Combined written and oral information prior to gastrointestinal endoscopy compared with oral information alone: a randomized trial.

BACKGROUND: Little is known about how to most effectively deliver relevant information to patients scheduled for endoscopy. METHODS: To assess the effects of combined written and oral information, compared with oral information alone on the quality of information before endoscopy and the level of anxiety. We designed a prospective study in two Swiss teaching hospitals which enrolled consecutive patients scheduled for endoscopy over a three-month period. Patients were randomized either to receiving, along with the appointment notice, an explanatory leaflet about the upcoming examination, or to oral information delivered by each patient's doctor. Evaluation of quality of information was rated on scales between 0 (none received) and 5 (excellent). The analysis of outcome variables was performed on the basis of intention to treat-analysis. Multivariate analysis of predictors of information scores was performed by linear regression analysis. RESULTS: Of 718 eligible patients 577 (80%) returned their questionnaire. Patients who received written leaflets (N = 278) rated the quality of information they received higher than those informed verbally (N = 299), for all 8 quality-of-information items. Differences were significant regarding information about the risks of the procedure (3.24 versus 2.26, p < 0.001), how to prepare for the procedure (3.56 versus 3.23, p = 0.036), what to expect after the procedure (2.99 versus 2.59, p < 0.001), and the 8 quality-of-information items (3.35 versus 3.02, p = 0.002). The two groups reported similar levels of anxiety before procedure (p = 0.66), pain during procedure (p = 0.20), tolerability throughout the procedure (p = 0.76), problems after the procedure (p = 0.22), and overall rating of the procedure between poor and excellent (p = 0.82). CONCLUSION: Written information led to more favourable assessments of the quality of information and had no impact on patient anxiety nor on the overall assessment of the endoscopy. Because structured and comprehensive written information is perceived as beneficial by patients, gastroenterologists should clearly explain to their patients the risks, benefits and alternatives of endoscopic procedures. Trial registration: Current Controlled trial number: ISRCTN34382782.

2011 Energy Independence Plan

Iowa has experienced remarkable progress in the past four years as the state has pursued a vision of becoming the nation’s energy leader. One of the most profound changes over this time has been a richer understanding of the economic future that can be created in Iowa by adding “Made in Iowa” alternatives to our nation’s energy mix. Built around a strong commitment to transforming our economy through innovation, collaboration, and implementation in the energy industry, the role of the Office of Energy Independence (Office) is to bring together the essential prerequisites for maintaining the long-term health and economic growth of our state. What is clearer than ever before is Iowa cannot achieve success if any entity chooses to pursue these goals independently. Rather, success requires that we consistently work to achieve our goals through integrated initiatives that place a high priority on moving us forward simultaneously, and on multiple fronts. Success is what our citizens expect from a leading state in the energy industry whose actions carry such far-reaching implications for the economy and the environment.

La gestió integrada de la qualitat i la seguretat en la docència: pràctiques de taller i de laboratori als estudis de grau de belles arts

El projecte s'inscriu dins de l'àmbit de la investigació i innovació docent aplicant criteris de gestió de qualitat en els que es tenen molt presents els aspectes relacionats amb la seguretat i la sostenibilitat. El projecte promou la investigació generant models de funcionament i verificant la qualitat dels resultats de la seva aplicació. Des d'aquest punt de vista la recerca incorpora aspectes relacionats amb la seguretat i la sostenibilitat dels procediments, la manipulació de productes i materials, la gestió de residus i el seu reciclatge als tallers i laboratoris de les Facultats de Belles Arts. Els resultats d'aquestes investigacions tenen una extensió social en l'àmbit de les Belles Arts en general. Existeix suficient evidència empírica sobre el deteriorament de la salut i els danys que causen un gran nombre de substàncies, productes i materials utilitzats habitualment en les Belles Arts i es sospita sobre els potencials efectes negatius d'altres productes. A Espanya, també és conegut el limitat desenvolupament en matèria de prevenció laboral, de protecció mediambiental i en paràmetres de sostenibilitat en relació amb l'Espai Europeu i, especialment, al nord d'Europa. Es pot considerar, encara, la tímida i escassament coordinada, encara que progressiva, implantació de mesures orientades a solucionar aquestes deficiències per part de les universitats espanyoles i el seu insuficient finançament. En un context d'elevada sensibilització social i dels mitjans de comunicació sobre els efectes del canvi climàtic i la contaminació els processos de canvi s'han de liderar des d'institucions de rang molt divers. Amb els antecedents esmentats el grup d'investigació advoca per continuar desenvolupant diferents modalitats de recerca, buscant alternatives eficaces en aquest àmbit. Alternatives que contemplin la possible substitució d'uns productes per altres, la reducció d'aquells insubstituïbles, la implantació de procediments de qualitat verificada, l'adopció de mesures de seguretat de naturalesa preventiva o mediambiental, l'exploració de recursos sostenibles, etc. per solucionar en la mesura possible l'esmentada problemàtica.

Cap a una escola secundària inclusiva: sabers i experiències de joves en situació d'exclusió

[cat] Aquest projecte revisa la narrativa al voltant del fracàs escolar a partir del desenvolupament de deu històries de joves - set nois i tres noies- de Catalunya en situació d'exclusió escolar. Dins d'aquest marc la recerca s'ha articulat a partir de tres eixos: (1) La realització d'un mapa dels estudis realitzats a Catalunya entorn l'anomenat fracàs escolar, amb la finalitat de situar i contextualitzar les seves narratives dominants. (2) La recerca entorn a les històries biogràfiques d'un grup de joves per explorar alternatives a l'actual crisi internacional de l'escola secundària que es reflecteix, entre d'altres fenòmens, en els elevats índexs d'abandonament d'aquesta etapa educativa per part dels estudiants. (3) La recerca conclou amb una sèrie de consideracions que pretenen contribuir a una narrativa a favor d¿una escola inclusiva per a l'educació secundària que tingui en compte les experiències i sabers d'aquests joves que, per diferents raons, no finalitzen la seva educació bàsica.

Guia Managgend: Indicadors de gestió i de gènere per a la competitivitat i creixement dels sectors públic i privat de Catalunya en una societat del coneixement complexa.

L'actual crisi econòmica, del model de producció i les greus conseqüències que està tenint en el teixit industrial, productiu, econòmic, de consum, de diferents sectors, així com la pèrdua de competitivitat i el descens de la nostra productivitat com quasi la més baixa d'Europa, ens porta a cercar solucions i alternatives en la gestió empresarial i a la direcció de les organitzacions públiques i privades,com un dels factors estratègics que podrien ajudar a col·laborar a la sortida de la crisi.

The InterActive Choice Aid: A new approach to supporting online consumer decision making

Interactive Choice Aid (ICA) is a decision aid, introduced in this paper, that systematically assists consumers with online purchase decisions. ICA integrates aspects from prescriptive decision theory, insights from descriptive decision research, and practical considerations; thereby combining pre-existing best practices with novel features. Instead of imposing an objectively ideal but unnatural decision procedure on the user, ICA assists the natural process of human decision-making by providing explicit support for the execution of the user's decision strategies. The application contains an innovative feature for in-depth comparisons of alternatives through which users' importance ratings are elicited interactively and in a playful way. The usability and general acceptance of the choice aid was studied; results show that ICA is a promising contribution and provides insights that may further improve its usability.

Governor's Youth Race and Detention Task Force; Full Force, May 2009

This report, the Full Report, is the culmination of the Task Force’s responsibilities as set out in Executive Order 5, dated October 30, 2007. The Executive Order specifies a number of goals and report requirements.There is a commonly held perception that the use of detention may serve as a deterrent to future delinquency. Data in this report reflect that approximately 40% of youth detained in 2006 were re-detained in 2006. Research conducted by national experts indicates that, particularly for low risk/low level offenders, that the use of detention is not neutral, and may increase the likelihood of recidivism. Comparable data for Iowa are not available (national data studied for this report provide level of risk, but risk level related to detention is not presently available for Iowa). The Task Force finds no evidence suggesting that recidivism levels (as related to detention risk) in Iowa should be different than found in other states. Data in this report also suggest that detention is one of the juvenile justice system’s more costly sanctions ($257 - $340 per day). Other sites and local jurisdictions have been able to redirect savings from the reduced use of juvenile detention to support less costly, community-based detention alternatives without compromising public safety.

Environmental Assessment: IA 12 in Mason City From S. Monroe Ave to S. Carolina Ave, Cerro Gordo County, Iowa, NHSX-122-1(14)--3H-17, 2013

DESCRIPTION OF PROPOSED ACTION This Environmental Assessment (EA) has been prepared in compliance with the requirements of the National Environmental Policy Act of 1969 (NEPA). This EA informs the public and interested agencies of the proposed action and alternatives to the proposed action in order to gather feedback on the improvements under consideration. Proposed Action The Iowa Department of Transportation (Iowa DOT) and the Federal Highway Administration (FHWA) are evaluating potential alternatives to improve IA 122 in the City of Mason City. IA 122/Business US 18 is a primary east-west travel route through the City that transitions from a 4- lane undivided roadway, to 2-lane one-way pairs, then back to a 4-lane undivided roadway (Figure 1-1). The Iowa DOT proposes to flatten the tight reverse curves on the east end of the project. The one-way pairs will be narrowed by eliminating on-street parking along the corridor to more clearly define travel lanes. This will serve to calm traffic flows and reduce crashes along the highway. Additionally, improvements to intersections as well as consolidating or removing access points to improve traffic operations are proposed within the project corridor. A new access road for the Mason City Fire Department on the west end of the project will allow emergency trucks better access to travel south and east. Study Area The primary area of investigation for the Project is generally bounded by IA 122 through Mason City, known locally as 5th and 6th Street Southwest from South Monroe Avenue to South Carolina Avenue. US 65, known locally as Federal Avenue, bisects the study area. At this intersection of US 65 and Iowa 122, the 5th and 6th Street SW changes to 5th and 6th St SE. For the purposes of this discussion, this area will be referred to collectively as the IA 122 corridor. The Study Area boundaries were established to allow the development of a wide range of alternatives that could address the purpose and need for the project. The Study Area is larger than the area proposed for construction activities for the Project. However, some impacts may extend beyond the Study Area; where this occurs, it will be noted and addressed in the Environmental Analysis Section (Section 5). Figure 1-1 outlines the Study Area of the proposed action.

Temps de desig: la novel-la de Jeanne Hersch

L'única novel·la publicada per la filòsofa Jeanne Hersch (Temps alternés, 1942) consisteix principalment en una reflexió sobre el temps i sobre la relació del subjecte amb l'Altre. Descriu dos tipus de temporalitat: un present etern, en què la narradora adolescent viu l'instant sense plantejar-se cap fita, i un present de maduresa fet de records i de projeccions cap al futur. Exposa també dues possibilitats de relació entre el subjecte i l'Altre: la separació total, marcada per l'hermetisme del propi cos, i la fusió, encarnada en el cos porós de la dona embarassada. Aquestes alternatives es resumeixen en l'oposició entre amor i desig.

Prise en soins de la schizophrénie chez la personne âgée

Care of the elderly schizophrenic patient : Despite the development of new aetiopathological models the treatment of late-life schizophrenia is still based essentially on antipsychotic medication. The absence of research specifically targeting late-life schizophrenics limits the value of recommendations on indication, dosage and treatment alternatives, particularly as the latter have scant regard for the age of schizophrenia onset (early, late, very late onset), for the various comorbidities and the polymedication so common in the elderly. The use of atypical neuroleptics at adapted doses should be combined with biopsychosocial care and treatment of psychiatric and somatic comorbidities. The choice of an adapted treatment is often conditioned, especially if early schizophrenia is con sidered, by many years of treatment and side effects which may limit compliance when the evolution itself has been unfavourable with persistent, sometimes handi capping residual symptoms. Moreover, schizophrenia is complicated by cognitive disorders for which the best therapeutic approach in the elderly remains uncertain.

Sign language in Landau-Kleffner syndrome.

This article reviews the history of sign language (SL) and the rationale for its use in children with profound auditory agnosia due to Landau-Kleffner syndrome (LKS), illustrated by studies of children and adults followed for many years and rare cases from the literature. The reasons that SL was successful and brought some children out of isolation while it could not be implemented in others are discussed. The nowadays earlier recognition and treatment of LKS and better awareness of the crucial need to maintain communication have certainly improved the outcome of affected children. Alternatives to oral language, even for less severe cases, are increasingly accepted. SL can be learned at different ages with a clear benefit, but the ambivalence of the patients and their families with the world and culture of the deaf may sometimes explain its refusal or limited acceptance. There are no data to support the fear that SL learning may delay or prevent oral language recovery in children with LKS. On the contrary, SL may even facilitate this recovery by stimulating functionally connected core language networks and by helping speech therapy and auditory training.

Production of Acetic Acid by Fermentation with Propionibacteria, HR-321, 1993

This project was undertaken jointly with a project supported by the Iowa Corn Promotion Board. Together the projects aimed at producing the organic acids, propionic acid and acetic acid, by fermentation. The impacts were to provide agriculturally-based alternatives to production of these acids, currently produced mainly as petrochemicals. The potentially high-demand use for acetic acid is as the "acetate" in Calcium Magnesium Acetate (CMA), the non-corrosive road deicer. Fermentation was, however, far from being an economically acceptable alternative. Gains were made in this work toward making this a feasible route. These advances included (1) development of a variant strain of propionibacteria capable of producing higher concentrations of acids; (2) comparison of conditions for several ways of cultivating free cells and establishment of the relative benefits of each; (3) achievement of the highest productivity in fermentations using immobilized cells; (4) identification of corn steep liquor as a lower cost substrate for the fermentation; (5) application of a membrane extraction system for acid recovery and reduction of product inhibition; and (6) initial use of more detailed economic analysis of process alternatives to guide in the identification of where the greatest payback potential is for future research. At this point, the fermentation route to these acids using the propionibacteria is technically feasible, but economically unfeasible. Future work with integration of the above process improvements can be expected to lead to further gains in economics. However, such work can not be expected to make CMA a less expensive deicer than common road salt.

Cap a una escola secundària inclusiva: sabers i experiències de joves en situació d'exclusió

[cat] Aquest projecte revisa la narrativa al voltant del fracàs escolar a partir del desenvolupament de deu històries de joves - set nois i tres noies- de Catalunya en situació d'exclusió escolar. Dins d'aquest marc la recerca s'ha articulat a partir de tres eixos: (1) La realització d'un mapa dels estudis realitzats a Catalunya entorn l'anomenat fracàs escolar, amb la finalitat de situar i contextualitzar les seves narratives dominants. (2) La recerca entorn a les històries biogràfiques d'un grup de joves per explorar alternatives a l'actual crisi internacional de l'escola secundària que es reflecteix, entre d'altres fenòmens, en els elevats índexs d'abandonament d'aquesta etapa educativa per part dels estudiants. (3) La recerca conclou amb una sèrie de consideracions que pretenen contribuir a una narrativa a favor d¿una escola inclusiva per a l'educació secundària que tingui en compte les experiències i sabers d'aquests joves que, per diferents raons, no finalitzen la seva educació bàsica.

Monen vaihtoehdon kansanäänestykset ja enemmistöjen mystiikka

Abstract: Referenda with multiple alternatives and the mystique of majorities