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Background Counseling to reduce access to lethal means such as firearms and medications is recommended for suicidal adults but does not routinely occur. We developed the Web-based Lock to Live (L2L) decision aid to help suicidal adults and their families choose options for safer home storage. Objective This study aimed to test the feasibility and acceptability of L2L among suicidal adults in emergency departments (EDs). Methods At 4 EDs, we enrolled participants (English-speaking, community-dwelling, suicidal adults) in a pilot randomized controlled trial. Participants were randomized in a 13:7 ratio to L2L or control (website with general suicide prevention information) groups and received a 1-week follow-up telephone call. Results Baseline characteristics were similar between the intervention (n=33) and control (n=16) groups. At baseline, many participants reported having access to firearms (33/49, 67%), medications (46/49, 94%), or both (29/49, 59%). Participants viewed L2L for a median of 6 min (IQR 4-10 min). L2L also had very high acceptability; almost all participants reported that they would recommend it to someone in the same situation, that the options felt realistic, and that L2L was respectful of values about firearms. In an exploratory analysis of this pilot trial, more participants in the L2L group reported reduced firearm access at follow-up, although the differences were not statistically significant. Conclusions The L2L decision aid appears feasible and acceptable for use among adults with suicide risk and may be a useful adjunct to lethal means counseling and other suicide prevention interventions. Future large-scale studies are needed to determine the effect on home access to lethal means. Trial Registration ClinicalTrials.gov NCT03478501; https://clinicaltrials.gov/ct2/show/NCT03478501

Mental illness is a growing, and largely unaddressed, problem for the population and for emergency department (ED) patients in particular. Extensive literature outlines sex and gender differences in mental illness’ epidemiology and risk and protective factors. Few studies, however, examined sex and gender differences in screening, diagnosis, and management of mental illness in the ED setting. Our consensus group used the nominal group technique to outline major gaps in knowledge and research priorities for these areas, including the influence of violence and other risk factors on the course of mental illness for ED patients. Our consensus group urges the pursuit of this research in general, and conscious use of a gender lens when conducting, analyzing, and authoring future ED-based investigations of mental illness.

The objective of this study was to describe the services, referral and reporting practices, and barriers to utilization of driver rehabilitation programs (DRPs) for older drivers. Identified through two national association databases, 204 driver rehabilitation programs completed an online survey. DRP availability varies, with a median of one program per 64,151 older adults (range: 1,006–676,981). The median cost for a complete evaluation was $400; 36% of DRPs reported no third-party reimbursement. Participants thought barriers to DRP use include cost/reimbursement, lack of program awareness, and issues with evaluator training. Models for insurance reimbursement, and increased awareness of program benefits by healthcare providers and older drivers, are needed.

OBJECTIVES: We sought to describe epidemiological patterns of acute injuries treated in emergency department (ED) and outpatient primary care settings in the United States. DESIGN: Retrospective cross-sectional analysis of data from the 2009 and 2010 National Health Care Surveys. SETTING: Emergency departments and outpatient primary care clinics. PARTICIPANTS: Older adults (≥65) with initial visits for acute injuries. MEASUREMENTS: Frequencies and incidence rates of medically attended injury according to participant characteristics and care setting. RESULTS: Of the 19.7 million medically attended acute injuries in older adults in 2009-10, 50% were treated at EDs and 50% at outpatient primary care clinics. The annual incidence rate of medically attended injuries rose with age, from 20.8 (95% confidence interval (CI) = 17.0-24.6) per 100 in those aged 65 to 74 to 41.5 (95% CI = 33.5-49.4) per 100 for those aged 85 and older. Of injury-related ED visits, 60% occurred outside standard business hours, 36% were triaged as low acuity, and 25% resulted in admission. Only 9% of injury-related primary care visits had injury prevention counseling documented. CONCLUSION: Medically attended injuries area common in older adults, and their incidence increases with advancing age. Half of all initial visits for acute injuries in older adults are to primary care clinics. Most injured individuals are discharged home, and injury prevention counseling is rarely documented. To inform injury prevention efforts appropriately and to avoid underestimating the burden of injury, future injury studies should include a range of outpatient and inpatient care settings. Language: en

Phase-shifted carrier (PSC) modulation has become an industry standard in its application to multilevel H-bridge static compensators (H-StatComs). The technique uses the cancellation of harmonics within each phase leg to significantly improve the harmonic performance relative to the switching frequency. This paper investigates subtle practical implementation issues which deteriorate the harmonic performance of this technique. The effects of nonuniform dc bus voltages and capacitor voltage balancing strategies are investigated. Simulation and experimental results are presented which show that the harmonic performance of the PSC technique deteriorates as the number of voltage levels produced by the H-StatCom increases.

Introduction The present study uses data from the American Automobile Association (AAA) Longitudinal Research on Aging Drivers (LongROAD) study to assess the association of the frailty phenotype with reduced driving space and involvement in motor vehicle crashes. Methods The LongROAD study is a multisite prospective cohort study of participants aged 65–79 years. Fried's frailty phenotype status at baseline and self-reported restricted driving space in the past three months and at least one self-reported crash in the recent year are examined. Multivariable logistic regression was used to obtain odds ratios, adjusting for covariates and clustering by site. Results Pre-frail (i.e. only 1–2 indicators of frailty) participants had 30% higher odds (adjusted OR = 1.3, 95% CI:1.0–1.8) of reporting involvement in a crash in the prior year than non-frail participants after adjusting for sex, age, depression, word recall, average miles driven per week, and site. No association for reduced driving space for frail older drivers was found. Conclusions The frailty phenotype is associated with motor vehicle crashes, but not reduced driving space. Our findings suggest that future research should be focused on the identification of pre-frail older adult drivers to improve the health and quality of life of older adult drivers.

Deaths and injuries from firearms are significant public health problems, and clinicians are in a unique position to identify risk among their patients and discuss the importance of safe firearm practices. Although clinicians may be ill-prepared to engage in such discussions, an adequate body of evidence is available for support, and patients are generally receptive to this type of discussion with their physician. Here, we provide an overview of existing research and recommended strategies for counseling and intervention to reduce firearm-related death and injury.

December 2015 saw another Congressional budget standoff and threatened government shutdown. This omnibus bill was particularly important for public health, because – for the first time in years – it contained language that would have reversed a 19-year-old prohibition on Centers for Disease Control and Prevention (CDC) funding for research on firearm injury. Unfortunately, 2016’s final Omnibus Appropriations bill did not reverse this prohibition. And so another year begins with the United States – and the world – debating how to solve the problem of firearm violence in this country, without the benefit of objective public health research.

The term microgrid is usually reserved for a modest sized, local distributed generation network that will largely operate standalone (i.e., without a grid connection.) The most common power flow control method utilized in a standalone microgrid is a technique known as power-frequency droop. This paper introduces the concept of utilizing an arctan function for the power-frequency droop profile. The use of this arctan function improves the small signal stability of the two-inverter microgrid, provides natural frequency bounding, and is flexible in its application. SABER simulations are performed to obtain the operating points about which the system is linearized for the stability analysis. Experimental results obtained from a dSPACE-controlled, low-voltage, two-inverter hardware system are presented to verify the theoretical and simulation results.

Objectives The objective was to describe self-harm assessment practices in U.S. emergency departments (EDs) and to identify predictors of being assessed. Methods This was a prospective observational cohort study of adults presenting to eight U.S. EDs. A convenience sample of adults presenting to the EDs during covered research shifts was entered into a study log. Self-harm assessment was defined as ED documentation of suicide attempt; suicidal ideation; or nonsuicidal self-injury thoughts, behaviors, or both. Institution characteristics were compared relative to percentage assessed. To identify predictive patient characteristics, multivariable generalized linear models were created controlling for weekend presentation, time of presentation, age, sex, and race and ethnicity. Results Among 94,354 charts, self-harm assessment ranged from 3.5% to 31%, except for one outlying site at 95%. Overall, 26% were assessed (11% excluding the outlying site). Current self-harm was present in 2.7% of charts. Sites with specific self-harm assessment policies had higher assessment rates. In the complete model, adjusted risk ratios (aRR) for assessment included age ≥ 65 years (0.56, 95% confidence interval [CI] = 0.35 to 0.92) and male sex (1.17, 95% CI = 1.10 to 1.26). There was an interaction between these variables in the smaller model (excluding outlying site), with males

The brushless doubly-fed reluctance machine has two sets of stator windings of different pole number linked by a reluctance type of rotor. The rotor modulates the stator MMF from one winding so that flux links the other winding creating mutual coupling. This is still a research machine and the design methodology is under development. Past works indicates that a ducted rotor with radial laminations is best suited to be the reluctance rotor. In this paper the geometry of the rotor is investigated. If the ducts are too thin then the reluctance ratio is low and the coupling is affected. If they are too wide then the reluctance path for the coupling flux is high and the machine will saturate quickly. It is found, using finite element analysis, that the duct ratio should be about 38% from the results in the paper. This is in line with previous work on synchronous reluctance machines that can also use ducted rotors (although they use axial lamination which are inappropriate for this application). © 2013 IEEE.

BACKGROUND Driving for older adults is a matter of balancing independence, safety and mobility, and prematurely relinquishing the car keys can impact morbidity and mortality. Discussions about “when to hang up the keys” are difficult for clinicians, drivers, and family members, and therefore are often avoided or delayed. “Advance Driving Directives” (ADDs) may facilitate conversations between health care providers and older drivers focused on prevention and advance planning for driving cessation.

Academic environments can feel unwelcoming for women in science, technology, engineering, and math (STEM) fields. Two studies examined academic environments of female undergraduates majoring in STEM fields at a university in the United States. In Study 1, we compared women in STEM who are in a welcoming environment to those in a traditional STEM environment in order to identify factors that may make environments seem welcoming to women. Women in the welcoming environment received more messages about women in STEM, were more likely to wear or carry markers of their major, and had more peer role models in STEM. In Study 2, we developed an intervention based on these factors to improve women’s implicit beliefs about their participation in STEM. In a sample of women in traditional STEM environments, we manipulated exposure to the intervention and the self-relevance of the intervention. The intervention decreased stereotyping concerns and indirect STEM stereotyping, and it increased implicit STEM identification when the intervention was made self-relevant. This research demonstrates the importance of a welcoming academic environment for women in STEM, and it also provides a model for how key elements of intensive university programs targeting women can be translated into a more general approach that reaches a wider audience.

Background As an important indicator of mobility, driving confers a host of social and health benefits to older adults. Despite the importance of safe mobility as the population ages, longitudinal data are lacking about the natural history and determinants of driving safety in older adults. Methods The Longitudinal Research on Aging Drivers (LongROAD) project is a multisite prospective cohort study designed to generate empirical data for understanding the role of medical, behavioral, environmental and technological factors in driving safety during the process of aging. Results A total of 2990 active drivers aged 65–79 years at baseline have been recruited through primary care clinics or health care systems in five study sites located in California, Colorado, Maryland, Michigan, and New York. Consented participants were assessed at baseline with standardized research protocols and instruments, including vehicle inspection, functional performance tests, and “brown-bag review” of medications. The primary vehicle of each participant was instrumented with a small data collection device that records detailed driving data whenever the vehicle is operating and detects when a participant is driving. Annual follow-up is being conducted for up to three years with a telephone questionnaire at 12 and 36 months and in-person assessment at 24 months. Medical records are reviewed annually to collect information on clinical diagnoses and healthcare utilization. Driving records, including crashes and violations, are collected annually from state motor vehicle departments. Pilot testing was conducted on 56 volunteers during March–May 2015. Recruitment and enrollment were completed between July 2015 and March 2017. Conclusions Results of the LongROAD project will generate much-needed evidence for formulating public policy and developing intervention programs to maintain safe mobility while ensuring well-being for older adults.

Perceptions of the relevance of race in everyday situations may matter for intergroup relations. Extending previous research, this work examines Blacks’ and Whites’ perceptions of race relevance in positive versus negative everyday situations affecting Black or White individuals. It also examines whether Black and White participants expect more intergroup disagreement regarding those perceptions than actually exists (i.e., interracial pluralistic ignorance). In Study 1, White participants saw significantly more race relevance in negative situations affecting Black (rather than White) individuals, whereas positive events seemed only marginally more race relevant when they featured Blacks. Study 2 replicated this pattern among White and Black participants. Furthermore, Study 2 uncovered interracial pluralistic ignorance: both Black and White participants expected to agree with their racial ingroup more than their racial outgroup, even though both groups reported similar race relevance perceptions. Participants’ own race relevance ratings and symbolic racist attitudes moderated the degree of expected disagreement.

This study aims to evaluate the factor structure of Career Decision Self-Efficacy scale-short form in a sample of Italian high school adolescents. confirmatory factor analysis (CFA) was used to test the degree to which a one-factor structure and a five-factor structure provided the best fit. In view of available research the five-factor structure was expected to provide the best fit. Moreover, factorial invariance in males and females was tested. It was expected to be invariant across groups. As expected the five-factor structure showed a better fit than the one-factor model and the factorial invariance resulted invariant across boys and girls.

Study objective To identify critical emergency medicine–focused firearm injury research questions and develop an evidence-based research agenda. Methods National content experts were recruited to a technical advisory group for the American College of Emergency Physicians Research Committee. Nominal group technique was used to identify research questions by consensus. The technical advisory group decided to focus on 5 widely accepted categorizations of firearm injury. Subgroups conducted literature reviews on each topic and developed preliminary lists of emergency medicine–relevant research questions. In-person meetings and conference calls were held to iteratively refine the extensive list of research questions, following nominal group technique guidelines. Feedback from external stakeholders was reviewed and integrated. Results Fifty-nine final emergency medicine–relevant research questions were identified, including questions that cut across all firearm injury topics and questions specific to self-directed violence (suicide and attempted suicide), intimate partner violence, peer (nonpartner) violence, mass violence, and unintentional ("accidental") injury. Some questions could be addressed through research conducted in emergency departments; others would require work in other settings. Conclusion The technical advisory group identified key emergency medicine–relevant firearm injury research questions. Emergency medicine–specific data are limited for most of these questions. Funders and researchers should consider increasing their attention to firearm injury prevention and control, particularly to the questions identified here and in other recently developed research agendas.

The Modular Multilevel Converter (MMC) has many features that make it suitable for photovoltaic systems. It has good output performance, flexibility in control and its modular and scalable design allow it to directly connect to high voltage networks. The converter's isolated DC links also allow for the connection of many individual PV arrays. This paper presents an MMC control scheme which, by controlling individual sub-module voltages, allows for maximum power point tracking of each photovoltaic array. The presented control scheme also allows for operation under largely varying converter arm irradiances, while maintaining balanced sinusoidal output currents to the grid, without the requirement of an overall DC link in the converter. Simulation results are presented to confirm that the control system operates as expected under these unbalanced conditions.

Current control is the most basic control loop for a current controlled inverter-fed machine. Current controllers fall into two categories depending on the reference frames they operate in — rotating reference frame controllers, and stationary frame controllers. This paper introduces a novel current control technique for inverter controlled machines known as Local Vector Control (LVC). This control technique can be used for the current control loops as well as outer control loops, and can operate without alteration in a stationary or rotating reference frame. Due to its high gain properties it potentially offers excellent transient performance, minimises the effects of disturbances, and operates with varying system parameters. This paper is a preliminary investigation of this algorithm applied to power electronic applications.

BACKGROUND: Health care providers have been encouraged to discuss firearms with patients; whether patients view these discussions as appropriate is unclear. OBJECTIVE: To estimate, in a national sample, the perceived appropriateness of provider discussions about firearms. DESIGN: Probability-based online survey conducted in April 2015. Analyses used survey weights to generate nationally representative estimates. SETTING: U.S. adults. PARTICIPANTS: 3914 English-speaking adults (55% participation rate). MEASUREMENTS: Participants were asked, MEASUREMENTS: " MEASUREMENTS: In general, would you think it is never, sometimes, usually, or always appropriate for physicians and other health professionals to talk to their patients about firearms? MEASUREMENTS: " RESULTS: A majority (66% [95% CI, 63% to 69%]) of participants said that it is at least sometimes appropriate for providers to talk to patients about firearms. Specifically, 23% (CI, 20% to 25%) said that provider discussions about firearms were always appropriate, 14% (CI, 11% to 16%) said that they were usually appropriate, and 30% (CI, 27% to 33%) thought they were sometimes appropriate; 34% (CI, 31% to 37%) felt that such discussions were never appropriate. Views varied by firearm ownership: 54% (CI, 52% to 57%) of gun owners said that provider discussions are at least sometimes appropriate, compared with 67% (CI, 62% to 71%) of nonowners living with an owner and 70% (CI, 66% to 74%) of nonowners not living with an owner. Firearm owners who were more likely to think that firearm discussions are at least sometimes appropriate included those with children at home (62% [CI, 57% to 67%]), those who thought that having a gun at home increases suicide risk (75% [CI, 67% to 83%), and those who thought that provider discussions of seat belts are at least sometimes appropriate (73% [CI, 70% to 75%]). LIMITATIONS: The provider discussion question did not specify clinical context. CONCLUSION: Two thirds of non-firearm owners and over one half of firearm owners in the United States believe that health care provider discussions about firearms are at least sometimes appropriate. The observed heterogeneity underscores the need to better understand assumptions that may underlie these views, particularly among firearm owners. PRIMARY FUNDING SOURCE: Fund for a Safer Future and Joyce Foundation. Language: en

This paper presents the Local Vector Control (LVC) algorithm that is applicable to power electronic systems. This controller does not differentiate between linear or non-linear systems and can operate, without change, in stationary or rotating reference frames. The performance of this current controller with particular emphasis on current clamp minimisation will be the paper's focus. A comparison between the LVC, PI and predictive dead-beat current controllers (PCC) is presented.

While most body image research emphasizes the thin ideal, a wider variety of body-ideal messages pervade U.S. popular culture today, including those promoting athleticism or curves. Two studies assessed women's reactions to messages conveying thin, athletic, and curvy ideals, compared to a control message that emphasized accepting all body types. Study 1 (N=192) surveyed women's responses to these messages and found they perceived body-acceptance and athletic messages most favorably, curvy messages more negatively, and thin messages most negatively. Further, greatest liking within each message category came from women who identified with that body type. Study 2 (N=189) experimentally manipulated exposure to these messages, then measured self-objectification and body satisfaction. Messages promoting a body-ideal caused more self-objectification than body-acceptance messages. Also, athletic messages caused more body dissatisfaction than thin messages. Together, these findings reveal the complexity of women's responses to diverse messages they receive about ideal bodies.

OBJECTIVE. We explored driving rehabilitation specialists’ (DRSs’) perspectives on older driver evaluations. METHOD. We conducted interviews with 26 DRSs across the United States who evaluate older drivers. Transcript analysis followed general inductive techniques to identify themes related to current systems and barriers to use. RESULTS. Themes, by Social–Ecological Model level, were as follows: (1) individual occupational therapists’ commitment to mobility and safety, perceived responsibilities, and experience; (2) DRSs’ relationships with drivers, medical providers, and licensing bureaus; (3) the community surrounding the DRSs, including the health care system and transportation resources; and (4) societal factors, including DRS reimbursement, reporting requirements and liability coverage, and role of national organizations. CONCLUSIONS. This qualitative study identified barriers to the development of an effective system for older driver evaluations. Future work should verify, refine, and expand these findings by targeting other stakeholder groups.

Women in science, technology, engineering, and mathematics (STEM) are labeled unfeminine, a costly social label that may discourage female students from pursuing these fields. Challenges to this stereotype include feminine STEM role models, but their counterstereotypic-yet-feminine success may actually be demotivating, particularly to young girls. Study 1 showed that feminine STEM role models reduced middle school girls’ current math interest, self-rated ability, and success expectations relative to gender-neutral STEM role models and depressed future plans to study math among STEM-disidentified girls. These results did not extend to feminine role models displaying general (not STEM-specific) school success, indicating that feminine cues were not driving negative outcomes. Study 2 suggested that feminine STEM role models’ combination of femininity and success seemed particularly unattainable to STEM-disidentified girls. The results call for a better understanding of feminine STEM figures aimed at motivating young girls.

A multilevel H-bridge StatCom inherently contains redundancy in the available switching states. This paper develops a variation on the typical model predictive control scheme which is able to exploit this redundancy to simultaneously balance the H-bridge capacitor voltages, provide excellent current reference tracking, and minimize converter switching losses. The scheme consists of a dead-beat current controller that has been integrated with heuristic models of the voltage balancing and switching loss characteristics. The integration of a pulsewidth modulation scheme is also described. Simulation and experimental results are presented that confirm the correct operation of the control and modulation strategies. Comparison with traditional control and modulation schemes is provided in terms of the key performance indicators associated with multilevel H-bridge StatComs.

Emergency medicine (EM) has an important role in public health, but the ideal approach for teaching public health to EM residents is unclear. As part of the national regional public health–medicine education centers-graduate medical education (RPHMEC-GM) initiative from the CDC and the American Association of Medical Colleges, three EM programs received funding to create public health curricula for EM residents. Curricula approaches varied by residency. One program used a modular, integrative approach to combine public health and EM clinical topics during usual residency didactics, one partnered with local public health organizations to provide real-world experiences for residents, and one drew on existing national as well as departmental resources to seamlessly integrate more public health–oriented educational activities within the existing residency curriculum. The modular and integrative approaches appeared to have a positive impact on resident attitudes toward public health, and a majority of EM residents at that program believed public health training is important. Reliance on pre-existing community partnerships facilitated development of public health rotations for residents. External funding for these efforts was critical to their success, given the time and financial restraints on residency programs. The optimal approach for public health education for EM residents has not been defined.

Suicide rates are higher at high altitudes; some hypothesize that hypoxia is the cause. We examined 8,871 suicides recorded in 2006 in 15 states by the National Violent Death Reporting System, with the victim's home county altitude determined from the National Elevation Dataset through FIPS code matching. We grouped cases by altitude (low

All suicides by Hispanics (n = 434) and non-Hispanic Whites (n = 3,370) in Colorado from 2004 to 2008 using the Violent Death Reporting System were examined. Hispanic victims were significantly younger. Adjusting for age and gender, Hispanic victims were less likely to have reported depressed mood [odds ratio (OR) 0.78; 95% confidence interval (CI) 0.63-0.97], mental health diagnosis (OR 0.53; 95% CI 0.41-0.7), or current psychiatric treatment (OR 0.47; 95% CI 0.43-0.77). There were no differences in reports of financial, relationship, job, or legal stresses. Hispanic suicides were equally likely to be by overdose, firearm, or hanging, but more likely to be in jail (OR 2.68; 95% CI 1.55-4.65). To prevent suicides, stronger partnerships are needed among public health, medical, mental health, and criminal justice professionals.

The present article describes the potential utility of item response theory (IRT) and adaptive testing for scale evaluation and for web-based career assessment. The article describes the principles of both IRT and adaptive testing and then illustrates these with reference to data analyses and simulation studies of the Career Confidence Inventory (CCI). The kinds of information provided by IRT are shown to give a more precise look at scale quality across the trait continuum and also to permit the use of adaptive testing, where the items administered are tailored to the individual being tested. Such tailoring can significantly reduce testing time while maintaining high quality of measurement. This efficiency is especially useful when multiscale inventories and/or a large number of scales are to be administered. Readers are encouraged to consider using these advances in career assessment.

The association between home firearms and the likelihood and nature of suicidal thoughts and plans was examined using the Second Injury Control and Risk Survey, a 2001-2003 representative telephone survey of U.S. households. Of 9,483 respondents, 7.4% reported past-year suicidal thoughts, 21.3% with a plan. Similar proportions of those with and without a home firearm reported suicidal thoughts, plans, and attempts. Among respondents with suicidal plans, the odds of reporting a plan involving a firearm were over seven times greater among those with firearms at home, compared with those without firearms at home. The results suggest people with home firearms may not be more likely to be suicidal, but when suicidal they may be more likely to plan suicide by firearm.

The psychometric properties of measures of self-efficacy for the six themes of Holland’s theory were examined using item response theory. Item and scale quality were compared across levels of the t...

Career assessment has advanced on several fronts, enabling a CAPA integrative online system for exploring college majors with unprecedented precision and utility. The key inventories in the system are the CAPA Confidence Inventory (CCI), with its 6 general and 27 specific scales, and the CAPA Interest Inventory, with its 6 general and 35 specific scales. Results for these inventories are displayed online when they are completed, enhanced with extensive interpretive materials. With regression models, college major clusters with best fit are displayed based on high scores on the specific confidence and interest scores. Several studies of the inventories and the CAPA assessment system with several thousand college students have demonstrated their validity and utility.

Due to their robustness and simplicity of control, dc machines continue to be widely used in many applications, including mining. Although a mature technology, dc machines still require research attention to accommodate for heavier loads and harder operation conditions dictated by production needs. Recent advances in sensoring, data acquisition, and signal processing technologies allow for direct measurement of quantities that used to be theoretically modeled or indirectly measured in the past. Within a research project with industry partners, the research team obtained the measurements of flux densities inside the motor air gap under both static and dynamic conditions. A variety of valuable information about the motor performance can be derived from these measurements. This paper focuses on one particular aspect of the commutation performance of dc machines, namely, the magnitudes and uniformity of current density through a brush, which, to a large degree, dictate the wear rates of the dc motor commutating group. This paper revisits the classical commutation theory, presents a mathematical model for current density estimation across a brush, and applies this model to the experimental results obtained. The results are then discussed and related to the commutation quality of the machine.

Providers in an urban emergency department (ED) responded to a confidential, online survey assessing their beliefs and practices with respect to reducing a suicidal person's access to lethal means of suicide. 26% of respondents (37% of ED nurses, 23% of ED physicians, and 9% of psychiatrists) believed that all of the jumpers from the Golden Gate Bridge would have found a lethal suicide alternative had a barrier been present, and an additional 38% thought that most would have. Two-thirds of respondents believed that providers in the ED should always ask suicidal patients about access to firearms, yet 52% (67% of nurses, 54% of ED physicians, and 13% of psychiatrists) reported rarely or never doing so. Psychiatrists were more likely than ED staff to report always asking. Further understanding these attitudes and behaviours could enhance suicide prevention activities in the ED.

The psychometric properties of Super’s Work Values Inventory—Revised (SWVI-R) were examined in a sample of 213 African American college students. Results indicated that the 12-values scales were as reliable and as valid in a sample of African Americans as has been demonstrated within a predominantly White college student sample. Values of coefficient α were similar to those found in White and normative samples, with a median α of .82 herein and medians of .82 and .84 in the normative and White college student samples. A three-factor higher order structure of the SWVI-R was found herein; the three factors were named secure work environment, motivation, and style of engagement. African Americans reported higher mean values scores than did White students but their rank ordering of values was very similar—lifestyle, work environment, and supervision were most highly valued, and creativity was the least valued. Values scores were significantly and consistently correlated with ethnic identity achievement.

This study was designed to compare a new inventory measuring concepts of the ‘‘healthy personality’’ with the most widely used inventory of the Big Five personality traits, the NEO personality inventory—Revised (NEO-PI-R). Using adjectives as the stimulus materials, Borgen and Betz (2008) developed a 17-scale inventory called the Healthy personality inventory (HPI), where the 17 dimensions of personality were organized into five broader personality styles. Overall, the results of this study suggest strong correspondences of HPI productivity styles with Neuroticism-Extroversion-Openness (NEO) conscientiousness, HPI interpersonal styles with NEO Extraversion, and HPI intrapersonal styles with NEO Neuroticism. The NEO Openness and Agreeableness dimensions mapped less clearly on the NEO. The relationships of these findings to the wealth of previous data on the correlates of Big Five personality traits are discussed, as are the advantages of using a personality inventory with more positively oriented concepts and scale names. The authors suggest that a personality inventory based on positive psychology may facilitate the growing area of research on the relationships of personality to career variables.

Emergency departments (EDs) rarely screen for older driving safety. The Trail-Making Test B (TMT-B) is a neuropsychological test that may predict ability to drive. We sought to examine the driving patterns of older ED patients and the feasibility of screening patients in the ED using the TMT-B.At a single ED at a tertiary care center, we administered the TMT-B and a survey of health status and driving habits to a convenience sample of adult (age 18 and older) ED patients. We excluded those with altered mentation, critical illness, or language barriers. The TMT-B, scored by the time of first attempt, requires connection of letters and numbers in sequence on paper, and a timeor = 180 s may suggest elevated driving risk. We compared time to complete the TMT-B among ED patients to published norms.Of 144 patients ages 18 to 95, 95 (72.2%) were current drivers, and 91.4 percent of drivers were able to complete the TMT-B; 47.1 percent of drivers were older (65+), and 88.8 percent of older drivers rated their ability as good or excellent. In multivariate logistic regression, neither TMT-B performance nor being older predicted a recent collision. The mean TMT-B completion time was 66.1 (SD = 36.3, median = 56) s among drivers under age 65 and 117.5 (SD = 79.2, median = 95) s among those 65 or older. Approximately 1.9 percent (95% CI: 0.04-10.2) of drivers under 65 and 14.0 percent (95% CI: 5.3-27.9%) of drivers 65 or older required 180 s or more for the TMT-B. Using unpaired T-tests, study TMT-B times were not significantly different from previously published norms except among 25- to 34-year-olds (79.2 versus 50.7 s; p0.05) and 80- to 84-year-olds (223.9 versus 146.8 s; p0.01).Many older ED patients drive, and relatively healthy ED patients are able to complete the TMT-B with results similar to standard nomograms. The TMT-B may prove useful as part of targeted driver screening programs in EDs.

The present study compared the effectiveness of two online career exploration systems in increasing the career decision self-efficacy and decidedness of 960 students enrolled in a program for undecided freshmen students at a large public university. Results indicated that both systems led to significant increases in career decision self-efficacy and college major decidedness in these students. The CAPA system, based on an integration of Bandura’s self-efficacy theory and traditional trait factor theory, led to proportionately greater increases in Career Decision Self-Efficacy Scale scores in comparison to FOCUS for the total group and for women. The systems were comparably effective with African American, Asian American, and White students.

OBJECTIVES: To assess whether resident physicians (MDs) could complete a death certificate for elderly patients with injury-related fatalities and whether their abilities were related to training or other factors. SETTING: A large tertiary teaching hospital in Boston, Massachusetts. PARTICIPANTS: Three hundred thirty-six MDs. DESIGN: Through an anonymous Web-based test, MDs were questioned regarding prior training and experience in completion of death certificates. The MDs read a case of an elderly patient who died from intracranial bleeding after a fall and then completed a test death certificate. Whether proper completion was associated with MD characteristics such as year of residency, self-assessment, or previous death certificate experience was examined. RESULTS: Almost two-thirds (63.6%) of MDs completed the test. Of participants, 52% (95% confidence interval (CI)=46-59%) filled out the death certificate with the correct primary cause of death and 10% (95% CI=6-14%) listed the three major contributing causes of death. Only 35% (95% CI=28-41%) correctly reported injury as a contributing cause of death, but 51% of the participants reported a high level of confidence in their ability to complete a death certificate accurately. CONCLUSION: Accurate completion of the sample death certificate and identification of injury was low, and MDs overrated their abilities. Death certificates completed by MDs may not be accurate and may underestimate the contribution of injury to elderly mortality. Language: en

The 2005 Emergency Cardiac Care guidelines for basic life support (BLS) recommend compression to ventilation ratio of 30:2. The effect of the additional exertion required to deliver more chest compressions may present a considerable physical burden on the provider.To compare cardiopulmonary resuscitation (CPR) performance and perceived exertion during compression to ventilation ratios of 15:2 and 30:2 with real-time feedback during two-rescuer CPR.Eighteen BLS-certified healthcare providers each performed 5 min of chest compressions on a manikin with compression to ventilation ratios of 15:2 or 30:2 on two separate sessions. Heart rate, capillary lactate, and OMNI rate of perceived exertion (RPE) were recorded before and after each session. Subjects were given continuous, automated, feedback via an accelerometer that measured rate, depth, duration, and release of compressions. Compression measurements and feedback messages were recorded continuously during each 5-min session. Data were analyzed using descriptive statistics and t-test to compare groups. Repeated measures ANOVA were used to compare data over the 5-min epoch.After performing external chest compressions for 5 min, peak heart rate (102+/-24 vs. 106+/-27), capillary lactate (2.2+/-0.95 vs. 2.2+/-0.96), and OMNI RPE (4.3+/-1.2 vs. 4.6+/-1.1) were higher were higher than baseline, but did not differ between 15:2 and 30:2. Compression rate (102+/-24 vs.106+/-27) and depth (38.8+/-3.6 vs. 38.2+/-2.9) did not differ between 15:2 and 30:2 groups or at any minute. Total chest compressions delivered were higher (p0.05) in the 30:2 group (457+/-43) compared to 15:2 (379+/-28). The average no flow time was lower (p0.05) in the 30:2 group (22+/-3.03) compared to the 15:2 group (33+/-2.64). Number of correction prompts (48+/-55 vs. 64+/-70) did not differ significantly between the 15:2 and 30:2 groups.In a cohort of healthcare providers, increasing the CPR ratio from 15:2 to 30:2 did not change physical or perceived exertion during a 5-min bout of CPR when continuous, real-time feedback is provided. The 30:2 compression to ventilation ratio resulted in more chest compressions per minute without decreasing CPR quality.