The Impact of Select Socio-demographic and Lifecycle Variables on the Importance Ratings of Vacation Enjoyment Attributes

The primary objective of this investigation was to identify the soft amenity attribute factors considered most important by interval resort owners in contributing to a satisfying resort vacation. A second objective was to determine whether attribute factor importance scores were effected by select socio-demographic and lifecycle variables. Using both focus groups and a Delphi survey technique, 1,200 randomly selected interval resort owners were asked to rate the mean importance of 75 soft amenity attributes on a five point Likert scale. Through factor analysis with varimax rotation, 18 vacation soft amenity attribute factors were identified. These factors accounted for 65.4% of the variance relating to vacation enjoyment. For subsequent analysis certain amenities were assigned to their second highest loading factor or omitted because they related to specific interval resort owner/manager issues. Mean scores for each of the remaining 14 factors was computed for each respondent and an analysis of variance or t-test was performed to compare the mean factor scores among different groups defined by the demographic and lifecycle variables. Hospitality and operating effectiveness and information on area attractions were rated as the most important vacation soft amenity factors. The independent variables of income, age and presence of children in the home exerted to greatest influence on attribute factor importance scores

Longitudinal Assessment of Growth in Hypoplastic Left Heart Syndrome: Results From the Single Ventricle Reconstruction Trial

Background: We sought to characterize growth between birth and age 3 years in infants with hypoplastic left heart syndrome who underwent the Norwood procedure. Methods and Results: We performed a secondary analysis using the Single Ventricle Reconstruction Trial database after excluding patients 2 SD below normal). Failure to find consistent risk factors supports the strategy of tailoring nutritional therapies to patient‐ and stage‐specific targets. Clinical Trial Registration URL: http://clinicaltrials.gov/. Unique identifier: NCT00115934

City of Ivanhoe Comprehensive Plan 2018-2038

the City of Ivanhoe is located in Tyler County, which is in southeastern Texas near the Louisiana border. The land is gently rolling, with an elevation ranging from 100 to 400 feet above sea level. Texas Target Communities developed this document in partnership with the City of Ivanhoe. In the summer of 2016, Tyler County and the City of Ivanhoe collaborated with Texas Target Communities to assess current community conditions and explore future development strategies. The project aimed to enhance community-wide discussion through a public participatory process, resulting in developing a comprehensive plan to help guide the future growth of the County and City. A representative task force of community members engaged in a participatory planning process, including visioning, goal setting, alternative scenario exploration, and strategies for implementation. Using courses on campus, TAMU urban planning students were exposed to the planning process and explored innovative ideas. The result of this collaboration is this document, which provides strategies for the community’s growth utilizing the natural resource and the assets of the City.The Ivanhoe Comprehensive Plan 2017-2037 provides guidance for the future development of the city. In the summer of 2016, Tyler County and the City of Ivanhoe collaborated with Texas Target Communities to assess current community conditions and explore future development strategies., which resulted in this comprehensive plan document.Texas Target Communitie

Will a Good Citizen Actively Support Organizational Change? Investigation of Psychological Processes Underlying Active Change Support

The present study investigated motivational factors of employees active change support (ACS). It also investigated good citizens response to the change by highlighting convergence and divergence of motivational factors between ACS and traditional extra-role behavior. The findings based on 166 staff responses and 346 supervisor assessments in a hospital that recently implemented a sharedgovernance structure suggest that active change support is a result of an active thinking process that involves perception of potential benefit from change but not necessarily the consequence of conventional predictors of extra-role behaviors (i.e., positive attitudes). The findings also suggest that good citizens are not necessarily the supporters of organizational change and that in actuality they confront motivational dilemma especially when they hold high quality relationship with their employer because they are reluctant to challenge the status quo

SMAD Signaling in the Airways of Healthy Rhesus Macaques versus Rhesus Macaques with Asthma Highlights a Relationship Between Inflammation and Bone Morphogenetic Proteins

Bone morphogenetic protein (BMP) signaling is important for correct lung morphogenesis, and there is evidence of BMP signaling reactivation in lung diseases. However, little is known about BMP signaling patterns in healthy airway homeostasis and inflammatory airway disease and during epithelial repair. In this study, a rhesus macaque (Macaca mulatta) model of allergic airway disease was used to investigate BMP signaling throughout the airways in health, disease, and regeneration. Stereologic quantification of immunofluorescent images was used to determine the expression of BMP receptor (BMPR) Ia and phosphorylated SMAD (pSMAD) 1/5/8 in the airway epithelium. A pSMAD 1/5/8 expression gradient was found along the airways of healthy juvenile rhesus macaques (n = 3, P , 0.005). Membrane-localized BMPRIa expression was also present in the epithelium of the healthy animals. After exposure to house dust mite allergen and ozone, significant down-regulation of nuclear pSMAD 1/5/8 occurs in the epithelium. When the animals were provided with a recovery period in filtered air, proliferating cell nuclear antigen, pSMAD 1/5/8, and membrane-localized BMPRIa expression were significantly increased in the epithelium of conducting airways (P , 0.005). Furthermore, in the asthmatic airways, altered BMPRIa localization was evident. Because of the elevated eosinophil presence in these airways, we investigated the effect of eosinophil-derived proteins on BMPRIa trafficking in epithelial cells. Eosinophil-derived proteins (eosinophil-derived neurotoxin, eosinophil peroxidase, and major basic protein) induced transient nuclear translocation of membrane-bound BMPRIa. This work mapping SMAD signaling in the airways of nonhuman primates highlights a potential mechanistic relationship between inflammatory mediators and BMP signaling and provides evidence that basal expression of the BMP signaling pathway may be important for maintaining healthy airways

Risk factors for prolonged length of stay after the stage 2 procedure in the single-ventricle reconstruction trial

BackgroundThe single-ventricle reconstruction trial randomized patients with single right ventricle lesions to a modified Blalock-Taussig or right ventricle-to-pulmonary artery shunt at the Norwood. This analysis describes outcomes at the stage 2 procedure and factors associated with a longer hospital length of stay (LOS).MethodsWe examined the association of shunt type with stage 2 hospital outcomes. Cox regression and bootstrapping were used to evaluate risk factors for longer LOS. We also examined characteristics associated with in-hospital death.ResultsThere were 393 subjects in the analytic cohort. Median stage 2 procedure hospital LOS (8 days; interquartile range [IQR], 6-14 days), hospital mortality (4.3%), transplantation (0.8%), median ventilator time (2 days; IQR, 1-3 days), median intensive care unit LOS (4 days; IQR, 3-7 days), number of additional cardiac procedures or complications, and serious adverse events did not differ by shunt type. Longer LOS was associated (R2 = 0.26) with center, longer post-Norwood LOS (hazard ratio [HR], 1.93 per log day; P < .001), nonelective timing of the stage 2 procedure (HR, 1.78; P < .001), and pulmonary artery (PA) stenosis (HR, 1.56; P < .001). By univariate analysis, nonelective stage 2 (65% vs 32%; P = .009), moderate or greater atrioventricular valve (AVV) regurgitation (75% vs 24%; P < .001), and AVV repair (53% vs 9%; P < .001) were among the risk factors associated with in-hospital death.ConclusionsNorwood LOS, PA stenoses, and nonelective stage 2 procedure, but not shunt type, are independently associated with longer LOS. Nonelective stage 2 procedure, moderate or greater AVV regurgitation, and need for AVV repair are among the risk factors for death

Variation in perioperative care across centers for infants undergoing the Norwood procedure

ObjectivesIn the Single Ventricle Reconstruction trial, infants undergoing the Norwood procedure were randomly allocated to undergo a right ventricle-to-pulmonary artery shunt or a modified Blalock-Taussig shunt. Apart from shunt type, subjects received the local standard of care. We evaluated variation in perioperative care during the Norwood hospitalization across 14 trial sites.MethodsData on preoperative, operative, and postoperative variables for 546 enrolled subjects who underwent the Norwood procedure were collected prospectively on standardized case report forms, and variation across the centers was described.ResultsGestational age, birth weight, and proportion with hypoplastic left heart syndrome were similar across sites. In contrast, all recorded variables related to preoperative care varied across centers, including fetal diagnosis (range, 55%-85%), preoperative intubation (range, 29%-91%), and enteral feeding. Perioperative and operative factors were also variable across sites, including median total support time (range, 74-189 minutes) and other perfusion variables, arch reconstruction technique, intraoperative medication use, and use of modified ultrafiltration (range, 48%-100%). Additional variation across centers was seen in variables related to postoperative care, including proportion with an open sternum (range, 35%-100%), median intensive care unit stay (range, 9-44 days), type of feeding at discharge, and enrollment in a home monitoring program (range, 1%-100%; 5 sites did not have a program). Overall, in-hospital death or transplant occurred in 18% (range across sites, 7%-39%).ConclusionsPerioperative care during the Norwood hospitalization varies across centers. Further analysis evaluating the underlying causes and relationship of this variation to outcome is needed to inform future studies and quality improvement efforts