An overview of aeroelasticity studies for the National Aerospace Plane

The National Aero-Space Plane (NASP), or X-30, is a single-stage-to-orbit vehicle that is designed to takeoff and land on conventional runways. Research in aeroelasticity was conducted by NASA and the Wright Laboratory to support the design of a flight vehicle by the national contractor team. This research includes the development of new computational codes for predicting unsteady aerodynamic pressures. In addition, studies were conducted to determine the aerodynamic heating effects on vehicle aeroelasticity and to determine the effects of fuselage flexibility on the stability of the control systems. It also includes the testing of scale models to better understand the aeroelastic behavior of the X-30 and to obtain data for code validation and correlation. This paper presents an overview of the aeroelastic research which has been conducted to support the airframe design

Problem gambling : From practice research to grounded theory.

This study combined the use of a single case experimental design with replications with the use of a grounded theory approach in a study of treatment-seeking problem gamblers. The sample for the single case experimental design was a case series of nine men meeting DSM IV criteria (APA 1994) for pathological gambling. They primarily gambled in off-course bookmakers and on slot machines, and had self-reported histories of problem gambling of between four and eighteen years duration. A cognitive behavioural approach to treatment based on that of Sharpe and Tarrier (1993) was utilised. This treatment incorporated motivational interviewing, self-monitoring, stimulus control, cognitive restructuring, cue exposure and relapse prevention. The approach was ineffective for a majority of the clients, with drop-out prior to completion of treatment the outcome for six of the clients. The three clients who completed treatment all achieved clinically significant changes in gambling behaviour. Proposed links between depressed mood and gambling behaviour, and anxiety and gambling behaviour were not supported.The grounded theory approach was in two parts. The first study investigated the reported gambling experiences of treatment-seeking men who met DSM IV criteria (APA 1994) for pathological gambling. Clinical materials and session transcripts from the treatment study formed the initial material. A further four interviews with informants selected for theoretical sampling reasons provided provisional verification of the grounded theory. The grounded theory identified gambling as emotion management as the core category. The use of gambling for this purpose interacted with the costs of gambling and the individual's experience and perception of control of gambling to determine behaviour in the context of gambling related triggers.The second grounded theory study involved an analysis of the reported experiences of seven regular but non-problematic gamblers for confirmatory purposes. Similarities and differences between the problem and non-problem gamblers were identified. Three aspects of the reported experiences of the gamblers appeared to differentiate problematic and nonproblematic experiences. These were the extensive use of gambling to manage negative emotions, beliefs regarding winning money back and perception of control.The study addressed both theoretical and treatment issues in problem gambling. The proposal that arousal is a major motivating variable in gambling was supported (Anderson and Brown 1984). The proposal that the use of gambling to moderate negative emotional states is a feature of problem gambling (Jacobs 1985; McConaghy 1988) was supported. The view that misperception of randomness is a feature of problem gambling was supported (Ladouceur and Walker 1996). The importance of self-efficacy in efforts at moderating gambling (Bandura 1977) was supported.Clear benefits were identified of combining a single case experimental design with a grounded theory approach. The use of a grounded theory approach with a deviant sample for confirmatory purposes was also beneficial

The Association of Changes in Local Health Department Resources With Changes in State-Level Health Outcomes

We explored the association between changes in local health department (LHD) resource levels with changes in health outcomes via a retrospective cohort study. We measured changes in expenditures and staffing reported by LHDs on the 1997 and 2005 National Association of County and City Health Officials surveys and assessed changes in state-level health outcomes with the America’s Health Rankings reports for those years. We used pairwise correlation and multivariate regression to analyze the association of changes in LHD resources with changes in health outcomes. Increases in LHD expenditures were significantly associated with decreases in infectious disease morbidity at the state level (P=.037), and increases in staffing were significantly associated with decreases in cardiovascular disease mortality (P=.014), controlling for other factors

Outcomes in Trials for Management of Caries Lesions (OuTMaC):protocol

Background Clinical trials on caries lesion management use an abundance of outcomes, hampering comparison or combination of different study results and their efficient translation into clinical practice. Core outcome sets are an agreed standardized collection of outcomes which should be measured and reported in all trials for a specific clinical area. We aim to develop a core outcome set for trials investigating management of caries lesions in primary or permanent teeth conducted in primary or secondary care encompassing all stages of disease. Methods To identify existing outcomes, trials on prevention and trials on management of caries lesions will be screened systematically in four databases. Screening, extraction and deduplication will be performed by two researchers until consensus is reached. The definition of the core outcome set will by based on an e-Delhi consensus process involving key stakeholders namely patients, dentists, clinical researchers, health economists, statisticians, policy-makers and industry representatives. For the first stage of the Delphi process, a patient panel and a separate panel consisting of researchers, clinicians, teachers, industry affiliated researchers, policy-makers, and other interested parties will be held. An inclusive approach will be taken to involve panelists from a wide variety of socio-economic and geographic backgrounds. Results from the first round will be summarized and fed back to individuals for the second round, where panels will be combined and allowed to modify their scoring in light of the full panel’s opinion. Necessity for a third round will be dependent on the outcome of the first two. Agreement will be measured via defined consensus rules; up to a maximum of seven outcomes. If resources allow, we will investigate features that influence decision making for different groups. Discussion By using an explicit, transparent and inclusive multi-step consensus process, the planned core outcome set should be justifiable, relevant and comprehensive. The dissemination and application of this core outcome set should improve clinical trials on managing caries lesions and allow comparison, synthesis and implementation of scientific data. Trial registration Registered 12 April 2015 at COMET (http://www.comet-initiative.org

When Patients Govern: Federal Grant Funding and Uncompensated Care at Federally Qualified Health Centers

To determine if the proportion of consumers on federally qualified health center (FQHC) governing boards is associated with their use of federal grant funds to provide uncompensated care

Differentiating normal and problem gambling: a grounded theory approach.

A previous study (Ricketts &amp; Macaskill, 2003) delineated a theory of problem gambling based on the experiences of treatment seeking male gamblers and allowed predictions to be made regarding the processes that differentiate between normal and problem gamblers. These predictions are the focus of the present study, which also utilised a grounded theory approach, but with a sample of male high frequency normal gamblers. The findings suggest that there are common aspects of gambling associated with arousal and a sense of achievement. The use of gambling to manage negative emotional states differentiated normal and problem gambling. Perceived self-efficacy , emotion management skills and perceived likelihood of winning money back were intervening variables differentiating problem and normal gamblers.</p

Global congruence of carbon storage and biodiversity in terrestrial ecosystems

Deforestation is a main driver of climate change and biodiversity loss. An incentive mechanism to reduce emissions from deforestation and forest degradation (REDD) is being negotiated under the United Nations Framework Convention on Climate Change. Here we use the best available global data sets on terrestrial biodiversity and carbon storage to map and investigate potential synergies between carbon and biodiversity-oriented conservation. A strong association (rS= 0.82) between carbon stocks and species richness suggests that such synergies would be high, but unevenly distributed. Many areas of high value for biodiversity could be protected by carbon-based conservation, while others could benefit from complementary funding arising from their carbon content. Some high-biodiversity regions, however, would not benefit from carbon-focused conservation, and could become under increased pressure if REDD is implemented. Our results suggest that additional gains for biodiversity conservation are possible, without compromising the effectiveness for climate change mitigation, if REDD takes biodiversity distribution into account

Developing a core outcome set for periodontal trials

Acknowledgments The authors wish to thank all patients and professionals who took part in the Delphi process and face-to-face consensus meeting. We wish to thank Jillian Sutherland, Shirley Bell, Margaret Mooney and Lorna Barnsley for helping to organise the face-to-face consensus meeting. Patient participant recruitment to this study was facilitated by SHARE–the Scottish Health Research Register. SHARE is supported by NHS Research Scotland and the Chief Scientists Office Funding: TL received research funding for the core outcome set development for the prevention and management of periodontal diseases which was provided by the Tattershall fund, Dundee Dental School. This grant provided funds for the e-Delphi software, SHARE services and the face-to-face consensus meeting travel and catering costs. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscriptPeer reviewedPublisher PD

A rural-urban comparative study of nonphysician providers in community and migrant health centers.

This is a study of the employment of nonphysician providers--nurse practitioners, physician assistants, and certified nurse midwives--in both rural and urban Community and Migrant Health Centers and of factors associated with their employment, based on a 1991 national survey of 383 Centers. Results of the survey suggest that nonphysician providers, in particular nurse practitioners and certified nurse midwives, primarily serve as physician substitutes, and are more likely to be employed by Centers that are larger and have affiliations with nonphysician provider training programs. Rural or urban location is not significantly related to the employment of nonphysician providers after controlling for center size. The fact that rural centers employ fewer nonphysician providers than urban centers can primarily be accounted for by their relatively small size, rather than a lack of interest. These findings demonstrate that the use of nonphysician providers is an important way both to achieve cost containment and improve access to primary care for those residing in medically underserved areas