The fit of Certified Disability Management Specialists' (CDMS) knowledge domains with Minnesota's Qualified Rehabilitation Consultants' (QRCS') competencies

Includes bibliographical references

Low-carbohydrate diets for gestational diabetes

Nutrition therapy provides the foundation for treatment of gestational diabetes (GDM), and has historically been based on restricting carbohydrate (CHO) intake. In this paper, randomized controlled trials (RCTs) are reviewed to assess the effects of both low- and higher CHO nutrition approaches in GDM. The prevailing pattern across the evidence underscores that although CHO restriction improves glycemia at least in the short-term, similar outcomes could be achievable using less restrictive approaches that may not exacerbate IR. The quality of existing studies is limited, in part due to dietary non-adherence and confounding effects of treatment with insulin or oral medication. Recent evidence suggests that modified nutritional manipulation in GDM from usual intake, including but not limited to CHO restriction, improves maternal glucose and lowers infant birthweight. This creates a platform for future studies to further clarify the impact of multiple nutritional patterns in GDM on both maternal and infant outcomes

The Importance of Human Reliability Analysis in Human Space Flight: Understanding the Risks

HRA is a method used to describe, qualitatively and quantitatively, the occurrence of human failures in the operation of complex systems that affect availability and reliability. Modeling human actions with their corresponding failure in a PRA (Probabilistic Risk Assessment) provides a more complete picture of the risk and risk contributions. A high quality HRA can provide valuable information on potential areas for improvement, including training, procedural, equipment design and need for automation

The Impact of Total Hip Replacement

This descriptive, correlational study replicated an investigation by Selman (1989) exploring the effects of Total Hip Replacement (THR) on quality of life to identify adaptation level in the four effector modes of Roy\u27s Adaptation Model: physiologic function, self-concept, role function and interdependence. The convenience sample consisted of 43 subjects with a mean age of 67 electing to undergo primary TBR at one 410-bed midwestern medical center July, 1994 through December, 1994. Subjects were tested prior to undergoing THR and four months postoperatively. The instrument used was the Arthritis Impact Measurement Scales (AIMS) an arthritis-specific, self-administered questionnaire.; Analysis of data revealed a significant improvement postoperatively in the self-concept, physiologic function and role function subscales, which was consistent with the original study. There was also significant postoperative improvement in pain and arthritis activity scores. Married subjects reported significantly greater improvement on the arthritis visual analog scale than subjects without spouses

Use of growth parameters of feeder steers to predict finishing performance

The objective of this experiment was to determine the feasibility of utilizing certain feeder calf characteristics to predict subsequent feedlot performance and carcass value. Data from 144 steers (72 Angus and 72 Angus-Hereford cross) in Trial I (1984-85) and 144 steers (same distribution of breeds) in Trial II (1985-86), purchased by an order buyer from East Tennessee and the surrounding area, formed the basis of this study. Animals were considered to be representative of the predominate breeds preferred by buyers of Tennessee feeder steers. Initial and final linear body measurements, subcutaneous fat thickness and weights were recorded for the growth phase in each Trial. Carcass traits and days on feed needed to reach 12 mm fat thickness were recorded for the finish phase of Trials I and II. In Trial I, initial width (P \u3c .001) and average daily gain during the growth phase (P \u3c .01) significantly effected subsequent carcass value. These variables were therefore utilized to allot the steers on Trial II to feedlot pens. These allotment systems proved to be effective in predicting days on feed needed to reach optimal slaughter endpoint of 12 mm fat thickness (P \u3c .01). However, no differences in the effectiveness of predicting days on feed were found between the two allotment systems. The results of analysis of variance on the combined data set from Trials I and II indicated that an increase in final height, initial length, initial width and total weight gain during the growth phase significantly increased subsequent carcass value (P \u3c .001). An increase in final fat thickness at the end of the growth phase also increased carcass value (P \u3c .0001). Neither initial height, final shoulder width, final length or initial fat thickness had any effect on carcass value. An increase in initial and final fat thickness significantly decreased the number of days on feed needed to reach optimal slaughter endpoint (P \u3c .0001). An increase in final shoulder width also decreased days on feed (P \u3c .01). However, initial and final height, initial and final length, initial shoulder width and total weight gain during the growth phase had no significant effect on days on feed. By grouping the animals in Trials I and II by net worth, it was determined that animals with higher linear body measurements and weight gains during the growth phase yielded higher carcass values due to the increase in carcass weight. The animals with lower linear body measurements and total weight gains during the growth phase required fewer average days on feed to reach optimal slaughter endpoint, however they yielded carcasses of lower values due to lower carcass weights. Initial shoulder width and weight gains during the growth phase can be an accurate predictors of subsequent feedlot performance and carcass value. Initial length and final height may be utilized as predictors of carcass value, also, after further study. Initial width and/or weight gain during the growth phase could be useful to the feedlot operator in predicting feedlot performance and carcass value of feeder steers of British breeds. Linear body measurements and weight gains might also be useful to the beef producer in selecting management techniques and marketing strategies to increase net revenue

The Use of Traditional Articulation Tests in Phonological Analysis

Phonological analysis is an established, comprehensive, and effective means of assessing the speech patterns of unintelligible children. However, many practicing speech-language pathologists have not incorporated this procedure into their diagnostic batteries and continue to use traditional articulation tests because of convenience and familiarity of the tests (Garber, 1984). If articulation tests could be modified to assess phonological simplification processes, speech-language pathologists may be more likely to use this method of speech analysis. The purpose of this study was to determine if traditional articulation tests employing a phonological analysis procedure are a valid measure of phonological simplification processes. This study compared results obtained on two traditional articulation tests, the Goldman-Fristoe Test of Articulation (Goldman and Fristoe, 1972) and the Fisher-Logemann Test of Articulation Competence (Fisher and Logemann, 1971), with those obtained on a phonological assessment tool, the Assessment of Phonological Processes (Hodson, 1980). The articulation tests were modified to analyze the phonological simplification processes found on Hodson\u27s test (APP). Twenty-four phonologically delayed children, eight 3-year-olds, eight 4-year-olds, and eight 5-year-olds, served as subjects. Each of the three test instruments was administered to all 24 subjects. Composite Phonological Deviancy Scores were obtained for all tests and compared statistically using the Pearson Product Moment Correlation Coefficient. Correlations comparing the two articulation tests with the APP were computed for the entire group of subjects, as well as by age groups. Results revealed high correlations between scores obtained on the Goldman-Fristoe and the APP for all age groups and between scores obtained on the Fisher-Logemann and the APP for all age groups at the .001 level of confidence. This indicates that traditional articulation tests can be used to analyze phonological simplification processes. Additional analysis of the data revealed the following: a) agreement between the tests increased as the subjects\u27 ages increased; and b) agreement between the tests increased when miscellaneous and assimilation process points were excluded. It was also concluded that certain factors should be considered before using a traditional articulation test for phonological analysis: a) child interest; b) administration time; c) number of items on the test and its effect on the Composite Phonological Deviancy Score; and d) adequate representation of each process by the test items. Further research examining the use of articulation tests with phonological analysis procedures and scoring methods other than Hodson\u27s is warranted

An analysis of war trauma and refugee distress among Bosnian Muslim women : exploring social and personal healing in the aftermath

This study is a narrative examination of the healing process in the aftermath of war trauma for nineteen Bosnian Muslim refugee women. Epistemologically informed by Feminist Standpoint Theory, a mixed methods approach of Grounded Theory, Narrative Analysis and Relational Voice Theory was used to show how recovery from multiple war trauma/violence has occurred only partially. By synthesizing theories of place identity, gender roles, and meaning making systems, the difficulties women face to integrate war and refugee experiences into social understanding is examined. Individuals in the study identified themselves as Bosnian women – culturally, nationally, ethnically, and religiously. Not only did war threaten those identifications, in some aspects, it fundamentally altered them. This paper argues that when the women were alienated from place attachments, their history and narratives were disrupted. They were dislocated from a literal space called “home” and they lost a sense of existential belonging and identity. Second, findings explicate how war and forced removals impacted familial and communal relationships. Women experienced relational losses through death and separation; they also lost the anchoring of their social identities. In exile, role expectations and demands radically shifted. Finally, narrative analysis demonstrates how traumatic events created an internal disorientation. Centralizing ethno-religious beliefs were shattered, leaving refugee women to face a crisis of meaning. Taken together, these findings elucidate how the radical discordance between pre/post-war place identification, role continuity, and cultural/religious belief systems is problematic and has made it difficult for Bosnian Muslim refugee women in the study to heal or to fully recover in the aftermath of war

Shuttle Risk Progression: Use of the Shuttle Probabilistic Risk Assessment (PRA) to Show Reliability Growth

It is important to the Space Shuttle Program (SSP), as well as future manned spaceflight programs, to understand the early mission risk and progression of risk as the program gains insights into the integrated vehicle through flight. The risk progression is important to the SSP as part of the documentation of lessons learned. The risk progression is important to future programs to understand reliability growth and the first flight risk. This analysis uses the knowledge gained from 30 years of operational flights and the current Shuttle PRA to calculate the risk of Loss of Crew and Vehicle (LOCV) at significant milestones beginning with the first flight. Key flights were evaluated based upon historical events and significant re-designs. The results indicated that the Shuttle risk tends to follow a step function as opposed to following a traditional reliability growth pattern where risk exponentially improves with each flight. In addition, it shows that risk can increase due to trading safety margin for increased performance or due to external events. Due to the risk drivers not being addressed, the risk did not improve appreciably during the first 25 flights. It was only after significant events occurred such as Challenger and Columbia, where the risk drivers were apparent, that risk was significantly improved. In addition, this paper will show that the SSP has reduced the risk of LOCV by almost an order of magnitude. It is easy to look back afte r 30 years and point to risks that are now obvious, however; the key is to use this knowledge to benefit other programs which are in their infancy stages. One lesson learned from the SSP is understanding risk drivers are essential in order to considerably reduce risk. This will enable the new program to focus time and resources on identifying and reducing the significant risks. A comprehensive PRA, similar to that of the Shuttle PRA, is an effective tool quantifying risk drivers if support from all of the stakeholders is given

Working Through The Past: Labor and Authoritorian Legacies in Comparative Perspective

[Excerpt] Democratization in the developing and post-communist world has yielded limited gains for labor. Explanations for this phenomenon have focused on the effect of economic crisis and globalization on the capacities of unions to become influential political actors and to secure policies that benefit their members. In contrast, the contributors to Working through the Past highlight the critical role that authoritarian legacies play in shaping labor politics in new democracies, providing the first cross-regional analysis of the impact of authoritarianism on labor, focusing on East and Southeast Asia, Eastern Europe, and Latin America. Legacies from the predemocratic era shape labor’s present in ways that both limit and enhance organized labor’s power in new democracies. Assessing the comparative impact on a variety of outcomes relevant to labor in widely divergent settings, this volume argues that political legacies provide new insights into why labor movements in some countries have confronted the challenges of neoliberal globalization better than others