Easy Breathing for Elementary School Children with Asthma at Dayton Public Schools

Approximately 8.4% or 6.4 million children are diagnosed with asthma in the United States. Asthma is a chronic and life threatening disease that cannot be cured but only managed. Asthma is also one of the most expensive conditions to manage, requiring direct health care services if not adequately controlled. Asthma symptoms and exacerbations are also the number one reason for school absences among children. The PICOT question that guided the review of the literature to answer the clinical question was: In children with asthma, how does a school-based self-management asthma education program compared to standard management affect school absences and unscheduled asthma health care visits over a 12-month period? The purpose of this evidenced-based practice project was to provide asthma education at school for children with asthma to improve asthma self-management skills and decrease asthma symptoms that lead to emergency room visits, hospital admissions, and school absences. Students enrolled in grades two through five identified with either parent reported or physician diagnosed asthma were asked by the school nurse to participate in the Open Airways for Schools asthma education program held at school once per week for five weeks taught by trained student nurses. Parents signed a consent form for the child to participate in the Open Airway for Schools program and were asked to complete a questionnaire about their child’s asthma. Childhood Asthma Control Tests (cACT) were administered to students and parents at the start of the program and then 4 weeks after the program. Students with rescue inhalers at school completed a Rescue Inhaler Skills Checklist (RISC) before the inhaler lesson in the Open Airways for Schools program and 4 weeks after the program was finished. School nurses and student nurses followed up with and encouraged students, parents, and outside health care providers to provide rescue inhalers and asthma action plans. An ANOVA was conducted on the cACT pre and post summary mean scores revealed no significant difference, F(1, 36)=1.34, p = 0.26; however, an ANOVA performed on the RISC pre and post summary mean scores revealed a significant difference, F(1, 27)=7.88, p = 0.009. Pre and post cACT summary mean scores at the individual school level suggested improvement among three of the seven schools; while, four of the seven schools noted improvement between the pre and post RISC summary mean scores. An ANCOVA further analyzed the covariates of grade, school, sex, ethnicity and number of sessions attended for cACT and RISC scores; significance was found in the difference of the cACT scores, F(1, 31)=4.910, p = 0.034; but the RISC scores found no difference, F(1, 22)=.0007, p = 0.933 with all covariates; at the individual school level significance was found, F(1, 26)=6.82, p=0.016. School absenteeism increased during the intervention, and emergency department visits and hospital admissions were insignificant. Limited time frame for tracking outcome data related to absences, emergency department visits, and hospital admissions, low return rates on Childhood Asthma Control Tests and rescue inhalers were limiting factors of this project. Nevertheless, self-management asthma education programs have the potential to improve asthma symptoms that impact everyday life. Properly controlled asthma is associated with less asthma symptoms, emergency department visits, and hospital admissions which have the potential to decrease overall economic expenditures for health care expenses, missed school for students and missed work for parents

Communicating strategically – talking less, targeting better Qualitative study on corporate communication’s learning in leading global companies

Companies need to communicate strategically in order to maintain dialogue and relationships with their stakeholders. In the crowded media and social media space the messages disappear in the noise generated by multiple actors. Therefore, to be heard the enterprises need to consider their communication strategically. It is not about the amount of information; it is about right targeting and usage of the right tools and channels. Social media allowed the companies to communicate directly with their stakeholders and customers. Different channels can address different stakeholders. This study focuses on a qualitative assessment of the learning patterns and profiles among 60 world leading companies. It includes enterprises from different countries and industries but with international scope of operations. The study proposes a maturity model for corporate communications strategic management

Two-channel Kondo physics due to As vacancies in the layered compound ZrAs1.58Se0.39

We address the origin of the magnetic-field independent -|A| T^{1/2} term observed in the low-temperature resistivity of several As-based metallic systems of the PbFCl structure type. For the layered compound ZrAs_{1.58}Se_{0.39}, we show that vacancies in the square nets of As give rise to the low-temperature transport anomaly over a wide temperature regime of almost two decades in temperature. This low-temperature behavior is in line with the non-magnetic version of the two-channel Kondo effect, whose origin we ascribe to a dynamic Jahn-Teller effect operating at the vacancy-carrying As layer with a C_4 symmetry. The pair-breaking nature of the dynamical defects in the square nets of As explains the low superconducting transition temperature T_{\rm{c}}\approx 0.14 K of ZrAs_{1.58}Se_{0.39}, as compared to the free-of-vacancies homologue ZrP_{1.54}S_{0.46} (T_{\rm{c}}\approx 3.7 K). Our findings should be relevant to a wide class of metals with disordered pnictogen layers.Comment: 17 pages, 8 figures; submitte

Modified PZT ceramics as a material that can be used in micromechatronics

Results on investigations of the PZT type ceramics with the following chemical composition: Pb0.94Sr0.06(Zr0.50 Ti0.50)0.99 Cr0.01O3 (PSZTC) which belongs to a group of multicomponent ceramic materials obtained on basis of the PZT type solid solution, are presented in this work. Ceramics PSZTC was obtained by a free sintering method under the following conditions: T sint = 1250 °C and t sint = 2 h. Ceramic compacts of specimens for the sintering process were made from the ceramic mass consisting of a mixture of the synthesized PSZTC powder and 3% polyvinyl alcohol while wet. The PSZTC ceramic specimens were subjected to poling by two methods: low temperature and high temperature. On the basis of the examinations made it has been found that the ceramics obtained belongs to ferroelectric-hard materials and that is why it may be used to build resonators, filters and ultrasonic transducers

An integrated DC-DC step-up charge pump and step-down converter in 130 nm technology

After the LHC luminosity upgrade the number of readout channels in the ATLAS Inner Detector will be increased by one order of magnitude and delivering the power to the front-end electronics as well as cooling will become a critical system issue. Therefore a new solution for powering the readout electronics has to be worked out. Two main approaches for the power distribution are under development, the serial powering of a chain of modules and the parallel powering with a DCDC conversion stage on the detector. In both cases switchedcapacitor converters in the CMOS front-end chips will be used. In the paper we present the design study of a step-up charge pump and a step-down converter. In optimized designs power efficiency of 85 % for the step-up converter and 92 % for the step-down converter has been achieved

X-ray Emission from SN 2012ca: A Type Ia-CSM Supernova Explosion in a Dense Surrounding Medium

X-ray emission is one of the signposts of circumstellar interaction in supernovae (SNe), but until now, it has been observed only in core-collapse SNe. The level of thermal X-ray emission is a direct measure of the density of the circumstellar medium (CSM), and the absence of X-ray emission from Type Ia SNe has been interpreted as a sign of a very low density CSM. In this paper, we report late-time (500--800 days after discovery) X-ray detections of SN 2012ca in {\it Chandra} data. The presence of hydrogen in the initial spectrum led to a classification of Type Ia-CSM, ostensibly making it the first SN~Ia detected with X-rays. Our analysis of the X-ray data favors an asymmetric medium, with a high-density component which supplies the X-ray emission. The data suggest a number density $> 10^8$ cm$^{-3}$ in the higher-density medium, which is consistent with the large observed Balmer decrement if it arises from collisional excitation. This is high compared to most core-collapse SNe, but it may be consistent with densities suggested for some Type IIn or superluminous SNe. If SN 2012ca is a thermonuclear SN, the large CSM density could imply clumps in the wind, or a dense torus or disk, consistent with the single-degenerate channel. A remote possibility for a core-degenerate channel involves a white dwarf merging with the degenerate core of an asymptotic giant branch star shortly before the explosion, leading to a common envelope around the SN.Comment: 11 pages, 4 figures. Accepted to MNRA

Multicomponent ceramic materials on the basis of PZT for the production of piezoelectric resonators

Investigations on the influence of the PbTiO3 content on the crystalline and domain structure of PZT-based four-component solid solutions have been performed. It has been shown that there is a close relation between the structure and temperature stability of the resonance frequency (fr) of the fabricated piezoceramic transducers. Better and more stable results have been obtained by doping and modifying the basic chemical composition obtaining Pb(Zr1¡xTix)O3. The compositions with minimal ¢fr=fr, within the temperature range T = 213–358 K (in relation to room temperature Tr = 293 K), exhibited (i) the smallest internal friction (Q¡1 m ), (ii) the highest mechanical quality (Qm), (iii) high values of spontaneous deformation of the elementary cell (±T and ±Re), (iv) the complex a-c-domain structure in the tetragonal phase (T) and the simple domain structure in the rhombohedral phase (Re). The practical result of the present work was the fabrication of piezoceramic electric band filters exhibiting ¢fr=fr < 0:2% and a high mechanical quality factor (Qm = 3225)

A Modelling Study of the Influence of Environment and Food Supply on Survival of Crassostrea gigas Larvae

A biochemically based model was developed to simulate the growth, development, and metamorphosis of larvae of the Pacific oyster (Crassostrea gigas). The unique characteristics of the model are that it: (1) defines larvae in terms of their protein, neutral lipid, polar lipid, carbohydrate, and ash content; (2) tracks weight separately from length to follow larval condition; and (3) includes genetic variation in growth efficiency and egg quality to better simulate cohort population dynamics. The model includes parameterizations for filtration, ingestion, and respiration, which determine larval growth rate, and processes controlling larval mortality and metamorphosis. Changes in larval tissue composition occur as the larva grows and in response to the biochemical composition of the food. Simulations of larval growth indicate that departures of temperature, salinity, or food content from optimum levels reduce larval cohort survival, either because of metabolic constraints that result in death, unsuccessful metamorphosis, or increased predation resulting from increased larval lifespan. Temperatures and salinities near optimal values improve larval survival at low food concentration by increasing ingestion rate or growth efficiency. Also, survival at a given food concentration can vary widely depending on food composition, which determines food quality. The simulations suggest that the ratio of carbohydrate + lipid-to-protein may best describe the overall food quality, with optimal food compositions being characterized by ratios near 1.2 to 1.4 over a range of food concentrations. In contrast, food compositions containing too much or too little protein reduce larval survival, even at saturating food concentrations. In simulations emphasizing genetic variability within the cohort, larvae with high growth efficiency originating from large eggs out-perform other egg quality-growth efficiency combinations over a wide range of temperature, salinity, and food contents. As a consequence, suboptimal temperature, salinity, or food content compresses genetic variation by uniformly favouring larvae from large eggs with a high growth efficiency. However, the larval survival obtained from simulations that use a range of food qualities is representative of a much broader range of genetic types. Thus, the simulations support the supposition that food quality is an important variable controlling the survival and genetic variability of C. gigas larval cohorts. (C) 2004 International Council for the Exploration of the Sea. Published by Elsevier Ltd. All rights reserved