Obtaining carbonation depth of concrete used two different procedures standard EHE-08

In the Standard EHE 08, for the first time, durability acquires the status of Limit State. Article 8 provides that the term Durability limit state, produced by physical and chemical actions, different loads and actions of structural analysis, which can degrade the concrete and reinforcement to unacceptable limits. The verification of this limit state can be done through a procedure set out in the provisions of the Standard. This procedure is based on the use of tables that, depending on the aggressiveness of the environment in which the structure is the concrete strength and the life of the project, setting the quality of the concrete cover (minimum thickness and maximum water cement ratio of concrete used) and the maximum crack width. This procedure, simple in its application, provides highly secure solutions. In addition, on Annex 9, the Standard EHE 08 offers models for testing the durability limit state in cases of corrosion of reinforcement due to carbonation of concrete or entry of chloride ions. The results obtained with these models are tighter than those obtained with the procedure of the articles. In this paper we use both methods in the study of reinforced concrete structures with potential problems of corrosion of reinforcement due to carbonation of concrete. Later checking the results obtained by both procedures. Results demonstrate that the use of the models listed in Annex 9 of Standard EHE 08 offer cheaper solutions than those obtained using the procedure of the articles

Modified Dialectical Behavior Therapy Program Applied Within a Time-Limited Corrections Setting

Dialectical Behavioral Therapy (DBT) is an empirically supported therapy developed to treat individuals with Borderline Personality Disorder that has sustained efficacy following completion of the treatment (Linehan, 1993; Van Den Bosch et al., 2005). The core concepts of DBT include mindfulness, interpersonal effectiveness, emotional regulation, and distress tolerance, which seek to foster more functional ways of interacting with others, coping with distress, and managing difficult emotions. Using a standard DBT format in a corrections setting can be difficult due to the population's multifaceted composition. The Denver County Jail is a unique corrections setting because it contains a unit specifically developed for male inmates with mental health issues. A corrections modified, time-limited DBT curriculum was developed to fit the needs of this unique population. During the course of the group, staff appeared to be accepting of the group material and initial feedback from inmates and officers was positive.

Psychological Perspectives on the Civil Liberties of Transgendered Inmates in a Prison Setting

As society becomes increasingly less binary, and moves towards a more spectrum based approach to mental illness, medical illness, and personality, it becomes necessary to address this shift within formerly rigid institutions. This paper explores this shift as it is occurring within correctional settings around the United States concerning the medical care, housing, and safety of transgendered inmates. As there is no legal standard for the housing or access to gender-affirming medical care (i.e., hormone therapy, sexual reassignment surgery), these issues are addressed on an institutional level, with very little consistency throughout the country. Currently, most institutions follow a genitalia-based system of classification. Within the system, core beliefs are held, some adaptive and some no longer adaptive, that drive the system's behavior and outcomes. With regard to transgendered inmates, several underlying beliefs within the system serve to maintain the status quo; however, the most basic underpinning is the system's reliance on a binary gender system. As views of humane treatment of the incarcerated expand and modernize, the role of mental health within corrections has also expanded. Psychologists, social workers, counselors, and psychiatrists are found in almost all correctional facilities, and have become a voice of advocacy for an often underserved population.

Adaptive designs in the time to event setting: The potential for benefit and risk

Thesis (Ph.D.)--University of Washington, 2016-06

Comparative susceptibility of indigenous and improved pig breeds to Classical swine fever virus infection: Practical and epidemiological implications in a subsistence-based, developing country setting

This study investigated the comparative susceptibility of indigenous Moo Laat and improved Large White/Landrace pig breeds to infection with classical swine fever virus (CSFV) under controlled conditions in the Lao People's Democratic Republic (Lao PDR). The Moo Laat (ML) and Large White/Landrace crossbreed (LWC) pigs were inoculated with a standard challenge strain designated Lao/Kham225 (infectivity titre of 10(2.75) TCID50/ml). The results demonstrated that both the native breed and an improved pig breed are fully susceptible to CSFV infection and the mortality rate is high. LWC pigs demonstrated lower (or shorter) survival times (50% survival time: 11 days), earlier and higher pyrexia and earlier onset of viraemia compared to ML pigs (50% survival time: 18 days). In the context of village-based pig production, the longer time from infection to death in native ML pigs means that incubating or early sick pigs are likely to be sold once an outbreak of CSF is recognized in a village. This increased longevity probably contributes to the maintenance and spread of disease in a population where generally the contact rate is low.

A new instrument for targeting falls prevention interventions was accurate and clinically applicable in a hospital setting

Background and Objective: To describe the diagnostic accuracy and practical application of the Peter James Centre Falls Risk Assessment Tool (PJC-FRAT), a multidisciplinary falls risk screening and intervention deployment instrument. Methods: In phase 1, the accuracy of the PJC-FRAT was prospectively compared to a gold standard (the STRATIFY) on a cohort of subacute hospital patients (n = 122). In phase 2, the PJC-FRAT was temporally reassessed using a subsequent cohort (n = 316), with results compared to those of phase 1. Primary outcomes were falls (events), fallers (patients who fell), and hospital completion rates of the PJC-FRAT. Results: In phase 1, PJC-FRAT accuracy of identifying falters showed sensitivity of 73% (bootstrap 95% confidence interval CI = 55, 90) and specificity of 75% (95% CI = 66, 83), compared with the STRATIFY (cutoff >= 2/5) sensitivity of 77% (95% CI = 59, 92) and specificity of 51% (95% CI = 41, 61). This difference was not significant. In phase 2, accuracy of nursing staff using the PJC-FRAT was lower. PJC-FRAT completion rates varied among disciplines over both phases: nurses and physiotherapists, >= 90%; occupational therapists, >= 82%; and medical officers, >= 57%. Conclusion: The PJC-FRAT was practical and relatively accurate as a predictor of falls and a deployment instrument for falls prevention interventions, although continued staff education may be necessary to maintain its accuracy. (c) 2006 Elsevier Inc. All rights reserved.

Imaging of the human fundus in the clinical setting:past present and future

The human fundus is a complex structure that can be easily visualized and the world of ophthalmology is going through a golden era of new and exciting fundus imaging techniques; recent advances in technology have allowed a significant improvement in the imaging modalities clinicians have available to formulate a diagnostic and treatment plan for the patient, but there is constant on-going work to improve current technology and create new ideas in order to gather as much information as possible from the human fundus. In this article we shall summarize the imaging techniques available in the standard medical retina clinic (i.e. not limited to the research lab) and delineate the technologies that we believe will have a significant impact on the way clinicians will assess retinal and choroidal pathology in the not too distant future.

A randomised controlled trial of the clinical effectiveness and cost-effectiveness of the levonorgestrel-releasing intrauterine system in primary care against standard treatment for menorrhagia:the ECLIPSE trial

BACKGROUND: Heavy menstrual bleeding (HMB) is a common problem, yet evidence to inform decisions about initial medical treatment is limited. OBJECTIVES: To assess the clinical effectiveness and cost-effectiveness of the levonorgestrel-releasing intrauterine system (LNG-IUS) (Mirena(®), Bayer) compared with usual medical treatment, with exploration of women's perspectives on treatment. DESIGN: A pragmatic, multicentre randomised trial with an economic evaluation and a longitudinal qualitative study. SETTING: Women who presented in primary care. PARTICIPANTS: A total of 571 women with HMB. A purposeful sample of 27 women who were randomised or ineligible owing to treatment preference participated in semistructured face-to-face interviews around 2 and 12 months after commencing treatment. INTERVENTIONS: LNG-IUS or usual medical treatment (tranexamic acid, mefenamic acid, combined oestrogen-progestogen or progesterone alone). Women could subsequently swap or cease their allocated treatment. OUTCOME MEASURES: The primary outcome was the patient-reported score on the Menorrhagia Multi-Attribute Scale (MMAS) assessed over a 2-year period and then again at 5 years. Secondary outcomes included general quality of life (QoL), sexual activity, surgical intervention and safety. Data were analysed using iterative constant comparison. A state transition model-based cost-utility analysis was undertaken alongside the randomised trial. Quality-adjusted life-years (QALYs) were derived from the European Quality of Life-5 Dimensions (EQ-5D) and the Short Form questionnaire-6 Dimensions (SF-6D). The intention-to-treat analyses were reported as cost per QALY gained. Uncertainty was explored by conducting both deterministic and probabilistic sensitivity analyses. RESULTS: The MMAS total scores improved significantly in both groups at all time points, but were significantly greater for the LNG-IUS than for usual treatment [mean difference over 2 years was 13.4 points, 95% confidence interval (CI) 9.9 to 16.9 points; p < 0.001]. However, this difference between groups was reduced and no longer significant by 5 years (mean difference in scores 3.9 points, 95% CI -0.6 to 8.3 points; p = 0.09). By 5 years, only 47% of women had a LNG-IUS in place and 15% were still taking usual medical treatment. Five-year surgery rates were low, at 20%, and were similar, irrespective of initial treatments. There were no significant differences in serious adverse events between groups. Using the EQ-5D, at 2 years, the relative cost-effectiveness of the LNG-IUS compared with usual medical treatment was £1600 per QALY, which by 5 years was reduced to £114 per QALY. Using the SF-6D, usual medical treatment dominates the LNG-IUS. The qualitative findings show that women's experiences and expectations of medical treatments for HMB vary considerably and change over time. Women had high expectations of a prompt effect from medical treatments. CONCLUSIONS: The LNG-IUS, compared with usual medical therapies, resulted in greater improvement over 2 years in women's assessments of the effect of HMB on their daily routine, including work, social and family life, and psychological and physical well-being. At 5 years, the differences were no longer significant. A similar low proportion of women required surgical intervention in both groups. The LNG-IUS is cost-effective in both the short and medium term, using the method generally recommended by the National Institute for Health and Care Excellence. Using the alternative measures to value QoL will have a considerable impact on cost-effectiveness decisions. It will be important to explore the clinical and health-care trajectories of the ECLIPSE (clinical effectiveness and cost-effectiveness of levonorgestrel-releasing intrauterine system in primary care against standard treatment for menorrhagia) trial participants to 10 years, by which time half of the cohort will have reached menopause. TRIAL REGISTRATION: Current Controlled Trials ISRCTN86566246. FUNDING: This project was funded by the NIHR Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 19, No. 88. See the NIHR Journals Library website for further project information.

Comparison of Common Field/Clinical Measures to Standard Laboratory Measures of Hydration Status

Context: Accurately determining hydration status is a preventative measure for exertional heat illnesses (EHI). Objective: To determine the validity of various field measures of urine specific gravity (Usg) compared to laboratory instruments. Design: Observational research design to compare measures of hydration status: urine reagent strips (URS) and a urine color (Ucol) chart to a refractometer. Setting: We utilized the athletic training room of a Division I-A collegiate American football team. Participants: Trial 1 involved urine samples of 69 veteran football players (age=20.1+1.2yr; body mass=229.7+44.4lb; height=72.2+2.1in). Trial 2 involved samples from 5 football players (age=20.4+0.5yr; body mass=261.4+39.2lb; height=72.3+2.3in). Interventions: We administered the Heat Illness Index Score (HIIS) Risk Assessment, to identify athletes at-risk for EHI (Trial 1). For individuals “at-risk” (Trial 2), we collected urine samples before and after 15 days of pre-season “two-a-day” practices in a hot, humid environment(mean on-field WBGT=28.84+2.36oC). Main Outcome Measures: Urine samples were immediately analyzed for Usg using a refractometer, Diascreen 7® (URS1), Multistix® (URS2), and Chemstrip10® (URS3). Ucol was measured using Ucol chart. We calculated descriptive statistics for all main measures; Pearson correlations to assess relationships between the refractometer, each URS, and Ucol, and transformed Ucol data to Z-scores for comparison to the refractometer. Results: In Trial 1, we found a moderate relationship (r=0.491, p<.01) between URS1 (1.020+0.006μg) and the refractometer (1.026+0.010μg). In Trial 2, we found marked relationships for Ucol (5.6+1.6shades, r=0.619, p<0.01), URS2 (1.019+0.008μg, r=0.712, p<0.01), and URS3 (1.022+0.007μg, r=0.689, p<0.01) compared to the refractometer (1.028+0.008μg). Conclusions: Our findings suggest that URS were inconsistent between manufacturers, suggesting practitioners use the clinical refractometer to accurately determine Usg and monitor hydration status.

Resigning: a classic grounded theory of working within constraints when caring for stroke patients in the acute general care setting

This research aims to explore the challenges nurses face, when caring for stroke patients on a general medical/surgical ward, in the acute care setting and identify how nurses resolve or process this challenge. Healthcare environments continue to face the pressures of constraints such as reduced staffing levels, budgets, resources and less time, which influence care provision. Patient safety is central in care provision where nurses face the challenge of delivering best quality care when working within constraints. The incidence of stroke is increasing worldwide and internationally stroke units are the recognised minimum standard of care. In Ireland with few designated stroke units in operation many stroke patients are cared for in the acute general care setting. A classic grounded theory methodology was utilised for this study. Data was collected and analysed simultaneously through coding, constant comparison, theoretical sampling and memoing. Individual unstructured interviews with thirty two nurses were carried out. Twenty hours of non-participant observations in the acute general care setting were undertaken. The main concern that emerged was working within constraints. This concern is processed by nurses through resigning which consists of three phases; idealistic striving, resourcing and care accommodation. Through the process of resigning nurses engage in an energy maintenance process enabling them to continue working within constraints. The generation of the theory of resigning explains how nurses’ resolve or process working within constraints. This theory adds to the body of knowledge on stroke care provision. This theory has the potential to enhance nursing care, minimise burnout and make better use of resources while advocating for best care of stroke patients.

Transplanting diglossia: attitudes towards Standard and Cypriot Greek among London’s Greek Cypriot community

The linguistic situation in Greek-speaking Cyprus has been traditionally described as a textbook case of diglossia à la Ferguson (1959) with Standard Modern Greek (SModGr) being labelled as the High variety and Cypriot Greek (CypGr), the regional ModGr variety of Cyprus, being labelled the Low variety (Arvaniti, 2011; Moschonas, 1996). More recently, however, it has been proposed that the linguistic repertoire available to speakers features an array of forms of CypGr, which is best described as a continuum ranging from basilectal to acrolectal varieties (Katsoyannou et al., 2006; Tsiplakou et al., 2006). The basilectal end encompasses low prestige varieties predominantly spoken in rural areas. The acrolectal end is occupied by the version of SModGr used in the public domain in Cyprus (Arvaniti, 2006/2010). SModGr is known to carry high prestige in Cyprus. Speakers of CypGr describe speakers of the standard as more attractive, more intelligent, more interesting and more educated than speakers of the Cypriot dialect (Papapavlou, 1998). In this paper, I explore the relation between SModGr and CypGr in a diasporic setting, namely, the Greek Cypriot community of London. The United Kingdom is home to a sizeable Greek Cypriot community, whose population is presently estimated to fall between 200,000 and 300,000 individuals (Christodoulou-Pipis, 1991; National Federation of Cypriots in the UK). Similarly to the Cyprus homeland, the members of the Greek Cypriot parikia (‘community’) share a rich linguistic repertoire, which, in addition to varieties of Greek, crucially includes English. As is often the case with diasporas, the parikia does not form a homogeneous speech community in that not all of its members have an equally good command of Greek or even English. Rather, different types of monolingual and bilingual speakers are found including a large number of heritage speakers in the sense of Benmamoun et al. (2013), Montrul (2008, 2015) and Polinsky & Kagan (2007). Twenty British-born heritage speakers of CypGr were interviewed on their attitudes towards the different varieties of Greek. Results indicate that the prestige relation between SModGr and CypGr that holds in Cyprus has been transplanted to the parikia. SModGr is widely perceived as the prestigious variety and is described in positive terms (‘correct’, ‘proper’). The use of CypGr, on the other hand, enjoys covert prestige: it is perceived as an index of solidarity and in-group membership but at the same time is also viewed by heritage speakers as reminiscent of the hardship and lack of education of the generation that brought CypGr to the UK. In certain cases, the use of CypGr by heritage speakers is actively discouraged by the first generation not only in the public domain but also in private domains such as the home. Active discouragement targets both lexical and grammatical variants that are traditionally associated with basilectal varieties of CypGr, and heritage language features, especially the adoption of morphologically adapted loanwords from English. References Arvaniti, Amalia. 2006/2010. Linguistic practices in Cyprus and the emergence of Cypriot Standard Greek. Mediterranean Language Review 17, 15–45. Benmamoun, Elabbas, Silvina Montrul & Maria Polinsky. 2013. Heritage languages and their speakers: opportunities and challenges for linguists. Theoretical Linguistics 39(3/4), 129–181. Christodoulou-Pipis, Irina. 1991. Greek Outside Greece: Language Use by Greek-Cypriots in Britain. Nicosia: Diaspora Books. Ferguson, Charles A. 1959. Diglossia. Word 15(2), 325–340. Katsoyannou, Marianna, Andreas Papapavlou, Pavlos Pavlou & Stavroula Tsiplakou. 2006. Didialektikes koinotites kai glossiko syneches: i periptosi tis kypriakis [Bidialectal communities and linguistic continuum: the case of Cypriot Greek]. In Mark Janse, Brian D. Joseph & Angela Ralli (eds.), Proceedings of the 2nd International Conference of Modern Greek Dialects and Linguistic Theory, Mytilene, Greece, 30 September – 3 October 2004, 156–171. Patras: University of Patras. Montrul, Silvina A. 2008. Incomplete Acquisition in Bilingualism: Re-examining the Age Factor. Amsterdam/Philadelphia: John Benjamins. Montrul, Silvina. 2015. The Acquisition of Heritage Languages. Cambridge: Cambridge University Press. Moschonas, Spiros. 1996. I glossiki dimorfia stin Kypro [Diglossia in Cyprus]. In “Ischyres” – “Astheneis” Glosses stin Evropaiki Enosi: Opseis tou glossikou igemonismou [“Strong” – “Weak” Languages in the European Union: Aspects of Linguistic Imperialism], 121–128. Thessaloniki: Kentro Ellinikis Glossas. Polinsky, Maria & Olga Kagan. 2007. Heritage languages: in the ‘wild’ and in the classroom. Languages and Linguistics Compass 1(5), 368–395. Tsiplakou, Stavroula, Andreas Papapavlou, Pavlos Pavlou & Marianna Katsoyannou. 2006. Levelling, koineization and their implications for bidialectism. In Frans L. Hinskens (Eds.), Language Variation – European Perspectives: Selected Papers from the Third International Conference on Language Variation in Europe (ICLaVE 3), Amsterdam, June 2005, 265–279. Amsterdam/Philadelphia: John Benjamins.

Key determinants of organisational silence for non-standard workers

Purpose – The purpose of this paper is to identify the key determinants of organisational silence from the perspective of non-standard workers (NSWs). The study focuses on three research themes: first, analysing the experiences motivating NSWs to remain silent; second, analysing the role of the NSW life cycle in the motivation to remain silent, the final theme is evaluation of the impact on organisational voice of an organisation employing a workforce in which NSWs and standard workers (SWs) are blended. Design/methodology/approach – The study utilises a phenomenological approach, as defined by Van Manen (2007), to collect and analyse the phenomenon of organisational silence from the perspective of NSWs. The NSWs are defined as individuals operating via Limited Liability UK registered companies created for the purpose of delivering services to organisations via a contract of services. This study employed a combination of phenomenology and hermeneutics to collect and analyse the data collected from the NSWs using semi-structured interviews (Lindseth and Norberg, 2004). Findings – The study concludes with three core findings. NSWs experience similar motivational factors to silence as experienced by standard workers (SWs). The key differential between a SW and a NSW is the role of defensive silence as a dominant motivator for a start-up NSW. The study identified that the reasons for this is that new NSWs are defensive to protect their reputation for any future contract opportunities. In addition, organisations are utilising the low confidence of new start up NSWs to suppress the ability of NSWs to voice. The research indicates how experienced NSWs use the marketing stage of their life cycle to establish voice mechanisms. The study identified that NSWs, fulfiling management and supervisory roles for organisations, are supporting/creating climates of silence through their transfer of experiences as SWs prior to becoming NSWs. Research limitations/implications – This study is a pilot study, and the findings from this study will be carried forward into a larger scale study through engagement with further participants across a diverse range of sectors. This study has identified that there is a need for further studies on organisational silence and NSWs to analyse more fully the impact of silence on the individuals and the organisation itself. A qualitative phenomenological hermeneutical study is not intended to be extrapolated to provide broad trends. The focus of the phenomenological hermeneutic research methodology is on describing and analysing the richness and depth of the NSW’s experiences of silence in organisational settings. Originality/value – This paper draws together the studies of worker classification, motivators for organisational silence, and the impact of blending SWs and NSWs in an organisational setting. The study demonstrates that academic research to date has focused predominantly on SWs to the exclusion of the 1.5 million, and growing, NSWs in the UK. This study examines these under-represented workers to analyse the participants’ experiences of organisational silence, and its consequences in organisational settings, demonstrating a need for further studies.

Meeting on Provisions in Licensing Incorporating new developments in daily licensing practice: Setting conditions for open access, patron driven access, and data & text mining

Following the workshop on new developments in daily licensing practice in November 2011, we brought together fourteen representatives from national consortia (from Denmark, Germany, Netherlands and the UK) and publishers (Elsevier, SAGE and Springer) met in Copenhagen on 9 March 2012 to discuss provisions in licences to accommodate new developments. The one day workshop aimed to: present background and ideas regarding the provisions KE Licensing Expert Group developed; introduce and explain the provisions the invited publishers currently use;ascertain agreement on the wording for long term preservation, continuous access and course packs; give insight and more clarity about the use of open access provisions in licences; discuss a roadmap for inclusion of the provisions in the publishers’ licences; result in report to disseminate the outcome of the meeting. Participants of the workshop were: United Kingdom: Lorraine Estelle (Jisc Collections) Denmark: Lotte Eivor Jørgensen (DEFF), Lone Madsen (Southern University of Denmark), Anne Sandfær (DEFF/Knowledge Exchange) Germany: Hildegard Schaeffler (Bavarian State Library), Markus Brammer (TIB) The Netherlands: Wilma Mossink (SURF), Nol Verhagen (University of Amsterdam), Marc Dupuis (SURF/Knowledge Exchange) Publishers: Alicia Wise (Elsevier), Yvonne Campfens (Springer), Bettina Goerner (Springer), Leo Walford (Sage) Knowledge Exchange: Keith Russell The main outcome of the workshop was that it would be valuable to have a standard set of clauses which could used in negotiations, this would make concluding licences a lot easier and more efficient. The comments on the model provisions the Licensing Expert group had drafted will be taken into account and the provisions will be reformulated. Data and text mining is a new development and demand for access to allow for this is growing. It would be easier if there was a simpler way to access materials so they could be more easily mined. However there are still outstanding questions on how authors of articles that have been mined can be properly attributed.