A survey of methods and an annotated bibliography of materials available for character education in the elementary school

Thesis (Ed.M.)--Boston Universit

Validating Dose Uncertainty Estimates Produced by AUTODIRECT: An Automated Program to Evaluate Deformable Image Registration Accuracy.

Deformable image registration is a powerful tool for mapping information, such as radiation therapy dose calculations, from one computed tomography image to another. However, deformable image registration is susceptible to mapping errors. Recently, an automated deformable image registration evaluation of confidence tool was proposed to predict voxel-specific deformable image registration dose mapping errors on a patient-by-patient basis. The purpose of this work is to conduct an extensive analysis of automated deformable image registration evaluation of confidence tool to show its effectiveness in estimating dose mapping errors. The proposed format of automated deformable image registration evaluation of confidence tool utilizes 4 simulated patient deformations (3 B-spline-based deformations and 1 rigid transformation) to predict the uncertainty in a deformable image registration algorithm's performance. This workflow is validated for 2 DIR algorithms (B-spline multipass from Velocity and Plastimatch) with 1 physical and 11 virtual phantoms, which have known ground-truth deformations, and with 3 pairs of real patient lung images, which have several hundred identified landmarks. The true dose mapping error distributions closely followed the Student t distributions predicted by automated deformable image registration evaluation of confidence tool for the validation tests: on average, the automated deformable image registration evaluation of confidence tool-produced confidence levels of 50%, 68%, and 95% contained 48.8%, 66.3%, and 93.8% and 50.1%, 67.6%, and 93.8% of the actual errors from Velocity and Plastimatch, respectively. Despite the sparsity of landmark points, the observed error distribution from the 3 lung patient data sets also followed the expected error distribution. The dose error distributions from automated deformable image registration evaluation of confidence tool also demonstrate good resemblance to the true dose error distributions. Automated deformable image registration evaluation of confidence tool was also found to produce accurate confidence intervals for the dose-volume histograms of the deformed dose

Modelling the Potential Population Impact and Cost-Effectiveness of Self-Testing for HIV: Evaluation of Data Requirements

HIV testing uptake has increased dramatically in recent years in resource limited settings. Nevertheless, over 50 % of the people living with HIV are still unaware of their status. HIV self-testing (HIVST) is a potential new approach to facilitate further uptake of testing which requires consideration, taking into account economic factors. Mathematical models and associated economic analysis can provide useful assistance in decision-making processes, offering insight, in this case, into the potential long-term impact at a population level and the price-point at which free or subsidized HIVST would be cost-effective in a given setting. However, models are based on assumptions, and if the required data are sparse or limited, this uncertainty will be reflected in the results from mathematical models. The aim of this paper is to describe the issues encountered in modeling the cost-effectiveness of introducing HIVST, to indicate the evidence needed to support various modeling assumptions, and thus which data on HIVST would be most beneficial to collect

Transforming NICU Care to Provide Comprehensive Family Support

AbstractParents whose babies are admitted to neonatal intensive care units (NICUs) are subject to a variety of stresses that increase their risk to suffer from postpartum depression, posttraumatic stress disorder, and anxiety disorders. Parental distress can adversely impact parent-infant bonding, which in turn can lead to worse outcomes for the child. An interdisciplinary workgroup convened by the National Perinatal Association (NPA) has published recommendations for psychosocial support of NICU parents. This article presents nurses, who are key players in quality improvement (QI) initiatives in their hospitals, with a QI approach to transforming care in NICUs to provide comprehensive family support using the NPA recommendations as a road map

Paediatric palliative and supportive care: caring for life: the needs of children and families in Western Australia

Palliative care is the relief of symptoms, regardless of their impact on the underlying disease process. The philosophical underpinning of current international paediatric palliative and supportive care models is that palliative and supportive care should be offered to all children with life threatening or chronic illnesses/disabilities with complex care needs. This approach allows the integration of cure-directed treatment and palliative care. allowing children to benefit from both philosophies of care. In Australia, there is increasing recognition of the need for the development of appropriate paediatric palliative care services, especially in Western Australia where supportive care services for children with life-limiting conditions are significantly underdeveloped. The needs of children with life threatening conditions and their families are unique and require special consideration to enable the appropriate delivery of multidisciplinary care that aims to relieve suffering and improve quality of life. Although traditionally skills and knowledge base were developed for end-of-life care for adults, palliative care for children with life-threatening illnesses may be combined with curative or disease-modifying therapy. In addition, a child\u27s progressive, life-threatening illness has a profound effect on all dimensions of family life. Families are affected emotionally, psychologically, and financially as family structure and organisation become permanently altered. Only recently have the specific palliative care needs of children and their families been recognised..

Managing menstruation in the workplace: an overlooked issue in low- and middle-income countries.

The potential menstrual hygiene management barriers faced by adolescent girls and women in workplace environments in low- and middle-income countries has been under addressed in research, programming and policy. Despite global efforts to reduce poverty among women in such contexts, there has been insufficient attention to the water and sanitation related barriers, specifically in relation to managing monthly menstruation, that may hinder girls' and women's contributions to the workplace, and their health and wellbeing. There is an urgent need to document the specific social and environmental barriers they may be facing in relation to menstrual management, to conduct a costing of the implications of inadequate supportive workplace environments for menstrual hygiene management, and to understand the implications for girls' and women's health and wellbeing. This will provide essential evidence for guiding national policy makers, the private sector, donors and activists focused on advancing girls' and women's rights

Foreclosure to Homelessness 2009: The Forgotten Victims of SubPrime Crisis

This study found that there are many interrelated consequences of the economic downturn that lead to both home foreclosure and to homelessness. There is an increased need for affordable housing, as well as targeted legal assistance, health care, living-wage jobs, income supports, access to education, civil rights protections and the various supports that will continue to be needed as a result of the recession.John Parvensky, Board of Directors President for the National Coalition for the Homeless and Executive Director of the Colorado Coalition for the Homeless states, "This report underscores the fact that we as a nation need to strengthen our efforts to prevent homelessness resulting from this economic crisis, while creating sufficient new affordable rental housing to ensure that no family in America has to experience the tragedy of homelessness."In a national survey of homeless service and advocacy agencies conducted by the these groups, 79 percent of respondents stated that at least some of their clients were homeless as a result of foreclosure, and about half estimated that more than ten percent of their clients were homeless because of foreclosure on a home they had been occupying. During 2008, RealtyTrac reported 3,157,806 foreclosure filings -- default notices, auction sale notices and bank repossessions, an 81 percent jump from 2007 and a 225 percent increase from 2006."We are one step away from foreclosure. More and more families and children are affected by job loss and the economy. 'Getting back on your feet' is next to impossible in today's society. The public needs to be made aware of who is becoming homeless... and that they could be next - just like any average family," an individual respondent to the national survey from North Carolina reported

The embodiment design of the heat rejection system for the portable life support system

The Portable Life Support System (PLSS) provides a suitable environment for the astronaut in the Extravehicular Mobility Unit (EMU), and the heat rejection system controls the thermal conditions in the space suit. The current PLSS sublimates water to the space environment; therefore, the system loses mass. Since additional supplies of fluid must be available on the Space Shuttle, NASA desires a closed heat rejecting system. This document presents the embodiment design for a radiative plate heat rejection system without mass transfer to the space environment. This project will transform the concept variant into a design complete with material selection, dimensions of the system, layouts of the heat rejection system, suggestions for manufacturing, and financial viability

Proposal for the design of a zero gravity tool storage device

Astronauts frequently use a variety of hand tools during space missions, especially on repair missions. A toolbox is needed to allow storage and retrieval of tools with minimal difficulties. The toolbox must contain tools during launch, landing, and on-orbit operations. The toolbox will be used in the Shuttle Bay and therefore must withstand the hazardous space environment. The three main functions of the toolbox in space are: to protect the tools from the space environment and from damaging one another, to allow for quick, one-handed access to the tools; and to minimize the heat transfer between the astronaut's hand and the tools. This proposal explores the primary design issues associated with the design of the toolbox. Included are the customer and design specifications, global and refined function structures, possible solution principles, concept variants, and finally design recommendations

The Development of Locoregional Therapies as a Strategy for Reducing Cervical Cancer Mortality in Low to Middle Income Countries.

Early detection concomitant with appropriate treatment intervention for pre-invasive cervical cancer has proved effective in the ‘war on cervical cancer’ in the developed world. Unfortunately, these advances have not been mirrored in the developing world, where incidence and mortality rates are currently approximately 90% of the world’s burden. Due to economic, infrastructure and skilled personnel constraints, the impact of cytology screening as a method for early detection and reducing mortality rates from cervical cancer is lower. Typically, women present with advanced disease that is difficult to treat because of de novo and pharmacokinetic resistance. Whilst the HPV vaccine is a welcome development in the fight against cervical cancer, for women who are outside the target age of vaccination, or indeed do not have access to vaccination, screening remains the only form of protection. Current excisional treatments available for cervical dysplasia are effective but have limitations, including increased incidence of obstetric complications and risk of recurrence. This is a particular issue in cases of HIV, which is endemic in the regions most affected by cervical cancer. Therefore, early detection combined with early treatment is an attractive strategy to reduce the number of women presenting with drug resistant disease in developing countries where cytology screening and vaccination services are poorly developed. This review makes the case for developing a locoregional treatment therapy for cervical dysplasia which could be incorporated into a cervical cancer screening strategy in a rural setting within a developing country