Executive Function: What It Is and How It Affects Reading Comprehension

Executive function is a very key component of development. Awareness of executive function has become more prominent in education. Research has been able to determine how the executive function develops in children versus adults. Specific areas of executive function have been identified. When the area was identified and how they influence behavior, interventions and strategies could be developed to counter the deficit. In the education world, assessing students with the purpose of identifying the deficits was difficult. Administering assessment naturally took care of the need for EF skills. New assessments needed to be developed. Companies have made those developments. Affective interventions for executive function have been developed. They are successfully implemented. Affective interventions for reading deficits have been successful. Data has been collected on both individually. Research needs to combine the interventions on both working together

Orbiter windward surface entry Heating: Post-orbital flight test program update

Correlations of orbiter windward surface entry heating data from the first five flights are presented with emphasis on boundary layer transition and the effects of catalytic recombination. Results show that a single roughness boundary layer transition correlation developed for spherical element trips works well for the orbiter tile system. Also, an engineering approach for predicting heating in nonequilibrium flow conditions shows good agreement with the flight test data in the time period of significant heating. The results of these correlations, when used to predict orbiter heating for a high cross mission, indicate that the thermal protection system on the windward surface will perform successfully in such a mission

For People Over the Age 65, Does the Use of Cloth Face Masks Help Lower the Transmission of COVID-19 Compared With the Use of Gaiter Masks?

The COVID19 pandemic has generated rumors and conspiracy theories: -Origin of the virus, its modes of transmission, the options for preventing and treating it, and the actions governments have taken (Vraga & Jacobsen, 2020). Which is more effective: cloth face masks or neck gaiters. Gaiter masks fit very loosely around the mouth and nose. According to Massachusetts Institute of Technology, your mask should fully cover your nose and chin: preventing breathing in any droplets (Schive, 2020). Masks need to be tightly woven; you cannot see the individual fibers when holding it up to the light (Schive, 2020). Masks should be at least two layers thick. A third layer adds extra protection (Schive, 2020). Cloth masks can spread droplets up to 2.5 inches (Woehnker, 2020). As predicted, cloth face masks have shown to be more effective in slowing transmissio

Examination of sex as an independent risk factor for adverse events after carotid endarterectomy

BackgroundThe incidence of adverse events after carotid endarterectomy (CEA) for women compared with men is controversial. This report compares the incidence of perioperative stroke and death in men and women by examining the effect of comorbidities and hospital setting on CEA outcomes.MethodsAll CEAs performed in non-Federal acute-care Virginia hospitals between 1997 and 2001 were reviewed. Patient demographics, comorbidities, and hospital characteristics were compared for possible relationships to perioperative adverse events.ResultsA total of 14,095 CEAs were performed in 34 urban and 28 rural hospitals (9 high-volume and 53 low-volume hospitals); 42% were performed on women, and 58% were performed on men. Women experienced a significantly higher stroke rate (1.23%) than men (0.87%; P = .04) with bivariate analysis. However, logistic regression analysis of comorbidities and hospital settings demonstrated that sex was actually not independently related to adverse outcomes in CEA (P = .08). Preoperative neurologic symptoms could not be evaluated as risk factors for adverse events. Acute coronary ischemia, history of arrhythmia, end-stage renal disease, nonwhite race, advanced age, and low hospital volume were all significantly related to mortality. History of arrhythmia was the only factor that was significantly related to the incidence of stroke.ConclusionsLogistic regression analysis of comorbidities and hospital setting indicated that female sex is not independently associated with higher mortality or a higher stroke rate during CEA. These data indicate that patients with carotid stenosis frequently have multiple medical problems that need to be carefully examined and controlled before any single patient or hospital factor is designated as significantly related to adverse outcomes

Sex differences in national rates of repair of emergency abdominal aortic aneurysm

Background The aim of this study was to assess the sex differences in both the rate and type of repair for emergency abdominal aortic aneurysm (AAA) in England. Methods Hospital Episode Statistics (HES) data sets from April 2002 to February 2015 were obtained. Clinical and administrative codes were used to identify patients who underwent primary emergency definitive repair of ruptured or intact AAA, and patients with a diagnosis of AAA who died in hospital without repair. These three groups included all patients with a primary AAA who presented as an emergency. Sex differences between repair rates and type of surgery (endovascular aneurysm repair (EVAR) versus open repair) over time were examined. Results In total, 15 717 patients (83·3 per cent men) received emergency surgical intervention for ruptured AAA and 10 276 (81·2 per cent men) for intact AAA; 12 767 (62·0 per cent men) died in hospital without attempted repair. The unadjusted odds ratio for no repair in women versus men was 2·88 (95 per cent c.i. 2·75 to 3·02). Women undergoing repair of ruptured AAA were older and had a higher in‐hospital mortality rate (50·0 versus 41·0 per cent for open repair; 30·9 versus 23·5 per cent for EVAR). After adjustment for age, deprivation and co‐morbidities, the odds ratio for no repair in women versus men was 1·34 (1·28 to 1·40). The in‐hospital mortality rate after emergency repair of an intact AAA was also higher among women. Conclusion Women who present as an emergency with an AAA are less likely to undergo repair than men. Although some of this can be explained by differences in age and co‐morbidities, the differences persist after case‐mix adjustment

Remediation programmes for practising doctors to restore patient safety: the RESTORE realist review

Background An underperforming doctor puts patient safety at risk. Remediation is an intervention intended to address underperformance and return a doctor to safe practice. Used in health-care systems all over the world, it has clear implications for both patient safety and doctor retention in the workforce. However, there is limited evidence underpinning remediation programmes, particularly a lack of knowledge as to why and how a remedial intervention may work to change a doctor’s practice. Objectives To (1) conduct a realist review of the literature to ascertain why, how, in what contexts, for whom and to what extent remediation programmes for practising doctors work to restore patient safety; and (2) provide recommendations on tailoring, implementation and design strategies to improve remediation interventions for doctors. Design A realist review of the literature underpinned by the Realist And MEta-narrative Evidence Syntheses: Evolving Standards quality and reporting standards. Data sources Searches of bibliographic databases were conducted in June 2018 using the following databases: EMBASE, MEDLINE, Cumulative Index to Nursing and Allied Health Literature, PsycINFO, Education Resources Information Center, Database of Abstracts of Reviews of Effects, Applied Social Sciences Index and Abstracts, and Health Management Information Consortium. Grey literature searches were conducted in June 2019 using the following: Google Scholar (Google Inc., Mountain View, CA, USA), OpenGrey, NHS England, North Grey Literature Collection, National Institute for Health and Care Excellence Evidence, Electronic Theses Online Service, Health Systems Evidence and Turning Research into Practice. Further relevant studies were identified via backward citation searching, searching the libraries of the core research team and through a stakeholder group. Review methods Realist review is a theory-orientated and explanatory approach to the synthesis of evidence that seeks to develop programme theories about how an intervention produces its effects. We developed a programme theory of remediation by convening a stakeholder group and undertaking a systematic search of the literature. We included all studies in the English language on the remediation of practising doctors, all study designs, all health-care settings and all outcome measures. We extracted relevant sections of text relating to the programme theory. Extracted data were then synthesised using a realist logic of analysis to identify context–mechanism–outcome configurations. Results A total of 141 records were included. Of the 141 studies included in the review, 64% related to North America and 14% were from the UK. The majority of studies (72%) were published between 2008 and 2018. A total of 33% of articles were commentaries, 30% were research papers, 25% were case studies and 12% were other types of articles. Among the research papers, 64% were quantitative, 19% were literature reviews, 14% were qualitative and 3% were mixed methods. A total of 40% of the articles were about junior doctors/residents, 31% were about practicing physicians, 17% were about a mixture of both (with some including medical students) and 12% were not applicable. A total of 40% of studies focused on remediating all areas of clinical practice, including medical knowledge, clinical skills and professionalism. A total of 27% of studies focused on professionalism only, 19% focused on knowledge and/or clinical skills and 14% did not specify. A total of 32% of studies described a remediation intervention, 16% outlined strategies for designing remediation programmes, 11% outlined remediation models and 41% were not applicable. Twenty-nine context–mechanism–outcome configurations were identified. Remediation programmes work when they develop doctors’ insight and motivation, and reinforce behaviour change. Strategies such as providing safe spaces, using advocacy to develop trust in the remediation process and carefully framing feedback create contexts in which psychological safety and professional dissonance lead to the development of insight. Involving the remediating doctor in remediation planning can provide a perceived sense of control in the process and this, alongside correcting causal attribution, goal-setting, destigmatising remediation and clarity of consequences, helps motivate doctors to change. Sustained change may be facilitated by practising new behaviours and skills and through guided reflection. Limitations Limitations were the low quality of included literature and limited number of UK-based studies. Future work Future work should use the recommendations to optimise the delivery of existing remediation programmes for doctors in the NHS. Study registration This study is registered as PROSPERO CRD42018088779. Funding This project was funded by the National Institute for Health Research (NIHR) Health Services and Delivery Research programme and will be published in full in Health Services and Delivery Research; Vol. 9, No. 11. See the NIHR Journals Library website for further project information. </jats:sec

Einflüsse der Stauaktivität des Bibers (Castor fiber albicus) auf physikalische und chemische Parameter von Mittelgebirgs-Bächen (Hessen, Deutschland)

AbstractFor a valuation of the influence of beavers on a riparian ecosystem a restriction on the constructed beaver ponds is not sufficient. In addition, the whole homerange in its total length must be taken into consideration. In 1995 the geomorphological effects and the chemical and physical alterations during the passing through two beaver homeranges were studied in the Spessart mountains (Hesse, Germany). Inside of the homeranges, the beavers transformed the running waters into series of small beaver pools and ponds. Parallel to the sectors, where riffles got disappeared because of the damming up, secondary brooks developed, which created various wetlands in the riparian ecosystem. Because of the enlargement of the water surface and the distribution of the brook water on adjacent areas, the water-freight of a brook can decrease under certain weather conditions. Thereby beavers can contribute to a higher retention of precipitation and to a diminuation of flood-disasters.The alterations of the measured parameters were bounded mostly on the pond and regenerated quickly below. In comparison of the water conditions entering and leaving the homerange, there was a meagre increase of temperature, pH, oxygen- and NO2-concentration measured. The concentration of nitrate, NH4 and o-phosphate decreased, the conductivity kept constant. Extensive effects on the water quality below the homeranges were not proven