Cultural Practice Considerations: The Coming Out Process for Mexican-Americans along the Rural Mexico-US Border

As the nation’s Latino and Mexican-American population continues to rise, social workers must consider the unique experiences of these groups. The decision to reveal a lesbian, gay, or bisexual (LGB) identity is often difficult and painful. This decision can be compounded for Mexican-American individuals as Latino heterosexual attitudes about sexuality continue to act as a barrier for Mexican-American LGB individuals and their families who live along the rural Mexico-United States (US) border. This article reviews the implications of lesbian, gay, or bisexual disclosure within Mexican-American families residing in rural communities along the Mexico-US border. The authors review the traditional Mexican-American family and the role of acculturation in the disclosure process. Implications for culturally competent social work practice, recommendations for clinical practice, and recommendations for future research are discussed

Quality management in heavy duty manufacturing industry: TQM vs. Six Sigma

‘Is TQM a management fad?’ This question has been extensively documented in the quality management literature; and will be tackled in this research though a critical literature review on the area. ‘TQM versus Six-Sigma’ debate, which has also been a fundamental challenge in this research filed, is addressed by a thematic and chronological review on the peer papers. To evaluate this challenge in practice, a primary research in heavy duty machinery production industry have been conducted using a case-study on, J C Bamford Excavators Ltd (JCB), the largest European construction machinery producer. The result highlights that TQM is a natural foundation to build up Six-Sigma upon; and not surprisingly the quality yield in a TQM approach complemented by Six-sigma is far higher and more stable than when TQM with no Six-Sigma focus is being put in place; thus presenting the overall finding that TQM and Six Sigma are compliments, not substitutes. The study will be concluded with an overview on quality management approaches in the heavy duty manufacturing industry to highlight the way forward for the industry

Prediction of survival probabilities with Bayesian Decision Trees

Practitioners use Trauma and Injury Severity Score (TRISS) models for predicting the survival probability of an injured patient. The accuracy of TRISS predictions is acceptable for patients with up to three typical injuries, but unacceptable for patients with a larger number of injuries or with atypical injuries. Based on a regression model, the TRISS methodology does not provide the predictive density required for accurate assessment of risk. Moreover, the regression model is difficult to interpret. We therefore consider Bayesian inference for estimating the predictive distribution of survival. The inference is based on decision tree models which recursively split data along explanatory variables, and so practitioners can understand these models. We propose the Bayesian method for estimating the predictive density and show that it outperforms the TRISS method in terms of both goodness-of-fit and classification accuracy. The developed method has been made available for evaluation purposes as a stand-alone application

Vertebroplasty: patient and treatment variations studied through parametric computational models

Background Vertebroplasty is increasingly used in the treatment of vertebral compression fractures. However there are concerns that this intervention may lead to further fractures in the adjacent vertebral segments. This study was designed to parametrically assess the influence of both treatment factors (cement volume and number of augmentations), and patient factors (bone and disc quality) on the biomechanical effects of vertebroplasty. Methods Specimen-specific finite element models of two experimentally-tested human three-vertebral-segments were developed from CT-scan data. Cement augmentation at one and two levels was represented in the respective models and good agreement in the predicted stiffness was found compared to the corresponding experimental specimens. Parametric variations of key variables associated with the procedure were then studied. Findings The segmental stiffness increased with disc degeneration, with increasing bone quality and to a lesser extent with increasing cement volume. Cement modulus did not have a great influence on the overall segmental stiffness and on the change in the elemental stress in the adjoining vertebrae. However, following augmentation, the stress distribution in the adjacent vertebra changed, indicating possible load redistribution effects of vertebroplasty. Interpretation This study demonstrates the importance of patient factors in the outcomes of vertebroplasty and suggests that these may be one reason for the variation in clinical results

Teaching Intelligence Testing in APA-Accredited Programs: A National Survey

We surveyed instructors at APA-accredited clinical and school psychology programs across the United States and Canada to determine typical teaching practices in individual intelligence testing courses. The most recent versions of the Wechsler scales (Wechsler, 1989, 1991, 1997) and the Stanford-Binet (Thorndike, Hagan & Sattler, 1986) remain the primary tests taught in this course. Course instructors emphasized having students administer intelligence tests; however, relatively few instructors reported assessing students' final level of competence with regard to their test administration skills. The intelligence testing course appears quite time-intensive for instructors, and many teach the course with the aid of a teaching assistant. When compared with previous findings, current results suggest a good measure of stability over time regarding the core issues addressed and skills taught in the intelligence testing course.Yeshttps://us.sagepub.com/en-us/nam/manuscript-submission-guideline

Digital transformations and the archival nature of surrogates

Large-scale digitization is generating extraordinary collections of visual and textual surrogates, potentially endowed with transcendent long-term cultural and research values. Understanding the nature of digital surrogacy is a substantial intellectual opportunity for archival science and the digital humanities, because of the increasing independence of surrogate collections from their archival sources. The paper presents an argument that one of the most significant requirements for the long-term access to collections of digital surrogates is to treat digital surrogates as archival records that embody traces of their fluid lifecycles and therefore are worthy of management and preservation as archives. It advances a theory of the archival nature of surrogacy founded on longstanding notions of archival quality, the traces of their source and the conditions of their creation, and the functional ‘‘work of the archive.’’ The paper presents evidence supporting a ‘‘secondary provenance’’ derived from re-digitization, re-ingestion of multiple versions, and de facto replacement of the original sources. The design of the underlying research that motivates the paper and summary findings are reported separately. The research has been supported generously by the US Institute of Museum and Library Services.Institute for Museum and Library ServicesPeer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/111825/1/J26 Conway Digital Transformations 2014-pers.pdfDescription of J26 Conway Digital Transformations 2014-pers.pdf : Main articl

CT screened arterial calcification as a risk factor for mortality after trauma

BACKGROUND: Arterial calcification on Computerised Tomography (CT) is a marker of cardiovascular disease. It is predictive of future adverse cardiac events and mortality in many disease states. The incidence of arterial disease and its impact on outcomes of the injured is not known. The objectives of this study were to describe the incidence of arterial calcification in trauma patients, and establish its impact on mortality. METHODS: A retrospective cohort study of all injured patients aged over 45 years presenting to a major trauma centre over a 34-month period. The presence and quantity of coronary, aortic and abdominal arterial calcification on admission CT scans of the chest, abdomen and pelvis was established, and the association between cardiovascular disease and in-hospital mortality following trauma was determined. RESULTS: Five hundred ninety-one patients were included in the study. Cardiac calcium was visible on 432 (73 %) scans, and abdominal arterial calcification on 472 (79.9 %). Fifty (8.5 %) patients died. Patients with Superior Mesenteric (SMA) and Common Iliac Artery calcification had a significantly higher mortality than those without (p < 0.01). In multivariarate analysis, only SMA calcification was independently associated with mortality (OR 2.462, 95 % CI 1.08–5.60, p = 0.032). Coronary calcium demonstrated no independent statistical relationship with death (Left Anterior Descending Artery OR 1.189, 95 % CI 0.51–2.78, Circumflex OR 1.290, 95 % CI 0.56–2.98, Right Coronary Artery OR 0.483, 95 % CI 0.21–1.10). DISCUSSION: This study has demonstrated that the identification of arterial calcification on admission CT scans of trauma patients is possible. Calcification was common, and present in around three-quarters of injured individuals over the age of 45 years. SMA calcium was an independent predictor of mortality. However, whilst the presence of arterial calcium demonstrated a tendency towards lower survival, this association was not significant in other territories, including the coronary arteries. Future studies should investigate further the association and pathophysiology linking SMA disease and mortality in trauma, in addition to the relationship between longer tem survival, adverse cardiac events and arterial calcification in injured patients. CONCLUSIONS: Arterial calcification can be reliably identified on trauma CT scans, and is common in injured patients. Abdominal vascular calcification appears to be a better predictor of mortality than coronary artery disease. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s13049-016-0317-1) contains supplementary material, which is available to authorized users