Secondary complications among person\u27s with spinal cord injury and best practices for life care planners

The current study was intended to deliver life care planners with a guide as to whether or not secondary complications (SCs) should be included within the LCP, while obtaining the professional opinion of physiatrists as to the incidence rate of SCs. Each research question was designed to determine whether differences exist between life care planners (LCPs) and physiatrists in their knowledge regarding SCs while comparing their responses with empirical research. In addition, it was determined to investigate whether costs should be included in a LCP based on the reports given from certified and non-certified LCPs; even though it meets the possibility (less than 50%) threshold rather than the probable (51% or greater) threshold. Lastly, this researcher wanted to examine the ethical considerations of LCPs as to whether they ever felt pressure to include costs in an effort to secure future employment by attorneys

Interview with Virginia Norquest

Supporting oral interviews conducted for The Norquest Family: A Porción of Edinburg.https://scholarworks.utrgv.edu/chapsoralhistories/1028/thumbnail.jp

Stigmatizing Effects of Visible Versus Invisible Disabilities

The concept of disability is complex and has been interpreted in a variety of ways. The degree to which a disorder is disabling depends on the interchange between the condition and other factors including the individual\u27s environment. Modern society\u27s emphasis on self-sufficiency and productivity contribute to the tendency to devalue those who are perceived as unable from these valued characteristics. Research suggests the visibility of a condition may lead to stigmatization, a concept generally associated with feelings of shame due to discontentment and devaluation of others. The authors present literature related to persons with visible and invisible disabilities, and the stigmatizing effects, while demonstrating the varying nature of stigma related to hiring practices and deliberate concealment, a phenomenon known well among persons with invisible disabilities. Additionally, the societal attitudes which lead to common barriers, negative experiences among persons with disabilities, and implications for practitioners are discussed

Differences Among Life Care Planners and Physiatrists Regarding the Likelihood and Frequency of Secondary Complications for Persons with Spinal Cord Injury

Life care planners (LCPs) who provide expert witness testimony must provide their professional opinions within a certain degree of life care planning probability or essentially a 51% chance or greater likelihood of the good or service occurring. In cases involving spinal cord injury (SCI), such opinions become complicated when attempting to include the costs of future secondary complications (SCs) that may or may not have a consistent body of empirical support and/or several physician specialists supporting the probability of occurrence. The present study surveyed 243 life care planners (LCPs), life care planning physiatrists (physiatrist LCPs), and non-life care planning physiatrists (physiatrist non-LCPs) in ascertaining their professional opinions regarding 13 SCs among individuals with a SCI, based upon level of injury. Results revealed that LCPs and physiatrist LCPs generally endorsed higher ratings for SCs in comparison to physiatrist non-LCPs. Life care planning in the legal arena is an adversarial specialization where LCP opinions are often contested by opposing attorneys and their retained experts when the opposition\u27s report(s) are perceived as unreasonably leaning in one direction (e.g., too costly to fund without validation). Being qualified and certified/licensed as an expert witness in any discipline is a privilege that carries with it a code of ethics and standards of practice (e.g., International Academy of Life Care Planners, n.d.). Triers of fact typically expect an impartial and objective set of opinions based upon a reliable and valid methodology from the expert which is generally supported by peers in that profession (Field, 2000; Hoyt & Aalberts, 2001; Johnston & Sartwelle, 2013). Expert witnesses who provide testimony must base their opinions on a certain degree of life-care planning probability, which is defined in the legal arena as a 51% or greater chance of occurring. Prior to 1993, this practice was not present as experts from various disciplines provided testimony they opined as probable, but there were no laws or litmus test required to determine reliability (Field, 2000; Hoyt & Aalberts, 2001). It was not until the 1993 Daubert v. Merrill Dow Pharmaceuticals and later the 1999 Kumho Tire Company v. Carmichael rulings that expert witnesses had to comply with stricter guidelines when proffering their opinions (Hoyt & Aalberts, 2001; Rutkin, 1999). After these rulings, experts were required to demonstrate that their opinions were generally accepted in their field, were subjected to peer-review publication, and employed a reliable methodology to arrive at their conclusions. In most expert witness disciplines, there appears to be a gray area where opposing experts do not always agree. Attorneys from both sides will often only retain an opposing expert when they perceive the life care plan developed by the opposing side is lacking in reasonableness, overall conclusions, and cost. Marini (2012) described the possibility versus probability dilemma life care planners face regarding when to include costs for yet-to-be determined future medical complications and when this is inappropriate. As Marini (2012) argued, some life care planners may cherry pick one or two studies in support of their opinions while ignoring the larger body of literature that does not. As noted earlier, the gray area exists when opposing experts cite different literature to support their opinions. Deutsch and Sawyer (1997) previously established a protocol for identifying and documenting potential medical complications that are yet-to-be determined. They stated that possible complication costs should not be included in a life care plan if they are not deemed probable to occur. Physician experts are also supposed to provide generally accepted opinions in their field. However, it is unknown as to whether their opinions have been scrutinized with the same rigor as non-physician life care planners (Marini, 2012). The purpose of the present study was to investigate the ratings of SCs among life care planners and physiatrists to provide those operating as a LCP with empirical support for cost inclusion in a plan when a SC reaches the probability threshold. In addition, we sought to examine whether differences occurred among physiatrists and LCPs when they provided their expert opinions of the likelihood of SCs occurring among people with a SCI. According to the 1993 Daubert and 1999 Kumho rulings, costs may be included if the empirical literature supports the prevalence of such occurrences with a 51% or greater frequency. However, as demonstrated through a comprehensive literature review by Ysasi et al. (2016), research on SCs among individuals with a SCI is often outdated; therefore, the research addressing the 13 secondary complications outlined in this research was long overdue

Satisfacción laboral en los trabajadores de la empresa de transportes nacional Logistico MV E.I.R.L, callao, 2021

La presente investigación que lleva como título “SATISFACCIÓN LABORAL EN LOS TRABAJADORES DE LA EMPRESA DE TRANSPORTES NACIONAL LOGISTICO MV E.I.R.L, CALLAO, 2021”, tuvo como objetivo: Determinar la dimensión que predomina en la satisfacción laboral en la empresa de transportes nacional logístico MV EIRL, Callao,2021, por consiguiente, se plantea la siguiente hipótesis: La dimensión que predomina en la satisfacción laboral en la empresa de transportes nacional logístico MV EIRL, Callao,2021 es la Motivación laboral. El diseño de la presente investigación es no experimental, de corte transversal, de tipo descriptiva, donde se analizará la Satisfacción laboral de los trabajadores de la empresa de transportes nacional logístico MV EIRL – Callao, 2021 para la recolección de datos se elaboró un cuestionario en donde podemos apreciar todas las dimensiones según basado en modelo de Medina & Gutiérrez (2021), que estuvo conformado por 28 ítems, en base a las 03 dimensiones con sus indicadores, con la escala de Likert; el cual se aplicó a toda la población de la EMPRESA DE TRANSPORTES NACIONAL LOGISTICO MV E.I.R.L. Con el análisis de la satisfacción laboral de los trabajadores de la empresa de transportes nacional logístico MV EIRL, se concluyó que la satisfacción laboral es alta lo que significa que dichos trabajadores esta satisfechos en su área laboral.Por consiguiente, nuestra hipótesis del presente trabajo es que predomina la Motivación laboral en la empresa la empresa de transportes nacional logístico MV EIRL.TesisGestión empresarial y emprendimient

Solar ultraviolet doses and vitamin D in a northern mid-latitude

Solar ultraviolet (UV) radiation is one of the most important factors in the development of skin cancer in human, solar erythema and skin aging. Nevertheless, numerous studies have shown the benefits of UV solar radiation in moderate doses, such as the reduction of blood pressure and mental health, treatment of various diseases, and the synthesis of vitamin D in the skin. This paper analyses data from solar ultraviolet erythemal (UVER) irradiance in W/m2 measured in a northern mid-latitude as Valencia (Spain) for the period 2003-2010. To estimate effective solar UV radiation in the production of vitamin D (UVD) we used the relationship proposed by McKenzie et al., 2009. It was obtained for one month for each season the minimum exposure time needed around solar noon and at 9 UTC and 15 UTC (Coordinated Universal Time) to obtain the recommended daily dose of 1000 IU. Also, it has been calculated time for erythema induction around solar noon for the same months. The median UVER daily dose during the summer months was 4000 J/m2day, and 700 J/m2day in winter. With regard to UVD, the median UVD daily dose in summer season was 7700 J/m2day, and in winter it was 1000 J/m2day. Around noon in January it takes more than two hours of solar exposure to obtain the recommended daily dose of vitamin D, whereas the rest of the year range between 7 minutes on July and 31 minutes on October. For the same months around noon, exposure times to produce erythema were obtained, these being of higher value to the previous. The results show that it is difficult to obtain the recommended vitamin D doses in winter in a northern mid-latitude, as the human body is almost entirely covered in this season.The research was supported by the Spanish Ministry of Education and Science within research project CGL2010-15931/CLI and by the Generalitat Valenciana within the project PROMETEO/2010/064.María-Antonia Serrano; Cañada, J.; Moreno, J.; Gurrea-Ysasi, G. (2017). Solar ultraviolet doses and vitamin D in a northern mid-latitude. Science of the Total Environment. 574:744-750. https://doi.org/10.1016/j.scitotenv.2016.09.102S74475057

Personal UV Exposure for Different Outdoor Sports

Exposure to ultraviolet (UV) radiation is the major environmental risk factor in the development of skin cancers and it occurs mainly during outdoor activities. The purpose of this study is to quantify the UV exposure suffered by amateur athletes (tennis players, hikers and runners) in their training schedules. The study on tennis player exposure took place at a tennis club in Valencia during the month of June 2011. With respect to the hiking group, the hikes studied took place in several mountainous areas of Spain and France from June to August 2011. Finally, the exposure suffered by ten runners, while participating in a running circuit in the province of Valencia, from March to November 2011, was studied. The athletes were monitored using personal dosimeters (VioSpor), with the tennis players and runners wearing them on the wrist, and the hikers on the shoulder. The median daily personal UV exposure for the hikers was 8.1 Standard Erythema Dose (SED), and for the tennis players 7.5 SED, per day of training. The runners received a median of 14.6 SED while participating in the running circuit, and about 2 SED per competition day. Median daily UV exposure of the hikers and tennis players exceeded 5 SED, which means that, in the case of non sun-adapted skin type III and the non-use of sun protection, erythema may be induced in these subjects. However, the exposure suffered by the runners did not exceed the maximum personal exposure of 5 SED. Accordingly, it is necessary to encourage the use of high protection sunscreens and protective clothing, and to avoid UV exposure in the hottest part of the day.This research was supported by the Spanish Ministry of Education and Science as part of research project CGL2010-15931 and the Generalitat Valenciana as part of project PROMETEO/2010/064.Serrano Jareño, MA.; Cañada, J.; Moreno, J.; Gurrea Ysasi, G. (2014). Personal UV Exposure for Different Outdoor Sports. Photochemical & Photobiological Sciences Photochemical and Photobiological Sciences. 13(4):671-679. https://doi.org/10.1039/c3pp50348h671679134Sklar, L. R., Almutawa, F., Lim, H. W., & Hamzavi, I. (2013). Effects of ultraviolet radiation, visible light, and infrared radiation on erythema and pigmentation: a review. Photochem. Photobiol. Sci., 12(1), 54-64. doi:10.1039/c2pp25152cNorval, M., Lucas, R. M., Cullen, A. P., de Gruijl, F. R., Longstreth, J., Takizawa, Y., & van der Leun, J. C. (2011). The human health effects of ozone depletion and interactions with climate change. Photochemical & Photobiological Sciences, 10(2), 199. doi:10.1039/c0pp90044cLucas, R. M., McMichael, A. J., Armstrong, B. K., & Smith, W. T. (2008). Estimating the global disease burden due to ultraviolet radiation exposure. International Journal of Epidemiology, 37(3), 654-667. doi:10.1093/ije/dyn017Juzeniene, A., Brekke, P., Dahlback, A., Andersson-Engels, S., Reichrath, J., Moan, K., … Moan, J. (2011). Solar radiation and human health. Reports on Progress in Physics, 74(6), 066701. doi:10.1088/0034-4885/74/6/066701De Gruijl, F. R. (2011). Sufficient Vitamin D from Casual Sun Exposure? Photochemistry and Photobiology, 87(3), 598-601. doi:10.1111/j.1751-1097.2011.00918.xWebb, A. R., Kift, R., Berry, J. L., & Rhodes, L. E. (2011). The Vitamin D Debate: Translating Controlled Experiments into Reality for Human Sun Exposure Times. Photochemistry and Photobiology, 87(3), 741-745. doi:10.1111/j.1751-1097.2011.00898.xNorval, M., Cullen, A. P., de Gruijl, F. R., Longstreth, J., Takizawa, Y., Lucas, R. M., … van der Leun, J. C. (2007). The effects on human health from stratospheric ozone depletion and its interactions with climate change. Photochemical & Photobiological Sciences, 6(3), 232. doi:10.1039/b700018aKampman, M. T., & Steffensen, L. H. (2010). The role of vitamin D in multiple sclerosis. Journal of Photochemistry and Photobiology B: Biology, 101(2), 137-141. doi:10.1016/j.jphotobiol.2010.04.003Zittermann, A., & Gummert, J. F. (2010). Sun, vitamin D, and cardiovascular disease. Journal of Photochemistry and Photobiology B: Biology, 101(2), 124-129. doi:10.1016/j.jphotobiol.2010.01.006Grant, W. B. (2010). Relation between prediagnostic serum 25-hydroxyvitamin D level and incidence of breast, colorectal, and other cancers. Journal of Photochemistry and Photobiology B: Biology, 101(2), 130-136. doi:10.1016/j.jphotobiol.2010.04.008Bikle, D. D. (2012). Protective actions of vitamin D in UVB induced skin cancer. Photochemical & Photobiological Sciences, 11(12), 1808. doi:10.1039/c2pp25251aHumble, M. B. (2010). Vitamin D, light and mental health. 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Dermatology, 217(1), 38-44. doi:10.1159/000121473Downs, N., Parisi, A., & Schouten, P. (2011). Basal and squamous cell carcinoma risks for golfers: An assessment of the influence of tee time for latitudes in the Northern and Southern hemispheres. Journal of Photochemistry and Photobiology B: Biology, 105(1), 98-105. doi:10.1016/j.jphotobiol.2011.07.007Moehrle, M., Korn, M., & Garbe, C. (2000). Bacillus subtilis spore film dosimeters in personal dosimetry for occupational solar ultraviolet exposure. International Archives of Occupational and Environmental Health, 73(8), 575-580. doi:10.1007/s004200000183Rigel, E. G., Lebwohl, M. G., Rigel, A. C., & Rigel, D. S. (2003). Ultraviolet Radiation in Alpine Skiing. Archives of Dermatology, 139(1). doi:10.1001/archderm.139.1.60Siani, A. M., Casale, G. R., Diémoz, H., Agnesod, G., Kimlin, M. G., Lang, C. A., & Colosimo, A. (2008). Personal UV exposure in high albedo alpine sites. 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A Comprehensive Literature Review of Secondary Complications of Spinal Cord Injury

Spinal cord injury (SCI) and secondary complications (SCs) that occur as a direct result of the injury can be a contributing factor for increased hospitalization and need for specialized healthcare. For instance, level of injury, time since injury, gender, age, and personal health care have shown to increase and/or decrease the incidence rate of specific SCs. The authors conducted a comprehensive literature review for 12 SCs to examine the relative prevalence of each for people with SCI. The data utilized was to determine the probability (\u3e50%) versus the possibility

Perceptual analysis of thermal-luminal comfort in areas shaded by vegetation in design education centers

[EN] The search for comfort in users is a priority objective in technical schools focused on spaces design. The use of spaces can be for residential, commercial or entertainment activities. It is a common mistake to consider that comfort is achieved exclusively through the analysis of the interior space, since it is also necessary to consider the relationship between the space and the surrounding environment, because it is affected by environmental variables such as radiation, wind, humidity, noise, etc. The change of these variables throughout the day influences the interior conditions of the spaces and in general, is needed to incorporate artificial systems to compensate the external climatological conditions (thermal machines, light sources, etc.). Grade students, in design schools acquire, throughout the curriculum, knowledge in relation to the limits of comfort required for interior spaces. In the last academic year of the degree in Architecture, students have sufficient capacity to be able to detect the fluctuations that occur in the variables of the external environment by measuring temperature and humidity with DATALOGGER, equipment capable of recording data over time or in relation to the location using its own sensors or externally connected, as well as the value of the light level with LUXOMETERS, which are instruments that measure the real and not subjective illuminance of an environment. On the other hand, students are also able to evaluate the quality of the indoor environment, detecting whether or not there is a difference with the outdoor environment and assessing, for each orientation, the need for protection against radiation, (possible incorporation of tree mass, etc.). The protocol for developing the work proposal is established with measurements at the beginning of the course (winter period), later in spring and at the end of the course (beginning of summer). For each space analyzed (indoor and outdoor), measurements are carried out three times a day (early in the morning, at noon and in the evening). With the data obtained in different moments of the day and stationary situations, students must be able to select the most suitable protection devices for the building under analysis (vegetation, canopies, etc.).Blanca-Giménez, V.; Gurrea-Ysasi, G.; Rodriguez-Burruezo, A.; Fita, I. (2019). Perceptual analysis of thermal-luminal comfort in areas shaded by vegetation in design education centers. En INNODOCT/18. International Conference on Innovation, Documentation and Education. Editorial Universitat Politècnica de València. 69-76. https://doi.org/10.4995/INN2018.2018.8779OCS697