ABSTRACT
Strongly shocked cylindrically convergent implosions were conducted on the OMEGA laser. The directly driven targets consist of a low-density foam core and an embedded aluminum shell covered by an epoxy ablator. The outer surface of the aluminum shell has imposed single-mode perturbations with wave numbers k=0.08, 0.25, and 0.7 (rad/microm) and initial amplitudes eta(0)/lambda=0.013, 0.04 and 0.11. The perturbation growth rate is found to scale with k and, in our convergent geometry, no evidence of saturation for eta/lambda as large as 5 is observed.
ABSTRACT
The national certification examination in nurse-midwifery/midwifery was adapted to the Puerto-Rican Spanish language. Specific attention was paid to creating a version of the examination that was both culturally and linguistically relevant, while remaining appropriately representative of national standards of practice. The procedures used in translation and cultural adaptation are described. The process used in review of the examination followed usual and customary practice. This included consideration of item critiques received from candidates (qualitative data) and the computation of standard measures of item performance, including item difficulty indices and the standard error of measurement (quantitative data). Additional analyses conducted for this specific purpose included the calculation of an index of differential item performance between both language versions. All measures of assessment indicated that the adapted language version was of high quality and psychometrically equivalent to the English language version, which was the comparison standard.
Subject(s)
Certification/standards , Language , Midwifery/standards , Female , Humans , Pregnancy , Puerto Rico , Reproducibility of Results , United StatesABSTRACT
The national certification examination in nurse-midwifery and midwifery now is offered exclusively in the multiple-choice format. The strategies used to develop equivalent examination forms are described. The manner of criterion-referenced standard setting is explained. Outcomes of the first five multiple-choice examination forms include an aggregate first-time failure rate of 8.3%. Multiple- and logistic-regression analyses indicate that examination scores of African-American and Hispanic ethnic candidates, and older candidates, are lower with regard to statistical significance; however, these differences are too modest to be of practical significance. No substantive relationship was observed between any demographic or academic variable and the probability of passing the examination. The experience gained by the ACNM Certification Council during development, administration, and evaluation of these first five multiple-choice examination forms has provided strong support for the transition to multiple-choice testing for the assessment of entry into practice of this competency-based profession.
Subject(s)
Certification , Educational Measurement/methods , Nurse Midwives/standards , Psychometrics , Humans , Logistic Models , Nurse Midwives/education , Reproducibility of Results , United StatesABSTRACT
We studied the effects of chewing nicotine gum on tic frequency and severity in 10 patients with Tourette's disorder (TD) on haloperidol, versus 9 untreated TD patients; placebo gum was administered to 5 of these untreated patients. Videotapes of patients during a 2-hr period of 30 min baseline, 30 min gum chewing, and two 30-min postgum-chewing periods were utilized. For those TD patients on haloperidol, significant reductions occurred in tic frequency and severity during the gum-chewing and the two postgum-chewing periods. Nicotine gum alone caused a decrease in tic frequency only during gum-chewing and one postgum-chewing period, while placebo gum showed no effect. In this study, nicotine markedly potentiated haloperidol effects in treating TD, and showed lesser effects on TD when used alone.
Subject(s)
Chewing Gum , Haloperidol/therapeutic use , Nicotine/therapeutic use , Tourette Syndrome/drug therapy , Adolescent , Adult , Child , Drug Synergism , Drug Therapy, Combination , Female , Haloperidol/administration & dosage , Haloperidol/pharmacology , Humans , Male , Middle Aged , Nicotine/administration & dosage , Nicotine/analogs & derivatives , Nicotine/pharmacology , Placebos , Polymethacrylic Acids/administration & dosage , Polymethacrylic Acids/therapeutic use , Polyvinyls/administration & dosage , Polyvinyls/therapeutic use , Psychiatric Status Rating Scales , Severity of Illness Index , Tobacco Use Cessation Devices , Tourette Syndrome/diagnosis , Tourette Syndrome/psychology , Videotape RecordingABSTRACT
In an open, nonblind study, 10 patients with Tourette's disorder who were being treated with haloperidol were videotaped before, while, and after chewing nicotine gum. The frequency of tics was reduced significantly during the 30-minute gum-chewing period and during the 1 hour after gum chewing. Nicotine appears to potentiate haloperidol effects in patients with Tourette's disorder.
Subject(s)
Haloperidol/therapeutic use , Nicotine/pharmacology , Tourette Syndrome/drug therapy , Adolescent , Adult , Chewing Gum , Child , Drug Synergism , Female , Haloperidol/pharmacology , Humans , Male , Middle Aged , Nicotine/administration & dosage , Tourette Syndrome/psychologyABSTRACT
Nicotine was found to markedly potentiate haloperidol-induced hypokinesia in rats. Nicotine alone was without effect. Subsequently, concurrent administration of 2 mg nicotine gum to 10 Tourette syndrome patients being treated with haloperidol produced a substantial decrease in tics and improvement of concentration and attention span. Nicotine gum alone was without effect. While 80% of children showed improvement with nicotine gum, 70% completely discontinued the gum because of side-effects, primarily involving nausea and bitter taste. Nicotine may prove useful for treating other neuroleptic responsive disorders, such as schizophrenia and Huntington's disease.
