This paper presents the results of research into the social impacts of stormwater management techniques applied within urban environments. The main aim of the study was to compare public and professional attitudes of stormwater management practices such as Sustainable Urban Drainage Systems (SUDS) and river management techniques. Any new and innovative technology used in residential areas, besides being economically and environmentally acceptable, must also be accepted by the residents. There has been considerable interest in the assessment of the public perception of SUDS in the UK by consultants, developers, the Environment Agency of England and Wales as well as by the Scottish Environment Protection Agency (SEPA). This research was undertaken to inform such interest and also to obtain a more holistic view of the perception by professionals of SUDS. A comparative study of the perceptions of river management in three densely populated European cities facing similar storm water management problems was carried out. The selected cities were Glasgow in Scotland - U. K., an area in west London, England - U.K., and part of Athens - Greece. All sites were located within flood-prone suburban areas, and different river management techniques have been proposed or adopted.


University of Hawaii at Manoa, Center on Disability Studies Professional Development summer course is now available. Register through UH Outreach College athttp://bit.ly/CDSphoto class start on 6/2/2018.For 25 years, researchers, programs, and activists have used "Photovoice" to engage people with disabilities, patients, youth, families and communities in representing their lives, point of view, and experience using photos, video, art, and writing. Photovoice is a participatory approach to understanding and communication that encourages dialogue and mutual learning. It generates powerful data on health, community, and real lives. It engages participants, professionals, and the public in identifying opportunities for change. It fosters knowledge and awareness on issues of importance to families, communities, and policymakers alike, and helps people to feel their 'voices' are heard.In this interactive online course (a combination of live Zoom sessions and asynchronous work) based on her award-winning in-person workshop, social scientist Laura Lorenz explores the foundations of Photovoice and shares photos from projects she has led in the US and South Africa since 2001 -- with teenage girls, youth living with HIV/AIDS, and adult brain injury survivors. For this course, disabilities from brain injury will serve as a running theme and focus throughout. Readings, presentations, and between-session assignments support person-centered learning and provide hands-on experience working with images and text. By the end of this training, participants will have a solid understanding of a popular approach to participatory health and community assessment, its ethical considerations, approaches to interpreting photos and text, and strategies for outreach. Participants will leave this course with hands-on experience and insights on adapting Photovoice to care, programming, and research intended to engage and benefit people with disabilities, patients, youth, families, and communities. Seminar Topics IncludeAchieving fair process in healthcareApplying Photovoice to clinical work, research, and community engagementAdapting Photovoice to different abilities and disabilitiesInterpreting Photovoice data (photos, captions) and options for wider sharingDeveloping a Photovoice plan for use in clinical care, programming, and researchWho Should AttendMental Health Professionals and Social Workers (Beginning, Intermediate, and Advanced Levels)Other audiences that will find this course useful:Evaluators, researchers, rehabilitation cliniciansActivists, artists, and community organizationsClass DetailsSaturday, June 2: 8:00 – 10:00 AM Foundations of PhotovoiceSunday, June 3: 8:00 – 10:00 AM Photovoice EthicsWednesday, June 6: 4:00 – 5:30 PM Working with Photos & CaptionsSaturday, June 9: 8:00 – 10:00 AM Reaching AudiencesSunday, June 10: 8:00 – 9:30 AM Planning Your Photovoice Project or ActivityLocation: Online (Hawaii Standard Time)Fees: $250 (Cancellation deadline: May 25, 2018)Continuing Education (CE) fee: $50For information about continuing education credit, please see www.lslorenz.com(link is external)Laura Lorenz, PhD, MEd, is a social scientist using innovative approaches to engage patients, youth, and communities in health. A major focus in her work has been collaborating with interdisciplinary teams on programming and research to improve quality of life and function for people with disabilities from brain injury. Before her graduate studies, Dr. Lorenz encouraged community partnerships, project replication, and behavior change through continuing education and photo-journalism in Africa, Asia, Latin America, and the U.S. (For more go to www.lslorenz.com(link is external


Coating textured, high surface area substrates, such as paper and textiles, with conjugated polymer films is challenging. Selected vapor deposition techniques allow for the film forming process to be largely divorced of substrate properties, such as surface energy and surface roughness, and have the potential to yield conformal coatings. However, reliable vapor deposition techniques with which to fabricate structurally-diverse conjugated polymer films do not exist. Here, we report two vapor deposition chambers that, combined, allow for in situ vapor phase polymerization of a representative selection of common conjugated monomers. Conformal coating of highly disordered, high surface area three-dimensional substrates, including a cotton towel and corduroy fabric, with either conductive PEDOT or poly(thieno[3,2-b]thiophene) films of precisely-controlled thickness is described.


In this chapter, we review the applications of optical coherence tomography (OCT) on the nondestructive characterization of the drying processes of colloidal droplets and latex coatings. Employing time-lapse, high-speed imaging, OCT can be used to monitor the dynamic process of drying colloidal droplets. With the aid of high-scattering, micron-sized tracer particles, fluid flows have been captured; phase boundaries are also visible in liquid crystal droplets; and the speckle contrast analysis differentiates the dynamics of particles, showing the packing process and the coffee ring phenomenon. In a waterborne latex coat, time-lapse OCT imaging reveals spatial changes of microstructures, i.e., detachment of latex, cracks, and shear bands; with speckle contrast analysis, 1D and 2D particles' packing process that is initiated from latex/air interface can also be monitored over time. OCT can serve as an experimental platform for fundamental studies of drying colloidal systems. In the future, OCT can also be employed as an in-line quality control tool of polymer coatings and paints for industrial applications.


Deep clustering integrates embedding and clustering together to obtain the optimal nonlinear embedding space, which is more effective in real-world scenarios compared with conventional clustering methods. However, the robustness of the clustering network is prone to being attenuated especially when it encounters an adversarial attack. A small perturbation in the embedding space will lead to diverse clustering results since the labels are absent. In this paper, we propose a robust deep clustering method based on adversarial learning. Specifically, we first attempt to define adversarial samples in the embedding space for the clustering network. Meanwhile, we devise an adversarial attack strategy to explore samples that easily fool the clustering layers but do not impact the performance of the deep embedding. We then provide a simple yet efficient defense algorithm to improve the robustness of the clustering network. Experimental results on two popular datasets show that the proposed adversarial learning method can significantly enhance the robustness and further improve the overall clustering performance. Particularly, the proposed method is generally applicable to multiple existing clustering frameworks to boost their robustness. The source code is available at https://github.com/xdxuyang/ALRDC.


This article describes the development and validation of the Sport Anxiety Scale-2 (SAS-2), a multidimensional measure of cognitive and somatic trait anxiety in sport performance settings. Scale development was stimulated by fi ndings that the 3-factor structure of the original Sport Anxiety Scale (SAS; Smith, Smoll, & Schutz, 1990) could not be reproduced in child samples and that several items on the scale produced confl icting factor loadings in adult samples. Alternative items having readability levels of grade 4 or below were therefore written to create a new version suitable for both children and adults. Exploratory and confi rmatory factor analyses replicated the original SAS factor structure at all age levels, yielding separate 5-item subscales for Somatic Anxiety, Worry, and Concentration Disruption in samples as young as 9 to 10 years of age. The SAS-2 has stronger factorial validity than the original scale did, and construct validity research indicates that scores relate to other psychological measures as expected. The scale reliably predicts precompetition state anxiety scores and proved sensitive to anxiety-reduction interventions directed at youth sport coaches and parents.


this paper reports an automated tracking and force measurement system for C. elegans in motion, based on microscopy computer vision. A polydimethylsiloxane (PDMS) device was microfabricated to allow C. elegans to move in a matrix of micropillars in a channel. An image processing algorithm has been developed to track the worm and deflecting micropillars automatically in purpose of quantifying multipoint locomotive forces of a moving C. elegans. The developed system is able to visually resolve force with a 0.33 µN resolution. A maximum force level of 55.41 µN for a young adult wild type C. elegans was observed.


Oat bran concentrated with respect to both soluble and insoluble dietary fibre was fed to adult rats, and its effects on serum cholesterol and liver fat infiltration were studied. The feeds contained 15, 30 or 45 g β-glucan/kg, except in control groups where the fibre of the feed was cellulose. Half the experimental groups received the feeds with an addition of 10 g cholesterol and 2 g cholic acid/kg in order to create an hypercholesterolaemic condition. In normocholesterolaemic rats the concentrated oat bran did not cause any significant changes in serum cholesterol concentrations, but reduced liver weight compared with control group rats fed on the cellulose-containing diet. In hypercholesterolaemic rats the concentrated oat bran reduced serum total cholesterol and increased high-density-lipoprotein cholesterol concentration. The effect was seen already at the 15 g/kg concentration of β-glucan, the higher doses tested did not significantly improve the effect. Infiltration of fat into liver cells, especially in the periportal areas, was observed only in hypercholesterolaemic animals. The fat infiltration was accentuated in proportion to the amount of oat-bran concentrate fed.


Children with Language Impairments (LI) have difficulties understanding and using language. Due to their language problems, LI children experience difficulties in communication in all aspects of life. They are at risk of behavioural problems, emotional and psychosocial difficulties, and they perform poorly in school. In the Dutch educational and therapeutic setting, the Dutch construct "communicatieve redzaamheid" (CR) is used to describe communication problems. CR can be loosely translated to English as communicative participation, competence or functioning.
CR is used to describe the activity limitations and participation restrictions a LI child experiences. It determines whether a child is eligible for educational support. Also, the description of problems in CR is used to set treatment goals on the ICF component of participation. Consensus on what CR is and how it can be described is lacking. This hinders communication between professionals and parents about the child's diagnosis and treatment.
This study aims to reach consensus between professionals working with LI children and their parents about the construct and operationalization of CR, using a Delphi Study.

This poster shows the first two steps of the conducted Delphi Study.


Although the monuments of Washington, D.C., honor more than two centuries of history and heroes, five years of that history produced more of the city's public commemorative sculpture than all the others combined. The heroes of the Civil War command Washington's choicest vantage points and most visible parks, lending their names to the city's most familiar circles and squares-Scott, Farragut, Logan, Sheridan, Dupont, and others. In Testament to Union, Kathryn Allamong Jacob tells the stories behind the many District of Columbia statues that honor participants in the Civil War, predominantly Union, and testify to their sacrifice and valor. In her introduction, Jacob puts these monuments in historical context, describing the often bitter battles over control of historical memory, the postwar monument business (a lone soldier-in-granite model could cost a community as little as 1,000), and the rise of the "city beautiful" movement that transformed Washington. She then offers individual descriptions of forty-one sculptures, providing a lively and informative guide to some of Washington's most beautiful and moving works of art. Organized geographically for easy use on walking or driving tours, the entries begin by listing the subject or title of the memorial along with its sculptor, medium, date, and location. Jacob describes its various elements and symbols, and she notes who commissioned the sculpture, who paid for it (or failed to pay in several cases), and who approved its design and placement. She also includes anecdotes and controversies that bring the monuments and their colorful history more fully to life. Admiral David Farragut's statue, for example, is cast from the propeller of his ship the U.S.S. Hartford, from whose rigging he shouted, "Damn the torpedoes! Full speed ahead!" during the battle of Mobile Bay. At the dedication of Lincoln Park's Emancipation Monument in 1876, the largest assembly of African-American to date, speaker Frederick Douglass shocked white listeners with thinly veiled criticism of the martyred Lincoln. Edwin Remsberg's photographs of the monuments capture striking images of war and sacrifice-the straining horses and terrified men of the cavalry grouping at the Grant Monument; the vivid tomb effigy of young John Meigs, depicting him as he was found dead in a field; the Pension Building frieze with its hundreds of finely detailed terra cotta soldiers and sailors marching and rowing across the face of the building. Along with swashbuckling generals atop pedestals bristling with cannon, unexpected subjects appear. A statue of John Ericsson, the Swedish-American who designed the Monitor and perfected the screw propeller for the Union Navy, is hidden in a circle of shrubbery beside the Potomac. A bas-relief of twelve nuns dedicated to the memory of various religious orders who nursed the wounded during the Civil War sits beside noisy Rhode Island Avenue. In addition to the enormous white temple to Lincoln on the Mall, four smaller statues of that president can be found in the city where he was assassinated. Washington's Civil War sculptures bear silent witness to the struggle to preserve the Union. They are the fruit of conscious efforts to shape the nation's memory of that struggle. For tourists and long-time residents, and for anyone interested in the Civil War or public art, Testament to Union is a wonderful guide to these tangible connections to the nation's past and an era when public monuments packed powerful messages.


Climate change alters the frequency and severity of extreme events, such as drought. Such events will be increasingly important in shaping communities as climate change intensifies. The ability of species to withstand extreme events (resistance) and to recover once adverse conditions abate (resilience) will determine their persistence. We estimated the resistance and resilience of bird species during and after a 13-year drought (the 'Big Dry') in floodplain forests in south-eastern Australia. We conducted bird surveys at the beginning and end of the Big Dry, and after the abrupt end to the drought (the 'Big Wet'), to evaluate species-specific changes in reporting rates among the three periods. We assessed changes in bird-breeding activity before and after the Big Wet to estimate demographic resilience based on breeding. Between the start and the end of the Big Dry (1998 vs. 2009), 37 of 67 species declined substantially. Of those, only two had increased reporting rates after the Big Wet (2009 vs. 2013) that were equal to or larger than their declines, while three partially recovered. All other declining species showed low resilience: 25 showed no change in reporting rates and seven declined further. The number of breeding species and total breeding activity of all species declined after the Big Wet, and there was no change in the number of young produced. The Big Dry caused widespread declines in the floodplain avifauna. Despite the drought being broken by 2 years of well-above-average rainfall and subsequent near-average rainfall, most species showed low resilience and there was little indication that overall breeding had increased. The effects of drought appeared to be pervasive for much of the floodplain avifauna, regardless of species traits (species body mass, fecundity, mobility or diet). Ecosystems such as these are likely to require active management and restoration, including reinstatement of natural flooding regimes, to improve ecological condition, to enhance resistance and resilience to extreme climate events.


Within the framework of sustainable development, and ever-increasing energy costs, wastewater treatment operators focus on developing on-site energy production: the main approach today is via sewage biogas. In most cases, H2S removal is necessary to meet the requirements of the energy conversion equipment inlet requirements (for cogeneration motors around 300 – 500 ppm, but for fuel cells around 1ppm or below). Therefore to optimise the overall energy and economic balance, it is necessary to dispose of efficient and cost-effective biogas treatments, amongst which biological treatments have promising prospects for H2S removal.
A biogas cleaning pilot plant was constructed in a wastewater treatment plant (WWTP) (January 2009) in Spain and has been operated for several projects. The pilot plant treats 10 Nm3/h of biogas and is able to produce both electricity and heat in a high efficient way. The MCFC-CONTEX project (collaborative project under auspices of the European Commission and supported by the Fuel Cell and Hydrogen Joint Undertaking, FCH-JU) is one of the few demonstration projects that studies biogas applications in Fuel Cells. The following project tried to review the state of the art of removal H2S technologies and summarized the experience gathered from the polishing stage of the MCFC-CONTEX project.
The biogas treatment was designed to reach the inlet requirements of fuel cells. H2S was identified as the main biogas pollutant and it causes severe and rapid degradation of fuel cell stacks. Examples of industrial biogas treatment units coupled to fuel cells consisting of a main H2S removal stage followed by a final H2S polishing system proved to be successful, thus this was the strategy implemented in the MCFC-CONTEX project. A biotrickling filter was installed, followed by adsorption-based systems, which were chosen for biogas polishing, as they are the only technology that can reduce the concentration of contaminants to the stringent extent of fuel cell's specifications. Specially, an impregnated activated carbon as the polishing source was tested for H2S removal.
The pilot plant was operated for 3 months. The biogas conditions were optimized to 2.5% of O2 content, a relative humidity of 90% and a residence time > 20 seconds. Under these conditions, the impregnated activated carbon showed a removal efficiency > 99.9% and an adsorption capacity of > 80% when the adsorbent started to saturate. Operational expenses were calculated at 0,5 – 1 c€/Nm3.
To sum-up, this report shows the state-of-the-art of biogas treatment technologies and focuses on the polishing stage experimentation. Results show that H2S removal technologies are ready to decrease the pollutant concentration from biogas until the inlet requirements for Combined Heat and Power (CHP) Technologies.


Stone Matrix Asphalt (SMA) is a gap-graded mix that is gaining popularity worldwide. SMA does not application in Iraq; in order for adopt the use of SMA mixtures particularly on high volume roads such as highways and urban intersections in Iraq. So, the new methodology has to be evaluated using Iraq materials and conventional laboratory methods to insure good performance in the Iraq's highway. The purpose of this study is to evaluate the effect of additives type and content on the performance of stone matrix asphalt mixtures. A detailed laboratory study is carried out by preparing asphalt mixtures specimens using aggregate from Al-Nibaay, (40-50) grade asphalt from dourah refinery and two types of fiber (carbon fiber and polypropylene fiber) with percentages (0.2, 0.3, 0.4, 0.5%) by weight of total mix and two types of polymer (phenol and polyethylene) with percentages (7.5, 10, 12.5, 15%) by weight of total mix were tested in the laboratory. Compacted mixtures were tested to evaluate the effects on SMA bulk specific gravity, maximum specific gravity, void content, Marshall Stability, Indirect Tensile Strength (ITS) and permanent deformation. Three different tests temperatures (20, 40,60C °) were employed in the creep test and two temperatures (5, 25 C °) were used in indirect tensile test to investigate the susceptibility of these mixes to change in temperature. The results clearly indicate the importance of using the proper type of stabilizing additive. According to the study results, polymers additives were found to be more effective than fibers additives. SMA Mix modified with phenol additives can be used in cold and normal temperature area, whereas SMA Mix modified with polyethylene additive can be used in high temperature area.


Children undergoing surgical procedures often experience pain in the recovery room where parents are typically responsible for managing children's distress. Research suggests that parents' behavior influences children's distress; however, no study has used time-window sequential analysis to examine the likelihood of parents' reassurance and children's distress interactions. The purpose of this study was to utilize time-window sequential analysis to examine the likelihood of parents' distress preceding and following the start of children's distress. Participants included 148 families with children 2-11 years old undergoing outpatient surgery. Reassurance was positively associated with children's distress, but sequential analyses revealed that children's nonverbal distress was significantly less likely to start and stop following parents' reassurance and children's verbal distress was significantly less likely to occur after fathers' reassurance. These data suggest that reassurance does not prompt distress to start; however, it may maintain children's distress. INDEX WORDS: Pediatric pain, Postoperative distress, Parent reassurance, Sequential analysis A SEQUENTIAL ANALYSIS OF PARENT REASSURANCE AND CHILD POSTOPERATIVE DISTRESS


The high-frequency (HF) component of the heart rate variability (HRV) is regarded as an index of cardiac vagal responsiveness. However, when vagal tone is decreased, nonneural mechanisms could account for a significant proportion of the HF component. To test this hypothesis, we examined the HRV spectral power in 20 patients with mild chronic heart failure (CHF) and 11 controls before and during ganglion blockade with trimethaphan camsylate (3-6 mg/min iv). A small HF component was still present during ganglion blockade, and its amplitude did not differ between CHF patients and controls. The average contribution of nonneural oscillations to the HF component was 15% (range 1-77%) in patients with CHF and 3% (range 0. 7-30%) in healthy controls (P < 0.005). During controlled breathing at 0.16 Hz, however, it decreased to 1% (range 0.2-13%) in healthy controls and 5% (range 1-44%) in CHF patients. Our results indicate that the HF component can significantly overestimate cardiac vagal responsiveness in patients with mild CHF. This bias is improved by controlled breathing, since this maneuver increases the vagal contribution to HF without affecting its nonneural component.


This thesis examines the range of models of legal regulation which have been adopted in Australia to deal with various forms of racial vilification—including criminalisation, civil liability via the creation of statutory torts, and civil liability via the human rights dispute resolution system. It reviews the history and current operation of all relevant federal, state and territorial laws, via an examination of relevant reports, legislation, parliamentary debates, statistical data, and judicial and quasi-judicial decisions, as well as secondary literature. The factors which have influenced the choice of different legislative models for the regulation of racial vilification are identified, and the implications of the choices that have been made for the level of protection provided for victims of racial vilification are discussed. In particular, this thesis analyses the impact of free speech 'rights' and values on the initial choice and subsequent modification of regulatory models by legislatures, and on the application and interpretation of relevant legislation by human rights agencies, prosecuting authorities, tribunals and courts. The capacity of existing regulatory models to achieve the underlying objectives of racial vilification laws in a democratic multicultural society are examined, including an assessment of the strengths and weaknesses of the various approaches to the regulation of racial vilification which have been utilised to date in Australia.


Emerging research in Neural Question Generation (NQG) has started to integrate a larger variety of inputs, and generating questions requiring higher levels of cognition. These trends point to NQG as a bellwether for NLP, about how human intelligence embodies the skills of curiosity and integration.
We present a comprehensive survey of neural question generation, examining the corpora, methodologies, and evaluation methods. From this, we elaborate on what we see as emerging on NQG's trend: in terms of the learning paradigms, input modalities, and cognitive levels considered by NQG. We end by pointing out the potential directions ahead.


It is discovered through a test of almost ten indexes in the four aspects of body patterning, physiological function, physical quality and health condition of senior citizens in Qingdao and a comparison between this test and previous survey results, that physical condition of female is superior to that of male. However, with growth of age, physical condition of both female and male declines, and especially overweight and decline of cardio-pulmonary function account for a great proportion, which will necessarily exert influences upon the overall health condition. With regard to the problems existing in physical health condition of senior citizens, we have to take feasible and effective measures to promote physical health of the group of senior citizens. Study of this article will provide significant guidance in carrying out fitness program and developing mass sports activities in Qingdao, and, meanwhile, will offer scientific evidence for developmental program of senior citizens sports work in Qingdao.


Despite the possible costs, confronting prejudice can have important benefits, ranging from the well-being of the target of prejudice to social change. What, then, motivates targets of prejudice to confront people who express explicit bias? In three studies, we tested the hypothesis that targets who hold an incremental theory of personality (i.e., the belief that people can change) are more likely to confront prejudice than targets who hold an entity theory of personality (i.e., the belief that people have fixed traits). In Study 1, targets' beliefs about the malleability of personality predicted whether they spontaneously confronted an individual who expressed bias. In Study 2, targets who held more of an incremental theory reported that they would be more likely to confront prejudice and less likely to withdraw from future interactions with an individual who expressed prejudice. In Study 3, we manipulated implicit theories and replicated these findings. By highlighting the central role that implicit theories of personality play in targets' motivation to confront prejudice, this research has important implications for intergroup relations and social change.


Time-dependent changes in milk composition and secretion from pregnancy through greater than or equal to 6 mo of exclusive breast-feeding were studied in 13 multiparous women. Concentrations and secretion rates of lipid, lactose, protein, sodium, chloride, potassium, total calcium, ionized calcium, magnesium, glucose, citrate, inorganic phosphate, creatinine, and urea and pH were analyzed longitudinally from day 6 until weaning commenced. The composition of the antepartum secretion was related to the permeability of the junctional complexes between mammary cells. Significant increases in lactose, glucose, pH, and ionized calcium and significant decreases in protein, sodium, potassium, chloride, and calcium concentrations were observed between 1 and 6 mo. Significant differences among individuals, which persisted through lactation, were observed for the concentrations of sodium, potassium, chloride, and inorganic phosphate. The amount of lactose, ionized calcium, and magnesium transferred to the infant was also characteristic of each mother-infant pair. Our data imply that lactation performance is determined in the first month postpartum.


Evaluation of the internal control system is a critical area in which the duties of internal and external auditors overlap. Internal auditors design and maintain internal controls which are evaluated, and often relied upon by external auditors. Both groups of professionals should be interested in any systematic differences, which may exist between their judgement practices. Specifically, this study examines whether internal auditors as a group, make similar judgements as external auditors. The study was conducted by means of a questionnaire which includes a brief description of the internal control environment of a hypothetical company. A pre-answered internal control questionnaire for a payroll internal control system was included. Each auditor receives six similar cases to test for judgement consensus and two repeat cases to test for judgement consistency. Both the repeat cases are unique for each auditor. h e of them follows the 1/4 replicate of 28 design and the other is a repeat of the case The case, which follows the experimental design, is used to determine the judgement model of each group of external and internal auditors. The final judgement model was able to explain 39.8% of the judgements of external auditors and 37.4% of judgements of the internal auditors. The overall conclusion was that judgements of both external and internal auditors were quite similar to each other in their ratings of the internal control strength of a given system.


Aim of the study Utilization of direct acting antiviral (DAA) therapy in candidates with well-compensated hepatitis C virus (HCV) cirrhosis and hepatocellular carcinoma (HCC) accruing end stage liver disease (MELD) exception points is highly variable among transplant centers based on center location, local organ procurement dynamics, HCV(+) organ availability, and patient preference. The association between DAA utilization prior to transplant and incidence of lymphovascular invasion on explant is unknown. Material and methods Retrospective evaluation from 2013-2017 of patients on a liver transplant (LT) waitlist with HCV-related cirrhosis, MELD-Na < 15, and HCC (within T2/Milan criteria). The cohort was divided into the pre-LT DAA treated group and untreated group with clinical/viral demographics collected. Tumor presenting characteristics, locoregional treatments, wait time to LT, dropout rates and explant pathology were compared. Results DAAs were used in 44 patients prior to LT (SVR12 of 37/44 [84%]) and 19 left untreated with LT performed in 81% (51/63) of the waitlisted cohort. No significant differences were found between groups with regards to clinical/viral demographics, local-regional therapy (LRT) sessions, or frequency of lymphovascular invasion on explant. The untreated cohort had a higher rate of dropout (6.3% vs. 3.2%) (p = 0.041). On subgroup analysis of 51 subjects undergoing LT, AFP > 250 ng/ml (p = 0.003) and multifocal HCC (> 1 lesion) (p = 0.006) were associated with lymphovascular invasion on explant while DAA therapy was not (p = 0.578). Conclusions DAA therapy for waitlist active HCV candidates accruing MELD exception points has no deleterious effects on bridging LRT, nor is it associated with increased frequency of lymphovascular invasion on explant. The latter appears driven by tumor related characteristics (AFP and number of lesions) irrespective of DAA utilization prior to LT.


Social media use related to chronic disease has become pervasive, yet little research has been done to examine how social media is currently used by healthcare consumers or how to best use various social media platforms to improve health outcomes. The purpose of this study was to gain an understanding of Instagram use for image sharing related to #rheumatoidarthritis. A visual ethnography approach using content analysis was completed. Images for analysis (n = 106) were randomly selected, using the Instagram public search feature, during seven distinct periods. Content analysis, conducted by two coders, was used to identify categories and provide a sentiment analysis of the images. Approximately 75% of the images were determined to be positive by both coders. Social interaction and self-expression were the most frequently identified categories, suggesting that individuals use Instagram primarily for sharing awareness, sharing encouragement, and self-expression regarding rheumatoid arthritis. This finding is consistent with the use of Instagram for social networking and self-promotion. This study reveals new insights about how Instagram serves as a social, personal, and health-related information sharing platform particularly for those who may be socially isolated due to rheumatoid arthritis.


The distinction between the First Amendment's coverage – those human activities the regulation of which is evaluated by invoking the First Amendment – and the protection it affords – the conditions under which a regulation violates the First Amendment – has been an important component of the Amendment's doctrinal architecture. Recent Supreme Court decisions place significant pressure on the coverage/protection distinction. This Essay examines those cases and the ways in which intuitively attractive results might be precluded by abandoning the distinction. Salvaging those results is possible, but only by deploying analytical moves that run athwart a constitutional "meta-doctrine," which I call the "too much work" principle. In addition to contributing to understanding the coverage/protection distinction and the Court's recent decisions, the Essay explains the role that meta-doctrines play in constitutional architecture more generally.


Study Design. Retrospective radiographic and clinical study. Objective. To examine the long-term outcome of selective thoracic fusion (STF) performed for lumbar "C" modifier curves in adolescent idiopathic scoliosis. Summary of Background Data. The efficacy of STF in lumbar "C" false double major curves is controversial. We examined the 5- to 24-year outcomes of patients with "C" lumbar curves who underwent STF at a single institution to determine which factors help predict successful outcome. Methods. Thirty-two patients (age, 14.8 ± 2.0 years) with a lumbar "C" modifier underwent primary STF and had minimum 5-year follow-up (mean, 6.8 years). All patients were fused distally to either T12 or L1. At latest follow-up, 18 were considered successful (group S), 2 required reoperation to accommodate worsening deformity (group R), and 12 were considered marginal outcomes (group M), as defined by >3 cm coronal imbalance (n = 5), >5 mm worsening of lumbar apical vertebra translation compared with preoperative (n = 4), >1 Nash-Moe grade worsening of lumbar apical vertebra rotation (n = 1), >10° thoracolumbar junction kyphosis which was at least 5° worse than preoperative (n = 5), and lumbar Cobb angle >5° worse than preoperative (n = 2). Clinical outcomes were determined by Scoliosis Research Society (SRS)-30 at final follow-up. Results. Of the multiple factors considered, 2-month postoperative standing lumbar sagittal alignment was most predictive for long-term outcome (P < 0.019 by Kruskal-Wallis ANOVA). Satisfactory outcomes had statistically significantly greater T12-S1 lordosis than those that were marginal (64.8° (group S) vs. 52.0° ° (group M); P = 0.014) or required reoperation (64.8° [group S] vs. 38.0° [group R]; P < 0.001). Traditionally considered variables such as apical vertebra rotation, apical vertebra translation, Cobb angle magnitudes, coronal and sagittal balance, and their respective thoracic-to-lumbar ratios were not independently significant. Conclusion. Selective thoracic fusions performed for lumbar "C" modifier scoliotic deformities generally have excellent long-term radiographic and SRS-30 outcomes at 5- to 24-year follow-up. Care should be taken to ensure that overcorrection of the thoracic curve is not performed beyond the ability of the lumbar curve to compensate. Furthermore, consideration of selective thoracic fusion should not be ruled out simply because the patient may have a somewhat stiff lumbar curve based on side-bending radiographs.


BACKGROUND
Certain cytokine genotypes are associated with acute graft versus host disease (aGVHD) after bone marrow transplantation (BMT). The present study aimed to determine existing association between TGF-beta1 codon 10 polymorphism and aGVHD after HLA-identical sibling BMT in the Iranian population.

MATERIAL/METHODS
In a retrospective case-control study, 168 subjects including 84 Iranian HLA-identical sibling BMT donor/recipient pairs were recruited. All of the patients were affected by hematological malignancies (AML=39, ALL=23 and CML=22). PCR-SSP method was performed to determine TGF-beta1 codon 10 T/C polymorphism genotypes.

RESULTS
The frequency of TGF-beta1 codon 10 TT, TC and CC genotypes among all subjects were 26.8%, 33.3% and 39.9% respectively. Recipients with the T allele developed aGVHD significantly less than those without the T allele (odds ratio =0.334, P=0.026).

CONCLUSIONS
Genetic background of TGF-beta1 may be involved as a protective factor in the development of aGVHD in HLA-matched sibling BMT in Iranian population. Moreover, this finding may indicate that the genetic markers in Iranians are, at least to some extent, linked to distinct genetic event from Japanese.


Impurities and colloidal substances are two of many fouling conditions that reduce the membrane filtration performance used in wastewater treatment. This study investigates the potential of fluidic oscillation generated microbubbles (MBs) to defoul the filtration membrane. Cartridge filters of microfiltration (MF) of 1 μm pore size were fouled using surface seawater collected from the Hull coastal area. The seawater was circulated at 5.8 L/min to actuate colloidal substance deposition on the membrane surface. The recorded feed channel pressure drop (Δ P ) across the membrane filters shown rapid fouling occurred in the first 8 hrs of the circulation. Fluctuations of Δ P during the next 8 hrs were observed showing the colloids filling the pores of the membrane, remaining steady for two hours showing membrane was completely fouled. The filtration membrane was cleaned and defouled using fluidic oscillator generated MBs. The fouled membranes were sparged with 1 L/min of air scouring for ∼1 to ∼2 hrs to remove the deposited colloids and impurities on the surface of the membrane. The membrane, analysed under Scanning Electron Microscopy (SEM), UV 254 and EC meter, shows the extent of MBs mediated removal of the deposited colloidal particle from the membrane surfaces. This study found that the highest defouling rate occurs with MBs generated by fluidic oscillator (closed vent), followed by MBs generated by fluidic oscillator (opened vent) and MBs generated without fluidic oscillator are9.53, 6.22, and 3.41 mbar/min, respectively.


Programmable spatial beam shaping using phase modulation has proven to be an efficient tool for direct and flexible femtosecond laser marking at a Fourier plane of an objective but not well adapted to deep machining or to photowriting in the bulk of a material. We propose an optimization of the focal volume by use of an additional wavefront correction located in the Fourier plane that compensates the focus component in particular. Theoretical predictions involving nonparaxial scalar diffraction are compared to experimental results obtained with a 100 kHz μJ-range femtosecond laser amplifier. Improvements in the beam characteristics, especially the Rayleigh range and the laser fluence, provided by such an additional wavefront control are underlined.


Finding an estimate of the channel impulse response (CIR) by correlating a received known (training) sequence with the sent training sequence is commonplace. Where required, it is also common to truncate the longer correlation to a sub-set of correlation coefficients by finding the set of N sequential correlation coefficients with the maximum power. This paper presents a new approach to selecting the optimal set of N CIR coefficients from the correlation rather than relying on power. The algorithm reconstructs a set of predicted symbols using the training sequence and various sub-sets of the correlation to find the sub-set that results in the minimum mean squared error between the actual received symbols and the reconstructed symbols. The application of the algorithm is presented in the context of the TDMA based GSM/GPRS system to demonstrate an improvement in the system performance with the new algorithm and the results are presented in the paper. However, the application lends itself to any training sequence based communication system often found within wireless consumer electronic device.


Remanié deposits of nodular phosphorite are found at the base of the Coralline Crag (Pliocene) and the Red Crag (Plio-Pleistocene) of Suffolk and Essex. The phosphatic components include phosphorite concretions (nodules), phosphatized vertebrate teeth and bones, and cobbles of sandstone cemented by a phosphatic matrix ('boxstones'). The phosphorite mineral is carbonate fluorapatite (francolite). The source of the phosphorite concretions was the London Clay (Eocene). They formed in unlithified anoxic sediment around sites of organic decay. The source of the 'boxstones' was a Miocene mud-rich sand formation tentatively correlated with the Belgian Anversian. They were formed by concretionary growth in anoxic sediment around sites of organic decay by a similar mechanism to that producing the London Clay concretions. Miocene teeth and bones with a low organic content were phosphatized by an apatite replacement process. This replacement process also enriched the phosphate content of derived phosphatic fossils and phosphorite concretions from the London Clay. Phosphorite formation in eastern England was linked with periods of transgression, while periods of regression were important in concentrating dense phosphatic material as a remanié deposit.


The paper focuses on challenges in the teaching of problem-solving in Grade 10 Mathematics, which may emanate from ignoring the background environment of the child (Graven & Schafer, 2013:4). It is important to affirm what learners know because their background knowledge is influenced by environmental surroundings (Leung, 2008:145), including social and cultural practices. The Department of Basic Education Report (2009) shows that the same topics in which Grade 10 Mathematics learners performed poorly corresponded with those in which they did poorly at the end of their Grade 12 examinations. The study is framed by community cultural wealth theory (Yosso, 2005), which posits knowledge as excluding communities. Rocha-Schmid (2010:344) contends that it is not correct to view excluded communities as objects for rehabilitation, but rather they should be conceived by a Freirean emancipatory project that perceives subaltern communities as authentic beings capable of engaging mathematical concepts in creative endeavours and critical thinking. Hence, the study asserts that it is crucial that parents, traditional leaders and community leaders, play a crucial role in the teaching and learning of Grade 10 Mathematics, so as to alleviate the identified challenges. The study utilised participatory action research (PAR) methods, which recognise community members as experts, and the empowerment of communities to find their own solutions to local issues (Moana, 2010:1). The researcher puts together a team of community members, the school population and education district officials as participants in the study. Each challenge was outlined and analysed using critical discourse analysis (CDA), enabling the participants to use the spoken/written word as evidence of the interpretation made at both the levels of discursive practice and social structures, to extract a deeper meaning and to make repertoires of each participant (Francis, 2012:18; Mahlomaholo, 2012a:51, 2012b:104).


This paper shows that an income effect can drive expenditure switching between domestic and imported goods. We use a unique Latvian scanner-level dataset, covering the 2008–09 crisis, to document several empirical findings. First, expenditure switching accounted for one-third of the fall in imports, and took place within narrowly-defined product groups. Second, there was no corresponding within-group change in relative prices. Third, consumers substituted from expensive imports to cheaper domestic alternatives. These findings motivate us to estimate a model of non-homothetic consumer demand, which explains two-thirds of the observed expenditure switching. Estimated switching is driven by income, not changes in relative prices. JEL Classifications: F1; F3; F4


Recent advances in cancer therapeutics stress the need for a better understanding of the molecular mechanisms driving tumor formation. This can be accomplished by obtaining a more complete description of the genes that contribute to cancer. We previously described an approach using the Sleeping Beauty (SB) transposon system to model hematopoietic malignancies in mice. Here, we describe modifications of the SB system that provide additional flexibility in generating mouse models of cancer. First, we describe a Cre-inducible SBase allele, RosaSBase(LsL), that allows the restriction of transposon mutagenesis to a specific tissue of interest. This allele was used to generate a model of germinal center B-cell lymphoma by activating SBase expression with an Aid-Cre allele. In a second approach, a novel transposon was generated, T2/Onc3, in which the CMV enhancer/chicken beta-actin promoter drives oncogene expression. When combined with ubiquitous SBase expression, the T2/Onc3 transposon produced nearly 200 independent tumors of more than 20 different types in a cohort of 62 mice. Analysis of transposon insertion sites identified novel candidate genes, including Zmiz1 and Rian, involved in squamous cell carcinoma and hepatocellular carcinoma, respectively. These novel alleles provide additional tools for the SB system and provide some insight into how this mutagenesis system can be manipulated to model cancer in mice.


This paper presents deep learning models for the classification of Diabetic Retinopathy (DR) grades. The goal of this research is to find and create a deep learning model that will help us identify the image with high accuracy into one of the five phases of the DR as no DR, mild, moderate, severe, and proliferative DR.The whole work is developed using four steps. The first, using Ben Graham's pre-possessing form, the fundus images were pre-processed. Secondly, in order to train the models, the preprocessed images are contributed to the deep learning algorithm. The third,deep learning models such as Deep CNN, Dense Net, and Group 19 Visual Geometry (VGG19) are developed to predict the severity of the DR. The APTOS Blindness Detection dataset is used to train the proposed deep learning models. Since the data set is imbalanced in nature, the issue of training bias contributes to it. Therefore, at the time of training the models, class weight technique is used to eliminate the training bias problem. In the case of DR grading structures, the proposed deep learning models work well. The Dense Net has been found to work better than the other two models.


This paper describes an exploratory study into the accessibility of the virtual world Second Life for two young people with aphasia. Aphasia is a communicative disorder most commonly caused by a stroke. It affects both written and spoken language, is frequently accompanied by right-sided paralysis and people with aphasia can experience isolation and social exclusion. Multi-user virtual worlds are a potential source of fun and contact with others, but how accessible are such worlds to those with communication issues?

We report an investigation into the accessibility and potential of Second Life for people with aphasia. This was accomplished through a critique and an empirical study involving two young people: Ann was in her mid twenties and Bob in his early thirties. They were selected because both were comfortable with computer technologies before their strokes and each continues to use them, albeit in a more limited capacity. We discuss implications of the results for people with aphasia interacting with multi-user virtual worlds.


The United States' preeminent position as the leading democracy in the world is threatened today by a breakdown in our politics that can be traced back to the 2000 election and the policy failures that occurred in the wake of the terrorist attacks on September 11, 2001. I have seen this erosion in America's standing firsthand in my work abroad. For the last 17 years I have worked on campaigns outside of the United States as a political consultant. That work, regarding the wav in which American consultants run high-level political campaigns abroad, has been the subject of a study group that I led this fall at the Harvard Institute of Politics. [ILLUSTRATION OMITTED] While working on one of these campaigns abroad in 2001, I flew to Dublin, Ireland where I had consulted on the previous general election in 1997 and was working again for the leaders of Fianna Fail, the party of the government at that time. 1 was headed for a series of political meetings in preparation for the upcoming general election in 2002. Since I was working for a client on the West Coast of the United States, when 1 began my trip to Dublin, my journey took me through the Denver airport on the way to Chicago to catch a non-stop flight to Ireland. In early October of 2001, the Dener airport - like many airports in America--could fairly be described as an armed camp. Throughout the spacious main terminal, troops with automatic weapons kept guard in the wake of the attacks on America by Al Qaeda terrorists. The reality of those terrorist attacks was palpable to every passenger that day, and as I saw firsthand when I worked for Senator John Kerry, the events of September 11, 2001, would shape the framework of our own American presidential campaign three years later. After arriving in Ireland, I had a scheduled meeting with Taoiseach Bertie Ahern, the Irish Prime Minister, at his constituency office in the Drumcondra section of Dublin. The small and unpretentious office known as "St. Luke's" was a convenient hideaway for the Taoiseach where he would frequently meet with both his local constituents and national political advisors. As I stepped out of my taxi at St. Luke's, the Taoiseach was arriving as well and met me on the sidewalk in front of the building. As he approached, he said in the most sincere and somber tones, "Tad, I'm very sorry." At first, I did not quite understand the meaning of the Taoiseach's condolence, but then I quickly realized that his heartfelt sympathy, something that was later conveyed to me by so many people who I met in Dublin in the days I spent there during that 2001 trip, was a reference to the terrorist attacks on my own country during the previous month. America's Falling Standing in the Post 9/11 World The United States' standing in the world reached a highpoint in the wake of the events of September 11, 2001. It was reflected to me not just in the sincere expressions of condolence from a Prime Minister to an American citizen on a business trip, but also in the way that so many people all across Ireland and elsewhere around the world expressed their heartfelt support for the United States in the wake of the terrorist attacks. During my career, I have worked on 14 foreign campaigns, which have permitted me to travel extensively to work for candidates for president and prime minister. I have seen firsthand how foreign leaders and the people who run their campaigns and nations feel about the United States. The time spent abroad also allows me to consume foreign media, not from the remote vantage point of a laptop computer in the United States, but rather, while watching local television broadcasts in hotel rooms and at campaign headquarters, listening to the radio news, and reading the hard copy broadsheets (which still play an important role in framing public opinion in capitals around the world). While there was much sympathy for the United States in the days after the attacks of September 11, 2001, America's standing in the wrorld fell precipitously in subsequent months and years. …


BACKGROUND
Consumption of cocoa-derived polyphenols has been associated with several health benefits; however, their effects on the intestinal microbiome and related features of host intestinal health are not adequately understood.

OBJECTIVE
The objective of this study was to determine the effects of eating flavanol-enriched cocoa powder on the composition of the gut microbiota, tissue metabolite profiles, and intestinal immune status.

METHODS
Male pigs (5 mo old, 28 kg mean body weight) were supplemented with 0, 2.5, 10, or 20 g flavanol-enriched cocoa powder/d for 27 d. Metabolites in serum, urine, the proximal colon contents, liver, and adipose tissue; bacterial abundance in the intestinal contents and feces; and intestinal tissue gene expression of inflammatory markers and Toll-like receptors (TLRs) were then determined.

RESULTS
O-methyl-epicatechin-glucuronide conjugates dose-dependently increased (P< 0.01) in the urine (35- to 204-fold), serum (6- to 186-fold), and adipose tissue (34- to 1144-fold) of pigs fed cocoa powder. The concentration of 3-hydroxyphenylpropionic acid isomers in urine decreased as the dose of cocoa powder fed to pigs increased (75-85%,P< 0.05). Compared with the unsupplemented pigs, the abundance ofLactobacillusspecies was greater in the feces (7-fold,P= 0.005) and that ofBifidobacteriumspecies was greater in the proximal colon contents (9-fold,P= 0.01) in pigs fed only 20 or 10 g cocoa powder/d, respectively. Moreover, consumption of cocoa powder reducedTLR9gene expression in ileal Peyer's patches (67-80%,P< 0.05) and mesenteric lymph nodes (43-71%,P< 0.05) of pigs fed 2.5-20 g cocoa powder/d compared with pigs not supplemented with cocoa powder.

CONCLUSION
This study demonstrates that consumption of cocoa powder by pigs can contribute to gut health by enhancing the abundance ofLactobacillusandBifidobacteriumspecies and modulating markers of localized intestinal immunity.


In this paper we make a methodological proposal to measure poverty accounting for time by proposing a new family of intertemporal poverty indexes that aims at reconciling the way poverty is measured in a static and a dynamic framework. Our index is able to consider the duration of the poverty spell and the social preference for equality in well-being given that, in contrast with others that have been previously proposed, it is sensitive to the level of inequality between individual complete poverty experiences over time. Moreover, other indices in the literature can be interpreted as special cases of our more general measure. An empirical illustration shows the relevance of considering the distribution of poverty experiences among the population in an international analysis.


This article investigates the literature of highly skilled migration framed within the concepts of brain drain, brain gain or brain circulation. It argues that students are a subset of highly skilled migrants with semi-finished human and social capital. Considering the lack of studies about students from Turkey in Germany, despite 50 years of migration experience, this article is designed to fill this gap in the literature. First, it explores the German higher education context: international students in Germany and particularly those from Turkey. Next, it concentrates on students leaving Turkey to be educated abroad, and subsequently it focuses on the stay or return intentions of international PhD students from Turkey enrolled at two graduate schools in Germany.


Stretchable electronic systems can play instrumental role for reconfigurable macro-electronics such as distributed sensor networks for wearable and bio-integrated electronics. Typically, polymer composite based materials and its deterministic design as interconnects are used to achieve such systems. Nonetheless, non-polymeric inorganic silicon is the predominant material for 90% of electronics. Therefore, we report the design and fabrication of an all silicon based network of hexagonal islands connected through spiral springs to form an ultra-stretchable arrangement for complete compliance to highly asymmetric shapes. Several design parameters are considered and their validation is carried out through finite element analysis. The fabrication process is based on conventional microfabrication techniques and the measured stretchability is more than 1000% for single spirals and area expansions as high as 30 folds in arrays. The reported method can provide ultra-stretchable and adaptable electronic systems for distributed network of high-performance macro-electronics especially useful for wearable electronics and bio-integrated devices.


OBJECTIVE
The purpose of this research was to investigate whether factors associated with first obtaining care for alcohol problems vary by source of care.

METHOD
This study used data from the National Epidemiologic Survey on Alcohol and Related Conditions to examine initiation of different types of care over a 3-year follow-up interval among individuals with baseline alcohol use disorders who had not previously obtained any care (n = 2,170). Three hierarchical, mutually exclusive types of care were compared: substance use disorder (SUD) specialty sources, general medical but no SUD specialty sources, and nonmedical sources only.

RESULTS
Having injured oneself or someone else because of drinking was associated with initiating all three types of care. Additional factors associated with initiating care from SUD specialty treatment sources (vs. no care) comprised male sex, alcohol use disorder severity, major financial problems, and nondependent tobacco/drug use. Factors associated with initiating care from general medical but not SUD specialty sources (vs. no care) comprised marriage/cohabitation, college student status, number of medical conditions, and other substance dependence. Factors associated with obtaining care only from nonmedical sources (vs. no care) comprised low income and anxiety disorder. When direct comparisons were made among types of care, factors drawing individuals into general medical care for reasons not necessarily related to alcohol problems were those that primarily distinguished utilization of general medical sources from the other two types of care.

CONCLUSIONS
Results support the importance of screening in general medical practice and student health services as an important means of identifying individuals in need of brief intervention or more intensive SUD treatment and reiterate the importance of nonmedical sources for individuals whose alcohol problems might never be addressed in routine medical visits.


Recently continuous cover forestry (CCF) has become an accepted approach to forest management in Britain, but uncertainty about its economic consequences may be a barrier to its wider use. A study was carried out to examine the costs and revenues of transforming a stand of Sitka spruce (Picea sitchensis (Bong.) Carr.) to CCF. The main conclusion is that transformation to CCF need not be more costly than clearfelling and replanting if natural regeneration is successful and the aim is to produce a simple canopy structure. The long-term value of transformation to a more complex canopy structure, with three or more strata, is lower and the extra costs need to be justified in terms of management objectives. The main output from the study is an analysis spreadsheet that empowers practitioners and policy makers to investigate the effects of costs, revenues and discount rates on estimates of net present value over 20 years, 100 years and in perpetuity, to suit local conditions. This paper summarises the method and results of the study in a British context, sets these in a wider international context, and considers the merits, applications and possible further developments of the approach.


There is an augmented use of multimedia applications for communication, information access and entertainment. Furthermore, a wide set of devices has become capable of consuming multimedia. This has created a need for Users to easily and transparently switch between these devices. Session mobility is a concept that aims at enabling seamless switching between terminals during a session. It involves capturing and transferring of session information, and finally reconstruction of the session at the destination terminal. One approach to session mobility is MPEG-21, which is an open framework for multimedia delivery and consumption. The vision of MPEG-21 is to provide seamless and universal delivery of multimedia over a wide range of terminals and networks. Session mobility based on MPEG-21 would therefore solve problems regarding differences in terminal capabilities and network characteristics between the participating devices. The transaction unit in the MPEG-21 framework is a Digital Item; a digital object that associates metadata with multimedia resources. Three parts of MPEG-21 are of importance in the context of session mobility. Digital Item Declaration determines the availability of the multimedia resources. Digital Item Adaptation provides tools for session mobility and adaptations of Digital Items. Digital Item Processing enables control of the session handover and enhances interoperability by allowing the content creator to provide suggested processing instructions. An implementation of session mobility is performed. It demonstrates how MPEG-21 tools are able to realize session mobility in an interoperable way. Digital Item Adaptation tools are used to automatically adapt the Digital Item according to the usage environment. A media player API is developed to provide an interface from the Digital Item to the terminal's media platform. This is necessary in order to let the content creator collect and reconstruct the application specific session state. The solution requires the terminal to support this API in addition to MPEG-21 Digital Item Processing. Consequently, the current specification of MPEG-21 Digital Item Processing is not specific enough to realize session mobility without making any assumptions about the terminal.


An attempt has been made in this research to analyze temporal variations in surface temperature in Ajmer District Rajasthan. The research is carried out to assess the relationship between the land surface temperatures (LST) and land cover (LC) changes both in quantitative and qualitative ways in Ajmer District area using Landsat TM/ETM+ data over the period 1989 to 2013.in this period we used three temporal TM/ETM data 1989, 2001 and 2013. Remote sensing of Land surface temperature (LST) has traditionally used the Normalized Difference Vegetation Index (NDVI) as the indicator of vegetation abundance to estimate the land surface temperature (LST)–vegetation relationship. Unsupervised classification methods have been taken to prepare the LC map. LST is derived from the thermal band of Landsat TM/ETM+ using the calibration of spectral radiance and emissivity correction of remote sensing. NDVI is derived from the NIR & RED Band using image enhancement technique (Indices). Arc-GIS have been utilized for data visualization. This procedure allowed analyzing whether LULC classes match LST classes. However, the results of such overlaying are hard to interpret. LST and LULC maps of these areas give the understanding on how the classes and corresponding LST have changed from one date to the other. Another option is to collect statistical data. it was impossible to calculate linear regression between LULC map and LST map. A solution to that matter is to use Normalized Vegetation Index (NDVI) instead of LULC classification result.


Get a corn dog and meet me at the harness races!Visit America's county fairs as they are vividly evoked through the images, stories, and voices of the people who make them happen - 4-H kids, fair managers, pie judges, farmers and ranchers, rodeo queens, entertainers, food vendors, midway pitchmen, and assorted local characters. Illustrated throughout with stunning color photographs, "Purebred and Homegrown" is an affectionate and thoughtful look at the history of county fairs and their tradition and persistence today, despite the diminished number of Americans who earn their living from agriculture.Author-photographers Drake Hokanson and Carol Kratz traveled 40,000 miles across America from Maine to Alaska, from Georgia to California, visiting ninety county fairs in thirty-five states. By day they interviewed, observed, and photographed; at night they camped among the carnies and the teens showing sheep, under the roller coaster, and next to the chicken barn. The story they tell goes beyond the stereotype of fairs as quaint anachronisms obsessed with giant pumpkins and instead reveals the county fair as an important institution that helped define us as a nation of free-thinking, self-reliant, community-focused people. They present the nearly 200-year-old county fair as a fountainhead of American ideals and rural life, as a place of reunion, and as perhaps the most traditional of all American celebrations.


The aim of this study was to analyze the psychophysiological responses of nursing students during a clinical simulation, as well as their psychological profile in relation to their coping style in stressful situations and its impact on academic performance. We analyzed several variables in three students: i) heart rate variability (HRV) at 5 moments: pre-session, beginning part, middle part, last part of the session and post-session; ii) cortical arousal by Critical Flicker Fusion Threshold; iii) brain oscillations by means of electroencephalography; iv) perceived stress before and after starting the practice; and v) the objective and subjective evaluation of academic performance. We expected to find psychophysiological markers indicating a habituation to the situation. However, the results based on HRV and the parameters of related indexes failed to indicate the expected autonomic adaptation during the practice, showing a high sympathetic autonomic nervous system modulation. This non-habituation outcome might be related to the students' high scores in the perceived stress scale associated with non-adaptive coping styles. In conclusion, a nursing clinical simulation scenario produced an anticipatory anxiety response in the students, which prevented them from achieving a habituation response, decreasing the Critical Flicker Fusion Threshold, and increasing anterior and decreasing temporal electroencephalogram activity.


Premise of research. Along the western coast of South America, the Peruvian and the Atacama Deserts extend over a length of 3500 km. For a short period in the year, the desert is affected by a dense fog formed under the influence of the Humboldt Current that gives rise to an ephemeral plant community called the "Lomas." Salvia rhombifolia Ruiz & Pavon is an endemic annual component of the Lomas. Previous observations indicated bee and bird visitors at the plant; however, no detailed studies were performed. Here, we test the hypothesis that both bees and birds are pollinators and thus increase the chance of pollination in the extreme habitat of the plant. Methodology. Fieldwork was conducted with three large populations of S. rhombifolia in the fog season of 2015. We combined morphometric analyses with corolla color, nectar volume, and sugar concentration to characterize the floral syndrome of this species. Data on pollinators, including frequency of visits, behavior, and morphometry, were analyzed statistically and compared with the floral traits to identify the best fit between flowers and pollinators. Pollinator efficiency was tested with single-visit experiments comparing the seed set after controlled bird and bee pollination. Pivotal results. Salvia rhombifolia exhibits small blue flowers (<1.5 cm). Nectar volume was low (ca. 1 μL) and sugar concentration moderate (22.8%). Pollinators were bees (six species) and hummingbirds (two species). Morphometric analyses of pollinators and flowers underlined their close mechanical fit. The fruit set under controlled conditions indicated that birds (100%) and bees (82%) were likely effective pollinators. Conclusions. The results clearly show that S. rhombifolia is not specialized for bees but an "intermediate" species that also attracts birds. The flexible use of pollinators appears to be triggered by the extreme abiotic conditions and the need to reproduce sexually.


We show extensive theoretical studies related to the generation and characterization of 2D and 3D ordered networks using 1D units that are connected covalently. We experimentally created multi-terminal junctions containing 1D carbon blocks in order to study the most common morphologies and branched structures that could be used in the theoretical design of network models. We found that the mechanical and electronic characteristics of ordered networks based on carbon nanotubes (ON-CNTs) are dominated by their specific super-architecture (hexagonal, cubic, square, and diamond-type). We show that charges follow specific paths through the nodes of the multi-terminal systems, which could result in complex integrated nanoelectronic circuits. The 3D architectures reveal their ability to support extremely high unidirectional stress when their mechanical properties are studied. In addition, these networks are shown to perform better than standard carbon aerogels because of their low mass densities, continuous porosities, and high surface areas.


The literature related to veterinary student attrition is limited, particularly in an Australasian context in recent years. With the increase in student numbers, the implementation of a demand-driven higher education system and the high costs associated with veterinary education, it is timely to evaluate factors affecting the success of veterinary students. Although caution should be used when applying broader data to veterinary education, it is well documented that student success is greatly influenced by student experience in first year. This study examined the relationship between a range of demographic and educational background factors of commencing veterinary students and their academic success within the course. The students included in the analysis were those who began a Bachelor of Veterinary Science (BVSc) degree at James Cook University (JCU) between 2006 and 2014. A series of univariate (chi-square and one-way ANOVA) and multi-variate (CHAID classification trees) statistical tests were used to assess whether there were differences in the outcomes for students with different demographic characteristics and educational backgrounds. Of all students who commenced a BVSc degree between 2006 and 2008, 74% had completed the course by 2014. In contrast to the literature, prior to 2012 the majority of students withdrew from the course after successfully completing first year and subsequently failing in second year or beyond. From 2013 onwards, it appears that the majority of students that left the course, do so before commencement of second year. This coincides with a major curriculum review that was implemented in 2013 aiming to better prepare students to the integrated nature of the veterinary curriculum typical of JCU's program after Year 1. The cohorts of students that have enrolled in the BVSc degree are quite diverse compared to the broader sector and the student body at JCU. Tertiary entry scores, students' commencing age and their home locality were the only independent predictors of performance in the course. Otherwise students' demographic characteristics (students' gender, country of birth, indigenous, disability and non-English speaking background status, and regional and socioeconomic background) had no effect on success in the course. These results suggest that the JCU veterinary course does not bias for or against the diverse demographic background of commencing students and hence ensures reasonable number of graduates with rural or remote origins which was part of the rationale for the courses' establishment. It is proposed to embed more blended learning activities in the curriculum to specifically support educationally disadvantaged students through the course.


This article aims to investigate some aspects of the social process related to water resources management and gender relations. Given that gender and water management are interrelated issues exposed to a growing attention at the international level, it is therefore necessary to identify relations between the academic literature, the institutional framework and the field-based research. This document has been inspired by the Nostrum DSS project (Network on Governance, Science and Technology for Sustainable Water Resources Management in the Mediterranean), a Co-ordination Action funded by the European Commission, which involves eighteen partners from the North and South shores of the basin. As the scope of the project is to disseminate Best Practice Guidelines for the design and implementation of Decision Support System tools (DSS) to identify optimal water resources management regimes, this article is proposing an analysis of a particular geographical and social frame related to the social actors involved in the project, but there are no connections between the paper and the project itself. To create a network between science, policy and civil society is one of the main objectives of the project in order to reach an improved governance and planning in the field of sustainable water management. Therefore, to investigate gender sensitivity in some areas of the basin shall provide a clue. This overview of academic and institutional background refers to a particular geographical and cultural area, the Middle Eastern and North African region. In the first section lies the theoretical background, that has been extrapolated from international organisations guidelines and scholars' publications. The second section is specifically focused on the Egyptian geographical context. The first paragraph presents a review of the guidelines suggested by international organisations related to policies on gender and water, as parts of the changes that the global scenario has recently been facing, with the shift from the micro level to the macro level. The second paragraph then describes the side effects of these overspread trends, which are identified in their missing relations with the social context of the intervention. The third and fourth paragraphs introduce the issue of women's role in water management in the Middle Eastern and North African Regions, while highlighting relations between women's involvement in the public sphere and the role they cover in local communities organisations. The proportion of the political representation faced by women in this region is also discussed, tackling their overspread participation in agriculture and their unrecognised working status. The fifth paragraph of this paper will discuss a case study in Egypt, concerning an initiative promoted by international donors and the government aimed at increasing community participation in the design and management of irrigation canals. The case study gives a concrete sample to discuss plusses and problems of women's participation in water users organisations, synthesising many of the theoretical issues that have been raised in the first three parts of this article.


Motivated by the study of the longitudinal development and progression of knee osteoarthritis (OA) over a 15-year period, this study developed non-parametric mixed-effect models for ordinal outcomes. A stochastic mixed-effect model was used to evaluate the similarity of trajectories associated with increasing disease severity of OA in both knees. Then, a non-parametric mixed-effects model, based on cubic B-splnes, was developed to characterize the unknown nonlinear trend of logits as a function of time1-order. A Markov Transition Model was developed to characterize the transitions among multi-states of knee OA. This newly developed approach allows more flexible functional dependence of the ordinal outcome, levels of increasing knee OA severity, on the covariates.


TempleMVV a system for visually mining very large high dimensional datasets is presented. The system first developed at Temple University's Department of Physics is based on U.S. Patent No. 5,228,119 and utilizes nested dimensions and hierarchical graphics. The system achieves very high performance which is independent of the size of the dataset by utilizing discrete recursive computing to the maximum degree possible. Data involving any mix of continuous or discrete numeric variables and nominal or ordinal categorical string variables can be mined. In this paper we will try to convey some of the types of knowledge that can be mined utilizing human pattern recognition skills when suitable graphic data representations are chosen. These include but are not limited to 2, 3,.... 10 way interactions; complex correlations which may be linear or non-linear, marginal or highly constrained, over an entire range or any sub-range of one or more variables; anomalously large and statistically significant frequencies for multi-dimensionally non-contiguous cells ("nuggets"); clustering and discriminate function analysis in up to ten dimensions. Recent enhancements to the system allow one to deal with datasets involving thousands of variables (e.g. "marketbasket" data). The system is superior to neural nets, CART, CHAID and clustering algorithms in several respects.


Coenzyme Q10 (CoQ10) supplementation has been shown to decrease oxidative stress in a number of clinical settings. However, there are mixed results regarding the role of CoQ10 supplementation on exercise performance. Chronic kidney disease is recognized as an inflammatory state, and hemodialysis patients have low level of exercise performance. We aimed to evaluate the effect of CoQ10 supplementation on oxidative stress markers and exercise performance measures. This was a prospective, double-blind, placebo-controlled, crossover study in which all patients received placebo and oral CoQ10 200 mg/d. Participants underwent 6-minute walking test and cycle ergometer. Blood samples were drawn to determine malondialdehyde, oxidized low-density lipoprotein, superoxide dismutase, and glutathione peroxidase. Walking distance in 6-minute walking test and estimated maximal oxygen consumption (VO2max) were recorded. Twenty-eight patients were randomized, but 23 patients completed the study protocol. Serum CoQ10 level significantly increased with supplementation compared with basal values (P < 0.05). Neither walking distance nor estimated VO2max was different between the placebo and CoQ10 groups (P > 0.05). Serum malondialdehyde levels significantly increased in both groups compared with baseline values just after the exercise (P < 0.05). There was no difference in markers of oxidative stress and antioxidant system between placebo and CoQ10 supplementation with exercise (P > 0.05). The results of this study showed no significant effect of CoQ10 supplementation on exercise performance measures and oxidative system markers compared with placebo in maintenance hemodialysis patients.


BACKGROUND
Acalabrutinib is a selective Bruton tyrosine kinase inhibitor approved for patients with relapsed or refractory mantle cell lymphoma, an aggressive B-cell malignancy. Treatment-related adverse events (AEs) can have a negative effect on treatment adherence.

OBJECTIVES
This article aims to provide nurses with firsthand guidance so that they can better support patients with mantle cell lymphoma initiating acalabrutinib.

METHODS
Safety data from the acalabrutinib ACE-LY-004 phase 2 trial in 124 patients with relapsed or refractory mantle cell lymphoma were reviewed, and strategies implemented at the University of Texas MD Anderson Cancer Center to manage trial AEs are described.

FINDINGS
The most common AEs of any grade were headache and diarrhea, but no patients discontinued treatment because of them. When doses were missed or modified, patients were reeducated about the importance of adherence and how to manage AEs. Grade 1-2 AEs were managed with over-the-counter medication, if needed. These strategies allowed for the tracking of occurrences of nonadherence, providing the opportunity to advise and educate patients and to manage AEs more effectively.


Research has identified benefits of large high-resolution displays (LHRDs) for exploring and understanding visual information. However, these displays are still not commonplace in work environments. Control rooms are one of the rare cases where LHRD workplaces are used in practice. To understand the challenges in developing LHRD workplaces, we conducted a contextual inquiry a public transport control room. In this work, we present the physical arrangement of the control room workplaces and describe work routines with a focus on the interaction with visually displayed content. While staff members stated that they would prefer to use even more display space, we identified critical challenges for input on LHRDs and designing graphical user interfaces (GUIs) for LHRDs.


Utilizing panel data collected in 27 countries from 1960 to 2010, we demonstrate that the relationship between per capita urban water consumption and per capita gross domestic product exhibits an N-shaped pattern. Following the environmental Kuznets curve literature, this relationship can be named the cubic water Kuznets curve. We also demonstrate that water policies significantly influence per capita urban water consumption, which implies that appropriate policy interventions might allow developing countries to achieve economic development with less per capita water consumption.


The morphologies of the perovskite (e.g. CH3NH3PbI3) layer are demonstrated to be critically important for highly efficient perovskite solar cells. This work applies 3-aminopropanoic acid as a self-assembled monolayer (C3-SAM) on a poly(3,4-ethylenedioxythiophene):poly(styrenesulfonate) (PEDOT:PSS) hole transport layer (HTL) to modify the crystallinity and coverage of the CH3NH3PbI3−xClx film, resulting in a much smoother perovskite surface morphology together with a PCE increase from 9.7% to 11.6%. Since all fabrication steps of these inverted structure devices are carried out under low temperature conditions (processing temperature < 120 °C), it is possible to employ this method on flexible polymer substrates using roll-coating for the layer deposition. The roll-coated perovskite film on C3-SAM modified PEDOT:PSS presents a similar trend of improvement and results in enhanced PCE from 3.7% to 5.1%. The successful application of the facile HTL modification indicates a common strategy for SAM material design and selection for efficiency enhancement in perovskite photovoltaic devices.


Limitations in acquiring training data restrict potential applications of deep reinforcement learning (RL) methods to the training of real-world robots. Here we train an RL agent to align a Mach-Zehnder interferometer, which is an essential part of many optical experiments, based on images of interference fringes acquired by a monocular camera. The agent is trained in a simulated environment, without any hand-coded features or a priori information about the physics, and subsequently transferred to a physical interferometer. Thanks to a set of domain randomizations simulating uncertainties in physical measurements, the agent successfully aligns this interferometer without any fine tuning, achieving a performance level of a human expert.


Recent reports suggest that transfusion of old red blood cell (RBC) units (>2 weeks) was associated with increased risks of postoperative complications and higher mortality rate caught public attention (Yap et al., Ann Thorac Surg 2008; 86:554–559 and Koch et al., 2008; 358:1229–1239). This rekindled the decades old discussion regarding the impact of RBC aging and storage lesions in patient care. The objectives of this review are to provide readers with an overview of the process of banking RBC that may have an impact on its quality, the reported clinical impact of storage lesions, the consequences of transfusing new RBC units only to the nation's blood supply and potential solutions that may improve the feasibility of blood banks to issue new blood units only. Am. J. Hematol. 85:117–122, 2010. VC 2009 Wiley-Liss, Inc.


Ground moving radar target classification is one of the recent research issues that has arisen in an airborne ground moving target indicator (GMTI) scenario. This work presents a novel technique for classifying individual targets depending on their radar cross section (RCS) values. The RCS feature is evaluated using the Chebyshev polynomial. The radar captured target usually provides an imbalanced solution for classes that have lower numbers of pixels and that have similar characteristics. In this classification technique, the Chebyshev polynomial's features have overcome the problem of confusion between target classes with similar characteristics. The Chebyshev polynomial highlights the RCS feature and is able to suppress the jammer signal. Classification has been performed by using the probability neural network (PNN) model. Finally, the classifier with the Chebyshev polynomial feature has been tested with an unknown RCS value. The proposed classification method can be used for classifying targets in a GMTI system under the warfield condition.


Objective: Drawing from the social-ecological framework, this multilevel study examines individual, family, and school correlates of bullying perpetration among a sample of high school-age students. Cross-level interactions address contextual influences across individuals and schools. Method: The analytic dataset contains anonymous responses (collected in 2012) of the Dane County Youth Survey (DCYS) from 12,185 high school students in Grades 9 through 12 (49.8% females). The survey assessed demographic characteristics, family relations, peer relations, substance use, bullying, victimization, and school connectedness. Results: Multilevel modeling was used to examine between-person and between-school differences in individual rates of bullying perpetration. Females reported less engagement in bullying perpetration than did males. Furthermore, alcohol and marijuana use was related to higher rates of bullying perpetration. In addition, between-person family dysfunction and school risk were both associated with higher rates of bullying perpetration. Similarly, between-person rates of school connectedness were associated with less bullying perpetration. At the school level, average between-school differences in family dysfunction was related to greater bullying perpetration. A cross-level interaction was also significant. Compared with individuals attending schools with higher average rates of family dysfunction, schools with lower rates of family dysfunction displayed lower levels of bullying perpetration. Conclusion: Prevention programs that consider various dimensions of the social-ecological perspective and, more specifically, family and school factors have potential to reduce bullying.


The human hand can take on a huge variety of shapes and functions, providing its owner with a powerful hammer at one time or a delicate pair of forceps at another. The universal utility of the hand is even more enhanced by the ability to amplify the function of the hand by using tools. To understand and appreciate how the human brain controls movements of the hand, it is important to investigate both the healthy motor behavior and dysfunction during everyday manipulative tasks. This book provides a contemporary summary of the physiology and pathophysiology of the manipulative and exploratory functions of the human hand. With contributions from scientists and clinical researchers of biomechanics, kinesiology, neurophysiology, psychology, physical medicine and rehabilitation, it covers the development of healthy human grasping over the lifespan, the wide spectrum of disability in the pathological state and links basic motor research with modern brain sciences.


Among the challenges facing the lawyer who renders legal services to clients with limited means are ethical and professional questions relating to the influence of third parties on the lawyer-client relationship. Although all lawyers may potentially face ethical dilemmas involving third parties, legal services lawyers are particularly vulnerable to such issues because, unlike most lawyers, legal services lawyers generally rely on the financial support of someone other than their client. These challenges may take many forms, affecting a variety of ethical and professional considerations. Levine examines a number of areas in which bar association committees, scholars, and courts have addressed the issue of third-party influence on legal services lawyers. Part I discusses the challenges to the fundamental value of attorney- client confidentiality that may arise as a result of the influence of third parties on legal services lawyers. Part II describes the more direct influence of third parties on legal services lawyers, addressing problems relating to the Model Rules of Professional Conduct. Finally, Part III briefly discusses some of the broader issues of third- party influence on resource allocation in legal services lawyering. Levine concludes by advocating that participants in these discussions should sense the importance of carrying forward the effort by synthesizing the contributions of all those involved on practical, theoretical, and philosophical levels.


Contemporary and future speech telecommunication systems now utilise low bit rate (LBR) speech coding techniques in efforts to eliminate bandwidth expansion as a disadvantage of digital coding and transmission. These speech coders employ model-based approaches in compressing human speech into a number of parameters, using a well-known process known as linear predictive coding (LPC). However, a major side-effect observed in these coders is that errors in the model parameters have noticeable and undesirable consequences on the synthesised speech quality, and unless they are protected from such corruptions, the level of service quality will deteriorate rapidly. Traditionally, forward error correction (FEC) coding is used to remove these errors, but these require substantial redundancy. Therefore, a different perspective of the error control problems and solutions is necessary. In this thesis, emphasis is constantly placed on exploiting the constraints and residual redundancies present in the model parameters. It is also shown that with such source criteria in the LBR speech coders, varying degrees of error protection from channel corruptions are feasible. From these observations, error control requirements and methodologies, using both block- and parameter-orientated aspects, are analysed, devised and implemented. It is evident, that under the unusual circumstances which LBR speech coders have to operate in, the importance and significance of source reliant error control will continue to attract research and commercial interests. The work detailed in this thesis is focused on two LPC-based speech coders. One of the ideas developed for these two coders is an advanced zero redundancy scheme for the LPC parameters which is designed to operate at high channel error rates. Another concept proposed here is the use of source criteria to enhance the decoding capabilities of FEC codes to exceed that of maximum likelihood decoding performance. Lastly, for practical operation of LBR speech coders, lost frame recovery strategies are viewed to be an indispensable part of error control. This topic is scrutinised in this thesis by investigating the behaviour of a specific speech coder under irrecoverable error conditions. In all of the ideas pursued above, the effectiveness of the algorithms formulated here are quantified using both objective and subjective tests. Consequently, the capabilities of the techniques devised in this thesis can be demonstrated, examples of which are: (1) higher speech quality produced under noisy channels, using an improved zero-redundancy algorithm for the LPC filter coefficients; (2) as much as 50% improvement in the residual BER and decoding failures of FEC schemes, through the utilisation of source criteria in LBR speech coders; and (3) acceptable speech quality produced under high frame loss rates (14%), after formulating effective strategies for recovery of speech coder parameters. It is hoped that the material described here provide concepts which can help achieve the ideals of maximum efficiency and quality in LBR speech telecommunications.


The number of electronic journals is growing as rapidly as the World Wide Web on which many are published. Readership of an electronic journal is important to quantify, just as it is for a printed journal. In maintaining the Journal of Interactive Media in Education (JIME), a scholarly electronic journal open to all, we require readership statistics more meaningful than the variations on the theme of "number of hits" given by many log analysis packages. Important aspects of JIME's open access are the decisions to not require subscription, nor the use of hidden tracking aids such as cookies. Readership information is acquired from the server log of client requests. We are investigating the identification of user sessions from such logs, and the development of classification of sessions into constituencies of readership. In this paper, we present the result of manual analysis from which we are developing automatic analysis mechanisms.


Purpose of the Study. This study sought: (a) to identify stakeholders' perceptions of the existing guidance program in Jamaican schools and (b) to identify aspects of the Comprehensive Guidance Counseling Program (CGCP) that are desired by stakeholders in order to observe if there were any significant gaps between the perceived current and desired status of guidance in Jamaican schools. Method. This was a self-report, descriptive survey study that involved 420 subjects (151 students, 130 teachers, 44 counselors, 37 principals, and 58 parents) from 54 schools (18 primary, 18 All-Age/Junior High, and 18 Secondary) across the three counties of Jamaica. Results. Results indicated that Jamaican school-age children are faced with real challenges that are impacting their academic, career, and personal/social development. The major issues identified by stakeholders as having the greatest negative impact on students' success included: death of someone close, fear of contracting STIs, HIV/AIDS, thoughts, of problems at home, fear of failing at school, and thoughts of being raped or sexually abused. Additionally, the Wilcoxon Signed Rank Test results showed significant differences between the perceived current and the desired status of guidance in Jamaican schools, and that stakeholders desire to have all essential elements of aCGCP implemented in Jamaican schools. Conclusion. Results of this study led to the following conclusions. Jamaican school-age children are faced with real challenges that are impacting their academic, career, and personal/social development. Stakeholders perceived the existing guidance program in Jamaican schools as lacking essential elements of a CGCP. There are significant gaps between the perceived current and desired status for all essential elements of a CGCP, therefore stakeholders desire to have a CGCP implemented in Jamaican schools. Consequently, stakeholders and policy makers need to clearly understand that school counselors will be better able to help solve current problems that plague our schools if they are given roles that permit them to deliver comprehensive counseling and guidance program services effectively.