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Objective Individuals living with serious mental illnesses are key stakeholders in user experience design and the development of the WorkingWell mobile app to enhance on-the-job follow-along support. In this study, Individual Placement and Support (IPS) consumers identify challenges in sustaining employment, provide data regarding their use of technology, and suggest technology-based solutions for coping on the job to inform app development. Method Focus groups were conducted in 3 agencies providing IPS services to examine consumers' perspectives on supported employment, work, and their preferences for technology-based supports. Qualitative data were coded thematically in a multistep, collaborate approach to ensure trustworthiness. Survey data were collected to describe participants and their current technology use; these data were analyzed descriptively. Results A total of 25 IPS consumers reported work challenges related to interpersonal relationships and social situations; job characteristics, tasks, and expectations; illness- and treatment-related issues; lifestyle/wellness and conditions apart from work; and motivation. The majority owned mobile phones, felt comfortable using technology, and could see how technology-based tools could help sustain employment. Participants highlighted the potential benefits of technology-based supports for work challenges, and underscored the potential for independence and empowerment as a consequence. Conclusions and implications for practice Study findings suggest the value of a WorkingWell mobile app that is innovative, easy to access, self-directed, and individually tailored to enhance IPS follow-along support. The WorkingWell app, if proven effective, will provide an empowering set of tools designed with input from individuals with serious mental illnesses, and integrated into a single, accessible interface. (PsycINFO Database Record

Although Malaysia is a major producer and exporter of wood products in the world, the status of wood products certification in the industry is relatively unknown. Therefore, a study was carried out to assess the status of chain of custody certification among wooden furniture manufacturers using a structured questionnaire to interview firms who had participated at the annual Malaysian International Furniture Fair (MIFF). Results collated indicate that the readiness to adopt chain of custody certification among wooden furniture manufacturers was low. The lack of price premiums, limited market potential and high cost was cited as the primary reasons deterring furniture manufacturers from adopting chain of custody certification. Furthermore, the use of plantation wood resources, such as Rubberwood (Hevea brasiliensis), perceived to be certified wood resources, reflects the lack of understanding among the manufacturers. This study shows that an increasing adoption of chain of custody certification among wooden furniture manufacturers in Malaysia can be realized in the market organisation, especially with regards to price premiums and market requirements.

Malaysia, a major producer and exporter of wood products has been slow to embrace wood products certification. A study was carried out with the intention of assessing the status of chain of custody certification among wooden furniture manufacturers. A structured questionnaire was used to interview firms who participated at the annual Malaysian International Furniture Fair in 2007. Results indicate that the readiness to adopt chain of custody certification among wooden furniture manufacturers was low. The lack of price premiums, limited market potential and high cost were cited as the primary reasons deterring furniture manufacturers from adopting chain of custody certification. Furthermore, the use of plantation wood resources, such as Rubberwood (Hevea brasiliensis Mll. Arg.), were perceived by many respondents to be certified wood resources, reflecting a lack of understanding among manufacturers. It was concluded that the promotion of chain of custody certification in Malaysia must focus on increasing awareness as well as highlighting the tangible and intangible benefits to be gained from such a scheme.

To assess the effect of bariatric surgical treatment of morbid obesity on bone mineral metabolism.We analyzed pertinent vitamin D and calcium metabolic variables in 136 patients who had undergone a malabsorptive bariatric operation. Measurements of bone mineral density (BMD), serum 25-hydroxyvitamin D (25-OHD), 1,25-dihydroxyvitamin D [1,25-(OH)2D], parathyroid hormone (PTH), calcium, phosphorus, and alkaline phosphatase were performed. Statistical analyses assessed correlations among various factors.The mean age (+/-SD) of the study group was 48.34 +/- 10.28 years. Their mean weight loss was 114.55 +/- 45.66 lb, and the mean duration since the bariatric surgical procedure was 54.02 +/- 51.88 months. Seventeen patients (12.5%) had a T-score of -2.5 or less, and 54 patients (39.7%) had a T-score between -1.0 and -2.5. Of 119 patients in whom serum 25-OHD was measured, 40 (34%) had severe hypovitaminosis D (25-OHD8ng/mL), and 50 patients (42%) had low hypovitaminosis D (serum 25-OHD 8 to 20 ng/mL). The magnitude of weight loss correlated negatively with serum 25-OHD, calcium, phosphorus, and calcium x phosphorus product values and positively with serum alkaline phosphatase level. Serum 25-OHD and calcium concentrations correlated positively with the BMD. PTH, serum 1,25-(OH)2D, and alkaline phosphatase concentrations correlated negatively with the BMD, a reflection of the presence of secondary hyperparathyroidism, an accelerated conversion of 25-OHD to 1,25-(OH)2D by the elevated PTH levels, and increased osteoblastic activity. The mean daily vitamin D supplementation was 6,472 +/- 9,736 IU.Hypovitaminosis D and subsequent bone loss are common in patients who have undergone a bariatric surgical procedure for morbid obesity. These patients require rigorous vitamin D supplementation.

The primary aim was to establish from acupuncture patients the type and frequency of adverse events they experienced and attributed to their treatment. Secondary aims included the measurement of patient reported adverse consequences arising from advice received about conventional/prescribed medication or from delayed conventional diagnosis and treatment.Postal survey of prospectively identified acupuncture patients. One in three members of the British Acupuncture Council (n = 638) invited consecutive patients to participate in the survey. Participating patients gave baseline data and consented to direct follow up by the researchers at 3 months. A structured questionnaire was used to collect data on perceived adverse events.9408 patients gave baseline information and consent and 6348 (67%) completed 3 month questionnaires. Responders were not dissimilar to non-responders for all known characteristics. 682 patients reported at least one adverse event over 3 months, a rate of 107 per 1000 patients (95% CI 100 to 115). Three patients reported a serious adverse event. The most common events reported were severe tiredness and exhaustion, pain at the site of needling, and headache. Patients receiving acupuncture treatment that was not funded by the NHS and patients not in contact with a GP or hospital specialist were less likely to report adverse events (odds ratios 0.59 and 0.66, respectively). 199 (3%) of responding patients reported receiving advice about conventional/prescribed medication, six of whom reported adverse consequences after taking the advice. Two patients reported delayed conventional treatment.Patients report a range of adverse events but these do not prevent most patients seeking further acupuncture. This large scale survey supports existing evidence that acupuncture is a relatively safe intervention when practised by regulated practitioners.

Previous studies have shown evidence of constitutive and cytokine-inducible nitric oxide (NO) synthase activity in cultured osteoblast-like cells from various species. Although cytokine-induced NO production has been found to inhibit osteoblast growth, the role of constitutive NO production in regulating osteoblast function is less clear and the isoforms of nitric oxide synthase (NOS) that are expressed by human osteoblasts have not been determined. Here, we investigated NOS expression in cultured human osteoblast-like cells and studied the effects of constitutive and cytokine-induced NO on osteoblast growth and differentiation. Low levels of NO were produced constitutively by osteoblast-like cells as reflected by analysis of medium nitrite concentrations, and evidence of ecNOS mRNA, protein, and bioactivity was found in primary osteoblasts (hOBs), TE85, and MG63 osteosarcoma cells. None of the osteoblast-like cells expressed nNOS, however, and iNOS was produced only by hOB cells after stimulation with the cytokines IL-1beta, TNF-alpha, and IFN-gamma. The NOS inhibitor, L-NMMA, did not affect growth or alkaline phosphatase activity in unstimulated osteoblasts. Incubation of hOB cells with cytokines inhibited growth and stimulated alkaline phosphatase activity and these effects were abrogated by L-NMMA. Cytokines also inhibited growth of TE85 cells and MG63 cells, but these effects appeared to be NO independent because they were not influenced by L-NMMA. Our experiments show that human osteoblasts constitutively produce NO through the ecNOS pathway, but demonstrate that this does not appear to exert an appreciable effect on osteoblast growth or differentiation under basal conditions. In contrast, IL-1beta, TNF-alpha, and IFN-gamma exerted growth-inhibiting and differentiation-inducing effects on osteoblasts that were partly NO dependent, indicating that NO may act predominantly as a modulator of cytokine-induced effects on osteoblast function.

The objective of this study was to evaluate the consumer perceptions towards rubberwood (Hevea brasiliensis) as a premier furniture material. The data for this study were collected from a questionnaire survey completed by 250 buyers who attended the international furniture fairs in Malaysia. Correlation analysis showed that the success factors of rubberwood as a furniture stock in comparison to other furniture wood species are its lower cost, availability, environmental friendliness and easy workability.

We have investigated the ability of cells derived from the human joint to generate nitric oxide (NO). Synovial fibroblasts, articular chondrocytes and osteoblasts were cultured from tissues of patients undergoing hip replacement surgery, and synovial fluid leucocytes were obtained from patients undergoing joint aspiration. There was little spontaneous generation of NO by any of the cells after culture, but synovial fibroblasts, articular chondrocytes and osteoblasts all produced large quantities of NO in response to a cytokine mix of interleukin (IL)-1 beta + tumour necrosis factor alpha (TNF alpha) + interferon (IFN gamma). Reverse transcription-polymerase chain reaction (RT-PCR) analysis showed the presence of mRNA transcripts for the inducible isoform of NO synthase in cytokine-stimulated but not in unstimulated cells. In contrast, leucocytes from synovial fluid did not produce NO either spontaneously or after cytokine stimulation, and mRNA for inducible NO synthase (iNOS) was not detected in these cells even by nested PCR. There were significant differences in the regulation of NO production between chondrocytes and other cells. Only chondrocytes generated NO in response to IL-1 beta or TNF alpha alone, whereas synovial fibroblasts and osteoblasts required the presence of at least two cytokines to generate NO. Dexamethasone (10(-6)M) had a small but significant inhibitory effect on NO production by chondrocytes, synovial fibroblasts and osteoblasts. Our results indicate that several cells within the human joint have the potential to generate NO in the presence of an appropriate pro-inflammatory cytokine stimulus, while leucocytes in synovial fluid are not a significant source of NO. The data support suggestions that NO is produced within the inflamed joint in diseases such as rheumatoid arthritis.

The aim of this study was to update and extend our knowledge of the bacterial load and microbial composition in Norway lobster (Nephrops norvegicus) under commercially relevant storage conditions to optimize handling procedures.Total viable counts were performed at different storage temperatures (0, 4, 8, 10, 12 or 16°C) and after different storage times (1-7 days). Storage at 16°C was found to be most detrimental, and storage at 0°C was found to be optimal. 16S-rRNA sequencing was utilized to determine the composition of the bacteria within the microflora. In this way, Photobacterium isolates, especially Photobacterium phosphoreum, were identified as the main specific spoilage organisms. The abilities to reduce trimethylamineoxide (TMAO) and to produce H(2)S were analysed in a selection of bacterial isolates. The higher the incubation temperature during storage, the more isolates were found to reduce TMAO and produce H(2)S.Nephrops norvegicus possesses an unusually high initial microbial load when fresh. Storage temperature is the most crucial factor affecting microbial growth, microbial activity and spoilage potential in N. norvegicus produce. Spoilage can be attributed mainly to P. phosphoreum.This study presents significant new findings with regard to the progression and causative agents of spoilage in N. norvegicus. Based on the results, we can recommend that N. norvegicus tails should be stored in a 0°C environment immediately after catch. Stored this way, the growth and spoilage activity of the microflora may be reduced significantly and an extension of shelf life might be attained.

Dr. Thomas Henry Manning, Officer of the Order of Canada, former Vice-Chairman and Executive Director of the Arctic Institute of North America, and famed Canadian Arctic expert, died on 8 November 1998 at Smiths Falls, Ontario, after a long illness. He was the author of more than fifty scholarly papers and reports, about half of them on zoological subjects, but he was probably best known for his record as an exceptional Arctic traveller on land and sea. ... Manning was awarded the Bruce Medal of the Scottish Geographical Society and Royal Philosophical Society of Edinburgh in 1944; the Patron's Medal of the Royal Canadian Geographical Society in 1948; and the Massey Medal of the Royal Society of Canada in 1977. He was appointed an Officer in the Order of Canada in 1974 and awarded an honorary doctorate of literature by McMaster University in 1979. Manning was exceptionally tough, vigorous, fearless, patient, hard-working and resourceful, qualities that made him the matchless Arctic traveller and scientist that he was, and earned him respect among Inuit and Southerners alike.

Some standards for childhood ophthalmological variables exist. However, for most parameters, the range of variation found in normal children remains poorly defined.We have determined the range of normal function for a number of commonly measured ophthalmological variables in 162 children, classified normal by Gold Standard ophthalmological examination. This group is representative of almost 12,000 normal children aged 4 1/2 to 5 1/2 in Nova Scotia.In 56.8% of eyes the visual acuity was 6/4.5. The use of a chart with crowding bars was more discriminating between differences in higher levels of acuity and highlighted differences in acuity between the two eyes. Randot stereoacuity showed a uniform, non-Gaussian distribution of scores. Cycloplegic refractive errors were distributed about a modal value of between +0.5 and +1.0 diopter. Forty percent of eyes had no detectable astigmatism. Ninety-seven percent of subjects had no heterophoria. Fusional vergence data are presented.Our results document the complete normal range for selected ophthalmological parameters in normal preschoolers. The values obtained were in general better than expected.

As we now progress in the field of bariatric surgery, improving methods and fine tuning operative procedures, we witness many benefits. Fewer complications, shorter hospital stays, and more evidence of successful weight loss consistently appear in the statistics that have been accumulated through years of research. The information accumulated through years of research. The information provided, continues to verify that surgery is the most viable treatment for morbid obesity. There is minimal literature, however, that addresses the emotional issues faced by the patients who have undergone bariatric procedures. Postoperatively we may find at intervals of 3 months, 6 months, and even 1 or more years, a patient struggling to deal with their identity. The resolution or improvements of various medical anomalies, may seem insignificant as the patient now begins to focus on emotional and physical changes. Their bodies' new shape may create distressing personal concerns. Family members may also struggle with these psychological and physical changes. The surgery has forced the patient to deal with the loss of a love that is not easily replaced, the love of food. These, all too frequently, are the actual postoperative complications, co-morbidity changes, and weight loss, most importantly, we must also understand our responsibility to address the patients' emotional well-being. While indicating our concerns for the psychological as well as physiological recovery, the patient may then realize a healthier transition into life beyond bariatric surgery.

In bariatric surgery we modify, in varying degrees, the gastrointestinal system. We observe the patients clinically over the postoperative period of a few months or more. During this time our main concern is to monitor them physiologically, noting the decline in weight, change in body structure, and vast improvement in their comorbidities. Frequently the reaction of the patient may be somewhat surprising to us. One or 2 years past surgery they have forgotten about having had diabetes and hypertension, diseases for which they had received a barrage of medical treatment. It does not seem to matter anymore that at one time they wore a size 2X and now can wear size 14. Now we are forced to wonder what the expectation of the patient was. Our goal was to improve their physiological and psychological well-being, assuming they would go hand in hand with weight loss. If the patient does not recognize an improvement in their quality of life and continues to question their self-worth, then perhaps we should reassess our goals and our obligations. The principles of surgery and how it is or should be done is fairly clear. If we are to maintain standards of quality in this particular field of medicine, we must recognize our commitment to patients and make these principles just as clear. The commitment involves ongoing postoperative assessment and teaching, assessment of emotional well-being and lessons in dietary and physical activity, including exposure to and involvement in group support.