Introduction: This chapter describes the characteristics of adult patients starting renal replacement therapy (RRT) in the UK in 2007 and the acceptance rate for RRT in Primary Care Trusts (PCT) or equivalent Health Authority (HA) areas in the UK. Methods: The basic demographics are reported for all UK centres and clinical characteristics of patients starting RRT from all except 1 centre in the UK. Late presentation, defined as time between first being seen by a nephrologist and start of RRT being <90 days was also studied. Age and gender standardised ratios for acceptance rate in PCTs or equivalent HAs were calculated. Results: In 2007, the acceptance rate in the UK was 109 per million population (pmp) compared to 111 pmp in 2006. Acceptance rates in England (107 pmp), Scotland (108 pmp) and Northern Ireland (105 pmp) have fallen slightly, whilst that in Wales (140 pmp) has risen. There were wide variations between PCTs/HAs with respect to the standardised ratios which were lower in more PCTs in the North West and South East of England and higher in London, the West Midlands and Wales. The median age of all incident patients was 64.1 years and for non-Whites 57.1 years. There was an excess of males in all age groups starting RRT and nearly 80% of patients were reported to be White. Diabetic renal disease remained the single most common cause of renal failure (21.9%). By 90 days, 67.4% of patients were on haemodialysis, 21.3% on peritoneal dialysis, 5.2% had had a transplant and 6.1% had died or had stopped treatment. The incidence of late presentation in those centres supplying adequate data was 21%. Conclusions: The acceptance rate has fallen in England, Northern Ireland and Scotland but continues to rise in Wales with wide variations in acceptance rate between PCTs/HAs.


: The calcification of the stylo-hyoid ligament is very often accidentally discovered during a panorex examination. Sometimes it is responsible of lateral and cervical pain spreading to the oral cavity and the maxilla. This anatomic landmark results in man from the more or less complete ossification of the hyo-branchial system due to the persistence of the Reichert cartilage. The anatomical environment of the ossified stylo-hyoid ligament is very rich in thick blood vessels and cranial nerves and can lead after compression or irritation to: vascular pain of the external carotid artery, recurrent syncopes by irritation of the carotid sinus, pain in the tonsils, phonation and swallowing troubles, referred pain in the temporo-mandibular joints. The standard clinical and radiographic examination will help to establish the differential diagnosis. The treatment is either non surgical, by cutaneous infiltration of local anesthetic or surgical, by the removal through the oral cavity of the calcified stylo-hyoid ligament.


An exact theory for two coupled modes traveling in the same direction with white random propagation constants is developed. Applications include tolerance studies for integrated optical directional couplers. The expected fields and the expected powers of the two modes are determined versus distance along the coupler, with the ratio of propagation-constant spectral density B0 to coupling C as a parameter. For small values of B0/C the powers in the two modes behave in a damped oscillatory manner, with distance along the coupler. For large values of B0/C the behavior is monotonic. In all cases, equal power division occurs for sufficiently large distance along the coupler when heat loss is absent. For an optical switch the maximum B0/C is given as a function of the required switch performance by the present results. The dividing line between oscillatory and monotonic behavior of the powers in the two modes versus distance occurs for B0/C = 4. This choice of parameters yields a power divider of minimum length whose performance is insensitive to the dimensions.


SYNOPSIS A glossary of Scottish mineral species, listing some 443 mineral names, and containing 399 valid species has been Compiled to fulfil a long recognized need. Wherever possible x-ray diffraction and chemical data have been used in the selection of the species. Entries for the glossary have been derived from an extensive literature survey, examination of many specimens from various museums and from data provided by individuals. The value of museum collections in works of this nature is highlighted, for without them coverage would be inadequate. Modern nomenclature in reference works is used as a yardstick for species status, but in some instances personal decisions had to be taken regarding the status of certain minerals. The mineral lists of Heddle have been revised and are now accredited with 162 valid species; this forms the nucleus of the glossary. Entries follow a standard sequence of name, ideal formula, crystal system, assemblage and locality details, except for Heddle entries. The first, or earliest found, reference is given for minerals discovered after 1901. Some minerals well entrenched in the literature are unsubstantiated. The glossary is accompanied by a text and three appendices, viz, minerals grouped anionically; mineral groups; and minerals which were discovered first in Scotland. Some 15 per cent of the species listed in this glossary have not been recorded previously for the United Kingdom.


This paper proposes a dimensionless approach to analyze the multi-parametric stability behavior of switching converters, which can be characterized by a nonlinear time-periodic (NTP) system. The main objective is to analyze how multiple circuit parameters affect the stability patterns of the derived NTP system and to simplify the parametric complexity of such NTP system. In contrast to previous work, the proposed method focuses on the parametric resultant relationships of the NTP system in the sense of topological equivalence, and investigates its stability in terms of the homeomorphic NTP system. Firstly, an equivalent stability theory of NTP systems is proposed. Then, based on the equivalent theory, a normalized map is introduced and various interesting properties are derived so as to formulate the dimensionless approach. Moreover, the approximate solution of the NTP system in dimensionless parameter space is calculated by using the Galerkin method, and its stability pattern is identified with the help of eigenvalue analysis approach. Finally, a case study of one-cycle controlled Zeta PFC converter is discussed in detail to exemplify the application of the proposed method. These analytical results agree well with those ones obtained from experimental measurements.


Do states have a moral obligation towards immigrants whose immigration is a result of necessity? While some types of necessitous immigrants receive international protection because states hold legal duties towards them, many others are left unprotected. This article looks into this "protection gap" and examines that moral justification for eliminating it by imposing additional obligations on states towards additional immigrants. Part I examines the international law foundations of this dilemma. Part II offers a typology of the different moral obligations that states might owe to different immigrants. Parts III, IV and V suggest a theoretical moralistic argument on the scope and the nature of the duty of states towards the immigrants of Elbonia. Part III discusses this duty in light of various approaches in distributive justice theory. Part IV explains the utilitarianism analysis of this issue. Part V describes the ethics of care feminist approach and the insights it could contribute to this dilemma. Each of these three Parts also includes a critique of the theoretical conceptualization of the duty by each of these schools of thought. Part VI characterizes the moral obligation as a relative one, rather than an absolute one, depending on the particular traits of the hosting state and of the immigrant. I conclude by summarizing the different views presented and suggesting further research.


This study focuses on risk management and specifically the exposure component. The exposure may be reduced by means of evacuation. This measure allows people and goods to be rescued from the area where the calamitous effects are announced. In the past years, many models have been proposed to simulate and design transport system under evacuation conditions. It must be underlined that the models applied to ordinary conditions cannot be directly applied to evacuation conditions due to very strong differences in demand, supply and interaction. Other models have been developed for emergency conditions. Nevertheless they consider only specific aspects and do not provide a comprehensive framework. This study presents the main quantitative results of a long-lasting research project for which a unifying approach for the simulation and design of a transportation system under evacuation conditions is adopted. In this project, an intelligent transportation system (ITS) is implemented to monitor real evacuation tests in a town where an emergency event has been simulated and experimented. In this study, a general methodology is reported with the description of the main models and procedures. Models are calibrated and validated by means of observed data obtained from ITS.


Abstract Purpose: To evaluate the treatment-induced toxicity (as primary endpoint) and the efficacy (as secondary endpoint) of stereotactic body radiation therapy (SBRT) in the treatment of mediastinal lymph nodes (LNs) in the so-called no-fly zone (NFZ) in cancers with various histology. Material and methods: Forty-two patients were retrospectively analyzed. Institutional dose/volume constraints for organs at risk (OARs) derived by published data were strictly respected. The correlation between treatment-related variables and toxicity was investigated by logistic regression, Chi-squared test or Fisher's exact test. Overall survival (OS), cause-specific survival (CSS), progression-free survival (PFS) and local control (LC) were collected from the follow-up reports. The impact of potential predictive factors on LC, PFS and OS were estimated by Cox proportional-hazard regression. Results: Median follow-up time was 16 months (range 1–41). Four patients had esophageal G1 toxicity. Ten and six patients had G1 and G2 pulmonary toxicity, respectively. Treatment site and irradiation technique were significantly correlated with G ≥ 2 and G ≥ 1 toxicity, respectively. OS probability at 19 months was 88.3% and corresponded to CSS. LC probability at 16 months was 66.3% (median LC duration: 22 months, range 1–41). Fifteen patients (35.7%) were disease-free at 25 months (median time, range 1–41). The biologically effective dose (BED) and the target dose coverage indexes were significantly correlated with LC. Conclusions: SBRT can be considered as a safe treatment option for selected patients with oligo-metastases/recurrences in the NFZ, if strict dose/volume constraints are applied.


To achieve non-resonant behavior, we propose a metallic grating device with linearly tapered slits. The tapering provides a gradual impedance variation from the entrance to the exit of the slits, leading to broadband and wide-angle enhanced transmission in the infrared. In addition, the light is strongly localized and enhanced at the slit exits, in contrast with straight slits. We describe the phenomenon with a transmission line model, which is in accordance with rigorous simulations.


The paper presents a novel approach, named bag-of-bags of words (BBoW), to address the problem of Content-Based Image Retrieval (CBIR) from image databases. The proposed bag-of-bags of words model extends the classical bag-of-words (BoW) model. An image is represented as a graph of local features on a regular grid. Then irregular partitions of images are built using different graph cutting methods. Each graph is then represented by its own signature. Compared to existing methods for image retrieval, such as Spatial Pyramid Matching (SPM), the BBoW model does not assume that similar parts of a scene always appear at the same location in images of the same category. The extension of the proposed model to pyramid gives rise to a method we name irregular pyramid matching. The experiments demonstrate the strength of our method for image retrieval when the partitions are stable across an image category. The experimental results for Caltech101 benchmark show that our method achieves comparative results as SPM, and is globally more stable.


Other signs and symptoms of myotonic dystrophy include clouding of the lens of the eye (cataracts) and abnormalities of the electrical signals that control the heartbeat (cardiac conduction defects). Some affected individuals develop a condition called diabetes mellitus, in which blood sugar levels can become dangerously high. The features of myotonic dystrophy often develop during a person's twenties or thirties, although they can occur at any age. The severity of the condition varies widely among affected people, even among members of the same family.


Triple pelvic osteotomy was performed for sequel of DDH including AVN between 1981 and 2002 for 329 patients (351 hips, 280 females, 49 males, average age at surgery 16.5 years, range 9–41 years, follow-up 4–25 years). A small modification of Steel's technique consisting of strictly subperiostal resection of segment from both pubic and ischial bone was used. Average gain of lengthening extremity was 1.8 cm. The average CE angle was improved from 7.8 to 35.5 degrees. Clinical results were evaluated according to Merle d'Aubigne and reflected to the preoperative clinical and radiological findings. There were 146 hip joints in 128 patients (76%) with excellent results in the group of congruent hips without arthrosis. In 182 hips in 178 patients with hip joints with some deformity, limited ROM and decentration, 40% were excellent, 32% good, 23% fair and 5% unsatisfactory results were achieved. The group of decentrated hip joints in young adults in incongruency limited ROM and sometimes severe arthrosis consisted of 23 monolateral surgeries with 39% unsatisfactory, 39% fair and 22% good results, respectively. No major neurovascular complications were seen. Non-unions were recorded in 19 patients (5.4%), including 2 triple and 2 double non-unions. Based on our long-term experience, we can conclude that triple pelvic osteotomy according to Steel in our modification is a safe method and gives regularly excellent or good results for correction of clinical and radiographic appearance of acetabular dysplasia when there is a proper indication.


We consider a linear finite dimensional control system depending on unknown parameters. We aim to design controls, independent of the parameters, to control the system in some optimal sense. We discuss the notions of averaged control, according to which one aims to control only the average of the states with respect to the unknown parameters, and the notion of simultaneous control in which the goal is to control the system for all values of these parameters. We show how these notions are connected through a penalization process. Roughly, averaged control is a relaxed version of the simultaneous control property, in which the differences of the states with respect to the various parameters are left free, while simultaneous control can be achieved by reinforcing the averaged control property by penalizing these differences. We show however that these two notions require of different rank conditions on the matrices determining the dynamics and the control. When the stronger conditions for simultaneous control are fulfilled, one can obtain the later as a limit, through this penalization process, out of the averaged control property.


Based upon laboratory and field studies, and examination of more than 3,500 museum specimens, Diabrotica longicornis barberi Smith and Lawrence is elevated to species rank. Diabrotica barberi and D. longicornis (Say) are distinct species whose ranges overlap in the central plains of the United States. Adults of D. longicornis are characterized by piceous antennae, tibiae, tarsi, and clypeus and are collected from cucurbits. Diabrotica barberi is commonly collected in cornfields and, where it is sympatric with D. longicornis, has yellow to testaceous antennae, tibiae, tarsi, and clypeus. The distinguishing colors prevailed in progeny of field-collected beetles fed from egg hatch to adulthood on a common diet. Sex pheromone extracts which attract D. barberi males did not attract D. longicornis males, and males of each species were attracted by conspecific virgin female beetles but not by females of the other species. In caged sexual compatibility experiments, mating success was asymmetrical. Discriminant analysis of 14 morphometric characters failed to discriminate completely between D. barberi and D. longicornis. Chromatic variation within D. barberi is geographically complex. The distribution of the two taxa is presented.


Welcome to this Special Edition of the CSPACE Journal , drawn from the 3 rd successive Reimagining Further Education Conference held on 27 June, 2018 at Birmingham City University. Known best by its Twitter hashtag #ReimagineFE, the conference has become the leading event on the further education calendar for practitioners, researchers, managers and leaders to come together and engage in action-oriented dialogue. The initial impetus for the first conference was to create a platform to counter the narrative of a precarious sector which was misunderstood by Whitehall and whose voice was largely ignored by policymakers. The act of reimagining was to create space for those with an interest in the broad further education sector to participate in dialogue about the current state of affairs and to imagine what FE could and should be.


The atrial granules containing the peptide hormone, Atrial natriuretic peptide (ANP) are present in the four regions of the atrial-auricular complex (two atria and two auricles). ANP-immunoreactivity was detected in all granules from the four regions. Ultrastructurally, atrial myocytes show the presence of very electron dense granules, with sparsely granular and homogeneous content, coated with a double membrane. The number of granules is greatest in the right atrium followed by the left atrium and left auricle and right auricle, in this order. The diameter of granules in the cardiocytes is significantly largest in the right atrium and reduced via the left auricle to the left atrium and right auricle. These data lead to suppose that the right atrium is the one that most synthesizes and stores the ANP. The number of ANP-granules is influenced by several physiological conditions: temperature, dehydration and nutritional condition. The main physiological stimulus for increased ANP release is the atrial muscle stretch, which normally occurs when extra cellular fluid volume or blood volume is elevated. The ANP is eliminated through the atrial myocytes, via exocytosis. Granule content is released into the extra-cellular space (extrusion). The ANP causes diuresis, natriuresis, vasodilatation and depression of blood pressure. It is also involved in the modification of the waterelectrolyte balance.


This article studies whether and why less educated natives are less ethnocentric in postindustrial Dutch cities than in industrial ones, as suggested by several theories in urban studies. A multilevel analysis of survey data collected among the native working populations (source: Cultural Change in the Netherlands Surveys 2004 and 2006) of 22 Dutch metropolitan agglomerations (sources: Statistics Netherlands Statline and Atlas of Municipalities) confirms that those concerned are indeed less ethnocentric in the most postindustrial cities. This pattern proves not to stem from the better opportunities at the bottom end of the labor market in these cities, as the ethnic competition theory suggests, but from the more tolerant cultural climate in these cities, as emphasized by Richard Florida in his work on creative cities.


The definition of green building is that it gives a more specific explanation in the relationship between ecological environment and service quality; however in the comprehensive evaluation system on whether the building can meet the requirements of green construction is particularly important. This paper first takes the definition of evaluation system of green building as the premise, compare on its index system. And have a discussion on general problems for the selection of indicators, as well as the specific principles that should be improved. Second is a further exploration to the construction of evaluation system of green building, which mainly combines selection principle of evaluation index, preliminary screening of evaluation index and relevance determination between indicators these three aspects for further study, from which to lay a solid foundation for the effective establishment of evaluation index. On this basis, the construction of new three-dimensional evaluation model of green building is specifically described, from which to determine the index weight, the establishment and analysis of a three-dimensional evaluation model. This is the main idea of the body of research and exploration, which also gives full guarantee to the scientificity and rationality for this paper, and provides solid theoretical and data support for the construction of fuzzy multilevel comprehensive evaluation index model.


TYPE A Clostridium perfringens has been associated with necrotising enteritis in 1–14-day-old foals in Kentucky (Donahue and Williams 2002, Timoney and others 2005) but the pathogenesis of the disease is not well understood, in part because few affected foals die and thus the availability of postmortem samples is rare. An autogenous bacterin-toxoid vaccine utilising a C. perfringens Type A strain (UK MF 05/00) that carries genes for the α toxin (CPA), β2 toxin (CPB2) and enterotoxin (CPE), further enriched with recombinant CPB2 toxin, is used to immunise mares on Kentucky breeding farms with histories of foal diarrhoea (Timoney and others 2005). Recently, a novel pore-forming toxin NetF has been strongly associated with foal necrotising enteritis and canine haemorrhagic gastroenteritis (Mehdizadeh Gohari and others 2015). Here, the authors report for the first time the identification of netF -positive type A C. perfringens in foals with enteritis and enterocolitis in Kentucky and …


In this article, we analyze how gender affects women's political participation. More specifically, we test the effect of gender ideology on young women's participation in political consumerism. The current literature suggests different reasons to explain the gap in political participation between men and women, most importantly focusing on socioeconomic resources, gender roles, and political socialization, whereas little attention has been devoted to the individual interpretation of a woman and man's own role in society. We test the effects of gender ideology on political consumerism, a form in which women participate more than men. We analyze political consumerism among young urban women, the population most likely to hold an egalitarian gender ideology. Moreover, we compare young women with different job conditions. Although the gender gap is closing or reversing in regard to specific forms of participation, such as consumerism, some inequalities remain, and our study contributes to understanding differences in participation among women themselves.


French Guiana is located in South America close to the equator (between 2° and 4° N), a huge asset in the production of electrical power with the use of solar panels. The yearly average solar-radiation is 5.8 kWh/m2day .The main focus of this study is to determine the solar energy potential in French Guiana using Kernel density estimation.
The knowledge of surface solar irradiance may be obtained using physical laws such as radiative transfert functions that link satellite apparent albedo to surface irradiance. However, due to the complexity of physical processes, it is difficult to develop accurate and reliable nonlinear observation law, in particular in a tropical area (our area of study). In this work we used a two dimensional Kernel density estimation with a learning dataset of clearness index data and apparent albedo data to estimate surface solar irradiance.
A time series of images every 30 min from the visible channel of the GOES-13 meteorological geostationary satellites from the year 2010 to 2013 has been selected with a spatial resolution of 1 km x 1 km. Hourly in-situ measurement data from six ground reference stations were provided by the French national meteorological agency.
The predicted solar irradiance values from the Kernel density estimation were given in the form of hourly, monthly and annual maps. The maps obtained highlighted interesting trends: the annual average maps showed that the western side of French Guiana receives the highest irradiance values and is dependent on the position of the InterTropical Convergence Zone (ITCZ).
The mean bias percentage error and mean RMSE values were respectively found to be less than 5% and 10% for the testing stations on a hourly basis. The kernel density estimation show great accuracies for evaluating solar resource potential. These results give a first overview of the solar energy potential in French Guiana.


Despite the title of Roland Barthes' essay "The Death of the Author," its treatment of literature is not entirely mortal: the author figure may be toppled, but from the rubble the reader is born. Still, the title references only a singular death, the "Death" of the author as a modern figure; in other words, any struggle between author and reader is neatly concluded. I propose to use a reading of Paul de Man's "Literary History and Literary Modernity" not only to gain a better understanding of what is meant by the word 'modern', but to challenge – through a close reading of "The Death of the Author" as well – the singularity of the author's death. De Man's presentation of modernity and literature relies on the idea of a temporal paradox that is the source of an unresolved struggle; Barthes, on the other hand, seems to eschew the problem of temporality in the modern author's mortality. Yet, in light of the presence of a second figure, the reader born upon the author's death, it will be shown that there is an eternal struggle inherent in the foundation of "The Death of the Author." And this struggle, after de Man, is a literary necessity. Literature exists in the promise of this combat, which, contrary to the title of Barthes' essay, will not necessarily result in the author's clean death. For literature as a struggle and as a gamble is just that: uncertain, risky, and yet something worthwhile.


Analysis in terms of the two-sector open economy shows that in bringing the market economy to East Germany, West Germany seems to have disregarded important fundamentals. Premature formation of a currency union led to a substantial real appreciation of the East German currency. Premature implementation of the West German system of wage bargaining resulted in inappropriate minimum wage schedules. Both measures made East German production possibilities and employment decline. [E24, P23]


Abstract Motivation Sequence-based deep learning approaches have been shown to predict a multitude of functional genomic readouts, including regions of open chromatin and RNA expression of genes. However, a major limitation of current methods is that model interpretation relies on computationally demanding post hoc analyses, and even then, one can often not explain the internal mechanics of highly parameterized models. Here, we introduce a deep learning architecture called totally interpretable sequence-to-function model (tiSFM). tiSFM improves upon the performance of standard multilayer convolutional models while using fewer parameters. Additionally, while tiSFM is itself technically a multilayer neural network, internal model parameters are intrinsically interpretable in terms of relevant sequence motifs. Results We analyze published open chromatin measurements across hematopoietic lineage cell-types and demonstrate that tiSFM outperforms a state-of-the-art convolutional neural network model custom-tailored to this dataset. We also show that it correctly identifies context-specific activities of transcription factors with known roles in hematopoietic differentiation, including Pax5 and Ebf1 for B-cells, and Rorc for innate lymphoid cells. tiSFM's model parameters have biologically meaningful interpretations, and we show the utility of our approach on a complex task of predicting the change in epigenetic state as a function of developmental transition. Availability and implementation The source code, including scripts for the analysis of key findings, can be found at https://github.com/boooooogey/ATAConv, implemented in Python.


Patient safety is a global public health concern. It is a health care discipline with ever evolving advancement and complexity resulting in consequential rise in patient harm. Since the pandemic, patient safety has been threatened even more by laying bare the inadequacies of health systems. Many unsafe care practices, risks, and errors contribute to patient harm and overall economic burden. These include medical, diagnostic, and radiation errors, healthcare associated infections, unsafe surgical procedures and transfusion practices, sepsis, venous thromboembolism, and falls. Although patient safety has become an integral part of the healthcare delivery model and resources have been dedicated towards it, much still needs to be achieved. An attitude of inclusivity for all care teams and anyone in contact with the patient, including the patients themselves, would enhance patient safety. Incorporating this attitude from educational infancy will allow for better identification of medical errors and inculcate critical analysis of process improvement. Implementing the 'Just Culture' by health care organizations can build the infrastructure to eliminate avoidable harm. To reduce avoidable harm and improve safety, a constant flow of information and knowledge should be available to mitigate the risks. Lastly, proper communication and effective leadership can play an imperative role to engage stakeholders and reduce harm.


The technology of explosive welding (EXW) was used for development of metallic multilayer ballistic resistant materials. Explosive cladded two or multilayer materials serve as final product or as semi-finished product for further processing, e.g. rolling. The objective is to create material with sufficient ballistic resistance at relatively small thickness of the resulting multilayer structure. Under retaining the weight of armoured vehicle its ballistic resistance can be increased or, under retaining its existing ballistic resistance the weight can be reduced. Resulting material should be producible of commercially available metallic materials using common technologies, especially the technology of roll welding (ROW). For the primary tests it is possible to model the resulting structure by means of EXW and some its properties can be verified in the initial stage of research of the multilayer structure (e.g. tests of heat processing, verification of diffusion processes, behaviour under various types of load, verification of ballistic resistance and other technological tests). Subsequently, production can start of large semi-finished products by means of ROW technology. Effective preparation is possible of the samples of multilayer materials by means of EXW technology in various material combinations - armour steel, tool steel and interlayer based on nickel, nickel alloys etc.


This paper aims to provide a better understanding of the gypsum hydric behavior used as coating during imbibition in liquid water. Firstly, we want to describe hydric transfer by determining sorptivity and hydraulic diffusivity of coating gypsum. Secondly, we evaluate the impact of the hemp fibers addition on hydric parameters. Experimentally, hydraulic diffusivity will be obtained by an overall measure of the moisture content (mc) in a defined sample volume, and the sorptivity describes capacity absorption. Through numerical simulation, hydraulic diffusivity will be determined by a local measure of the mc.


Performative control of voice is the process of real-time speech synthesis or modification by the means of hands or feet gestures. Vokinesis, a system for real-time rhythm and pitch modification and control of singing is presented. Pitch and vocal effort are controlled by a stylus on a graphic tablet. The concept of Syllabic Control Points (SCP) is introduced for timing and rhythm control. A chain of phonetic syllables have two types of temporal phases : the steady phases, which correspond to the vocalic nuclei, and the transient phases, which correspond to the attacks and/or codas. Thus, syllabic rhythm control methods need transient and steady phases control points, corresponding to the ancient concept of the arsis and thesis is prosodic theory. SCP allow for accurate control of articulation, using hand or feet. In the Tap mode, SCP are triggered by pressing and releasing a control button. In the Fader mode, continuous variation of the SCP sequencing rate is controlled with expression pedals. Vokinesis has been tested successfully in musical performances, using both syllabic rhythm control modes. This system opens new musical possibilities, and can be extended to other types of sounds beyond voice.


This study considers the problem of designing an efficient and low-cost infrastructure for connecting static multihop wireless networks with wired backbone, while ensuring QoS requirements such as bandwidth and delay. This infrastructure is useful for designing low-cost and fast deployed access networks in rural and suburban areas. It may also be used for providing access to sensor networks or for efficient facility placement in wireless networks. In these networks, some nodes are chosen as access points and function as gateways to access a wired backbone. Each access point serves a cluster of its nearby user, and a spanning tree rooted at the access point is used for message delivery. The study addresses both the design optimization and the operation aspects of the system. From the design perspective, we seek for a partition of the network nodes into a minimal number of disjoint clusters that satisfy multiple constraints; each cluster is required to be a connected graph with an upper bound on its radius. We assume that each node has a weight (representing its bandwidth requirement), and the total weight of all cluster nodes is also bounded. We show that these clustering requirements can be formulated as an instance of the capacitated facility location problem (CFLP) with additional constraints. By breaking the problem into two subproblems and solving each one separately, we propose polynomial time approximation algorithms that calculate solutions within a constant factor of the optimal ones. From the operation viewpoint, we introduce an adaptive delivery mechanism that maximizes the throughput of each cluster without violating the QoS constraints.


This letter proposes an analytical method based on 3-D Fourier integral to obtain accurate spectra of both the switching functions and the synthesized terminal quantities of a matrix converter. The challenges associated with the spectral analysis of matrix converter waveforms are twofold. On one hand, the modulation signal contains both the input and output frequencies. Unlike the third-harmonic injection in the modulation functions, the input frequency and the output frequency are typically independent from each other and will not form an integer ratio. On the other hand, it is very common that the switching frequency or the carrier frequency is not rational multiple of either the input frequency or the output frequency. These aforementioned challenges make it a very challenging task to accurately characterize the spectra of matrix converter waveforms through commonly resorted numerical methods such as a fast Fourier transform (FFT). The contribution of the proposed analytical method lies in providing accurate solution to spectral analysis of matrix converters when the FFT approach fails to characterize the spectral performance of matrix converters under typical operating conditions.


Canine aggression is a very discussed topic, especially when a person is injured. The problem of dog bites towards human beings must be tackled and scientifically analysed, in order to address the policy makers to effective measures. The aim of this study was to assess the effects of Italian breed-specific legislation on potentially dangerous dogs (Sirchia's Ordinance issued on the 9th September 2003 called "Protection of the public safety against the risk of aggressions by potentially dangerous dogs") on the trend of dog bites towards people in the city of Florence (Italy). Data for the current study were collected by the Veterinary and Urban Health, Local Sanitary Enterprise 10 in the city of Florence (Italy). Reports drew from the certifications of medical reports coming from different Hospital Emergency Departments in Florence, from the denunciation done at the canine registry office, and from the observational reports carried out at the observatory for the prophylaxis of the rabies. Reports referred to dog bites occurred in the city of Florence from September 2002 to August 2005. In total, 556 cases were gathered. The characteristics of injuries, dogs, owners and victims involved in dog bites in the year preceding the Sirchia's Ordinance were compared to the same characteristics in the two years after the issue of such Ordinance (short and long-term effects) using the c 2 test (p<0.05).The findings suggest that the above-mentioned ordinance has not caused any significant change on the trend of dog bites in the taken sample, nor in the short-term neither in the long-term. In fact, even if a numerical decrease has been observed in the period following the ordinance, a trend of reduction was already in progress since 1986. In addition, the characteristics of owners, injured people and dogs involved in the aggressive episodes remained unvaried, apart from a decrease in minor injuries. Finally, after the Ordinance the number of dog owners whose personal details were unknown increased. These findings suggest that restrictive legislative measures regarding potentially dangerous dogs are not effective for the control of canine aggression towards people.


Extractive Relations explores the nature of industrial power and its role in shaping what we understand to be the global mining sector. The authors examine issues at the forefront of contemporary debates: corporate obligations in safeguarding the rights of people displaced by mining, the recognition of community rights and interests in supporting or opposing mining developments, the handling of non-judicial grievances and workability of corporate remedy systems, and the logic of community relations departments in navigating these issues inside and outside of the typical modern mining establishment. The authors develop a unique theoretical approach that highlights the different types and uses of power in these settings. This perspective is supported by the authors' own sustained engagement with the mining sector over many years, drawing on cases from over twenty countries. The analysis of these issues from both 'inside' and 'outside' the sector is a key point of differentiation. For readers seeking to understand how mining companies interpret and interact with the communities and interests around their operations, this book provides invaluable insight and analysis.


Skin cancer mortality resulting from stratospheric ozone depletion has been widely studied. Similarly, there is a deep body of literature on surface ozone and its health impacts, with modeling and observational studies demonstrating that surface ozone concentrations can be increased when stratospheric air mixes to the Earth's surface. We offer the first quantitative estimate of the trade-off between these two effects, comparing surface air quality benefits and UV-related harms from stratospheric ozone depletion. Applying an idealized ozone loss term in the stratosphere of a chemistry-transport model for modern-day conditions, we find that each Dobson unit of stratospheric ozone depletion results in a net decrease in the global annual mortality rate of ~40 premature deaths per billion population (d/bn/DU). The impacts are spatially heterogeneous in sign and magnitude, composed of a reduction in premature mortality rate due to ozone exposure of ~80 d/bn/DU concentrated in Southeast Asia, and an increase in skin cancer mortality rate of ~40 d/bn/DU, mostly in Western Europe. This is the first study to quantify air quality benefits of stratospheric ozone depletion, and the first to find that marginal decreases in stratospheric ozone around modern-day values could result in a net reduction in global mortality due to competing health impact pathways. This result, which is subject to significant methodological uncertainty, highlights the need to understand the health and environmental trade-offs involved in policy decisions regarding anthropogenic influences on ozone chemistry over the 21st century.


BACKGROUND: Solute rejection by a molecularly imprinted membrane was observed for the first time. Enantioselective poly[(acrylonitrile)-co-(acrylic acid)] membranes were prepared by a wet-phase inversion method using D-phenylalanine (D-Phe) and L-phenylalanine (L-Phe) as templates, separately, in order to compare the imprinting effects of these isomers using an ultrafiltration experiment.

RESULTS: Recognition sites were successfully created in the prepared membranes, which had a nanoporous structure. The rejection selectivities of 0.13 and 0.28, adsorption selectivities of 2.25 and 2.40 and permselectivities of 1.94 and 2.08 were achieved for the D- and L-Phe-imprinted membranes, respectively, after 16 mL (34 min) of ultrafiltration.

CONCLUSION: Solute rejection by a molecularly imprinted membrane was selective. The performance characteristics of both the D- and L-Phe-imprinted membranes were different. Thus, the selection of an appropriate stereoisomer as a template plays an important role in the imprinting of membranes with regard to chiral resolution by ultrafiltration. Copyright © 2008 Society of Chemical Industry


Both organic and inorganic contaminants which have been implicated in causing cancer in man or, more commonly, in laboratory animals can be found in drinking water. Apart from arsenic there are none for which there is convincing epidemiological evidence of a significant risk to man. However environmental epidemiology is fraught with difficulties. There are also difficulties in interpreting laboratory animal data and extrapolating this to the low concentrations found in drinking water although mathematical models can be very useful if used sensibly. There is a danger that the rather extreme public perception of cancer could lead to over regulation of some contaminants in water, possibly with an increase in risk from other hazards such as microbiological contamination.


Constructing arguments on the level of journalism ethics violations by identifying the main factors influences journalists to work against their professional interest, and evaluating editorial policy documents and editorial meeting were the basic objectives achieved. Methodological wise, both quantitative and qualitative approaches were employed. About 117 journalists were involved. There are significant, if not critical, media ethics violations by Ethiopian broadcast media journalists. Both in cash and in kind journalist collect benefits from news sources and news makers. In return, they offer positive and success story coverage. Government and media have symbiotic relationships, but in Ethiopia, it is more than that- government officials influence the media. Public official pressures, amateurism and burden of living cost are main factor influence journalists to act unethically. The media editorial policies are not clear and accessible. Media fired and punish in fine "unethical" journalists.


Morphing aircraft wings require flexible skins that can undergo large strains, have low in-plane stiffness. In this paper, the sandwiched structure is designed to maintain airfoil shape throughout transition and not to suffer from large out-of-plane deformation under aerodynamic pressure loads. It consists of honeycomb and flexible skin. Honeycomb which is high-strain capable in one direction without dimensional change in the perpendicular in-plane axis provides distributed support to the honeycomb. Flexible skin is used to create the smooth aerodynamic surface. The morphing wing structure is developed together with the sandwiched skin technology. It is capable of changing in chordwise and increasing chord by 20%. Elastomeric and SMP skins are selected for use. Embedded heating wire springs act as the activation system for the SMP. Experiment results show the morphing wing model with elastomeric or SMP skins can be driven successfully by DC motor.


The functional linkages between law and media have long been significant in shaping American democratic governance. Over the past thirty-five years, environmental analysis has similarly become essential to shaping international and domestic governmental policy. Environmentalism - focusing as it does on realistic interconnected accounting of the full potential negative consequences as well as benefits of proposed actions, policies, and programs, over the long term as well as the short term, with careful consideration of all realistic alternatives - provides a legal perspective important for societal sustainability. Because environmental values and norms are often in tension with established industrial interests that resist public interest accountability, they are inevitably forced to play on political battlefields dominated by lobbyists' spin and corporate stratagems for manipulating public perceptions. The press, to which Thomas Jefferson entrusted the critical task of informing the discretion of the populace, is a crucially important and often disappointing resource of democratic governance, not least in the area of environmental law. This Essay surveys these problems and explores the potential for environmental lawyers to improve the relationships among environmental analysis, media, and societal governance at both the micro level of daily practice and macro level of national policy and law-making.


A new management model is needed for the Latin American coastal zone and its resources. During the nineties, some very interesting management initiatives were implemented. Nevertheless, in general terms, coastal management is relatively backward in comparison with other regions of the world. There are also very different levels of coastal management within the various Latin American countries themselves. In spite of these differences, the cultural homogeneity of the area could serve to facilitate international cooperation for more integrated management. Such an initiative would not only help to find a specific Latin American management model, but would also contribute to improving the levels of technical training, scientific knowledge, exchange of experiences and South-South co-operation. Also, the effectiveness of the initiatives carried out by countries with more highly developed systems of coastal management could be reduced if the surrounding States do not undertake similar initiatives.


During operation within an Advance Gas Cooled Reactor (AGR) 9Cr-1Mo steel is subjected to high temperature CO2 rich gas. This leads to complex interactions taking place between the CO2 and the steel. The steel is subjected to simultaneous carburisation and oxidation changing both the chemistry and the physical properties of the steel. Experimental samples were exposed on behalf of EDF Energy to better understand the processes taking place and to better understand the factors which affect time to breakaway oxidation taking place.A range of microscopy techniques have been used to study experimental samples exposed to samples aged using accelerated exposure conditions including Scanning Electron Microscopy SEM), Focused Ion Beam Microscopy (FIB) and Transmission Electron Microscopy (TEM) to better understand the corrosion processes taking place under these conditions.Carburisation of the substrate takes place with carbides forming preferentially along grain boundaries or martensitic laths depending on substrate microstate. These carbides increase in complexity with exposure time with the carbide distribution favouring higher C containing carbides at later exposures (M7C3 vs M23C6). The increase in carbide volume throughout the spinel is associated with the internal oxidation characteristics of the steel, the porosity of the oxide scale and is linked with breakaway oxidation. Some of these substrate carbides have been shown to resist oxidation at the main oxidation front through the growth of a Cr rich shell, this allows the carbide to remain within the spinel for potentially thousands of hours. The porosity across the oxide scale changes with exposure time, and a mechanism of porosity development has been linked with the substrate carbide distribution and frequency.The oxidation behaviour of the steel has been shown to be dependent on both microstructure and carbide distribution, with both the internal oxidation zone and spinel oxide showing evidence of the prior microstructure and carbide distribution. Breakaway samples have been shown to have a thinner internally oxidised regions relative to the pre-breakaway samples.Predictions for time to breakaway have been made based off the growth rate of the IOZ across the fin tips and extrapolated to lower temperatures using the Arrhenius Equation and activation energy calculated from the fin tips. These predictions take the geometry of the fins into account, important as breakaway is always observed to initiate at the fin tips and not the main body.


Background: Use of IV tPA has increased over time, as has the adherence to the NQF endorsed performance measure for receipt of IV tPA within 3 hours. Little is known about trends in the reasons for patient ineligibility for IV tPA. This study examines trends in reasons for not providing IV tPA over time and by race and gender among acute ischemic stroke patients in the Paul Coverdell National Acute Stroke Registry (PCNASR), a quality improvement program for acute stroke implemented by state health departments. Methods: There were 13,164 PCNASR patients enrolled from 2008- 2010 with a clinical diagnosis of acute ischemic stroke with documentation of LKW and who arrived within 2 hours of LKW. Cochran-Armitage tests were used to test for trend on accepted reasons for not providing IV tPA within 3 hours of time last known well (LKW). Chi-square tests were used to test for differences among reasons between men and women and between non-Hispanic whites and minorities. Multiple reasons for not giving tPA could be selected. Results: Among 13,164 acute ischemic patients admitted between 2008 and 2010 with documentation of LKW and who arrived within 2 hours of LKW, 3781 (28.7%) received IV tPA, 7284 (55.3%) had documented reasons for not receiving IV tPA, and 2099 (16.0%) did not receive IV tPA. Contraindications to IV tPA, advanced age, rapid improvement and inability to determine eligibility increased over time. Mild stroke decreased over time. Conditions with warning, advanced age, limited life expectancy and family refusal were more common in women; mild stroke and rapid improvement were more common in men. Contraindications were more common in minorities; advanced age, mild stroke and rapid improvement, and family refusal were more common in non-Hispanic whites. When advanced age was selected, 46.6% of patients were over age 90 and 3.4% were under age 80. When stroke too mild was selected, 44.8% of patients had missing NIHSS scores, 42.1% of scores were 0-4, 8.8% were 5-9, and 4.3% were ≥ 10. The three most common reasons for not providing tPA were rapid improvement (40.9%), mild stroke (33.0%), and contraindications (29.2%) in 2010. Conclusions: More than half of ischemic stroke patients arriving within 2 hours of LKW were ineligible to receive IV tPA. There was little use of advanced age for patients under age 80. Documentation of stroke too mild was not substantiated by an NIHSS score in nearly half of patients. Better documentation of NIHSS score should be provided.


Abstract Protosalvinia first occur in association with conodonts of the Upper trachytera Zone and below the Three Lick Bed in the Ohio Shale and the Ellicott Shale of the central and northern Appalachian Basin, as well as in the Clegg Creek Member of the New Albany Shale of the Illinois Basin. In the Chattanooga Shale of the southern Appalachian Basin, Protosalvinia are found no lower than the Upper marginifera Zone or associated with obviously reworked conodonts in the Middle expansa Zone. Regionally Protosalvinia are associated with a disconformity and may be found with conodonts of the Lower expansa Zone.


Objective: To investigate the effectiveness of a preseason strength and conditioning "Prehab" program on decreasing non-contact injuries and improving outcome measures of strength, agility, and balance in collegiate men's and women's basketball players, men's and women's soccer players, and women's volleyball players.
Methods: Forty-five National Collegiate Athletic Association Division I athletes participated. Participants performed a 10- week Prehab program consisting of five progressive levels advancing every two weeks. Exercises included lumbopelvic stabilization, scapular stabilization, plyometric training, and sport specific exercises. Test measures were taken before and after the Prehab intervention. Outcome measures included vertical jump height, number of push-ups, front/lateral plank time, single limb stance time, back extensor endurance time, thoracic spine rotation range of motion, number of single leg squats, Cross Hop test, Single Leg Crossover test, and closed kinetic chain upper extremity stability test (CKCUEST), as well as the number of non-contact injuries.Results: After completion of the Prehab program, participants showed significant improvement in vertical jump height, number of push-ups, front/lateral plank time, single limb stance time on the right, back extensor endurance time, thoracic spine rotation to the left, Single Leg Crossover test, and CKCUEST. Additionally, all other outcome measures showed a trend toward improvement. Participants experienced a total of 42 inseason repetitive stress injuries in the intervention year and 38 in the year after the intervention.
Conclusion: Participation in the "Prehab" program led to a reduced number of in-season non-contact injuries and significant improvements in 9 of the 11 outcomes measures of strength, agility, and balance in collegiate athletes. The lack of significance in some of the outcome measures may be due to the small sample size. A repeat of this study using a randomized-control design with a larger sample size may yield more significant results.


Background Electronic cigarettes (e-cigarettes) have become subject to highly contested public and political debates, including the role of commercial stakeholders in development and implementation of e-cigarette policy. There are concerns that e-cigarette debates provide opportunities for commercial stakeholders to demonstrate alignment with public health interests, build reputation, and gain influence over policy processes. While previous research on commercial sector engagement in policymaking has enhanced understanding of its impact on public health, a striking research gap exists regarding commercial actors' engagement in e-cigarette debates. Setting Taking the Scottish context as a case study, this project aims to increase understanding of commercial stakeholders' engagement in policy debates on e-cigarettes, generate debate on the sector's engagement in e-cigarette policy, and contribute to the development of effective e-cigarette policy. The project is investigating commercial stakeholders' interests in, and positions on, the benefits, harms and regulation of e-cigarettes, the ways in which interests and positions are presented and evidence is framed, and efforts to build collaboration and shape e-cigarette policy. Methods A mixed-method approach has been applied, combining the use of social network analysis to systematically analyse the relationships between commercial and other policy stakeholders and thematic analysis of documentary and interview data to explore the nature of commercial stakeholders' engagement in policy debates on e-cigarettes in Scotland. Publicly available policy documents and data from semi-structured, in-depth interviews with key stakeholders have been analysed. Results The analysis focuses on stakeholders' interests in, and positions on, the benefits and harms of e-cigarettes, the ways in which positions are presented, and their efforts to build coalitions in order to achieve specific policy outcomes. It finds that, while commercial stakeholders support e-cigarette regulation in general (e.g. age restrictions); there are efforts to influence regulation in a way that fits within their economic interests. This project shows that commercial stakeholders seek endorsement from public health organisations, in order to make health claims that can support the 'harm reduction argument'. The presentation will also discuss non-commercial stakeholders' arguments about whether commercial stakeholders should be included in e-cigarette policy debates or not.


The Cevennes-Vivarais region in southern France frequently suffers from Heavy Precipitation Events (HPEs), especially during the autumn season. The northwestern Mediterranean Sea is a source of heat and moisture for these HPEs, with strong air sea exchanges, which are mainly controlled by the near-surface wind intensity and the Sea Surface Temperature (SST). The aim of this study is to characterize the SST structures, location and variability related to HPEs. Indeed, the Gulf of Lion is characterized by a cyclonic circulation with three main oceanic features: (1) the Northern Current (NC), (2) the Balearic Front (BF), (3) and the deep Convective Cell (CC). The MEDidterranean ReanalYsiS (MEDRYS1V2), an ocean reanalysis at 1/12A‹Âs resolution was used over the 2000-2011 period to identify the NC, BF and CC oceanic feature's locations and for the calculation of an SST index. Then, an unsupervised cluster analysis method, using Principle Component Analysis for dimension reduction and the Silhouette for clustering, was used 20 in order to determine the most typical periods. The Local Moran's I (LMI) spatial statistical method, was used to highlight the areas of significant temporal variability of SST, considering the periods defined with the clustering method. For each period [early autumn (August-September), October and late autumn (November-December)], the LMI values, only considering the HPE initial stage, are extracted and compared to the averaged LMI values. The results highlight that in August-September, the Rhone river outflow have the most significant effect on SST variability on average, same as during HPEs. In October, for the HPEs initial stage, the largest variability seems to be related to the effects of the Mistral and Tramontane wind. In later autumn, there is a southward displacement of the BF and CC patterns and during the HPEs initial stage, the most significant SST variability is found near the center of the CC.


User-driven annotation of learning content allows the user to interact with it in a flexible and an intuitive manner and hence personalize the content. This interaction, in most cases, follows the "paper and pen" note-taking paradigm. Though not without its advantages, this paradigm does not scale when the courses are delivered online as Web pages. These paper notes are not synchronous with the content, hence may seem out of context, they may be misplaced, and don't make allowances for collaborative learning. In this paper we describe u-Annotate, a user-driven freeform digital ink annotation application for Web e-learning content which aims at facilitating the learner to annotate the online content with the aid of pen computing devices such as graphic tablets, etc. Learners can freely mark up the content, save the annotations for recall at a later date, as well as share these with other learners


Genome Walking (GW) comprises a number of PCR-based methods for the identification of nucleotide sequences flanking known regions. The different methods have been used for several purposes: from de novo sequencing, useful for the identification of unknown regions, to the characterization of insertion sites for viruses and transposons. In the latter cases Genome Walking methods have been recently boosted by coupling to Next Generation Sequencing technologies. This review will focus on the development of several protocols for the application of Next Generation Sequencing (NGS) technologies to GW, which have been developed in the course of analysis of insertional libraries. These analyses find broad application in protocols for functional genomics and gene therapy. Thanks to the application of NGS technologies, the original vision of GW as a procedure for walking along an unknown genome is now changing into the possibility of observing the parallel marching of hundreds of thousands of primers across the borders of inserted DNA molecules in host genomes.


Abstract With reactivity being the most important integral reactor physics quantity—and simultaneously the one that can be measured with the highest accuracy—there is a great interest in understanding how possible space- and energy-dependent data and/or modeling discrepancies may propagate into a calculated reactivity change, and with which magnitude this occurs. In the context of pin removal reactivity effects in a light water reactor assembly, for example, it is illustrative to carry out, for any arbitrary localized material composition perturbation, a decomposition of the total effect into individual space- and energy-dependent contributions of the different unit cells in the assembly. If this decomposition is normalized to +100% in the case of a positive reactivity effect and to – 100% in the case of a negative reactivity effect, an importance map is established that indicates the relative contribution (in percent) of each individual contributing cell to the total reactivity effect caused by the localized material composition change. Such an importance map can be interpreted as a sensitivity matrix that quantifies the final discrepancy in a calculated reactivity effect, with respect to its reference value, as a weighted sum of the complete collection of cell-wise data and/or modeling discrepancies. The current paper outlines the basic theory and gives certain practical applications of the proposed decomposition methodology. Thus, it is found that the developed methodology offers in-depth, quantitative explanations for calculational discrepancies observed in the analysis of fuel pin removal experiments conducted in the framework of the LWR-PROTEUS program at the Paul Scherrer Institute.


SummaryThe 1986 Tax Reform Act (TRA) had little effect on the overall U. S. effective capital income tax rate. However, TRA significantly reduced differences in effective taxation of corporate and noncorporate capital for a number of U. S. industries. The Mutual Production Model developed in Gravelle and Kotlikoff (1989) can be used to study the efficiency gains from the reduction in corporate tax wedges within industries. Unlike the Harberger Model, the Mutual Production Model permits both corporate and noncorporate firms to produce the same goods and, therefore, to coexist within a given industry.This paper develops an 11-industry-55-year dynamic life cycle version of the Mutual Production Model. We use this model to study the steady-state efficiency gains associated with the new law. While we do not simulate the economy's transition path, our steady-state welfare changes are those that arise from compensating transitional generations for the first-order redistribution of income associated with the Tax Reform.We find that the 1986 Tax Reform law reduces excess burden by 85 percent of our model's economy's present value of consumption. This efficiency gain reflects the Tax Reform's reduction in corporate-noncorporate tax wedges, particularly in those industries with significant noncorporate production. Measured as a flow the 1988 estimated efficiency gain from the Tax Reform Act is $31 billion.


Stop Now And Plan (SNAP®) is an empirically supported cognitive behavioural program for children identified as presenting with externalizing problems. The purpose of this investigation was to examine the implementation of the SNAP® for Schools program as a universal prevention program for children not identified as presenting with internalizing or externalizing problems, specifically, whether the program would lead to reductions in emotion dysregulation, anxiety, intolerance of uncertainty, and anxiety sensitivity. It was hypothesized that the SNAP® for Schools program would reduce emotion dysregulation and internalizing constructs in non-identified, school-aged children. The sample consisted of elementary school children in Grades 3 and 4. Participating children completed a battery of symptom measures one week pre- ( n = 65) and post-SNAP® ( n = 57) as well as one month after ( n = 54) completing SNAP® in their classrooms. For children who scored in the upper 10% on the measure total and/or subscale scores, reductions in emotion dysregulation, anxiety, and anxiety sensitivity were observed. Findings contribute to a better understanding of the effectiveness of SNAP® for reducing emotion dysregulation and internalizing symptoms in children with elevated internalizing symptoms and emotion dysregulation. Limitations and future directions are discussed. Keywords: Stop Now and Plan®; universal prevention program; internalizing symptoms; emotion dysregulation; cognitive behaviour therapy


Abstract:This chapter will examine trends in human trafficking in Caribbean and African islands over the past five years as documented in the US Department of State's annual Trafficking in Persons Report (2016–2021). The countries that will be examined include Antigua and Barbuda, Bahamas, Barbados, Cuba, Dominican Republic, Haiti, St. Lucia, St. Vincent, and the Grenadines in the Caribbean region and Cabo Verde, Comoros, Madagascar, Mauritius, Seychelles, Zanzibar, Tunisia, and Bijagos, Guinea-Bissau, in Africa. This article will examine what countries in these two regions have accomplished in the areas of prosecution of traffickers, victim protection, and prevention activities, as well as discuss the challenges and shortcomings in the anti-trafficking efforts of these island countries. The chapter will discuss the common elements across these regions facilitating success and failures in combating human trafficking. The chapter will end by discussing what policy recommendations, capacity-building initiatives, and cross-regional collaborations could be launched to address these collective trafficking problems.


This paper examines factors that may influence the estimates of the Value of a Statistical Life obtained from contingent valuation surveys that elicit the willingness to pay (WTP) for mortality risk reductions. We examine the importance of distributional assumptions, the choice of the welfare statistics of interest, the procedure for computing them, outliers, undesirable response effects, and internal validity of the WTP responses. We illustrate the importance of these factors using dichotomous-choice and open-ended WTP data from four recent contingent valuation surveys.


T use of antimicrobial drugs in food-producing animals can result in antimicrobial drug–resistant infections in humans. A good example is the use of fluoroquinolone in poultry and the emergence of fluoroquinolone-resistant Campylobacter infections among humans. However, topics of intense debate include the widespread use of antimicrobial drugs in animals, the extent to which antimicrobial drug use in animals affects human health, what drugs used in animals could be cause for concern to humans, and how to prevent overall risks to human health. The issue is complex from both policy and science perspectives. Antimicrobial drugs are used to raise all types of food-producing animals, but detailed drug use data are still lacking, making efforts to change drug use practices particularly challenging. In addition, because mobile genetic elements can confer new resistance on bacteria that already have complex ecology, there is often a lack of direct evidence to link the use of a particular antimicrobial drug to a specific resistant organism in humans. Policies that drive antimicrobial drug use, or lack of use, in animals can have profound effects on the health of the world's population, the health of the agricultural industry, and the world's food supply. However, even those well-versed in the topic of antimicrobial drug resistance find the issues of antimicrobial drug use in food-producing animals to be confusing and loaded with contrary political opinions on the significance of the public health threat and how best to address it. Laura H. Kahn's book One Health and the Politics of Antimicrobial Resistance should be considered an essential primer for anyone who chooses to grapple with this challenging but crucial public health issue. The book is a concise summary of events and milestones that have been driving forces in the use of antimicrobial drugs for food production efforts and objectively outlines the effect these efforts have had on the problem of drug resistance. For example, few are aware of the effect World War II had on supply chains of traditional animal feed supplements such as cod liver oil and fishmeal. In the United States, this interruption resulted in the transition to using antimicrobial drugs to boost the growth of food-producing animals. The author not only provides the US perspective but also describes the history of antimicrobial drug use in Europe, the steps these countries have taken to curb the tide of drug resistance, and where progress has been made. An example is the decrease in vancomycin-resistant enterococci carriage among healthy people in the Netherlands and Germany after avoparcin was banned. The author demonstrates her command of both the politics and the science of establishing medication guidelines throughout the book and approaches the subject with professional objectivity. In the concluding chapter, she provides concrete recommendations for policy, surveillance systems, and scientific research to understand and prevent antimicrobial resistance from a One Health perspective.


The OED defines "theatricality" in essentially negative terms, as the degraded cultural progeny of the theatre itself, and in the process associates it with spectacle. Assuming cultic proportions in late-Regency London, theatricality, I argue, comes full circle to engulf theatre itself. Epitomized by the mesmeric Kean and an increasing reliance on spectacular effects, this is the point at which Lamb enters the argument. A combined study of theatrical culture and periodical writing in the Romantic period, I demonstrate how such a spectacularization of theatre informs Lamb's performance with Elia of an "essayistic figure".Through Elia's ludic, phantasmal ontology in the London Magazine - in which the illusion of autobiography is enacted and the essay form transcended with assertions of fictive liberty - Lamb's use of a persona is, like theatricality itself, derivative of theatre. Yet the frequent readjustment of expectations that Elia's playfulness demands of the reader clearly designates Lamb's as a readerly mode of theatricality that diametrically opposes the dominant model of ritualistic spectatorship.Indeed, Lamb's career seemingly embodies the Romantic ambivalence over theatre identified by Mary Jacobus. Both failed playwright and avid theatre-goer, Lamb famously priveliges the reader's over the audience's experience of Shakesperare's tragedies, then later - as Elia - celebrates artificial comedy for the escape it affords from the "diocese of strict conscience". Elia can perhaps, therefore, be read as Lamb's attempt at managing theatre on his own terms: an appropriation of its illusory, emancipative qualities to the unspectacular format of the familiar essay.


Background: Inflammatory bowel diseases (IBD), are chronic, relapsing-remitting diseases of the gastrointestinal tract, including Crohn's disease (CD), Ulcerative colitis (UC) and Unclassified IBD (IBDU). Their pathogenesis involves genes and environment as cofactors in inducing autoimmunity; particularly the interactions between enteric pathogens and immunity is being studied. Helicobacter pylori (HP) is common pathogen causing gastric inflammation. Studies found an inverse prevalence association between HP and IBD, suggesting a potential protecting role of HP from IBD. Methods: A literature search of the PubMed database was performed using the key words''helicobacter pylori'',''inflammatory bowel disease'',''crohn disease'', "ulcerative colitis". Embase, Medline (OvidSP), Web of Science, Scopus, PubMed publisher, Cochrane and Google Scholar were also searched. Prevalence rate-ratios among HP in IBD patients, HP in CD patients, HP in UC patients, HP in IBDU patients were extracted, each group was compared with controls, to verify the inverse association between HP and IBD prevalence. Results: In all groups the dispersion of data suggested an inverse association between IBD group and controls, even when the comparison was carried out separately between each group of newly diagnosed patients and controls, to rule out the possible bias of ongoing pharmacologic therapy. Conclusions: The results of this review show a striking inverse association between HP infection and the prevalence of IBD, independently from the type of IBD considered across distinct geographic regions. Anyway, data should be interpreted cautiously, as wider, prospective and more homogeneous research on this topic are awaited, which could open new scenarios about environmental etiology of IBD. (www.actabiomedica.it)


textabstractFocusing on urban Kenya, this paper attempts to identify the sources of the
temporal increase in women's employment rate between 1986 and 1998. The
paper relies on labour survey data, household responses to coping strategies
and case studies. The analysis presented in the paper shows that the bulk of the
increase in women's insertion into the labour market comes from an increase
in the work participation of married women. While women's higher
educational endowments, particularly the increase in secondary education,
account for an improvement in their employment prospects, the period also
witnesses a sharp decline in the importance given to education in determining
employment and by 1998, university graduates were just as likely to be
employed as individuals with no education. The period between 1986 and 1998
witnessed civil service reforms, restructuring of the private sector, firm
closures and increasing job insecurity. Notwithstanding the role of education,
declining opportunities for males, who in 1986 were the primary breadwinners
and the accompanying income and employment insecurities within households
seem to be the key factors prompting the sharp increase in the labour supply of
(married) women. The analysis presented in this paper focused mainly on the
period 1986 and 1998 and while more recent data would have provided an
updated picture of the issues discussed in this paper, there is little evidence to
suggest that the situation of women in Kenya's labour market has changed
substantially in recent years.


Obviously, glamour is queer. But has this always been true? This article offers queer histories of capitalism and interwar glamour through an analysis of George Platt Lynes's photographic work. Lynes, an American photographer for Condé Nast publications, was one of numerous queer photographers, including Baron de Meyer, Cecil Beaton, George Hoyningen-Huene, and Horst P. Horst, who defined a queer aesthetics of fashion photography in New York, Paris, London, and Hollywood in the years before World War II. I historicize what Lynes called the "amorous regard" of his fashion photography through an analysis of his male nudes and the sexual history for which they are a visual record. In this article, I show how both Lynes's fashion images and his male nudes emerged from a marketimbricated queer kinship network to produce a discourse of interwar glamour that accommodated both dominant readings of heteronormativity and resistant readings of queer, white, belonging.


Some methods of formation of preforms for drawing of polarization-maintaining optical fibers are based on utilization of the surface tension of glass in the liquid state. Under the action of surface tension non-circular glass articles begin to flow, which results in formation of an anisotropic internal structure of the preforms. The hydrodynamic analysis of two such methods is given in the present work. Analytical solutions of the Stokes equations with linearized boundary conditions for the corresponding creeping surface-tension-driven flows of liquid glass are obtained. By means of these solutions a processing strategy may be predetermined with a view to a specific internal structure of the fibre. The theoretical results are compared with experimental data and agreement is fairly good. Cooling and solidifying of the preform at some intermediate moment of time yields a non-symmetric internal structure, whereas the outer boundary is already practically circular. Owing to the difference in the thermoelastic properties of the materials in the cladding and outer matrix, an anisotropic field of elastic stresses is created in the cross-section of hard preform (as well as in the optical fibre drawn from it) which results in birefringence. Accordingly, the core becomes capable of transmitting signals with a certain polarization. Analytical solution of the corresponding thermoelastic problem with linearized boundary conditions is obtained. The predicted results for the fields of elastic stresses and birefringence agree fairly well with numerical data obtained by the finite element method.


We hypothesize that imperfect quality measurement in contracts for fresh fruits and vegetables results in a moral-hazard problem, and that the final price of the produce provides additional information regarding quality. As a consequence, growers are not shielded from all price risk. This hypothesis is tested informally with observations on actual contracts in California.


The aim of this article is to analyse the perceived effect of corruption on health for a sample of 15 MENA countries over the period 1996-2018. This study used an econometric approach and a system of simultaneous equations models (SEMs) to explore relationships among latent variables and to examine the direct and indirect effects of corruption on health. Results showed that corruption affect negatively health care services and hinders economic growth for the MENA region. Furthermore, we found a bi-directional causal relationships between economic growth and health, and as well as between corruption and economic growth. However, the results support the occurrence of unidirectional causality between corruption and health. These empirical insights are of particular interest to policymakers as they help identify areas that are sensitive to corruption in health sector and the palliative strategies to be put in place.


A multiangle single-wavelength ellipsometric method has been applied to the evaluation of anisotropy and stress in SiO(2) films grown on silicon substrate. The method is nondestructive, and it does not require a priori knowledge of the dielectric functions of the oxide layer. A novel theoretical anisotropic multiple-layer program is used to calculate the Fresnel reflection coefficients at various angles of incidence; and an iterative least-squares algorithm compares the theoretical calculations to the experimental data. The data-fitting process yields the index, the thickness, and the anisotropy of the oxide layer and also the index and thickness of the SiO(x) transition layer.


The way in which systems should be decomposed so they can be better understood and better designed remains a fundamental problem in the information systems discipline. A number of different decomposition methodologies have been proposed. However, no methodology has emerged as dominant, presumably because the relative strengths and limitations of each methodology are still unclear. Case study research that has compared the methodologies, for example, has produced only equivocal results. In the absence of a theory of decomposition, it is difficult to make insightful predictions about the merits and failings of a particular methodology. Consequently, it is difficult to undertake empirical research that produces compelling results. Accordingly, in this paper we develop a rudimentary model of decomposition that we hope might form the basis of a subsequent, more complete theory of decomposition.


Natural rubber latex (NRL) allergy is a serious illness that presents itself with a spectrum of clinical signs and symptoms, including urticaria, allergic rhinitis, asthma, and anaphylaxis. NRL allergy is more commonly encountered among healthcare professionals and patients who undergo frequent surgical procedures because of sipina bifida or urogenital malformation. The ratio may rise to as high as 30% among children who have sipina bifida, while NRL allergy prevalence is just about 5% in healthcare professionals. Moreover, NRL allergy is the second most important cause of perioperative anaphylaxis. In routine practice, diagnosis of NRL allergy is based on specific IgE analysis and skin prick test. Nevertheless, not only is the diagnostic value of each one alone reaches 100%, but also false positive test results are encountered. The precision of the diagnostic methods used for NRL allergy is important because false positive IgE results may negatively influence the patients' quality of life due to the stringent measures required to ensure latex-free environment. For this reason, the search for diagnostic methods, which would confer more sensitive and specific results for a precise diagnosis, has been intensified in the last two decades, and for this purpose, recently recombinant NRL allergens are being used for the diagnosis of NRL allergy. In this article, performances of old and new diagnostic methods used in NRL allergy and what we gained from recombinant NRL allergens have been discussed.


Precision engineering has been used in the macroworld and in the microscale only with rigid materials. Soft flexible materials commonly used for microfluidics and other bio-MEMS applications have not been aligned with elastic averaging. We report the use of complementary raised and recessed circular features to align polymer layers and demonstrate alignment accuracy and repeatability. The alignment is accomplished in a Petri dish with a thin layer of liquid between the two surfaces of micromolded elastomeric polymer sheets. The layers are aligned with simple hand-eye manipulation. We test circular geometries of varying diameters, obtaining accuracy and repeatability values in the range of 1-3 mum across thin polymer sheets molded from silicon masters. This is a significant improvement over existing manual, moving stage, and self-alignment techniques and a novel proof of concept that paves the way for complex 3-D polymer constructs.


The main aim of the study is to explore and understand the potential for CSR practices to generate and confer unique benefits to a firm from their involvement in its activities, and exploring the scope to connect CSR and its accompanying benefits with the entrepreneurial practices of the firm. Following social constructionist philosophy this study was conducted to understand the construction of reality at the interface of CSR and entrepreneurship in large exemplary CSR practicing and entrepreneurial firms. Focusing on strategic CSR (SCSR) theories and opportunity based view of entrepreneurship, this study followed corporate entrepreneurship (CE) and social entrepreneurship (SE) theoretical underpinnings to establish a link between CSR and firm entrepreneurship to develop a theoretical framework for corporate social entrepreneurship (CSE) for creating economic, social and shared value.

This is a qualitative exploratory study and the research site was Bangladesh. Case study method was used as the main method in this study and semi structured interviews as the main method for data for case studies. Secondary sources of information, company records, project profiles and other archival data were also used in this study. Four purposively selected case firms which are exemplary CSR and entrepreneurial firms operating in Bangladesh are selected for case study along with other external stakeholders. Two phases of fieldwork were carried out as per the research plan to collect rich and deep data. Data analysis considered 32 usable interviews of first phase of fieldwork and 9 follow-up interviews of second phase of fieldwork. During the first phase of fieldwork after initial purposive sampling, snowballing also followed to capture deep and thick data to generate rich insights. Since this study mainly followed qualitative cross case analysis, four purposively selected case firms comprised main data set which are exemplary CSR and entrepreneurial firms operating in Bangladesh. Cross case analyses were done to draw out the findings. Transcribed interview data were analyzed using Atlas.ti qualitative data analysis software. Open coding was used to analyze data following thematic coding process. Code co-occurrence analyses were used to do cross case analysis. Within the fields of CSR and entrepreneurship, this study explored the interaction between CSR and firm entrepreneurship focusing on corporate entrepreneurship and social entrepreneurship domains.

Findings of the study suggest that the interaction of CSR practices with firm entrepreneurship may bring a better climate for exploring and exploiting business opportunities through promoting entrepreneurial behaviour, scope for innovation and better strategic and entrepreneurial practices for creating shared value. Moreover, this interaction along with social oriented vision, strategic management practices, internal environment and value based culture together are conducive for enacting corporate social entrepreneurship (CSE) to promote robust CSR practices and greater value creation.

Due to qualitative cross case analysis involving limited number of cases and primarily dependency on the interview data, generalizability of the findings are limited to theoretical inference. Based on the empirical work, developed CSE theoretical model is the outcome of data analysis in a triangulating fashion which offers validity and reliability. The main implications of this study is that addressing social problems through exploring and exploiting opportunities in the shared value creation space, managers may create an enabling environment and pursue strategies which are conducive for socio-entrepreneurial business practices. Also, CSE theoretical framework is expected to be strategic and entrepreneurial simultaneously which can be effective in bringing competitive advantage for firms.


This research is motivated by the achievement of student learning outcomes Physics 1 were not as expected. Further analysis of the results of student answers, found one of the concepts are still low achievement of learning outcomes is the projectile motion. Projectile Motion is part of the topic of the two-dimensional motion. The purpose of this study is to investigate and uncover the difficulties experienced by students on the concept of a projectile motion in order to plan appropriate learning program. The method used is descriptive analysis with a sample of 42 students who take the Basic Physics Course I on LPTK in West Java. Collecting data form of essai test. Based on the test results, it is known that students have difficulty following. First, drawing the vector component in the direction x (horizontal) and y (vertical). Second, distinguish the velocity vector, the vector component of velocity, the velocity vector component in the x and y directions. Third, focus on memorizing formulas bullet time taken for half a parabolic trajectory, maximum of height, maximum of distance. Fourth, always assumed final velocity moving object parabola when it hits the ground is always zero. Fifth, the velocity to zero at the top (when only the speed in the vertical direction is zero). Sixth, the acceleration is owned by the object in the x and y directions. Seventh, found some students use the law of sines cosines triangle on the determination of the distance / high and reverse (ideally the determination of the distance / high based on the velocity information).


SUMMARY: Acetohydroxyacid synthetase produced by Penicillium chrysogenum
q176 and a high penicillin-producing mutant have been compared. Both were sensitive to valine as the major feedback inhibitor. Inhibition of the enzyme in q176 appears to be effected through two valine binding sites, but only one of these remains in the high yielding strain and it is non-competitive with respect to pyruvate. The amount of enzyme activity detectable in the high yielding strain is more than twice the level in q176. Control of acetohydroxy-acid synthetase by other related amino acids was shown to be complex and involved sites other than the valine binding site.


The macrophage disappearance reaction (MDR), as an invivo analogue of in vitro tests for delayed hypersensitivity, was utilized in mice with M. tuberculosis or mouse thyroid extract (MTE). The optimal schedule for the induction of macrophages in peritoneal exudates and the optimal concentration of antigen for the MDR were determined. Macrophage disappearance occurred 4 h after immunized mice received an intraperitoneal injection of 200 microng of soluble antigen. The MDR was found to be antigen specific. Intraperitoneal injection of an unrelated antigen or tissue culture medium alone did not cause macrophage disappearance; however, the re-injection of the antigen used for immunization caused a 70-80% reduction of macrophages. Macrophage disappearance was greater in mice immunized with M. tuberculosis than in mice immunized with MTE. Comparison of the MDR with the footpad test in these 2 groups showed that mice immunized with M. tuberculosis developed a higher degree of delayed hypersensitivity than the group immunized with MTE. These results demonstrate that the MDR represents a specific and quantitative method for detecting the delayed type of cellular immune response in mice.


Objective To describe the functional profile of swallowing and feeding in patients admitted to a clinical intensive care unit. Methods: A survey on the speech therapy care provided at clinical intensive care unit, from May to August 2006, to establish indicators to describe swallowing functional profile. In this study we included patients referred for suspected dysphagia after undergoing long periods of mechanical ventilation and/or tracheostomy, and we excluded those suspected of neurogenic dysphagia. Results: We observed a 65% prevalence of oropharyngeal dysphagia in four months of speech therapy. Among the patients who were previously submitted to orotracheal intubation, we observed oropharyngeal dysphagia in 64% of assessments, and we noticed a reduction in dysphagia severity after speech therapy. Thirtynine percent of cases required further speech therapy. Conclusion: Speech therapy in non-neurogenic dysphagia in clinical ICU focuses mainly on patients who were intubated for more than 48 hours. These patients benefited from the intervention through the use of therapeutic techniques based on the necessary criteria for safe feeding habits.


In Canada many changes have been made, and more are pending, to their grain transportation policies. This package of policy changes has two offsetting impacts on freight rates for Canadian grain producers. The removal of transportation subsidies on grain for export offshore has roughly doubled the cost of transporting grain for the Canadian producer. In addition, the change in pooling points will increase freight rates even more for producers in the eastern part of the prairies. Whether federally owned grain hopper cars are sold to the railways, or to an association of Canadian producers, the cost of the sale is likely to be born by producers through increased freight rates over a number of years. In addition, Canadian producers will bear the cost of investing in new cars, a cost that was previously born by the government. The combined impact of all of these changes is to more than double freight rates for producers in the western part of the Prairies, with larger freight rate increases for eastern Prairie producers. A number of other policy changes including rail line abandonment and car allocation procedures, and the privatization of CN railway, are likely to increase the responsiveness and efficiency of the rail system, and to reduce freight costs over the medium to long run. Changes in the elevator system, port privatization and the construction of high throughput country and terminal elevators are likely to increase the efficiency of the grain handling system. In addition, if the correct incentives for investment in grain hopper cars are adopted, it is possible that the shortage of hopper cars that has occurred in the past might be eased, further increasing the efficiency of the delivery system. The increased cost of exporting to offshore markets has increased the economic incentive for Canadian producers and grain companies to export to the U.S. market. However, due to control of exports by the Canadian Wheat Board, and their concern over the political consequences of large flows of grain to the U.S., those exports may not occur. The uncertainty surrounding the Wheat Board's actions may make it difficult for grain handling companies to anticipate trade flows and make adjustments to the infrastructure in the United States needed to accommodate increased grain flows. The large increase in freight rates occurred when grain prices were at high levels, dampening the impact of increased freight rates on Canadian producers. If all other factors remain equal, increased costs of that size are likely to result in a shift in the production patterns on the Prairies. The extent of adjustment will depend on the production alternatives facing Prairie producers. The large increase in freight rates prompted Canadian transportation specialists to re-examine the feasibility of transshipment of Canadian grain through U.S. ports. Shipping Prairie grain through Pacific North West ports was not found to be cost effective at this time. While the cost of shipping through the Gulf was found to be comparable to shipping through Canadian ports, institutional constraints are likely to prevent substantial transshipment. Some policy changes are likely to increase the viability of the Canadian rail transportation and handling and reduce the cost of shipping over time. However, it seems unlikely that these efficiency improvements will fully offset the large increase in transportation costs that Canadian grain producers have just experienced. This means that the increased economic incentive for some Canadian producers to ship to the U.S. market, compared to offshore markets, is likely to remain.


This paper analyzes the interplay between economic incentives and social norms in a public finance context. We assume that to live off one's own work is a social norm, and that the larger the population fraction adhering to this norm, the more intensely it is felt by the individual. It is shown that this may give rise to multiple equilibria and to non-linearities that do not arise from economic incentives alone. In the model, individuals also vote on taxes and transfers. Hence, the social norm influences both their economic and political behavior. We show that monotone and continuous changes in external factors may result in non-monotone, and even discontinuous, changes in the political equilibrium.


Abstract. Atmospheric circulation indices can be used to explain the variability of runoff on a continental scale. Beside well-known regional anomalies of precipitation and runoff that correlate with phases of the North Atlantic Oscillation (NAO) there are also drifting fields of annual discharge anomalies. Following the trend of the NAO, these fields move along a longitudinal axis from western Europe to the Lena catchment in Siberia and back again. The same pattern is observable in the changing flow regimes. This paper describes the origin and causes of these anomaly fields and explains them as the results of important climate variations in the northern hemisphere.


Nowadays, Cardiac catheterization plays an essential role in the diagnostic evaluation of the patients with suspected or known cardiac diseases, and it is an important preoperative cardiac screening protocol for vascular surgeries. Reducing the fear and anxiety of patients, health workers should provide their patients with teaching sessions, as in other studies the positive effect of teaching on psychological aspect of patents is concluded. So, determining the effect of teaching on these patients a semi experimental one-group study was conducted, in which 70 adult patients (36 men, 34 women,) all were waiting for their first time cardiac catheterization, filled up Spielberg inventory questionnaires to assess their level of anxiety and other questionnaires for their knowledge level. Findings showed a significant relation between anxiety and knowledge level of the sample group before and after teaching (P=0/000), and we also found that reduction of anxiety is related to patients high knowledge level (P=0/0001, r= 0/395). To conclude, providing the patients with appropriate information will diminish their anxiety level and promote their knowledge, so, it is recommended that the nurse managers provide programs to highlight the instructional role of nurses. A similar research on patients waiting for other invasive procedures is recommended.