Power Station Foundations in Deep Expansive Soil

The site for a large (3600 MW) thermal power station is underlain by deep expansive soils which posed difficult conditions for the design of stable foundations. After describing the soil and ground-water conditions and attendant foundation problems, the paper goes on to describe how the amount and rate of heave were predicted. Most of the foundations are piled, but the piles will be subject to uplift as the soil swells. Large scale tests to acquire information for the prediction of uplift forces are described, as well as measures for reducing the uplift forces

Use of an Inner-city Well-baby Clinic

This prospective, longitudinal investigation examined factors that influenced the use of well-baby services among a low-income, minority, high-risk group. The health belief model was used as the theoretical framework. Data were collected from 44 primiparous, black mothers attending an urban maternal child health care clinic by interviews at the first and sixth months after the birth of their infants. Analysis focused on the cues component of the model and explored the kinds of cues that influenced the mothers to bring their babies to the well-baby clinic. One important finding was that for mothers influenced by health information from radio or television, FYI commercials on television were most often reported.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/72805/1/j.1525-1446.1987.tb00535.x.pd

Clinical outcomes in pediatric hemodialysis patients in the USA: lessons from CMS’ ESRD CPM Project

Although prospective randomized trials have provided important information and allowed the development of evidence-based guidelines in adult hemodialysis (HD) patients, with approximately 800 prevalent pediatric HD patients in the United States, such studies are difficult to perform in this population. Observational data obtained through the Center for Medicare & Medicaid Services’ (CMS’) End Stage Renal Disease (ESRD) Clinical Performance Measures (CPM) Project have allowed description of the clinical care provided to pediatric HD patients as well as identification of risk factors for failure to reach adult targets for clinical parameters such as hemoglobin, single-pool Kt/V (spKt/V) and serum albumin. In addition, studies linking data from the ESRD CPM Project and the United States Renal Data System have allowed evaluation of associations between achievement of those targets and the outcomes of hospitalization and death. The results of those studies, while unable to prove cause and effect, suggest that the adult ESRD CPM targets may assist in identifying pediatric HD patients at risk for poor outcomes

Molecular brakes regulating mTORC1 activation in skeletal muscle following synergist ablation

The goal of the current work was to profile positive (mTORC1 activation, autocrine/paracrine growth factors) and negative [AMPK, unfolded protein response (UPR)] pathways that might regulate overload-induced mTORC1 (mTOR complex 1) activation with the hypothesis that a number of negative regulators of mTORC1 will be engaged during a supraphysiological model of hypertrophy. To achieve this, mTORC1- IRS-1/2 signaling, BiP/CHOP/IRE1, and AMPK activation were determined in rat plantaris muscle following synergist ablation (SA). SA resulted in significant increases in muscle mass of 4% per day throughout the 21 days of the experiment. The expression of the insulin-like growth factors (IGF) were high throughout the 21st day of overload. However, IGF signaling was limited, since IRS-1 and -2 were undetectable in the overloaded muscle from day 3 to day 9. The decreases in IRS-1/2 protein were paralleled by increases in GRB10 Ser501/503 and S6K1 Thr389 phosphorylation, two mTORC1 targets that can destabilize IRS proteins. PKB Ser473 phosphorylation was higher from 3– 6 days, and this was associated with increased TSC2 Thr939 phosphorylation. The phosphorylation of TSC2 Thr1345 (an AMPK site) was also elevated, whereas phosphorylation at the other PKB site, Thr1462, was unchanged at 6 days. In agreement with the phosphorylation of Thr1345, SA led to activation of AMPK1 during the initial growth phase, lasting the first 9 days before returning to baseline by day 12. The UPR markers CHOP and BiP were elevated over the first 12 days following ablation, whereas IRE1 levels decreased. These data suggest that during supraphysiological muscle loading at least three potential molecular brakes engage to downregulate mTORC1. m

Primary care physicians' perceptions of barriers and facilitators to management of chronic kidney disease: A mixed methods study.

BackgroundGiven the high prevalence of chronic kidney disease (CKD), primary care physicians (PCPs) frequently manage early stage CKD. Nonetheless, there are challenges in providing optimal CKD care in the primary care setting. This study sought to understand PCPs' perceptions of barriers and facilitators to the optimal management of CKD.Study designMixed methods study.Settings and participantsCommunity-based PCPs in four US cities: Baltimore, MD; St. Louis, MO; Raleigh, NC and San Francisco, CA.MethodologyWe used a self-administered questionnaire and conducted 4 focus groups of PCPs (n = 8 PCPs/focus group) in each city to identify key barriers and facilitators to management of patients with CKD in primary care.Analytic approachWe conducted descriptive analyses of the survey data. Major themes were identified from audio-recorded interviews that were transcribed and coded by the research team.ResultsOf 32 participating PCPs, 31 (97%) had been in practice for >10 years, and 29 (91%) practiced in a non-academic setting. PCPs identified multiple barriers to managing CKD in primary care including at the level of the patient (e.g., low awareness of CKD, poor adherence to treatment recommendations), the provider (e.g., staying current with CKD guidelines), and the health care system (e.g., inflexible electronic medical record, limited time and resources). PCPs desired electronic prompts and lab decision support, concise guidelines, and healthcare financing reform to improve CKD care.ConclusionsPCPs face substantial but modifiable barriers in providing care to patients with CKD. Interventions that address these barriers and promote facilitative tools may improve PCPs' effectiveness and capacity to care for patients with CKD

When the working day is through: The end of work as identity?

This article seeks to present a counter-case to the ‘end of work thesis’ advocated by writers such as Beck, Sennett and Bauman. It argues that work remains a significant locus of personal identity and that the depiction by these writers of endemic insecurity in the workplace is inaccurate and lacks empirical basis. The article draws upon case study data to illustrate how, across a range of workplaces, work remains an importance source of identity, meaning and social affiliation

Playing safe: Assessing the risk of sexual abuse to elite child athletes

Young athletes frequently suffer from being seen as athletes first and children second. This has consequences for their legal, civil and human rights as children (Kelly et al., 1995) and for the way in which sport organisations choose to intervene on their behalf to protect them from physical, psychological and sexual abuses (Brackenridge, 1994). Sport careers peak at different ages depending on the sport: in some, children as young as 12 or 13 may reach the highest levels of competitive performance; in others, full maturity as an athlete may come late into adulthood or even middle age. Recognition of this variation has given rise to the concept of ‘sport age’ (Kirby, 1986) referring to sport-specific athlete development. This concept is of significance in helping to identify the developmental process in terms of athletic, rather than chronological, maturity. The risk of sexual abuse in sport, formerly ignored or denied, has now been documented in a number of studies, using both quantitative and qualitative methods (Kirby & Greaves, 1996; Brackenridge, 1997; Volkwein, 1996). Drawing on data from these studies and from the previous work on sport age and athletic maturation, this paper proposes a possible means of identifying and assessing relative risk of sexual abuse to elite young athletes in selected sports. The concept of a ‘stage of imminent achievement’ (SIA) is proposed as the period of peak vulnerability of young athletes to sexual abuse

A Golf Programme for People with Severe and Enduring Mental Health Problems

This article reports a pioneering golf programme for people with severe and enduring mental health problems. Following a discussion of the problems and possibilities of golf as a form of physical activity for this group, we outline the structure, organisation, and ethos of the golf programme. Through an analysis of qualitative case study data collected during the programme, we discuss the response to the programme from service users and mental health professionals. We conclude by highlighting aspects of the programme which were critical to its success and offering suggestions for further initiatives in this area

What explains the uneven take-up of ISO 14001 at the global level?: a panel-data analysis

Since its release in the mid-1990s, close to 37 000 facilities have been certified to ISO 14001, the international voluntary standard for environmental management systems. Yet, despite claims that the standard can be readily adapted to very different corporate and geographic settings, its take-up has been highly geographically variable. This paper contributes to a growing body of work concerned with explaining the uneven diffusion of ISO 14001 at the global level. Drawing from the existing theoretical and empirical literature we develop a series of hypotheses about how various economic, market, and regulatory factors influence the national count of ISO 14001 certifications. These hypotheses are then tested using econometric estimation techniques with data for a panel of 142 developed and developing countries. We find that per capita ISO 14001 counts are positively correlated with income per capita, stock of foreign direct investment, exports of goods and services to Europe and Japan, and pressure from civil society. Conversely, productivity and levels of state intervention are negatively correlated. The paper finishes by offering a number of recommendations to policymakers concerned with accelerating the diffusion of voluntary environmental standards