Objectives To explore barriers and facilitators to prescribing error reporting across primary care. Design Qualitative semi-structured face-to-face and telephone interviews were conducted to explore facilitators and barriers to reporting prescribing errors. Data collection and thematic analysis were informed by the COM-B model of behaviour change. Framework analysis was used for coding and charting the data with the assistance of NVivo software (V.12). General and context specific influences on prescribing error reporting were mapped to constructs from the COM-B model (ie, capability, opportunity and motivation). Setting Primary care organisations, including community pharmacy, general practice and community care from North East England. Participants We interviewed a maximal variation purposive sample of 25 participants, including prescribers, community pharmacists and key stakeholders with primary care or medicines safety roles at local, regional and national levels. Results Our findings describe a range of factors that influence the capability, opportunity and motivation to report prescribing errors in primary care. Three key contextual factors are also highlighted that were found to underpin many of the behavioural influences on reporting in this setting: the nature of prescribing; heterogeneous priorities for error reporting across and within different primary care organisations; and the complex infrastructure of reporting and learning pathways across primary care. Findings suggest that there is a lack of consistency in how, when and by whom, prescribing errors are reported across primary care. Conclusions Further research is needed to identify cross-organisational and interprofessional consensus on agreed reporting thresholds and how best to facilitate a more collaborative approach to reporting and learning, that is, sensitive to the needs and priorities of disparate organisations across primary care. Despite acknowledged challenges, there may be potential for an increased role of community pharmacy in prescribing error reporting to support future learning.


The nucleation of lead onto vitreous carbon electrodes has been investigated. Diffusion-controlled growth of nuclei inhibits nucleation, giving rise to saturation with nuclei and introducing correlations in their location on the electrode surface. Similar nuclear number densities were obtained from direct, microscopic observation of the surface and from analysis of potentiostatic current transients considering the development of nucleation exclusion zones around already established nuclei. At low overpotentials nuclei were found to be uniformly distributed on the surface, whereas at high overpotentials the results were found to be consistent with simulations of the process that allowed for the existence of exclusion zones around nuclei, with radii proportional to the square root of their age.


The literature on travel demographics and mode choice provides information about individuals and their travel patterns at the aggregate level and by using variables such as income, race/ethnicity, gender, and age. These findings provide useful insight into the modes that travelers use and the purpose, duration, and distance of trips. However, we know much less about the ways people experience travel, both physically and emotionally, and the effects these experiential aspects can have on individual travel decisions. This research uses ethnographic fieldwork methods to examine the experience of bus travel, and particularly behaviors, types of interactions, and social expectations on buses.This study focuses on five bus lines in Los Angeles running along several of the city's main thoroughfares as part of the Los Angeles County Metropolitan Transportation Authority (Metro) transit network - three established local (Metro Local) routes and two newer bus rapid transit (BRT or Metro Rapid) lines. The findings suggest that life on buses includes a myriad of complex social and interpersonal interactions. Bus riding involves established norms and rules of behavior around waiting, boarding, riding, and alighting. Behaviors and incidents that occur outside this scope of normalcy are identified and considered disruptions. Regular disruptions to the social order can be characterized in several dimensions: 1) negative and positive disruptions, 2) the impact of disruptions on individuals and groups, 3) their quality as brief or more sustained, 4) routine and more unusual disruptions, and 5) the intimate to stranger relationships among those involved in a disruption.A comparison of the Local and Rapid lines shows that they differ in terms of the consistency of branding and the physical features and amenities along the routes. This study also introduces the idea of experiential reliability, or the consistency of experience. Fewer disruptions occur in the tighter social space of the Rapid buses, while the Local bus experience includes ongoing disruptions to the social order. Lastly, various types of stigma management occur in bus spaces. Riders both respond to and ignore particular stigmatized riders - the outcasts, the disruptors, and the freeloaders. People also manage the modal stigma of buses through such strategies as complaining, commiserating, destigmatizing the bus-riding experience, and reconceptualizing the bus-rider identity.


The groundwater potential of the Makurdi sandstone was investigated at Anyoga Eddi Adum East during February-March 1998. Fifteen hundred meters of EM34-3 surveying was undertaken, using a 20 m inter-coil spacing, as were two resistivity soundings. Three boreholes were drilled: two deep
exploratory boreholes and one shallow cored observation borehole. Two boreholes (BGS 36 and BGS
37) were completed with screen and casing; BGS 38 contained little water and was therefore backfilled.
BGS36 and BGS 37 were test pumped; during these exercises water samples were obtained for
hydrochemical analysis. The following conclusions are made from the results obtained:
The Makurdi Sandstone at Anyoga Eddi Adum East comprises interbedded sandstones and
mudstones. Sandstone layers up to 4 m thick are present.
The sandstones are fine to medium grained, well cemented, feldspathic and frequently
bioturbated. The sandstones contain interbedded thin mudstone beds that often show load casting
features. The mudstone can be soft and is often shaley and carbonaceous. Thin sandstone,
siltstone and limestone layers occur interbedded within the mudstone sequence.
Where sandstone occurs at shallow depths, it has been weathered. Within the top few metres,
feldspar has been leached increasing the inter-granular permeability and porosity; kaolinite clay is
also present. At slightly greater depths, secondary silicate deposition is present, which produces
very hard and dense siliceous sandstone layers with negligible inter-granular permeability.
Where predominately mudstone is present at shallow depths, it has been weathered to olive-green
illite-smectite rich clay (similar to Edumoga).
The aquifer properties of the Makurdi Sandstone at Anyoga are disappointing. Groundwater was
only found where significant sandstone occurred within the weathered zone. The inter-granular
permeability of the sandstone is low, the majority of the water found in the two successful
probably supplied by slow seepage from the sandstone.
The yield from neither borehole is sufficiento sustain a hand pump. A hand dug well
constructed through the weathered zone to the fractures below would be the most appropriate
technology for abstracting groundwater.
The storage coefficient at Anyoga was typical of a confined aquifer (0.0001). The exploratory
boreholes could be kept open to routinely measure water levels within the aquifer to monitor the
sustainability.
The electrical conductivity measured using the EM34-3 varied from 10-30 mmhos/m. The lower
measurements were associated with sandstone in the weathered zone, while the higher
measurements indicated more mudstone within the weathered zone. Therefore, low EM34-3
readings are the best targets for groundwater. Resistivity soundings could also distinguish the
sandstone from the mudstone.
It is recommended that a more detailed study is made of the weathered zone of the sandstone to
discover more about how and where the hard siliceous layers are likely to occur (e.g. in valleys or
on ridges). A diamond-coring bit would be required to obtain samples.


In this contribution we present a determination of the strong coupling from a fit of QCD predictions for energy-energy correlation measured in electron-positron collisions at various center-of-mass energies. Experimental data are compared to precise theoretical calculations
incorporating NNLO QCD predictions combined with NNLL resummation in the back-to-back region. Hadronization corrections are assessed using modern shower Monte Carlo programs matched to NLO fixed-order computations. The final result obtained from a global fit is $\alpha_S(M_Z)=0.11750\pm0.0287(comb.)$.


State Succession — Effect on Private Rights — Currency of Successor State — Transfer of Sovereignty from Former Netherlands Indies to Indonesia.


'Oze' (Bosqueia angolensis) is found in the tropical rain forest and grows in thick humid forest of undisturbed land. It belongs to the family Moracea. Wholesome 'oze' (Bosqueia angolensis) seeds were given different treatments, which included blanching, cooking, roasting and malting. The samples obtained from these treatments were analyzed for anti-nutritional properties. The 'oze' seeds had up to eleven antinutrients with alkaloids (2730 mg/100 g) and Total phenols (2500 mg/100 g) predominating. Except for Total phenols and Trypsin inhibitors (37.3 TIU/100 g) all the other anti-nutrients were found more in the hulls than the edible cotyledons. Also all anti-nutrients except phytates and oxalates were eliminated by malting. [Journal of American Science. 2011;7(1):1-6]. (ISSN: 1545-1003).


Received: May 07, 2018 Accepted: May 22, 2018 Published: May 30, 2018 Volume: 1 Issue: 2 This paper aims to examine the ethnic variations of condolence messages written by Malaysians. Data comprise 36 authentic SMS condolence messages written in English by predominantly 47% Chinese, 33% Malays and 20% Indians. Data were retrieved from the recipient and then projected as a word document. They are then coded according to ethnicity, age and gender and the number of words were counted. The speech act theory is applied to determine the expressive functions and this is then followed by a linguistic analysis. Analysis suggests that the SMS condolences can be classified into 13 expressive functions. The condolences written by Chinese writers expressed more hope and sympathy; those written by Malay writers were more indirect and polite and they expressed more apologies while those written by Indian writers expressed more God-related statements. Since the findings are derived from a small set of data the outcome of this paper cannot be generalised. Nonetheless, they are authentic data which are difficult to access hence, these findings will serve as a window for other cultures to understand the ethnic differences of multicultural Malaysia. Indeed, the outcome of this paper can contribute to a better understanding of intercultural communication. KEYWORDS


AIM
To determine the prevalence of health problems uncovered by a Standardized Assessment for Elderly Patients in a Primary Care Setting (STEP), to explore how often STEP uncovered conditions new to general practitioners (GP) and ascertain how often STEP results led GPs to plan further interventions.

METHODS
This descriptive, interim analysis was based on the data of 189 elderly patients (median age, 78 years; interquartile range [IQ], 74-81) and their 20 GPs collected in Hannover region, Germany, between June 2008 and April 2009. Study nurses in the practice setting applied the 44-item STEP instrument, based mainly on self-reporting, as well as a standardized patient interview. Subsequently, GPs indicated whether the problems were new to them, and whether they planned further action or health interventions on the basis of the problems identified by STEP.

RESULTS
A median of 11 health problems (IQ, 8-14) were uncovered per patient, of which a median of 2 (IQ, 1-4) were new to the GP and interventions were planned for a median of 2 problems (IQ, 0-4). Many of the identified health problems are typical of old age. The following health problems uncovered by STEP were often new to the GPs (percentages differ to numbers due to missing GP ratings): cognitive impairment (33 of 64 affected by this problem, 73%), missing or unknown immunization status (84 of 160, 55%), and recent chest pain (19 of 37, 53%). Alcohol misuse was new in all 4 affected patients (100%) and recent falls were new in 5 of 7 patients (83%). Interventions for affected patients were frequently planned for problems of immunization (for 83 patients of 160 reporting the problem, 57%), current anxiety (4 of 9, 50%), and chest pain (14 of 37, 44%). Moreover, further management was frequently planned for depression (10 of 29, 39%) and cognitive impairment (16 of 64, 38%).

CONCLUSION
Using a geriatric assessment in primary care discloses relevant heath problems and treatment needs that GPs may otherwise overlook.


This chapter summarises the
main findings of the
National Health Accounts (NHA) Project
that was conducted in the
late 1990s. the
NHA Project is the
natural successor of what
was generally known as the
Health Expenditure Review. the
Review described patterns
of health care financing and expenditure in apartheid South Africa, highlighting extensive
geographic disparities, disproportionate spending on hospital-based care in the
public
sector, and severe cost escalation in the
private sector. the
NHA Project evaluates the
extent to which these problems have been addressed by reforms put in place by the
new
government during its first term of office. It focuses on the
three financial years 1996 / 97 to
1998 / 99, making comparisons with 1992 / 93, the
year investigated by the
Review. The NHA Project reveals two eras of lbgpublicl/bg health sector financing. the
first ran from
1992 / 93 to 1997 / 98. It was characterised by substantial growth in government financing of
health care, the
re-distribution of health sector funds across provinces, and the
shift of
resources to primary health care. In contrast, data from 1998 / 99 indicate falling per capita
financing of health care by government, a reversal of re-distribution trends between
provinces and limited growth in PHC expenditure. It is unlikely that these latter phenomena
were temporary, as they were associated with major policy changes that affect the
long-term climate for public health care financing. Indeed, the
implementation of the
government's
macro-economic policy, changes to the
formula determining global budgets for provinces,
and the
elevation of other sectors - such as defence - in the
budgeting process, mark a
transition between these two eras of financing. These policies, together with limited
economic growth and persistent public sector inefficiencies, have curtailed the
potential
for increasing access and equity in the
public health sector. The NHA data also highlight several key features of lbgprivatel/bg health sector development in
the post-apartheid era. These include growth in private sector provision (most markedly in
bed numbers), rapid growth in expenditure, and contraction of the
number of people with
regular access to private care. Together, these trends suggest an overall decline in
value-for-money in the
private sector, at least prior to the
implementation in 2000 of the
Medical
Schemes Act of 1998. During this period, some of those previously able to afford private
care undoubtedly became dependent on public services, particularly hospitals. This would
have represented an additional burden on a public sector that was already over-stretched. In view of these rather disappointing findings, the
chapter suggests a number of policy
areas which government needs to address in order to achieve its publicly stated objectives.


Particle pollutants are estimated to cause more than 500,000 deaths
 annually. In his perspective, Nel describes how the adverse effects of ultrafine air particles are
 linked to their ability to gain access to the lung and systemic
 circulation, where toxic components lead to tissue damage and
 inflammation. Increased insight into which particle components are
 most damaging, and the molecular mechanisms of injury, will help to
 prevent PM mortality.


Process modelling is the activity of constructing and analyzing models, which are applicable and useful to solve predefined problems. It allows engineering process to be analyzed, and consequently leads to quality and efficiency improvement. As metrology becomes increasingly important in modern manufacturing, process modelling based on measurement techniques and operations becomes necessary and valuable. Measurement uncertainty, which is obtained from measurement operation, is regarded as a key factor in metrology-based process modelling. By analyzing measurement uncertainty, metrology-based process models can tangibly improve manufacturing quality and efficiency, improve the actualize communication between design and manufacturing, and, ultimately, achieve product lifecycle integration between design, manufacturing and verification functions. Digital measurement models can simulate measurement process, and predict task-specific measurement uncertainty in the digital environment, before carrying out capital-consuming physical measurements. However, the integration between digital and physical measurement environments is not fully approved. Measurement uncertainty predicted by the digital measurement model may show little practical significance with that obtained from physical measurements. The quality of digital measurement result highly relies on input quantities loaded into the digital measurement model. And it is hardly possible to verify digital measurement results for all of the measurement scenarios because of the high variability and complexity of inspected features and measurement tasks. This research has reviewed the fundamental technologies relating to measurement process modelling and measurement uncertainty evaluation in a digital environment, especially for coordinate measurement machines (CMMs). An initial verification work has been carried out by 'measuring' small features on a large-volume component in a realistic shop floor environment. This verification work has realized the limitations of the digital measurement model, and the challenge of integrating digital and physical measurement environments. Based on the initial verification work, a Measurement Planning and Implementation Framework has been proposed, aiming to analyse and improve the relationship between digital and physical measurement environments. The Framework is deployed with the statistics methods to analyse measurement uncertainty obtained from the digital and the physical measurement environments, and quantitatively predict influence levels of measurement uncertainty contributors. The verification work of the Framework has been carried out in a finely-control laboratory environment with environmental control. The robustness of the Framework has been evaluated, indicating the potential of deploying statistical methods for measurement uncertainty analysis, which extends the utilization of measurement uncertainty for decision-making processes. The contributions to knowledge of the research include: (1) Verification of the performance of a digital CMM model under meaningful measurement scenarios; (2) Development of a metrology-based process modeling framework to integrate digital and physical measurement environments through quantitative measurement uncertainty analysis.


Purpose – Fusion of new technologies and convergence has led to the emergence of new industries. This paper aims to present experiences of the concept of convergence from a patent citation analysis viewpoint. The main objective of the paper is to develop a tool for anticipating the emerging new industry segments. Design/methodology/approach – The patent analysis methods have been used to get an idea of the stage of new industry segment in the intersection of the paper and electronics industries. The authors distinguish self-citations from external citations, and further divide citations into two groups: within the industry and beyond the industry. Backward citations are used to evaluate the spill-overs between industries and forward citations are used to evaluate the significance of technology-based industry transformation. Findings – The recognized trends of the trajectory changes and growing overlaps of technological fields show indications for possible convergence between industries. Differentiating between external and self-citations within and beyond industry citations helps to provide more comprehensive prospects of a future technology competitive environment. Research limitations/implications – This study evaluated technology development in converging environments. It would be a scientifically significant contribution if the novel patent analysis methods could be used effectively for creating understanding in advance about the technology development and industry convergences. Originality/value – The presented patent citation methodology provides new insights into the analysis of industry evolution, technological innovations and business development related to converging industries and technologies.


A study was carried out on the chemistry and vegetation of two streams containing elevated levels of heavy metals. In neither stream had the presence of these metals prevented the development of an algal flora, though species numbers were low in comparison with uncontaminated streams. The algal biomass was high in both streams, probably due to the lack of invertebrate grazers. Green algae were dominant. One of these streams, a highly calcareous mine effluent in Northern England (Durham code no. 0097), was studied throughout its annual cycle. Concentrations of heavy metals accumulated by the dominant algae (Mougeotia spp.) were equated with the physical and chemical properties of the water. Zn was supersaturated in the stream water (6.84 mg 1 (^-1) at pH 7.85); this was shown to be the major factor which influenced Zn accumulated by the algae. Samples from the other stream, a smelter tip seepage in South-East France (Durham code no. 3026), were available from an earlier visit. This stream contained extremely high levels of heavy metals (Zn = 3840 mg 1(^-1); Cd = 345 mg l(^-1)) and was dominated by the green alga Hormidium rivulare. Ten strains of green algae were isolated from these two streams and were shown to be resistant to Zn in the laboratory, probably as a result of genetic adaptation. Environmental factors which were likely to be affecting Zn toxicity were investigated for isolates of the dominant algae. Mg reduced Zn toxicity in both streams and may have an important role in the development of resistance by these algae. Field levels of Cd did not influence algal growth at field levels of Zn. The role of carboxylic acids in algal Zn resistance was investigated but could not be established. Accumulation studies suggest that Zn resistance by green algae involves internal detoxification of the metal and not exclusion.


ABSTRACT The presence of microorganisms, especially during storage, can lead to the rapid deterioration of macauba fruits (Acrocomia aculeata) and reduce the quality of extracted oil for biodiesel production. An alternative to ensure the quality of the oil is the use of ozone gas, a oxidizing agent that has high antimicrobial and sanitizing power. The objective of this study was to evaluate the influence of high concentrations of ozone gas on macaúba fruit and its effect on the quality of the oil throughout storage for the production of biodiesel. Ozonation was performed 20 days after harvest using fruits with and without the epicarp. Ozone was applied at a concentration of 18.0 mg L-1 and a flow of 1.5 L min-1 for 10 h. After ozonation, the fruits were stored for different periods, and the physical-chemical parameters of the oil were evaluated. The ozonation of fruits without the epicarp visually reduced microorganism attack. In general, the ozonation process of macauba fruits maintained the visual characteristics of the fruits and the physical-chemical characteristics of the oil for biodiesel production compared to untreated fruits. The average acidity values of the oil were lower in the treatments with the ozone gas. Removal of the epicarp tends to facilitate the ozonation process, potentially by improving gas penetration into the fruit.


This paper analyzes how the values premised in Zimbabwe's colonial history and liberation struggle, ideological differences and partocracy have influenced the perspectives of the Zimbabwe and the Western governments respectively in understanding the causes that led to the imposition of sanctions on Zimbabwe. Furthermore, this article explores the nature of Zimbabwe sanctions by making comparative analysis of the perceptions of both the sanctioners and the sanctionees. Fundamental to this analysis is the diversity in jargon used in addressing the nature of sanctions. This paper concludes by proffering recommendations on how the parties involved can resolve this "war on lingo" to resolve Zimbabwe's catastrophe.

 Key words: Comprehensive sanctions, targeted/smart sanctions, economic sanctions, restrictive measures, Zimbabwe, EU, US.


A key area of debate over cybersecurity policy concerns whether the President should have authority to shut down all or part of the Internet in the event of a cyber-emergency or cyber-war. The proposed Cybersecurity Act of 2009, for example, contained what critics derided as an Internet "kill switch." The current iteration of a comprehensive cybersecurity reform bill, the Cybersecurity Act of 2012, opts for a soft public-private contingency plan model instead of a kill switch. But the kill switch may yet live. Sponsors of the present legislation have argued that Section 606 of the Communications Act of 1934 already gives the U.S. President plenary powers over the Internet in times of emergency or war. If this claim is correct, it should be particularly troubling to network neutrality advocates who have argued for expansive FCC jurisdiction over the Internet, since the Executive powers under Section 606 are tied to the FCC's authority over communications policy. This paper evaluates the language, history, and application of Section 606, and argues that, instead of implicitly relying on the vague and antiquated provisions of a statute crafted long before the Internet was born, cybersecurity reform should include explicit executive emergency powers with clear and appropriate limitations.


Uncertainty creates anxiety so attempts have been made to reduce it using mathematical techniques. In the electronics industry the very large quantities of devices processed have provided reliable statistics and the opportunity to employ statistical methods. However, in fields such as decision-making and risk assessment there are strong criticisms of the probability calculus that have been triggered by discrepancies between the analysis of experts and non-experts. A radically different alternative is to view risk assessment and decision-making as exercises in rhetoric centred on storytelling language games. And to see the risk assessors as part of a political network attempting to influence action.


Due to the spatial-locality property of data caches and the temporal-locality property of instruction caches, significant leakage reduction can be achieved by switching a large number of cache lines into the low-power standby or drowsy mode. It has been shown that 80%-90% of the data cache lines can be maintained in drowsy state without affecting the performance by more than 0.6% (IEEE Trans. Very Large Scale Integr. (VLSI) Syst., vol. 12, no. 2, pp. 167-184, Feb. 2004). However, with the introduction of the drowsy-cache design technique, new fault behaviors appear and more restrictive design rules must be applied to the chip fabrication process. In this paper, we simulate all possible spot defects (SDs) under normal mode and drowsy mode in different resistance regions using HSpice. Six new fault models appear with the introduction of drowsy mode for memory arrays. When we derive a march algorithm for the new fault models of this low-power cache, several simplification rules are utilized to reduce the test complexity. According to these simplification rules, each of these new faults has its equivalent counterpart existent in both data caches and instruction caches. As a result, we develop a march algorithm which can detect all SDs in either data caches or instruction caches. Since some faults occur only in drowsy mode, a built-in self-repair (BISR) scheme is developed. By utilizing BISR, the cache can still work even if some cache lines fail to work in drowsy mode


This article presents a study on principal retention in New South Wales, Australia. Factors in job retention included economic security, role enjoyment, and the opportunity to contribute. Disincentives to the principalship included lack of support from the employing authority, inadequate pay, isolation, growing responsibilities, difficult parents, and interfering pastors. Findings suggested that the ideal principal role would include greater remuneration, a more supportive employing authority, clearly defined role expectations, and job recognition.


In this study we examined the immunological parameters underlying the natural immunity to inhaled nonpathogenic proteins. We addressed this question by examining the effect of intranasal exposure to OVA in both wild-type mice and mice reconstituted with OVA-TCR transgenic CD4 1 T cells. Intranasal administration of OVA induced an initial phase of activation during which CD4 1 T cells were capable of proliferating and producing cytokines. Although many of the OVA-specific CD4 1 T cells were subsequently depleted from the lymphoid organs, a stable population of such T cells survived but remained refractory to antigenic rechallenge. The unresponsive state was not associated with immune deviation due to selective secretion of Th1- or Th2-type cytokines, and the presence of regulatory CD8 1 T cells was not required. Moreover, neutralization of the immunosuppressive cytokines IL-10 and TGF- b did not abrogate the induction of tolerance. Inhibition of the interaction of T cells with CD86, but not CD80, at the time of exposure to intranasal Ag prevented the development of unresponsiveness, while selective blockade of CTLA-4 had no effect. Our results suggest that intranasal exposure to Ags results in immunological tolerance mediated by functionally impaired CD4 1 T cells via a costimulatory pathway that requires CD86. The Journal of Immunology, 1999, 163: 2592–2600.


Managing and co-ordinating tourism in a destination requires the organisation and co-operation of a large number of sectors, businesses, local authorities and individuals. Since tourism is an important driver in many economies destination governance in tourist destinations needs to be done well, to achieve economic aims and maintain sufficient infrastructure. This book provides a guide to the theoretical and methodological understanding of how to implement best practice governance procedures, with case studies illustrating good performance. [from publisher website]


Abstract The objective of this work was to evaluate the effect of increasing bud load per plant on epidemiological variables of downy mildew on 'Sauvignon Blanc'. The study was carried out in a commercial vineyard in a high-altitude region of the municipality of São Joaquim, in the state of Santa Catarina, Brazil, during the 2016/2017 and 2017/2018 vintages. The treatments consisted of four bud loads: 15, 30, 50, and 75 per vine. The maximum incidence, maximum severity, beginning of symptom appearance, time to reach maximum disease incidence and severity, area under the incidence and severity disease progress curve were determined. Increasing bud load over 50 per vine results in higher incidence and severity of downy mildew (Plasmopara viticola) in 'Sauvignon Blanc' leaves but does not influence the time to reach maximum disease incidence and severity. Increasing bud load over 50 per vine results in an increase in the area under the disease incidence and severity progress curve for downy mildew in 'Sauvignon Blanc' leaves. To adopt over 50 buds per vine treatment, it is necessary additional disease control measures, with an emphasis on integrated management to control downy mildew.


Due to the strategists in business World, the most important strategic consideration in international economic and industrial competition is in managing innovation and technology context. Increasing the competitive advantage of each economic institution needs the increase of technologic content improvement applied in production process of that institution. The present paper aims to study and evaluate the technology intensity and TCC in Iran Tractor Manufacturing Company (ITMCO). According to the results of research work, the authors have offered proposals to improve the technology by introducing the turning points and defects existed in technology parts in the company.


INTRODUCTION Chronic urticaria (CU) is one of the toughest problems. The main difficulty is the search for an etiological factor in 70-90% of cases the cause of chronic urticaria remains unclear. In the development and persistence of CU recently paid great importance to the role of Helicobacter pylori infection (HP), which is the most common bacterial infection in humans. However, the influence of HP eradication on the course of CU is poorly understood. AIM to improve the diagnosis and treatment of urticaria patients with Helicobacter-associated diseases of the upper gastrointestinal tract. MATERIALS AND METHODS The study included 184 patients with clinical manifestations of urticaria and HP-associated gastroduodenal pathology in the age of 18. RESULTS Infection with HP was more frequently detected in patients with chronic idiopathic urticaria in comparison with patients with allergic urticaria (73% and 56% respectively, p < 0.05). In patients with allergic and chronic idiopathic urticaria HP-associating chronic gastritis were detected respectively in 90% and 81% of cases, gastric ulcer (4% and 11%) and duodenal ulcers (6% and 13%) in the first and second groups, respectively (p < 0.05). HP eradication was achieved in 69.2% of patients in the group with AU and 61.8% of patients with CU, while in 20.5% of patients with CU didn't recur in the year. The influence of HP eradication on the course of allergic urticaria isn't established. In order to achieve stable remission CU by HP eradication in patients with diseases of the digestive tract of prognostically important is the combination of the following factors: the initial elevated levels of antibodies to HP (IgG-AP) in the range of 1:360 to 1:900, serum cytokines: interleukin 1beta in the range (68-22 pg/ml) and TNF alpha (84-50 pg/ml), reduced levels of total IgE from 0 to 38 IU/ml. CONCLUSION To patients with HP-associated gastrointestinal diseases, combined with idiopathic urticaria is shown holding Helicobacter therapy, because it leads to remission of allergies at 20.5% of patients remaining--to reduce the frequency of exacerbations. To patients with allergic urticaria an HP eradication for the treatment and prevention of AK is not reasonable.


The aberrant behaviour of drivers is regarded as the most significant contributory factor in road traffic accidents in Pakistan. This research is founded on the premise
that personal attitudes are key determinant of driving behaviours, and aims to identify the key socio-cognitive determinants of aberrant driving in response to the
lack of road safety research in the country. A multi-method approach is taken and three studies have been carried out. Study 1, a qualitative study, based on interviews, provides a common understanding of the road safety issues in Pakistan.
Study 2, a quantitative study, used the results of Study 1 to generate an Attitudinal Questionnaire (AQ) which was inspired by the Ajzen's Theory of Planned Behaviour (TPB: Ajzen 1991), and a modified Driver Behaviour Questionnaire
(DBQ: Lawton et al. 1997) focusing on intentional traffic violations. The study obtained self-reports of attitudes, norms, perceived control and opinion of drivers
regarding a number of road traffic violations and enforcement as well as their aberrant behaviours. The responses to the statements in the questionnaires were first factor analysed to identify underlying attitudinal and behavioural constructs. Later, Cluster Analysis used attitudinal constructs to group drivers into four distinct
clusters, namely the autonomous, opportunists, regulators and risk-averse. In Study 3, the real-world driving behaviours of a sample of the drivers in each of the four
clusters were observed using the Wiener Fahrprobe (WF: Risser 1985) technique.
The collective results from the studies indicate that the behaviours of drivers are interpretable in relation to their attitudes, and are partly influenced by their socio-
demographic characteristics and driving environment. Specifically, attitudes towards enforcement and rule-compliance appear to be the strongest determinant of
behaviours of drivers in Pakistan. Results in particular indicate that being affluent, female and student negatively influence driving behaviours in the country. The
research also examines the suitability and applicability ofthe AQ, DBQ, and the WF techniques and methods within a Pakistani context. Finally, the research findings are
used to recommend targeted as well as general information-based road safety solutions.


Legally adopted in France and the UK, privatization of water services is still vigorously debated in the Netherlands. Advocates of privatization believe it is the best way to save on utility costs and to increase their transparency. Opponents believe that the Dutch water sector already provides high quality services for low prices, including an additional public performance that is expected to be excluded in a free market. The author argues that the performance of water service providers should not be assessed only in terms of efficiency, but in terms of the effects on the entire water system as well as the protection of small customers. It is quite possible that without privatization, a public agency could also improve its efficiency and become more competitive in relation to other service providers. Privatization seems to be more a matter of political ideology (based on a belief that the public sector operates inefficiently) than a matter of hard facts. The success of privatization depends at least on the performance of a complementary public regulatory regime. The question should not be whether the public or the private sector performs better hypothetically, but how the actual performance regarding public goods and services can be improved.


BACKGROUND AND PURPOSE: Sturge-Weber syndrome (SWS) is frequently associated with neurologic complications such as seizures, so diagnosing this condition has important implications for patient management. The purpose of this study was to report unusual neuroimaging findings in patients with facial port-wine stain (PWS) and clinically suspected SWS. MATERIALS AND METHODS: Cranial MR imaging was reviewed for all children with facial port-wine stain (PWS) involving the upper face and eyelids who were referred to Great Ormond Street Hospital between 2003 and 2007 for investigation of suspected SWS. Patients were excluded from further analysis if the imaging findings were normal on initial and subsequent scans and the subject remained free of neurologic disease, or if the imaging showed the well-recognized pattern of exclusively supratentorial pial enhancement representing the pial angioma of SWS. For the remaining patients, the neurologic, dermatologic, and ophthalmologic records were examined and all available imaging was reviewed by a neuroradiologist. We documented the presence and distribution of pial enhancement; corroborative features of SWS, such as atrophy, calcification, choroid plexus changes, and ocular abnormalities; and all other intracranial abnormalities. RESULTS: Of the 62 patients referred for assessment, imaging findings were considered typical of SWS in 32 (52%) and were normal or showed abnormalities attributable to an unrelated pathology in 20 (32%). Of the remaining 10 patients, in 7 (11%), there was evidence of a pial angioma in an unusual distribution involving infratentorial structures, with the angioma in 1 patient being diagnosed at postmortem only; in 2 (3%), there were imaging abnormalities with some features in common with typical SWS, such as subcortical calcification, but with no evidence of pial enhancement; in 1 (1.6%), the initial MR imaging finding was normal, but repeat imaging subsequently revealed pial enhancement. CONCLUSIONS: Involvement of infratentorial structures is common but may be relatively subtle and should be actively sought. Cases in which there are certain patterns of imaging abnormalities but an apparent absence of supratentorial pial enhancement on MR imaging may represent formes frustes of SWS; visualization of pial angiomatosis may also be delayed until later in childhood than expected.


Although Value Sensitive Design offers a theoretical and methodological framework to account for values in design, many questions and controversies are left. The current work aims to contribute to this value debate, by taking stock of large Research through Design (RtD) programs including their developed artifacts, to explore to what extent the explicit and tacit knowledge generated enabled actors to make public and cultural values explicit. Differently put, seven ongoing RtD projects have been studied in an elaborate RtD process articulated in three phases, differentiating in their focus: 1) understanding the values involved in the RtD projects; 2) share insights to steer peer debate on Research on Values, and 3) co-analyse the data and generate further insights. The current research brings forward two main contributions to the RTD community. On the one hand, using ongoing RtD projects in an RtD approach provides a kaleidoscopic perspective on how research and design constantly inform each other through the application of design. On the other hand, the adoption of this kaleidoscopic RtD approach in the context of multidisciplinary research on values acts as a catalyst that generated knowledge and insights to stimulate the debate on accounting values in design research.


The preliminary results of a work for analysis and modeling of a dynamic vision based robotic manipulator are presented. The major motion related factors such as motion blur of images, and dynamics of the robot joints are emphasized. Simulations in two and three dimensions are implemented.<<ETX>>


A wireless sensor network is a collection of a large number of sensors nodes densely deployed. Sensor nodes are used to sense environmental data and collect information at a central place. Sensors have been a regular part in our daily life, they can be very much used in isolation to solve many problems like in car, ac, and to measure temperature, sound, pollution levels, humidity, wind speed direction and pressure. They can be used in isolation. But the important focus is on some crucial applications where human life is associated, environmental is associated for example the battlefields, earth quick monitoring, flood monitoring, weather forecasting etc. These are some of the biggest applications which need the invention of sensor nodes rather than manual human forces. Here sensor nodes cannot work in isolation because one sensor cannot gather appropriate data. Therefore, it is needed to deploy a large number of sensor nodes, which can exchange data through some communication strategy or protocol, and thereafter the data should be maintained to a common place where some action should be taken. For providing efficient applications among these sensor nodes, an efficient routing protocol or algorithm needs which could provide the QoS to the end user. Most of the routing protocols for WSNs are designed without explicitly considering the Quality of Service (QoS) of the generated routes. It has been observed that such routing protocols are inadequate at the time of data delivery route which requires guaranteed QoS. QoS routing requires discovering a route from source to destination to fulfill the QoS necessities. QoS is more complicated to assurance in sensor network due to dynamic topology and energy constraints. In this paper, recent issues and challenges have been considered in terms of research gap yet, QoS routing approaches have been deliberated, distribution of literature over recent years and QoS parameters distribution over recent years have been exposed, which are valuable for researchers for further investigation.


The conventional narrative of American environmentalism is no longer very helpful for conservationists and restorationists seeking philosophical justification and guidance for their work. The tradition has often been cropped into a narrower and simplified account of the battle between the philosophies of wise use and preservation, a move bolstered by the turn to historical images of President Teddy Roosevelt and John Muir visiting California's Yosemite National Park in the early years of the twentieth century. This cropped conservation picture needs to be restored and widened to engage the pragmatism that has always been a part of the U.S. environmental tradition, but that became eclipsed by preservationist ideology with the rise of the fields of environmental history and environmental philosophy in the late twentieth century. Restoring this lost pragmatism to the environmental tradition will prove vital to recovering the value of environmental history and philosophy for conservation and restoration practice and to reclaiming a more holistic and useful narrative of people, culture, and environment.


Chemical preparation, X-ray single crystal, thermal behaviour, and IR spectroscopic studies on a new organic compound, the bis (tertbutylamonium) dihydrogendiphosphate denoted TBAP, are described. The TBAP crystallizes in the monoclinic system with C2/c space group. The unit cell dimensions are a=19.840(7)A, b=8.932(4) A, c=12.518(5)A, i¢=136.81(2)A, with V=1518.3(11) A and Z= 4. The structure has been solved by a direct method and refined to a reliability R factor of 0.0444 using 1649 independent reflections. The central oxygen atomof the H2P2O7 group is located on a twofold axis providing a binary internal symmetry of the phosphoric entity. Two kinds of hydrogen bonds coexist in the structure. The mineral anions, linked by the first one O-HÂ…O, built chains running parallel to the c axis. The organic cations, assemble these chains by the second one N-HÂ…O to perform a three dimensional network.


The present invention relates to a polymeric material reinforced with electrical and mechanical properties superior single-wall nanotubes (SWNT) or multiple-wall nanotubes (MWNT). The invention also relates to the use of the method for manufacturing a reinforced polymeric material and the electrical distribution material.


Background: αvβ3 binds to IGF1, and the αvβ3-IGF1-IGF1R complex is formed in non-transformed cells. Results: IGF1 induces signals with the complex formation in anchorage independence. IGF1R or Src inhibitors did not suppress the complex formation. Conclusion: αvβ3-ECM interaction is not required for IGF signaling. The complex formation occurs before IGF1R activation. Significance: This study identifies new therapeutic targets in IGF signaling. Integrin αvβ3 plays a role in insulin-like growth factor 1 (IGF1) signaling (integrin-IGF1 receptor (IGF1R) cross-talk) in non-transformed cells in anchorage-dependent conditions. We reported previously that IGF1 directly binds to αvβ3 and induces αvβ3-IGF1-IGF1R ternary complex formation in these conditions. The integrin-binding defective IGF1 mutant (R36E/R37E) is defective in inducing ternary complex formation and IGF signaling, whereas it still binds to IGF1R. We studied if IGF1 can induce signaling in anchorage-independent conditions in transformed Chinese hamster ovary cells that express αvβ3 (β3-CHO) cells. Here we describe that IGF1 signals were more clearly detectable in anchorage-independent conditions (polyHEMA-coated plates) than in anchorage-dependent conditions. This suggests that IGF signaling is masked by signals from cell-matrix interaction in anchorage-dependent conditions. IGF signaling required αvβ3 expression, and R36E/R37E was defective in inducing signals in polyHEMA-coated plates. These results suggest that αvβ3-IGF1 interaction, not αvβ3-extracellular matrix interaction, is essential for IGF signaling. Inhibitors of IGF1R, Src, AKT, and ERK1/2 did not suppress αvβ3-IGF-IGF1R ternary complex formation, suggesting that activation of these kinases are not required for ternary complex formation. Also, mutations of the β3 cytoplasmic tail (Y747F and Y759F) that block β3 tyrosine phosphorylation did not affect IGF1R phosphorylation or AKT activation. We propose a model in which IGF1 binding to IGF1R induces recruitment of integrin αvβ3 to the IGF-IGF1R complex and then β3 and IGF1R are phosphorylated. It is likely that αvβ3 should be together with the IGF1-IGF1R complex for triggering IGF signaling.


This is a quasi experimental research designed to determine the effects of Direct and Indirect instructional strategies on Mathematics achievement among junior secondary school students. The population consisted of students in a Public Secondary School in Owerri, Imo State. A sample of 102 students from two (2) intact classes (A & B) was drawn using simple random sampling (Balloting) on class basis. Group A students were taught Mathematics using Direct Instructional strategy, while Group B students were taught using Indirect Instructional strategy. The treatment lasted for 10 weeks of 20 sessions. Three research questions and three null hypotheses guided the study. Mathematics Achievement Test (MAT) was administered on the subjects at the end of treatment. The MAT was validated and its reliability test produced co-efficient of 0.86. Data collected were analyzed with Mean (x), Standard Deviation (SD), t-test analysis. Results got after data analysis indicated that direct instructional strategy has a better effect on students achievement in Mathematics compared to indirect instructional strategy; significant difference existed between direct and indirect instruction on students achievement in Mathematics; and gender is a significant factor in determining the effect of direct and indirect instructional strategy on students" achievement in Mathematics, in favour of the males. Based on these results, recommendations were made for the adoption of direct instructional strategy in teaching Mathematics in secondary schools.


: The value of plain chest radiography in the diagnosis of primary hepatocellular cancer (PHC) was assessed in 449 patients. An elevated right hemidiaphragm and pulmonary metastases were present in 11% and strongly suggest a diagnosis of PHC. In all, the right hemidiaphragm was raised in 30% of patients. Pulmonary metastases were present on admission in 19% of patients and appeared later in a further 6%. Secondary deposits were found in the lungs at necropsy in 52% of patients, compared with only 24% in whom there was radiological evidence of metastases during life. In 36% of patients chest radiographs were normal on admission.


BACKGROUND
Suicide ranks as the third leading cause of death among youth aged 15-24 years. Schools provide ideal opportunities for suicide prevention efforts. However, research is needed to identify programs that effectively impact youth suicidal ideation and behavior. This study examined the immediate and 3-month effect of Surviving the Teens® Suicide Prevention and Depression Awareness Program on students' suicidality and perceived self-efficacy in performing help-seeking behaviors.

METHODS
High school students in Greater Cincinnati schools were administered a 3-page survey at pretest, immediate posttest, and 3-month follow-up. A total of 1030 students participated in the program, with 919 completing matched pretests and posttests (89.2%) and 416 completing matched pretests and 3-month follow-ups (40.4%).

RESULTS
Students were significantly less likely at 3-month follow-up than at pretest to be currently considering suicide, to have made a suicidal plan or attempted suicide during the past 3 months, and to have stopped performing usual activities due to feeling sad and hopeless. Students' self-efficacy and behavioral intentions toward help-seeking behaviors increased from pretest to posttest and were maintained at 3-month follow-up. Students were also more likely at 3-month follow-up than at pretest to know an adult in school with whom they felt comfortable discussing their problems. Nine in 10 (87.3%) felt the program should be offered to all high school students.

CONCLUSIONS
The findings of this study lend support for suicide prevention education in schools. The results may be useful to school professionals interested in implementing effective suicide prevention programming to their students.


Pili bifurcati is an uncommon hair shaft dysplasia characterized by bifurcation of the hair shaft. The two characteristics that define the dysplasia are: 1. Each bifurcation produces two separate parallel branches which fuse again to form a single shaft. 2. Each branch of the successive bifurcations is covered with its own cuticle. Currently, there is confusion between the terms "pili bifurcati" and "pili gemini". The name "pili gemini" is used to define a kinetic papilla that splits at the upper end from single to double-tipped during the anagen phase and consequently the same follicular matrix produces two different-sized hair shafts having separate cuticles that emerge through a single pilary canal. Pili gemini maintains the double tipped papilla and consequently the hair shaft does not fuse again. Papillar tips that divide into several tips will produce several hair shafts, that characteristically do not fuse again. When the same papilla changes its shape repeatedly during the anagen phase, it can produce hair shafts with bifurcations at irregular intervals: pili multibifurcati. And, as it is also possible for one of the new papillae to split again in two, the hair shaft may be doubly bifurcated: pili bi, bifurcati. Pili bifurcati should be distinguished from acquired splitting of hair shafts that do not represent true bifurcations because the two split parts are never surrounded by a complete cuticle. Such acquired splitting may be called "central trichoptilosis".


The debate on economic growth and the environment has continued to draw considerable passion. Economists tend to be dominated by the Kuznets inverted "U" shaped curve expositions that contend that environmental conditions tend to deteriorate until a certain per capita threshold income
is reached after which they will improve (see World Bank. 1992; Panayotou, 1993; Antle and Heidebrink, 1995; Seldon and Song, 1994). However, sustainable development arguments
originating from green groups in the North claim that the South economies should avoid the growth path of the North so as to avoid environmental catastrophe, premised on the argument that environment costs are difficult to estimate and prices cannot be apportioned to living matter. This
position is pervasively pushed at the World Trade Organisation (WTO) where some insist that trade should be linked to environmental standards. To gamer sUpJX>rt from the South, there has been a push to expand development assistance to assist them to strengthen environment-friendly production capabilities. Critics argue that this effort is a double whammy for developing economies,
at one level restricting the independence of South's development JX>licies, and at another level merely opening demand for the North's environment-friendly technologies.
It is extremely difficult to ignore the contention that environmental costs cannot be assessed against
income levels as it will not be in sync with normative definitions of development. However, given that economic activities typically generate emissions, it is not sufficient to just remove them all together. While taking cognisance of the need to prevent the proliferation of environmentally hazardous emissions, it might still be worth re-examining the Kuznets curve. Indeed it is interesting to see if latecomers shorten the time period, threshold per capita incomes and pollution intensities
given rising awareness and the growth of environment-friendly technologies. However, while these are interesting exercises, this paper looks at Malaysia to see if the Kuznets curve trends are being replicated. This paper attempts to contribute to this literature by examining economic growth and the evolution of environmental governance in Malaysia. The next section introduces the analytical framework. The following section discusses economic transition in Malaysia, followed by its corollary on the environment The subsequent section deals with its impact on the environment, including governance.


The authors present tunneling results for junctions comprising Mn doped Al films produced by sputter deposition, with Mn concentrations in the range of 0-5000 ppm. Our results for S'/I/S', S'/I/S, and N/I/S junctions demonstrate that Al-Mn alloys can serve both as superconductors with critical temperatures reduced from that of Al and as normal metals. The authors find Al-Mn in this doping range to be otherwise identical to pure Al in terms of its BCS-like tunnel characteristics (for superconductors) and its ability to produce high-quality tunnel barriers.


Online mental health interventions can benefit people experiencing a range of psychological difficulties, but attrition is a major problem in real-world deployments. We discuss strategies to reduce attrition, and present SilverCloud, a platform designed to provide more engaging online experiences. The paper presents the results of a practice-based clinical study in which 45 clients and 6 therapists used an online Cognitive Behavioural Therapy programme for depression. Pre and post-treatment assessments, using the Beck Depression Inventory, indicate a statistically significant improvement in depressive symptoms, with a large effect size, for the moderate-to-severe clinical sub-sample receiving standalone online treatment (n=18). This group was the primary target for the intervention. A high level of engagement was also observed compared to a prior online intervention used within the same service. We discuss strategies for design in this area and consider how the quantitative and qualitative results contribute towards our understanding of engagement.


The RNA-guided CRISPR-Cas9 nuclease has revolutionized genome engineering, yet its mechanism for DNA target selection is not fully understood. A crucial step in Cas9 target recognition involves unwinding of the DNA duplex to form a three-stranded R-loop structure. Work reported here demonstrates direct detection of Cas9-mediated DNA unwinding by a combination of site-directed spin labeling and molecular dynamics simulations. The results support a model in which the unwound nontarget strand is stabilized by a positively charged patch located between the two nuclease domains of Cas9 and reveal uneven increases in flexibility along the unwound nontarget strand upon scissions of the DNA backbone. This work establishes the synergistic combination of spin-labeling and molecular dynamics to directly monitor Cas9-mediated DNA conformational changes and yields information on the target DNA in different stages of Cas9 function, thus advancing mechanistic understanding of CRISPR-Cas9 and aiding future technological development.


This paper provides following three contributions to the study of developing and applying model driven engineering (MDE) techniques to quality of service (QoS) configuration of distributed real-time and embedded (DRE) systems. First, we describe the challenges associated with mapping domain-level QoS policies of DRE systems to middleware configuration space. Second, we discuss a domain specific modeling language (DSML) to capture QoS requirements of DRE system at a higher level of abstraction, simplifying the system QoS specification process. Third, we describe model transformations to automate the mapping of domain-specific QoS requirements.Our results indicate that our approach provides significant benefits in terms of productivity, scalability, reusability and automation of middleware QoS mapping compared to traditional QoS configuration techniques for publish/subscribe-based DRE systems.


Wormhole packet switching, used in many NoC designs, introduces jitter. This may produce violations of application deadlines. Several works in the literature propose stream workload models, and techniques for buffer sizing. These works do not consider the concurrency between different flows, or the NoC model is too abstract, masking the jitter introduced by data packaging and router processing. One technique to deal with jitter is to introduce a decoupling buffer (D-buffer) on the target IP. This buffer receives data from the NoC with jitter, while the target IP consumes data from this buffer at the application rate, without jitter. Two problems must be solved to implement D-buffers: (i) which size must the buffer have? (ii) how much time should be expected before data consumption starts (threshold)? This work proposes a general method to define D-buffer size and threshold, considering the influence of packaging, arbitration, routing and concurrency between flows. A traffic model for stream applications is detailed and used to characterize jitter sources in wormhole packet switching. Experimental results demonstrate the impact on multimedia flows with fixed and variable packet sizes (from real traffic traces). Simple traffic models employing constant frame sizes result in small D-buffers. On the other hand, employing multimedia frames from application traces (i.e. real application data) increases buffer size and threshold while still suppressing jitter. Another parameter analyzed in the paper is the percentage of deadline violations as a function of D-buffer size. The method guarantees throughput with no deadline violation and does not modify the NoC structure. The cost of adding such D-buffers is an increased latency and extra silicon area.


Vascular surgery has matured as a subspecialty of general surgery during the past 25 years. The discipline currently faces a number of challenges including duration and scope of training, financing of graduate medical education, specialty and subspecialty certification, hospital privileging or credentialing, and practice opportunities. This article reviews these issues in terms of present realities and future opportunities. Emphasis is placed on curricular redesign to tailor length and breadth of training to future career goals, be they private practice as a general surgeon with vascular surgery interests, a vascular surgical subspecialist, a rural versus an urban practice, or a subspecialist in an academic setting. A plea is made for regulatory bodies, including the Residency Review Committee for Surgery and the American Board of Surgery, as well as specialty societies, particularly the American College of Surgeons, to maintain a flexible and constructive posture in dealing with proposed educational innovations. With cooperative efforts of both the Association of Program Directors in Surgery and the Association of Program Directors in Vascular Surgery, vascular surgery education and training of both general surgeons and vascular surgeons should be enhanced to fulfill the workforce needs as we enter the next millennium.


1. An experimental analysis of ciliary metachronism was performed on ctenophores of two types: those with a continuation of the ciliated groove running between adjacent comb plates (lobates), and those in which the ciliated grooves end at the first plate of each comb row (cydippids and beroids).

2. The results showed that the comb plates of cydippids and beroids are co-ordinated by mechanical forces arising from the movement of the plates themselves. Only along the ciliated grooves and at their junctions with the comb rows is a neuroid conduction process likely in this group of ctenophores.

3. Ctenophores with an interplate ciliated groove, on the other hand, do not depend on mechanical interaction between active plates for co-ordination. Instead, the lobates use neuroid conduction at the junction between the interplate ciliated groove and the comb plate, at the junction between adjacent interplate ciliated grooves, and probably along the ciliated grooves and interplate ciliated grooves as well. Ciliary co-ordination may therefore be entirely neuroid in lobate ctenophores.

4. In both types of ctenophores the comb plates may be triggered to beat by depolarization of the comb-plate cells. Electiical excitation of a plate could be caused by mechanical deformation of its base arising from the motion of the preceding plate (in cydippids and beroids), or by a neuroid process at the interplate ciliated groove-comb plate junction (in lobates).

5. These findings resolve a long-standing controversy over the mechanism of ciliary co-ordination in ctenophores.


Veterans are three times more likely to have diabetes than the general population. Diabetes self-management education and support (DSMES) is a critical component of diabetes care that galvanizes more informed and engaged patients. Many Veterans are disabled or reside in rural areas and have limited access to comprehensive DSMES. Clinical Video Telehealth (CVT) extends access to specialty services from regional Veterans Affairs (VA) Healthcare Centers to Community-Based Outpatient Clinics where many Veterans receive healthcare. The purpose of this study was to examine and compare proximal (3-6 month) and distal (12 and 18 month) metabolic outcomes (A1C, lipids, BMI and blood pressure) of Veterans who received comprehensive group DSMES via CVT vs. in-person . Veterans who received DSMES from 2012 to 2017 by CVT (n=197) and in-person (n=359) were identified in the VA computerized medical record. The CVT group was similar to those that attended in-person, but were less racially diverse. A linear mixed model was used to compare changes in metabolic outcomes within and between groups over time. A1C improved at 3 months and was sustained for 12-18 months in both groups. Neither group showed changes in lipids, BMI, or blood pressure. In conclusion, CVT is an effective means of improving A1C by expanding DSMES access to Veterans who receive community care. Disclosure M. DiNardo: None. A.O. Youk: None. N. Beyer: None. J.N. Beattie: None. D. Obrosky: None.


[1] Long-range transport of sulfur dioxide (SO2) from east Asia to the central North Pacific troposphere was observed on transit flights during the NASA Transport and Chemical Evolution over the Pacific mission. A series of SO2-enhanced layers above the boundary layer was observed during these flights. The significant features included enhanced SO2 layers associated with low water vapor and low turbulence that were usually dynamically isolated from the marine boundary layer. This study shows that atmospheric dynamics were very important in determining the SO2 distributions in the central Pacific during March and April 2001. Trajectory studies revealed that SO2-enhanced layers could be connected to both volcanic and anthropogenic sources in east Asia. These trajectory studies also showed that the air parcels usually were lifted 2 km above the source regions and then progressed to the east in the midlatitudes (30°–60°N). The air parcels arrived in the central Pacific within 2–3 days. Sulfur dioxide transported at altitudes of 2–4 km dominated the SO2 distribution in the central Pacific. A comparison of SO2 observations and results of chemical transport models indicated that SO2 was removed primarily by cloud processes. Therefore, in the absence of cloud, SO2 can be transported long distances if the trajectory is decoupled from the boundary layer. Another important observation was that the Miyake-jima volcano made a major contribution to the SO2 concentrations in the central Pacific troposphere during March and April 2001. At times, the volcanic SO2 had more influence in the central Pacific than the six largest anthropogenic SO2 source regions in east Asia.


BACKGROUND
Knowledge of antipsychotic drug levels at point of care (POC) may significantly aid therapeutic decision-making. To support the development of future POC devices and to validate the use of fingerstick capillary blood sampling, two robust hydrophilic interaction LC-ESI/MS/MS methods were developed and validated. Two PK studies were completed evaluating the correlation between fingerstick blood and plasma concentrations with corresponding venous blood and plasma concentrations for several commonly prescribed atypical antipsychotics and selected metabolites. Sensitive and reliable LC-MS/MS bioanalytical assays were developed to support these studies.

RESULTS
Three methods, requiring only 25-μl matrix volumes, were developed using supported liquid extraction with hydrophilic interaction LC-MS/MS detection and validated according to regulatory guidance.

CONCLUSION
Robust and efficient LC-MS/MS assays were established and were effective in providing antipsychotic drug matrix comparator results in the intended clinical studies.


A new catalytic asymmetric Henry reaction has been developed that uses a C(1)-symmetric chiral aminopyridine ligand derived from camphor and picolylamine. A variety of aromatic, heteroaromatic, aliphatic, and unsaturated aldehydes react with nitromethane and other nitroalkanes in the presence of DIPEA (1.0 equiv), Cu(OAc)(2)*H(2)O (5 mol %), and an aminopyridine ligand (5 mol %) to give the expected products in high yields (up to 99 %), moderate-to-good diastereoselectivites (up to 82:18), and excellent enantioselectivities (up to 98 %). The reaction is air-tolerant and has been used in the synthesis of the antifungal agent miconazole.


This paper deals with an improved demodulation technique for LoRa signal. The principle consists in detecting the possible errors of demodulation, by comparing the highest peak of the periodogram of the dechirped received signal weighted by a coefficient beta? smaller than one with the other peaks of the periodogram. If an error is detected, a second demodulation stage is processed at an oversampling rate (OSR) higher than the first demodulation stage. Otherwise, the result of the first demodulation is kept. A thorough performance analysis of the suggested technique, based on order statistics, is carried out, in terms of detection rate, error rate, and complexity. It is shown that beta? can be tuned to adjusts the trade-off between performance and complexity. Moreover, simulations results shows that it is possible, for relatively low signal-to-noise (SNR) values, to reach the performance of the demodulation at highest OSR while keeping the complexity of the demodulation at lowest OSR.


Lead sulfide quantum dots (PbS QDs) show great potential for efficient, low cost photovoltaic applications. Currently, device efficiencies are limited by the high density of trap states caused by lattice imperfections on the QD surface. Introducing a thin shell of a wide bandgap semiconductor to the QD surface is a promising method to passivate these trap states. Here we demonstrate solar cells made from PbS–CdS core–shell QDs, yielding a 147 mV increase in VOC compared to core only PbS QDs. We explore the physical reason for this enhancement and demonstrate that it is indeed caused by improved passivation of the PbS surface by the CdS shell, leading to a lower electron trap density.


The original aim of this research was to determine the best means of calculating the relative delay time parameter of the Laurenson runoff routing method of flood estimation. Early testing conducted as a part of achieving this end showed that the model could be quite insensitive to the means used to calculate relative delay. Model sensitivity to the means of calculating this parameter had apparently not yet been verified, and if it was insensitive, the best means of calculating the parameter was not required. Hence it was decided to test the thesis that the model was insensitive to the means of calculating the relative delay time parameter. The thesis was tested by applying the model to a range of flood sizes on two catchments using five different means of calculating relative delay time. The differences in model output produced by these delay hypotheses were examined in relation to the average model error. In a number of cases the effects on model performance of these different delay hypotheses were quite small, but in other cases they were quite large. Hence the conclusion had to be drawn that the model is sensitive to the means of calculating relative delay time. The fact that the means of calculating relative delay. time Has unimportant in a conditional sense left the possibility that the model could be used under these conditions, if they could be defined. However, in the long term it meant that the best means of calculating relative delay time was required. During the course of the investigation a number of problems in relation to model use were encountered. The attempts made to solve these problems should provide useful information on model application in the future.


Laboratory studies in children have found that, following a self-reported satiating meal, girls who consume relatively large amounts of palatable food in the absence of hunger have a higher BMI and gain more weight across middle childhood than do girls who consume less. Loss of control eating (LOC) in children has been associated with increased BMI, aberrant eating, and general psychopathology in cross-sectional and longitudinal research. Eating in the absence of hunger (EAH) appears to be a behavioral analogue of the dietary disinhibition that is a feature of LOC. However, no studies of which we are aware have examined the relationship between a laboratory measure of EAH and LOC. Additionally, the majority of studies examining EAH have been conducted in homogenous samples comprised primarily of non-Hispanic White girls. Thus, the aims of this study were to replicate the EAH paradigm in a racially diverse sample, evaluate the relationship between BMI and EAH, and examine whether EAH consumption was associated with self-reported LOC in a sample of 51 Black and White girls age 10-13 years. Results indicated that girls consumed an average of 339.7 (SD = 283.3) calories in the absence of hunger. EAH intake was not associated with race or BMI. EAH intake predicted LOC, such that for each additional 100 calories consumed, girls were 1.7 times more likely to report LOC. Longitudinal research is needed in younger children to evaluate the nature of EAH as an early behavioral marker of risk for LOC and its sequelae. Additional research is also needed to examine the relationship between mood and EAH in children with LOC. Findings from the current study suggest that EAH may be used to identify young children at risk for development of aberrant eating and weight problems. Future studies should identify young children who consume large amounts during the EAH procedure and design interventions aimed at reducing eating that is in response to environmental cues.


In this work, diesel soot has been characterized chemically using a diffuse reflectance infrared Fourier transform spectroscopy (DRIFTS) technique. Diesel soot samples were generated under combustion conditions reproducing the typical urban operating mode of a diesel engine. Initial experiments performed to ensure the repeatability of the DRIFTS analysis and the sample preparation method showed that the standard deviations were always lower than 20% for the DRIFTS analysis itself, and lower than 25% when sample preparation was included. This is of special interest as regards application of the DRIFTS technique for quantitative analysis. The functional groups on the soot surface were identified on the basis of the infrared bands observed in the spectra at room temperature, indicating that the diesel soot analyzed comprises a mixture of aromatic hydrocarbons, carboxylic compounds, hydroxyl species, ether groups, and methylene and methyl groups. Analyses were also carried out at different temperatures in the interval of 298-858 K in order to analyze the thermal stability of the functional groups, with carbonyl groups, lactones and ethers appearing to be the most thermally stable compounds.


This paper focuses on the narrow issue of proof of death to open up a broader discussion of several interrelated themes regarding early common-law development: the fashioning of specialized writs and legal processes to deal with doubtful deaths in criminal and civil cases alike, the cross-fertilization of ideas about proof in canon law and the common law, litigants' strategies in responding to and taking advantage of problems of proof, and the common law's reliance on a combination of strict proceduralism and equitable flexibility to reduce the likelihood of false felony convictions or illegitimate outcomes in cases involving the right to possession of land. From the few records I have found thus far in the plea rolls, I tentatively conclude that felony homicide cases were not likely to proceed to trial and conviction where doubt existed as to whether a homicide had actually occurred. Beyond the criminal context, however, doubt about a death underlying a claim to landed property did not preclude adjudication on the merits. Drawing such insights from frequently terse legal records, this paper also highlights the problems of proof faced by medieval historians in making sense of our source materials.


Purpose: This study aimed to explore dementia-specialized education and the training needs of employees from various dementia-related institutions in South Korea and propose directions for future development of the standard curriculum. Methods: Qualitative data were generated from four round-table meetings with 44 participants recruited from the metropolitan centers for dementia (N=12), regional dementia-relief centers (N=15), long-term care settings (N=7), and public long-term care hospitals (N=10). Each meeting was held for about 120 minutes, and participants discussed the knowledge, skills, and attitudes required for their job, satisfactory and non-satisfactory experiences of education programs they had participated in, and what should improve. All contents discussed in each meeting were recorded and transcribed verbatim. Data were analyzed using a conventional content-analysis method. Results: Eight categories and 19 subcategories emerged under the three themes of (a) educational contents recognized as necessary, (b) advantages and disadvantages of completed dementia education, and (c) directions for improving educational programs for employees of dementia-related institutions. Conclusion: Dementia-specialized education and training should be standardized and structured systematically and differently depending on the job characteristics, type, and required level of expertise. Communication with and attitudes toward patients with dementia is re-emphasized as a common content regardless of occupation and institution; thus, sufficient training time should be secured. Qualified instructors and various platforms are also necessary to effectively deliver quality education.


: Long-distance walking is an ancient activity practiced across cultures for many reasons, including the improvement of one's health. It has even been suggested that long-distance walking may be considered a form of psychotherapy. This scoping review examined the relationship between long-distance walking and mental health among adults. Publication trends and definitions were also examined, and the reason why long-distance walking may have therapeutic effects was discussed. Systematic searches in three online databases were performed using a selection of long-distance walking terms. Both quantitative and qualitative studies were included if they examined associations between long-distance walking and mental health in an adult population. Mental health was conceptualized in broad terms, including descriptions of mental states as well as more specific measurements or notions of mental health. A total of 8557 records were screened and 26 studies were included, out of which 15 were quantitative, 9 were qualitative, and 2 were mixed. The findings showed that long-distance walking was positively related to mental health. This was most consistent with regard to emotional distress compared to somewhat inconsistent findings regarding well-being. Therefore, long-distance walking may be more appropriately used to counter some personal or emotional struggle rather than to achieve hedonic pleasure.


Bone mass loss caused by microgravity is considered as one of the worst influences to human body during long-term spaceflight. As one of the countermeasures to retain bone mass, muscle electrical stimulation is just started in spaceflight application and needs further research. This work is aimed to investigate the effects of muscle electrical stimulation based on the tail-suspended rat experiment. The statistical results of bone mineral density have shown that muscle electrical stimulation can retain bone mass to a certain extent under the condition of simulated microgravity


QCD at zero baryon density in the limit of infinite quark mass undergoes a first order deconfinement phase transition at a critical temperature $T_c$ corresponding to the breaking of the global centre symmetry. In the presence of dynamical quarks this symmetry is explicitly broken. Lowering the quark mass the first order phase transition weakens and terminates in a second order Z(2) point. Beyond this line confined and deconfined regions are analytically connected by a crossover transition. As the continuum limit is approached (i.e. the lattice spacing is decreased) the region of first order transitions expands towards lower masses. We study the deconfinement critical point with standard Wilson fermions and $N_f=2$ flavours. To this end we simulate several kappa values on $N_\tau=8$ and various aspect ratios in order to extrapolate to the thermodynamic limit, applying finite size scaling. We estimate if and when a continuuum extrapolation is possible.


Internet of Things is the next-generation Internet network created by intelligent objects with software and sensors, employed in a wide range of fields such as automotive, construction, health, textile, education and transportation. With the advent of Industry 4.0, Internet of Things has been started to be used and it has led to the emergence of innovative business models. The processing and production capabilities of Internet of Things objects in hidden and critical data provide great advantages for the next generation of Internet. However, the integrated features of Internet of Things objects cause vulnerabilities in terms of security, making them the target of cyber threats. In this study, a security model which offers an integrated risk-based Internet of Things security approach for the Internet of Things vulnerabilities while providing detailed information about Internet of Things and the types of attacks targeting Internet of Things is proposed. In addition, in this study, the vulnerabilities of Internet of Things were explained by classifying attack types threatening the physical layer, network layer, data processing layer and application layer. Moreover, the risk-based security model has been proposed by examining the vulnerabilities and threats of smart objects that generate the Internet of Things. The proposed Internet of Things model is a holistic security model that separately evaluates the Internet of Things layers against vulnerabilities and threats based on the risk-level approach.


The paper presents an evaluation of network services (CBR, VBR and TCP over UBR) in the future ATM tactical network. The included numerical results refer to the tested network configuration, called the extended bottleneck topology. Compared to cable ATM network, the studied system takes into account the wireless environment of the tactical network. More precisely, the presence of transmission errors as well as radio access control protocol is assumed. Additionally, a comparison of ATM service quality between wireless and cable network is included.


Objective: In the past years, heart rate (HR) has emerged as a highly relevant modifiable risk factor for heart failure (HF) patients. However, most of the clinical trials so far evaluated the role of HR in stable chronic HF cohorts. The aim of this multi-center, prospective observational study was to assess the association between HR and therapy with HR modulators (beta blockers, ivabradine, or a combination of ivabradine and beta blockers) at hospital discharge with patients' cardiovascular mortality and re-hospitalization at 6 months in acutely decompensated HF patients. Materials and Methods: We recruited 289 HF patients discharged alive after admission for HF decompensation from 10 centers in northern Italy over 9 months (from April 2017 to January 2018). The primary endpoint was the combination of cardiovascular mortality or re-hospitalizations for HF at 6 months. Results: At 6 months after discharge, 64 patients were readmitted (32%), and 39 patients died (16%). Multivariate analysis showed that HR at discharge ≥ 90 bpm (OR = 8.47; p = 0.016) independently predicted cardiovascular mortality, while therapy with beta blockers at discharge was found to reduce the risk of the composite endpoint. In patients receiving HR modulators the event rates for the composite endpoint, all-cause mortality, and cardiovascular mortality were lower than in patients not receiving HR modulators. Conclusions: Heart rate at discharge ≥90 bpm predicts cardiovascular mortality, while therapy with beta blockers is negatively associated with the composite endpoint of cardiovascular mortality and hospitalization at 6 months in acutely decompensated HF patients. Patients receiving a HR modulation therapy at hospital discharge showed the lowest rate of cardiovascular mortality and re-hospitalization.


This paper aims to present an e-learning environment initiative to train students in decision-making processes. The project consists in a learning environment based in gamification where a student can play in some situations while the psychological profile description is generated in background. The learning environment allows assessing student in the decision-making processes through some psychological competences related with the decision-making. These competences are: a) conviction ability, self-confidence; b) orientation to be a methodical and planner person; c) the ability to keep a dynamism and concentration level; d) the self-control in some eventualities; e) the characteristics that shows a persevering person, who insists in the consecution of goals; and f) the features of integrity, while exists coherence between the actions with that proposes. The environment proposes some tips to enhance the psychological skills. These final game statistics deploy several characteristics, graphics and possible actions to improve psychological skills. In the validation process, the product obtained as a web application for managing a learning environment in decision-making skills for students, the application obtained subjective impressions of all participants and demonstrated the potential value of the approach to learning of decision-making. The purpose of this evaluation was to get values with which to analyze the feedback about decision-making and other basics skills to improve. The gamification of the teaching processes allows adding attractive features to motivate the student to engage with academic issues. In complement to this situation, the use of game consolidates as go-between to characterize details of student difficulties, along with the possible improve actions. Keywords : gamification, decision-making, e-learning, learning environment, psychological competences.


The medicinal plants and natural products are products with a great scientific interest due their possible use like phytodrugs. In this context, the phytochemical composition and the antibacterial and antibiotic modulatory activity of the extract and fractions of Annona squamosa against Staphylococus aureus and Escherichia coli were performed. All natural products have not showed clinically relevant antibacterial activity, with MIC ≥ 1024 mg/mL. However, the extract combined with some aminoglycoside showed a synergistic effect against multiresistant strains E. coli 27 and S. aureus 358. Due these results, A. squamosa (Annonaceae) must be more studied to be used as a source of natural products with adjuvant potential to enhance the antibiotic activity, combating by this way the microbial antibiotic resistance.


Since their discovery over a decade ago, fluorescent carbon nanodots, or C-dots, have seen a drastic rise in various synthetic approaches as well as widespread applicability across diverse research fields. More recently, carbon nanodots have shown particular promise in a wide range of photovoltaic devices as inexpensive sensitizer candidates and as functional dopants within photoactive materials, electrolytes, and counter electrodes. While still in their infancy, carbon nanodot-incorporated devices already show encouraging enhancements in device performance, although due to current limiting factors such as poor charge collection and photocurrent generation, there is still much room for further discovery and improvement. Herein, we provide a detailed overview of the current state-of-the-art carbon nanodot-incorporated devices (and their limitations) and suggest some paths forward in the hopes of sparking new ideas on how to better synthesize and purify these materials, which will ultimately lead to a more thorough understanding of their properties so that further performance enhancements within carbon nanodot-incorporated solar-energy harvesting systems may be realized.


This paper describes a program (RAMP) which facilitates robot design analysis, project management, and design documentation. Requirements for such a program are proposed, and the literature is investigated. Design of the program is discussed in an object-oriented manner, and the system-level objects are described. The extent and method of implemented analysis objects is presented in more detail. Examples of use are discussed in terms of component selection, deflection analysis, and end-effector position error. Finally, the future augmentation of RAMP is described.


Abstract Aims: The present field study investigated the difference between practicing a nondirective relaxation technique – Acem Meditation – for stress relief and merely learning about stress and stress management in a population of active, working professionals. Methods: A six-months follow-up of an intervention group (N = 73) and a control group (N = 47) recruited from six large Norwegian companies. Results: The findings revealed significant improvements in the intervention group on all outcome variables – comprising mental distress (GHQ-12), worries and nervousness (EPQ-N), sleep problems (BIS) and musculoskeletal pain. In the control group, there were no changes. The differences between the intervention group and control group were significant, regarding EPQ-N, GHQ-12 and musculoskeletal pain. Conclusion: A nondirective meditation technique promoted specific bodily and psychological benefits for active working professionals: less pain and sleep problems, and a personal style less characterized by worries and nervousness. Acem Meditation used as a stress management technique may be a positive supplement to other measures a company puts forward, both to reduce negative health impacts of stress and to improve the capacity to cope with the stressors at work and in daily life. Replications of this study with an RCT design are warranted.


Purpose: To investigate the pathobiological origin of local relapse after chemoradiotherapy, we studied genetic relationships of primary tumors (PT) and local relapses (LR) of patients treated with chemoradiotherapy. Experimental Design: First, low-coverage whole genome sequencing was performed on DNA from 44 biopsies of resected head and neck squamous cell carcinoma (HNSCC) specimens (median 3 biopsies/tumor) to assess suitability of copy number alterations (CNAs) as biomarker for genetic relationships. CNAs were compared within and between tumors and an algorithm was developed to assess genetic relationships with consideration of intratumor heterogeneity. Next, this CNA-based algorithm was combined with target enrichment sequencing of genes frequently mutated in HNSCC to assess the genetic relationships of paired tumors and LRs of patients treated with chemoradiotherapy. Results: Genetic relationship analysis using CNAs could accurately (96%) predict tumor biopsy pairs as patient-matched or independent. However, subsequent CNA analysis of PTs and LRs after chemoradiotherapy suggested genetic relationships in only 20% of cases, and absence in 80%. Target enrichment sequencing for mutations confirmed absence of any genetic relationship in half of the paired PTs and LRs. Conclusions: There are minor variations in CNA profiles within different areas of HNSCC tumors and many between independent tumors, suggesting that CNA profiles could be exploited as a marker of genetic relationship. Using CNA profiling and mutational analysis of cancer driver genes, relapses after chemoradiotherapy appear to be partially genetically related to the corresponding PTs, but seem often genetically unrelated. This remarkable observation warrants further studies and will impact therapeutic innovations and prognostic modeling when using index tumor characteristics.


An experimental investigation has been carried out into the mixing of a row of jets
injected into a confined cross-flow. Measurements were made on a fully annular test facility,
the geometry of the rig simulating that found in the dilution zone of a gas turbine combustion
chamber. A small temperature difference of 44°C between the cross-flow and dilution fluid
allowed the mixing characteristics to be assessed, with hot jets being injected into a relatively
cold cross-flow at a jet to cross-flow momentum flux ratio of 4.0. The investigation
concentrated on differences in the mixing of individual dilution jets, as indicated by the
regularity of the temperature patterns around the cross-flow annulus. Despite the uniform
conditions approaching the dilution holes there were significant differences in the temperature
patterns produced by the dilution jets around the annulus. [Continues.]


Firefighter paramedics are frequently exposed to dangerous and stressful situations due to their occupational duties. Repeated exposure to traumatic events can take a cumulative toll on an individual's physical and mental health and potentially lead to a diagnosis of posttraumatic stress disorder. Although it is very common and expected for individuals to endorse symptoms of posttraumatic stress disorder immediately following a traumatic event, a large number are able to recover with minimal changes in functioning. Resiliency has emerged as a significant construct in explaining how humans cope with adversity and trauma. Resiliency can be defined as the ability to successfully cope, adapt, or manage stressful or traumatic situations. This study identified potential psychological and behavioral health variables that mediate the relationship between resiliency and posttraumatic stress symptoms (PTSS). Specifically, the primary objective of this article was to examine how depression, anxiety, and sleep mediate the relationship between resiliency and PTSS in firefighter paramedics. Participants included 125 full-time firefighter paramedics. Voluntary recruitment occurred at one South Florida fire department that comprised four fire stations. Participants were recruited for the study via their employee e-mail. Participants completed a battery of self-report questionnaires administered by clinical psychology doctoral students from a local university. Results suggest depression, anxiety, and sleep significantly mediate the relationship between resiliency and PTSS. The clinical implications of these findings and future research directions are discussed.


The aim of this study was to determine the sustainability factor related with the implementation of CMHN in South and West Jakarta. The method of the study was cross sectional, data of the nurses was collected by questionnaire of CMHN and pearson correlation was used to analyzed the data. Interviews conducted on stakeholder to get stakeholder perceptions about the sustainability factor of CMHN. The ability of nurse in the implementation of CMHN is 45,86%. The nurse perception toward sustainability factor of CMHN is 67,49%. The result of study shows the significant relationship between the sustainability factor with the implementation of CMHN. The result of analysis interviews with stakeholder about 8 sustainability factors is obtained into several themes: the positive opinion of stakeholder toward the CMHN (the existence of nursing care to the patients, detecting of new case, and reducing stigma) and the effort for the sustainability of CMHN (increasing the perception, budget planning, and socialization). The result of the study is recomended to improve the community mental health nursing service in other region.