Alien Registration- Willette, Pauline (Fort Fairfield, Aroostook County)

https://digitalmaine.com/alien_docs/24587/thumbnail.jp

Post-war developments in music education : an investigation of music education policy and practice, as implemented within three local education authorities during the period, 1944-1988

In recent times there has been a resurgence of interest in the history of music\ud education, which has opened up new opportunities for the re-interpretation of\ud both established and changing philosophies, pedagogies and practices. Historical\ud research into music services within LEAs is still a fertile area for investigation.\ud This thesis brings new arguments and evidence to bear upon an under-researched\ud and emerging area of study.\ud The focus of this particular investigation emerged from the author’s earlier\ud research into the history of the Inner London Education Authority (ILEA) music\ud service, the findings of which revealed three interrelated factors underpinning its\ud development: funding and commitment, strong leadership, and the ‘London’\ud factor. These earlier research findings prompted further questions leading to the\ud conception of the rationale and focus for this thesis. The first was to ask if\ud government reports, and the ensuing initiatives they fuelled, had led to other\ud LEAs developing their approaches to state music education in similar or parallel\ud ways and at similar rates, and the second was to examine the role that individuals\ud played in steering the direction of music education within the different\ud authorities.\ud Empirical research has provided an overview of the developments in England\ud within three separate demographically contrasting LEAs: Leicestershire, London\ud and Manchester, which in turn represent a large rural county, the capital city, and\ud a relatively large northern industrial city. During the period of the chosen time\ud frame of this study the LEAs, and those appointed to lead them, were at their\ud most powerful and influential, but, from the mid-1970s onwards, their autonomy\ud gradually declined as education became more centralised through government\ud intervention, resulting in loss of power and the consequent sidelining of their\ud role, a situation which impacted significantly on state provision for music. This\ud thesis examines the consequences of the effects of decision making, by\ud organisations, and their individual interpretation, on music education thinking\ud and practice.\u

Assay of empagliflozin tablets by a stability-indicating micellar electrokinetic chromatography method and cytotoxicity study of degraded samples

The first method by micellar electrokinetic chromatography (MEKC) for the determination of empagliflozin in tablets was developed and validated following the ICH guidelines. The separation was achieved in a fused silica capillary with 50 µm x 40 cm (inner diameter x effective length) at 28 ºC, +28 kV voltage, hydrodynamic injection 4s (50 mBar), detection at 225 nm and paracetamol was the internal standard. The running electrolyte was a mixture of 20 mM tris(hydroxymethyl) aminomethane (pH 10) and 100 mM sodium dodecyl sulphate (1:1). Specificity was evaluated by the stress testing and the method was specific, with no interference of the degradation product. Linearity was observed in the range of 50 to 150 μg/mL (r=0.9999). The method showed adequate accuracy (recovery value=100.60±0.60%), precision (RSD values <2%) and robustness, which was evaluated by a full factorial design 23. Drug degradation kinetics was evaluated in alkaline andacidic conditions and first-order kinetic was observed in both conditions. The cytotoxicity of sample solutions degraded by UVA and UVC radiation, alkaline and acid media were studied as well. A similar cellular viability profile was observed with a slight decrease only in samples degraded by UVC radiation and basic medium

Practice Coaching model to embed the culture of enhanced recovery: a service evaluation

Poster presented at 'The Future Nurse: enriching people's experience of care' University of Exeter Academy of Nursing, RD&E Hospital, 3rd October 2019

Pessaries (mechanical devices) for managing pelvic organ prolapse in women

Background Pelvic organ prolapse is a common problem in women. About 40% of women will experience prolapse in their lifetime, with the proportion expected to rise in line with an ageing population. Women experience a variety of troublesome symptoms as a consequence of prolapse, including a feeling of 'something coming down' into the vagina, pain, urinary symptoms, bowel symptoms and sexual difficulties. Treatment for prolapse includes surgery, pelvic floor muscle training (PFMT) and vaginal pessaries. Vaginal pessaries are passive mechanical devices designed to support the vagina and hold the prolapsed organs back in the anatomically correct position. The most commonly used pessaries are made from polyvinyl‐chloride, polythene, silicone or latex. Pessaries are frequently used by clinicians with high numbers of clinicians offering a pessary as first‐line treatment for prolapse. This is an update of a Cochrane Review first published in 2003 and last published in 2013. Objectives To assess the effects of pessaries (mechanical devices) for managing pelvic organ prolapse in women; and summarise the principal findings of relevant economic evaluations of this intervention. Search methods We searched the Cochrane Incontinence Specialised Register which contains trials identified from the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, MEDLINE In‐Process, MEDLINE Epub Ahead of Print, ClinicalTrials.gov, WHO ICTRP and handsearching of journals and conference proceedings (searched 28 January 2020). We searched the reference lists of relevant articles and contacted the authors of included studies. Selection criteria We included randomised and quasi‐randomised controlled trials which included a pessary for pelvic organ prolapse in at least one arm of the study. Data collection and analysis Two review authors independently assessed abstracts, extracted data, assessed risk of bias and carried out GRADE assessments with arbitration from a third review author if necessary. Main results We included four studies involving a total of 478 women with various stages of prolapse, all of which took place in high‐income countries. In one trial, only six of the 113 recruited women consented to random assignment to an intervention and no data are available for those six women. We could not perform any meta‐analysis because each of the trials addressed a different comparison. None of the trials reported data about perceived resolution of prolapse symptoms or about psychological outcome measures. All studies reported data about perceived improvement of prolapse symptoms. Generally, the trials were at high risk of performance bias, due to lack of blinding, and low risk of selection bias. We downgraded the certainty of evidence for imprecision resulting from the low numbers of women participating in the trials. Pessary versus no treatment: at 12 months' follow‐up, we are uncertain about the effect of pessaries compared with no treatment on perceived improvement of prolapse symptoms (mean difference (MD) in questionnaire scores ‐0.03, 95% confidence interval (CI) ‐0.61 to 0.55; 27 women; 1 study; very low‐certainty evidence), and cure or improvement of sexual problems (MD ‐0.29, 95% CI ‐1.67 to 1.09; 27 women; 1 study; very low‐certainty evidence). In this comparison we did not find any evidence relating to prolapse‐specific quality of life or to the number of women experiencing adverse events (abnormal vaginal bleeding or de novo voiding difficulty). Pessary versus pelvic floor muscle training (PFMT): at 12 months' follow‐up, we are uncertain if there is a difference between pessaries and PFMT in terms of women's perceived improvement in prolapse symptoms (MD ‐9.60, 95% CI ‐22.53 to 3.33; 137 women; low‐certainty evidence), prolapse‐specific quality of life (MD ‐3.30, 95% CI ‐8.70 to 15.30; 1 study; 116 women; low‐certainty evidence), or cure or improvement of sexual problems (MD ‐2.30, 95% ‐5.20 to 0.60; 1 study; 48 women; low‐certainty evidence). Pessaries may result in a large increase in risk of adverse events compared with PFMT (RR 75.25, 95% CI 4.70 to 1205.45; 1 study; 97 women; low‐certainty evidence). Adverse events included increased vaginal discharge, and/or increased urinary incontinence and/or erosion or irritation of the vaginal walls. Pessary plus PFMT versus PFMT alone: at 12 months' follow‐up, pessary plus PFMT probably leads to more women perceiving improvement in their prolapse symptoms compared with PFMT alone (RR 2.15, 95% CI 1.58 to 2.94; 1 study; 260 women; moderate‐certainty evidence). At 12 months' follow‐up, pessary plus PFMT probably improves women's prolapse‐specific quality of life compared with PFMT alone (median (interquartile range (IQR)) POPIQ score: pessary plus PFMT 0.3 (0 to 22.2); 132 women; PFMT only 8.9 (0 to 64.9); 128 women; P = 0.02; moderate‐certainty evidence). Pessary plus PFMT may slightly increase the risk of abnormal vaginal bleeding compared with PFMT alone (RR 2.18, 95% CI 0.69 to 6.91; 1 study; 260 women; low‐certainty evidence). The evidence is uncertain if pessary plus PFMT has any effect on the risk of de novo voiding difficulty compared with PFMT alone (RR 1.32, 95% CI 0.54 to 3.19; 1 study; 189 women; low‐certainty evidence). Authors' conclusions We are uncertain if pessaries improve pelvic organ prolapse symptoms for women compared with no treatment or PFMT but pessaries in addition to PFMT probably improve women's pelvic organ prolapse symptoms and prolapse‐specific quality of life. However, there may be an increased risk of adverse events with pessaries compared to PFMT. Future trials should recruit adequate numbers of women and measure clinically important outcomes such as prolapse specific quality of life and resolution of prolapse symptoms. The review found two relevant economic evaluations. Of these, one assessed the cost‐effectiveness of pessary treatment, expectant management and surgical procedures, and the other compared pessary treatment to PFMT

Going for GOLD! Greater Manchester Growing Older with Learning Disabilities: An inclusive research project to reduce social isolation amongst older adults with learning disabilities

This research was part of the Greater Manchester Growing Older with Learning Disabilities (GM GOLD) project, which was carried out by a team of 16 older people with learning disabilities. The aim was to reduce social isolation amongst older adults (aged 50+) with learning disabilities and to find out what makes somewhere an age-friendly place to live for older adults with learning disabilities. The team was supported by 'research buddies' from Manchester Metropolitan University and the partner organisations to conduct interviews and focus groups with 59 older people (aged 50-79 years) with learning disabilities from eight Greater Manchester areas (Bolton, Bury, Manchester, Oldham, Rochdale, Salford, Tameside, Wigan). Later life transitions for people with learning disabilities are particularly disruptive, and they are at particular risk of social isolation and loneliness. People with learning disabilities have the same rights to relationships and to participate in the cultural life of the community as the rest of society. If society, neighbourhoods and communities do not become more inclusive of people with learning disabilities, in addition to the legal, moral and ethical implications, this is likely to result in additional demand for public services

Worldwide Dissemination of the blaOXA-23 Carbapenemase Gene of Acinetobacter baumannii1

Controlling the spread of this gene will be difficult

Impact of Rosuvastatin Treatment on HDL-Induced PKC- β

Background. Endothelial function is impaired in chronic heart failure (CHF). Statins upregulate endothelial NO synthase (eNOS) and improve endothelial function. Recent studies demonstrated that HDL stimulates NO production due to eNOS phosphorylation at Ser1177, dephosphorylation at Thr495, and diminished phosphorylation of PKC-βII at Ser660. The aim of this study was to elucidate the impact of rosuvastatin on HDL mediated eNOS and PKC-βII phosphorylation and its relation to endothelial function. Methods. 18 CHF patients were randomized to 12 weeks of rosuvastatin or placebo. At baseline, 12 weeks, and 4 weeks after treatment cessation we determined lipid levels and isolated HDL. Human aortic endothelial cells (HAEC) were incubated with isolated HDL and phosphorylation of eNOS and PKC-βII was evaluated. Flow-mediated dilatation (FMD) was measured at the radial artery. Results. Rosuvastatin improved FMD significantly. This effect was blunted after treatment cessation. LDL plasma levels were reduced after rosuvastatin treatment whereas drug withdrawal resulted in significant increase. HDL levels remained unaffected. Incubation of HAEC with HDL had no impact on phosphorylation of eNOS or PKC-βII. Conclusion. HDL mediated eNOS and PKC-βII phosphorylation levels in endothelial cells do not change with rosuvastatin in CHF patients and do not mediate the marked improvement in endothelial function

The different roles of ‘design process champions’ for digital libraries in African higher education

The concept of design stakeholders is central to effective design of digital libraries. We report on research findings that identified the presence of a key subset of stakeholders which we term ‘design process champions’. Our findings have identified that these champions can change interaction patterns and the eventual output of the other stakeholders (project participants) in the design process of digital library projects. This empirical research is based upon 38 interviews with key stakeholders and a review of documentary evidence in ten innovative digital library design projects (e.g. mobile clinical libraries) located in three African universities in Kenya, Uganda and South Africa. Through a grounded theory approach two different types of the ‘design process champions’ emerged from the data with varying levels of effectiveness in the design process: (i) domain champions and (ii) multidisciplinary champions. The domain champions assume a ‘siloed’ approach of engagement while the multidisciplinary champions take on a participatory engagement throughout the design process. A discussion of the implications of information specialists functioning as domain champions is highlighted. We conclude by suggesting that the multidisciplinary champions’ approach is particularly useful in supporting sustainability of digital library design projects