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The county of Dalarna is at present carrying through a process of digitalization where traditional x-ray film is being replaced with digital detectors. Earlier used methods for dose optimization turned out not being sufficient. This report presents a method to harmonize dose levels between x- ray sites equipped with Fujifilm imaging plate systems. An exposure index, S, related to the dose level of the examination is computed to every x-ray image. S turned out to be inversely proportional to the detector dose used at the examination. Detector dose is also the one simulated factor that doubtlessly affects S the most.There are however a lot of parameters, e.g difference between patients, that are not easily simulated even though they still have considerable affect. The method for harmonizing dose levels between x-ray sites are based on statistics of collected S-values for a kind of examination. The average of the collected S-values levels variations and is a more solid measure of the dose level for the examination. By means of this method the dose level of frontal images of the lungs at a site have been reduced by 30 per cent without endanger the diagnostic security.

The release of the Exposure Draft Leases by the Financial Accounting Standards Board in August 2010 has brought about much discussion regarding the proposed treatment for lease accounting. The changes proposed include the capitalization of operating leases by lessees, which are currently regarded as off-balance sheet financing. When the proposed changes take place, industries that have substantial off-balance sheet leases currently, such as the retail industry, will face significant adjustments for assets and liabilities, as well as changes in their income statement. This paper quantifies these changes in the retail industry and examines the effect of these changes on each firm’s current debt covenant agreements.

Cadmium (Cd) is a priority pollutant in ecosystems worldwide. It is highly toxic to aquatic organisms including fish at fairly low concentrations. Numerous studies have investigated the influence of Cd exposure on fish, but few of them have considered how environmentally relevant levels of Cd affect reproduction, particularly reproductive behaviour. To assess the toxicity of Cd on fish reproduction, breeding fathead minnows (Pimephales promelas) were exposed to water-borne Cd for 21 days at four different concentrations (0, 1, 2.5 and 5 µg/L, respectively) based on a standard short-term reproductive assay and reproductive performance as well as behaviour were examined during or at the end of the exposure period. The results showed that Cd accumulated in a dose-dependent manner in the livers and ovaries of female fish. Brood size and mean egg production were significantly reduced in Cd-exposure treatment groups. When fertilized eggs were incubated in the water containing 2.5 µg/L or higher Cd, there was delayed hatching, but at the same time there was greater synchronous hatching after hatching started. Hatching success of Cd-exposed eggs also declined compared to the control. No significant difference was observed among treatments in adult fish survival, the number of breeding attempts, fertilization success, egg size, plasma β-estradiol levels of female, larval deformities, reproductive behaviour, gonadosomatic index or liver somatic index. The results of this study demonstrate that Cd is able to impair reproduction of fathead minnow at the concentration as low as 0.64 µg/L. It is harmful to both breeding fish and their offspring. The traditional endpoints used in standard reproduction assay (e.g. egg production and brood size) are probably more sensitive than behavioural endpoints, but the traditional method of interpreting reproductive impairment may underestimate toxic effects. The findings of this study have important implications for understanding the effects of chronic Cd exposure in metal-impacted feral fish populations. It can be applied to the protection or restoration of fish populations in Cd contaminated aquatic systems.

The present review focuses on understanding the explanatory mechanisms behind the use of violence within intimate relationships, highlighting the consequences of adolescents’ exposure to Inter-parental violence and gauging the role of their (adolescents) appraisal and coping strategies. The theories reviewed stress the significant impact of close figures’ behaviors on the developing child and adolescent trough observational and imitational processes, secure and insecure attachment patterns and related internal working models as well as trough building own understanding of the world and human interrelations. The review revealed also that adolescents’ exposure to Inter-parental violence constituted an unequivocal risk factor leading to a range of consequences categorized as internalizing and externalizing problems. It however indicates that the outcome behaviors are not a result of a linear process because there is range of mediating factors that explain the association between adolescents’ exposure to Inter-parental violence and outcome behaviors. Finally, appraisal of Inter-parental violence was identified as a central mechanism that impacts both the magnitude of the consequences of exposure and the adolescents’ conception and execution of coping strategies.

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Problem: Nurses are potentially exposed to hazardous drugs (HDs) in their practice. HD exposure is associated with adverse outcomes (reproductive problems, learning disabilities in offspring of nurses exposed during pregnancy, and cancer occurrence). Safe handling precautions (safety equipment and personal protective equipment, [PPE]) minimize exposure to HDs and decrease the potential for adverse outcomes. Despite existing OSHA recommendations, adherence to precautions is below recommendations. The purpose of this study was to examine relationships among factors affecting nurses’ use of HD safe handling precautions, to identify factors that promote or interfere with HD precaution use, and to determine nurse managers’ perspectives on use of safe handling precautions. This study used a conceptual model which proposes that both individual and organizational factors influence precaution use. Methods: A cross-sectional, correlational design was used. Nurses (N = 165; 46% response rate) from oncology centers across the US who reported handling chemotherapy completed a mailed survey. Instruments measured HD precaution use, knowledge, self efficacy, barriers, perceived risk, conflict of interest, interpersonal influences and workplace safety climate. Hierarchical regression was used. Twenty managers of nurses handling chemotherapy were interviewed. Results: Nurses were experienced in oncology (M = 15.8 ± 7.6) yrs, well-educated (62.5% ≥BSN), certified in oncology nursing (85%), worked in outpatient settings (69%), and on average treated 6.8 ± 5.2 patients per day. Chemotherapy exposure knowledge was high (M = 10.9, ± 1, 0-12 scale); as was self efficacy for using PPE (M = 20.8 ± 3, 7-24 scale), and perceived risk (M = 3.14 ± .6, 0-4 scale). Total precaution use during HD administration and disposal was low (M = 1.9, SD = 1.1, 0= never to 5 = 100%). Nurse characteristics did not predict HD precaution use. In the final model (R2 = .29, F (2, 155) = 24.6, p < .000), fewer patients per day, fewer barriers and better workplace safety climate were independent predictors of higher precaution use. Conclusions: Results emphasize the importance of organizational influence on nurses’ HD safe handling precaution use and suggest fostering a positive workplace safety climate and reducing barriers as interventions.

A growing body of literature suggests that Virtual Reality is a successful tool for exposure therapy for anxiety disorders. Virtual Reality (VR) researchers posit the construct of presence, interpreting an artificial stimulus as if it were real, as the mechanism that enables anxiety to be felt during virtual reality exposure therapy (VRE). However, empirical studies on the relation between presence and anxiety in VRE have yielded mixed findings. The current study tested the following hypotheses 1) Presence is related to in session anxiety and treatment outcome; 2) Presence mediates the extent that pre-existing (pre-treatment) anxiety is experienced during exposure with VR; 3) Presence is positively related to the amount of phobic elements included within the virtual environment. Results supported presence as the mechanism by which anxiety is experienced in the virtual environment as well as a relation between presence and the phobic elements, but did not support a relation between presence and treatment outcome

Background: Determinants of vitamin D status are of interest when studying the epidemiology of disease in population groups because vitamin D is now recognized to decrease the risk of diseases such as osteoporosis, cancer, and cardiovascular disease. Understanding modifiable determinants of vitamin D status are important for managing vitamin D deficiency at the individual level and for addressing this issue at population level. Objective: The objective of this study was to evaluate the associations between serum vitamin D status (deficiency and insufficiency) and distinct demographic, dietary, and lifestyle characteristics of adults in the United States using a large, nationally representative sample survey, the National Health and Nutrition Examination Survey (NHANES) 2005-2006. Methods: The study sample consisted of 2340 adults aged 20-59 who had serum 25(OH)D measured and who had completed various questionnaires concerning dietary intake of vitamin D and other lifestyle factors. Multivariate logistic regression was used to estimate the odds ratio (OR) of vitamin D deficiency, insufficiency, and sufficiency in adults based on distinct demographic, dietary, and lifestyle characteristics. Statistical significance was set at α < 0.05. Results: The prevalence of vitamin D deficiency was higher in obese adults than in underweight to normal weight adults (50.9% ± 4.57 vs. 29.3% ± 3.57), higher in adults who reported no sunburns than in adults who reported ≥ 3 sunburns (49.9% ± 3.82 vs. 18.0% ± 3.07), and higher in adults who use sun protective measures regularly than in adults who do not (48.4% ± 3.93 vs. 27.0% ± 3.75). The prevalence of vitamin D deficiency increased as dietary intake of vitamin D decreased. Non-Hispanic black adults were significantly more likely to be vitamin D deficient (OR = 45.27, 95% CI = 17.27-118.64) and insufficient (OR = 9.37, 95% CI = 3.43-25.61) than non-Hispanic white adults. Significant positive associations were found between vitamin D deficiency and several characteristics, namely obesity (OR = 7.43, 95% CI = 4.33-12.77), physical inactivity (OR = 1.63, 95% CI = 1.03-2.58) poor dietary vitamin D intake (OR = 2.34, 95% CI = 1.44-3.81), non-supplement use or supplement use with a low amount of vitamin D (OR = 1.75, 95% CI = 1.05-2.89), and activities that decrease exposure to sunlight (from OR = 2.97, 95% CI = 2.14-4.13 to OR = 5.30, 95% CI = 3.17-8.85). Conclusion: The results of this nationally representative study demonstrate that obesity, physical inactivity, poor dietary intake of vitamin D, and low sunlight exposure increases the risk for vitamin D deficiency in U.S adults. Future studies are needed to investigate whether vitamin D supplementation, sunlight exposure, and vitamin D-fortified foods are efficient in correcting vitamin D deficiency and insufficiency among these groups.

Background: Prevalence of obesity in US children has increased substantially. The influence of vitamin D intake on body mass index (BMI) is yet to be clearly defined. Results are mixed regarding the relationship of vitamin D deficiency with obesity in children. The objective of this study was to examine the association between vitamin D intake and BMI over a 6 month period in pre-to early adolescent children in Pittsburgh, PA. Methods: Secondary analysis was done on 256 healthy 6-14 year old (54% male) Caucasian and African American (70%) children from Pittsburgh, PA. Participants completed a food frequency questionnaire (FFQ) and a Sun Exposure Questionnaire (SEQ) and provided anthropometric measures at 2 time points 6 months apart. Vitamin D intake was compared by BMI status (normal = <85th percentile, overweight = 85th to 95th percentile, obese = >95th percentile) as well as by change in BMI over 6 months. Statistical analysis included descriptive statistics, Kruskal-Wallis analysis of variance, Spearman’s correlation, Chi Square test, and regression analysis (vitamin D intake, gender, race, baseline BMI, total energy intake, sun exposure and sunscreen use). Results: Median reported vitamin D intake was 245.85 IU at baseline and 382.51 IU at 6 month follow up. After subdividing children by BMI, at baseline the obese group reported lowest median intake (188 IU) and at 6 month follow up the normal group reported lowest median intake (374 IU) (P=0.03). Overall relation between vitamin D intake and BMI was significant (P=0.033) but weak (r=-0.015). Regression analysis revealed only baseline BMI status (P=<0.001) as a predictor of 6 month follow up BMI. No relation was observed between change in BMI and vitamin D intake. Conclusion: The results of this study do not support a strong relationship between vitamin D intake and change in BMI status over a 6 month time period.