The Village of River Ranch: A Post Occupancy Evaluation of a Traditional Neighborhood Development in Lafayette, Louisiana

The proponents of New Urbanism claim the neighborhoods they design, called Traditional Neighborhood Developments (TNDs), promote community, sense of place, physical health, and environmental sustainability. Critics assert that community is stressed at the expense of individuality, that design unity has become rigid uniformity, and that the neighborhoods are orchestrated and do not reflect real life. This thesis, a post occupancy evaluation (POE), examines how one TND works for its residents and whether it accomplishes the goals of the architect/planner. An additional, essential purpose of this POE is to serve the feed-forward role of informing future neighborhood planning projects. The Village of River Ranch in Lafayette, Louisiana is the site of my research. Utilization of multiple research methods (survey, interviews, naturalistic observations) offered opportunities for triangulation and the ability to produce a more comprehensive analysis

Alien Registration- Trainer, Elizabeth (Rangeley, Franklin County)

https://digitalmaine.com/alien_docs/19756/thumbnail.jp

Mediation and Legal Literacy

This study uses fieldwork to investigate the sponsorship of legal literacy within a court mediation program. This examination of institutional involvement in literacy sponsorship demonstrates the ideological nature of literacy by showing the importance of context, investigating literacybased relationships, and uncovering the intertwined nature of oral and written forms of discourse. Little research so far has examined the sponsor’s perspective on literacy, and this study also examines how sponsors may accrue and distribute benefits. Further, the study explicates an approach to literacy sponsorship through mediation which, while still embedded with disparate power relations, may provide an equitable literacy sponsorship model for other community organizations

A dynamic tactile matrix of closely spaced probes.

Massachusetts Institute of Technology. Dept. of Electrical Engineering. Thesis. 1965. M.S.Bibliography: leaf 30.M.S

Epigenetics and social inequalities in asthma and allergy

Respiratory illnesses, such as asthma and allergy disorders, are disproportionately more common among minority racial/ethnic groups and those of low socioeconomic status. In the United States, asthma prevalence and severity are highest among Puerto Ricans (19.2%), American Indians/Alaska Natives (13%), and Black Americans (12.7%) and higher in families living below the poverty threshold than among those living above it (11% vs 8%–9%).1 Many studies of asthma/allergy inequalities assume that genetic differences underlie racial/ethnic differences in these disorders, pointing to genetic ancestry differences between races, but most genetic variants fail to explain racial/ethnic differences and are usually studied only in White populations.2 In reality, racial and ethnic groups—terms that are often used interchangeably and in overlapping ways—can exhibit varying levels of genetic ancestry, cultural traits, and environmental exposures that all may be entangled together. Thus, any genetic finding differing by race/ethnicity can be confounded by social and environmental factors that also track with different ancestries. However, epigenetic mechanisms (i.e., heritable and stable changes in gene expression) may prove important in explaining these inequalities, as they are influenced by a combination of environmental, social, and genetic factors

Improved Management of Stillbirth using a Care Pathway.

PurposeEach year approximately 3,200 women have a stillbirth in the UK. Although national evidence-based guidance has existed since 2010, case reviews continue to identify suboptimal clinical care and communication with parents. Inconsistencies in management include induction and management of labour and the frequency of investigation after stillbirth. The paper aims to discuss these issues.Design/methodology/approachAn audit of stillbirths was performed in 2014 in 13 maternity units in the North West of England, this confirmed variation in practice described nationally. An integrated care pathway (ICP) was developed from national guidelines to enable optimal care for the management of stillbirth, reduce variation, standardise investigations and coordinate patient-focussed care. This was launched in 2015 and updated in 2016 to resolve the issues that were apparent after implementation.FindingsEach participating unit had commenced using the ICP by May 2015. Following implementation there were changes in care, most notably from diverse methods for the induction of labour to guideline-directed induction of labour. There were trends towards better care in terms of information given, choices offered, more appropriate analgesia in labour and improved post-delivery investigation for cause. Staff feedback about the ICP was positive.Practical implicationsThe use of this ICP improved care for women who had a stillbirth and their families. Issues with implementing a changed care pathway meant that further iterations were required, ongoing improvement is expected following the refinement of the ICP.Originality/valueICPs have been used for various clinical conditions. However, this is the first example of their use in women who had a stillbirth

Trimethoprim use for urinary tract infection and risk of adverse outcomes in older patients: cohort study.

OBJECTIVE: To determine if trimethoprim use for urinary tract infection (UTI) is associated with an increased risk of acute kidney injury, hyperkalaemia, or sudden death in the general population. DESIGN: Cohort study. SETTING: UK electronic primary care records from practices contributing to the Clinical Practice Research Datalink linked to the Hospital Episode Statistics database. PARTICIPANTS: Adults aged 65 and over with a prescription for trimethoprim, amoxicillin, cefalexin, ciprofloxacin, or nitrofurantoin prescribed up to three days after a primary care diagnosis of UTI between April 1997 and September 2015. MAIN OUTCOME MEASURES: The outcomes were acute kidney injury, hyperkalaemia, and death within 14 days of a UTI treated with antibiotics. RESULTS: Among a cohort of 1 191 905 patients aged 65 and over, 178 238 individuals were identified with at least one UTI treated with antibiotics, comprising a total of 422 514 episodes of UTIs treated with antibiotics. The odds of acute kidney injury in the 14 days following antibiotic initiation were higher following trimethoprim (adjusted odds ratio 1.72, 95% confidence interval 1.31 to 2.24) and ciprofloxacin (1.48, 1.03 to 2.13) compared with amoxicillin. The odds of hyperkalaemia in the 14 days following antibiotic initiation were only higher following trimethoprim (2.27, 1.49 to 3.45) compared with amoxicillin. However, the odds of death within the 14 days following antibiotic initiation were not higher with trimethoprim than with amoxicillin: in the whole population the adjusted odds ratio was 0.90 (95% confidence interval 0.76 to 1.07) while among users of renin-angiotensin system blockers the odds of death within 14 days of antibiotic initiation was 1.12 (0.80 to 1.57). The results suggest that, for 1000 UTIs treated with antibiotics among people 65 and over, treatment with trimethoprim instead of amoxicillin would result in one to two additional cases of hyperkalaemia and two admissions with acute kidney injury, regardless of renin-angiotensin system blockade. However, for people taking renin-angiotensin system blockers and spironolactone treatment with trimethoprim instead of amoxicillin there were 18 additional cases of hyperkalaemia and 11 admissions with acute kidney injury. CONCLUSION: Trimethoprim is associated with a greater risk of acute kidney injury and hyperkalaemia compared with other antibiotics used to treat UTIs, but not a greater risk of death. The relative risk increase is similar across population groups, but the higher baseline risk among those taking renin-angiotensin system blockers and potassium-sparing diuretics translates into higher absolute risks of acute kidney injury and hyperkalaemia in these groups

Global research priorities to accelerate early child development in the sustainable development era

CITATION: Dua, T. et al. 2016. Global research priorities to accelerate early child development in the sustainable development era. Lancet Global Health, 4(12):e887–e889, doi:10.1016/S2214-109X(16)30218-2.The original publication is available at https://www.journals.elsevier.com/the-lancet-global-healthBetween 1990 and 2015, the under-5 mortality rate declined by 53%, resulting in approximately 48 million more children reaching their fifth birthday than would have occurred had 1990 mortality rates continued.1 Many of these children, however, continue to live in conditions of adversity—marked by extreme poverty, undernutrition, conflict, and insecurity—and are not afforded the level of care required to ensure that they meet their developmental potential.2 Neuroscience research in the past two decades is unequivocal that the period from conception through early childhood (ie, at least the first 3 years) is foundational in terms of brain development.Grand Challenges Canadahttp://www.thelancet.com/journals/langlo/article/PIIS2214-109X(16)30218-2/fulltextPublisher's versio