description of hydrochemical conditions in the Arctic Ocean on the basis of a greater body of hydrochemical information for the years 1948-2000 and using the up-to-date methods of analysis and electronic forms of presentation of hydrochemical information. The most wide-spread characteristics determined in water samples were used as hydrochemical indices. They are: dissolved oxygen, phosphate, silicate, pH, total alkalinity, nitrite and nitrate. An important characteristics of water salt composition - "salinity" has been considered in the Oceanographic Atlas of the Arctic Ocean (1997, 1998). Presentation of the hydrochemical characteristics in this Hydrochemical Atlas is wider if compared with that of the former Atlas (Gorshkov, 1980). Maps of climatic distribution of the hydrochemical elements were constructed for all the standard depths, and seasonal variability of the hydrochemical parameters is given not only for the surface, but also for the underlying standard depths up to 400 m and including. Statistical characteristics of the hydrochemical elements are given for the first time. Detailed accuracy estimates of initial data and map construction are also given in the Atlas. Calculated values of mean-root deviations, maximum and minimum values of the parameters demonstrate limits of their variability for the analyzed period of observations. Therefore, not only investigations of chemical statics are summarized in the Atlas, but also some elements of chemical dynamics are demonstrated. Digital arrays of the hydrochemical elements obtained in nodes of a regular grid are the new form of characteristics presentation in the Atlas. It should be mentioned that the same grid and the same boxes were used in the Atlas, as those that had been used by creation of the US-Russian climatic Oceanographic Atlas. It allows to combine hydrochemical and oceanographic information of these Atlases. The first block of the digital arrays contains climatic characteristics calculated using direct observational data. These climatic characteristics were not calculated in the regions without observations, and the information arrays for these regions have gaps. The other block of climatic information in a gridded form was obtained with the help of objective analysis of observational data. Procedure of the objective analysis allowed us to obtain climatic estimates of the hydrochemical characteristics for the whole water area of the Arctic Ocean including the regions not covered by observations. Data of the objective analysis can be widely used, in particular, in hydrobiological investigations and in modeling of hydrochemical conditions of the Arctic Ocean. Array of initial measurements is a separate block. It includes all the available materials of hydrochemical observations in the form, as they were presented in different sources. While keeping in mind that this array contains some amount of perverted information, the authors of the Atlas assumed it necessary to store this information in its primary form. Methods of data quality control can be developed in future in the process of hydrochemical information accumulation. It can be supposed that attitude can vary in future to the data that were rejected according to the procedure accepted in the Atlas. The hydrochemical Atlas of the Arctic Ocean is the first specialized and electronic generalization of hydrochemical observations in the Arctic Ocean and finishes the program of joint efforts of Russian and US specialists in preparation of a number of atlases for the Arctic. The published Oceanographic Atlas (1997, 1998), Atlas of Arctic Meteorology and Climate (2000), Ice Atlas of the Arctic Ocean prepared for publication and Hydrochemical Atlas of the Arctic Ocean represent a united series of fundamental generalizations of empirical knowledge of Arctic Ocean nature at climatic level. The Hydrochemical Atlas of the Arctic Ocean was elaborated in the result of joint efforts of the SRC of the RF AARI and IARC. Dr. Ye. Nikiforov was scientific supervisor of the Atlas, Dr. R. Colony was manager on behalf of the USA and Dr. L. Timokhov - on behalf of Russia.

Safety, feasibility, and long-term results of percutaneous closure of atrial septal defects using the Amplatzer septal occluder without periprocedural echocardiography.

OBJECTIVES We sought to assess the safety and efficacy of percutaneous closure of atrial septal defects (ASDs) under fluoroscopic guidance only, without periprocedural echocardiographic guidance. BACKGROUND Percutaneous closure of ASDs is usually performed using simultaneous fluoroscopic and transthoracic, transesophageal (TEE), or intracardiac echocardiographic (ICE) guidance. However, TEE requires deep sedation or general anesthesia, which considerably lengthens the procedure. TEE and ICE increase costs. METHODS Between 1997 and 2008, a total of 217 consecutive patients (age, 38 ± 22 years; 155 females and 62 males), of whom 44 were children ≤16 years, underwent percutaneous ASD closure with an Amplatzer ASD occluder (AASDO). TEE guidance and general anesthesia were restricted to the children, while devices were implanted under fluoroscopic guidance only in the adults. For comparison of technical safety and feasibility of the procedure without echocardiographic guidance, the children served as a control group. RESULTS The implantation procedure was successful in all but 3 patients (1 child and 2 adults; 1.4%). Mean device size was 23 ± 8 mm (range, 4-40 mm). There was 1 postprocedural complication (0.5%; transient perimyocarditis in an adult patient). At last echocardiographic follow-up, 13 ± 23 months after the procedure, 90% of patients had no residual shunt, whereas a minimal, moderate, or large shunt persisted in 7%, 1%, and 2%, respectively. Four adult patients (2%) underwent implantation of a second device for a residual shunt. During a mean follow-up period of 3 ± 2 years, 2 deaths and 1 ischemic stroke occurred. CONCLUSION According to these results, percutaneous ASD closure using the AASDO without periprocedural echocardiographic guidance seems safe and feasible.

Results of the Technical Validation of an Accessible Contact Manager for Mobile Devices

The apparition of new mobile phones operating systems often leads to a flood of mobile applications rushing into the market without taking into account needs of the most vulnerable users groups: the people with disabilities. The need of accessible applications for mobile is very important especially when it comes to access basic mobile functions such as making calls through a contact manager. This paper presents the technical validation process and results of an Accessible Contact Manager for mobile phones as a part of the evaluation of accessible applications for mobile phones for people with disabilities.

Effects of feeding strategy, fiber source of the diet, and crude protein content on productive performance of broiler breeder hens

A 12-wk experiment was conducted to investigate the effect of feeding program, dietary fiber, and CP content of the diet on productive performance of Ross broiler breeder hens (41 wk of age). There were 12 treatments arranged factorially with 2 levels of CP (14.5 vs. 17.4%), 3 fiber sources (0 vs. 3% inulin vs. 3% cellulose), and 2 levels of feed intake (160 vs. 208 g/d) that corresponded to restricted (R) or ad libitum (AL) feeding systems. The experimental diets contained 2,800 kcal ME with either 0.65 (14.5% CP) or 0.78% Lys (17.4% CP).

Towards dynamic term size computation via program transformation

Knowing the size of the terms to which program variables are bound at run-time in logic programs is required in a class of applications related to program optimization such as, for example, recursion elimination and granularity analysis. Such size is difficult to even approximate at compile time and is thus generally computed at run-time by using (possibly predefined) predicates which traverse the terms involved. We propose a technique based on program transformation which has the potential of performing this computation much more efficiently. The technique is based on finding program procedures which are called before those in which knowledge regarding term sizes is needed and which traverse the terms whose size is to be determined, and transforming such procedures so that they compute term sizes "on the fly". We present a systematic way of determining whether a given program can be transformed in order to compute a given term size at a given program point without additional term traversal. Also, if several such transformations are possible our approach allows finding minimal transformations under certain criteria. We also discuss the advantages and present some applications of our technique.

A technique for dynamic term size computation via program transformation

Knowing the size of the terms to which program variables are bound at run-time in logic programs is required in a class of applications related to program optimization such as, for example, granularity analysis and selection among different algorithms or control rules whose performance may be dependent on such size. Such size is difficult to even approximate at compile time and is thus generally computed at run-time by using (possibly predefined) predicates which traverse the terms involved. We propose a technique based on program transformation which has the potential of performing this computation much more efficiently. The technique is based on finding program procedures which are called before those in which knowledge regarding term sizes is needed and which traverse the terms whose size is to be determined, and transforming such procedures so that they compute term sizes "on the fly". We present a systematic way of determining whether a given program can be transformed in order to compute a given term size at a given program point without additional term traversal. Also, if several such transformations are possible our approach allows finding minimal transformations under certain criteria. We also discuss the advantages and applications of our technique and present some performance results.

Dynamic term size computation in logic programs via program transformation

Knowing the size of the terms to which program variables are bound at run-time in logic programs is required in a class of applications related to program optimization such as, for example, recursion elimination and granularity analysis. Such size is difficult to even approximate at compile time and is thus generally computed at run-time by using (possibly predefined) predicates which traverse the terms involved. We propose a technique based on program transformation which has the potential of performing this computation much more efficiently. The technique is based on finding program procedures which are called before those in which knowledge regarding term sizes is needed and which traverse the terms whose size is to be determined, and transforming such procedures so that they compute term sizes "on the fly". We present a systematic way of determining whether a given program can be transformed in order to compute a given term size at a given program point without additional term traversal. Also, if several such transformations are possible our approach allows finding minimal transformations under certain criteria. We also discuss the advantages and present some applications of our technique.

Neurite, a finite difference large scale parallel program for the simulation of the electrical signal propagation in neurites under mechanical loading

With the growing body of research on traumatic brain injury and spinal cord injury, computational neuroscience has recently focused its modeling efforts on neuronal functional deficits following mechanical loading. However, in most of these efforts, cell damage is generally only characterized by purely mechanistic criteria, function of quantities such as stress, strain or their corresponding rates. The modeling of functional deficits in neurites as a consequence of macroscopic mechanical insults has been rarely explored. In particular, a quantitative mechanically based model of electrophysiological impairment in neuronal cells has only very recently been proposed (Jerusalem et al., 2013). In this paper, we present the implementation details of Neurite: the finite difference parallel program used in this reference. Following the application of a macroscopic strain at a given strain rate produced by a mechanical insult, Neurite is able to simulate the resulting neuronal electrical signal propagation, and thus the corresponding functional deficits. The simulation of the coupled mechanical and electrophysiological behaviors requires computational expensive calculations that increase in complexity as the network of the simulated cells grows. The solvers implemented in Neurite-explicit and implicit-were therefore parallelized using graphics processing units in order to reduce the burden of the simulation costs of large scale scenarios. Cable Theory and Hodgkin-Huxley models were implemented to account for the electrophysiological passive and active regions of a neurite, respectively, whereas a coupled mechanical model accounting for the neurite mechanical behavior within its surrounding medium was adopted as a link between lectrophysiology and mechanics (Jerusalem et al., 2013). This paper provides the details of the parallel implementation of Neurite, along with three different application examples: a long myelinated axon, a segmented dendritic tree, and a damaged axon. The capabilities of the program to deal with large scale scenarios, segmented neuronal structures, and functional deficits under mechanical loading are specifically highlighted.

"Deporte inclusivo en la escuela": diseño y análisis de un programa de intervencion para promover la inclusión del alumnado con discapacidad en Educación Física

La Educación Física se muestra, a priori, como un área idónea para trabajar intervenciones educativas para facilitar la inclusión de alumnos con discapacidad. Sin embargo, poco se conoce sobre el potencial que presentan los deportes adaptados y paralímpicos como contenido para fomentar la sensibilización y concienciación del alumnado sin discapacidad, especialmente en situaciones inclusivas de práctica. Por otro lado, la actitud del docente y su formación se presentan como claves en este contexto, ya que es quien en última instancia selecciona los contenidos a trabajar. Entendemos que en EF disponemos de una ocasión única en el curriculum para fomentar la participación activa y efectiva del alumno con discapacidad en clase (especialmente a nivel de desarrollo de la competencia motriz, entre otras), si bien esto depende de factores relacionados con los dos agentes anteriores. Es por todo ello que la Educación Física, como protagonista y como contenido, se muestra como un contexto adecuado para la investigación de los procesos de inclusión de alumnos con discapacidad en el ámbito educativo. Este trabajo de investigación pretende arrojar luz a los interrogantes que condicionan y limitan este contexto, desde una perspectiva multidisciplinar, con distintas metodologías, sobre los tres agentes indicados. La falta de consenso en la literatura en cuanto a las características y tipo de intervenciones eficaces para facilitar esta sensibilización del alumnado, unido a que es un ámbito relativamente reciente como tema de investigación, nos ha impulsado a trabajar en esta línea. El primer objetivo de este trabajo de investigación fue diseñar e implementar un programa de sensibilización y concienciación hacia la discapacidad basado en los deportes adaptados en el área de Educación Física para alumnos de secundaria y bachillerato. Inicialmente, se realizó una búsqueda bibliográfica tanto a nivel nacional como internacional, con el fin de definir las características principales que aporta la literatura científica en este aspecto. Apoyándonos por un lado, en el programa educativo Paralympic School Day (CPI, 2004) y por otro, en la citada revisión, desarrollamos un planteamiento inicial de estructura y fases. Dicho proyecto, fue presentado al Comité Paralímpico Español y a las federaciones deportivas españolas para personas con discapacidad, con la finalidad de recabar su apoyo institucional en forma de aval y recursos no solo a nivel económico sino también como apoyo logístico y de difusión. Tras su aprobación y gracias también al apoyo de la UPM, la Fundación Sanitas y Liberty Seguros, se procedió a diseñar el programa. Para el desarrollo de los materiales didácticos se contactó con expertos en la materia de EF y Actividad Física Adaptada tanto del ámbito educativo (profesores de educación secundaria y profesorado universitario) como del deportivo a nivel nacional. A su vez, se comenzó a difundir entre el profesorado de los centros con el fin de detectar su interés en participar durante el curso académico (2012-2013) en el programa “Deporte Inclusivo en la Escuela”. Con la finalización del desarrollo de los materiales didácticos, se visitó a los centros educativos para presentar el dossier informativo donde se explicaba el programa, así como las características y fases para su implementación. El programa está fundamentado en la Teoría del Contacto (Allport, 1954) y basado en los deportes adaptados y paralímpicos, planteado con una metodología inclusiva, seleccionando la información, la simulación y el contacto directo como estrategias para el fomento de la sensibilización y concienciación hacia la inclusión. En la reunión celebrada en la Facultad de Ciencias de la Actividad Física y del Deporte (INEF-UPM) en febrero de 2013, se coordinó junto con el profesorado la implementación del programa en cada uno de los 13 centros educativos, con acciones concretas como la adecuación de la propuesta didáctica en la planificación anual del profesor, el préstamo de material o la ponencia del deportista paralímpico entre otras cuestiones. Para la consecución del objetivo 2 de este trabajo, analizar el efecto del programa en los distintos agentes implicados en el mismo, alumnos sin discapacidad, profesorado de EF y alumnos con discapacidad, se calendarizó la toma de datos y la administración de las diferentes herramientas metodológicas para antes (pretest) como después de la intervención (posttets). En el caso de los alumnos sin discapacidad (N= 1068), se analizó el efecto de la intervención sobre la actitud hacia la inclusión, utilizando el cuestionario “Children Attitude Integrated Physical Education-Revised” (CAIPE-R; Block, 1995) de carácter cuantitativo tras su validación y adaptación al contexto español. Los resultados mostraron cambios significativos positivos en la actitud el grupo que mantuvo un contacto no estructurado con alumnos con discapacidad. En esta muestra también se midió la actitud hacia el juego cooperativo con compañeros con discapacidad en clases de EF usando el cuestionario “Children's Beliefs Toward Cooperative Playing With Peers With Disabilities in Physical Education” (CBIPPD-MPE; Obrusnikova, Block, y Dillon, 2010). El desarrollo de un sistema de categorías fundamentado en la Teoría del Comportamiento Planificado (Azjen, 1991) sirvió como base para el análisis de las creencias del alumnado sin discapacidad. Tras la intervención, las creencias conductuales emergentes se mantuvieron, excepto en el caso de los factores identificados como obstáculos de la inclusión. En el caso de las creencias normativas también se mantuvieron tras la intervención y respecto a las creencias de control, los alumnos identificaron al profesor como principal agente facilitador de la inclusión. En el caso de los profesores de EF participantes en el programa (N=18), se analizó el efecto del programa en su actitud hacia la inclusión de alumnos con discapacidad en EF con el cuestionario “Attitud toward inclusion of individual with physical disabilities in Physical Education” (ATISDPE-R; Kudláèek, Válková, Sherrill, Myers, y French, 2002). Los resultados mostraron que no se produjeron diferencias significativas tras la intervención en la actitud general, encontrando algunas diferencias en determinados ítems relacionados con los beneficios de la inclusión en los alumnos sin discapacidad relacionados con los docentes con experiencia previa con discapacidad y en EF antes de la intervención. La otra dimensión analizada fue el efecto de la intervención en la autoeficacia del profesor en la enseñanza de la EF en condiciones inclusivas, habiendo utilizado el cuestionario "Self-efficacy in teaching PE under inclusive conditions" (SEIPE; Hutzler, Zach, y Gafni, 2005). Los resultados en este caso muestran diferencias significativas positivas en cuestiones relacionadas como sentirse capaces de mejorar las condiciones óptimas de enseñanza con alumnos con discapacidad física como movilidad reducida severa y amputación y discapacidad visual tanto en situaciones deportivas, como juegos o actividades fuera del centro educativo a favor de los docentes. En cuanto al género, los hombres obtuvieron valores superiores a las mujeres en relación a sentirse más capaces de incluir a alumnos con discapacidad física tanto en juegos durante el recreo como en la enseñanza de técnica deportiva. Los profesores con menos de 10 años de docencia mostraron valores más positivos en cuanto a sentirse capaces de incluir a un alumno con discapacidad fisica en deportes durante su tiempo libre. El análisis del diario del profesor muestra por un lado, las tendencias emergentes como principales elementos facilitadores u obstaculizadores de la inclusión en EF, identificando al propio alumno sin discapacidad, el propio profesor, los contenidos, los materiales y la organización. Por otro lado, el análisis de los contenidos propuestos en el programa. En el caso de los alumnos con discapacidad (N=22), se analizó el impacto del programa de intervención en el autoconcepto, con el cuestionario "Autoconcepto forma 5" (AF5; F. García y Musitu, 2001). Se encontraron diferencias significativas a favor de las mujeres antes de la intervención en la dimensión familiar, mientras que los hombres obtuvieron valores más altos en las dimensiones social y físico. En cuanto a la edad, se encontraron diferencias significativas antes de la intervención, con valores superiores en los alumnos más jóvenes (12-14 años) en la dimensión físico, mientras que los alumnos mayores (15-17 años) mostraron valores más altos en la dimensión social del cuestionario. Respeto al tipo de discapacidad, los alumnos con discapacidad motórica mostraron mejores valores que los que tienen discapacidad auditiva para la dimensión físico antes de la intervención. En cuanto al autoconcepto general, las diferencias significativas positivas se producen en la dimensión académica. En cuanto al efecto del programa en la autoestima de los alumnos con discapacidad, se utilizó la Escala de "Autoestima de Rosenberg" (Rosenberg, 1989), no obteniendo diferencias significativas en cuanto el género. Apareciendo diferencias significativas antes de la intervención en el caso de la variable edad en los alumnos más jóvenes, en cuanto a que desearían valorarse más, y en los alumnos con discapacidad auditiva en que no se sienten muy orgullosos de ellos mismos. Se produce una mejora en la autoestima general en cuanto a que se sienten menos inútiles tras la intervención. En relación al objetivo 3 de este trabajo, tras el análisis de los resultados y haber discutido los mismos con los autores de referencia, emergió la propuesta de orientaciones tanto para los programa de intervención en EF para la sensibilización y concienciación del alumnado hacia la inclusión como de cara a la formación específica del profesorado, como clave en este tipo de intervenciones. Creemos que el programa “Deporte Inclusivo Escuela” se convierte en un elemento transformador de la realidad, ya que responde a las necesidades detectadas a la luz de esta investigación y que vienen a dar respuesta a los distintos agentes implicados en su desarrollo. Por un lado, atiende la demanda del ámbito educativo en cuanto a las necesidades de formación del profesorado, sensibilización y concienciación del alumnado sin discapacidad, además de facilitar oportunidades de participación activa al alumno con discapacidad en las sesiones de EF. Por otro lado, satisface la demanda por parte de las instituciones deportivas del ámbito de la discapacidad en cuanto a la promoción y difusión de los deportes adaptados y paralímpicos. Por último, desde el ámbito universitario, se muestra como un recurso en la formación del alumnado del grado en Ciencias de la Actividad Física y del Deporte, por su participación directa con la discapacidad. Por estos motivos, este trabajo se muestra como un punto de partida adecuado para seguir avanzando en la investigación en esta área. ABSTRACT Physical Education (PE) seems a priori, as a suitable area to work educational interventions to facilitate the inclusion of students with disabilities. However, little is known about the potential that have adapted and Paralympic sports as content to raise awareness of students without disabilities, especially in inclusive practice context. On the other hand, teachers’ attitude and their training are presented as key in this context because it is who selects the content to work. We understand that PE have a unique opportunity in the curriculum to encourage active and effective participation of students with disabilities in class (especially at motor competence development, etc.), although this depends on factors related to the two agents. For these reasons that the PE, as actors and as content is displayed as a context for investigating the processes of inclusion of students with disabilities in education. This research aims to shed light on the questions that condition and limit this context, from a multidisciplinary perspective, with different methodologies on the three agents mentioned. The lack of accord in the literature regarding the characteristics and type of effective facilitators of awareness of students, and that is a new area as a research topic, has prompted us to work in this topic research. The first aim of this research was to design and implement a program of awareness towards disability based on adapted sports in the area of physical education for middle and high school students. Initially, a literature search was performed both nationally and internationally, in order to define the main features that brings the scientific literature in this area. On the one hand, we supported in the Paralympic School Day (IPC, 2004) educative program and on the other hand, in that review, we developed an initial approach to structure and phases. The project was presented to the Spanish Paralympic Committee and the Spanish Sports Federations for people with disabilities, in order to obtain institutional support in the form of guarantees and resources not only in economic terms but also as logistical support and dissemination. Thanks to the support of Fundación Sanitas, Liberty Seguros and Politechnical University of Madrid, we proceeded to design the program. For the development of teaching resources it was contacted experts in the field of Adapted Physical Activity and physical education and both the field of education (high school teachers and university professors) as the adapted sport national. In turn, it began to spread among the teachers of the schools in order to identify their interest in participating in the academic year (2012-2013) in the "Inclusive Sport in School" program. With the completion of the development of educational materials to schools he was visited to present the briefing where the program, as well as features and steps for its implementation are explained. The program is based on the Contact Theory (Allport, 1954) and based on adapted and Paralympic sports, raised with an inclusive approach, selecting strategies for promoting awareness and awareness to inclusion like information, contact and simulation of disability. At the meeting held at the Faculty of Sciences of Physical Activity and Sport (INEF-UPM) in February 2013, it was coordinated with the teachers implementing the program in each of the 13 schools with concrete actions such as adequacy of methodological approach in the annual planning of the teacher, the loan or the presentation of materials Paralympian among other issues. To achieve the objective 2 of this paper, to analyze the effect of the program on the various actions involved it, students without disabilities, PE teachers and students with disabilities, the date for management of the different methodological tools for before (pretest) and after the intervention (posttets). For students without disabilities (N= 1068), the effect of the intervention on the attitude towards inclusion was analyzed, using the quantitative questionnaire "Integrated Physical Education Attitude Children-Revised" (CAIPE-R; Block, 1995), after validation and adaptation to the Spanish context. The results showed significant positive changes in the attitude of the group with no structured contact with students with disabilities. This shows the beliefs towards the cooperative play was with peers with disabilities in PE classes also measured, using the questionnaire "Children's Beliefs Toward Cooperative Playing With Peers With Disabilities in Physical Education" (CBIPPD-MPE; Obrusnikova, Block, and Dillon, 2010). The development of a system of categories based on the Theory of Planned Behavior (Azjen, 1991) served as the basis for analysis of the beliefs of students without disabilities. After surgery, emerging behavioral beliefs remained, except in the case of the factors identified as barriers to inclusion. In the case of normative beliefs also they remained after surgery and regarding control beliefs, students identified the teacher as the main facilitator of inclusion. Regarding PE teachers participating in the program (N = 18), the effect of the program was analyzed their attitude toward inclusion of students with disability in PE with the questionnaire "Toward Attitude inclusion of Individual with in Physical Education "(ATISDPE-R; Kudláèek, Válková, Sherrill, Myers, and French, 2002). The results showed no significant difference occurred after surgery in the general attitude, finding some differences in certain related benefits of inclusion in students without disability relating to teachers with previous experience with disability in PE before intervention. The other dimension was analyzed the effect of the intervention on self-efficacy of teachers in the teaching of PE in inclusive terms, having used the questionnaire "Self-efficacy in PE teaching even under conditions" (SEIPE; Hutzler, Zach, and Gafni, 2005). The results showed significant differences positive in issues like being able to enhance the optimal conditions for teaching students with physical disabilities as amputation and severe visual impairment in both sports situations, such as games or activities outside the school to for teachers. Regard to gender, men earned higher values regarding women about feel more able to include students with physical disabilities in both games during recess and teaching sports technique. Teachers with less than 10 years of teaching showed more positive values as you feel able to include a student with physical disabilities in sports during their leisure time. The analysis of daily teacher shows on the one hand, emerging trends as key facilitators or barrier of the inclusion elements in PE, identifying the students without disabilities themselves, the professor, contents, materials and organization. Furthermore, the analysis of daily teacher about the contents proposed in the program. In the case of students with disabilities (N=22), the impact of the intervention program on self-concept was analyzed, with the questionnaire "Self-concept form 5" (AF5, F. Garcia and Musitu, 2001). The women showed significant differences before the intervention in family dimension, while men scored higher values in the social and physical dimensions were found. In terms of age, significant differences were found before the intervention, with higher values in younger students (12-14 years) in the physical dimension, while older children (15-17 years) showed higher values the social dimension of the questionnaire. Respect disabilities, students with motor disabilities showed better values than those with hearing impairment to the physical dimension before surgery. As for the general self-concept, positive significant differences occur in the academic dimension. As for the effect of the program on self-esteem of students with disabilities Scale "Rosenberg Self-Esteem" (Rosenberg, 1989) was used, not getting significant differences in gender. Only appear significant difference before the intervention in the case of younger students as they wish to be valued more, and students with hearing disabilities who do not feel very proud of themselves. Improved self-esteem generally occurs in that they feel less useless after surgery. With regard to the aim 3 of this research, after analyzing the results and have discussed them with the authors, it emerged the proposal of guidelines for both intervention program EF for sensitization and awareness of students towards inclusion as in the face of specific training for teachers, as key in such interventions. We believe that "Inclusive Sport Schools" program becomes a transforming element of reality, as it responds to the needs identified in the light of this research and come to respond to the various elements involved in its development. On the one hand, it meets the demand of the education sector in terms of the needs of teacher training, awareness of students without disability, and facilitates opportunities for students with disabilities for active participation in PE class. On the other hand, it meets the demand of sports institutions in the field of disability regarding the promotion and dissemination of adapted and Paralympic sports. Finally, it is shown as a resource from the university level for the training of degree in Physical Activity and Sport Science students, by its direct involvement with disability. For these reasons, this work is shown as a good starting point to further advance research in this area.

Customizing for clients: developing a library liaison program from need to plan*

Building on the experiences of librarian representatives to curriculum committees in the colleges of dentistry, medicine, and nursing, the Health Science Center Libraries (HSCL) Strategic Plan recommended the formation of a Library Liaison Work Group to create a formal Library Liaison Program to serve the six Health Science Center (HSC) colleges and several affiliated centers and institutes. The work group's charge was to define the purpose and scope of the program, identify models of best practice, and recommend activities for liaisons. The work group gathered background information, performed an environmental scan, and developed a philosophy statement, a program of liaison activities focusing on seven |primary areas, and a forum for liaison communication. Hallmarks of the plan included intensive subject specialization (beyond collection development), extensive communication with users, and personal information services. Specialization was expected to promote competence, communication, confidence, comfort, and customization. Development of the program required close coordination with other strategic plan implementation teams, including teams for collection development, education, and marketing. This paper discusses the HSCL's planning process and the resulting Library Liaison Program. Although focusing on an academic health center, the planning process and liaison model may be applied to any library serving diverse, subject-specific user populations.

On the steric and mass-induced contributions to the annual sea level variations in the Mediterranean Sea

The sea level variation (SLVtotal) is the sum of two major contributions: steric and mass-induced. The steric SLVsteric is that resulting from the thermal and salinity changes in a given water column. It only involves volume change, hence has no gravitational effect. The mass-induced SLVmass, on the other hand, arises from adding or subtracting water mass to or from the water column and has direct gravitational signature. We examine the closure of the seasonal SLV budget and estimate the relative importance of the two contributions in the Mediterranean Sea as a function of time. We use ocean altimetry data (from TOPEX/Poseidon, Jason 1, ERS, and ENVISAT missions) to estimate SLVtotal, temperature, and salinity data (from the Estimating the Circulation and Climate of the Ocean ocean model) to estimate SLVsteric, and time variable gravity data (from Gravity Recovery and Climate Experiment (GRACE) Project, April 2002 to July 2004) to estimate SLVmass. We find that the annual cycle of SLVtotal in the Mediterranean is mainly driven by SLVsteric but moderately offset by SLVmass. The agreement between the seasonal SLVmass estimations from SLVtotal – SLVsteric and from GRACE is quite remarkable; the annual cycle reaches the maximum value in mid-February, almost half a cycle later than SLVtotal or SLVsteric, which peak by mid-October and mid-September, respectively. Thus, when sea level is rising (falling), the Mediterranean Sea is actually losing (gaining) mass. Furthermore, as SLVmass is balanced by vertical (precipitation minus evaporation, P–E) and horizontal (exchange of water with the Atlantic, Black Sea, and river runoff) mass fluxes, we compared it with the P–E determined from meteorological data to estimate the annual cycle of the horizontal flux.

Tailoring the surface chemistry of zeolite templated carbon by electrochemical methods

One option to optimize carbon materials for supercapacitor applications is the generation of surface functional groups that contribute to the pseudocapacitance without losing the designed physical properties. This requires suitable functionalization techniques able to selectively introduce a given amount of electroactive oxygen groups. In this work, the influence of the chemical and electrochemical oxidation methods, on the chemical and physical properties of a zeolite templated carbon (ZTC), as a model carbon material, have been studied and compared. Although both oxidation methods generally produce a loss of the original ZTC physical properties with increasing amount of oxidation, the electrochemical method shows much better controllability and, unlike chemical treatments, enables the generation of a large number of oxygen groups (O = 11000- 3300 μmol/g), with a higher proportion of active functionalities, while retaining a high surface area (ranging between 1900-3500 m2/g), a high microporosity and an ordered 3-D structure.