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OBJECTIVES/GOALS: The purpose of this study is to identify and quantitatively describe environmental barriers to community engagement and activity participation for adults with stroke and low income. Repeated electronic surveys collected in real time will reduce recall bias and improve characterization of barriers. METHODS/STUDY POPULATION: 20-30 community-dwelling adults with stroke and low income will be recruited for this pilot study. Inclusion criteria: > 1 month post stroke and evidence that they have the vision, literacy, and cognitive capacities to answer survey questions on a smart device. Exclusion criteria: severe aphasia, severe mental illness or substance abuse within 3 months, and ataxia. Participants will complete standardized assessments of daily activities, engagement in and perceptions about community activities, social support, and perceived environmental barriers. Participants then complete four surveys per day for 14 days using an app on an iPod Touch, reporting activities attempted and barriers encountered. RESULTS/ANTICIPATED RESULTS: This is the first study of this kind and is a work in progress. We anticipate that the environmental barriers reported will include physical (e.g. built structures, climate, and natural terrain), social (e.g. support or lack thereof; stigma), political (e.g. access to transportation; healthcare services), and technological barriers (e.g. difficulties with personal equipment and/or technologies such as elevators, ticket kiosks, etc.). DISCUSSION/SIGNIFICANCE OF IMPACT: An increased understanding of the barriers facing community-dwelling adults with stroke and low income will facilitate the development of culturally-appropriate and more accessible self-management programs to help this population re-engage in their communities and return to pre-stroke activities.
To characterize the association of longitudinal changes in maternal anthropometric measures with neonatal anthropometry and to assess to what extent late-gestational changes in maternal anthropometry are associated with neonatal body composition.
In a prospective cohort of pregnant women, maternal anthropometry was measured at six study visits across pregnancy and after birth, neonates were measured and fat and lean mass calculated. We estimated maternal anthropometric trajectories and separately assessed rate of change in the second (15–28 weeks) and third trimester (28–39 weeks) in relation to neonatal anthropometry. We investigated the extent to which tertiles of third-trimester maternal anthropometry change were associated with neonatal outcomes.
Women were recruited from twelve US sites (2009–2013).
Non-obese women with singleton pregnancies (n 2334).
A higher rate of increase in gestational weight gain was associated with larger-birth-weight infants with greater lean and fat mass. In contrast, higher rates of increase in maternal anthropometry measures were not associated with infant birth weight but were associated with decreased neonatal lean mass. In the third trimester, women in the tertile of lowest change in triceps skinfold (−0·57 to −0·06 mm per week) had neonates with 35·8 g more lean mass than neonates of mothers in the middle tertile of rate of change (−0·05 to 0·06 mm per week).
The rate of change in third-trimester maternal anthropometry measures may be related to neonatal lean and fat mass yet have a negligible impact on infant birth weight, indicating that neonatal anthropometry may provide additional information over birth weight alone.
The Earth is dramatically carbon poor comparing to the interstellar medium and the proto-sun. The carbon to silicon ratios in inner solar system objects show a correlation with heliocentric distance, which suggests that the destruction of carbon grains has occurred before planet formation. To examine this hypothesis, we perform model calculations using a chemical reaction network under the physical conditions typical of protoplanetary disks. Our results show that, when carbonaceous grains are destroyed and converted into the gas phase and the gas becomes carbon-rich, the abundances of carbon-bearing species such as HCN and carbon-chain molecules, increase dramatically near the midplane, while oxygen-bearing species such as H2O and CO2 are depleted. The carbon to silicon ratios obtained by our model calculations qualitatively reproduce the observed gradient with disk radius, but there are some quantitative discrepancies from the observed values of the solar system objects. We adopted the model of a disk around a Herbig Ae star and performed line radiative transfer calculations to examine the effect of carbon grain destruction through observations with ALMA. The results indicate that HCN, H13 CN and c-C3 H2 may be good tracers of this process.
Background: MRI criteria are used to support multiple sclerosis diagnosis and evolution. However, normal age-related lesions (ARLs) can be cofounded with MS white matter lesion (MSL). Methods: Two Multiparametric 7T MRI scans 4 motnhs apart from 5 relapsing MS (RMS) patients were analyzed and compared to 5 matched healthy controls (HC) aiming to differentiate MSLs from ARLs. Six-echo GRE, FLAIR and MPRAGE sequences were acquired. Results: Average size of ARLs was 51 mm3 and of MSLs was 69 mm3 (p=0.27). Both have the same general appearance on FLAIR and MPRAGE contrasts, but different contrast on the R2* and QS maps. Inter-visit variation on MPRAGE was significantly higher in MSLs. Inter-visit signal change in the other contrasts (QSM, R2* and FLAIR) was not significant. Conclusions: R2*, QS maps and inter-visit variation using MPRAGE allowed differentiating MSLs from ARLs in 5 RMS with mean long term disease duration. This could improve correct early diagnosis and accurate lesion load accumulation evolution.
A new instrument for high-resolution optical logging has been built and tested in Antarctica. Its purpose is to obtain records of volcanic products and other scattering features, such as bubbles and impurities, preserved in polar ice sheets, and it achieves this by using long wavelength near-infrared light that is absorbed by the ice before many scattering events occur. Longer wavelengths ensure that the return signal is composed primarily of a single or few backscattering event(s) that limit its spatial spread. The compact optical logger features no components on its body that draw power, which minimizes its size and weight. A prototype of the logger was built and tested at Siple Dome A borehole, and the results were correlated with prior optical logging profiles and records of volcanic products from collected ice core samples.
Burns Weston, a member of the Board of Editors of this Journal from 1974 to 1999, and an Honorary Editor thereafter, died unexpectedly on October 28, 2015, late in his eighty-first year, in Iowa City, Iowa. All who knew him, as friend, colleague, student, or collaborator, marveled at his seemingly boundless energy and determination, his focused devotion to whatever project involved him, his deep intellect and flowing humor, his endless imagination for creating a better world, his talent at institution building, and his ongoing curiosity propelling a dedication to achieving progress in the human condition. His professional life featured an inexhaustible determination to use international law to protect human dignity around the world. His interests, expertise, and scholarship in international claims law, human rights law, environmental law, nuclear disarmament, and global governance in particular were surpassing in their consistent excellence, continuous push against familiar doctrinal parameters, and his rich profusion of published scholarship.
It is often assumed that some individuals reliably increase energy intake (EI) post-exercise (‘compensators’) and some do not (‘non-compensators’), leading researchers to examine the characteristics that distinguish these two groups. However, it is unclear whether EI post-exercise is stable over time. The present study examined whether compensatory eating responses to a single exercise bout are consistent within individuals across three pairs of trials. Physically inactive, overweight/obese women (n 28, BMI 30·3 (sd 2·9) kg/m2) participated in three pairs of testing sessions, with each pair consisting of an exercise (30 min of moderate-intensity walking) and resting testing day. EI was measured using a buffet meal 1 h post-exercise/rest. For each pair, the difference in EI (EIdiff= EIex− EIrest) was calculated, where EIex is the EI of the exercise session and EIrest is the EI of the resting session, and women were classified as a ‘compensator’ (EIex>EIrest) or ‘non-compensator’ (EIex≤ EIrest). The average EI on exercise days (3328·0 (sd 1686·2) kJ) was similar to those on resting days (3269·4 (sd 1582·4) kJ) (P= 0·67). Although EI was reliable within individuals across the three resting days (intraclass correlation coefficient (ICC) 0·75, 95 % CI 0·60, 0·87; P< 0·001) and three exercise days (ICC 0·83, 95 % CI 0·70, 0·91; P< 0·001), the ICC for EIdiff across the three pairs of trials was low (ICC 0·20, 95 % CI − 0·02, 0·45; P= 0·04), suggesting that compensatory eating post-exercise is not a stable construct. Moreover, the classification of ‘compensators’/‘non-compensators’ was not reliable (κ =− 0·048; P= 0·66). The results were unaltered when ‘relative’ EI was used, which considers the energy expenditure of the exercise/resting sessions. Acute compensatory EI following an exercise bout is not reliable in overweight women. Seeking to understand what distinguishes ‘compensators’ from ‘non-compensators’ based on a single eating episode post-exercise is not justified.
We investigated temporal trends in BMI, and assessed hypothesized predictors of trends including socio-economic position (SEP) and province-level economic development, in Argentina.
Using multivariable linear regression, we evaluated cross-sectional patterning and temporal trends in BMI and examined heterogeneity in these associations by SEP and province-level economic development with nationally representative samples from Argentina in 2005 and 2009. We calculated mean annual changes in BMI for men and women to assess secular trends.
Women, but not men, exhibited a strong cross-sectional inverse association between SEP and BMI, with the lowest-SEP women having an average BMI 2·55 kg/m2 greater than the highest-SEP women. Analysis of trends revealed a mean annual increase in BMI of 0·19 kg/m2 and 0·15 kg/m2 for women and men, respectively, with slightly greater increases occurring in provinces with greater economic growth. No significant heterogeneity in trends existed by individual SEP.
BMI is increasing rapidly over time in Argentina irrespective of various sociodemographic characteristics. Higher BMI remains more common in women of lower SEP compared with those of higher SEP.
A method has been devised and tested for measuring the c-axis orientation of crystal grains in thin sections of glacier ice. The crystal orientation and grain size of ice are of great interest to glaciologists since these parameters contain information on the prior thermal and flow history of the ice. The traditional method of determining c-axis orientation involves a transmission measurement through an ice sample, a process that is time-consuming and therefore impractical for obtaining a continuous record. A reflection- or backscatter-based method could potentially be used inside boreholes, with bubbles as reflectors to avoid such drawbacks. The concept demonstration of this paper is performed on ice slices, enabling a direct comparison of accuracy with traditional methods. Measurements of the crystal orientations (θ, ϕ) in 11 grains showed an average error of ±0.8° in ϕ, with no grain error >1.4°. Measurements of θ showed an average error of ±8.2° on ten grains, with unexplained disagreement on the remaining grain. Although the technique is applied specifically to glacier ice, it should be generally applicable to any transparent birefringent polycrystalline material.
The primary objective of this study was to quantify the impact of a clinical practice intervention to promote the delivery of salbutamol by metered-dose inhaler (MDI) in a pediatric emergency department (PED). A secondary objective was to retrospectively document the components of the intervention.
PED inventory data for salbutamol inhalation solution (nebules), MDIs, and holding chambers were obtained from the pharmacy department. Patient data were obtained fromthe hospital's decision support unit. Interrupted time series analysis was used to evaluate trends in salbutamol inventory data, patient triage acuity, and hospital admissions from January 1, 2003, to May 31, 2010. Interviews and administrative documents were used to identify components of the intervention, which began in 2006.
There was a 1,215% increase in the proportion of salbutamol delivered as MDIs compared to total inhaled salbutamol (MDI plus nebulization solution) following the intervention (95% CI 1,032% to 1,396%, p < 0.001). Increases in salbutamol MDI use were associated with the implementation of an institution-specific asthma care map. A relative decrease of 32% in the hospital admission rate (absolute –7.25%: 95% CI –8.31 to –6.19, p < 0.001) was associated with the change in salbutamol MDI use and the use of the asthma care map.
A multifaceted intervention, designed and implemented by local PED clinical leaders, resulted in a pronounced change in salbutamol inhalation practice, with an associated decrease in admission rates. This intervention demonstrated many of the criteria for successful health system change. Findings from this research may be contextualized to inform change elsewhere.
The formal commissioning of the IRWG occurred at the 1991 Buenos Aires General Assembly, following a Joint Commission meeting at the IAU GA in Baltimore in 1988 that identified the problems with ground-based infrared photometry. The meeting justification, papers, and conclusions, can be found in Milone (1989). In summary, the challenges involved how to explain the failure to achieve the milli-magnitude precision expected of infrared photometry and an apparent 3% limit on system transformability. The proposed solution was to redefine the broadband Johnson system, the passbands of which had proven so unsatisfactory that over time effectively different systems proliferated, although bearing the same “JHKLMNQ” designations; the new system needed to be better positioned and centered in the spectral windows of the Earth's atmosphere, and the variable water vapour content of the atmosphere needed to be measured in real time to better correct for atmospheric extinction.
The formal origin of the IRWG occured at the Buenos Aires General Assembly, following a Joint Commission meeting at the IAU GA in Baltimore in 1988 that identified the problems with ground-based infrared photometry. The situation is summarized in Milone (1989). In short, the challenges involved how to explain the failure to achieve the milli-magnitude precision expected of infrared photometry and an apparent 3% limit on system transformability. The proposed solution was to redefine the broadband Johnson system, the passbands of which had proven so unsatisfactory that over time effectively different systems proliferated, although bearing the same JHKLMNQ designations; the new system needed to be better positioned and centered in the atmospheric windows of the Earth's atmosphere, and the variable water vapour content of the atmosphere needed to be measured in real time to better correct for atmospheric extinction.
We describe constraints on grip points in reaching and lifting objects. Most objects afford a choice of points providing stable grip with thumb and index finger. We overview experiments showing how micro (surface texture determining friction) and macro (local shape for determining direction of the surface normal relative to interdigit force, and global shape for determining center of mass) geometric features affect precision grip. We summarize the roles of visual and haptic cues in selection of grip points and describe how planning takes account not only of the object but also the intended action in directing grasp to these points. We support our arguments with evidence taken from studies of normal and disordered motor behavior.
In characterizing the sensorimotor control of grasping, other chapters in this book have emphasized coordination between the hand, which shapes to and grasps the object, and the arm, which moves the hand to the object and lifts both hand and object through space (Jones & Lederman, 2006; see also Chapters 1, 11–13). Generally, the object concerned has been provided with vertical and parallel sides, the grasp has been a precision grip, and the goal of the action has been to maintain a stable grip so that the object neither translates nor rotates relative to the hand.
The spatial arrangement of population and economic activities is an important and complex dimension of Chinese economic development. Yet it is understudied, with Yuan-li Wu's (1967) classic work, The Spatial Economy of Communist China, standing as the last comprehensive analysis, which is now seriously outdated. This present chapter is not intended to be its update. Instead, we aim at a more modest goal: to examine two key aspects of changes the Chinese spatial economy has undergone in the past half century, with a focus on the last ten or fifteen years. These two changes are (a) the extensive urbanization that has occurred since the early 1980s, involving migration from rural areas to traditional cities and industrialization of the rural sector with growth of many townships into urban centers and expansion of existing cities and (b) the changing spatial inequalities across provinces, resulting from allocation of state investment and budgetary resources, distribution of foreign direct investment (FDI), and other pertinent factors. It is hoped that this chapter will help the reader to understand the enormous changes in the spatial configurations of the Chinese economy, how they are shaped by the institutional landscape and policies, and how they have impinged on economic development.
As a prelude to our subsequent discussion, it is useful at the outset to briefly highlight some critical economic thinking on the importance of the spatial dimension in the process of development.
Although the importance of accuracy in describing primary data cannot be overemphasized, this is only one of the steps in gathering data that are needed to interpret an assemblage. The ultimate goal is to relate animal remains to the other materials from the specific site and to other sites so that larger cultural and biological inferences can be made (Schmid 1972:7; Smith 1976). To make these larger inferences, it is often necessary to derive secondary data by estimating relative proportions or specific indices from the primary data. Secondary data, by their nature, are less descriptive and more subjective than primary data. Secondary data, often derived from primary data mathematically, summarize many primary observations and require explanation and interpretation. Disagreements about all aspects of secondary data are numerous.
The secondary data reviewed in this chapter are: estimates of body dimensions, construction of age classes and sex ratios, relative frequencies of taxa, skeletal frequencies, estimates of dietary contributions; modifications, and niche breadth. These are clearly interrelated and can be interpreted in terms of many different research questions either together or alone. Methods for deriving secondary data often are developed to pursue a specific research problem and may not be widely applied. Regional zooarchaeological traditions and the frequency with which specific methods appear in the literature are strongly correlated. The methods for deriving secondary data surveyed in this chapter are widely used and have broad applications.