Taking the national guideline for care of acute myocardial infarction to the bedside: developing the guideline applied in practice (GAP) initiative in Southeast Michigan.

BACKGROUND: The Guideline Applied in Practice (GAP) program was developed in 2000 to improve the quality of care by improving adherence to clinical practice guidelines. For the first GAP project, the American College of Cardiology (ACC) partnered with the Southeast Michigan Quality Forum Cardiovascular Subgroup and the Michigan Peer Review Organization (MPRO) to develop interventions that might facilitate the use of the ACC/AHA Acute Myocardial Infarction (AMI) guideline in the practice setting. Ten Michigan hospitals participated in implementing the project, which began in March 2000. DESIGNING THE PROJECT: The project developed a multifaceted intervention aimed at key players in the care delivery triangle: the physician, nurse, and patient. Intervention components included a project kick-off presentation and dinner, creation and implementation of a customized tool kit, identification and assignment of local nurse and physician opinion leaders, grand rounds site visits, and measurement before and after the intervention. IMPLEMENTING THE PROJECT: The GAP project experience suggests that hospitals are enthusiastic about partnering with ACC to improve quality of care; partners can work together to develop a program for guideline implementation; rapid-cycle implementation is possible with the GAP model; guidelines and quality indicators for AMI are well accepted; and hospitals can adapt the national guideline for care into usable tools focused on physicians, nurses, and patients. DISCUSSION: Important structure and process changes--both of which are required for successful QI efforts--have been demonstrated in this project. Ultimately, the failure or success of this initiative will depend on an indication that the demonstrated improvement in the quality indicators is sustained over time.     

Attitudes toward sex, arousal, and the retention of contraceptive information.

Previous research has suggested that woman with a negative emotional orientation toward sexuality (i.e., erotophobia) have difficulty learning and retaining sexually relevant material such as contraceptive information. It has been hypothesized that these women become aroused by this material and that this arousal interferes with their ability to learn it. The importance of this issue led us to conduct the current study. Erotophobic and erotophilic women viewed presentations about contraception while their physiological responses were being monitored. In addition, they were tested on the information contained in the presentation before, immediately after, and again 4–6 wks after the presentation. Results indicate that the erotophobic women knew less contraceptive information before the presentation and were more aroused by the presentation. This arousal, however, did not interfere with retention of the material. Results are discussed in terms of individual differences in reactions to sexual material and the ability to learn, retain, and use contraceptive information. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effect of sexual motivation on men's risk perception for sexually transmitted disease: There must be 50 ways to justify a lover.

Recent research has incorporated situational factors into assessment of risk. Working from a rational appraisal framework, however, these studies have not emphasized contextual features that might introduce motivated risk assessment. In the current study, participants (N?=?40 male undergraduates) lowered their risk perceptions for STDs following the induction of a sexual motivation. In an initial baseline condition, participants estimated the risk of contracting STDs from partners with relatively high- or low-risk sexual histories. In a subsequent trial, participants repeated the imagery task while viewing photographs that were high or low in sex appeal. As predicted, participants reduced their risk perceptions when they viewed photographs high in sex appeal. The only necessary precondition was the presence of nondiagnostic information from which they could construct biased risk estimates. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A 10-year longitudinal study of body weight, dieting, and eating disorder symptoms.

This article describes a 10-year longitudinal study of eating attitudes and behaviors. A sample of 509 women and 206 men completed a detailed survey in 1982 while they were in college. The authors contacted participants 10 years later and administered a 2nd questionnaire to assess stability and change in eating behaviors that occurred during the transition to early adulthood. Women in the study had substantial declines in disordered eating behavior as well as increased body satisfaction. However, body dissatisfaction and desires to lose weight remained at relatively high levels. Men, who rarely dieted or had eating problems in college, were prone to weight gain following college, and many of them reported increased dieting or disordered eating. The authors conclude that disordered eating generally tends to decline during the transition to early adulthood. However, body dissatisfaction remains a problem for a substantial segment of the adult population. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Occupation-differential construct validity of the Job Content Questionnaire (JCQ) psychological job demands scale with physical job demands items: a mixed methods research

The construct validity of the Job Content Questionnaire (JCQ) psychological demands scale in relationship to physical demands has been inconsistent. This study aims to test quantitatively and qualitatively whether the scale validity differs by occupation. Hierarchical clustering analyses of 10 JCQ psychological and physical demands items were conducted in 61 occupations from two datasets: one of non-faculty workers at a university in the United States (6 occupations with 208 total workers) and the other of a Belgian working population (55 occupations with 13,039 total workers). The psychological and physical demands items overlapped in 13 of 61 occupation-stratified clustering analyses. Most of the overlaps occurred in physically-demanding occupations and involved the two psychological demands items, 'work fast' and 'work hard'. Generally, the scale reliability was low in such occupations. Additionally, interviews with eight university workers revealed that workers interpreted the two psychological demands items differently by the nature of their tasks. The scale validity was occupation-differential. PRACTITIONER SUMMARY: The JCQ psychological job demands scale as a job demand measure has been used worldwide in many studies. This study indicates that the wordings of the 'work fast' and 'work hard' items of the scale need to be reworded enough to differentiate mental and physical job demands as intended, 'psychological.'     

Privacy-aware peer-to-peer content distribution using automatically recombined fingerprints

Multicast distribution of content is not suited to content-based electronic commerce because all buyers obtain exactly the same copy of the content, in such a way that unlawful redistributors cannot be traced. Unicast distribution has the shortcoming of requiring one connection with each buyer, but it allows the merchant to embed a different serial number in the copy obtained by each buyer, which enables redistributor tracing. Peer-to-peer (P2P) distribution is a third option which may combine some of the advantages of multicast and unicast: on the one hand, the merchant only needs unicast connections with a few seed buyers, who take over the task of further spreading the content; on the other hand, if a proper fingerprinting mechanism is used, unlawful redistributors of the P2P-distributed content can still be traced. In this paper, we propose a novel fingerprinting mechanism for P2P content distribution which allows redistributor tracing, while preserving the privacy of most honest buyers and offering collusion resistance and buyer frameproofness.     

High capacity audio watermarking using the high frequency band of the wavelet domain

This paper proposes a novel high capacity robust audio watermarking algorithm by using the high frequency band of the wavelet decomposition at which the human auditory system (HAS) is not very sensitive to alteration. The main idea is to divide the high frequency band into frames and, for embedding, to change the wavelet samples depending on the average of relevant frame??s samples. The experimental results show that the method has a very high capacity (about 11,000 bps), without significant perceptual distortion (ODG in [?1 ,0] and SNR about 30dB), and provides robustness against common audio signal processing such as additive noise, filtering, echo and MPEG compression (MP3).     

Characterization of flue gas desulfurization particulates in equalization basins

Particulates in pilot-scale flue gas desulfurization (FGD) scrubber water were characterized by powder X-ray diffraction, scanning electron microscopy with energy dispersive spectroscopy, and size analysis based on Stokes’ Law after settling in an equalization basin of a pilot-scale constructed wetland treatment system. Three sources were interpreted for specific particle types identified in samples analyzed: FGD wet scrubbing processes, coal combustion byproducts, and uncombusted material from coal. Gypsum (CaSO₄ · 2H₂O) from the FGD scrubbing process comprises ∼95% of the particulates. Iron oxide particles and cenospheres in the particulate samples are interpreted as coal combustion products. Particles interpreted as originating from unburned coal contain carbon and metals including Zn and Fe. The most abundant elements in the particulates analyzed are O, C, Ca, S, Fe, and Si, with maximum mean content of individual elements ranging from 13% to 70% among particle types. Less abundant elements include Al, K, Mg, Ti, and Mo, with maximum mean content from 0.1% to 3.8%.