An Update on the Self-Care of Heart Failure Index

Background: The Self-care of Heart Failure Index (SCHFI) is a measure of self-care defined as a naturalistic decision-making process involving the choice of behaviors that maintain physiological stability (maintenance) and the response to symptoms when they occur (management). In the 5 years since the SCHFI was published, we have added items, refined the response format of the maintenance scale and the SCHFI scoring procedure, and modified our advice about how to use the scores. Objective: The objective of this article was to update users on these changes. Methods: In this article, we address 8 specific questions about reliability, item difficulty, frequency of administration, learning effects, social desirability, validity, judgments of self-care adequacy, clinically relevant change, and comparability of the various versions. Results: The addition of items to the self-care maintenance scale did not significantly change the coefficient α, providing evidence that the structure of the instrument is more powerful than the individual items. No learning effect is associated with repeated administration. Social desirability is minimal. More evidence is provided of the validity of the SCHFI. A score of 70 or greater can be used as the cut-point to judge self-care adequacy, although evidence is provided that benefit occurs at even lower levels of self-care. A change in a scale score more than one-half of an SD is considered clinically relevant. Because of the standardized scores, results obtained with prior versions can be compared with those from later versions. Conclusion: The SCHFI v.6 is ready to be used by investigators. By publication in this format, we are putting the instrument in the public domain; permission is not required to use the SCHFI

Psychometric Testing of the Self-Care of Hypertension Inventory

Background: Hypertension (HTN) is a global public health issue. Self-care is an essential component of HTN treatment, but no instruments are available with which to measure self-care of HTN. Objectives: The purpose of this study is to test the psychometric properties of the Self-care of Hypertension Inventory (SC-HI). Methods: Using the Self-care of Chronic Illness theory, we developed a 24-item measure of maintenance, monitoring, and management appropriate for persons with chronic HTN, tested it for content validity, and then tested it in a convenience sample of 193 adults. Exploratory factor analysis was used to identify measure structure. Cronbach\u27s α and factor determinacy scores and were used to assess reliability. Validity was tested with the Medical Outcomes Study General Adherence Scale and the Decision Making Competency Inventory. Results: Seventy percent of the sample was female; mean age was 56.4 ± 13 years; mean duration of HTN was 11 ± 9 years. Removal of 1 item on alcohol consumption resulted in a unidimensional self-care maintenance factor with acceptable structure and internal consistency (α = .83). A multidimensional self-care management factor included “consultative” and “autonomous” factors (factor determinacy score = 0.75). A unidimensional confidence factor captured confidence in and persistence with each aspect of self-care (α = .83). All the self-care dimensions in the final 23-item instrument were associated with treatment adherence and several with decision making. Conclusion: These findings support the conceptual basis of self-care in patients with HTN as a process of maintenance, monitoring, and management. The SC-HI confidence scale is promising as a measure of self-efficacy in self-care

Non-renormalization of next-to-extremal correlators in N=4 SYM and the AdS/CFT correspondence

We show that next-to-extremal correlators of chiral primary operators in N=4 SYM theory do not receive quantum corrections to first order in perturbation theory. Furthermore we consider next-to-extremal correlators within AdS supergravity. Here the exchange diagrams contributing to these correlators yield results of the same free-field form as obtained within field theory. This suggests that quantum corrections vanish at strong coupling as well.Comment: 21 pages, LaTex, 9 eps figures, typos corrected and references adde

New Developments and Emergent Challenges in International Inclusive Education—A Response to Growing Family Needs and the Pandemic

Home education is a phenomenon that has been increasing globally over the past decade, particularly for families of children with special educational needs or disabilities. The impact of the COVID-19 pandemic has exacerbated this phenomenon with many families continuing to home educate even after their children can officially return to school. This paper reports on a small-scale design-based research project that explored the needs of families who are home educating children with autistic spectrum disorder (ASD). Working in partnership with educational settings, practitioners, and families during the second year of the pandemic, academic researchers in Malaysia and England designed, implemented and evaluated a home learning pack for children with ASD aged 6–12 years old. The findings emphasised the role of economic, social and cultural capital for the families involved and how this impacted their ability to work and educate their children successfully. This raises crucial questions in relation to the place of home education within the wider international inclusive education debate and matters of social equality whilst also highlighting key questions for future research in this field on how policy and provision might develop to meet a growing diversity of need

Factors affecting the bacterial community composition and heterotrophic production of Columbia River estuarine turbidity maxima

© The Author(s), 2017. This article is distributed under the terms of the Creative Commons Attribution License. The definitive version was published in MicrobiologyOpen 6 (2017): e00522, doi:10.1002/mbo3.522.Estuarine turbidity maxima (ETM) function as hotspots of microbial activity and diversity in estuaries, yet, little is known about the temporal and spatial variability in ETM bacterial community composition. To determine which environmental factors affect ETM bacterial populations in the Columbia River estuary, we analyzed ETM bacterial community composition (Sanger sequencing and amplicon pyrosequencing of 16S rRNA gene) and bulk heterotrophic production (3H-leucine incorporation rates). We collected water 20 times to cover five ETM events and obtained 42 samples characterized by different salinities, turbidities, seasons, coastal regimes (upwelling vs. downwelling), locations, and particle size. Spring and summer populations were distinct. All May samples had similar bacterial community composition despite having different salinities (1–24 PSU), but summer non-ETM bacteria separated into marine, freshwater, and brackish assemblages. Summer ETM bacterial communities varied depending on coastal upwelling or downwelling conditions and on the sampling site location with respect to tidal intrusion during the previous neap tide. In contrast to ETM, whole (>0.2 μm) and free-living (0.2–3 μm) assemblages of non-ETM waters were similar to each other, indicating that particle-attached (>3 μm) non-ETM bacteria do not develop a distinct community. Brackish water type (ETM or non-ETM) is thus a major factor affecting particle-attached bacterial communities. Heterotrophic production was higher in particle-attached than free-living fractions in all brackish waters collected throughout the water column during the rise to decline of turbidity through an ETM event (i.e., ETM-impacted waters). However, free-living communities showed higher productivity prior to or after an ETM event (i.e., non-ETM-impacted waters). This study has thus found that Columbia River ETM bacterial communities vary based on seasons, salinity, sampling location, and particle size, with the existence of three particle types characterized by different bacterial communities in ETM, ETM-impacted, and non-ETM-impacted brackish waters. Taxonomic analysis suggests that ETM key biological function is to remineralize organic matter.National Science Foundation Grant Number: OCE-042460

Education for a Future in Crisis: Developing a Humanities-Informed STEM Curriculum

In the popular imagination, science and technology are often seen as fields of knowledge production critical to social progress and a cooperative future. This optimistic portrayal of technological advancement also features prominently in internal discourses amongst scientists, industry leaders, and STEM students alike. Yet, an overwhelming body of research, investigation, and first-person accounts highlight the varying ways modern science, technology, and engineering industries contribute to the degradation of our changing environments and exploit and harm global low-income and marginalized populations. By and large, siloed higher-education STEM curricula provide inadequate opportunities for undergraduate and graduate students to critically analyze the historical and epistemological foundations of scientific knowledge production and even fewer tools to engage with and respond to modern community-based cases. Here, we describe the development of a humanities- and social sciences-informed curriculum designed to address the theory, content, and skill-based needs of traditional STEM students considering technoscientific careers. In essence, this course is designed to foster behavior change, de-center dominant ways of knowing in the sciences, and bolster self-reflection and critical-thinking skills to equip the developing STEM workforce with a more nuanced and accurate understanding of the social, political, and economic role of science and technology. This curriculum has the potential to empower STEM-educated professionals to contribute to a more promising, inclusive future. Our framework foregrounds key insights from science and technology studies, Black and Native feminisms, queer theory, and disability studies, alongside real-world case studies using critical pedagogies.Comment: 25 pages, 1 figure, 4 table

Evaluation of APREQCFR Coordination Procedures for Charlotte Douglas International Airport

NASA has been collaborating with the Federal Aviation Administration (FAA) and aviation industry partners to develop and demonstrate new concepts and technologies for the Integrated Arrival, Departure, and Surface (IADS) traffic management capabilities under the Airspace Technology Demonstration 2 (ATD-2) project. One of the goal of The IADS capabilities in the ATD-2 project is to increase predictability and increase throughput via improving TMI compliance. The IADS capabilities that will impact TMI compliance are built upon previous NASA research, the Precision Departure Release Capability (PDRC). The proposed paper will evaluate the APREQCFR process between ATC Tower and Center and information sharing between ATC Tower and the airline Ramp tower. Subjective measures collected from the HITL surveys (e.g., workload, situational awareness, acceptability, usability) and performance metrics such as TMI, TMAT, and pushback advisory compliance from APREQCFR flights and will be reported

Constraints on the parameters of the Left Right Mirror Model

We study some phenomenological constraints on the parameters of a left right model with mirror fermions (LRMM) that solves the strong CP problem. In particular, we evaluate the contribution of mirror neutrinos to the invisible Z decay width (\Gamma_Z^{inv}), and we find that the present experimental value on \Gamma_Z^{inv}, can be used to place an upper bound on the Z-Z' mixing angle that is consistent with limits obtained previously from other low-energy observables. In this model the charged fermions that correspond to the standard model (SM) mix with its mirror counterparts. This mixing, simultaneously with the Z-Z' one, leads to modifications of the \Gamma(Z --> f \bar{f}) decay width. By comparing with LEP data, we obtain bounds on the standard-mirror lepton mixing angles. We also find that the bottom quark mixing parameters can be chosen to fit the experimental values of R_b, and the resulting values for the Z-Z' mixing angle do not agree with previous bounds. However, this disagreement disappears if one takes the more recent ALEPH data.Comment: 7 pages, 2 figures, REVTe