Letter to Andrew H. Foote aboard the USS Cumberland, from Chaplain Charles Samuel Stewart, writing from New York, dated November 23, 1843.

Andrew Hull Foote is known for his naval service and contribution to reforms in the US Navy. At the time of this letter, it appears that Foote was on a Mediterranean cruise aboard the USS Cumberland. Chaplain Charles S. Stewart writes to Foote from New York to encourage his prospect and promise for moral and spiritual good upon the USS Cumberland.https://digitalcommons.wofford.edu/littlejohnmss/1263/thumbnail.jp

Pennsylvania’s True Commonwealth: The State of Manufacturing – Challenges and Opportunities (Full Report)

The Industrial Resource Center Network of Pennsylvania is the state’s affiliate of the National Institute of Standards and Technology’s Hollings Manufacturing Extension Partnership program. Both the IRC program and the MEP have longstanding traditions of self-assessment and evolution as ways of being accountable to the public and of promoting continuous improvement. The IRC program and the MEP are charged with helping manufacturing in general, and small to midsized manufacturers in particular, improve their competitive position. The IRC program uses the outcomes from these assessments to think about the challenges their constituents face due to rapid evolution in the globally competitive environment. Additionally, the IRC Program has joined with the MEP to discover best management and production practices, standardize them in terms of educational and training practices, and then disseminate these practices widely. Again, this is with an emphasis on small and midsized establishments and businesses. This report builds on the 2004 report, Manufacturing Pennsylvania’s Future, written by Deloitte Consulting and the Maxine Goodman Levin College of Urban Affairs at Cleveland State University. In August 2010, as the negative impact of the Great Recession was beginning to ebb and after a decade of global competitive challenges, the IRC Program embarked on a new round of self-evaluation and assessment. The economic development and nonprofit management research groups at Cleveland State University’s Levin College were engaged to examine the state of manufacturing in the Commonwealth, discover the management practices of the “best of the best” manufacturers in the state, and suggest practice innovations that would enhance the competitive position of Pennsylvania’s manufacturers. This work was undertaken with the MPI Group. The project was supported by funding from the Industrial Resource Center program, the Hollings Manufacturing Extension Partnership of the National Institute of Standards and Technology, the John D.and Catherine T. MacArthur Foundation’s Network on Building Resilient Regions, and the Pennsylvania Department of Community and Economic Development, with funding provided by the National Telecommunications and Information Administration. The work benefited from the advice and review of an external advisory board that was facilitated by Ken Voytek, NIST/MEP’s chief economist, and Joe Houldin, CEO of the Delaware Valley Industrial Resource Center. They worked with: Emily DeRocco, President, the Manufacturing Institute of the National Association of Manufacturers; Samuel Leiken, Vice President of the Council on Competitiveness; Howard Wial, Ph.D., Fellow of the Metropolitan Policy Program of the Brookings Institution; and Mike Trebing, Senior Economic Analyst, Federal Reserve Bank of Philadelphia. The work was also reviewed and discussed by the IRC’s Strategic Advisory Board and the directors of the network\u27s seven centers. The report also benefited from data provided by the Central Pennsylvania Workforce Development Corporation (CPWDC). The research team acknowledges the many contributions of our advisers and funders. Their participation and support do not mean that each agrees with all we have written. The team alone is responsible for the findings and interpretation of the data

Pennsylvania’s True Commonwealth: The State of Manufacturing – Challenges and Opportunities (Full Report)

The Industrial Resource Center Network of Pennsylvania is the state’s affiliate of the National Institute of Standards and Technology’s Hollings Manufacturing Extension Partnership program. Both the IRC program and the MEP have longstanding traditions of self-assessment and evolution as ways of being accountable to the public and of promoting continuous improvement. The IRC program and the MEP are charged with helping manufacturing in general, and small to midsized manufacturers in particular, improve their competitive position. The IRC program uses the outcomes from these assessments to think about the challenges their constituents face due to rapid evolution in the globally competitive environment. Additionally, the IRC Program has joined with the MEP to discover best management and production practices, standardize them in terms of educational and training practices, and then disseminate these practices widely. Again, this is with an emphasis on small and midsized establishments and businesses. This report builds on the 2004 report, Manufacturing Pennsylvania’s Future, written by Deloitte Consulting and the Maxine Goodman Levin College of Urban Affairs at Cleveland State University. In August 2010, as the negative impact of the Great Recession was beginning to ebb and after a decade of global competitive challenges, the IRC Program embarked on a new round of self-evaluation and assessment. The economic development and nonprofit management research groups at Cleveland State University’s Levin College were engaged to examine the state of manufacturing in the Commonwealth, discover the management practices of the “best of the best” manufacturers in the state, and suggest practice innovations that would enhance the competitive position of Pennsylvania’s manufacturers. This work was undertaken with the MPI Group. The project was supported by funding from the Industrial Resource Center program, the Hollings Manufacturing Extension Partnership of the National Institute of Standards and Technology, the John D.and Catherine T. MacArthur Foundation’s Network on Building Resilient Regions, and the Pennsylvania Department of Community and Economic Development, with funding provided by the National Telecommunications and Information Administration. The work benefited from the advice and review of an external advisory board that was facilitated by Ken Voytek, NIST/MEP’s chief economist, and Joe Houldin, CEO of the Delaware Valley Industrial Resource Center. They worked with: Emily DeRocco, President, the Manufacturing Institute of the National Association of Manufacturers; Samuel Leiken, Vice President of the Council on Competitiveness; Howard Wial, Ph.D., Fellow of the Metropolitan Policy Program of the Brookings Institution; and Mike Trebing, Senior Economic Analyst, Federal Reserve Bank of Philadelphia. The work was also reviewed and discussed by the IRC’s Strategic Advisory Board and the directors of the network\u27s seven centers. The report also benefited from data provided by the Central Pennsylvania Workforce Development Corporation (CPWDC). The research team acknowledges the many contributions of our advisers and funders. Their participation and support do not mean that each agrees with all we have written. The team alone is responsible for the findings and interpretation of the data

Supervised Exercise Intervention and Overall Activity in CKD.

Introduction: Patients are often instructed to engage in multiple weekly sessions of exercise to increase physical activity. We aimed to determine whether assignment to a supervised exercise regimen increases overall weekly activity in individuals with chronic kidney disease (CKD). Methods: We performed a secondary analysis of a pilot randomized 2 × 2 factorial design trial examining the effects of diet and exercise (10%-15% reduction in caloric intake, 3 supervised exercise sessions/wk, combined diet restriction/exercise, and control). Activity was measured as counts detected by accelerometer. Counts data were collected on all days for which an accelerometer was worn at baseline, month 2, and month 4 follow-up. The primary outcome was a relative change from baseline in log-transformed counts/min. Generalized estimating equations were used to compare the primary outcome in individuals in the exercise group and the nonexercise group. Results: We examined 111 individuals randomized to aerobic exercise or usual activity (n = 48 in the exercise group and n = 44 controls). The mean age was 57 years, 42% were female, and 28% were black. Median overall adherence over all time was 73%. Median (25th, 75th percentile) counts/min over nonsupervised exercise days at months 2 and 4 were 237.5 (6.5, 444.4) for controls and 250.9 (7.7, 529.8) for the exercise group ( Conclusion: Engaging in a supervised exercise program does not increase overall weekly physical activity in individuals with stage 3 to 4 CKD

PrEdiction of Risk and Communication of outcomE followIng major lower limb amputation – a collaboratiVE study (PERCEIVE): Protocol for the PERCEIVE qualitative study

INTRODUCTION: Deciding whether to proceed with a major lower limb amputation is life-changing and complex, and it is crucial that the right decision is made at the right time. However, medical specialists are known to poorly predict risk when assessing patients for major surgery, and there is little guidance and research regarding decisions about amputation. The process of shared decision-making between doctors and patients during surgical consultations is also little understood. Therefore, the aim of this study is to analyse in depth the communication, consent, risk prediction and decision-making process in relation to major lower limb amputation. METHODS AND ANALYSIS: Consultations between patients and surgeons at which major lower limb amputation is discussed will be audio-recorded for 10–15 patients. Semi-structured follow-up interviews with patients (and relatives/carers) will then be conducted at two time points: as soon as possible/appropriate after a decision has been reached regarding surgery, and approximately 6 months later. Semi-structured interviews will also be conducted with 10–15 healthcare professionals working in the UK National Health Service (NHS) involved in amputation decision-making. This will include surgeons, anaesthetists and specialist physiotherapists at 2–4 NHS Health Boards/Trusts in Wales and England. Discourse analysis will be used to analyse the recorded consultations; interviews will be analysed thematically. Finally, workshops will be held with patients and healthcare professionals to help synthesise and interpret findings. ETHICS AND DISSEMINATION: The study has been approved by Wales REC 7 (20/WA/0351). Study findings will be published in international peer-reviewed journal(s) and presented at national and international scientific meetings. Findings will also be disseminated to a wide NHS and lay audience via presentations at meetings and written summaries for key stakeholder groups

The PERCEIVE quantitative study: PrEdiction of Risk and Communication of outcome following major lower limb amputation: protocol for a collaboratiVE study

BACKGROUND: Accurate prediction of outcomes following surgery with high morbidity and mortality rates is essential for informed shared decision-making between patients and clinicians. It is unknown how accurately healthcare professionals predict outcomes following major lower-limb amputation (MLLA). Several MLLA outcome-prediction tools have been developed. These could be valuable in clinical practice, but most require validation in independent cohorts before routine clinical use can be recommended. The primary aim of this study is to evaluate the accuracy of healthcare professionals’ predictions of outcomes in adult patients undergoing MLLA for complications of chronic limb-threatening ischaemia (CLTI) or diabetes. Secondary aims include the validation of existing outcome-prediction tools. METHOD: This study is an international, multicentre prospective observational study including adult patients undergoing a primary MLLA for CLTI or diabetes. Healthcare professionals’ accuracy in predicting outcomes at 30-days (death, morbidity and MLLA revision) and 1-year (death, MLLA revision and ambulation) will be evaluated. Sixteen existing outcome-prediction tools specific to MLLA will be examined for validity. Data collection began on 1 October 2020; the end of follow-up will be 1 May 2022. The C-statistic, Hosmer–Lemeshow test, reclassification tables and Brier score will be used to evaluate the predictive performance of healthcare professionals and prediction tools, respectively. STUDY REGISTRATION AND DISSEMINATION: This study will be registered locally at each centre in accordance with local policies before commencing data collection, overseen by local clinician leads. Results will be disseminated to all centres, and any subsequent presentation(s) and/or publication(s) will follow a collaborative co-authorship model

Some economic problems of the Illinois River Valley

Papers presented before the Economics Section of the Illinois State Academy of Science, Peoria, Illinois, May 8, 1931.Includes bibliographical references

Avelumab Alone or in Combination With Chemotherapy Versus Chemotherapy Alone in Platinum-Resistant or Platinum-Refractory Ovarian Cancer (JAVELIN Ovarian 200): An Open-Label, Three-Arm, Randomised, Phase 3 Study

The majority of patients with ovarian cancer will experience relapse and develop platinum-resistant disease after being treated with frontline platinum-based chemotherapy. Treatment options for platinum-resistance or platinum-refractory disease are very limited, usually involving nonplatinum chemotherapy, and they are associated with poor objective response rates and life expectancy

Selection into Financial Literacy Programs: Evidence from a Field Study

As financial literacy has been shown to correlate with good financial decisions, policymakers promote educational programs to improve individuals' financial decisions. But who selects into educational programs and who acquires information about personal finance? This paper, in a field study with more than 870 individuals, offers individuals free information about their credit reports (and credit scores). About 55 percent choose to participate in this small counseling program. To test whether those who self-select to acquire information about personal finance differ from those who do not on (normally) unobservable characteristics, we elicit time preferences, using incentivized choice experiments. Our results show that the two groups differ sharply in their discount factors: those who choose to acquire information do not discount the future as much as those who choose not to acquire information. This result has implications for financial education programs