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If you are looking to replace the windows in your home, look no further than our team for guidance on your project. We will walk you through the many options you have and ensure you receive the best product for your needs, with expert installation that will stand the test of time. The Screen Shop partners with industry-leading brands to offer the finest, most innovative replacement windows. Milgard is one of the largest, most trusted manufacturers in the area. They feature a comprehensive line of wood, vinyl, fiberglass, and aluminum windows. With many styles to choose from, top-quality window options, and a Full Lifetime Warranty, homeowners across the San Jose area choose Milgard for their replacement window and new construction needs.

Another great manufacturer we partner with, Marvin, has made-to-order windows that offer superior energy efficiency, product innovation, and extensive customization options. We can handle all your purchase and installation needs for patio glass doors and screens. Having a new patio door installed can provide a better view, easier access to the outdoors, energy efficiency, and increased home value. Our window screens are manufactured in our shop, and we special order screen doors.

Whether you are looking for wood or aluminum frame screens, we are here to help turn the vision of your project into reality. Call us today for your window, patio glass door, and screen needs at Primary Website. Described my window problem to Sue. She had me watch an online video then either make my own repair, order parts through them if I could repair it myself or schedule an appt if I needed them to make the repair.

I was able to follow the video and the window works now. I think that's the way a business should work. Our investigation of the more complex shape and growth patterns in the shoot apical meristem where new organs are initiated shows that a stress based feedback on fiber directions is capable of reproducing the main features of in vivo cellulose fiber directions , deformations and material properties in different regions of the shoot. In particular, we show that this purely mechanical model can create radially distinct regions such that cells expand slowly and isotropically in the central zone while cells at the periphery expand more quickly and in the radial direction , which is a well established growth pattern in the meristem.

Mission Impossible? Managers of early childhood education programs know that it is imperative that their organization's collective energy be focused in a single direction , one that has been envisioned and determined by the organization's leadership, with input from all who will affect or be affected by it. A mission statement provides a constant reminder within an…. Family planning program clients are increasingly seeking oral contraceptive pills by brand name. Direct -to-consumer ads have spurred this recent increase in brand-specific requests for prescription drugs.

While print consumer pitches for prescription drugs have been around for a long time, proposed guidance issued by the US Food and Drug Administration FDA in August allows pharmaceutical companies to more easily broadcast product claim commercials on television and radio. Now, half of all direct -to-consumer advertising dollars spent by pharmaceutical companies during January-February were directed to television ads, almost twice the share spent upon television last year.

The effects of this new policy are presenting in providers ' offices. With the increase in advertising comes a potential for violations of the US Food, Drug, and Cosmetic Act, which regulates provider and consumer prescription drug advertising. Microtubules provide directional information for core PCP function. Planar cell polarity PCP signaling controls the polarization of cells within the plane of an epithelium. How polarity is globally coordinated with tissue axes is unresolved. Forest rodents provide directed dispersal of Jeffrey pine seeds.

Some species of animals provide directed dispersal of plant seeds by transporting them nonrandomly to microsites where their chances of producing healthy seedlings are enhanced. We investigated whether this mutualistic interaction occurs between granivorous rodents and Jeffrey pine Pinus jeffreyi in the eastern Sierra Nevada by comparing the effectiveness of random abiotic seed dispersal with the dispersal performed by four species of rodents: deer mice Peromyscus maniculatus , yellow-pine and long-eared chipmunks Tamias amoenus and T.

We conducted two caching studies using radio-labeled seeds, the first with individual animals in field enclosures and the second with a community of rodents in open forest. We used artificial caches to compare the fates of seeds placed at the range of microsites and depths used by animals with the fates of seeds dispersed abiotically. Finally, we examined the distribution and survival of naturally establishing seedlings over an eight-year period. Several lines of evidence suggested that this community of rodents provided directed dispersal.

Animals preferred to cache seeds in microsites that were favorable for emergence or survival of seedlings and avoided caching in microsites in which seedlings fared worst. Seeds buried at depths typical of animal caches 5—25 mm produced at least five times more seedlings than did seeds on the forest floor. The four species of rodents differed in the quality of dispersal they provided.

Small, shallow caches made by deer mice most resembled seeds dispersed by abiotic processes, whereas many of the large caches made by ground squirrels were buried too deeply for successful emergence of seedlings. Chipmunks made the greatest number of caches within the range of depths and microsites favorable for establishment of pine seedlings.

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Directed dispersal is an important element of the population dynamics of Jeffrey pine, a. In the present research, the peers of children with autism at primary school level and in an inclusive environment were taught using direct modeling and video modeling education processes, and it was observed whether or not they could effectively and efficiently teach how to play games to their friends with autism. This study used adapted…. Dark matter directional detection: comparison of the track direction determination.

Several directional techniques have been proposed for a directional detection of Dark matter, among others anisotropic crystal detectors, nuclear emulsion plates, and low-pressure gaseous TPCs. The key point is to get access to the initial direction of the nucleus recoiling due to the elastic scattering by a WIMP. In this article, we aim at estimating, for each method, how the information of the recoil track initial direction is preserved in different detector materials.

We use the SRIM simulation code to emulate the motion of the first recoiling nucleus in each material. We show that in an emulsion mix and an anisotropic crystal, the initial direction is lost very early, while in a typical TPC gas mix, the direction is well preserved.

Current directions in military health-care provider resilience. After more than a decade of war, the US military continues to place significant emphasis on psychological health and resilience. While research and programs that focus on the broader military community's resilience continue to emerge, less is known about and until recently little focus has been placed on military medical provider resilience. In this article, we review the literature on military medical provider resilience, provide an overview of the programmatic and technological advances designed to sustain and develop military medical provider resilience, and finally offer recommendations for future research.

Modeling human neuronal aging at a cellular level remains challenging. Human neurons are accessible from iPSCs, but during reprogramming age-associated traits of somatic cells get lost. In this issue of Cell Stem Cell, Mertens et al. Providers ' response to child eating behaviors: A direct observation study. Child care providers play an important role in feeding young children, yet little is known about children's influence on providers ' feeding practices. This qualitative study examines provider and child 18 months -4 years feeding interactions.

Trained data collectors observed eating occasions in 48 family child care homes and recorded providers ' responses to children's meal and snack time behaviors. Child behaviors initiating provider feeding practices were identified and practices were coded according to higher order constructs identified in a recent feeding practices content map. Analysis examined the most common feeding practices providers used to respond to each child behavior. Children's acceptance of food elicited more autonomy supportive practices vs.

Requests for seconds was the most common behavior, resulting in coercive controlling practices e. Future interventions should train providers on responding to children's behaviors and helping children become more aware of internal satiety and hunger cues. Inconsistency between direct and indirect comparisons of competing interventions: meta-epidemiological study. To investigate the agreement between direct and indirect comparisons of competing healthcare interventions.

Meta-epidemiological study based on sample of meta-analyses of randomised controlled trials. Inclusion criteria Systematic reviews that provided sufficient data for both direct comparison and independent indirect comparisons of two interventions on the basis of a common comparator and in which the odds ratio could be used as the outcome statistic. Inconsistency measured by the difference in the log odds ratio between the direct and indirect methods. The study included independent trial networks including trials with , patients in total that allowed both direct and indirect comparison of two interventions.

Indirect comparison had already been explicitly done in only 13 of the 85 Cochrane reviews included. The statistically significant inconsistency was associated with fewer trials, subjectively assessed outcomes, and statistically significant effects of treatment in either direct or indirect comparisons.

Significant inconsistency between direct and indirect comparisons may be more prevalent than previously observed. Direct and indirect estimates should be combined in mixed treatment comparisons only after adequate assessment of the consistency of the evidence. Objective To investigate the agreement between direct and indirect comparisons of competing healthcare interventions. Design Meta-epidemiological study based on sample of meta-analyses of randomised controlled trials. Main outcome measure Inconsistency measured by the difference in the log odds ratio between the direct and indirect methods.

Conclusions Significant inconsistency between direct and indirect comparisons may be more prevalent than previously observed. Purpose: Advance directive AD documents are based on state-specific statutes and vary in terms of content. These differences can create confusion and inconsistencies resulting in a possible failure to honor the health care wishes of people who execute health care documents for one state and receive health care in another state. The purpose of…. The goal of this article is to frame some new directions to social comparison research in organizational settings.

Four themes are developed. Coupons

First, we examine the role of organizational variables in shaping the basic sub processes in social comparison , such as the selection of referents. The second theme focuses on the meaning of level of…. Long term pavement performance directive : annual profiler-dipstick comparisons. The objective of this directive is to initiate a formal program for Profiler - Dipstick comparisons.

These comparison tests should be performed as a minimum, on an annual basis, or within 90 days after major repairs to any of the LTPP profile measure Direct comparison of four implicit memory tests. Four verbal implicit memory tests, word identification, word stem completion, word fragment completion, and anagram solution, were directly compared in one experiment and were contrasted with free recall. On all implicit tests, priming was greatest from prior visual presentation of words, less but significant from auditory presentation, and least from pictorial presentations. Typefont did not affect priming.

In free recall, pictures were recalled better than words. The four implicit tests all largely index perceptual lexical operations in recognizing words, or visual word form representations. Comparison of NGA-West2 directivity models. Five directivity models have been developed based on data from the NGA-West2 database and based on numerical simulations of large strike-slip and reverse-slip earthquakes. All models avoid the use of normalized rupture dimension, enabling them to scale up to the largest earthquakes in a physically reasonable way.

Several strategies for determining the zero-level for directivity have been developed. We show comparisons of maps of the directivity amplification. This comparison suggests that the predicted geographic distributions of directivity amplification are dominated by effects of the models' assumptions, and more than one model should be used for ruptures dipping less than about 65 degrees. Although there is a considerable body of knowledge about domestic violence, a limited proportion focuses on domestic violence in rural settings.

Using a nonprobability purposive sampling technique, 93 providers of domestic violence services from rural and urban localities in North Carolina and Virginia were located and asked to complete a…. Direct cost comparison of totally endoscopic versus open ear surgery. Totally endoscopic ear surgery is a relatively new method for managing chronic ear disease. This study aimed to test the null hypothesis that open and endoscopic approaches have similar direct costs for the management of attic cholesteatoma, from an Australian private hospital setting.

A retrospective direct cost comparison of totally endoscopic ear surgery and traditional canal wall up mastoidectomy for the management of attic cholesteatoma in a private tertiary setting was undertaken. Indirect and future costs were excluded. A direct cost comparison of anaesthetic setup and resources, operative setup and resources, and surgical time was performed between the two techniques. Totally endoscopic ear surgery is more cost-effective, from an Australian private hospital perspective, than canal wall up mastoidectomy for attic cholesteatoma.

The Patient Self-Determination Act PSDA requires hospitals, home health agencies, nursing homes, and hospice providers to offer new patients information about advance directives. There is little evidence regarding whether encounters with these health-care providers prompt advance directive completion by patients. To examine whether encounters with various types of health-care providers were associated with higher odds of completing advance directives by older patients. Logistic regression using longitudinal data from the and waves of the Health and Retirement Study. Participants were US adults aged 65 and older who reported not possessing advance directives in Four binary variables measured whether participants had spent at least 1 night in a hospital, underwent outpatient surgery, received home health or hospice care, or spent at least one night in a nursing home between and Outpatient surgery was not associated with advance directive completion.

Older adults with no advance directive in who encountered health-care providers covered by the PSDA were more likely to have advance directives by The exception was outpatient surgery which is frequently provided in freestanding surgery centers not subject to PSDA mandates.

It may be time to consider amending the PSDA to cover freestanding surgery centers. The hospice must maintain a safe physical environment free of hazards for patients, staff, and visitors. Expanding oral care opportunities: direct access care provided by dental hygienists in the United States. Dental hygienists expand access to oral care in the United States. Many Americans have access to oral health care in traditional dental offices however millions of Americans have unmet dental needs.

For decades dental hygienists have provided opportunities for un-served and under-served Americans to receive preventive services in a variety of alternate delivery sites, and referral to licensed dentists for dental care needs. Publications, state practice acts, state public health departments, the American Dental Hygienists' Association, and personal interviews of dental hygiene practitioners were accessed for information and statistical data. Dental hygienists in 36 states can legally provide direct access care.

Dental hygienists are providing preventive services in a variety of settings to previously un-served and under-served Americans, with referral to dentists for dental needs. Dental hygienists have provided direct access to care in the United States for decades. The exact number of direct access providers in the United States is unknown.

Limited research and anecdotal information demonstrate that direct access care has facilitated alternate entry points into the oral health systems for thousands of previously un-served and underserved Americans. Older adults, persons with special needs, children in schools, pregnant women, minority populations, rural populations, and others have benefited from the availability of many services provided by direct access dental hygienists. Legislatures and private groups are becoming increasingly aware of the impact that direct access has made on the delivery of oral health care.

Many factors continue to drive the growth of direct access care. Additional research is needed to accumulate qualitative and quantitative outcome data related to direct access care provided by dental hygienists and other mid level providers of oral health services. Case study: Comparison of motivation for achieving higher performance between self- directed and manager- directed aerospace engineering teams.

The problem is determining the best method of providing a motivating environment where design engineers may contribute within a team in order to achieve higher performance in the organization. Theoretically, self- directed work teams perform at higher levels. But, allowing a design engineer to contribute to the team while still maintaining his or her anonymity is the key to success.

Therefore, a motivating environment must be established to encourage greater self-actualization in design engineers. The purpose of this study is to determine the favorable motivational environment for design engineers and describe the comparison between two aerospace design-engineering teams: one self- directed and the other manager directed. Following the comparison , this study identified whether self- direction or manager- direction provides the favorable motivational environment for operating as a team in pursuit of achieving higher performance.

The methodology used in this research was the case study focusing on the team's levels of job satisfaction and potential for higher performance. The collection of data came from three sources, a surveys, b researcher observer journal and c collection of artifacts. The surveys provided information regarding personal behavior characteristics, potentiality for higher performance and motivational attributes.

The researcher journal provided information regarding team dynamics, individual interaction, conflict and conflict resolution. The milestone for performance was based on the collection of artifacts from the two teams. The findings from this study illustrated that whether the team was manager- directed or self- directed does not appear to influence the needs and wants of the. A comparison of consumer- directed and agency- directed personal assistance services programmes. A convenience sample was used for this cross-sectional study with one data collection point.

Outcomes were compared for consumer- directed and agency- directed PAS. Hierarchical regressions were also used to determine the predictors of outcomes across PAS programmes. In-home interviews were conducted by a trained data collector from April to December Self-reported outcomes were primarily predicted by the following variables: service arrangement, type of provider , importance of directing PAS, health status, number of personal assistants used in past 12 months, sufficient PAS hours received, and social support.

Consumer- directed PAS enhances outcomes for many persons with disabilities. Self-reported outcomes are affected by many factors that could be addressed in PAS programme development. Interdisciplinary research on patient- provider communication: a cross-method comparison. Patient- provider communication, a key aspect of healthcare delivery, has been assessed through multiple methods for purposes of research, education, and quality control. Common techniques include satisfaction ratings and quantitatively- and qualitatively-oriented direct observations.

Identifying the strengths and weaknesses of different approaches is critically important in determining the appropriate assessment method for a specific research or practical goal. Analyzing ten videotaped simulated encounters between medical students and Standardized Patients SPs , this study compared three existing assessment methods through the same data set.

Methods included: 1 dichotomized SP ratings on students' communication skills; 2 Roter Interaction Analysis System RIAS analysis; and 3 inductive discourse analysis informed by sociolinguistic theories. The large dichotomous contrast between good and poor ratings in 1 was not evidenced in any of the other methods.

Following a discussion of strengths and weaknesses of each approach, we pilot-tested a combined assessment done by coders blinded to results of 1 - 3. This type of integrative approach has the potential of adding a quantifiable dimension to qualitative, discourse-based observations. Subjecting the same data set to separate analytic methods provides an excellent opportunity for methodological comparisons with the goal of informing future assessment of clinical encounters. Comparing consumer- directed and agency models for providing supportive services at home.

To examine the service experiences and outcomes of low-income Medicaid beneficiaries with disabilities under two different models for organizing home-based personal assistance services: agency- directed and consumer- directed. The sample was stratified by service model agency- directed or consumer- directed , client age over or under age 65 , and severity. Outcome measures were developed in three areas: safety, unmet need, and service satisfaction.

Factor analysis was used to reduce multiple outcome measures to nine dimensions. Multiple regression analysis was used to assess the effect of service model on each outcome dimension, taking into account the client- provider relationship, client demographics, and case mix. Recipients of IHSS services as of mid were interviewed by telephone.

The survey was conducted in late and early On various outcomes, recipients in the consumer- directed model report more positive outcomes than those in the agency model, or they report no difference. Statistically significant differences emerge on recipient safety, unmet needs, and service satisfaction. A family member present as a paid provider is also associated with more positive reported outcomes within the consumer- directed model, but model differences persist even when this is taken into account.

Although both models have strengths and weaknesses, from a recipient perspective the consumer- directed model is associated with more positive outcomes. Although health professionals have expressed concerns about the capacity of consumer direction to assure quality, particularly with respect to safety, meeting unmet. Incentive programs directed at both providers and patients have become increasingly widespread. Pay-for-performance P4P where providers receive financial incentives to carry out specific care or improve clinical outcomes has been widely implemented.

The existing literature indicates they probably spur initial gains which then level off or partially revert if incentives are withdrawn. The literature also indicates that process measures are easier to influence through P4P programs but that intermediate outcomes such as glucose, blood pressure, and cholesterol control are harder to influence, and the long term impact of P4P programs on health is largely unknown. Programs directed at patients show greater promise as a means to influence patient behavior and intermediate outcomes such as weight loss; however, the evidence for long term effects are lacking.

In combination, both patient and provider incentives are potentially powerful tools but whether they are cost-effective has yet to be determined. Coordinated vigilance provides evidence for direct reciprocity in coral reef fishes. Reciprocity is frequently assumed to require complex cognitive abilities.

Therefore, it has been argued that reciprocity may be restricted to animals that can meet these demands. Here, we provide evidence for the potential presence of direct reciprocity in teleost fishes. We demonstrate that in pairs of coral reef rabbitfishes f. Siganidae , one fish frequently assumes an upright vigilance position in the water column, while the partner forages in small crevices in the reef substratum. Both behaviours are strongly coordinated and partners regularly alternate their positions, resulting in a balanced distribution of foraging activity.

Compared to solitary individuals, fishes in pairs exhibit longer vigilance bouts, suggesting that the help provided to the partner is costly. In turn, fishes in pairs take more consecutive bites and penetrate deeper into crevices than solitary individuals, suggesting that the safety provided by a vigilant partner may outweigh initial costs by increasing foraging efficiency.

Thus, the described system appears to meet all of the requirements for direct reciprocity. We argue that the nature of rabbitfish pairs provides favourable conditions for the establishment of direct reciprocity, as continuous interaction with the same partner, simultaneous needs, interdependence, and communication relax the cognitive demands of reciprocal cooperation. Self- directed exploration provides a Ncs1-dependent learning bonus. Understanding the mechanisms of memory formation is fundamental to establishing optimal educational practices and restoring cognitive function in brain disease.

Here, we show for the first time in a non-primate species, that spatial learning receives a special bonus from self- directed exploration. In contrast, when exploration is escape-oriented, or when the full repertoire of exploratory behaviors is reduced, no learning bonus occurs. These findings permitted the first molecular and cellular examinations into the coupling of exploration to learning. Coupon Codes December 2016

We found elevated expression of neuronal calcium sensor 1 Ncs1 and dopamine type-2 receptors upon self- directed exploration, in concert with increased neuronal activity in the hippocampal dentate gyrus and area CA3, as well as the nucleus accumbens. Acute knock-down of Ncs1 in the hippocampus also decoupled exploration from efficient learning.

These results are potentially relevant for augmenting learning and memory in health and disease, and provide the basis for further molecular and circuit analyses in this direction. Subjects completed skill tests pretraining baseline , immediately after training acquisition , and then retention was assessed at 12 hours, 3 and 6 months. The primary outcome was retention of excellent CPR skills at 3 months. Excellent CPR was defined as systolic blood pressure of mm Hg or higher and compression rate to per minute. Adjusted for age, ABP-trained providers were 5.

Direct comparison of fractional and integer quantized Hall resistance. A cryogenic current comparator bridge capable of currents down to the nanoampere range was used to directly compare two resistance values of two GaAs-based devices located in two cryostats. A value of 1- 5.

While not relevant for practical metrology, such a test of the validity of the underlying physics is of significance in the context of the upcoming revision of the SI. A direct potential fitting RKR method: Semiclassical vs. The comparisons show higher levels of agreement than generally recognized, when the SC calculations incorporate a quantum defect correction to the vibrational quantum number, in keeping with the Kaiser modification. One particular aspect of this is better agreement between quantal and SC estimates of the zero-point vibrational energy, supporting the need for the Y00 correction in this context.

On the other hand, the SC method can be much faster than the quantal method in exploratory work with different potential functions, where it is convenient to use finite-difference methods to evaluate the partial derivatives required in nonlinear fitting. Board directly be a provider of core services, intensive services, or training services, or act as a One Board directly be a provider of core services, intensive services, or training services, or act as a One-Stop Operator? System and method of providing quick thermal comfort with reduced energy by using directed spot conditioning.

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Wang, Mingyu; Kadle, Prasad S. A heating, ventilation, and air conditioning HVAC system and a method of controlling a HVAC system that is configured to provide a perceived comfortable ambient environment to an occupant seated in a vehicle cabin. The system includes a nozzle configured to direct an air stream from the HVAC system to the location of a thermally sensitive portion of the body of the occupant.

The system also includes a controller configured to determine an air stream temperature and an air stream flow rate necessary to establish the desired heat supply rate for the sensitive portion and provide a comfortable thermal environment by thermally isolating the occupant from the ambient vehicle cabin temperature. The system may include a sensor to determine the location of the sensitive portion. The nozzle may include a thermoelectric device to heat or cool the air stream. Coupon Code Coupons August Promo Codes August

Subjective cognitive complaints, psychosocial factors and nursing work function in nurses providing direct patient care. The aim of this study was to examine relationships among subjective cognitive complaints, psychosocial factors and nursing work function in nurses providing direct patient care. Cognitive functioning is a critical component for nurses in the assurance of error prevention, identification and correction when caring for patients. Negative changes in nurses' cognitive and psychosocial functioning can adversely affect nursing care and patient outcomes.

A descriptive correlational design with stratified random sampling. The sample included 96 nurses from the major geographic regions of the United States. Stepwise multiple linear regression analyses were used to examine relationships among subjective cognitive complaints, psychosocial factors and nursing work function. Overall, participants reported minimal work function impairment and low levels of subjective cognitive complaints, depression and stress. In multivariate analyses, depression was not associated with nurses' work function.

However, perceived stress and subjective concerns about cognitive function were associated with greater impairment of work function. Nurses experiencing subjective cognitive complaints should be encouraged to address personal and environmental factors that are associated with their cognitive status. Additionally, stress reduction in nurses should be a high priority as a potential intervention to promote optimal functioning of nurses providing direct patient care.

Healthcare institutions should integrate individual and institutional strategies to reduce factors contributing to workplace stress. Urolithiasis risk: a comparison between healthcare providers and the general population. Healthcare providers have many health-related risk factors that might contribute to urolithiasis: a heavy workload, a stressful workplace, and an unhealthy quality of life.

However, the urolithiasis risk in healthcare providers is not clear. Using Taiwan's National Health Insurance Research Database, we identified 50, physicians, 20, pharmacists, , nurses, and 25, other healthcare providers as the study cohort and then randomly selected an identical number of patients who are not healthcare providers general population as the comparison cohort for this study.

Conditional logistical regression analysis was used to compare the urolithiasis risk between healthcare providers and comparisons. Physician specialty subgroups were also analyzed. Physicians had a lower urolithiasis risk than did the general population adjusted odds ratio [AOR]: 0. For pharmacists, nurses, and other healthcare providers , the urolithiasis risk was not significantly different than that for general population.

Subgroup analysis showed that surgeons and family medicine physicians had a lower urolithiasis risk than did physician comparisons AOR: 0. Although job stress and heavy workloads affect physicians' health, physicians had a lower urolithiasis risk than did the general population and other healthcare providers.

This might be attributable to their greater medical knowledge and access to healthcare. Our findings provide useful information for public health policy makers about the disease risks of healthcare providers. Directly observed daily mouth care provided to care home residents in one area of Kent, UK. To gather accurate data on the daily mouth care provided in care homes including tooth brushing, oral health assessment, and recording of care provided.

Direct observation and notes review.


Both nursing and 'regular' care homes. Provision of mouth morning care. Carers used a toothbrush to clean inside a resident's mouth in just 7 cases 4. Smaller care homes were no more likely to brush residents teeth than larger care homes, and nursing homes were no more likely to brush teeth than other care homes. This is the first observational study in the UK to assess oral care actually provided to residents by carers in care homes.

The findings reveal a substantially different picture of daily mouth care than was previously understood and suggest that many of the nation's care home residents may not be receiving adequate, or any, oral health care. The need for realtime data to aid in disaster management and monitoring has been clearly demonstrated for the past several years, e. Users want and often require the means to get earth observation data for operational regional use as soon as they are generated by satellites.

This paper describes the satellites, their Direct Broadcast DB capabilities, the data uses, what it takes to deploy a DB ground station, and the future of the DB. Kinds of well-being: A conceptual framework that provides direction for caring. This article offers a conceptual framework by which different kinds and levels of well-being can be named, and as such, provides a foundation for a resource-oriented approach in situations of illness and vulnerability rather than a deficit-oriented approach. We introduce 18 kinds of well-being that are intertwined and inter-related, and consider how each emphasis can lead to the formulation of resources that have the potential to give rise to well-being as a felt experience.

By focusing on a much wider range of well-being possibilities, practitioners may find new directions for care that are not just literal but also at an existential level. Direct -to-consumer DTC personal genomic testing PGT allows individuals to learn about their genetic makeup without going through a physician, but some consumers share their results with their primary care provider PCP. Longitudinal, prospective cohort study. Online survey before and 6 months after results.

Consumer satisfaction with the DTC PGT experience; whether and, if so, how many results could be used to improve health; how many results were not understood; and beliefs about the PCP's understanding of genetics. Participants were asked with whom they had discussed their results.

Genetic reports were linked to survey responses. The proportion that shares results is expected to increase with time after testing as consumers find opportunities for discussion at later appointments or if results become relevant as medical needs evolve. National Institutes of Health. Optimal level of Au nanoparticles on Pd nanostructures providing remarkable electro-catalysis in direct ethanol fuel cell. The designing and fabrication of economically viable electro-catalysts for ethanol oxidation reaction EOR in direct ethanol fuel cell DEFC has been one of the challenging issues over the decades.

The catalytic proficiency of bimetallic NPs nm are found to be strongly dependent on the Pd:Au ratio. The catalysts are further subjected to electrochemical analysis through voltammetry along with the temperature study on activation parameters. The quantitative determination of EOR products during the electrolysis is carried out by ion chromatographic analysis; vis-a-vis the coulombic efficiency of the product yield were derived from each of the compositions.

Furthermore, a strong correlation among catalytic performances and bimetallic composition is established by screening the catalysts in an in-house fabricated direct ethanol anion exchange membrane fuel cell, DE AEM FC. Older nurses' experiences of providing direct care in hospital nursing units: a qualitative systematic review. Most developed countries throughout the world are experiencing an aging nursing workforce as their population ages.

Older nurses often experience different challenges then their younger nurse counterparts. With the increase in older nurses relative to younger nurses potentially available to work in hospitals, it is important to understand the experience of older nurses on high paced hospital nursing units. This understanding will lend knowledge to ways of lessening the loss of these highly skilled experienced workers and improve patient outcomes.

To identify, evaluate and synthesize the existing qualitative evidence on older nurses' experiences of providing direct care to patients in hospital nursing units. The review considered studies which included registered nurses 45 years and over who work as direct caregivers in any type of in-patient hospital nursing unit. The phenomenon of interest was the experience of older nurses in providing direct nursing care in any type of in-patient hospital nursing unit i. The review excluded studies focussing entirely on enrolled nurses, licensed practical nurses and licensed vocational nurses.

Qualitative data including, but not limited to the following methodologies: phenomenology, grounded theory, ethnography, action research and feminist research. Any disagreements that arose between the reviewers were resolved through. Comparison of antral tap with endoscopically directed nasal culture.

The diagnosis of acute bacterial rhinosinusitis continues to generate controversy in critically ill patients. The efficacy of endoscopically directed cultures in these patients is unknown. Microbiologic data were collected and analyzed for any statistical difference between groups.

A total of 29 sides underwent simultaneous tap and endoscopically directed tissue culture. The ETCs were culture-positive in all but 1 patient with positive taps. Two patients ultimately required sinus surgery. In patients with fever of unknown origin and computed tomography evidence of sinusitis, an antral tap continues to provide important information concerning maxillary sinusitis. Directed evolution of a model primordial enzyme provides insights into the development of the genetic code. The contemporary proteinogenic repertoire contains 20 amino acids with diverse functional groups and side chain geometries.

Primordial proteins, in contrast, were presumably constructed from a subset of these building blocks. Subsequent expansion of the proteinogenic alphabet would have enhanced their capabilities, fostering the metabolic prowess and organismal fitness of early living systems. While the addition of amino acids bearing innovative functional groups directly enhances the chemical repertoire of proteomes, the inclusion of chemically redundant monomers is difficult to rationalize. Here, we studied how a simplified chorismate mutase evolves upon expanding its amino acid alphabet from nine to potentially 20 letters.

The increase in fitness they confer indicates that building blocks with very similar side chain structures are highly beneficial for fine-tuning protein structure and function. Influenza vaccination and decisional conflict among regulated and unregulated direct nursing care providers in long-term-care homes.

The purpose of this study was to determine whether direct nursing care providers have decisional conflict about receiving influenza vaccinations and characteristics associated with decisional conflict. The researchers used a self-administered questionnaire mailed to direct nursing care providers in two long-term-care organizations. Unregulated direct nursing care providers had more decisional conflict than regulated providers , especially related to feeling uninformed about the pros and cons of influenza vaccination.

Unclear valuing of the pros and cons of influenza vaccination was related to the age of the direct care providers in both organizations. Decisional conflict and influenza vaccination practices may be determined, in part, by age and by the culture of a health care organization. A decision aid to improve knowledge and clarify values may improve decision quality and increase influenza vaccination rates. Cobern, William W. There are continuing educational and political debates about "inquiry" versus " direct " teaching of science. Traditional science instruction has been largely direct but in the US, recent national and state science education standards advocate inquiry throughout K education.

While inquiry-based instruction has the advantage of modelling aspects…. Flat-panel detector FPD digital radiography systems have direct and indirect conversion systems, and the 2 conversion systems provide different imaging performances. We measured some imaging performances [input-output characteristic, presampled modulation transfer function presampled MTF , noise power spectrum NPS ] of direct and indirect FPD systems.

Moreover, some image samples of the NPSs were visually evaluated by the pair comparison method. The results of visual evaluations showed the same tendency as that found for NPSs. We elucidated the cause of the difference in NPSs in a simulation study, and we determined that the cause of the difference in the noise components of the direct and indirect FPD systems was closely related to the presampled MTF. Estimation of haemoglobin is the most widely used method to assess anaemia. Although direct cyanmethaemoglobin method is the recommended method for estimation of haemoglobin, but it may not be feasible under field conditions.

Hence, the present study was undertaken to compare indirect cyanmethaemoglobin method against the conventional direct method for haemoglobin estimation. Haemoglobin levels were estimated for adolescent girls aged yr residing in an urban slum in Delhi by both direct and indirect cyanmethaemoglobin methods, and the results were compared. The mean haemoglobin levels for whole blood samples estimated by direct and indirect cyanmethaemoglobin method were Sensitivity and specificity of indirect cyanmethaemoglobin method were Using regression analysis, prediction equation was developed for indirect haemoglobin values.

The present findings revealed that indirect cyanmethaemoglobin method overestimated the prevalence of anaemia as compared to the direct method. However, if a correction factor is applied, indirect method could be successfully used for estimating true haemoglobin level. More studies should be undertaken to establish agreement and correction factor between direct and indirect cyanmethaemoglobin methods. Direct comparison of optical lattice clocks with an intercontinental baseline of km. Two-way satellite time and frequency transfer technique, based on the carrier-phase, was employed for a direct comparison , with a baseline of km between Japan and Germany.

A frequency comparison was achieved for 83, s, resulting in a fractional difference of 1. This measurement directly confirms the agreement of the two optical frequency standards on an intercontinental scale. Experimental comparison of inquiry and direct instruction in science. There are continuing educational and political debates about 'inquiry' versus ' direct ' teaching of science. While inquiry-based instruction has the advantage of modelling aspects of the nature of real scientific inquiry, there is little unconfounded comparative research into the effectiveness and efficiency of the two instructional modes for developing science conceptual understanding.

This research undertook a controlled experimental study comparing the efficacy of carefully designed inquiry instruction and equally carefully designed direct instruction in realistic science classroom situations at the middle school grades.

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The research design addressed common threats to validity. We report on the nature of the instructional units in each mode, research design, methods, classroom implementations, monitoring, assessments, analysis and project findings. There is great utility in having a flexible and automated objective observation direction system for the decadal survey missions and beyond. Such a system allows us to optimize the observations made by suite of sensors to address specific goals from long term monitoring to rapid response.

We have developed such a prototype using a network of communicating software elements to control a heterogeneous network of sensor systems, which can have multiple modes and flexible viewing geometries. Our system makes sensor systems intelligent and situationally aware. Together they form a sensor web of multiple sensors working together and capable of automated target selection, i. This system is implemented in three components.

The first component is a Sensor Web simulator. The Sensor Web simulator describes the capabilities and locations of each sensor as a function of time, whether they are orbital, sub-orbital, or ground based. STK makes it easy to analyze and visualize optimal solutions for complex space scenarios, and perform complex analysis of land, sea, air, space assets, and shares results in one integrated solution. The second component is target scheduler that was implemented with STK Scheduler. STK Scheduler is powered by a scheduling engine that finds better solutions in a shorter amount of time than traditional heuristic algorithms.

The global search algorithm within this engine is based on neural network technology that is capable of finding solutions to larger and more complex problems and maximizing the value of limited resources. The third component is a modeling and data assimilation system. It provides situational awareness by supplying the time evolution of uncertainty and information content metrics that are used to tell us what we need to observe and the.

Describes a computerized partial degree auditing system, MAPP Monitoring Academic Progress Policy , developed at the University of Florida to monitor students' progress into appropriate majors and apply institutional policy concerning degrees. The system generates letters directing students to advisors when needed. Discusses advantages for…. Reconstructing gravitational wave source parameters via direct comparisons to numerical relativity I: Method. In this talk, we describe a procedure to reconstruct the parameters of sufficiently massive coalescing compact binaries via direct comparison with numerical relativity simulations.

For sufficiently massive sources, existing numerical relativity simulations are long enough to cover the observationally accessible part of the signal. Due to the signal's brevity, the posterior parameter distribution it implies is broad, simple, and easily reconstructed from information gained by comparing to only the sparse sample of existing numerical relativity simulations. We describe how followup simulations can corroborate and improve our understanding of a detected source. Since our method can include all physics provided by full numerical relativity simulations of coalescing binaries, it provides a valuable complement to alternative techniques which employ approximations to reconstruct source parameters.

Due to logistical and cost constraints, acidic deposition is rarely measured at forest research or sampling locations. A crucial first step to assessing the effects of acid rain on forests is an accurate estimate of acidic deposition at forest sample sites. admin