Biến tần trung thế ứng dụng trong công nghiệp cho các ngành như: Xi măng, nước, khai thác mỏ, sắt thép, nhà máy điện hóa chất, … Thiết bị giảm đáng kể dòng hài trên nguồn điện, độ tin cậy cao và dễ dàng bảo trì.
CÔNG TY CỔ PHẦN HẠO PHƯƠNG
Trụ sở chính:
Địa chỉ: Số 88 đường Vĩnh Phú 40, Kp. Hòa Long, P. Vĩnh Phú, Thuận An, Bình Dương.
Văn phòng Hà Nội:
Địa chỉ: Số 95 TT4 – KĐT Mỹ Đình Sông Đà – Phường Mỹ Đình – Q. Nam Từ Liêm – Hà Nội
Chi nhánh Cambodia:
Địa chỉ: The Park Land SenSok, Borey Chip Mong, House Number 22, P11.Sangkat Phnom Penh Thmey, Khan San Sok, Phnom Penh.
Email: cs@haophuong.com – Website: haophuong.com
Facebook: https://www.facebook.com/haophuongcompany/
HOTLINE: 1800 6547
EN0567 - Assignment
C003 Powerlab
3-phase Induction Motor Performance
Dr M Jovanovic – EN0567 lab sheets Page-1
OBJECTIVES W hen you have completed this assignment you will be able to:
Determine the parameters used to measure squirrel-cage
induction motor performance.
Plot and understand the typical steady-state operating
characteristics of small induction motors.
KNOWLEDGE LEVEL
Before you start this assignment you should:
Have a clear understanding of voltage and current in 3 phase
AC circuits.
Be familiar with the use of the 68-500 Virtual Instrumentation
System and the connections required to the 68-
441dynamometer.
For details on the connections between the PC, the 68-441
Torque/Speed control panel and the 68-500 Multi-Channel
Input/Output panel, see the Manual Multi-Channel Input /
Output System – 68-500. See also this manual for details of
the Virtual Instrumentation software 68-911.
PRACTICALS For Y and connected stator windings determine and compare
various steady-state operating characteristics of the motor under
different loading conditions.
EN0567 – Assignment
C003 Powerlab
3-Phase Induction Motor Performance
Dr M Jovanovic – EN0567 lab sheets Page-2
FORMULAE
Input Power = 3VIcos (1)
where cos is the power factor and V and I are the line voltage
and current (rms values). The 3-phase power input is available
directly from the virtual instrumentation system.
Output power = 2nT/60 (2)
where n is the speed in rev/min and T is the torque in Nm.
Efficiency = 100 x %
PowerInput
PowerOutput
(3)
EQUIPMENT REQUIRED
Universal Power Supply 60-105
Three phase dual voltage squirrel cage induction motor 64-
501
Armature Current Dynamometer system consisting of a
shunt DC machine 63-110 with a fitted 68-430 DC tacho-
generator and 68-441 panel.
Shaft coupling and key 68-703
System Frame 91-200
Universal Bin 91-240
Standard Set of Patch Leads 68-800
PC with 68-911 software for Virtual Instrumentation.
Notes
Circuit diagrams for Virtual instrumentation are provided.
Refer to the Multi-channel I/O Unit Manual 68-500 for the setting up of
the virtual instrumentation voltmeters, ammeters etc, and the use of
stored Set-Up files.
DO refer to the Help information available in the 68-500 software.
EN0567 – Assignment
C003 Powerlab
3-Phase Induction Motor Performance
Dr M Jovanovic – EN0567 lab sheets Page-3
Circuit Diagrams and Wiring
Figure 1: Virtual Instrumentation Wiring
EN0567 – Assignment
C003 Powerlab
3-Phase Induction Motor Performance
Dr M Jovanovic – EN0567 lab sheets Page-4
Figure 2: Magnified Multi-channel I/O Unit 68-500 Patching Diagram from Figure 1
Figure 3: Star and Delta wiring
EN0567 – Assignment
C003 Powerlab
3-Phase Induction Motor Performance
Dr M Jovanovic – EN0567 lab sheets Page-5
Figure ...
Biến tần trung thế ứng dụng trong công nghiệp cho các ngành như: Xi măng, nước, khai thác mỏ, sắt thép, nhà máy điện hóa chất, … Thiết bị giảm đáng kể dòng hài trên nguồn điện, độ tin cậy cao và dễ dàng bảo trì.
CÔNG TY CỔ PHẦN HẠO PHƯƠNG
Trụ sở chính:
Địa chỉ: Số 88 đường Vĩnh Phú 40, Kp. Hòa Long, P. Vĩnh Phú, Thuận An, Bình Dương.
Văn phòng Hà Nội:
Địa chỉ: Số 95 TT4 – KĐT Mỹ Đình Sông Đà – Phường Mỹ Đình – Q. Nam Từ Liêm – Hà Nội
Chi nhánh Cambodia:
Địa chỉ: The Park Land SenSok, Borey Chip Mong, House Number 22, P11.Sangkat Phnom Penh Thmey, Khan San Sok, Phnom Penh.
Email: cs@haophuong.com – Website: haophuong.com
Facebook: https://www.facebook.com/haophuongcompany/
HOTLINE: 1800 6547
EN0567 - Assignment
C003 Powerlab
3-phase Induction Motor Performance
Dr M Jovanovic – EN0567 lab sheets Page-1
OBJECTIVES W hen you have completed this assignment you will be able to:
Determine the parameters used to measure squirrel-cage
induction motor performance.
Plot and understand the typical steady-state operating
characteristics of small induction motors.
KNOWLEDGE LEVEL
Before you start this assignment you should:
Have a clear understanding of voltage and current in 3 phase
AC circuits.
Be familiar with the use of the 68-500 Virtual Instrumentation
System and the connections required to the 68-
441dynamometer.
For details on the connections between the PC, the 68-441
Torque/Speed control panel and the 68-500 Multi-Channel
Input/Output panel, see the Manual Multi-Channel Input /
Output System – 68-500. See also this manual for details of
the Virtual Instrumentation software 68-911.
PRACTICALS For Y and connected stator windings determine and compare
various steady-state operating characteristics of the motor under
different loading conditions.
EN0567 – Assignment
C003 Powerlab
3-Phase Induction Motor Performance
Dr M Jovanovic – EN0567 lab sheets Page-2
FORMULAE
Input Power = 3VIcos (1)
where cos is the power factor and V and I are the line voltage
and current (rms values). The 3-phase power input is available
directly from the virtual instrumentation system.
Output power = 2nT/60 (2)
where n is the speed in rev/min and T is the torque in Nm.
Efficiency = 100 x %
PowerInput
PowerOutput
(3)
EQUIPMENT REQUIRED
Universal Power Supply 60-105
Three phase dual voltage squirrel cage induction motor 64-
501
Armature Current Dynamometer system consisting of a
shunt DC machine 63-110 with a fitted 68-430 DC tacho-
generator and 68-441 panel.
Shaft coupling and key 68-703
System Frame 91-200
Universal Bin 91-240
Standard Set of Patch Leads 68-800
PC with 68-911 software for Virtual Instrumentation.
Notes
Circuit diagrams for Virtual instrumentation are provided.
Refer to the Multi-channel I/O Unit Manual 68-500 for the setting up of
the virtual instrumentation voltmeters, ammeters etc, and the use of
stored Set-Up files.
DO refer to the Help information available in the 68-500 software.
EN0567 – Assignment
C003 Powerlab
3-Phase Induction Motor Performance
Dr M Jovanovic – EN0567 lab sheets Page-3
Circuit Diagrams and Wiring
Figure 1: Virtual Instrumentation Wiring
EN0567 – Assignment
C003 Powerlab
3-Phase Induction Motor Performance
Dr M Jovanovic – EN0567 lab sheets Page-4
Figure 2: Magnified Multi-channel I/O Unit 68-500 Patching Diagram from Figure 1
Figure 3: Star and Delta wiring
EN0567 – Assignment
C003 Powerlab
3-Phase Induction Motor Performance
Dr M Jovanovic – EN0567 lab sheets Page-5
Figure ...
Performance Evaluation of a Three Phase Nine Level Inverter with Reduced Swit...Scientific Review
This paper presents a three phase nine level cascaded H-bridge (CHB) multilevel inverter with RL load. A sinusoidal and trapezoidal PWM method is used to achieve minimum total harmonics distortion (THD) in the output current of multilevel inverters. The analysis of the output current harmonics is carried out and compared with the seven level conventional cascaded H-bridge inverters. The proposed inverter is verified through simulation and the simulation results are compared with the conventional multilevel inverter. From the result the proposed inverter offers much less total harmonic distortion.
Performance Evaluation of a Three Phase Nine Level Inverter with Reduced Sw...Scientific Review SR
This paper presents a three phase nine level cascaded H-bridge (CHB) multilevel inverter with RL load. A sinusoidal and trapezoidal PWM method is used to achieve minimum total harmonics distortion (THD) in the output current of multilevel inverters. The analysis of the output current harmonics is carried out and compared with the seven level conventional cascaded H-bridge inverters. The proposed inverter is verified through
simulation and the simulation results are compared with the conventional multilevel inverter. From the result the
proposed inverter offers much less total harmonic distortion
Speed Control Of DC motor By Using PWM TechniqueRITESH D. PATIL
Generally the pwm is the duty cycle which greater control on the dc motor effectively & the pulses reach the full supply voltage and will produce more torque in a motor by being able to overcome the internal motor resistances more easily.
Speed control of Three phase Induction motor using AC voltage regulatorShivagee Raj
The role of AC Voltage Regulator in speed control of three phase Induction Motor is to vary the supply voltage which in turn, changes the speed of motor .
A Three-to-Five-Phase Matrix Converter BasedFive- Phase Induction Motor Drive...idescitation
This paper presents a five-phase induction motor drive
system fed from a three-to-five-phase matrix converter. This
is a new concept of generating variable voltage and variable
frequency five-phase output using a special matrix converter.
This matrix converter is proposed recently which transform
the available three-phase supply to five-phase supply. Simple
carrier-based PWM scheme with enhanced approach is
employed to control the output of the matrix converter.
Enhanced approach is utilized so as to increase the output
voltage magnitude of the three-to-five-phase matrix converter.
The motor is controlled in constant v/f mode. Simulation study
is carried out for excitation, acceleration, loadingand reversing
transients. High quality dynamics are observed.
International Journal of Engineering Research and Applications (IJERA) is an open access online peer reviewed international journal that publishes research and review articles in the fields of Computer Science, Neural Networks, Electrical Engineering, Software Engineering, Information Technology, Mechanical Engineering, Chemical Engineering, Plastic Engineering, Food Technology, Textile Engineering, Nano Technology & science, Power Electronics, Electronics & Communication Engineering, Computational mathematics, Image processing, Civil Engineering, Structural Engineering, Environmental Engineering, VLSI Testing & Low Power VLSI Design etc.
The peer-reviewed International Journal of Engineering Inventions (IJEI) is started with a mission to encourage contribution to research in Science and Technology. Encourage and motivate researchers in challenging areas of Sciences and Technology.
Explore the Issue PapersYou will choose a topic from the Complet.docxelbanglis
Explore the Issue Papers
You will choose a topic from the Complete Marriage and Family Home Reference Guide to study more closely. In 4–6 pages, you will compare current knowledge with facts from research and then examine the chosen topic from both a psychological and a theological perspective.
1. Briefly provide your initial thoughts on the topic. This section will not require source material. The purpose is simply for you to identify what you know about this topic. You may discuss facts, a biblical perspective, the moral dilemma involved in the topic, or just your thoughts around the topic. This section must be 1 page.
2. Look at the research that has been done on the topic. This section must be well-organized with headings and subheadings and must include at least 4 empirical sources. This section must be 2–3 pages. You may consider, but are not confined to, the following prompts and questions:
· Check some of what you know against what research has to say. How could this topic affect a marriage or family?
· What are benefits and consequences of approaching this topic and working through it within the affected family unit?
3. Compare the psychological and theological perspectives of the topic. The point here is to compare what the research says about the topic to what the Bible says about the topic. Not all of the topics from "The Quick-Reference Guide to Marriage and Family Counseling" are directly mentioned in the Bible. However, you may use biblical principles and discuss similarities and discrepancies found between these 2 perspectives. This section must be 1–2 pages.
4. The conclusion of this paper must include a good summary of the information provided in the preceding 3 sections. You must also provide an idea for future study of the topic. What further information could be provided in relation to this topic? For example, what are some variables that play a part of depression in marriage? Is depression within marriage easier to work through if the depression is a result of a mood disorder or of circumstances outside of the marriage?
5. Correct current APA formatting must be implemented throughout this paper, including avoiding first person and using properly formatted citations and headings. A title page and references page must be included; however, an abstract will NOT be necessary for this assignment. Assignment instructions and the grading rubric must be carefully reviewed to ensure that all assignment criteria are met.
Reference
Dobson, J. (2000). Complete marriage and family home reference guide. Carol Stream, IL: Tyndale House Publishers, Inc. ISBN: 9780842352673.
OVERVIEW
Synthesize conceptual information pertinent to the research question; this is information that you extract from the articles selected for this review. Submit a draft literature review.
Note: Developing a research proposal requires specific steps that need to be executed in a sequence. The assessments in this course are presented in sequence ...
Performance Evaluation of a Three Phase Nine Level Inverter with Reduced Swit...Scientific Review
This paper presents a three phase nine level cascaded H-bridge (CHB) multilevel inverter with RL load. A sinusoidal and trapezoidal PWM method is used to achieve minimum total harmonics distortion (THD) in the output current of multilevel inverters. The analysis of the output current harmonics is carried out and compared with the seven level conventional cascaded H-bridge inverters. The proposed inverter is verified through simulation and the simulation results are compared with the conventional multilevel inverter. From the result the proposed inverter offers much less total harmonic distortion.
Performance Evaluation of a Three Phase Nine Level Inverter with Reduced Sw...Scientific Review SR
This paper presents a three phase nine level cascaded H-bridge (CHB) multilevel inverter with RL load. A sinusoidal and trapezoidal PWM method is used to achieve minimum total harmonics distortion (THD) in the output current of multilevel inverters. The analysis of the output current harmonics is carried out and compared with the seven level conventional cascaded H-bridge inverters. The proposed inverter is verified through
simulation and the simulation results are compared with the conventional multilevel inverter. From the result the
proposed inverter offers much less total harmonic distortion
Speed Control Of DC motor By Using PWM TechniqueRITESH D. PATIL
Generally the pwm is the duty cycle which greater control on the dc motor effectively & the pulses reach the full supply voltage and will produce more torque in a motor by being able to overcome the internal motor resistances more easily.
Speed control of Three phase Induction motor using AC voltage regulatorShivagee Raj
The role of AC Voltage Regulator in speed control of three phase Induction Motor is to vary the supply voltage which in turn, changes the speed of motor .
A Three-to-Five-Phase Matrix Converter BasedFive- Phase Induction Motor Drive...idescitation
This paper presents a five-phase induction motor drive
system fed from a three-to-five-phase matrix converter. This
is a new concept of generating variable voltage and variable
frequency five-phase output using a special matrix converter.
This matrix converter is proposed recently which transform
the available three-phase supply to five-phase supply. Simple
carrier-based PWM scheme with enhanced approach is
employed to control the output of the matrix converter.
Enhanced approach is utilized so as to increase the output
voltage magnitude of the three-to-five-phase matrix converter.
The motor is controlled in constant v/f mode. Simulation study
is carried out for excitation, acceleration, loadingand reversing
transients. High quality dynamics are observed.
International Journal of Engineering Research and Applications (IJERA) is an open access online peer reviewed international journal that publishes research and review articles in the fields of Computer Science, Neural Networks, Electrical Engineering, Software Engineering, Information Technology, Mechanical Engineering, Chemical Engineering, Plastic Engineering, Food Technology, Textile Engineering, Nano Technology & science, Power Electronics, Electronics & Communication Engineering, Computational mathematics, Image processing, Civil Engineering, Structural Engineering, Environmental Engineering, VLSI Testing & Low Power VLSI Design etc.
The peer-reviewed International Journal of Engineering Inventions (IJEI) is started with a mission to encourage contribution to research in Science and Technology. Encourage and motivate researchers in challenging areas of Sciences and Technology.
Explore the Issue PapersYou will choose a topic from the Complet.docxelbanglis
Explore the Issue Papers
You will choose a topic from the Complete Marriage and Family Home Reference Guide to study more closely. In 4–6 pages, you will compare current knowledge with facts from research and then examine the chosen topic from both a psychological and a theological perspective.
1. Briefly provide your initial thoughts on the topic. This section will not require source material. The purpose is simply for you to identify what you know about this topic. You may discuss facts, a biblical perspective, the moral dilemma involved in the topic, or just your thoughts around the topic. This section must be 1 page.
2. Look at the research that has been done on the topic. This section must be well-organized with headings and subheadings and must include at least 4 empirical sources. This section must be 2–3 pages. You may consider, but are not confined to, the following prompts and questions:
· Check some of what you know against what research has to say. How could this topic affect a marriage or family?
· What are benefits and consequences of approaching this topic and working through it within the affected family unit?
3. Compare the psychological and theological perspectives of the topic. The point here is to compare what the research says about the topic to what the Bible says about the topic. Not all of the topics from "The Quick-Reference Guide to Marriage and Family Counseling" are directly mentioned in the Bible. However, you may use biblical principles and discuss similarities and discrepancies found between these 2 perspectives. This section must be 1–2 pages.
4. The conclusion of this paper must include a good summary of the information provided in the preceding 3 sections. You must also provide an idea for future study of the topic. What further information could be provided in relation to this topic? For example, what are some variables that play a part of depression in marriage? Is depression within marriage easier to work through if the depression is a result of a mood disorder or of circumstances outside of the marriage?
5. Correct current APA formatting must be implemented throughout this paper, including avoiding first person and using properly formatted citations and headings. A title page and references page must be included; however, an abstract will NOT be necessary for this assignment. Assignment instructions and the grading rubric must be carefully reviewed to ensure that all assignment criteria are met.
Reference
Dobson, J. (2000). Complete marriage and family home reference guide. Carol Stream, IL: Tyndale House Publishers, Inc. ISBN: 9780842352673.
OVERVIEW
Synthesize conceptual information pertinent to the research question; this is information that you extract from the articles selected for this review. Submit a draft literature review.
Note: Developing a research proposal requires specific steps that need to be executed in a sequence. The assessments in this course are presented in sequence ...
Experimental and Quasi-Experimental DesignsChapter 5.docxelbanglis
Experimental and Quasi-Experimental Designs
Chapter 5
*
Introduction
Experiments are best suited for explanation and evaluation research
Experiments involve:
Taking action
Observing the consequences of that action
Especially suited for hypothesis testing
Often occur in the field
The Classical Experiment Classical experiment: a specific way of structuring researchInvolves three major components:
Independent variable and dependent variable
Pretesting and posttesting
Experimental group and control group
Independent and Dependent Variables
The independent variable takes the form of a dichotomous stimulus that is either present or absent
It varies (i.e., is independent) in our experimental process
The dependent variable is the outcome, the effect we expect to see
Might be physical conditions, social behavior, attitudes, feelings, or beliefs
Pretesting and Posttesting
Subjects are initially measured in terms of the DV prior to association with the IV (pretested)
Then, they are exposed to the IV
Then, they are remeasured in terms of the DV (posttested)
Differences noted between the measurements on the DV are attributed to influence of IV
Experimental and Control Groups
Experimental group: exposed to whatever treatment, policy, initiative we are testing
Control group: very similar to experimental group, except that they are NOT exposed
Can involve more than one experimental or control group
If we see a difference, we want to make sure it is due to the IV, and not to a difference between the two groups
Placebo
We often don’t want people to know if they are receiving treatment or not
We expose our control group to a “dummy” independent variable just so we are treating everyone the same
Medical research: participants don’t know what they are taking
Ensures that changes in DV actually result from IV and are not psychologically based
Double-Blind Experiment
Experimenters may be more likely to “observe” improvements among those who received drug
In a double-blind experiment, neither the subjects nor the experimenters know which is the experimental group and which is the control group
Selecting Subjects
First, must decide on target population – the group to which the results of your experiment will apply
Second, must decide how to select particular members from that group for your experiment
Cardinal rule – ensure that experimental and control groups are as similar as possible
RandomizationRandomization: produces an experimental and control group that are statistically equivalentEssential feature of experimentsEliminates systematic bias
Experiments and Causal Inference
Experimental design ensures:
Cause precedes effect via taking posttest
Empirical correlation exists via comparing pretest to posttest
No spurious 3rd variable influencing correlation via posttest comparison between experimental and control groups, and via randomization
Example of Research Using an Experimental Design
Researchers at the University of Marylan ...
Explain the role of the community health nurse in partnership with.docxelbanglis
Explain the role of the community health nurse in partnership with community stakeholders for population health promotion. Explain why it is important to appraise community resources (nonprofit, spiritual/religious, etc.) as part of a community assessment and why these resources are important in population health promotion.
...
Explain how building partner capacity is the greatest challenge in.docxelbanglis
Explain how building partner capacity is the greatest challenge in Operation INHERENT RESOLVE (OIR) in Iraq with these points:
· Explain how the Department of Defense (DoD) can overcome that challenge through Security Cooperation.
· Explain how the DoD can overcome that challenge through Enhancing U.S. Military Logistics
Summation of how the DoD ought to consider how it could transition to teaching our partners to fish, rather than simply fishing for them.
· APA format.
· 1150 words.
· Six work citations
· must include:
· a Cover Page,
· Abstract,
· Body of the paper, and
· Endnotes
Last name_First_Course(ex AP5510)_Assignment_Title
Assignment Title
By
Name
Course Name
DD MMM YYYY
Instructor: (Instructor’s Name)
College
Distance Learning
JBSA
Effective, purposeful communication is essential in the military profession. Following these instructions will help you properly complete your writing assignment and will improve your chances for success.
This template exemplifies the format for essays. Each essay must include a properly formatted cover page (see above), double-spaced text, Times New Roman 12pt font, 1-inch margins, as well as full endnote-style citations for paraphrasing and quotations in accordance with the Author Guide, Section 5.5. Endnotes are not counted as part of your total word count. The, Appendix A provides examples of endnote formats. Do not include a bibliography in these short essay assignments; however, ensure your full endnotes contain all source information.
Use quotation marks when you quote directly from the work of other writers. This is a relatively short assignment, so use block quotations sparingly to allow your own original thoughts to shine through.
You may notice minor variations between your consolidated lesson readers, which require different endnote formats. Some bundle the readings into a single document with continuous pagination (see example endnote 1 at the end of this document).
Other lesson readers retain each author’s original pagination (see example note 2).
You should use the author’s original pagination wherever it is possible to do so. Remember, cite any material used from the instructional narrative portion of the consolidated lesson reading file with “as the author (see example endnote 3).
The midterm and final essay exams are academic papers; write each in a narrative style, not a bullet/point paper. Refer to the assignment rubric located in your Grade Center for grading criteria. If you have any questions, contact your course instructor.
Much like your next level of leadership, the program requires effective writing founded on critical thinking and communication skills. Each essay you write as you progress toward graduation provides an opportunity for you to hone these abilities. Additionally, these assignments comprise a large portion of your final grade in each course. Therefore, successful course completion is contingent on your writing performance. The most ...
Experience as a Computer ScientistFor this report, the pro.docxelbanglis
Experience as a Computer Scientist
For this report, the professional interviewed is a computer Engineer/ Web Developer who works for Omnivision Technologies Inc., a corporation that designs and develops advanced digital technologies to use in mobile phones, notebooks, security cameras etc. across the United States. Mr. Nagarik Sharma is the technical manager of the organization and works at its headquarter in Santa Clara, California, and has been working in this position for the last five years. He provided very useful information about the computer science profession and highlighted a number of challenges common in the career. Further, he provided some recommendations on how the challenges can be dealt with. From the information provided by the him, it is clear that the computer science profession is full of challenges particularly regarding the fast changing technology. The interview revealed several important topics which require further research.
Methodology
The interview was conducted on a skype video call and lasted for slightly above 30 minutes. Before the interview, the interviewee was made clear to understand that the questions which were to be asked during the interview regards the profession, its concerns and challenges. The phone call was recorded during the entire conversation and the information later transcribed and key points extracted. This report is based only on important points and not everything that the interviewee said.
Essential Background
Computer science is a field of technology that deals with studying processes that interact with data and which can be depicted as data in program form. An expert in computer science has knowledge in computation theory as well as the practice of software systems design. Computer scientists are also popularly known as computer and information scientists and can work in a range of environments. For instance, these professionals work in private software publishers, government agencies, academic institutions, and engineering firms (Page & Smart, 2013). Wherever they work, computer scientists’ general roles include solving computing problems as well as developing new products.
The professional interviewed for this report has in-depth knowledge in computer systems and management. Through his leadership skill, he organizes the successful delivery of effective and efficient technical solutions within the company. He is responsible for planning, designing, developing, production, and testing communication systems.
He is also responsible for supervising:
· Technical and Operations teams
· Landline and Cellular network
· IT Infrastructure
· Service platforms
He works with the chief technical officer (who is an expert in telecommunications engineering) to design and develop software that facilitates landline and cellular networks.
Challenges
· Education: According to the interviewee, the challenges in the field of computer science starts right from education and training. He says that ...
Expansion and Isolationism in Eurasia How did approaches t.docxelbanglis
Expansion and Isolationism in Eurasia
How did approaches to cultural interaction shape empires in Eurasia?
Introduction
In 1279, under the leadership of Kublai Khan, the Mongols ousted the Song dynasty
and completed their conquest of China. As they
took control, they established the Yuan dynasty,
with Kublai Khan serving as emperor. However,
Mongol rule over China was relatively short lived.
Within 100 years, the Yuan dynasty would be
forced out by Chinese rebels.
Under Mongol rule, the Chinese became
increasingly angered by policies that favored
Mongols and foreigners. This anger and resentment
eventually resulted in unrest. Around 1350, small
states in China began to emerge to fight the
Mongols. Chinese leaders turned to military force to
advance their interests and establish regional
power. Some leaders were members of the upper class, and others were religious
leaders or bandits supported by peasants. By the middle of the 1350s, these Chinese
powers were united in their campaign to get rid of Mongol rule.
The years of ongoing warfare spurred military innovation among the Chinese.
Although the Mongols had access to gunpowder weapons, they did not develop new
technologies. In contrast, the first large cannons in China were manufactured by the
Chinese rebels. While the term “Gunpowder Empire” is often associated with the
Ottoman Empire, the Safavid Empire, and the Mughal Empire, the Chinese
advancements in gunpowder weaponry has led some historians to regard Ming China
as the world’s first gunpowder empire.
1
Expansion and Isolationism in Eurasia
How did approaches to cultural interaction shape empires in Eurasia?
In this lesson, you will learn about three countries in Eurasia that used gunpowder
to expand and maintain their control: China, Japan, and Russia. You will consider the
rise and fall of the Ming and Qing dynasties in China. You will examine the unification of
Japan under the Tokugawa. Finally, you will explore the growth of the Russian Empire
during the Romanov dynasty.
Section 1. China Under the Ming and Qing
Between the 14th and the early 20th centuries,
two dynasties governed China: the Ming and the Qing.
Both dynasties took power during times of upheaval.
To restore order, they established strong, centralized
rule and revived traditional Chinese values, including
Confucian ideals.
The Ming Revival By the mid-1300s, China was in
turmoil. The Mongols’ hold on power had became
unstable. Disease and natural disasters had weakened
the Mongol grip. Additionally, feuds broke out within the government, leaving the
countryside unprotected against bandits and rebels.
As life became more dangerous and difficult, Chinese peasants grew increasingly
frustrated with the incompetence of their rulers. Led by Zhu Yuanzhang, a peasant
uprising successfully invaded the city of Nanjing. In 1368, aided by gunpowder
weapons, Zhu and his army capt ...
Experimental PsychologyWriting and PresentingPaper Secti.docxelbanglis
Experimental Psychology
Writing and Presenting
Paper Sections
Title
Introduction
Method
Tables and figures (if applicable)
Results
Tables and figures (if applicable)
Discussion
References
Presentation
Simplify, limit number of words, use color and formatting to highlight important points. Check spelling.
Include slides with the following
Title
Introduction
Method
Results
Tables and figures
Discussion
References (provide as a separate slide, but there is no need to discuss or ensure visibility of individual items on this slide.)
...
EXPEDIA VS. PRICELINE -- WHOSE MEDIA PLAN TO BOOK Optim.docxelbanglis
EXPEDIA VS. PRICELINE -- WHOSE
MEDIA PLAN TO BOOK?
Optimedia's Antony Young Analyzes the Media Strategies
Behind Rival Travel Sites
By Antony Young
Published: June 30, 2010
As schools break for summer, some families -- like mine -- are still planning their vacations. So I
took a look at two prominent travel sites, Expedia and Priceline, to see which one's media strategy
is likely to attract more trip planners.
Their media plans are especially important as the travel industry picks up after a tough 2009.
Demand for flights and hotels are rebounding and so, too, are airfares and room rates. With
slimmer margins on airline tickets, hotels have very much become the major battleground for
Expedia and Priceline and this is reflected in the focus of their advertising. Online Travel Agencies
(OTA's) accounted for 34.7% of all U.S. hotel bookings in the first quarter of 2010, up from 27.8% in
2009, Priceline CMO Brett Keller said in a recent speech.
Creative executions
Expedia launched a new branding campaign for 2010. Its tagline, "Where you book matters,"
accompanied a new logo incorporated into its creative messaging. The campaign, which targets
frequent leisure travelers, launched Dec. 26 with commercials featuring a visual metaphor of
building blocks as a way to demonstrate how consumers interact with Expedia. The first spot starts
with upbeat soft-rock music narrated by an unseen woman dictating her specifications for the
perfect "girls' weekend." She talks about having multiple hotel options and the ability to compare
dates for the best savings. Expedia's signature "dot coooom" jingle ends the spot. A spot with a
man's voice and trip goals was launched in February.
http://adage.com/
Priceline has built its position in the market on the opportunity for customers to name their own
price, brought to life through some hilarious spots fronted by pitchman William Shatner. This year,
Shatner introduced his new sidekick "Big Deal," a 520 lb 6'5" character who helps persuade hotels
to take a deal. In February, the Big Deal ads were joined by new creative that featured the
Negotiator's "Evil Twin" (played, of course, by Shatner). Priceline takes a karate chop at
Expedia.com (and Hotels.com), claiming that Priceline can get prices 50% lower.
The strategies of the two companies differed noticeably. Expedia.com attracted 16.7 million unique
visitors in May, 59% more than the 10.5 million who visited Priceline.com, according to ComScore.
And Expedia media seems to reflect this, promoting the site as the generic travel brand for a broad
audience and highlighting its full range of services and travel destinations. Priceline is more single-
mindedly focused on price, and its media appears to target lower down the purchase funnel with an
emphasis on converting transactions.
RATINGS
Outstanding
Highly effective
Good
Disappointing
A disaster
Television strategy
Expedia. ...
Experiments with duckweed–moth systems suggest thatglobal wa.docxelbanglis
Experiments with duckweed–moth systems suggest that
global warming may reduce rather than promote
herbivory
TJISSE VAN DER HEIDE, RUDI M. M. ROIJACKERS, EDWIN T. H. M. PEETERS AND
EGBERT H. VAN NES
Department of Environmental Sciences, Aquatic Ecology and Water Quality Management group, Wageningen University,
Wageningen, The Netherlands
SUMMARY
1. Wilf & Labandeira (1999) suggested that increased temperatures because of global
warming will cause an increase in herbivory by insects. This conclusion was based on the
supposed effect of temperature on herbivores but did not consider an effect of temperature
on plant growth.
2. We studied the effect of temperature on grazing pressure by the small China-mark moth
(Cataclysta lemnata L.) on Lemna minor L. in laboratory experiments.
3. Between temperatures of 15 and 24 �C we found a sigmoidal increase in C. lemnata
grazing rates, and an approximately linear increase in L. minor growth rates. Therefore, an
increase in temperature did not always result in higher grazing pressure by this insect as
the regrowth of Lemna changes also.
4. At temperatures below 18.7 �C, Lemna benefited more than Cataclysta from an increase in
temperature, causing a decrease in grazing pressure.
5. In the context of global warming, we conclude that rising temperatures will not
necessarily increase grazing pressure by herbivorous insects.
Keywords: Cataclysta, grazing, herbivory, Lemna, temperature
Introduction
Duckweeds (Lemnaceae) are often abundant in dit-
ches and ponds (Landolt, 1986). Especially when
nitrogen and phosphorus concentrations in the water
column are high, the surface area can become covered
with dense floating mats of duckweed (Lüönd, 1980,
1983; Portielje & Roijackers, 1995). These mats have
large impacts on freshwater ecosystems, restricting
oxygen supply (Pokorny & Rejmánková, 1983), light
availability of algae and submerged macrophytes
(Wolek, 1974) and temperature fluxes (Dale &
Gillespie, 1976; Landolt, 1986; Goldsborough, 1993).
These changed conditions often have a negative effect
on the biodiversity of the ecosystem (Janse & van
Puijenbroek, 1998). Other free-floating plants such as
red water fern (Azolla filiculoides), water hyacinth
(Eichhornia crassipes) and water lettuce (Pistia stratiotes)
often cause serious problems in tropical and sub-
tropical regions (Mehra et al., 1999; Hill, 2003).
Various species of herbivorous insects consume
free-floating macrophytes. Several species of weevils
(Coleoptera: Curculionidae) are able to consume large
amounts of red water fern, water hyacinth and water
lettuce (Cilliers, 1991; Hill & Cilliers, 1999; Aguilar
et al., 2003), while the larvae of the semi-aquatic Small
China-mark moth (Cataclysta lemnata) are capable of
removing large parts of floating cover of Lemnaceae
covers (Wesenberg-Lund, 1943). Duckweed is not
only used as food source, but also as building material
Correspondence: Rudi M. M. Roijacker ...
EXP4304.521F19: Motivation 1
EXP4304.521F19: Motivation: Further Study Summaries (FSS); Version 1; Last modified August 22, 2019
Overview: Reeve’s textbook provides “readings for further study” at the end of most chapters. Choose readings of
interest throughout the course; then, for five select readings, compose a 1-3 page “further study summary” (FSS). FSS
instructions are posted under “Files” on CANVAS.
Deadline: Each FSS is worth up to 25 points. Final drafts of FSS #1-5 due by Monday, December 9.
Relation of FSS to DRP: Students may choose any “readings for further study” from the textbook for their FSS. Some
students find it helpful to select readings that are relevant to the directed research proposal (DRP; details below).
Questions and Feedback: Please email with any requests for developmental feedback, requests for help with the USF
library, and/or questions about academic honesty. Working drafts of FSS #1-5 may be submitted in advance of the
deadline for developmental feedback and/or for early-grading; working drafts of FSSs are to be emailed to
[email protected] with Request for Feedback in Subject Line.
Instructions/Rubric:
• Please number each summary (FSS #1, #2, #3, #4, and #5) – thank you!
• Please number your responses so that answers directly correspond to the questions provided below
• Per #7 below, FSS must follow the “APA citation basics” from Paiz et al. (2013) – see pages 2-3
• Review (i.e., non-empirical) articles are acceptable for summaries; please adjust instructions as needed
• Sample FSS available – see pages 4-7
1. Article: What is the article? (+2)
a) Title of article
b) Name of journal
c) Name of author(s)
2. Source: What is the source of the article? (+2) This will either be a chapter and page from the textbook (e.g.,
Grand Theories Era of Ch. 2, p. 45) or it will be chapter and slide from my lecture (e.g., Self-Determination
Theory, Ch. 5, slide 2)
3. Summary: What is the study about? (See a-d below) (+4)
a) What are the main research questions?
b) What is the design of the study?
c) What are its results?
d) Were there any ethical concerns?
4. Analysis of Theory and Results: Is the study well-done? (+3) How well does the method test its hypotheses? Is
there something that could be done in the future to improve the study?
5. Motivation and Emotion: What does the study have to do with motivation and emotion? (+3) Why do you
think this reading was identified as worthy of further investigation?
6. Value Added: What are TWO things that you learned from the further reading, relative to the textbook
chapter? (+8) What is the value of the article “above and beyond the chapter” if any?
7. In-text Citations and Reference Page: Follow APA citation-basics (+2) (Paiz et al., 2013;
https://owl.english.purdue.edu/owl/resource/560/02/ -- see next two pages) (+3)
mailto:[email protected]
https://owl.english.purdue.edu/owl/resource/560/ ...
Exercise Package 2 Systems and its properties (Tip Alwa.docxelbanglis
Exercise Package 2:
Systems and its properties: (Tip: Always use the components symbols, C, RS, KT, etc., in the derivation of
transfer function and only plug in component values at the last step. Show your steps and tell me a complete
story.)
1) Consider a 100mH inductor with v-i relationship in passive device labeling convention:
a. Find transfer function H(s) with current flowing through the inductor as the input, i(t),
and voltage across the inductor as the output, v(t), (in the unit of Ohms).
b. Find the same input-output relationship in the expression of differential equation.
c. Find v1(t) with input i1(t)=2sin(100t) (mA) and v2(t) with input i2(t)=0.4cos(500t) (mA)
respectively.
d. Show time invariant such that v(t)=v1(t−τ) as i(t)=i1(t−τ)=2sin(100t−0.9) (mA).
e. Show linearity using superposition such that v(t)=v1(t)+v2(t) as i(t)=i1(t)+i2(t).
2) Given following, a practical integrator, circuit, where Rf=100KΩ, R1=9.1KΩ, RS=100Ω, C=0.1µF,
and the OpAmp is an ideal operational amplifier:
a. Find the transfer function in between the output VO(t) and input VS(t), VO(t)=H(s){VS(t)}.
b. Find the same input-output relationship in the expression of differential equation.
c. Find VO1(t) (sinusoidal steady state response) with input VS1(t)=0.2sin(100t) (V) and VO2(t)
with input VS2(t)=0.4cos(5000t) (V) respectively.
d. Show time invariant such that VO(t)= VO1(t−τ) as VS(t)= VS1(t−τ)=0.2sin(100t−0.9) (V).
e. Show linearity using superposition such that VO(t)= VO1(t)+VO2(t) with VS(t)=VS1(t)+ VS2(t).
3) Here is a typical coupling network in electronics where coupling capacitor, selected, C=0.022µF,
input impedance, Zi=5.7KΩ, and input source resistor, RS=520Ω:
a. Find the transfer function, H(s), Vout(t)=H(s){Vin(t)}.
b. Find the same input-output relationship in the expression of differential equation.
c. Find VOut(t) (sinusoidal steady state response) with input Vin1(t)=2sin(50t+0.4) (V) and
Vin2(t) with input Vin2(t)=4cos(10000t) (V) respectively.
4) Here is a typical bypass network in electronics where bypass capacitor, selected, C=10µF, and
the equivalent (Thevenin) resistor of circuit to be bypassed, Req=376Ω:
Vcc+
Vcc-
Vo
Vs
Rf
R1Rs
C
Vin Vout
CRs
Zi
a. Find the transfer function, H(s), VS(t)=H(s){IS(t)} (note: the unit is ohm).
b. Find the same input-output relationship in the expression of differential equation.
c. Find VS1(t) (sinusoidal steady state response) with input Is1(t)=0.2cos(10t+0.3) (A) and
VS2(t) with input IS2(t)=0.5cos(10000t) (A) respectively.
5) The following circuit is an active filter (2nd order Butterworth low-pass filter), with the selected
values: R=10KΩ, C=8200pF, Rf=68KΩ, and R1=120KΩ.
a. Derive the transfer function, H(s), Vout(t)=H(s){Vin(t)}. (Tip: the selected R is much greater
than RS such that RS can be ignored in the derivation. Label extraordinary nodes and use
node voltage method. OpAmp is considered ideal.)
b. Show that th ...
Exercises for Chapter 8 Exercises III Reflective ListeningRef.docxelbanglis
Exercises for Chapter 8
Exercises III: Reflective Listening
Reflective Listening I
Instructions: People communicate words and ideas, and sometimes it seems appropriate to respond to the content of what someone has just said. Behind the words, however, lie the feelings. Often it is most helpful to respond to the feelings.
Following are statements made by people with problems. For each statement, first identify the feeling; write down the word you think best describes how the person might be feeling. Next, write a brief empathic response—a short sentence that includes the feeling. Refer to the sample openers provided in Chapter 7 under the heading “Useful Responses.”
1. “When I was in court, the defense attorney really pounded me. You know, like he thought I was lying or didn’t believe me or thought I was exaggerating.”
FEELING:
EMPATHIC RESPONSE:
2. “Those dirty, lousy creeps! Everything was fine in my life, and they really, really ruined everything! I don’t care if I go on or not. Why live if someone can just take everything away from you in one night?”
FEELING:
EMPATHIC RESPONSE:
3. “I know you said this is temporary housing and all, but I never had a place like this place. I can’t stand to think I have to move again sometime, and God knows where I’ll go.”
FEELING:
EMPATHIC RESPONSE:
4. “This whole setup is the pits. He gets to stay in the house after beating me half to death, and I have to go to this cramped little room. Does that make sense?”
FEELING:
EMPATHIC RESPONSE:
Instructions Part II: Now go back and respond to the content in each of these vignettes.
Reflective Listening II
Instructions: People communicate words and ideas, and sometimes it seems appropriate to respond to the content of what someone has just said. Behind the words, however, lie the feelings. Often it is most helpful to respond to the feelings.
Following are statements made by people with problems. For each statement, first identify the feeling; write down the word you think best describes how the person might be feeling. Next, write a brief empathic response—a short sentence that includes the feeling. Refer to the sample openers provided in Chapter 7 under the heading “Useful Responses.”
1. “Sometimes it kind of makes me sick to think of all the stuff I did when I was drinking. I’d like to go and take it all back, but how do you ever do that?”
FEELING:
EMPATHIC RESPONSE:
2. “I just can’t go out in the car. All I hear is the screech of tires and the awful thud and scrape of metal. I thought I was dying. I can see it all before me as if it was yesterday.”
FEELING:
EMPATHIC RESPONSE:
3. “We have a neighborhood problem here! Yes we do! A real big idiot lives in that house. A real nut! He trimmed my own yard with a string trimmer and threw stones all over my car. Ruined the paint!”
FEELING:
EMPATHIC RESPONSE:
4. “I never meant to get pregnant. I know everyone says that, but I didn’t! I can’t think straight. What about my job and school and all ...
Exercise 9-08On July 1, 2019, Sheridan Company purchased new equ.docxelbanglis
Exercise 9-08
On July 1, 2019, Sheridan Company purchased new equipment for $80,000. Its estimated useful life was 8 years with a $12,000 salvage value. On December 31, 2022, the company estimated that the equipment’s remaining useful life was 10 years, with a revised salvage value of $5,000.
Prepare the journal entry to record depreciation on December 31, 2019. (Credit account titles are automatically indented when amount is entered. Do not indent manually. If no entry is required, select "No Entry" for the account titles and enter 0 for the amounts.)
Account Titles and Explanation
Debit
Credit
enter an account title
enter a debit amount
enter a credit amount
enter an account title
enter a debit amount
enter a credit amount
Prepare the journal entry to record depreciation on December 31, 2020. (Credit account titles are automatically indented when amount is entered. Do not indent manually. If no entry is required, select "No Entry" for the account titles and enter 0 for the amounts.)
Account Titles and Explanation
Debit
Credit
enter an account title
enter a debit amount
enter a credit amount
enter an account title
enter a debit amount
enter a credit amount
Compute the revised annual depreciation on December 31, 2022.
Revised annual depreciation
$
Prepare the journal entry to record depreciation on December 31, 2022. (Credit account titles are automatically indented when amount is entered. Do not indent manually. If no entry is required, select "No Entry" for the account titles and enter 0 for the amounts.)
Account Titles and Explanation
Debit
Credit
enter an account title
enter a debit amount
enter a credit amount
enter an account title
enter a debit amount
enter a credit amount
Compute the balance in Accumulated Depreciation—Equipment for this equipment after depreciation expense has been recorded on December 31, 2022.
Accumulated Depreciation—Equipment
$
Problem 9-03A
Ivanhoe Company had the following assets on January 1, 2022.
Item
Cost
Purchase Date
Useful Life
(in years)
Salvage Value
Machinery
$73,000
Jan. 1, 2012
10
$ 0
Forklift
32,000
Jan. 1, 2019
5
0
Truck
38,400
Jan. 1, 2017
8
3,000
During 2022, each of the assets was removed from service. The machinery was retired on January 1. The forklift was sold on June 30 for $12,200. The truck was discarded on December 31.
Journalize all entries required on the above dates, including entries to update depreciation, where applicable, on disposed assets. The company uses straight-line depreciation. All depreciation was up to date as of December 31, 2021. (Credit account titles are automatically indented when the amount is entered. Do not indent manually. If no entry is required, select "No Entry" for the account titles and enter 0 for the amounts.)
Date
Account Titles and Explanation
Debit
Credit
choose a transaction date
enter an account title
enter a debit amount
enter a credit amount
enter an ac ...
ExemplaryVery GoodProficientOpportunity for ImprovementU.docxelbanglis
Exemplary
Very Good
Proficient
Opportunity for Improvement
Unacceptable
Element 1a: Content of Executive Summary: Responding to the Questions
6.5 (5%)
Student presents a thorough and complete Executive Summary with rich, articulate, and well-reasoned responses to all of the questions posed in the assignment and eloquently embeds them into a cohesive and compelling Executive Summary, with direct and relevant references to the Course and Program Outcomes.
6.04 (4.65%)
Student presents an Executive Summary with well-reasoned responses to all of the questions posed in the assignment and embeds them into an Executive Summary with references to the Course and Program Outcomes.
5.53 (4.25%)
Student presents an Executive Summary of the course that addresses the questions posed in the assignment and makes some connections to the Course and Program Outcomes. Some examples and resources support thinking.
4.88 (3.75%)
Student provides cursory coverage of some or all the questions posed as part of the requirements for the Executive Summary or does not address all of the questions, although he/she does provide a summary of one or two.
0 (0%)
Not submitted or little to no evidence of addressing the criterion.
Element 1b: Content of Executive Summary: Impact of Lessons Learned In Course
6.5 (5%)
Student provides a comprehensive summary of his/her main lessons from the course and how those support his/her achievement of at least two course outcomes providing a rich assessment of the main ideas or conclusions he/she has taken from the experience in the course including assessing how these will affect his/her practices now and in the future.
6.04 (4.65%)
Student provides a summary of his/her main lessons from the course and how those support his/her achievement of one or two course outcomes providing an assessment of the main ideas or conclusions he/she has taken from the experience in the course including assessing how these will affect his/her practices now and in the future.
5.53 (4.25%)
Student provides a description of the main lessons of the course and how those relate to his/her achievement of course and program outcomes as well as how these will affect his/her practices now and in the future.
4.88 (3.75%)
Student summarizes a few main points from the classroom, but does not create an Executive Summary aligned with the expectations as outlined in the document provided in the classroom.
0 (0%)
Not submitted or little to no evidence of addressing the criterion.
Element 1c: Format of Executive Summary: Beginning
6.5 (5%)
Student begins the Executive Summary with a compelling statement of its purpose and presents a succinct and cohesive summary that focuses on the main outcomes he/she ascertained from the course and his/her experience in engaging in the assignments and discussions. Relevant examples and resources support thinking.
6.04 (4.65%)
Student begins the Executive Summary with a statement of its purpose and presents a succinct summary that focuses on ...
Exercise Question #1 Highlight your table in Excel. Copy the ta.docxelbanglis
Exercise Question #1
Highlight your table in Excel. Copy the table. In Word, place cursor where you want to Paste the Table. Right click and under Paste Options click Picture. This will paste the Table into your Word document as a Picture.
Discussion: Your Discussion should be double spaced and fill the rest of the page.
Exercise Question #2
Discussion:
1064
435
323
243
134
Project A
Project B
Project C
Project D
Weighted
& Total
Score
Project\
Criteria &
Weight
Criteria 1Criteria 2Criteria 3
1073
134
353
543
231
Project D
Project\
Criteria &
Weight
Project B
Criteria 2Criteria 3
Weighted
& Total
Score
Project A
Criteria 1
Project C
C9-1
CASE STUDY 9
ST. LUKE'S HEALTH CARE SYSTEM
Hospitals have been some of the earliest adopters of wireless local area
networks (WLANs). The clinician user population is typically mobile and
spread out across a number of buildings, with a need to enter and access
data in real time. St. Luke's Episcopal Health System in Houston, Texas
(www.stlukestexas.com) is a good example of a hospital that has made
effective use wireless technologies to streamline clinical work processes.
Their wireless network is distributed throughout several hospital buildings
and is used in many different applications. The majority of the St. Luke’s
staff uses wireless devices to access data in real-time, 24 hours a day.
Examples include the following:
• Diagnosing patients and charting their progress: Doctors and
nurses use wireless laptops and tablet PCs to track and chart patient
care data.
• Prescriptions: Medications are dispensed from a cart that is wheeled
from room to room. Clinician uses a wireless scanner to scan the
patient's ID bracelet. If a prescription order has been changed or
cancelled, the clinician will know immediately because the mobile device
displays current patient data.
http://www.stlukestexas.com/
C9-2
• Critical care units: These areas use the WLAN because running hard
wires would mean moving ceiling panels. The dust and microbes that
such work stirs up would pose a threat to patients.
• Case management: The case managers in the Utilization Management
Department use the WLAN to document patient reviews, insurance
calls/authorization information, and denial information. The wireless
session enables real time access to information that ensures the correct
level of care for a patient and/or timely discharge.
• Blood management: Blood management is a complex process that
involves monitoring both patients and blood products during all stages of
a treatment process. To ensure that blood products and patients are
matched correctly, St. Luke’s uses a wireless bar code scanning process
that involves scanning both patient and blood product bar codes during
the infusion process. This enables clinicians to confirm patient and blood
product identification before proceeding with t ...
Executive SummaryXYZ Development, LLC has requested ASU Geotechn.docxelbanglis
Executive Summary
XYZ Development, LLC has requested ASU Geotechnical, Inc. to organize a geotechnical evaluation with recommendations regarding foundation for three planned structures. XYZ Development, LLC has planned to construct a three-story medical tower, a one-story office building, and a multi-story parking garage on a 10-acre property that is in West Memphis, AR. In addition, an 18-feet high retaining wall is planned to be constructed on the north side of the parking garage.
ASU Geotechnical, Inc. was provided with soil data included a log of a borehole that extended to a depth of 100 feet. Has recommended a 6’ x 6’ shallow foundation for the one- story building at depth of 5 feet. The expected settlement under the foundation for the parking garage was calculated to be 1.09 inches, and the expected settlement for the medical tower was calculated to be 0.78 inch. Also, ASU Geotechnical, Inc. has recommended a drilled shaft deep foundation design to be used for the three-story medical tower. Furthermore, for the 3-story medical tower the pile should have a diameter of 48 inches and reach a depth of 40 feet below the ground surface with a total of 2 piles required per column. For the multi-story parking garage, a drilled shaft should have a diameter of 48 inches and reach a depth of 70 feet below the ground surface with a total of 2 piles required per column.
The expected total differential settlement for the parking garage was calculated to be 0.31 inches, and the total differential settlement for the tower was calculated to be 0.23 inch. The recommended dimensions for the retaining wall include a 12-foot-wide footing base with 1.5-foot thickness. The entire retaining wall should have a total height of 20 feet, with only 18 feet above the ground surface. The 0.5 foot of soil above the toe was placed to adjust the effects of sliding of the wall. The base of the stem wall should have a thickness of 1.5-foot, and the top of the stem wall should have a thickness of 8 inches. Also, the factor of safety for sliding was calculated to be 1.59, the factor of safety for the bearing capacity was calculated to be 2.78
Introduction
XYZ Development, LLC in planning to construct residential and commercial facilities on a 10-acre property that is in West Memphis, AR the largest city in Crittenden County. The property will include a one-story office building, a three-story medical tower, and a multi-story parking garage with an 18-feet high retaining wall on the north side of the parking garage. The expected maximum column load for the one- story office building would be 50 kips, 350 kips for the three-story medical tower, and 900 kips for the parking garage. The dead load was expected to be 65 % of the maximum column load with column spacing at 35 feet. ABC Engineering, Inc. has requested ASU geotechnical Inc. to submit a geotechnical report that included: shallow foundation recommendations, total and different settlements under the maximum column ...
Exemplary
Proficient
Progressing
Emerging
Element (1): Responsiveness: Did the student respond to the main question of the week?
9 points (28%)
Posts exceed requirements of the Discussion instructions (e.g., respond to the question being asked; go beyond what is required [i.e., incorporates additional readings outside of the assigned Learning Resources, and/or shares relevant professional experiences]; are substantive, reflective, and refers to Learning Resources demonstrating that the student has considered the information in Learning Resources and colleague postings).
9 points
Posts are responsive to and meet the requirements of the Discussion instructions. Posts respond to the question being asked in a substantive, reflective way and refer to Learning Resources demonstrating that the student has read, viewed, and considered the Learning Resources and colleague postings.
7–8 points
Posts are somewhat responsive to the requirements of the Discussion instructions. Posts are not substantive and rely more on anecdotal evidence (i.e., largely comprised of student opinion); and/or does not adequately demonstrate that the student has read, viewed, and considered Learning Resources and colleague postings.
4–6 points
Posts are unresponsive to the requirements of the Discussion instructions; miss the point of the question by providing responses that are not substantive and/or solely anecdotal (i.e., comprised of only student opinion); and do not demonstrate that the student has read, viewed, and considered Learning Resources and colleague postings.
0–3 points
Element (2): Critical Thinking, Analysis, and Synthesis: Is the student able to make meaning of the information?
9 points (28%)
Posts demonstrate the student’s ability to apply, reflect, AND synthesize concepts and issues presented in the weekly Learning Objectives. Student has integrated and mastered the general principles, ideas, and skills presented. Reflections include clear and direct correlation to authentic examples or are drawn from professional experience; insights demonstrate significant changes in awareness, self-understanding, and knowledge.
9 points
Posts demonstrate the student’s ability to apply, reflect OR synthesize concepts and issues presented in the weekly Learning Objectives. The student has integrated many of the general principles, ideas, and skills presented. Reflections include clear and direct correlation to authentic examples or are drawn from professional experience, share insights that demonstrate a change in awareness, self- understanding, and knowledge.
7–8 points
Posts demonstrate minimal ability to apply, reflect, or synthesize concepts and issues presented in the weekly Learning Objectives. The student has not fully integrated the general principles, ideas, and skills presented. There are little to no salient reflections, examples, or insights/experiences provided.
4–6 points
Posts demonstrate a lack of ability to apply, reflect, or synthesize c ...
Executive SummaryBuilding Information Modelling (BIM) is a modelli.docxelbanglis
Executive Summary
Building Information Modelling (BIM) is a modelling software defined by its unique approach towards building and construction. It is designed to operate through modelling technology which is comprised of multiple processes for production, communication, and analysis of building information and data models. The use of BIM is aimed at improving the efficiency of designing, construction and operation of buildings and other structures through information retrieval, 3D visualization, and integrated automated drawing production. BIM also helps in automatic detection of conflicts in data and information continuity, intelligent documentation, and the automation of material take. Despite the fact that there are several benefits associated with the use and application of BIM in the construction industry, there is a wide perception among stakeholders that it is not fully implemented as it should be due to factors such as the initial cost of implementation which is quite high and lack of client demand in the design and construction of buildings. These barriers act as a major hindrance towards the implementation of BIM on a wider scale. For the process to be more effective, clients need to have adequate knowledge and understanding on the application and benefits of BIM and the processes involved in the implementation. This research includes a detailed literature review on building designs and various application models including 2D models which have been used in the construction industry. A detailed analysis of the limitations of visualization, cost estimation, as well as consistency in information and data retrieval is also outlined in the paper. In addition, the challenges faced in building design and have been addressed using 3D models have also been addressed.
Table of Contents
Executive Summary 1
Introduction 4
Literature Review 6
The Original Design Model 6
Initial 2D CAD Method 6
Current Design Tools 7
Building Information Modelling (BIM) 7
The Concept used in BIM 8
The Maturity and Capability BIM Models 9
Aim(s) and Scope of the Project 9
Significance of the Project 10
Methodology 10
Research Gaps 11
Resources Requirements for BIM 11
Application of Building Information Modelling In the Construction Industry 11
Structural Information 13
Structural Design Process 13
Structural Workflows 13
Construction Analysis 14
Benefits of Building Information Modelling 14
a. Proper Coordination 15
Collaboration 16
Visualisation 17
Cost Estimation 18
Conclusion 19
Reference 22
Introduction
BIM modelling is a digital representation of both the physical and functional features of a building structure. With the increasing adoption of Information Technology (IT) within the construction industry, BIM is slowly become a very popular concept. It is capable of sharing data and information on particular facilities thus providing a reliable platform for informed decision making (Ibrahim, & Komali, 2018, p. 13). These details are critic ...
How to Make a Field invisible in Odoo 17Celine George
It is possible to hide or invisible some fields in odoo. Commonly using “invisible” attribute in the field definition to invisible the fields. This slide will show how to make a field invisible in odoo 17.
2024.06.01 Introducing a competency framework for languag learning materials ...Sandy Millin
http://sandymillin.wordpress.com/iateflwebinar2024
Published classroom materials form the basis of syllabuses, drive teacher professional development, and have a potentially huge influence on learners, teachers and education systems. All teachers also create their own materials, whether a few sentences on a blackboard, a highly-structured fully-realised online course, or anything in between. Despite this, the knowledge and skills needed to create effective language learning materials are rarely part of teacher training, and are mostly learnt by trial and error.
Knowledge and skills frameworks, generally called competency frameworks, for ELT teachers, trainers and managers have existed for a few years now. However, until I created one for my MA dissertation, there wasn’t one drawing together what we need to know and do to be able to effectively produce language learning materials.
This webinar will introduce you to my framework, highlighting the key competencies I identified from my research. It will also show how anybody involved in language teaching (any language, not just English!), teacher training, managing schools or developing language learning materials can benefit from using the framework.
Read| The latest issue of The Challenger is here! We are thrilled to announce that our school paper has qualified for the NATIONAL SCHOOLS PRESS CONFERENCE (NSPC) 2024. Thank you for your unwavering support and trust. Dive into the stories that made us stand out!
Unit 8 - Information and Communication Technology (Paper I).pdfThiyagu K
This slides describes the basic concepts of ICT, basics of Email, Emerging Technology and Digital Initiatives in Education. This presentations aligns with the UGC Paper I syllabus.
Palestine last event orientationfvgnh .pptxRaedMohamed3
An EFL lesson about the current events in Palestine. It is intended to be for intermediate students who wish to increase their listening skills through a short lesson in power point.
A Strategic Approach: GenAI in EducationPeter Windle
Artificial Intelligence (AI) technologies such as Generative AI, Image Generators and Large Language Models have had a dramatic impact on teaching, learning and assessment over the past 18 months. The most immediate threat AI posed was to Academic Integrity with Higher Education Institutes (HEIs) focusing their efforts on combating the use of GenAI in assessment. Guidelines were developed for staff and students, policies put in place too. Innovative educators have forged paths in the use of Generative AI for teaching, learning and assessments leading to pockets of transformation springing up across HEIs, often with little or no top-down guidance, support or direction.
This Gasta posits a strategic approach to integrating AI into HEIs to prepare staff, students and the curriculum for an evolving world and workplace. We will highlight the advantages of working with these technologies beyond the realm of teaching, learning and assessment by considering prompt engineering skills, industry impact, curriculum changes, and the need for staff upskilling. In contrast, not engaging strategically with Generative AI poses risks, including falling behind peers, missed opportunities and failing to ensure our graduates remain employable. The rapid evolution of AI technologies necessitates a proactive and strategic approach if we are to remain relevant.
2. High voltages are present in this laboratory exercise. Do not
make or modify any
banana jack connections with the power on unless otherwise
specified.
Setup and connections
In this part of the exercise, you will set up and connect the
equipment.
1. Refer to the Equipment Utilization Chart in Appendix A to
obtain the list of
equipment required to perform the exercise.
Install the equipment in the Workstation.
Mechanically couple the Four-Pole Squirrel Cage Induction
Motor to the
Four-Quadrant Dynamometer/Power Supply using a timing belt.
PROCEDURE OUTLINE
PROCEDURE
Voltage waveform without overmodulation
Voltage waveform with overmodulation
Sine wave modulating the duty
cycle (with overmodulation)
/2
duty cycle = 100%
/2
3. duty cycle = 0%
Time
V
o
lta
g
e
a
t
th
e
o
u
tp
u
t
o
f
a
t
h
re
e
-p
5. 3. Connect the Power Input of the Data Acquisition and Control
Interface to
a 24 V ac power supply.
Connect the Low Power Input of the Chopper/Inverter to the
Power Input of
the Data Acquisition and Control Interface. Turn the 24 V ac
power supply
on.
4. Connect the USB port of the Data Acquisition and Control
Interface to a
USB port of the host computer.
Connect the USB port of the Four-Quadrant
Dynamometer/Power Supply to
a USB port of the host computer.
5. Turn the Four-Quadrant Dynamometer/Power Supply on, then
set the
Operating Mode switch to Dynamometer.
6. Turn the host computer on, then start the LVDAC-EMS
software.
In the LVDAC-EMS Start-Up window, make sure that the Data
Acquisition
and Control Interface and the Four-Quadrant
Dynamometer/Power Supply
are detected. Make sure that the Computer-Based
Instrumentation and
Chopper/Inverter Control functions for the Data Acquisition and
Control
Interface are available. Select the network voltage and
frequency that
6. correspond to the voltage and frequency of your local ac power
network, then
click the OK button to close the LVDAC-EMS Start-Up
window.
7. Connect the Digital Outputs of the Data Acquisition and
Control
Interface (DACI) to the Switching Control Inputs of the
Chopper/Inverter
using a DB9 connector cable.
On the Chopper/Inverter, set the Dumping switch to the O (off)
position. The
Dumping switch is used to prevent overvoltage on the dc bus of
the
Chopper/Inverter. It is not required in this exercise.
8. Set up the circuit shown in Figure 10. Use the diodes in the
Rectifier and
Filtering Capacitors to implement the three-phase full-wave
rectifier. Use the
Chopper/Inverter to implement the Three-phase inverter.
Connect the
Thermistor Output of the Four-Pole Squirrel Cage Induction
Motor to the
Thermistor Input of the Four-Quadrant Dynamometer/Power
Supply.
Notice that the prefix IGBT
has been left out in this
manual when referring to
the IGBT Chopper/Inverter
module.
8. -Phase PWM inverter.
-2-
3).
nominal frequency
indicated on the Four-Pole Squirrel Cage Induction Motor front
panel.
Three-phase filter
Three-phase
inverter
Three-phase
rectifier
Three-
phase
induction
machine
Switching control
signals from DACI
Brake
N
10. on. The motor
should start to rotate.
11. In LVDAC-EMS, open the Oscilloscope. Use channel 1 to
display the dc bus
voltage (input E1), channels 2 and 3 to display the line voltage
at the output
of the three-phase PWM inverter before and after filtering
(inputs E2 and E3,
respectively), and channel 4 to display the current flowing in
the motor stator
windings (input I1).
Select the Continuous Refresh mode, set the time base to
display only one
complete cycle of the voltage and current waveforms (this
provides more
precision for observing the trains of rectangular bipolar pulses
produced by
the three-phase PWM inverter), and set the trigger controls so
that the
Oscilloscope triggers when the waveform of the motor stator
current passes
through 0 A with a positive slope.
Select convenient vertical scale and position settings to
facilitate observation
of the waveforms.
12. Print or save the waveforms displayed on the Oscilloscope
screen for future
reference. It is suggested that you include these waveforms in
your lab
report.
13. Describe the waveform of the voltage at the output of the
13. PWM inverter after filtering (input E3), indicated in the
Harmonic Analyzer
display.
RMS value of the fundamental-frequency component in the line
voltage
at the output of the three-phase PWM inverter after filtering: V
a Compare the rms value of the fundamental-frequency
component in the line voltage at the output of the three-phase
PWM inverter after filtering measured
using the Harmonic Analyzer with the rms value of the line
voltage measured
previously using the Oscilloscope. The values should be
identical because the
voltage waveform is sinusoidal.
19. In the Harmonic Analyzer window, set the Input parameter
to E2 to measure
the line voltage at the output of the three-phase PWM inverter
before filtering.
Measure and record the rms value of the fundamental-frequency
component
in the line voltage at the output of the three-phase PWM
inverter before
filtering (input E2), indicated in the Harmonic Analyzer
display.
RMS value of the fundamental-frequency component in the line
voltage
at the output of the three-phase PWM inverter before filtering:
V
a The rms value of the fundamental-frequency component in the
line voltage at the output of the three-phase PWM inverter
15. voltage
input E3. The circuit should be as shown in Figure 11.
Figure 11. Three-phase, variable-frequency induction-motor
drive (without three-phase filter).
22. In the Chopper/Inverter Control window, start the Three-
Phase
PWM Inverter.
On the Power Supply, turn the three-phase ac power source on.
Measure and record the rms value of the fundamental-frequency
component
in the line voltage at the output of the three-phase PWM
inverter indicated in
the Harmonic Analyzer display.
RMS value of the fundamental-frequency component in the line
voltage
at the output of the three-phase PWM inverter: V
a Compare the rms value of the fundamental-frequency
component in the line voltage measured without filter to that
measured in step 19 when the filter was in
the circuit.
Three-phase
inverter
Three-phase
full-wave rectifier
Three-
17. Oscilloscope screen is sinusoidal even if the filter is removed.
Overmodulation
In this part of the exercise, you will increase the rms value of
the line voltage at
the output of a three-phase PWM inverter by increasing the
amplitude of the sine
wave that modulates the duty cycle of the switching transistors
of the
PWM inverter to a level that causes overmodulation.
a For the remaining of this exercise, the rms value of the line
voltage at the output of the three-phase PWM inverter always
refers to the rms value of the
fundamental-frequency component in the line voltage (i.e., the
rms value of
the 1f component measured with the Harmonic Analyzer).
26. Compare the rms value of the line voltage at the output of
the three-phase
PWM inverter measured in step 22 with the nominal line voltage
of the
Four-Pole Squirrel Cage Induction Motor (indicated on its front
panel). Does
the maximum line voltage which can be obtained at the outputs
of the three-
phase PWM inverter without overmodulation (i.e., with
modulation index set
to 1) allow the induction motor to be operated at its nominal
voltage?
19. 30. Print or save the waveforms displayed on the Oscilloscope
screen for future
reference. It is suggested that you include these waveforms in
your lab
report.
31. Compare the voltage waveforms at the output of the three-
phase
PWM inverter obtained with and without overmodulation (i.e.,
obtained in
step 30 and step 24, respectively). Do you observe that the
voltage
waveform obtained with overmodulation contains less
rectangular pulses,
indicating that overmodulation occurs?
32. Do your observations confirm that overmodulation allows
the rms value of the
maximum voltage at the output of a three-phase PWM inverter
to be
increased?
33. In the Chopper/Inverter Control window, stop the Three-
Phase
PWM Inverter.
Effect of the frequency on the induction motor speed and
magnetizing
current
In this part of the exercise, you will use the same circuit as in
21. of teeth on the pulley of the machine under test, respectively.
The
pulley ratio between the Four-Quadrant Dynamometer/Power
Supply
and the Four-Pole Squirrel Cage Induction Motor is 24:24.
is
required to match the characteristics of the thermistor in the
Four-
Pole Squirrel Cage Induction Motor with the Thermistor Input
in the
Four-Quadrant Dynamometer/Power Supply.
-Torque Primer Mover/Brake by
setting
the Status parameter to Started or by clicking the Start/Stop
button.
de of the meters by clicking
on the
corresponding button.
Operation at motor nominal frequency
35. In the Chopper/Inverter Control window, make the
following settings:
-Phase
PWM inverter.
he Switching Frequency parameter to 2000 Hz.
-2-
3).
23. Frequency Motor speed of
rotation
(r/min)
DC bus voltage
(V)
RMS value of the
motor magnetizing
current
(A)
Amplitude of the
motor magnetizing
current (peak value)
(A)
Nominal
frequency
4/3 the nominal
frequency
1/2 the nominal
frequency
37. On the Oscilloscope, use channel 1 to display the dc bus
24. voltage (input E1),
and channel 2 to display the motor stator current (input I1).
Select convenient vertical scale and position settings to
facilitate observation
of the waveforms.
38. Measure and record the dc bus voltage as well as the rms
value and
amplitude of the motor magnetizing current in Table 2.
Operation at 4/3 the motor nominal frequency
39. In the Chopper/Inverter Control window, gradually increase
the frequency of
the three-phase PWM inverter up to about 4/3 the motor
nominal frequency
while observing the motor speed and magnetizing current.
Measure and record the motor speed, the dc bus voltage, as well
as the
rms value and amplitude of the motor magnetizing current in
Table 2.
40. Gradually decrease the frequency of the three-phase PWM
inverter to the
motor nominal frequency.
The stator current meas-
ured when an induction
motor operates with no
mechanical load is virtually
equal to the motor magnet-
izing current.
27. decrease in direct proportion with the decrease in frequency?
47. How does the motor magnetizing current vary when the
frequency is
decreased? Explain why.
48. Compare the magnetizing current measured at 1/2 the motor
nominal
frequency to that measured at the motor nominal frequency as
well as to the
motor full-load current rating indicated on the Four-Pole
Squirrel Cage
Induction Motor front panel. What are the consequences of
decreasing the
frequency to 1/2 the motor nominal frequency while keeping the
voltage
constant?
Saturation curves
In this part of the exercise, you will plot the saturation curves
of the three-phase
induction motor at the motor nominal frequency, 2/3 the
nominal frequency,
29. frequency indicated on the Four-Pole Squirrel Cage Induction
Motor
front panel.
e-Phase PWM Inverter.
51. On the Power Supply, turn the three-phase ac power source
on.
For each value of the Peak Voltage parameter shown in Table 3,
measure
the rms value of the line voltage applied to the motor stator
windings using
the Harmonic Analyzer and the peak value of the current
flowing in the motor
stator windings (peak magnetizing current) using the
Oscilloscope (use the
horizontal cursors to make the measurement). To obtain optimal
results,
begin your measurements with the highest Peak Voltage setting
as shown in
Table 3.
To reduce the data acquisition time and to prevent the motor
from
overheating, it is strongly recommended to use the Data Table
in
LVDAC-EMS to record the circuit parameters measured.
Table 3. RMS value of the motor stator winding voltage (at the
fundamental frequency) and
peak magnetizing current of the three-phase induction motor at
various frequencies.
30. Peak voltage
(% of dc
bus/2)
(%)
/ / /
Motor line
voltage
(V)
Peak
magnetizing
current
(A)
Motor line
voltage
(V)
Peak
magnetizing
current
(A)
Motor line
voltage
(V)
34. rectifier and a three-
phase PWM inverter. You learned that varying the operating
frequency of the
PWM inverter varies the frequency of the ac voltage applied to
the induction
motor, and thus, the motor speed. You also learned that varying
the modulation
index of the PWM inverter allows the voltage applied to the
motor stator windings
to be adjusted. You were introduced to the use of
overmodulation in the
PWM inverter to increase the maximum voltage that can be
applied to the motor
stator windings. You saw that for a given frequency, the
maximum flux density
( .) in the stator of the motor is directly proportional to the rms
value of
voltage applied to the motor stator windings. You also saw that
when the voltage
increases and reaches a certain value, saturation occurs in the
stator causing the
motor magnetizing current to start increasing at a rate which
largely exceeds that
of the motor voltage. You learned that for a given voltage, the
maximum flux
density is inversely proportional to the frequency of the ac
voltage applied to the
motor windings, and consequently, the magnetizing current of
the motor
decreases when the frequency increases and vice versa. You
were introduced to
the use of a harmonic analyzer to measure the rms value of the
fundamental-
frequency component of a non-sinusoidal signal (e.g., the
unfiltered voltage at
the output of a three-phase PWM inverter).
35. 1. How can the ac voltage at the output of a three-phase PWM
inverter be
varied?
2. How does the magnetizing current vary when saturation starts
to occur in the
stator of an induction motor?
3. What should be done for an induction motor to be able to
produce the
highest possible torque?
4. How do the maximum flux density ( .) and peak magnetizing
current of an
induction motor vary when the PWM inverter frequency
decreases and the
voltage at the PWM inverter output (motor stator voltage)
remains constant?
CONCLUSION
REVIEW QUESTIONS
37. for prevalence rate differences across groups, and (2) com-
paring the strength of predictors across groups. 3,732 White,
African American, Hispanic, and Asian/Pacific Islander
women from the New York City area completed the Preg-
nancy Risk Assessment Monitoring System from 2004 to
2007, a population-based survey that assessed sociodemo-
graphic risk factors, maternal stressors, psycho-education
provided regarding depression, and prenatal and postpartum
depression diagnoses. Sociodemographic and maternal
stressors accounted for increased rates in PPD among Blacks
and Hispanics compared to Whites, whereas Asian/Pacific
Islander women were still 3.2 times more likely to receive a
diagnosis after controlling for these variables. Asian/Pacific
Islanders were more likely to receive a diagnosis after their
providers talked to them about depressed mood, but were less
likely than other groups to have had this conversation. Pre-
natal depression diagnoses increased the likelihood for PPD
diagnoses for women across groups. Gestational diabetes
38. decreased the likelihood for a PPD diagnosis for African
Americans; a trend was observed in the association between
having given birth to a female infant and increased rates of
PPD diagnosis for Asian/Pacific Islanders and Whites. The
risk factors that account for prevalence rate differences in
postpartum diagnoses depend on the race/ethnic groups
being compared. Prenatal depression is confirmed to be a
major predictor for postpartum depression diagnosis for all
groups studied; however, the associations between other
postpartum depression risk factors and diagnosis vary by
race/ethnic group.
Keywords Postpartum depression � Health status
disparities � Asian Americans � Prenatal depression �
Gestational diabetes
Introduction
Postpartum depression (PPD) is a serious health concern
affecting approximately 13 % of all women [1]. At least
19.2 % of women experience depression within 12 months
after giving birth [2]. The associations between prenatal
39. depression and PPD depression are well documented [3–5].
Psychosocial factors including high stress, low social sup-
port, and low marital satisfaction are also predictors [4, 5].
Surprisingly little is known about the extent to which
postpartum depression varies by race and ethnicity, given the
effects of culture on the experiences and manifestations of
depression [6, 7]. This dearth of information on postpartum
depression in ethnic minorities is well recognized. In a
published review of maternal depression, the Agency for
Healthcare Research and Quality found ‘‘screening instru-
ments [to be] poorly representative of the U.S. population,’’
and that ‘‘populations [from studies] were overwhelmingly
Caucasian’’ [8]. A review by O’Hara found that meta-anal-
yses on postpartum depression had omitted race and eth-
nicity as risk factors for postpartum depression [4].
Research studies on postpartum depression that have
included ethnic minorities generally compare African
C. H. Liu (&)
40. Beth Israel Deaconess Medical Center, Harvard Medical School,
75 Fenwood Road, Boston, MA 02115, USA
e-mail: [email protected]
E. Tronick
Child Development Unit, University of Massachusetts,
100 Morrissey Blvd, Boston, MA 02125, USA
e-mail: [email protected]
123
Matern Child Health J (2013) 17:1599–1610
DOI 10.1007/s10995-012-1171-z
Americans and Hispanics with Whites. In these studies,
group differences in prevalence rates have shown to be
inconsistent. Across studies, the rates of postpartum
depression in African American and Hispanic women were
found to be higher [9], lower [10], or no different [11]
compared to Whites. What accounts for observed racial and
ethnic differences in prevalence is unclear. In some studies,
sociodemographic risk variables were associated with
41. higher levels of depressive symptomatology among Afri-
can Americans, raising the possibility that sociodemo-
graphic variables rather than race and ethnicity account for
different levels of postpartum depression [12–14]. In con-
trast, others have shown greater levels of depressive
symptomatology among African Americans and Hispanics
than Whites, after accounting for sociodemographic factors
[9]. While certain social factors could increase risk, some
factors might buffer against postpartum depression within
groups. For instance, low income foreign-born Hispanic
women with social support exhibited lower rates of post-
partum depression [15], whereas bilingual Hispanic women
were at greater risk than those who spoke only Spanish
[11]. It is possible that factors such as social support or
nativity and its effect on the likelihood of postpartum
depression differ by race/ethnicity because they express
different meanings or incur different implications for each
group. Moreover, stigmas about psychological problems
42. and help-seeking may have an effect on identifying post-
partum depression, resulting in a subsequent effect on
reported prevalence of postpartum depression rates [6, 16].
Given the mixed picture across groups, this study aimed to
systematically determine the extent to which prevalence
rates across race and ethnicity are explained by factors
associated with postpartum depression.
This study uniquely includes Asian/Pacific Islander
(API) women within the U.S. As the fastest growing ethnic
minority group, over 16 million APIs are estimated to be
living in the U.S [17, 18]. The research on API postpartum
experiences is limited, which is striking given that API
women may hold several risk factors.
If psychiatric history is a major predictor, API women
may be at greatest risk: those between the ages of
15–24 years have the highest rate of depression and su-
icidality compared to any other ethnicity, gender, or age
[19–21]. One study showed APIs to be at lower risk for
43. postpartum depressive symptoms compared to Whites,
African Americans, and Hispanics [14], while another
study reported a greater percentage of APIs with post-
partum symptoms compared to White Americans [22].
Analyses conducted by the New York City Department of
Health and Mental Hygiene on data from the 2004 to 2007
New York City (NYC) Pregnancy Risk Assessment Mon-
itoring System (PRAMS) revealed a higher rate of PPD
diagnoses among APIs compared to other groups [23–25].
From the most recent sample in 2007, 10.4 % of API
received a PPD diagnosis compared to 1.7 % of non-His-
panic White women [26]. These findings suggest a poten-
tial risk for postpartum depression in APIs.
This study examines racial/ethnic disparities in PPD
diagnosis by identifying predictors accounting for preva-
lence differences. Because previous studies have either
focused mostly on small samples of one group, or did not
examine these risk factors by race/ethnicity, we hypothe-
44. size that associations of risk factors and PPD differ by race/
ethnic group. The risk factors evaluated were selected
based on the current literature [27–31]. Our study also
sought to explain disparities in PPD rates from a published
report by the NYC Department of Health and Mental
Hygiene. We utilized the study’s comprehensive popula-
tion-based dataset. We also sought to determine the
strength of predictors within each group and differences
across groups. Accordingly, we stratified our analyses by
race/ethnicity. Determining the strength of predictors by
group is essential for identifying individuals most at risk,
and may inform the possible causes of depression for dif-
ferent groups. Unique to this study was the use of diagnosis
as an outcome measure, the inclusion of information on
whether providers talked to women about depressed mood,
and an adequate sample size of APIs. This allowed us to
also examine disparities in psycho-education and diagnosis
across groups.
45. Methods
Sample
This study used the NYC PRAMS from 2004 to 2007, a
population-based survey administered to postpartum
women from NYC. Coordinated by the Centers for Disease
Control and Prevention and state health departments,
PRAMS’ goal is to monitor maternal behaviors and expe-
riences of women before, during, and after live birth
pregnancies. The dataset was provided by the NYC
Department of Health and Mental Hygiene (DOHMH).
The participants were part of an ongoing population-
based random sampling of NYC live births. NYC mothers
of approximately 180 infants with registered birth certifi-
cates that gave birth during the previous 2–4 months were
contacted for participation monthly. Eighty-three percent
responded by mail and 17 % by phone. The sample was
randomized without replacement and stratified by birth
weight. The final dataset was weighted for stratification,
46. nonselection, and nonresponse.
According to the DOHMH, a total of 4,813 responses
were received with response rates of at least 70 % from
July to December of 2004, May to December of 2005, and
1600 Matern Child Health J (2013) 17:1599–1610
123
January to December of 2006. A rate of 65 % was achieved
from January to December of 2007. For 2004–2005,
responses were weighted to represent 138,266 live births.
For 2006 and 2007, responses represented 119,079 and
122,222 live births, respectively. Based on the DOHMH
analysis, respondents differed from non-respondents on
some key sociodemographic variables (p .05). APIs
compared to other racial and ethnic groups, younger
women, and women with less education were less likely to
respond to the survey.
Measures
The birth certificate provided information on maternal race/
47. ethnicity and nativity (i.e., U.S. or non-U.S. born mothers).
Women were classified as Hispanic or non-Hispanic based
on self-report. Non-Hispanic women were categorized in
one of the following groups: White, African American,
Asian/Pacific Islander, and American Indian/Alaskan
Native. Maternal age, nativity (U.S. Born versus Foreign
Born) and education (categorized as: 0–8, 9–11, 12, 13–15,
and [16 years) were based at the time of infant birth from
information in the birth certificate. Mean infant age at the
time of survey completion was 9.7 months; there were no
significant differences in infant age across groups.
The PRAMS survey itself provided information for
remaining variables. To obtain income, women were asked
to indicate ‘‘total household income before taxes in the
12 months before the new baby was born’’ by checking off
one of the following options: $10,000, $10,000–$14,999,
$15,000–$19,999, $20,000–$24,999, $25,000–$34,999,
$35,000–$49,999, $50,000–$74,999, and [$75,000. Stress-
ful events during pregnancy were obtained by ‘‘yes’’ or
48. ‘‘no’’ responses to events that may have occurred during
the last 12 months before the new baby was born. Exam-
ples include ‘‘I moved to a new address,’’ ‘‘I had a lot of
bills to pay,’’ ‘‘I got separated or divorced from my hus-
band or partner,’’ and ‘‘Someone very close to me died.’’
These events were counted and categorized into the fol-
lowing: 0, 1–2, 3–5, and 6–13 events. A ‘‘yes’’ or ‘‘no’’
response was also used to obtain information on following:
gestational diabetes (‘‘High blood sugar (diabetes) that
started during this pregnancy’’), social support from partner
(responses of ‘‘My husband or partner’’ to the question
‘‘During your most recent pregnancy, who would have
helped you if a problem had come up’’), NICU (Neonatal
Intensive Care Unit) (‘‘After your baby was born, was he or
she put in an intensive care unit?’’), unintended pregnancy
(‘‘When you got pregnant with your new baby, were you
trying to get pregnant?’’). The NYC PRAMS included
additional questions related to depression. Mothers were
49. asked to respond ‘‘yes’’ or ‘‘no’’ regarding prenatal
depression (‘‘At any time during your most recent
pregnancy, did a doctor, nurse, or other health care worker
diagnose you with depression?’’), and discussion about
mood (‘‘At any time during your most recent pregnancy or
after delivery, did a doctor, nurse, or other health care
worker talk with you about ‘‘baby blues’’ or postpartum
depression?’’). In addition, mothers were asked about PPD
diagnosis (‘‘Since your new baby was born, has a doctor,
nurse, or other health care worker diagnosed you with
depression?’’). The response to this item was the outcome
variable used for the analyses in this study.
The language of the survey (English or Spanish version)
was also noted.
Variables
Covariates included maternal age, household income,
maternal education, nativity, and infant age at the time the
mother completed the questionnaire. Variables considered
50. as potential stressors included: gestational diabetes,
stressful events, social support, NICU, intention for preg-
nancy, and prenatal depression. Discussion about mood
served as an additional predictor of PPD diagnosis.
Responses with missing variables of interest for this
study were eliminated. Variables with less than a 100 %
response rate included household income (86.9 %),
maternal education (99.3 %), maternal age (97.0 %), and
PPD diagnosis (99.4 %) resulting in an unweighted study
sample of 3,732.
Statistical Analyses
To account for the stratified and weighted sample, the data
was analyzed using the complex samples module of SPSS
version 17.0 (SPSS Inc., Chicago, IL). A non-race stratified
model was conducted to determine the likelihood of
receiving a PPD diagnosis for each race/ethnic group with
Whites as the reference group. A series of four logistic
regression models were employed where the variables of
51. interest (race/ethnicity, sociodemographic, stressors, and
discussion about mood) were sequentially added to the
model, allowing incremental examination of the variables’
effects in identifying factors that explain racial/ethnic
disparities in PPD.
Prevalence estimates within each group were generated
according to predictors. To compare the characteristics of
those with and without PPD and to understand associated
predictors, race-stratified logistic regressions incorporated
all predictors, with sociodemographic variables as covari-
ates. Adjusted odds ratios for each predictor were gener-
ated by race/ethnic group. Note that our models failed to
converge with the inclusion of language, nativity, and
NICU variables because of low cell sizes; thus, these
variables were dropped from our analyses. Unless
Matern Child Health J (2013) 17:1599–1610 1601
123
52. otherwise noted, all reported proportions represent weigh-
ted averages.
Results
Compared to other groups, API women showed the highest
rate for PPD, followed by Hispanics and African Ameri-
cans. White women had the lowest rate of PPD. The high
rate of a PPD diagnosis among API women is consistent
with previous analyses from this dataset, which utilized a
larger sample size than the dataset here, as this set includes
only women with complete data on the predictor variables.
Other racial/ethnic differences among assessed variables
are presented (Table 1).
A major objective was to determine whether sociode-
mographic variables, stressor variables, and discussion
about mood accounted for PPD differences. In the unad-
justed model, likelihood estimates indicate that API women
were 4.6 times more likely and Hispanic women 2.7 times
more likely than Whites to receive a PPD diagnosis.
53. African American were 1.7 times more likely to receive the
diagnosis than Whites, although this was not statistically
significant (Table 2). Once sociodemographic factors were
entered, African Americans were no more likely to receive
a diagnosis than Whites. For Hispanics, the greater likeli-
hood for a diagnosis compared to Whites was less pro-
nounced after accounting for sociodemographic factors and
was eliminated with the inclusion of stressors. The diag-
nosis likelihood was slightly reduced for APIs after
accounting for sociodemographic factors, and significantly
reduced with stressor variables, although diagnosis likeli-
hood was still more than double the rate of Whites and
African Americans. In contrast to the other groups, diag-
nosis likelihood for APIs increased to 3.2 times relative to
Whites, after accounting for reports of having discussed
mood with a provider. Prenatal depression was by far the
strongest predictor for all women compared to other
stressors, although women who gave birth to females were
54. more likely to receive a diagnosis than women with male
infants. Overall, those who had a discussion about mood
were also more likely to receive a diagnosis.
Profiles of women with PPD diagnoses compared to
women without a diagnosis differed by race/ethnicity. The
majority of White women reporting a PPD diagnosis
received a postgraduate education, while API and African
American women with the diagnosis tended to be high
school graduates. Approximately half of the White women
with PPD had household incomes above $75,000 per year.
Among APIs, Hispanics, and African Americans, more
women with PPD had less than $15,000 of household
income per year than those without a diagnosis (Table 3).
With regard to stressors, we found a significantly higher
rate of gestational diabetes among those with PPD than
those without PPD, but only for White women. However,
after controlling for sociodemographic variables through
our race-stratified adjusted model, gestational diabetes did
55. not significantly predict PPD in White, API, or Hispanic
women (Table 4). In fact, African American women with
gestational diabetes were less likely to receive a diagnosis
of PPD.
Compared to those without PPD, there was a higher
percentage among APIs and Hispanics with the diagnosis
who had an unintended pregnancy. In addition, the
majority of APIs with PPD had a diagnosis of prenatal
depression compared to the other groups. Stressful events
were not associated with greater likelihood for PPD, but
API women who reported having 6–13 stressful events
were significantly more likely to have PPD, a rate that was
statistically significant. The association between prenatal
depression and PPD persisted for all groups, even after
controlling for sociodemographic variables.
Overall, there was a higher rate of women with PPD
who had a discussion about mood with their providers than
women without the diagnosis. However, the association
56. between PPD and discussion about mood with providers
was specific to only API and African American women in
the adjusted model.
Women from all groups who received a diagnosis of
PPD were more likely to have given birth to females
although the differences were not statistically significant.
However, having a female infant seemed to slightly
increase the likelihood of a PPD diagnosis among White
and API women based on the race-stratified analyses.
Discussion
This study assessed PPD estimates and identified predictors
of PPD as defined by women’s reports of receiving a
diagnosis from a health care provider. We included API
women and used race-stratified analyses, allowing us to
determine whether predictors varied by race/ethnicity.
This study also sought to identify factors that explained
racial/ethnic disparities obtained in a previous analysis of
the dataset by the NYC Department of Health and Mental
57. Hygiene. As with other studies, we found that sociode-
mographic factors accounted for the higher rates of PPD
among African Americans and Hispanics. Based on such
findings, some have argued for prevention or intervention
programs to provide resources (e.g., financial support,
education) in addressing the racial/ethnic disparities of
PPD for African Americans and Hispanics [12]. However,
unlike other studies that primarily assessed reported
symptoms [9, 12, 14], we used the diagnosis of PPD as the
1602 Matern Child Health J (2013) 17:1599–1610
123
outcome measure. This raises the possibility that sociode-
mographic status accounts for the rates at which one
receives a diagnosis; in our study, African Americans and
Hispanics with lower sociodemographic statuses were less
likely to receive a diagnosis compared to Whites. If race/
ethnic disparities are found among rates of diagnosis, then
58. the diagnostic process may be another area to target for
improvement among lower sociodemographic status
groups.
Among ethnic minorities in our study, API women were
the most likely to receive a PPD diagnosis, and unlike
African Americans and Hispanics, the likelihood of
receiving a PPD diagnosis for APIs remained significantly
higher even after accounting for other variables (e.g.,
sociodemographic factors). Prenatal depression was asso-
ciated with PPD for all groups in our study, but the like-
lihood was highest for APIs. Although psychiatric history
for depression was not available, the strong association
between prenatal depression and PPD observed among the
API women in our sample adds to the growing concern of
depression experiences and its effects on API women
during motherhood [19–21]. A number of factors specific
to API women’s experiences are potentially associated
with later postpartum mood. The high rate of depression
59. and suicidal ideation during adolescence and young
adulthood may reflect family and societal pressures faced
by young women to uphold high academic standards and
traditional gender roles [32]. These young women likely
must negotiate their cultural values and beliefs when
assuming a mother’s identity [33, 34]. In addition, the
cultural preference for male infants may affect PPD.
Table 1 Weighted percentage distribution of mothers who
recently
gave birth that completed the NYC PRAMS from 2004 to 2007,
by
characteristic, according to race/ethnicity
White Asian/
Pacific
Islander
Hispanic Black
(n = 1,043) (n = 425) (n = 1,253) (n = 1,027)
Maternal age
20 2.4a 0.9a 9.9b 6.9c
20–34 70.1
65. 34.1
c
56.3
d
Non-U.S. born 31.1 88.9 65.6 43.0
Missing data 0.5 0 0.3 0.7
Language of questionnaire
English 99.1
a
99.5
a
51.2
b
98.8
a
Spanish 0 0 48.5 0
Missing data 0.5 0.5 0.3 1.2
NICU
Yes 5.1 5.9 6.4 14.4
No 94.9
a
66. 94.1
a
93.6
a
85.5
b
Don’t know 0 0.1 0 0.1
Gender
Male 49.3
a
52.1
a
51.1
a
52.0
a
Female 50.7 47.9 48.9 48.0
Diabetes
No 92.4 85.1 89.9 89.9
Yes 7.6
a
14.9
b
69. Table 1 continued
White Asian/
Pacific
Islander
Hispanic Black
(n = 1,043) (n = 425) (n = 1,253) (n = 1,027)
Intention for pregnancy
No 30.9
a
35.1
a
59.0
b
66.5
c
Yes 69.1 64.9 41.0 33.5
Prenatal depression diagnosis
No 97.2 87.6 92.4 94.5
Yes 2.8
a
70. 12.4
b
7.6
c
5.5
d
Discussion about mood
No 46.0 61.4 42.7 39.3
Yes 54.0
a
38.6
b
57.3
a,c
60.7
c
Postpartum depression diagnosis
No 97.4 89.3 93.6 96.3
Yes 2.6
a
10.7
b
6.4
71. c
3.7
a
Lower case superscripts that differ across each row represent
statistically
different values across racial/ethnic groups. Conversely, groups
within a
row that share the same superscript demonstrate no statistically
significant
difference in values within p .05
Matern Child Health J (2013) 17:1599–1610 1603
123
Table 2 Logistic regression models of race/ethnicity, other
sociodemographic factors, stressors, and discussion of mood
with provider, with
adjusted odds of postpartum depression diagnosis
Model 1 Model 2 Model 3 Model 4
OR CI OR CI OR CI OR CI
Race
White 1.0 1.0 1.0 1.0
Asian/Pacific Islander 4.6*** 2.6–8.2 4.0*** 2.2–7.2 2.7** 1.4–
74. 0.8–5.1
Social support
No 1.0 1.0
Yes 1.1 0.7–1.9 1.2 0.7–2.0
Intention for pregnancy
No 1.0 1.0
Yes 1.2 0.8–1.8 1.2 0.8–1.8
Prenatal depression diagnosis
No 1.0 1.0
Yes 17.3*** 10.9–27.5 15.0*** 9.4–23.8
Discussion about mood
No 1.0
Yes 2.6*** 1.6–4.1
�
p 0.1; * p .05; ** p .01; *** p .001
1604 Matern Child Health J (2013) 17:1599–1610
123
75. Table 3 Weighted percentage of mothers who completed the
NYC PRAMS from 2004 to 2007, by characteristic according to
race/ethnicity and
postpartum depression diagnosis
White Asian/Pacific Islander Hispanic Black
No PPD PPD No PPD PPD No PPD PPD No PPD PPD
(n = 1,010) (n = 33) (n = 383) (n = 42) (n = 1,162) (n = 91) (n =
979) (n = 48)
Maternal age
20 2.3 5.9 1 0 9.6 13.4 6.2 25.2***
20–34 70.4 62 74.1 86.1
�
77.7 63.7** 74.2 63.4
�
C35 27.4 32.1 24.9 13.9 12.6 22.9** 19.6 11.5
Maternal education
0–8 1.7 0 2.4 4.9 11.5 15.8 1.7 0.7
9–11 4 9 10.6 11.4 19.3 23 15.9 12.5
12 22.9 12.1 23 52.8*** 34.9 25.9
�
31.4 49.3***
13–15 16.5 5.3 14.5 16.5 20.7 27.7 28.2 26.2
78. Yes 90.6 84.7 91.4 86.3 77.3 71.7 75.4 68.6
Intention for pregnancy
Matern Child Health J (2013) 17:1599–1610 1605
123
Chinese women with a female infant were more likely to
experience PPD [35, 36]. In another study on Indian
women, having a female infant increased the effects of
other risk factors [37]. Recent findings have also demon-
strated a greater likelihood for Asian women to develop
gestational diabetes, which is associated with PPD [38–40].
Other explanations for Asian American depression in the
literature range from biological [41] to social [42]. Toge-
ther, these explanations may represent a general vulnera-
bility for depression generalizing to API women’s
depressed mood during the postpartum period. Future
studies in PPD research may want to specifically examine
the association between psychiatric history and PPD by
79. race/ethnicity to determine if psychiatric history predicts
PPD more strongly in API women.
Furthermore, discussing depressed mood with providers
increased the likelihood for women to receive a diagnosis.
This was especially true for APIs where the likelihood of
receiving a diagnosis was 3.2 times more than White
women after our analyses considered such discussions as a
factor. These high rates could reflect the quality of the
diagnostic processes that take place between API women
and their providers. The use of a diagnostic criterion by the
NYC PRAMS to assess PPD is unlike other prevalence
studies that typically use structured assessments for PPD
(e.g., a single question on depressive mood during preg-
nancy, multiple items covering symptomatology, etc.) [9,
12–14]. APIs tend to endorse somatic experiences rather
than psychological symptoms [43, 44]. Conversations with
a provider could increase sensitivity during the assessment,
thus facilitating a positive diagnosis. Increased research on
80. the diagnostic process within a health care setting would
greatly enhance understanding of how dialogues between
provider and patient result in diagnoses. In particular,
future research should consider differences in the charac-
teristics of providers and clinics among those who did and
did not receive a PPD diagnosis, and the nature of the
actual exchanges occurring between providers and patients.
It was particularly striking that approximately half of the
providers did not talk to women about PPD. Racial/ethnic
disparities were also found when assessing these rates.
While the majority of African American, Hispanic, and
White women reported having had a conversation with
their providers, only 38.6 % of API women in our study
reported this. Given that Asians tend to minimize their
psychological distress [6, 16], providers may not realize
distress nor recognize the need to bring up depressed mood.
APIs who had a conversation were 9.1 times more likely to
receive a diagnosis than APIs without, regardless of their
81. sociodemographic background. Thus, although APIs were
the group most likely to benefit from information about
depressed mood, they were the least likely to be provided
with it. Additionally, African Americans showed the
highest rate of having been presented with information
about mood compared to the other groups; those with a
conversation were 5.8 times more likely to receive a
diagnosis.
Altogether, and of greatest concern were the low rates of
assessment for all groups, and especially for APIs. Our
findings suggest that the information presented by a pro-
vider has powerful implications for determining diagnosis,
especially for APIs and African Americans. This finding
has implications for studies obtaining prevalence rates
without considering racial/ethnic disparities within the
screening or diagnostic process. Differences in prevalence
rates may be attributed to the lack of medical information
and treatment opportunities available to certain groups.
82. Our inclusion of known predictors for PPD in race-
stratified analyses allowed us to compare the strength of
stressors across groups. Most of the group differences in
the predicted likelihood for PPD were not statistically
significant suggesting few group differences in the
Table 3 continued
White Asian/Pacific Islander Hispanic Black
No PPD PPD No PPD PPD No PPD PPD No PPD PPD
(n = 1,010) (n = 33) (n = 383) (n = 42) (n = 1,162) (n = 91) (n =
979) (n = 48)
No 31.1 26.3 33.4 49.2 58.2 69.8 66.4 67.6
Yes 68.9 73.7 66.6 50.8* 41.8 30.2** 33.6 32.4
Prenatal depression diagnosis
No 98 67.1 93.8 35.8 95 54.4 95.4 71
Yes 2 32.9*** 6.2 64.2*** 5 45.6*** 4.6 29***
Discussion about mood
No 46.5 26.1 66.2 21.1 43.5 30.5 40.5 8.6
Yes 53.5 73.9* 33.8 78.9*** 56.5 69.5** 59.5 91.4***
83. �
p 0.1; * p .05; ** p .01; *** p .001
1606 Matern Child Health J (2013) 17:1599–1610
123
association between stressors and PPD. Furthermore,
stressful events were not associated with a greater likeli-
hood at a statistical level, with the exception of API
women; those who reported 6-13 stressful events were
significantly more likely to receive a diagnosis. The
explanation may reside in the distribution of reported
stressful events for APIs; compared to other groups, the
majority of API women reported zero stressful events. As
such, the few APIs who disclosed high numbers of stressful
events may have been the most likely to receive a diag-
nosis. APIs may still minimize their experience of stress
despite being asked to state the occurrence of stressful
events given their tendency to minimize psychological
problems in general [6, 16]. Providers may want to inquire
84. further about actual events and how it affects their API
patients both psychologically and physically.
A number of associations between stressors and PPD
require clarification through further research. There was a
trend for increased PPD rates among API and White
women who gave birth to female infants. Few studies have
included infant gender in PPD studies within the U.S.;
those that have find no association [45, 46]. Given these
studies’ small samples (n 200), any effects may have
been too small to detect. One study did find increased self-
esteem in mothers of male infants, although this association
was mediated by paternal support [47]. The statistical trend
in our data may indicate actual preferences for infant
gender, but it could also reflect other factors moderated by
infant gender. Our findings demonstrate the need to include
infant gender in future studies and to identify mechanisms
that explain this association.
In addition, we did not find a general link between
85. gestational diabetes and PPD, despite a previous study’s
results [39]. When examining groups separately, APIs in
our study were more likely to have gestational diabetes;
however, this did not predict PPD. Instead, we found a
decrease in the likelihood for PPD diagnoses among
African Americans with gestational diabetes. There is
evidence to suggest that African Americans may be less
inclined to disclose symptoms even though providers speak
Table 4 Race/ethnicity stratified logistic regression showing
adjusted odds of postpartum depression diagnosis per predictor
by race/ethnic
group
White Asian/Pacific Islander Hispanic Black
OR CI OR CI OR CI OR CI
Gender
Male 1.0 1.0 1.0 1.0
Female 2.2
�
0.9–5.8 2.6
�
0.9–7.2 1.5 0.8–2.7 1.5 0.5–4.1
87. No 1.0 1.0 1.0 1.0
Yes 29.4*** 8.5–101.4 52.1*** 16.4–166.0 15.3*** 7.6–30.9
8.1*** 2.9–22.8
Discussion about mood
No 1.0 1.0 1.0 1.0
Yes 1.7 0.6–4.8 9.1** 2.5–33.4 1.3 0.7–2.6 5.8** 2.1–15.9
Only adjusted odds ratios are presented because race/ethnic
stratified analyses did not converge when including unadjusted
factors in the model.
This was due to zero to small sample sizes in race 9
sociodemographic contingency tables
�
p 0.1; * p .05; ** p .01; *** p .001
Matern Child Health J (2013) 17:1599–1610 1607
123
with them about prenatal depression and PPD at a higher
rate [48]. Mistrust and perceived discrimination within the
medical care setting may prevent disclosure about depres-
sion [22, 49]. In particular, some studies have found that
88. among those with depressive mood accompanied with
diabetes, African Americans were less likely to be recog-
nized as depressed and to receive depression treatment
[49–51]. Given our initial findings, the association between
gestational diabetes and PPD may not be generalizable,
although further research is needed to fully understand the
relationship. Studies that do not stratify by race may
overlook differences in the effect of gestational diabetes on
depression by race/ethnicity.
Interpretation of results should be made with caution in
light of our limitations. As with any self-report, inaccura-
cies in this data are possible given recall problems. In
addition, prenatal and PPD diagnoses were used in our
study. It would have been far preferable to obtain corrob-
orating information from medical records; however, this
information was unavailable within this survey study. It is
possible that providers employed different standards for
diagnoses, which may be reflected in this data, for instance,
89. the consideration of ‘‘baby blues’’ or the inclusion of dif-
ferent methods to assess depression (e.g., questionnaire,
verbal report). Furthermore, these diagnoses may not nec-
essarily reflect actual depression rates, but as discussed,
may be more of a reflection of provider sensitivity to
detecting symptoms in a particular group. Finally, the race/
ethnic categories are a proxy for a culture, and are com-
prised of heterogeneous subgroups. For instance, the
unique experiences of Chinese, Japanese or Filipino groups
may have been overlooked since they were combined into
one race/ethnic category.
Conclusion
Our results highlight racial/ethnic disparities in PPD and its
diagnosis, inviting a more nuanced approach in the con-
sideration of PPD risk factors. Although we relied on broad
race/ethnic categories, these findings demonstrate at a basic
level, the possibility of differential effects in the risk fac-
tors associated with PPD. Explanations for racial/ethnic
90. disparities in diagnosis compared to Whites differ by group
and are not necessarily due to sociodemographic status or
stress, factors that usually explain racial/ethnic disparities.
While prenatal depression seems to be a major risk factor
for PPD across all groups, the extent to which a factor is a
‘‘risk’’ for a particular racial/ethnic group needs to be
evaluated. These associations point to the possibility of
group-specific mechanisms leading to a PPD diagnosis.
Universal postpartum depression screening as a single
approach may not be adequate given the role that provider-
patient interactions might have as suggested by these study
findings. Rather, this study broadly reveals a need to con-
sider the diagnostic process between provider-patient by
race/ethnicity to better understand the source of treatment
disparities.
Acknowledgments The authors would like to acknowledge the
NYC Department of Health and Mental Hygiene Bureau of
Maternal,
Infant and Reproductive Health PRAMS Team, Bureau of Vital
91. Statistics, and the CDC PRAMS Team, Program Services and
Development Branch, Division of Reproductive Health. Support
during the preparation of this manuscript was provided through
a
grant from the Sackler Foundation for Psychobiological
Research and
through the Stuart T. Hauser Clinical Research Training
Fellowship
(2T32MH016259-30).
References
1. O’Hara, M. W., & Swain, A. M. (1996). Rates and risk of
postpartum depression-A meta-analysis. International Review of
Psychiatry, 8, 37–54.
2. Gavin, N. I., Gaynes, B. N., Lohr, K. N., Meltzer-Brody, S.,
Gartlehner, G., & Swinson, T. (2005). Perinatal depression: A
systematic review of prevalence and incidence. Obstetrics and
Gynecology, 106, 1071–1083.
3. Leigh, B., & Milgrom, J. (2008). Risk factors for antenatal
depression, postnatal depression and parenting stress. BMC Psy-
chiatry, 8, 24.
92. 4. O’Hara, M. W. (2009). Postpartum depression: What we
know.
Journal of Clinical Psychology, 65, 1258–1269.
5. Robertson, E., Grace, S., Wallington, T., & Stewart, D. E.
(2004).
Antenatal risk factors for postpartum depression: A synthesis of
recent literature. General Hospital Psychiatry, 26, 289–295.
6. Kleinman, A. (2004). Culture and depression. New England
Journal of Medicine, 351, 951–953.
7. Chentsova-Dutton, Y. E., & Tsai, J. L. (2007). Cultural
factors
influence the expression of psychopathology. In S. O. Lilienfeld
& W. T. O’Donohue (Eds.), The great ideas of clinical science:
17 principles that every mental health professional should
understand (pp. 375–396). New York: Routledge/Taylor &
Francis Group.
8. United States. Agency for Healthcare Research and Quality.
(2005). Perinatal depression: Prevalence, screening accuracy,
and
screening outcomes. In B. N. Gaynes, N. Gavin, S. Meltzer-
93. Brody, K. N. Lohr, T. Swinson, G. Gartlehner, S. Brody, W.
Miller Evidence Report/Technology Assessment No. 119. Con-
tract No. 290-02-0016.
9. Howell, E. A., Mora, P. A., Horowitz, C. R., & Levanthal, H.
(2005). Racial and ethnic differences in factors associated with
early postpartum depressive symptoms. Obstetrics and Gyne-
cology, 105, 1442–1450.
10. Wei, G., Greaver, L. B., Marson, S. M., Herndon, C. H.,
Rogers,
J., & Robeson Healthcare Corporation. (2008). Postpartum
depression: racial differences and ethnic disparities in a tri-
racial
and bi-ethnic population. Maternal and Child Health Journal,
12,
699–707.
11. Yonkers, K. A., Ramin, S. M., Rush, J., Navarrete, M. A.,
Car-
mody, T., March, D., et al. (2001). Onset and persistence of
postpartum depression in an inner-city maternal health clinic
system. American Journal of Psychiatry, 158, 1856–1863.
94. 12. Beeghly, M., Olson, K. L., Weinberg, M. K., Pierre, S. C.,
Downey, N., & Tronick, E. Z. (2003). Prevalence, stability, and
socio-demographic correlates of depressive symptoms in black
1608 Matern Child Health J (2013) 17:1599–1610
123
mothers during the first 18 months postpartum. Maternal and
Child Health Journal, 7, 157–168.
13. Hobfoll, S. E., Ritter, C., Lavin, J., Hulsizer, M. R., &
Cameron,
R. P. (1995). Depression prevalence and incidence among inner-
city pregnant and postpartum women. Journal of Consulting and
Clinical Psychology, 63, 445–453.
14. Rich-Edwards, J. W., Kleinman, K., Abrams, A., Harlow, B.
L.,
McLaughlin, T. J., Joffe, H., et al. (2006). Sociodemographic
predictors of antenatal and postpartum depressive symptoms
among women in a medical group practice. Journal of Epide-
miology and Community Health, 60, 221–227.
95. 15. Huang, Z. J., Wong, F. Y., Ronzio, C. R., & Yu, S. M.
(2007).
Depressive symptomatology and mental health help-seeking
patterns of U.S.- and foreign-born mothers. Maternal and Child
Health Journal, 11, 257–267.
16. Hsu, L. K. G., Wan, Y. M., Chang, H., Summergrad, P.,
Tsang, B.
Y. P., & Chen, H. (2008). Stigma of depression is more severe
in
Chinese Americans than Caucasian Americans. Psychiatry:
Interpersonal and Biological Processes, 71, 210–218.
17. U.S. Census Bureau. (2010). National population
projections.
Washington, DC.
18. United States. Census Bureau, Population Division. (2008).
Projections of the population by sex, race and Hispanic origin
for
the United States: 2010 to 2050.
19. Centers for Disease Control and Prevention. (2003). Deaths:
Leading causes for 2001. National Vital Statistics Reports, vol.
96. 52.
20. United States. Public Health Service, National Center for
Health
Statistics. (2003). Health, United States, 2003.
21. Duldulao, A. A., Takeuchi, D. T., & Hong, S. (2009).
Correlates
of suicidal behaviors among Asian Americans. Archives of Sui-
cide Research, 13, 277–290.
22. Hayes, D., Ta, V., Hurwitz, E., Mitchell-Box, K., & Fuddy,
L.
(2010). Disparities in self-reported postpartum depression
among
Asian, Hawaiian, and Pacific Islander Women in Hawaii: Preg-
nancy Risk assessment monitoring system (PRAMS), 2004–
2007.
Maternal and Child Health Journal, 14, 765–773.
23. New York City Department of Health and Mental Hygiene,
Bureau of Maternal, Infant and Reproductive Hygiene. (2004).
Number and percent of women diagnosed with postpartum
depression by select sociodemographic characteristics: NYC
PRAMS, 2004–2005.
97. 24. New York City Department of Health and Mental Hygiene,
Bureau of Maternal, Infant and Reproductive Hygiene. (2006).
Number and percent of women diagnosed with postpartum
depression by select sociodemographic characteristics: NYC
PRAMS, 2006.
25. New York City Department of Health and Mental Hygiene,
Bureau of Maternal, Infant and Reproductive Hygiene. (2007).
Number and percent of women diagnosed with postpartum
depression by select sociodemographic characteristics: NYC
PRAMS, 2007.
26. New York City Department of Health and Mental Hygiene,
Bureau of Maternal, Infant and Reproductive Hygiene (2010).
Number and percent of women diagnosed with postpartum
depression.
27. Segre, L. S., O’Hara, M. W., Arndt, S., & Stuart, S. (2007).
The
prevalence of postpartum depression: The relative significance
of
three social status indices. Social Psychiatry and Psychiatric
98. Epidemiology, 42, 316–321.
28. Dennis, C. L., & Letourneau, N. (2007). Global and
relationship-
specific perceptions of support and the development of post-
partum depressive symptomatology. Social Psychiatry and Psy-
chiatric Epidemiology, 42, 389–395.
29. Bernazzani, O., Marks, M. N., Bifulco, A., Siddle, K.,
Asten, P.,
& Conroy, S. (2005). Assessing psychosocial risk in pregnant/
postpartum women using the contextual assessment of maternity
experience (CAME): Recent life adversity, social support and
maternal feelings. Social Psychiatry and Psychiatric Epidemiol-
ogy, 40, 497–508.
30. Boyce, P., & Hickey, A. (2005). Psychosocial risk factors to
major depression after childbirth. Social Psychiatry and Psychi-
atric Epidemiology, 40, 605–612.
31. Wolf, A. W., De Andraca, I., & Lozoff, B. (2002). Maternal
depression in three Latin American samples. Social Psychiatry
and Psychiatric Epidemiology, 37, 169–176.
99. 32. Noh, E. (2007). Asian American women and suicide:
Problems of
responsibility and healing. Women & Therapy, 30, 87–107.
33. Kumar, R. (1994). Postnatal mental illness: A transcultural
per-
spective. Social Psychiatry and Psychiatric Epidemiology, 29,
250–264.
34. Morsbach, G., Sawaragi, I., Riddell, C., & Carswell, A.
(1983). The
occurrence of ‘maternity blues’ in Scottish and Japanese
mothers.
Journal of Reproductive and Infant Psychology, 1, 29–35.
35. Xie, R. H., He, G., Liu, A., Bradwejn, J., Walker, M., &
Wen, S.
W. (2007). Fetal gender and postpartum depression in a cohort
of
Chinese women. Social Science and Medicine, 65, 680–684.
36. Xie, R. H., He, G., Koszycki, D., Walker, M., & Wen, S. W.
(2009). Prenatal Social Support, Postnatal Social Support, and
Postpartum Depression. Annals of Epidemiology, 19, 637–643.
37. Patel, V., Rodrigues, M., & DeSouza, N. (2002). Gender,
100. poverty,
and postnatal depression: A study of mothers in Goa, India. The
American Journal of Psychiatry, 159, 43–47.
38. Chu, S. Y., Abe, K., Hall, L. R., Kim, S. Y., Njoroge, T., &
Qin,
C. (2009). Gestational diabetes mellitus: All Asians are not
alike.
Preventive Medicine, 49, 265–268.
39. Kozhimannil, K. B., Pereira, M. A., & Harlow, B. L. (2009).
Association between diabetes and perinatal depression among
low-income mothers. JAMA: Journal of the American Medical
Association, 301, 842–847.
40. Pedula, K., Hillier, T., Schmidt, M., Mullen, J., Charles, M.,
&
Pettitt, D. (2009). Ethnic differences in gestational oral glucose
screening in a large US population. Ethnicity and Disease, 19,
414–419.
41. Way, B. M., & Lieberman, M. D. (2010). Is there a genetic
contribution to cultural differences? Collectivism, individualism
and genetic markers of social sensitivity. Social Cognitive and
101. Affective Neuroscience, 5, 203–211.
42. Wong, S. L. (2001). Depression level in inner-city Asian
Amer-
ican adolescents: The contributions of cultural orientation and
interpersonal relationships. Journal of Human Behavior in the
Social Environment, 3, 49–64.
43. Ryder, A. G., Yang, J., & Heini, S. (2002). Somatization
versus
psychologization of emotional distress: A paradigmatic example
for cultural psychopathology. In W. J. Lonner, D. L. Dinnel, S.
A. Hayes, & D. N. Sattler (eds) Online readings in psychology
and culture, Unit 9. Center for Cross-Cultural Research,
Western
Washington University: Washington.
44. Ryder, A. G., Yang, J., Zhu, X., Yao, S., Yi, J., Heine, S. J.,
et al.
(2008). The cultural shaping of depression: Somatic symptoms
in
China, psychological symptoms in North America? Journal of
Abnormal Psychology, 117, 300–313.
102. 45. Cho, J., Holditch-Davis, D., & Miles, M. (2008). Effects of
maternal depressive symptoms and infant gender on the interac-
tions between mothers and their medically at-risk infants.
Journal
of Obstetric, Gynecologic, and Neonatal Nursing, 37, 58–70.
46. Beebe, B., Jaffe, J., Buck, K., Chen, H., Cohen, P.,
Feldstein, S.,
et al. (2008). Six-week postpartum maternal depressive symp-
toms and 4-month mother-infant self-and-interactive contin-
gency. Infant Mental Health Journal, 29, 442–471.
47. Shea, E., & Tronick, E. (1988). The Maternal Self-Report
Inventory: A research and clinical instrument for assessing
Matern Child Health J (2013) 17:1599–1610 1609
123
maternal self-esteem. In H. E. Fitzgerald, B. M. Lester, & M.
W. Yogman (Eds.), Theory and research in behavioral pediatrics
(Vol. 4, pp. 101–141). New York: Plenum Publishing
Corporation.
103. 48. Sussman, L. K., Robins, L. N., & Earls, F. (1987).
Treatment-
seeking for depression by Black and White Americans. Social
Science and Medicine, 24, 187–196.
49. Wagner, J., Tsimikas, J., Abbott, G., de Groot, M., &
Heapy, A.
(2007). Racial and ethnic differences in diabetic patient-
reported
depression symptoms, diagnosis, and treatment. Diabetes
Research and Clinical Practice, 75, 119–122.
50. Wagner, J. A., Perkins, D. W., Piette, J. D., Lipton, B., &
Aikens,
J. E. (2009). Racial differences in the discussion and treatment
of
depressive symptoms accompanying type 2 diabetes. Diabetes
Research and Clinical Practice, 86, 111–116.
51. Tiwari, A., Rajan, M., Miller, D., Pogach, L., Olfson, M., &
Sambamoorthi, U. (2008). Guideline-consistent antidepressant
treatment patterns among veterans with diabetes and major
depressive disorder. Psychiatric Services, 59, 1139–1147.
1610 Matern Child Health J (2013) 17:1599–1610
104. 123
Copyright of Maternal & Child Health Journal is the property of
Springer Science & Business
Media B.V. and its content may not be copied or emailed to
multiple sites or posted to a
listserv without the copyright holder's express written
permission. However, users may print,
download, or email articles for individual use.
Rates and Predictors of Postpartum Depression by Race and
Ethnicity: Results from the 2004 to 2007 New York City
PRAMS Survey (Pregnancy Risk Assessment Monitoring
System)AbstractIntroductionMethodsSampleMeasuresVariables
Statistical
AnalysesResultsDiscussionConclusionAcknowledgmentsReferen
ces
CLINICAL ISSUES
The effect of nurse–patient interaction on anxiety and
depression in
cognitively intact nursing home patients
Gørill Haugan, Siw T Innstrand and Unni K Moksnes
Aims and objectives. To test the effects of nurse–patient
interaction on anxiety and depression among cognitively intact
nursing home patients.
Background. Depression is considered the most frequent mental
105. disorder among the older population. Specifically, the
depression rate among nursing home patients is three to four
times higher than among community-dwelling older people,
and a large overlap of anxiety is found. Therefore, identifying
nursing strategies to prevent and decrease anxiety and depres-
sion is of great importance for nursing home patients’ well-
being. Nurse–patient interaction is described as a fundamental
resource for meaning in life, dignity and thriving among nursing
home patients.
Design. The study employed a cross-sectional design. The data
were collected in 2008 and 2009 in 44 different nursing
homes from 250 nursing home patients who met the inclusion
criteria.
Methods. A sample of 202 cognitively intact nursing home
patients responded to the Nurse–Patient Interaction Scale and
the Hospital Anxiety and Depression Scale. A structural
equation model of the hypothesised relationships was tested by
means of LISREL 8.8 (Scientific Software International Inc.,
Lincolnwood, IL, USA).
Results. The SEM model tested demonstrated significant direct
relationships and total effects of nurse–patient interaction on
depression and a mediated influence on anxiety.
Conclusion. Nurse–patient interaction influences depression, as
well as anxiety, mediated by depression. Hence, nurse–
106. patient interaction might be an important resource in relation to
patients’ mental health.
Relevance to clinical practice. Nurse–patient interaction is an
essential factor of quality of care, perceived by long-term nurs-
ing home patients. Facilitating nurses’ communicating and
interactive skills and competence might prevent and decrease
depression and anxiety among cognitively intact nursing home
patients.
Key words: anxiety, depression, nurse–patient interaction,
nursing home, structural equation model analysis
Accepted for publication: 11 September 2012
Introduction
With advances in medical technology and improvement in the
living standard globally, the life expectancy of people is
increasing worldwide. The document An Aging World (US
Census Bureau 2009) highlights a huge shift to an older popu-
lation and its consequences. Within this shift, the most rapidly
growing segment is people over 80 years old: by 2050, the per-
centage of those 80 and older would be 31%, up from 18% in
1988 (OECD 1988). These perspectives have given rise to the
108. 2192 Journal of Clinical Nursing, 22, 2192–2205, doi:
10.1111/jocn.12072
For many of those in the fourth age, issues such as physi-
cal illness and approaching mortality decimates their func-
tioning and subsequently lead to the need for nursing home
(NH) care. A larger proportion of older people will live for
shorter or longer time in a NH at the end of life. This
group will increase in accordance with the growing popula-
tion older than 65, and in particular for individuals older
than 80 years. Currently, 1�4 million older adults in the
USA live in long-term care settings, and this number is
expected to almost double by 2050 (Zeller & Lamb 2011).
In Norway, life expectancy by 2050 is 90�2 years for men
and 93�4 years for women (Statistics of Norway 2010).
Depression is one of the most prevalent mental health
problems facing European citizens today (COM 2005);
and, the World Health Organization (WHO 2001) has esti-
mated that by 2020, depression is expected to be the high-
est ranking cause of disease in the developed world.
109. Moreover, depression is described to be one of the most
frequent mental disorders in the older population and is
particularly common among individuals living in long-term
care facilities (Choi et al. 2008, Karakaya et al. 2009,
Lattanzio et al. 2009, Drageset et al. 2011, Phillips et al.
2011). A linear increase in prevalence of depression with
increasing age is described (Stordal et al. 2003); the three
strongest explanatory factors on the age effect of depression
are impairment, diagnosis and somatic symptoms, respec-
tively (Stordal et al. 2001, 2003). Worse general medical
health is seen as the strongest factor associated with depres-
sion among NH patients (Djernes 2006, Barca et al. 2009).
A review that included 36 studies from various countries,
reported a prevalence rate for major depression ranging
from 6–26% and from 11–50% for minor depression.
However, the prevalence rate for depressive symptoms ran-
ged from 36–49% (Jongenelis et al. 2003). Twice as many
women are likely to be affected by depression than men
110. (Kohen 2006), and older people lacking social and emo-
tional support tend to be more depressed (Grav et al.
2012). A qualitative study on successful adjustment among
women in later life identified three main areas as being the
main obstacles for many; these were depression, maintain-
ing intimacy through friends and family and managing the
change process associated with older age (Traynor 2005).
Significantly more hopelessness, helplessness and depres-
sion are found among patients in NHs compared with those
living in the community (Ron 2004). Jongenelis et al.
(2004) found that depression was three to four times higher
in NH patients than in community-dwelling adults. Moving
to a NH results from numerous losses, illnesses, disabilities,
loss of functions and social relations, and approaching mor-
tality, all of which increases an individual’s vulnerability
and distress; in particular, loneliness and depression are iden-
tified as risks to the well-being of older people (Routasalo
et al. 2006, Savikko 2008, Drageset et al. 2012). The NH
111. life is institutionalised, representing loss of social relation-
ships, privacy, self-determination and connectedness.
Because NH patients are characterised by high age, frailty,
mortality, disability, powerlessness, dependency and vulner-
ability, they are more likely to become depressed. A recent
literature review showed several studies reporting prevalence
of depression in NHs ranging from 24–82% (Drageset et al.
2011). Also, with a persistence rate of more than 50% of
depressed patients still depressed after 6–12 months, the
course of major depression and significant depressive symp-
toms in NH patients tend to be chronic (Rozzini et al.
1996, Smalbrugge et al. 2006a).
Moreover, studies in NHs report a large co-occurrence of
depression and anxiety (Beekman et al. 2000, Kessler et al.
2003, Smalbrugge et al. 2005, Van der Weele et al. 2009,
Byrne & Pachana 2010). A recent review concerning anxi-
ety and depression reports a paucity of findings on anxiety
in older people (Byrne & Pachana 2010). Hence, more
112. research is urgently required into anxiety disorders in older
people, as these are highly prevalent and associated with
considerable disease burden (ibid.).
Depression and anxiety in NH patients are associated
with negative outcomes such as poor functioning in
activities of daily living and impaired quality of life (QoL)
(Smalbrugge et al. 2006b, Diefenbach et al. 2011, Drageset
et al. 2011), substantial caregiver burden and worsened
medical outcomes (Bell & Goss 2001, Koenig & Blazer
2004, Sherwood et al. 2005), increased risk of hospital
admission (Miu & Chan 2011), a risk of increased demen-
tia (Devanand et al. 1996) and a higher mortality rate
(Watson et al. 2003, Ahto et al. 2007). Accordingly, efforts
to prevent and decrease depression and anxiety are of great
importance for NH patients’ QoL.
Social support and relations to significant others are
found to be a vital resource for QoL and thriving among
NH patients (Bergland & Kirkevold 2005, 2006, Drageset
114. Fakhr-Movahedi et al. 2011). Excellent nursing care is
characterised by a holistic view with inherent human values
and moral; thus, excluding the patient as a unique human
being should be regarded as noncaring and amoral practice
(Haugan Hovdenes 2002, Nåden & Eriksson 2004, Aust-
gard 2008, Watson 2008). NH patients are in general
extremely vulnerable and hence the nurse–patient relation-
ship and the nurse–patient interaction are critical to their
experience of dignity, self-respect, sense of self-worth and
well-being (Dwyer et al. 2008, Harrefors et al. 2009,
Heliker 2009). NH patient receiving self-worth therapy
showed statistically significantly reduced depressive symp-
toms relative to control groups members 2 months after
receiving the intervention (Tsai et al. 2008). Self-worth
therapy comprised establishment of a therapeutic relation-
ship offering feedback and focusing the patient’s dignity,
emotional and mental well-being (ibid.).
Caring nurses engage in person-to-person relationships
115. with the NH patients as unique persons. Good nursing care
is defined by the nurses’ way of being present together with
the patient while performing nursing activities, in which
attitudes and competence are inseparately connected. ‘Pres-
ence’, ‘connectedness’ and ‘trust’ are described as funda-
mental cores of holistic nursing care (McGilton & Boscart
2007, Potter & Frisch 2007, Carter 2009) in the context of
the nurse–patient relationship in which the nurse–patient
interaction is taking place. Trust is seen as a confident
expectation that the nurses can be relied upon to act with
good will and to secure what is best for the individuals
residing in the NH. Hence, trust is the core moral ingredi-
ent in nurse–patient relationships; even more basic than
duties of beneficence, respect, veracity, and autonomy
(Carter 2009).
Caring is a context-specific interpersonal process that is
characterised by expert nursing practice, interpersonal sen-
sitivity, and intimate relationships (Finfgeld-Connett 2008)
116. which increases patient’s well-being (Nakrem et al. 2011,
Hollinger-Samson & Pearson 2000, Cowling et al. 2008,
Rchaidia et al. 2009, Reed 2009). The relationship between
NH staff attention and NH patients’ affect and activity par-
ticipation have been assessed among depressed NH
patients, showing that positive staff engagement was signifi-
cantly related to patients’ interest, activity participating,
and pleasure (Meeks & Looney 2011). These results suggest
that staff behaviour and engagement could be a reasonable
target for interventions to increase positive affect among
NH patients (ibid.).
In summary, the literature suggests depression as a com-
mon mental disorder among older people characterised by
high age, impairment, and somatic symptoms. In addition,
a large overlap of anxiety is reported. The patients’ sense
of loss of independency and privacy, feelings of isolation
and loneliness, and lack of meaningful activities are risk
factors for depression in NH patients. Nurse–patient inter-
117. action might be a resource for preventing and decreasing
depression among NH patients. To the authors’ knowl-
edge, previous research has not examined these relation-
ships in NHs by means of structural equation modelling
(SEM).
Aims
The main aim of this study was to investigate the relation-
ships between nurse–patient interaction, anxiety and
depression among cognitively intact NH patients by means
of SEM. Based on the theoretical and empirical knowledge
of depression, anxiety and nurse–patient interaction our
research question was: ‘Does the nurse–patient interaction
affect anxiety and depression in cognitively intact NH
patients?’ The following hypotheses were formulated:
� Hypothesis 1 (H1): nurse–patient interaction positively
affects anxiety.
� Hypothesis 2 (H2): nurse–patient interaction positively
affects depression.
� Hypothesis 3 (H3): depression negatively affects anxiety.
118. Methods
Design and ethical considerations
The study employed a cross-sectional design. The data was
collected in 2008 and 2009 in 44 different NHs from 250
NH patients who met the inclusion criteria: (1) local
authority’s decision of long-term NH care; (2) residential
time six months or longer; (3) informed consent compe-
tency recognised by responsible doctor and nurse; and (4)
capable of being interviewed. Two counties comprising in
total 48 municipalities in central Norway were selected,
from which 25 (at random) were invited to contribute in
this study. In total, 20 municipalities were partaken. Then,
all the NHs in each of the 20 municipalities was asked to
participate. A total of 44 NHs took part in the study. To
include as many participants from rural and central NHs,
respectively, the NHs was one by one invited to participate,
until the minimum of n = 200 was reached. The NH
patients were approached by a head nurse they knew
120. the areas in which the interviewers operated.
The questionnaires relevant for the present study were part
of a questionnaire comprising 130 items. The interviews
lasted from 45–120 minutes due to the individual partici-
pant’s tempo, form of the day, and need for breaks. Inter-
viewers held a large-print copy of questions and possible
responses in front of the participants to avoid misunder-
standings. Approval by the Norwegian Social Science Data
Services was obtained for a licence to maintain a register
containing personal data (Ref. no. 16443) and likewise we
attained approval from The Regional Committee for
Medical and Health Research Ethics in Central Norway
(Ref. no. 4.2007.645) as well as the directory of the 44 NHs.
Participants
The total sample comprised 202 (80�8%) of 250 long-term
NH patients representing 44 NHs. Long-term NH care was
defined as 24-hour care; short-term care patients, rehabilita-
tions patients, and cognitively impaired patients were not
121. included. Participants’ age was 65–104, with a mean of
86 years (SD = 7�65). The sample comprised 146 women
(72�3%) and 56 men (27�7%), where the mean age was
87�3 years for women and 82 years for men. A total of 38
(19%) were married/cohabitating, 135 (67%) were widows/
widowers, 11 (5�5%) were divorced, and 18 (19%) were
single. Duration of time of NH residence when interviewed
was at mean 2�6 years for both sexes (range 0�5–13 years);
117 were in rural NHs, while 85 were in urban NHs. In
all, 26�1% showed mild to moderate depression, only one
woman scored >15 indicating severe depression, 70�4%
was not depressed, and nearly 88% had no anxiety disor-
der. Missing data was low in frequency and was handled
by means of the listwise procedure; for the nurse–patient
interaction 4�0% and for anxiety and depression 5�0% had
some missing data.
Measures
The Nurse–Patient Interaction Scale (NPIS) was developed
to identify important characteristics of NH patients’ experi-
ences of the nurse–patient interaction. The NPIS comprises
14 items identifying essential relational qualities stressed in
the nursing literature (Watson 1988, Martinsen 1993,
122. Eriksson 1995a,b, Nåden & Eriksson 2004, Nåden &
Sæteren 2006, Levy-Malmberg et al. 2008). Examples of
NPIS-items include ‘Having trust and confidence in the staff
nurses’; ‘The nurses take me seriously’, ‘Interaction with
nurses makes me feel good’ as well as experiences of being
respected and recognised as a person, being listened to and
feel included in decisions. The items were developed to
measure the NH patients’ ability to derive a sense of well-
being and meaningfulness through the nurse–patient inter-
action (Haugan Hovdenes 1998, 2002, Hollinger-Samson
& Pearson 2000, Finch 2006, Rchaidia et al. 2009). The
NPIS has shown good psychometric properties with good
content validity and reliability among NH patients;
(Haugan et al. 2012). The NPIS is a 10-points scale from 1
(not at all)–10 (very much); higher numbers indicating
better nurse–patient interaction (Appendix 1). Cronbach’s
Table 1 Means (M), standard deviations (SD), Cronbach’s
alpha, and correlation coefficients for the study variables