The Lived Experience of Bipolar Disorder: A Systematic Review and Meta-Synthesis

The purpose of this meta-synthesis was to review the available qualitative research on the lived experience of persons with bipolar disorder in order to find common themes that may enhance practitioner understanding. In this meta-synthesis, limited to studies conducted in the United States, 12 studies involving 234 participants met the authors’ inclusion criteria, and the following four major crosscutting themes, with subthemes, were identified: the process of acceptance of the diagnosis; its negative impact on relationships; internal coping strategies; and reliance on social support. Implications of these findings for direct practice are explored

Faculty Input in Evaluation for a College with Many Disciplines

The co-presenters will describe how faculty in one academic unit of a large College combining many academic disciplines were tasked with examining best practices and development of a faculty merit performance evaluation rubric. Perspective on the project will be offered by the initiating School Director, Dean of the College and Associate Dean of the College

Linking Quantitative Motor Assessments to the Underlying Brian Injury: A Preliminary Report

Using custom software and an inexpensive novel motion capture controller, we adapted and automated traditional subjective motor assessments in an integrated system to develop a quantitative motor assessment (QMA) that is low-cost, and highly sensitive. Twelve participants who have suffered a traumatic brain injury performed the QMA and had MRI scans of their brain. We compared the individual QMA results from the TBI group to normative standards (developed in an earlier work). We also compared the QMA results to measures of damage found in MRI results. Preliminary analysis of a subset of data are reported here

Moving forward through consensus: protocol for a modified Delphi approach to determine the top research priorities in the field of orthopaedic oncology.

IntroductionOrthopaedic oncology researchers face several obstacles in the design and execution of randomised controlled trials, including finite fiscal resources to support the rising costs of clinical research and insufficient patient volume at individual sites. As a result, high-quality research to guide clinical practice has lagged behind other surgical subspecialties. A focused approach is imperative to design a research programme that is economical, streamlined and addresses clinically relevant endpoints. The primary objective of this study will be to use a consensus-based approach to identify research priorities for international clinical trials in orthopaedic oncology.Methods and analysisWe will conduct a 3-phase modified Delphi method consisting of 2 sequential rounds of anonymous web-based questionnaires (phases I and II), and an in-person consensus meeting (phase III). Participants will suggest research questions that they believe are of particular importance to the field (phase I), and individually rate each proposed question on 5 criteria (phase II). Research questions that meet predetermined consensus thresholds will be brought forward to the consensus meeting (phase III) for discussion by an expert panel. Following these discussions, the expert panel will be asked to assign scores for each research question, and research questions meeting predetermined criteria will be brought forward for final ranking. The expert panel will then be asked to rank the top 3 research questions, and these 3 research questions will be distributed to the initial group of participants for validation.Ethics and disseminationAn ethics application is currently under review with the Hamilton Integrated Research Ethics Board in Hamilton, Ontario, Canada. The results of this initiative will be disseminated through peer-reviewed publications and conference presentations

Clinical Service Delivery along the Urban/Rural Continuum

Background: Engagement in the core public health functions and ten essential services remains the standard for measuring local health department (LHD) performance; their role as providers of clinical services remains uncertain, particularly in rural and underserved communities. Purpose: To examine the role of LHDs as clinical service providers and how this role varies among rural and nonrural communities. Methods: The 2013 National Association of County and City Health Officials (NACCHO) Profile was used to examine the geographic distribution of clinical service provision among LHDs. LHDs were coded as urban, large rural, or small rural based on Rural/Urban Commuting Area codes. Bivariate analysis for clinical services was conducted by rural/urban status. For each service, the proportions of LHDs that directly performed the service, contracted with other organizations to provide the service, or reported provision of the service by independent organizations in the community was compared. Results: Analyses show significant differences in patterns of clinical services offered, contracted, or provided by others, based on rurality. LHDs serving rural communities, especially large rural LHDs, tend to provide more direct services than urban LHDs. Among rural LHDs, larger rural LHDs provided a broader array of services and reported more community capacity for delivery than small rural LHDs- particularly maternal and child health services. Implications: There are capacity differences between large and small rural LHDs. Limited capacity within small rural LHDs may result in providing less services, regardless of the availability of other providers within their communities. These findings provide valuable information on clinical service provision among LHDs, particularly in rural and underserved communities

Local Health Department Clinical Service Delivery along the Urban/Rural Continuum

Background: Engagement in the core public health functions and ten essential services remains the standard for measuring local health department (LHD) performance; their role as providers of clinical services remains uncertain, particularly in rural and underserved communities. Purpose: To examine the role of LHDs as clinical service providers and how this role varies among rural and nonrural communities. Methods: The 2013 National Association of County and City Health Officials (NACCHO) Profile was used to examine the geographic distribution of clinical service provision among LHDs. LHDs were coded as urban, large rural, or small rural based on Rural/Urban Commuting Area codes. Bivariate analysis for clinical services was conducted by rural/urban status. For each service, the proportions of LHDs that directly performed the service, contracted with other organizations to provide the service, or reported provision of the service by independent organizations in the community was compared. Results: Analyses show significant differences in patterns of clinical services offered, contracted, or provided by others, based on rurality. LHDs serving rural communities, especially large rural LHDs, tend to provide more direct services than urban LHDs. Among rural LHDs, larger rural LHDs provided a broader array of services and reported more community capacity for delivery than small rural LHDs- particularly maternal and child health services. Implications: There are capacity differences between large and small rural LHDs. Limited capacity within small rural LHDs may result in providing less services, regardless of the availability of other providers within their communities. These findings provide valuable information on clinical service provision among LHDs, particularly in rural and underserved communities

Actividades deportivas en el medio natural: su representación en libros de texto de Educación Física en Primaria

The objective of this research is to analyze the sport activities carried out in the natural environment represented in the textbooks of Physical Education (PE) in Primary Education (EP), published according to Organic Law of Education 2/2006, of May 3rd, (LOE). 4339 images have been analyzed, from 44 different textbooks, belonging to eight Spanish publishers. The SAIMEF (Physical Analysis Images Analysis System) tool, elaborated ad hoc, was used to analyze the content of the images. The pilot test, panel of experts and triangulation with several observers were some of the scientific criteria that endorsed this tool. The results show that the presence of images related to sport activities in the natural environment continues to be very scarce in PE textbooks. The editorial Teide represents in greater proportion this type of activities compared to the rest of publishers. In the third cycle appears a greater number of images, predominating drawings over pictures. The most represented sport activity is the orientation, with a 25.6%, included within the multidisciplinary sports, prevailing the terrestrial environment. The representation of sports in the natural environment varies according to the analyzed publishers. Thus, in Anaya and Bruño predominates the orientation, in Edelvives, Paidotribo and Serbal predominates the ski, and in the publishers Santillana and Teide prevails the escalation. It is necessary to reflect on the low representation of these activities in EF textbooks

Investigation of Bearing Fatigue Damage Life Prediction Using Oil Debris Monitoring

Research was performed to determine if a diagnostic tool for detecting fatigue damage of helicopter tapered roller bearings can be used to determine remaining useful life (RUL). The taper roller bearings under study were installed on the tail gearbox (TGB) output shaft of UH- 60M helicopters, removed from the helicopters and subsequently installed in a bearing spall propagation test rig. The diagnostic tool was developed and evaluated experimentally by collecting oil debris data during spall progression tests on four bearings. During each test, data from an on-line, in-line, inductance type oil debris sensor was monitored and recorded for the occurrence of pitting damage. Results from the four bearings tested indicate that measuring the debris generated when a bearing outer race begins to spall can be used to indicate bearing damage progression and remaining bearing life

Avaliação da eficácia, segurança e tolerabilidade da sibutramina em obesos - estudo randomizado duplo-cego

This is a double-blind, placebo-controlled study of the efficacy, safety, and tolerability of sibutramine in the management of obese patients for a 6-month period. METHOD: Sixty-one obese patients (BMI >;30, ;5% in 40% of the patients on sibutramine compared with 12.9% in the placebo group. We also detected weight gain in 45.2% of the placebo group compared to 20% in the sibutramine group. The sibutramine group showed improvement in HDL- cholesterol values (increased by 17%) and triglyceride values (decreased by 12.8%). This group also showed an increase in systolic blood pressure (6.7%, 5 mmHg). There were no changes in echocardiograms comparing the beginning and end of follow-up, and side effects did not lead to discontinuation of treatment. DISCUSSION: Sibutramine proved to be effective for weight loss providing an 8% loss of the initial weight. Compliance to prolonged treatment was good, and side effects did not result in discontinuation of treatment. These data confirmed the good efficacy, tolerability, and safety profiles of sibutramine for treatment of obesity.O presente estudo objetivou comparar a eficácia, segurança e tolerabilidade da sibutramina em pacientes obesos. MÉTODO: Selecionamos 61 pacientes obesos (3