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Sample records for premiums long-term costs

  1. 17 CFR 256.225 - Unamortized premium on long-term debt.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 17 Commodity and Securities Exchanges 3 2010-04-01 2010-04-01 false Unamortized premium on long... COMPANIES, PUBLIC UTILITY HOLDING COMPANY ACT OF 1935 6. Long-Term Debt § 256.225 Unamortized premium on long-term debt. (a) This account shall include the excess of the cash value of consideration...

  2. The costs of long-term care: distribution and responsibility.

    PubMed

    Wallack, S S; Cohen, M A

    1988-01-01

    Long-term care costs will result in financial hardship for millions of elderly Americans and their families. The growing number of elderly people has focused public attention on the catastrophic problem of coverage for long-term care. Social insurance is unlikely to emerge as a solution in the USA. One reason is that the expected total cost is viewed as an unmanageable burden by both Federal and State governments. To others, it is the uncertainty surrounding the projected costs. This paper reports on the results of a double-decrement life-table analysis, based on a national survey of the elderly taken in early 1977 and one year later, that estimated the distribution and total lifetime nursing-home costs of the elderly. Combining the probability of nursing-home entry and length of stay, a 65-year-old faces a 43% chance of entering a nursing home and spending about +11,000 (1980 dollars). The distribution of lifetime costs is however very skewed with 13% of the elderly consuming 90% of the resources. Thus, while the costs of nursing-home care can be catastrophic for an individual, spread across a group they are not unmanageable. Given the distribution of income and assets among the elderly, a sizeable proportion could readily afford the necessary premiums of different emerging insurance and delivery programmes. Alternative private and public models of long-term care must be evaluated in terms of the goals of a finance and delivery system for long-term care. PMID:3129256

  3. Applying activity-based costing in long-term care.

    PubMed

    Wodchis, W P

    1998-01-01

    As greater numbers of the elderly use health services, and as health care costs climb, effective financial tracking is essential. Cost management in health care can benefit if costs are linked to the care activities where they are incurred. Activity-based costing (ABC) provides a useful approach. The framework aligns costs (inputs), through activities (process), to outputs and outcomes. It allocates costs based on client care needs rather than management structure. The ABC framework was tested in a residential care facility and in supportive housing apartments. The results demonstrate the feasibility and advantages of ABC for long term care agencies, including community-based care. PMID:10339203

  4. The long-term costs of career interruptions.

    PubMed

    Ketsche, Patricia G; Branscomb, Lisette

    2003-01-01

    This article is based on a study that analyzed the long-term salary implications of career choices made by healthcare administrators. The study used a cohort of graduates from a single health administration program; these individuals had comparable levels of human capital at the outset of their careers. We estimated the effect of periods of part-time employment and job interruptions--voluntary and involuntary--on long-term salary progression. We also estimated the impact of other career choices, such as membership in a professional organization or the decision to relocate. After controlling for these choices, we estimated the residual effect of gender on salary. We found that voluntary interruptions had a greater effect on long-term salary growth than did involuntary interruptions of the same length or periods of part-time employment. Individuals evaluating options for balancing career and family constraints should understand the long-term cost of choosing a career interruption rather than part-time employment during periods of heightened responsibilities outside the workplace. Healthcare administrators should also be educated about the positive association between professional memberships and career advancement to make informed decisions about participation in such organizations. Surprisingly, after controlling for all choice variables, gender had no measurable effect on long-term salary growth. Half of those who indicated a voluntary interruption for dependent care reasons preferred part-time or flexible-hour work if it had been available. These results suggest that a pool of healthcare administrators might compete for positions if more part-time opportunities were available. PMID:12592867

  5. Cost considerations for long-term ecological monitoring

    USGS Publications Warehouse

    Caughlan, L.; Oakley, K.L.

    2001-01-01

    For an ecological monitoring program to be successful over the long-term, the perceived benefits of the information must justify the cost. Financial limitations will always restrict the scope of a monitoring program, hence the program's focus must be carefully prioritized. Clearly identifying the costs and benefits of a program will assist in this prioritization process, but this is easier said than done. Frequently, the true costs of monitoring are not recognized and are, therefore, underestimated. Benefits are rarely evaluated, because they are difficult to quantify. The intent of this review is to assist the designers and managers of long-term ecological monitoring programs by providing a general framework for building and operating a cost-effective program. Previous considerations of monitoring costs have focused on sampling design optimization. We present cost considerations of monitoring in a broader context. We explore monitoring costs, including both budgetary costs--what dollars are spent on--and economic costs, which include opportunity costs. Often, the largest portion of a monitoring program budget is spent on data collection, and other, critical aspects of the program, such as scientific oversight, training, data management, quality assurance, and reporting, are neglected. Recognizing and budgeting for all program costs is therefore a key factor in a program's longevity. The close relationship between statistical issues and cost is discussed, highlighting the importance of sampling design, replication and power, and comparing the costs of alternative designs through pilot studies and simulation modeling. A monitoring program development process that includes explicit checkpoints for considering costs is presented. The first checkpoint occur during the setting of objectives and during sampling design optimization. The last checkpoint occurs once the basic shape of the program is known, and the costs and benefits, or alternatively the cost

  6. 18 CFR 367.2250 - Account 225, Unamortized premium on long-term debt.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... FEDERAL ENERGY REGULATORY COMMISSION, DEPARTMENT OF ENERGY REGULATIONS UNDER THE PUBLIC UTILITY HOLDING... POWER ACT AND NATURAL GAS ACT Balance Sheet Chart of Accounts Long-Term Debt § 367.2250 Account...

  7. 18 CFR 367.2250 - Account 225, Unamortized premium on long-term debt.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... FEDERAL ENERGY REGULATORY COMMISSION, DEPARTMENT OF ENERGY REGULATIONS UNDER THE PUBLIC UTILITY HOLDING... POWER ACT AND NATURAL GAS ACT Balance Sheet Chart of Accounts Long-Term Debt § 367.2250 Account...

  8. 18 CFR 367.2250 - Account 225, Unamortized premium on long-term debt.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... FEDERAL ENERGY REGULATORY COMMISSION, DEPARTMENT OF ENERGY REGULATIONS UNDER THE PUBLIC UTILITY HOLDING... POWER ACT AND NATURAL GAS ACT Balance Sheet Chart of Accounts Long-Term Debt § 367.2250 Account...

  9. 18 CFR 367.2250 - Account 225, Unamortized premium on long-term debt.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... FEDERAL ENERGY REGULATORY COMMISSION, DEPARTMENT OF ENERGY REGULATIONS UNDER THE PUBLIC UTILITY HOLDING... POWER ACT AND NATURAL GAS ACT Balance Sheet Chart of Accounts Long-Term Debt § 367.2250 Account...

  10. 18 CFR 367.2250 - Account 225, Unamortized premium on long-term debt.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... FEDERAL ENERGY REGULATORY COMMISSION, DEPARTMENT OF ENERGY REGULATIONS UNDER THE PUBLIC UTILITY HOLDING... POWER ACT AND NATURAL GAS ACT Balance Sheet Chart of Accounts Long-Term Debt § 367.2250 Account...

  11. Taxation Categories for Long-term Care Insurance Premiums and Mortality Among Elderly Japanese: A Cohort Study

    PubMed Central

    Fujino, Yoshihisa; Tanaka, Ryuichi; Kubo, Tatsuhiko; Matsuda, Shinya

    2013-01-01

    Background This cohort study examined the association between taxation categories of long-term care insurance premiums and survival among elderly Japanese. Methods A total of 3000 participants aged 60 years or older were randomly recruited in Y City, Japan in 2002, of whom 2964 provided complete information for analysis. Information on income level, mobility status, medical status, and vital status of each participant was collected annually from 2002 to 2006. Follow-up surveys on survival were conducted until August 2007. Hazard ratios (HRs) were estimated by a Cox model, using taxation categories at baseline. In these analyses, age-adjusted and age- and mobility-adjusted models were used. Results A significantly higher mortality risk was seen only in the lowest taxation category among men: as compared with men in the second highest taxation category, the HR in the lowest category was 2.53 (95% CI, 1.26–5.08, P = 0.009). This significant association between taxation category and mortality was lost after adjustment for mobility. There was no other difference in mortality among taxation categories in men or women. Conclusions The present findings only partly supported our hypothesis that taxation category is a good indicator of socioeconomic status in examining health inequalities among elderly Japanese. PMID:23258217

  12. Fall-Related Hospitalization and Facility Costs among Residents of Institutions Providing Long-Term Care

    ERIC Educational Resources Information Center

    Carroll, Norman V.; Delafuente, Jeffrey C.; Cox, Fred M.; Narayanan, Siva

    2008-01-01

    Purpose: The purpose of this study was to estimate hospital and long-term-care costs resulting from falls in long-term-care facilities (LTCFs). Design and Methods: The study used a retrospective, pre/post with comparison group design. We used matching, based on propensity scores, to control for baseline differences between fallers and non-fallers.…

  13. Direct costs of acute respiratory infections in a pediatric long-term care facility.

    PubMed

    Murray, Meghan T; Heitkemper, Elizabeth; Jackson, Olivia; Neu, Natalie; Stone, Patricia; Cohen, Bevin; Saiman, Lisa; Hutcheon, Gordon; Larson, Elaine L

    2016-01-01

    Acute respiratory tract infections (ARI) are a major burden in pediatric long-term care. We analyzed the financial impact of ARI in 2012-2013. Costs associated with ARI during the respiratory viral season were ten times greater than during the non-respiratory viral season, $31 224 and $3242 per 1000 patient-days, respectively (P < 0·001). ARI are burdensome for pediatric long-term care facilities not only because of the associated morbidity and mortality, but also due to the great financial costs of prevention. PMID:26425787

  14. Japan's universal long-term care system reform of 2005: containing costs and realizing a vision.

    PubMed

    Tsutsui, Takako; Muramatsu, Naoko

    2007-09-01

    Japan implemented a mandatory social long-term care insurance (LTCI) system in 2000, making long-term care services a universal entitlement for every senior. Although this system has grown rapidly, reflecting its popularity among seniors and their families, it faces several challenges, including skyrocketing costs. This article describes the recent reform initiated by the Japanese government to simultaneously contain costs and realize a long-term vision of creating a community-based, prevention-oriented long-term care system. The reform involves introduction of two major elements: "hotel" and meal charges for nursing home residents and new preventive benefits. They were intended to reduce economic incentives for institutionalization, dampen provider-induced demand, and prevent seniors from being dependent by intervening while their need levels are still low. The ongoing LTCI reform should be critically evaluated against the government's policy intentions as well as its effect on seniors, their families, and society. The story of this reform is instructive for other countries striving to develop coherent, politically acceptable long-term care policies. PMID:17767690

  15. Paying for long-term care.

    PubMed Central

    Estes, C L; Bodenheimer, T

    1994-01-01

    Everyone agrees that insurance for long-term care is inadequate in the United States. Disagreement exists, however, on whether such insurance should be provided through the private or public sector. Private insurance generally uses the experience-rating principle that persons with higher risk of illness are charged higher premiums. For private insurance for long-term care, this principle creates a dilemma. Most policies will be purchased by the elderly; yet, because the elderly have a high risk of needing long-term care, only about 20% of them can afford the cost of premiums. A public-private partnership by which the government partially subsidizes private long-term-care insurance is unlikely to resolve this dilemma. Only a social insurance program for long-term care can provide universal, affordable, and equitable coverage. PMID:8128712

  16. Gauging the Purported Costs of Public Data Archiving for Long-Term Population Studies

    PubMed Central

    Evans, Simon Robin

    2016-01-01

    It was recently proposed that long-term population studies be exempted from the expectation that authors publicly archive the primary data underlying published articles. Such studies are valuable to many areas of ecological and evolutionary biological research, and multiple risks to their viability were anticipated as a result of public data archiving (PDA), ultimately all stemming from independent reuse of archived data. However, empirical assessment was missing, making it difficult to determine whether such fears are realistic. I addressed this by surveying data packages from long-term population studies archived in the Dryad Digital Repository. I found no evidence that PDA results in reuse of data by independent parties, suggesting the purported costs of PDA for long-term population studies have been overstated. PMID:27058254

  17. 45 CFR 152.21 - Premiums and cost-sharing.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 45 Public Welfare 1 2013-10-01 2013-10-01 false Premiums and cost-sharing. 152.21 Section 152.21...-EXISTING CONDITION INSURANCE PLAN PROGRAM Benefits § 152.21 Premiums and cost-sharing. (a) Limitation on... the applicable standard risk rate that would apply to the coverage offered in the State or States....

  18. 45 CFR 152.21 - Premiums and cost-sharing.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 45 Public Welfare 1 2011-10-01 2011-10-01 false Premiums and cost-sharing. 152.21 Section 152.21...-EXISTING CONDITION INSURANCE PLAN PROGRAM Benefits § 152.21 Premiums and cost-sharing. (a) Limitation on... the applicable standard risk rate that would apply to the coverage offered in the State or States....

  19. 45 CFR 152.21 - Premiums and cost-sharing.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 45 Public Welfare 1 2010-10-01 2010-10-01 false Premiums and cost-sharing. 152.21 Section 152.21...-EXISTING CONDITION INSURANCE PLAN PROGRAM Benefits § 152.21 Premiums and cost-sharing. (a) Limitation on... the applicable standard risk rate that would apply to the coverage offered in the State or States....

  20. 45 CFR 152.21 - Premiums and cost-sharing.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 45 Public Welfare 1 2014-10-01 2014-10-01 false Premiums and cost-sharing. 152.21 Section 152.21...-EXISTING CONDITION INSURANCE PLAN PROGRAM Benefits § 152.21 Premiums and cost-sharing. (a) Limitation on... the applicable standard risk rate that would apply to the coverage offered in the State or States....

  1. Shifting the Paradigm for Long Term Monitoring at Legacy Sites to Improve Performance while Reducing Cost

    SciTech Connect

    Eddy-Dilek, Carol A.; Looney, Brian B.; Seaman, John; Kmetz, Thomas

    2013-01-10

    A major issue facing many government and private industry sites that were previously contaminated with radioactive and chemical wastes is that often the sites cannot be cleaned up enough to permit unrestricted human access. These sites will require long-term management, in some cases indefinitely, leaving site owners with the challenge of protecting human health and environmental quality in a cost effective manner. Long-term monitoring of groundwater contamination is one of the largest projected costs in the life cycle of environmental management at the Savannah River Site (SRS), the larger DOE complex, and many large federal and private sites. Currently, most monitoring strategies are focused on laboratory measurements of contaminants measured in groundwater samples collected from wells. This approach is expensive, and provides limited and lagging information about the effectiveness of cleanup activities and the behavior of the residual contamination. Over the last twenty years, DOE and other federal agencies have made significant investments in the development of various types of sensors and strategies that would allow for remote analysis of contaminants in groundwater, but these approaches do not promise significant reductions in risk or cost. Scientists at SRS have developed a new paradigm to simultaneously improve the performance of long term monitoring systems while lowering the overall cost of monitoring. This alternative approach incorporates traditional point measurements of contaminant concentration with measurements of controlling variables including boundary conditions, master variables, and traditional plume/contaminant variables. Boundary conditions are the overall driving forces that control plume movement and therefore provide leading indication to changes in plume stability. These variables include metrics associated with meteorology, hydrology, hydrogeology, and land use. Master variables are the key variables that control the chemistry of the

  2. Decomposing Cost Efficiency in Regional Long-term Care Provision in Japan

    PubMed Central

    Yamauchi, Yasuhiro

    2016-01-01

    Many developed countries face a growing need for long-term care provision because of population ageing. Japan is one such example, given its population's longevity and low birth rate. In this study, we examine the efficiency of Japan's regional long-term care system in FY2010 by performing a data envelopment analysis, a non-parametric frontier approach, on prefectural data and separating cost efficiency into technical, allocative, and price efficiencies under different average unit costs across regions. In doing so, we elucidate the structure of cost inefficiency by incorporating a method for restricting weight flexibility to avoid unrealistic concerns arising from zero optimal weight. The results indicate that technical inefficiency accounts for the highest share of losses, followed by price inefficiency and allocation inefficiency. Moreover, the majority of technical inefficiency losses stem from labor costs, particularly those for professional caregivers providing institutional services. We show that the largest share of allocative inefficiency losses can also be traced to labor costs for professional caregivers providing institutional services, while the labor provision of in-home care services shows an efficiency gain. However, although none of the prefectures gains efficiency by increasing the number of professional caregivers for institutional services, quite a few prefectures would gain allocative efficiency by increasing capital inputs for institutional services. These results indicate that preferred policies for promoting efficiency might vary from region to region, and thus, policy implications should be drawn with care. PMID:26493427

  3. Decomposing Cost Efficiency in Regional Long-term Care Provision in Japan.

    PubMed

    Yamauchi, Yasuhiro

    2016-03-01

    Many developed countries face a growing need for long-term care provision because of population ageing. Japan is one such example, given its population's longevity and low birth rate. In this study, we examine the efficiency of Japan's regional long-term care system in FY2010 by performing a data envelopment analysis, a non-parametric frontier approach, on prefectural data and separating cost efficiency into technical, allocative, and price efficiencies under different average unit costs across regions. In doing so, we elucidate the structure of cost inefficiency by incorporating a method for restricting weight flexibility to avoid unrealistic concerns arising from zero optimal weight. The results indicate that technical inefficiency accounts for the highest share of losses, followed by price inefficiency and allocation inefficiency. Moreover, the majority of technical inefficiency losses stem from labor costs, particularly those for professional caregivers providing institutional services. We show that the largest share of allocative inefficiency losses can also be traced to labor costs for professional caregivers providing institutional services, while the labor provision of in-home care services shows an efficiency gain. However, although none of the prefectures gains efficiency by increasing the number of professional caregivers for institutional services, quite a few prefectures would gain allocative efficiency by increasing capital inputs for institutional services. These results indicate that preferred policies for promoting efficiency might vary from region to region, and thus, policy implications should be drawn with care. PMID:26493427

  4. Long term outcome and cost-effectiveness of stenting versus balloon angioplasty for acute myocardial infarction

    PubMed Central

    Suryapranata, H; Ottervanger, J; Nibbering, E; van't, H; Hoorntje, J; de Boer, M J; Al, M; Zijlstra, F

    2001-01-01

    OBJECTIVE—To investigate the long term clinical outcome and cost-effectiveness of stenting compared with balloon angioplasty in patients with acute myocardial infarction.
METHODS—Patients with acute myocardial infarction were randomly allocated to primary stenting (112) or balloon angioplasty (115). The primary end point was the cumulative first event rate of death, non-fatal reinfarction, or target vessel revascularisation. Secondary end points were restenosis at six months and the cost-effectiveness at follow up.
RESULTS—After 24 months, the combined clinical end point of death/reinfarction was 4% after stenting and 11% after balloon angioplasty (p = 0.04). Subsequent target vessel revascularisation was necessary in 15 patients (13%) after stenting and in 39 (34%) after balloon angioplasty (p < 0.001). The cumulative cardiac event-free survival rate was also higher after stenting (84% v 62%, p < 0.001). The angiographic restenosis rate after stenting was less than after balloon angioplasty (12% v 34%, p < 0.001). Despite the higher initial costs of stenting (Dfl 21 484 v Dfl 18 625, p < 0.001), the cumulative costs at 24 months were comparable with those of balloon angioplasty (Dfl 31 423 v Dfl 32 933, p = 0.83).
CONCLUSIONS—Compared with balloon angioplasty, primary stenting for acute myocardial infarction results in a better long term clinical outcome without increased cost.


Keywords: stenting; angioplasty; myocardial infarction; cost-benefit analysis PMID:11359749

  5. Cost Effectiveness of Premium Versus Regular Gasoline in MCPS Buses.

    ERIC Educational Resources Information Center

    Baacke, Clifford M.; Frankel, Steven M.

    The primary question posed in this study is whether premium or regular gasoline is more cost effective for the Montgomery County Public School (MCPS) bus fleet, as a whole, when miles-per-gallon, cost-per-gallon, and repair costs associated with mileage are considered. On average, both miles-per-gallon, and repair costs-per-mile favor premium…

  6. Long-Term Care Benefits May Reduce End-of-Life Medical Care Costs

    PubMed Central

    Evered, Sharrilyn R.; Center, Bruce A.

    2014-01-01

    Abstract This study explores whether personal care services for functionally dependent or cognitively impaired individuals paid for by a long-term care (LTC) insurance policy can reduce health care utilization and costs at the end of life. This retrospective study uses propensity score matching methodology, hierarchical multiple regression, and Poisson regression to compare 830 decedents who utilized benefits from a voluntary LTC insurance plan (“claimants”) to 6860 decedents who never purchased coverage but were similar to claimants on 17 variables, including age, sex, frailty, burden of illness markers, and propensity to have needed LTC services. Claimants using LTC benefits experienced significantly lower health care costs at end of life, including 14% lower total medical costs, 13% lower pharmacy costs, 35% lower inpatient admission costs, and 16% lower outpatient visit costs. They also experienced 8% fewer inpatient admissions and 10% fewer inpatient days. The presence of dementia at the end of life moderated these effects. This study suggests that use of insurance-based LTC services measurably reduces health care expenditures at the end of life. (Population Health Management 2014;17:332–339) PMID:24784144

  7. Long-Term Surveillance and Maintenance Operations and Maintenance Subtask Cost Savings Estimates

    SciTech Connect

    Waugh, Jody

    2013-02-01

    The Long-Term Surveillance and Maintenance (LTSM) Operations and Maintenance (O&M) subtask in Task Order 501 focuses on using applied science and technology to cost-effectively improve the management of U.S. Department of Energy’s (DOE) Legacy Management (LM) sites. Work under this subtask has generated numerous innovative solutions concerning how LM addresses site management issues. Many of these solutions have not only improved LTSM of the sites and our understanding of how to apply science and technology as the means to solve problems, but they also have resulted in considerable long-term cost savings. The purpose of this paper is to document the most significant cost savings that have occurred because of the work done under the LTSM O&M subtask. The LTSM O&M subtask is organized into the following four areas: (1) Surface Projects, (2) Laboratory O&M, (3) Subsurface Projects, and (4) System Operations and Analysis at Remote Sites (SOARS). Surface Projects focus on issues related to the monitoring, performance, sustainability, phytoremediation, and enhancement of disposal cells. The laboratory is used by Legacy Management Support project scientists to conduct bench-scale tests of promising technologies and concepts. Subsurface Projects address issues of groundwater plume persistence through contaminant residence and analysis of rate-limited processes. SOARS gathers data from many LM sites in real time to aid scientists and engineers in monitoring pilot studies, evaluating site conditions, and adjusting operational parameters (e.g., pump rates). This paper presents estimated projected cost savings that have occurred because of LTSM O&M activities. Estimates to conduct the activities and the estimated potential savings that will occur are provided in Section 2.0. However, some potential cost savings are intangible and cannot be estimated; Section 3.0 summarizes these savings. Finally, Section 4.0 presents a summary table of the savings identified in this report

  8. Dancing Bees Improve Colony Foraging Success as Long-Term Benefits Outweigh Short-Term Costs

    PubMed Central

    Schürch, Roger; Grüter, Christoph

    2014-01-01

    Waggle dancing bees provide nestmates with spatial information about high quality resources. Surprisingly, attempts to quantify the benefits of this encoded spatial information have failed to find positive effects on colony foraging success under many ecological circumstances. Experimental designs have often involved measuring the foraging success of colonies that were repeatedly switched between oriented dances versus disoriented dances (i.e. communicating vectors versus not communicating vectors). However, if recruited bees continue to visit profitable food sources for more than one day, this procedure would lead to confounded results because of the long-term effects of successful recruitment events. Using agent-based simulations, we found that spatial information was beneficial in almost all ecological situations. Contrary to common belief, the benefits of recruitment increased with environmental stability because benefits can accumulate over time to outweigh the short-term costs of recruitment. Furthermore, we found that in simulations mimicking previous experiments, the benefits of communication were considerably underestimated (at low food density) or not detected at all (at medium and high densities). Our results suggest that the benefits of waggle dance communication are currently underestimated and that different experimental designs, which account for potential long-term benefits, are needed to measure empirically how spatial information affects colony foraging success. PMID:25141306

  9. Rapid, simple, and cost-effective treatments to achieve long-term hydrophilic PDMS surfaces

    NASA Astrophysics Data System (ADS)

    Hemmilä, Samu; Cauich-Rodríguez, Juan V.; Kreutzer, Joose; Kallio, Pasi

    2012-10-01

    This paper describes rapid, simple, and cost-effective treatments for producing biocompatible and long-term hydrophilic polydimethylsiloxane (PDMS) surfaces identified in an experimental study investigating 39 treatments in all. The wetting of the surfaces was monitored during six months. Changes in surface morphology and chemical composition were also analyzed. Some of the treatments are presented here for the first time, while for earlier presented treatments the selection of investigated parameters was wider and the observation period for the surface wetting longer. The PDMS surfaces were modified by surface activation, physisorption, and synthesis of both “grafting to” and “grafting from” polymer brushes. In surface activation, the PDMS sample was exposed to oxygen plasma, with several combinations of exposure time and RF power. In the physisorption and synthesis of polymer brushes, three commercially available and biocompatible chemicals were used: 2-hydroxyethyl methacrylate (HEMA), polyethylene glycol (PEG), and polyvinylpyrrolidone (PVP). Thirty-three of the 39 treatments rendered the PDMS hydrophilic, and in 12 cases the hydrophilicity lasted at least six months. Seven of these long-term hydrophilic coatings supported a contact angle of 30° or less. Three of the long-lasting hydrophilic coatings required only minutes to prepare.

  10. Readmission Rates and Long-Term Hospital Costs Among Survivors of In-Hospital Cardiac Arrest

    PubMed Central

    Chan, Paul S.; Nallamothu, Brahmajee K.; Krumholz, Harlan M.; Curtis, Lesley H.; Li, Yan; Hammill, Bradley G.; Spertus, John A.

    2014-01-01

    Background Although in-hospital cardiac arrest is common, little is known about readmission patterns and inpatient resource use among survivors of in-hospital cardiac arrest. Methods and Results Within a large national registry, we examined long-term inpatient utilization among 6972 adults ≥65 years who survived an in-hospital cardiac arrest. We examined 30-day and 1-year readmission rates and inpatient costs, overall and by patient demographics, hospital disposition (discharge destination), and neurological status at discharge. The mean age was 75.8 ± 7.0 years, 56% were men, and 12% were black. There were a total of 2005 readmissions during the first 30 days (cumulative incidence rate: 35 readmissions/100 patients [95% CI: 33–37]) and 8751 readmissions at 1 year (cumulative incidence rate: 185 readmissions/100 patients [95% CI: 177–190]). Overall, mean inpatient costs were $7,741 ± $2323 at 30 days and $18,629 ± $9411 at 1 year. Thirty-day inpatient costs were higher in patients of younger age (≥85 years: $6052 [reference]; 75–84 years: $7444 [adjusted cost ratio, 1.23 [1.06–1.42]; 65–74 years: $8291 [adjusted cost ratio, 1.37 [1.19–1.59]; both P<0.001]) and black race (whites: $7413; blacks: $9044; adjusted cost ratio, 1.22 [1.05–1.42]; P<0.001), as well as those discharged with severe neurological disability or to skilled nursing or rehabilitation facilities. These differences in resource use persisted at 1 year and were largely due to higher readmission rates. Conclusion Survivors of in-hospital cardiac arrest have frequent readmissions and high follow-up inpatient costs. Readmissions and inpatient costs were higher in certain subgroups, including patients of younger age and black race. PMID:25351479

  11. 45 CFR 152.21 - Premiums and cost-sharing.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 45 Public Welfare 1 2012-10-01 2012-10-01 false Premiums and cost-sharing. 152.21 Section 152.21 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES REQUIREMENTS RELATING TO HEALTH CARE ACCESS PRE... and cost-sharing by other insurers offering health insurance coverage to individuals in the...

  12. Long Term Societal Costs of Anterior Discectomy and Fusion (ACDF) versus Cervical Disc Arthroplasty (CDA) for Treatment of Cervical Radiculopathy

    PubMed Central

    Ghori, Ahmer; Konopka, Joseph F.; Cha, Thomas D.; Bono, Christopher M.

    2016-01-01

    Background Current literature suggests that anterior cervical discectomy and fusion (ACDF) and cervical disc arthroplasty (CDA) have comparable clinical outcomes for the treatment of cervical radiculopathy. Given similar outcomes, an understanding of differences in long-term societal costs can help guide resource utilization. The purpose of this study was to compare the relative long-term societal costs of anterior cervical discectomy and fusion (ACDF) to cervical disc arthroplasty (CDA) for the treatment of single level cervical disc disease by considering upfront surgical costs, lost productivity, and risk of subsequent revision surgery. Methods We completed an economic and decision analysis using a Markov model to evaluate the long-term societal costs of ACDF and CDA in a theoretical cohort of 45-65 year old patients with single level cervical disc disease who have failed nonoperative treatment. Results The long-term societal costs for a 45-year old patient undergoing ACDF are $31,178 while long-term costs for CDA are $24,119. Long-term costs for CDA remain less expensive throughout the modeled age range of 45 to 65 years old. Sensitivity analysis demonstrated that CDA remains less expensive than ACDF as long as annual reoperation rate remains below 10.5% annually. Conclusions Based on current data, CDA has lower long-term societal costs than ACDF for patients 45-65 years old by a substantial margin. Given reported reoperation rates of 2.5% for CDA, it is the preferred treatment for cervical radiculopathy from an economic perspective. PMID:26913221

  13. Integrated, long term, sustainable, cost effective biosolids management at a large Canadian wastewater treatment facility.

    PubMed

    Leblanc, R J; Allain, C J; Laughton, P J; Henry, J G

    2004-01-01

    The Greater Moncton Sewerage Commission's 115,000 m3/d advanced, chemically assisted primary wastewater treatment facility located in New Brunswick, Canada, has developed an integrated, long term, sustainable, cost effective programme for the management and beneficial utilization of biosolids from lime stabilized raw sludge. The paper overviews biosolids production, lime stabilization, conveyance, and odour control followed by an indepth discussion of the wastewater sludge as a resource programme, namely: composting, mine site reclamation, landfill cover, land application for agricultural use, tree farming, sod farm base as a soil enrichment, topsoil manufacturing. The paper also addresses the issues of metals, pathogens, organic compounds, the quality control program along with the regulatory requirements. Biosolids capital and operating costs are presented. Research results on removal of metals from primary sludge using a unique biological process known as BIOSOL as developed by the University of Toronto, Canada to remove metals and destroy pathogens are presented. The paper also discusses an ongoing cooperative research project with the Université de Moncton where various mixtures of plant biosolids are composted with low quality soil. Integration, approach to sustainability and "cumulative effects" as part of the overall biosolids management strategy are also discussed. PMID:15259950

  14. ORTHODONTIC RETENTION. Studies of retention capacity, cost-effectiveness and long-term stability.

    PubMed

    Tynelius, Gudrun Edman

    2014-01-01

    Retention strategies, cost-effectiveness and long-term stability of treatment outcome are essential aspects of orthodontic treatment planning. The overall aim of this thesis was to compare and evaluate three different retention strategies, with special reference to short- and long-term clinical stability and cost-effectiveness. The approach was evidence-based, hence randomized controlled methodology was used in order to generate high levels of evidence. This thesis is based on four studies: Papers I and II are based on randomized controlled trials, evaluating the stability of treatment outcome after one and two years of retention, using three different retention strategies: a maxillary vacuum-formed retainer combined with a mandibular canine-to-canine retainer; a maxillary vacuum-formed retainer combined with stripping of the mandibular anterior teeth and a prefabricated positioner. Paper III presents a cost-minimization analysis of two years of retention treatment. Paper IV is based on a randomized controlled trial documenting the results five years post-retention. The following conclusions were drawn: Papers I and II. From a clinical perspective, asssessment after one year of retention disclosed that the three retention methods were successful in retaining the orthodontic treatment results. After two years of retention, all three retention methods were equally effective in controlling relapse at a clinically acceptable level. Most of the relapse occurred during the first year of retention; only minor or negligible changes were found during the second year. The subjects were grouped according to the level of compliance (excellent or good). After two years of retention there was a negative correlation between growth in body height and relapse of mandibular LII in the group of subjects with excellent compliance. The group with good compliance showed a positive correlation (Paper II, Figure 3). After two years of retention, growth in body height, initial crowding and

  15. Long-Term Cost-Effectiveness of Transanal Irrigation in Patients with Neurogenic Bowel Dysfunction

    PubMed Central

    Emmanuel, Anton; Kumar, Gayathri; Christensen, Peter; Mealing, Stuart; Størling, Zenia M.; Andersen, Frederikke; Kirshblum, Steven

    2016-01-01

    Background People suffering from neurogenic bowel dysfunction (NBD) and an ineffective bowel regimen often suffer from fecal incontinence (FI) and related symptoms, which have a huge impact on their quality of life. In these situations, transanal irrigation (TAI) has been shown to reduce these symptoms and improve quality of life. Aim To investigate the long-term cost-effectiveness of initiating TAI in patients with NBD who have failed standard bowel care (SBC). Methods A deterministic Markov decision model was developed to project the lifetime health economic outcomes, including quality-adjusted life years (QALYs), episodes of FI, urinary tract infections (UTIs), and stoma surgery when initiating TAI relative to continuing SBC. A data set consisting of 227 patients with NBD due to spinal cord injury (SCI), multiple sclerosis, spina bifida and cauda equina syndrome was used in the analysis. In the model a 30-year old individual with SCI was used as a base-case. A probabilistic sensitivity analysis was applied to evaluate the robustness of the model. Results The model predicts that a 30-year old SCI patient with a life expectancy of 37 years initiating TAI will experience a 36% reduction in FI episodes, a 29% reduction in UTIs, a 35% reduction in likelihood of stoma surgery and a 0.4 improvement in QALYs, compared with patients continuing SBC. A lifetime cost-saving of £21,768 per patient was estimated for TAI versus continuing SBC alone. Conclusion TAI is a cost-saving treatment strategy reducing risk of stoma surgery, UTIs, episodes of FI and improving QALYs for NBD patients who have failed SBC. PMID:27557052

  16. A Long-Term Experimental Study Demonstrates the Costs of Begging That Were Not Found over the Short Term

    PubMed Central

    Soler, Manuel; Ruiz-Raya, Francisco; Carra, Laura G.; Medina-Molina, Eloy; Ibáñez-Álamo, Juan Diego; Martín-Gálvez, David

    2014-01-01

    Parent–offspring conflict theory predicts that begging behaviour could escalate continuously over evolutionary time if it is not prevented by costliness of begging displays. Three main potential physiological costs have been proposed: growth, immunological and metabolic costs. However, empirical evidence on this subject remains elusive because published results are often contradictory. In this study, we test for the existence of these three potential physiological costs of begging in house sparrow (Passer domesticus) nestlings by stimulating a group of nestlings to beg for longer and another group for shorter periods than in natural conditions. All nestlings were fed with the same quantity of food. Our study involves a long-term experimental treatment for begging studies (five consecutive days). Long-term studies frequently provide clearer results than short-term studies and, sometimes, relevant information not reported by the latter ones. Our long-term experiment shows (i) a clear effect on the immune response even since the first measurement (6 hours), but it was higher during the second (long-term) than during the first (short-term) test; (ii) evidence of a growth cost of begging in house sparrow nestlings not previously found by other studies; (iii) body condition was affected by our experimental manipulation only after 48 hour; (iv) a metabolic cost of begging never previously shown in any species, and (v) for the first time, it has shown a simultaneous effect of the three potential physiological costs of begging: immunocompetence, growth, and metabolism. This implies first, that a multilevel trade-off can occur between begging and all physiological costs and, second, that a lack of support in a short-term experiment for the existence of a tested cost of begging does not mean absence of that cost, because it can be found in a long-term experiment. PMID:25372280

  17. A long-term experimental study demonstrates the costs of begging that were not found over the short term.

    PubMed

    Soler, Manuel; Ruiz-Raya, Francisco; Carra, Laura G; Medina-Molina, Eloy; Ibáñez-Álamo, Juan Diego; Martín-Gálvez, David

    2014-01-01

    Parent-offspring conflict theory predicts that begging behaviour could escalate continuously over evolutionary time if it is not prevented by costliness of begging displays. Three main potential physiological costs have been proposed: growth, immunological and metabolic costs. However, empirical evidence on this subject remains elusive because published results are often contradictory. In this study, we test for the existence of these three potential physiological costs of begging in house sparrow (Passer domesticus) nestlings by stimulating a group of nestlings to beg for longer and another group for shorter periods than in natural conditions. All nestlings were fed with the same quantity of food. Our study involves a long-term experimental treatment for begging studies (five consecutive days). Long-term studies frequently provide clearer results than short-term studies and, sometimes, relevant information not reported by the latter ones. Our long-term experiment shows (i) a clear effect on the immune response even since the first measurement (6 hours), but it was higher during the second (long-term) than during the first (short-term) test; (ii) evidence of a growth cost of begging in house sparrow nestlings not previously found by other studies; (iii) body condition was affected by our experimental manipulation only after 48 hour; (iv) a metabolic cost of begging never previously shown in any species, and (v) for the first time, it has shown a simultaneous effect of the three potential physiological costs of begging: immunocompetence, growth, and metabolism. This implies first, that a multilevel trade-off can occur between begging and all physiological costs and, second, that a lack of support in a short-term experiment for the existence of a tested cost of begging does not mean absence of that cost, because it can be found in a long-term experiment. PMID:25372280

  18. Medicaid program; premiums and cost sharing. Final rule.

    PubMed

    2008-11-25

    This final rule implements and interprets the provisions of sections 6041, 6042, and 6043 of the Deficit Reduction Act of 2005 (DRA), and section 405(a)(1) of the Tax Relief and Health Care Act of 2006 (TRHCA). The DRA was amended by the TRHCA which revised sections 6041, 6042, and 6043 of the DRA including limitations on cost sharing for individuals with family incomes at or below 100 percent of the federal poverty line. These sections amended the Social Security Act (the Act) by adding a new section 1916A to provide State Medicaid agencies with increased flexibility to impose premium and cost sharing requirements on certain Medicaid recipients. This flexibility supplements the existing authority States have to impose premiums and cost sharing under section 1916 of the Act. The DRA provisions also specifically address cost sharing for non-preferred drugs and non-emergency care furnished in a hospital emergency department. PMID:19143111

  19. 41 CFR 301-11.15 - What expenses may be considered part of the daily lodging cost when I rent on a long-term basis?

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... considered part of the daily lodging cost when I rent on a long-term basis? When you rent a room, apartment, house, or other lodging on a long-term basis (e.g., weekly, monthly), the following expenses may be... considered part of the daily lodging cost when I rent on a long-term basis? 301-11.15 Section...

  20. 41 CFR 301-11.15 - What expenses may be considered part of the daily lodging cost when I rent on a long-term basis?

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... considered part of the daily lodging cost when I rent on a long-term basis? When you rent a room, apartment, house, or other lodging on a long-term basis (e.g., weekly, monthly), the following expenses may be... considered part of the daily lodging cost when I rent on a long-term basis? 301-11.15 Section...

  1. Comparison of low cost measurement techniques for long-term monitoring of atmospheric ammonia.

    PubMed

    Sutton, M A; Miners, B; Tang, Y S; Milford, C; Wyers, G P; Duyzer, J H; Fowler, D

    2001-10-01

    An inter-comparison of techniques for long-term sampling of atmospheric ammonia (NH3) was conducted with a view to establishing a national network with > 50 sites. Key requirements were for: a low cost system, simplicity and durability to enable a postal exchange with local site operators, a precision of < +/- 20% for monthly sampling at expected NH3 concentrations of 1-2 micrograms m-3, a detection limit sufficient to resolve the small NH3 concentrations (< 0.2 microgram m-3) expected in remote parts of the UK, and a quantitative means to establish quality control. Five sampling methods were compared: A, a commercially available membrane diffusion tube (exposed in triplicate), with membranes removed immediately after sampling; B, the above method, with the membranes left in place until analysis; C, open-ended diffusion tubes (exposed with 4 replicates); D, a new active sampling diffusion denuder system; and E, an active sampling bubbler system. Method D consisted of two 0.1 m acid coated glass denuders in series with sampling at approximately 0.3 l min-1. These methods were deployed at 6 locations in the UK and the Netherlands and compared against reference estimates. Method D was the most precise and sensitive of the techniques compared, with a detection limit of < 0.1 microgram m-3. The bubbler provided a less precise estimate of NH3 concentration, and also suffered several practical drawbacks. The diffusion tubes were found to correlate with the reference at high concentrations (> 3 micrograms m-3), but were less precise and overestimated NH3 at smaller concentrations. Of the passive methods, A was the most precise and C the least precise. On the basis of the results, method D has been implemented in the national network, together with application of method A to explore spatial variability in regions with expected high NH3 concentrations. PMID:11695110

  2. A retrospective investigation of energy efficiency standards: policies may have accelerated long term declines in appliance costs

    NASA Astrophysics Data System (ADS)

    Van Buskirk, R. D.; Kantner, C. L. S.; Gerke, B. F.; Chu, S.

    2014-11-01

    We perform a retrospective investigation of multi-decade trends in price and life-cycle cost (LCC) for home appliances in periods with and without energy efficiency (EE) standards and labeling polices. In contrast to the classical picture of the impact of efficiency standards, the introduction and updating of appliance standards is not associated with a long-term increase in purchase price; rather, quality-adjusted prices undergo a continued or accelerated long-term decline. In addition, long term trends in appliance LCCs—which include operating costs—consistently show an accelerated long term decline with EE policies. We also show that the incremental price of efficiency improvements has declined faster than the baseline product price for selected products. These observations are inconsistent with a view of EE standards that supposes a perfectly competitive market with static supply costs. These results suggest that EE policies may be associated with other forces at play, such as innovation and learning-by-doing in appliance production and design, that can affect long term trends in quality-adjusted prices and LCCs.

  3. Long-Term Effects of Outpatient Geriatric Evaluation and Management on Health Care Utilization, Cost, and Survival

    ERIC Educational Resources Information Center

    Engelhardt, Joseph B.; Toseland, Ronald W.; Gao, Jian; Banks, Steven

    2006-01-01

    Purpose: The long-term effectiveness and efficiency of an outpatient geriatric evaluation and management (GEM) program was compared to usual primary care (UPC). Design and Method: A randomized controlled group design was used. Health care utilization, cost of care, and survival were assessed during a 48-month period among a sample of 160 male…

  4. What Are the Long-Term Economic Costs of Psychological Problems during Childhood? Fact Sheet

    ERIC Educational Resources Information Center

    Steinberg, Paul

    2010-01-01

    Recent research has established evidence of a strong link between poor physical health during childhood (and even in utero) and health and economic outcomes much later in adulthood. But much less is known about the long-term economic consequences of psychological conditions experienced during childhood, although childhood psychological…

  5. Risk-Adjusted Impact of Administrative Costs on the Distribution of Terminal Wealth for Long-Term Investment

    PubMed Central

    Guillén, Montserrat; Jarner, Søren Fiig; Pérez-Marín, Ana M.

    2014-01-01

    The impact of administrative costs on the distribution of terminal wealth is approximated using a simple formula applicable to many investment situations. We show that the reduction in median returns attributable to administrative fees is usually at least twice the amount of the administrative costs charged for most investment funds, when considering a risk-adjustment correction over a reasonably long-term time horizon. The example we present covers a number of standard cases and can be applied to passive investments, mutual funds, and hedge funds. Our results show investors the potential losses they face in performance due to administrative costs. PMID:25180200

  6. Shifting the Paradigm for Long Term Monitoring at Legacy Sites to Improve Performance while Reducing Costs - 13422

    SciTech Connect

    Eddy-Dilek, Carol A; Looney, Brian B.; Gaughan, Thomas; Kmetz, Thomas; Seaman, John

    2013-07-01

    A major issue facing many government and private industry sites that were previously contaminated with radioactive and chemical wastes is that often the sites cannot be cleaned up enough to permit unrestricted human access. These sites will require long-term management, in some cases indefinitely, leaving site owners with the challenge of protecting human health and environmental quality in a cost effective manner. Long-term monitoring of groundwater contamination is one of the largest projected costs in the life cycle of environmental management at the Savannah River Site (SRS), the larger DOE complex, and many large federal and private sites. Currently, most monitoring strategies are focused on laboratory measurements of contaminants measured in groundwater samples collected from wells. This approach is expensive, and provides limited and lagging information about the effectiveness of cleanup activities and the behavior of the residual contamination. Over the last twenty years, DOE and other federal agencies have made significant investments in the development of various types of sensors and strategies that would allow for remote analysis of contaminants in groundwater, but these approaches do not promise significant reductions in risk or cost. Scientists at SRS have developed a new paradigm to simultaneously improve the performance of long term monitoring systems while lowering the overall cost of monitoring. This alternative approach incorporates traditional point measurements of contaminant concentration with measurements of controlling variables including boundary conditions, master variables, and traditional plume/contaminant variables. Boundary conditions are the overall driving forces that control plume movement and therefore provide leading indication to changes in plume stability. These variables include metrics associated with meteorology, hydrology, hydrogeology, and land use. Master variables are the key variables that control the chemistry of the

  7. Clarithromycin Leads to Long-Term Survival and Cost Benefit in Ventilator-Associated Pneumonia and Sepsis.

    PubMed

    Tsaganos, Thomas; Raftogiannis, Maria; Pratikaki, Maria; Christodoulou, Sofia; Kotanidou, Anastasia; Papadomichelakis, Evangelos; Armaganidis, Apostolos; Routsi, Christina; Giamarellos-Bourboulis, Evangelos J

    2016-06-01

    Increasing numbers of admissions for sepsis impose a heavy burden on health care systems worldwide, while novel therapies have proven both expensive and ineffective. We explored the long-term mortality and hospitalization costs after adjunctive therapy with intravenous clarithromycin in ventilator-associated pneumonia (VAP). Two hundred patients with sepsis and VAP were enrolled in a published randomized clinical trial; 100 were allocated to blind treatment with a placebo and another 100 to clarithromycin at 1 g daily for three consecutive days. Long-term mortality was recorded. The hospitalization cost was calculated by direct quantitation of imaging tests, medical interventions, laboratory tests, nonantibiotic drugs and antibiotics, intravenous fluids, and parenteral and enteral nutrition. Quantities were priced by the respective prices defined by the Greek government in 2002. The primary endpoint was 90-day mortality; cumulative hospitalization cost was the secondary endpoint. All-cause mortality rates on day 90 were 60% in the placebo arm and 43% in the clarithromycin arm (P = 0.023); 141 patients were alive on day 28, and mortality rates between days 29 and 90 were 44.4% and 17.4%, respectively (P = 0.001). The mean cumulative costs on day 25 in the placebo group and in the clarithromycin group were €14,701.10 and €13,100.50 per patient staying alive, respectively (P = 0.048). Respective values on day 45 were €26,249.50 and €19,303.10 per patient staying alive (P = 0.011); this was associated with the savings from drugs other than antimicrobials. It is concluded that intravenous clarithromycin for three consecutive days as an adjunctive treatment in VAP and sepsis offers long-term survival benefit along with a considerable reduction in the hospitalization cost. (This study has been registered at ClinicalTrials.gov under registration no. NCT00297674.). PMID:27044546

  8. A portable low-cost long-term live-cell imaging platform for biomedical research and education.

    PubMed

    Walzik, Maria P; Vollmar, Verena; Lachnit, Theresa; Dietz, Helmut; Haug, Susanne; Bachmann, Holger; Fath, Moritz; Aschenbrenner, Daniel; Abolpour Mofrad, Sepideh; Friedrich, Oliver; Gilbert, Daniel F

    2015-02-15

    Time-resolved visualization and analysis of slow dynamic processes in living cells has revolutionized many aspects of in vitro cellular studies. However, existing technology applied to time-resolved live-cell microscopy is often immobile, costly and requires a high level of skill to use and maintain. These factors limit its utility to field research and educational purposes. The recent availability of rapid prototyping technology makes it possible to quickly and easily engineer purpose-built alternatives to conventional research infrastructure which are low-cost and user-friendly. In this paper we describe the prototype of a fully automated low-cost, portable live-cell imaging system for time-resolved label-free visualization of dynamic processes in living cells. The device is light-weight (3.6 kg), small (22 × 22 × 22 cm) and extremely low-cost (<€1250). We demonstrate its potential for biomedical use by long-term imaging of recombinant HEK293 cells at varying culture conditions and validate its ability to generate time-resolved data of high quality allowing for analysis of time-dependent processes in living cells. While this work focuses on long-term imaging of mammalian cells, the presented technology could also be adapted for use with other biological specimen and provides a general example of rapidly prototyped low-cost biosensor technology for application in life sciences and education. PMID:25441413

  9. The effect of owning private long-term care insurance policies on out-of-pocket costs.

    PubMed Central

    Rice, T; Thomas, K; Weissert, W

    1991-01-01

    This article examines the effect of owning long-term care insurance policies on the amount of out-of-pocket costs incurred by the elderly during their nursing home stays, and the importance of different policy features and restrictions. Data were drawn from the 1985 National Nursing Home Survey, and from copies of long-term care insurance policies collected from 11 leading companies during the spring and summer of 1988. The study results show a great deal of uncertainty concerning amounts the policies are likely to pay toward nursing home stays. This implies that the policies collected did not adequately fulfill one of the primary purposes of insurance: a reduction in risk and uncertainty. To examine whether rapid policy changes in recent years have made a difference, we assessed each of seven policy features and found that the two most important restrictions in long-term care insurance policies are prior hospitalization and level-of-care requirements. Recently, the National Association of Insurance Commissioners (NAIC) recommended that states prohibit the sale of policies containing these restrictions. Our findings confirm the wisdom of this recommendation. We did find, however, that two other policy restrictions--policy maximums and lack of inflation adjustment--are problematic. We recommend that the NAIC expand its model regulations to require that policy maximums be a minimum of four years, and that some form of inflation protection be incorporated into policy benefit structures. PMID:1899410

  10. Cost analysis of long-term outcomes of an urban mental health court.

    PubMed

    Kubiak, Sheryl; Roddy, Juliette; Comartin, Erin; Tillander, Elizabeth

    2015-10-01

    Multiple studies have demonstrated decreased recidivism and increased treatment engagement for individuals with serious mental illness involved in Mental Health Courts (MHC). However, the limited availability of social and fiscal resources requires an analysis of the relationship between a program's effectiveness and its costs. Outcome costs associated with a sample of 105 participants discharged for more than 1 year - and grouped by completion status - were compared to an eligible sample not enrolled (n=45). Transactional costs analysis (TCA) was used to calculate outcomes associated with treatment, arrest, and confinement in the 12-month post-MHC. Total outcome costs for the Successful Group ($16,964) significantly differed from the Unsuccessful ($32,258) and Compare Groups ($39,870). Costs associated with the higher number of arrests for those in the Compare Group created the largest differences. Total cost savings between Successful and Compare (M=$22,906) equated to $916,240 and savings between Unsuccessful and Compare (M=$7612) were $494,708. The total combined cost savings for participants in the 12-month post-MHC period was $1,411,020. While it is important to understand that MHCs and the individuals that they serve vary and these results are for a felony-level court, policy makers and researchers can use these results to guide their decision-making. PMID:25982871

  11. Summary of the cost analysis report for the long-term management of depleted uranium hexafluoride

    SciTech Connect

    Dubrin, J.W.; Rahm-Crites, L.

    1997-09-01

    This report is a summary of the Cost Analysis Report which provides comparative cost data for the management strategy alternatives. The PEIS and the Cost Analysis Report will help DOE select a management strategy. The Record of Decision, expected in 1998, will complete the first part of the Depleted Uranium Hexafluoride Management Program. The second part of the Program will look at specific sites and technologies for carrying out the selected strategy. The Cost Analysis Report estimates the primary capital and operating costs for the different alternatives. It reflects the costs of technology development construction of facilities, operation, and decontamination and decommissioning. It also includes potential revenues from the sale of by-products such as anhydrous hydrogen fluoride (ABF). These estimates are based on early designs. They are intended to help in comparing alternatives, rather than to indicate absolute costs for project budgets or bidding purposes. More detailed estimates and specific funding sources will be considered in part two of the Depleted Uranium Hexafluoride Management Program.

  12. Development of a cost-effective and flexible vibration DAQ system for long-term continuous structural health monitoring

    NASA Astrophysics Data System (ADS)

    Nguyen, Theanh; Chan, Tommy H. T.; Thambiratnam, David P.; King, Les

    2015-12-01

    In the structural health monitoring (SHM) field, long-term continuous vibration-based monitoring is becoming increasingly popular as this could keep track of the health status of structures during their service lives. However, implementing such a system is not always feasible due to on-going conflicts between budget constraints and the need of sophisticated systems to monitor real-world structures under their demanding in-service conditions. To address this problem, this paper presents a comprehensive development of a cost-effective and flexible vibration DAQ system for long-term continuous SHM of a newly constructed institutional complex with a special focus on the main building. First, selections of sensor type and sensor positions are scrutinized to overcome adversities such as low-frequency and low-level vibration measurements. In order to economically tackle the sparse measurement problem, a cost-optimized Ethernet-based peripheral DAQ model is first adopted to form the system skeleton. A combination of a high-resolution timing coordination method based on the TCP/IP command communication medium and a periodic system resynchronization strategy is then proposed to synchronize data from multiple distributed DAQ units. The results of both experimental evaluations and experimental-numerical verifications show that the proposed DAQ system in general and the data synchronization solution in particular work well and they can provide a promising cost-effective and flexible alternative for use in real-world SHM projects. Finally, the paper demonstrates simple but effective ways to make use of the developed monitoring system for long-term continuous structural health evaluation as well as to use the instrumented building herein as a multi-purpose benchmark structure for studying not only practical SHM problems but also synchronization related issues.

  13. [The costs of treatment and rehabilitation of long-term psychiatric patients].

    PubMed

    Meder, J; Lupiński, P

    1999-01-01

    The cost of treatment of mentally ill patients is taking an ever more important place in the health care systems of many countries. This is caused by an increasing interest of the taxpayers who want to know where their money goes in relation to medical expenses. It is logical that taxpayers' expectations include improvement of the health care system. Medicine cannot be considered in the category of a profit making economy because some of the fields of medicine are not and cannot be profitable. At the borderline between economy and medicine, pharmaco-economy was born. This new science considers the cost of treatment of various sicknesses; furthermore it tests the comparative costs and the use of pharmaceutical products. In pharmaco-economy we distinguish three different types of costs: the continuous cost (consequent to medical treatment), the indirect cost (related to losses on support of patients and their family members), the unassessable cost (psychological losses). A correct economical analysis is multi-factual and refers to different sides of our lives. With this understanding we can only consider the general economical results, that is, the so called "economical treatment result". It is believed that this way of thinking can cause an intensive development in the rehabilitation of chronic mentally ill patients in Poland. This rehabilitation can be a classical example of modern economy: hypothetically high initial costs cause their substantial reduction in the progressive development of the programme until they reach their effective reduction at the end, i.e. the progressive improvement of the patients functioning within their natural environment. PMID:10786243

  14. Doctors commitment and long-term effectiveness for cost containment policies: lesson learned from biosimilar drugs

    PubMed Central

    Menditto, Enrica; Orlando, Valentina; Coretti, Silvia; Putignano, Daria; Fiorentino, Denise; Ruggeri, Matteo

    2015-01-01

    Background Agency is a pervasive feature of the health care market, with doctors acting as agents for both patients and the health care system. In a context of scarce resources, doctors are required to take opportunity cost into account when prescribing treatments, while cost containment policies cannot overlook their active role in determining health care resource allocation. This paper addresses this issue, investigating the effects of cost containment measures in the market of biosimilar drugs that represent a viable and cost-saving strategy for the reduction of health care expenditure. The analysis focuses on a particular region in Italy, where several timely policies to incentivize biosimilar prescribing were launched. Methods Drugs were identified by the anatomical therapeutic chemical classification system. Information about biosimilar drugs and their originator biological products was extracted from the IMS Health regional database. Drug consumption was expressed in terms of counting units, while expenditure was evaluated in Euro (€). The market penetration of biosimilars was analyzed by year and quarterly. Results In the Campania region of Italy, the effects of cost containment policies, launched between 2009 and 2013, showed the prescription of biosimilars strongly increasing in 2010 until prescribing levels reached and exceeded the market share of the reference biological products in 2012. After a slight reduction, a plateau was observed at the beginning of 2013. At the same time, the use of the originator products had been decreasing until the first quarter of 2011. However, after a 1-year plateau, this trend was reversed, with a new increase in the consumption of the originators observed. Conclusion Results show that the cost containment policies, applied to cut health expenditure “to cure and not to care”, did not produce the cultural change necessary to make these policies effective in the long run. Therefore, top-down policies for cost

  15. DOE geothermal R&D program focused on facilitating long-term, cost-effective private resource development

    SciTech Connect

    Mock, John E.

    1992-01-01

    Analyses conducted in support of the National Energy Strategy projected that as much as 22,000 megawatts of cost-effective, moderate-temperature geothermal energy are available to the U.S. over the long-term, or to the year 2030. Thus, the primary hydrothermal technology research goal of the Department's Geothermal Division is to facilitate the ability of the private sector to exploit competitively this large source of energy up to that capacity level or greater. The primary mechanism for implementing this goal is an R&D core program cost-shared with industry focused on major cost-sensitive technology areas: exploration technology, reservoir engineering and management, and drilling. The NES analyses also indicated that electricity generated with energy derived from hot dry rock could be a geographically dispersed, logical follow-on to hydrothermal electricity in the longer term. In order to demonstrate whether energy at useful temperatures can be extracted over extended periods at competitive energy prices, a long-term flow test of an experimental HDR system will be conducted. This paper describes DOE's current participation in R&D activities leading to the development of ''cutting edge'' technology that will serve the geothermal industry's interest well into the next century.

  16. Cost-effective long-term groundwater monitoring design using a genetic algorithm and global mass interpolation

    NASA Astrophysics Data System (ADS)

    Reed, Patrick; Minsker, Barbara; Valocchi, Albert J.

    2000-12-01

    A new methodology for sampling plan design has been developed to reduce the costs associated with long-term monitoring of sites with groundwater contamination. The method combines a fate-and-transport model, plume interpolation, and a genetic algorithm to identify cost-effective sampling plans that accurately quantify the total mass of dissolved contaminant. The plume interpolation methods considered were inverse-distance weighting, ordinary kriging, and a hybrid method that combines the two approaches. Application of the methodology to Hill Air Force Base indicated that sampling costs could be reduced by as much as 60% without significant loss in accuracy of the global mass estimates. Inverse-distance weighting was shown to be most effective as a screening tool for evaluating whether more comprehensive geostatistical modeling is warranted. The hybrid method was effective for implementing such a tiered approach, reducing computational time by more than 60% relative to kriging alone.

  17. Assessing long-term health and cost outcomes of patient-centered medical homes serving adults with poor diabetes control.

    PubMed

    Pagán, José A; Carlson, Erin K

    2013-10-01

    The patient-centered medical home (PCMH) is an integrated primary care delivery model particularly suited for patients with poor diabetes control. Although PCMH models targeting adults with diabetes have shown some early success, little is known about the long-term benefits of medical homes in terms of health and cost outcomes. The performance of a PCMH model in adults with poor diabetes control was assessed using simulated controlled trial data obtained from the Archimedes model of disease progression and health care utilization. Using the Cardio-Metabolic Risk data set, we compared health and cost outcomes over a 20-year period between adults with poor diabetes control (HbA1c >9%) receiving standard care and these same adults receiving care under a PCMH model with a 49% HbA1c intervention improvement rate at a per-beneficiary per-month care management cost of $20 per month. The results suggest that the PCMH model has the potential to not only reduce the proportion of the population with bilateral blindness, foot amputations, and myocardial infarctions-and the mortality rate-but it can also do so in a cost-effective manner ($7898 per quality-adjusted life year). The PCMH model is cost saving for the population 50 to 64 years old and it is particularly cost-effective for men ($883 per quality-adjusted life year). Moreover, these effects are relatively large for adults 30 to 49 years old (lower bilateral blindness and death rates), women (lower foot amputation and death rates), and men (lower bilateral blindness and myocardial infarction rates). The PCMH model has potential long-term benefits to both patients with poor diabetes control as well as health care systems and providers willing to invest in this health care delivery approach. PMID:23799676

  18. 47 CFR 52.32 - Allocation of the shared costs of long-term number portability.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... universal service support mechanism (See 47 CFR 54.701 of this chapter), the TRS Fund (See 47 CFR 64.604(c)(4)(iii)(H) of this chapter), and the North American Numbering Plan cost recovery (See 47 CFR 52.16... “telecommunications service” shall include “interconnected VoIP service” as that term is defined in 47 CFR 9.3....

  19. 47 CFR 52.32 - Allocation of the shared costs of long-term number portability.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... universal service support mechanism (See 47 CFR 54.701 of this chapter), the TRS Fund (See 47 CFR 64.604(c)(4)(iii)(H) of this chapter), and the North American Numbering Plan cost recovery (See 47 CFR 52.16... “telecommunications service” shall include “interconnected VoIP service” as that term is defined in 47 CFR 9.3....

  20. 47 CFR 52.32 - Allocation of the shared costs of long-term number portability.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... universal service support mechanism (See 47 CFR 54.701 of this chapter), the TRS Fund (See 47 CFR 64.604(c)(4)(iii)(H) of this chapter), and the North American Numbering Plan cost recovery (See 47 CFR 52.16... “telecommunications service” shall include “interconnected VoIP service” as that term is defined in 47 CFR 9.3....

  1. 47 CFR 52.32 - Allocation of the shared costs of long-term number portability.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... universal service support mechanism (See 47 CFR 54.701 of this chapter), the TRS Fund (See 47 CFR 64.604(c)(4)(iii)(H) of this chapter), and the North American Numbering Plan cost recovery (See 47 CFR 52.16... “telecommunications service” shall include “interconnected VoIP service” as that term is defined in 47 CFR 9.3....

  2. 47 CFR 52.32 - Allocation of the shared costs of long-term number portability.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... “telecommunications service” shall include “interconnected VoIP service” as that term is defined in 47 CFR 9.3. ... universal service support mechanism (See 47 CFR 54.701 of this chapter), the TRS Fund (See 47 CFR 64.604(c)(4)(iii)(H) of this chapter), and the North American Numbering Plan cost recovery (See 47 CFR...

  3. Developments toward a Low-Cost Approach for Long-Term, Unattended Vapor Intrusion Monitoring

    PubMed Central

    Tolley, William K.

    2014-01-01

    There are over 450,000 sites contaminated by chemicals in the US. This large number of contaminated sites and the speed of subsurface migration of chemicals pose considerable risk to nearby residences and commercial buildings. The high costs for monitoring around these site stem from the labor involved in placing and replacing the passive sorbent vapor samplers and the resultant laboratory analysis. This monitoring produces sparse data sets that do not track temporal changes well. To substantially reduce costs and better track exposures, less costly, unattended systems for monitoring soil gases and vapor intrusion into homes and businesses are desirable to aid in the remediation of contaminated sites. This paper describes progress toward the development of an inexpensive system specifically for monitoring vapor intrusion; the system can operate repeatedly without user intervention with low detection limits (1 × 10−9, or 1 part-per-billion). Targeted analytes include chlorinated hydrocarbons (dichloroethylene, trichloroethane, trichloroethylene, and perchloroethylene) and benzene. The system consists of a trap-and-purge preconcentrator for vapor collection in conjunction with a compact gas chromatography instrument to separate individual compounds. Chemical detection is accomplished with an array of chemicapacitors and a metal-oxide semiconductor combustibles sensor. Both the preconcentrator and the chromatography column are resistively heated. All components are compatible with ambient air, which serves as the carrier gas for the gas chromatography and detectors. PMID:24903107

  4. Cost tradeoffs in consequence management at nuclear power plants: A risk based approach to setting optimal long-term interdiction limits for regulatory analyses

    SciTech Connect

    Mubayi, V.

    1995-05-01

    The consequences of severe accidents at nuclear power plants can be limited by various protective actions, including emergency responses and long-term measures, to reduce exposures of affected populations. Each of these protective actions involve costs to society. The costs of the long-term protective actions depend on the criterion adopted for the allowable level of long-term exposure. This criterion, called the ``long term interdiction limit,`` is expressed in terms of the projected dose to an individual over a certain time period from the long-term exposure pathways. The two measures of offsite consequences, latent cancers and costs, are inversely related and the choice of an interdiction limit is, in effect, a trade-off between these two measures. By monetizing the health effects (through ascribing a monetary value to life lost), the costs of the two consequence measures vary with the interdiction limit, the health effect costs increasing as the limit is relaxed and the protective action costs decreasing. The minimum of the total cost curve can be used to calculate an optimal long term interdiction limit. The calculation of such an optimal limit is presented for each of five US nuclear power plants which were analyzed for severe accident risk in the NUREG-1150 program by the Nuclear Regulatory Commission.

  5. 42 CFR 447.72 - Alternative premium and cost sharing exemptions and protections for individuals with family...

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 4 2013-10-01 2013-10-01 false Alternative premium and cost sharing exemptions and....72 Section 447.72 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND... Provisions Alternative Premiums and Cost Sharing Under Section 1916a § 447.72 Alternative premium and...

  6. 42 CFR 447.72 - Alternative premium and cost sharing exemptions and protections for individuals with family...

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 4 2012-10-01 2012-10-01 false Alternative premium and cost sharing exemptions and....72 Section 447.72 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND... Provisions Alternative Premiums and Cost Sharing Under Section 1916a § 447.72 Alternative premium and...

  7. 42 CFR 447.72 - Alternative premium and cost sharing exemptions and protections for individuals with family...

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 4 2011-10-01 2011-10-01 false Alternative premium and cost sharing exemptions and....72 Section 447.72 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND... Provisions Alternative Premiums and Cost Sharing Under Section 1916a § 447.72 Alternative premium and...

  8. Evaluating the long-term performance of low-cost adsorbents using small-scale adsorption column experiments.

    PubMed

    Callery, O; Healy, M G; Rognard, F; Barthelemy, L; Brennan, R B

    2016-09-15

    This study investigated a novel method of predicting the long-term phosphorus removal performance of large-scale adsorption filters, using data derived from short-term, small-scale column experiments. The filter media investigated were low-cost adsorbents such as aluminum sulfate drinking water treatment residual, ferric sulfate drinking water treatment residual, and fine and coarse crushed concretes. Small-bore adsorption columns were loaded with synthetic wastewater, and treated column effluent volume was plotted against the mass of phosphorus adsorbed per unit mass of filter media. It was observed that the curve described by the data strongly resembled that of a standard adsorption isotherm created from batch adsorption data. Consequently, it was hypothesized that an equation following the form of the Freundlich isotherm would describe the relationship between filter loading and media saturation. Moreover, the relationship between filter loading and effluent concentration could also be derived from this equation. The proposed model was demonstrated to accurately predict the performance of large-scale adsorption filters over a period of up to three months with a very high degree of accuracy. Furthermore, the coefficients necessary to produce said model could be determined from just 24 h of small-scale experimental data. PMID:27295617

  9. Cost-Effectiveness of a Long-Term Internet-Delivered Worksite Health Promotion Programme on Physical Activity and Nutrition: A Cluster Randomized Controlled Trial

    ERIC Educational Resources Information Center

    Robroek, Suzan J. W.; Polinder, Suzanne; Bredt, Folef J.; Burdorf, Alex

    2012-01-01

    This study aims to evaluate the cost-effectiveness of a long-term workplace health promotion programme on physical activity (PA) and nutrition. In total, 924 participants enrolled in a 2-year cluster randomized controlled trial, with departments (n = 74) within companies (n = 6) as the unit of randomization. The intervention was compared with a…

  10. Long-Term Care

    MedlinePlus

    ... this page please turn Javascript on. Long-Term Care What Is Long-Term Care? Long-term care involves a variety of services ... the Escape (Esc) button on your keyboard.) Most Care Provided at Home Long-term care is provided ...

  11. Excess costs of dementia disorders and the role of age and gender - an analysis of German health and long-term care insurance claims data

    PubMed Central

    2012-01-01

    Background Demographic ageing is associated with an increasing number of dementia patients, who reportedly incur higher costs of care than individuals without dementia. Regarding Germany, evidence on these excess costs is scarce. Adopting a payer perspective, our study aimed to quantify the additional yearly expenditures per dementia patient for various health and long-term care services. Additionally, we sought to identify gender-specific cost patterns and to describe age-dependent cost profiles. Methods The analyses used 2006 claims data from the AOK Bavaria Statutory Health Insurance fund of 9,147 dementia patients and 29,741 age- and gender-matched control subjects. Cost predictions based on two-part regression models adjusted for age and gender and excess costs of dementia care refer to the difference in model-estimated means between both groups. Corresponding analyses were performed stratified for gender. Finally, a potentially non-linear association between age and costs was investigated within a generalized additive model. Results Yearly spending within the social security system was circa €12,300 per dementia patient and circa €4,000 per non-demented control subject. About two-thirds of the additional expenditure for dementia patients occurred in the long-term care sector. Within our study sample, male and female dementia patients incurred comparable total costs. However, women accounted for significantly lower health and significantly higher long-term care expenditures. Long-term care spending increased in older age, whereupon health care spending decreased. Thus, at more advanced ages, women incurred greater costs than men of the same age. Conclusions Dementia poses a substantial additional burden to the German social security system, with the long-term care sector being more seriously challenged than the health care sector. Our results suggest that female dementia patients need to be seen as a key target group for health services research in an

  12. The cost-effectiveness of short-term and long-term psychotherapy in the treatment of depressive and anxiety disorders during a 5-year follow-up.

    PubMed

    Maljanen, Timo; Knekt, Paul; Lindfors, Olavi; Virtala, Esa; Tillman, Päivi; Härkänen, Tommi

    2016-01-15

    Both short-term and long-term psychotherapies are used extensively in treating different mental disorders, but there have been practically no attempts to compare their cost-effectiveness. The aim of this study, which is part of the Helsinki Psychotherapy Study, is to assess the cost-effectiveness of two short-term therapies compared to that of a long-term therapy. In this study 326 outpatients suffering from mood or anxiety disorder were randomized to solution-focused therapy (SFT), short-term psychodynamic psychotherapy (SPP) or to long-term psychodynamic psychotherapy (LPP). Psychiatric symptoms and working ability were assessed at baseline and then 4-9 times during a 5-year follow-up using eight widely used measures including e.g. Beck Depression Inventory (BDI), Hamilton Depression Rating Scale (HDRS), Symptom Check List, anxiety scale (SCL-90-Anx), Hamilton Anxiety Rating Scale (HARS), Symptom Check List, Global Severity Index (SCL-90-GSI), and the Work-subscale (SAS-Work) of the Social Adjustment Scale (SAS-SR). Both direct and indirect costs were measured. During the 5-year follow-up period statistically significant improvements were observed in all health indicators in all therapy groups. At first the recovery was faster in the short-term therapy groups than in the LPP group, but taking the whole follow-up period into account, the effectiveness of the LPP was somewhat greater than that of the short-term therapies. Especially the direct costs were, however, much higher in the LPP group than in the short-term therapy groups. Thus the long-term therapy can hardly be regarded as cost-effective compared to short-term therapies when patients are randomized to the therapy groups. PMID:26540079

  13. Change in healthcare utilization and costs following initiation of benzodiazepine therapy for long-term treatment of generalized anxiety disorder: a retrospective cohort study

    PubMed Central

    2012-01-01

    Background Selective serotonin reuptake inhibitors, serotonin-norepinephrine reuptake inhibitors, and benzodiazepine anxiolytics are used in the US to treat generalized anxiety disorder (GAD). While benzodiazepines typically provide rapid symptomatic relief, long-term use is not recommended due to risks of dependency, sedation, falls, and accidents. Methods Using a US health insurance database, we identified all persons with GAD (ICD-9-CM diagnosis code 300.02) who began a long-term course of treatment (≥90 days) with a benzodiazepine anxiolytic between 1/1/2003 and 12/31/2007, We compared healthcare utilization and costs over the six-month periods preceding and following the date of treatment initiation (“pretreatment” and “post-treatment”, respectively), and focused attention on accident-related encounters (e.g., for treatment of fractures) and care received for other reasons possibly related benzodiazepine use (e.g., sedation, dizziness). Results A total of 866 patients met all study entry criteria; 25% of patients began treatment on an add-on basis (i.e., adjunctive to escitalopram, paroxetine, sertraline, or venlafaxine), while 75% of patients did not receive concomitant therapy. Mean total healthcare costs increased by $2334 between the pretreatment and post-treatment periods (from $4637 [SD=$9840] to $6971 [$17,002]; p<0.01); costs of accident-related encounters and other care that was possibly related to use of benzodiazepines increased by an average of $1099 ($1757 [$7656] vs $2856 [$14,836]; p=0.03). Conclusions Healthcare costs increase in patients with GAD beginning long-term (≥90 days) treatment with a benzodiazepine anxiolytic; a substantial proportion of this increase is attributable to care associated with accidents and other known sequelae of long-term benzodiazepine use. PMID:23088742

  14. 5 CFR 894.402 - Do the premiums I pay reflect the cost of providing benefits?

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 5 Administrative Personnel 2 2014-01-01 2014-01-01 false Do the premiums I pay reflect the cost of providing benefits? 894.402 Section 894.402 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) CIVIL SERVICE REGULATIONS (CONTINUED) FEDERAL EMPLOYEES DENTAL AND VISION INSURANCE PROGRAM...

  15. 5 CFR 894.402 - Do the premiums I pay reflect the cost of providing benefits?

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 5 Administrative Personnel 2 2013-01-01 2013-01-01 false Do the premiums I pay reflect the cost of providing benefits? 894.402 Section 894.402 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) CIVIL SERVICE REGULATIONS (CONTINUED) FEDERAL EMPLOYEES DENTAL AND VISION INSURANCE PROGRAM...

  16. 5 CFR 894.402 - Do the premiums I pay reflect the cost of providing benefits?

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 5 Administrative Personnel 2 2011-01-01 2011-01-01 false Do the premiums I pay reflect the cost of providing benefits? 894.402 Section 894.402 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) CIVIL SERVICE REGULATIONS (CONTINUED) FEDERAL EMPLOYEES DENTAL AND VISION INSURANCE PROGRAM...

  17. 5 CFR 894.402 - Do the premiums I pay reflect the cost of providing benefits?

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 5 Administrative Personnel 2 2012-01-01 2012-01-01 false Do the premiums I pay reflect the cost of providing benefits? 894.402 Section 894.402 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) CIVIL SERVICE REGULATIONS (CONTINUED) FEDERAL EMPLOYEES DENTAL AND VISION INSURANCE PROGRAM...

  18. 42 CFR 447.62 - Alternative premiums and cost sharing: Basis, purpose and scope.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 4 2012-10-01 2012-10-01 false Alternative premiums and cost sharing: Basis, purpose and scope. 447.62 Section 447.62 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS PAYMENTS FOR...

  19. 42 CFR 447.78 - Aggregate limits on alternative premiums and cost sharing.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 4 2013-10-01 2013-10-01 false Aggregate limits on alternative premiums and cost sharing. 447.78 Section 447.78 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS PAYMENTS FOR SERVICES Payments:...

  20. 42 CFR 447.80 - Enforceability of alternative premiums and cost sharing.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 4 2013-10-01 2013-10-01 false Enforceability of alternative premiums and cost sharing. 447.80 Section 447.80 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS PAYMENTS FOR SERVICES Payments:...

  1. 42 CFR 447.78 - Aggregate limits on alternative premiums and cost sharing.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 4 2012-10-01 2012-10-01 false Aggregate limits on alternative premiums and cost sharing. 447.78 Section 447.78 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS PAYMENTS FOR SERVICES Payments:...

  2. 42 CFR 447.78 - Aggregate limits on alternative premiums and cost sharing.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 4 2011-10-01 2011-10-01 false Aggregate limits on alternative premiums and cost sharing. 447.78 Section 447.78 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS PAYMENTS FOR SERVICES Payments:...

  3. 42 CFR 447.62 - Alternative premiums and cost sharing: Basis, purpose and scope.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 4 2011-10-01 2011-10-01 false Alternative premiums and cost sharing: Basis, purpose and scope. 447.62 Section 447.62 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS PAYMENTS FOR...

  4. 42 CFR 447.62 - Alternative premiums and cost sharing: Basis, purpose and scope.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 4 2013-10-01 2013-10-01 false Alternative premiums and cost sharing: Basis, purpose and scope. 447.62 Section 447.62 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS PAYMENTS FOR...

  5. 42 CFR 447.80 - Enforceability of alternative premiums and cost sharing.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 4 2012-10-01 2012-10-01 false Enforceability of alternative premiums and cost sharing. 447.80 Section 447.80 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS PAYMENTS FOR SERVICES Payments:...

  6. 42 CFR 447.78 - Aggregate limits on alternative premiums and cost sharing.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false Aggregate limits on alternative premiums and cost sharing. 447.78 Section 447.78 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS PAYMENTS FOR SERVICES Payments:...

  7. 42 CFR 447.62 - Alternative premiums and cost sharing: Basis, purpose and scope.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false Alternative premiums and cost sharing: Basis, purpose and scope. 447.62 Section 447.62 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS PAYMENTS FOR...

  8. 5 CFR 894.402 - Do the premiums I pay reflect the cost of providing benefits?

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 5 Administrative Personnel 2 2010-01-01 2010-01-01 false Do the premiums I pay reflect the cost of providing benefits? 894.402 Section 894.402 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) CIVIL SERVICE REGULATIONS (CONTINUED) FEDERAL EMPLOYEES DENTAL AND VISION INSURANCE PROGRAM...

  9. Modeling Costs and Impacts of Introducing Early Infant Male Circumcision for Long-Term Sustainability of the Voluntary Medical Male Circumcision Program.

    PubMed

    Njeuhmeli, Emmanuel; Stegman, Peter; Kripke, Katharine; Mugurungi, Owen; Ncube, Gertrude; Xaba, Sinokuthemba; Hatzold, Karin; Christensen, Alice; Stover, John

    2016-01-01

    Voluntary medical male circumcision (VMMC) has been shown to be an effective prevention strategy against HIV infection in males [1-3]. Since 2007, the President's Emergency Plan for AIDS Relief (PEPFAR) has supported VMMC programs in 14 priority countries in Africa. Today several of these countries are preparing to transition their VMMC programs from a scale-up and expansion phase to a maintenance phase. As they do so, they must consider the best approaches to sustain high levels of male circumcision in the population. The two alternatives under consideration are circumcising adolescents 10-14 years old over the long term or integrating early infant male circumcision (EIMC) into maternal and child health programs. The paper presents an analysis, using the Decision Makers Program Planning Tool, Version 2.0 (DMPPT 2.0), of the estimated cost and impact of introducing EIMC into existing VMMC programs in several countries in eastern and southern Africa. Limited cost data exist for the implementation of EIMC, but preliminary studies, such as the one detailed in Mangenah, et al. [4-5], suggest that the cost of EIMC may be less than that of adolescent and adult male circumcision. If this is the case, then adding EIMC to the VMMC program will increase the number of circumcisions that need to be performed but will not increase the total cost of the program over the long term. In addition, we found that a delayed or slow start-up of EIMC would not substantially reduce the impact of adding it to the program or increase cumulative long-term costs, which should make introduction of EIMC more feasible and attractive to countries contemplating such a program innovation. PMID:27410233

  10. Modeling Costs and Impacts of Introducing Early Infant Male Circumcision for Long-Term Sustainability of the Voluntary Medical Male Circumcision Program

    PubMed Central

    Stegman, Peter; Kripke, Katharine; Mugurungi, Owen; Ncube, Gertrude; Xaba, Sinokuthemba; Hatzold, Karin; Christensen, Alice; Stover, John

    2016-01-01

    Voluntary medical male circumcision (VMMC) has been shown to be an effective prevention strategy against HIV infection in males [1–3]. Since 2007, the President’s Emergency Plan for AIDS Relief (PEPFAR) has supported VMMC programs in 14 priority countries in Africa. Today several of these countries are preparing to transition their VMMC programs from a scale-up and expansion phase to a maintenance phase. As they do so, they must consider the best approaches to sustain high levels of male circumcision in the population. The two alternatives under consideration are circumcising adolescents 10–14 years old over the long term or integrating early infant male circumcision (EIMC) into maternal and child health programs. The paper presents an analysis, using the Decision Makers Program Planning Tool, Version 2.0 (DMPPT 2.0), of the estimated cost and impact of introducing EIMC into existing VMMC programs in several countries in eastern and southern Africa. Limited cost data exist for the implementation of EIMC, but preliminary studies, such as the one detailed in Mangenah, et al. [4–5], suggest that the cost of EIMC may be less than that of adolescent and adult male circumcision. If this is the case, then adding EIMC to the VMMC program will increase the number of circumcisions that need to be performed but will not increase the total cost of the program over the long term. In addition, we found that a delayed or slow start-up of EIMC would not substantially reduce the impact of adding it to the program or increase cumulative long-term costs, which should make introduction of EIMC more feasible and attractive to countries contemplating such a program innovation. PMID:27410233

  11. Can biochar serve as a toop to reduce soil GHG costs of agricultural production in the long term?

    NASA Astrophysics Data System (ADS)

    Kammann, Claudia; Finke, Christoph; Schröder, Matthias; Schmidt, Hans-Peter; Lima, Amanda; Teixeira, Wenceslau; Clough, Tim; Müller, Christoph

    2013-04-01

    With a growing world population and growing demands for bioenergy there is an urgent need to improve the greenhouse gas (GHG) emission-to-yield ratio of agricultural production. 'Young, production-fresh biochar has repeatedly been observed to reduce N2O emissions in a variety of agricultural soils, but it is unknown how long initial N2O-reducing effects will persist. Biochar-amended soils may even develop a potential for higher N2O emissions decades after Biochar application due to the formation of higher soil organic matter stocks when mineral N is applied. Unfortunately the longest-running field trials are not older than a few years, thus our ability for predictions is rather limited. To investigate the long-term effect that Biochar addition to soils may have on soil GHG emissions we conducted three different laboratory incubation studies with potential 'long-term analogs' that may offer insights: (I) N-rich Biochar-manure compost, versus pure manure-compost, or manure-compost were the same amount of untreated, fresh Biochar was added; (II) temperate soil from a 100-year old charcoal making (kiln) site in Germany compared to the original adjacent forest soil; and (III) two tropical Terra preta soils (secondary forest and cultivation) compared to their respective adjacent ferralsols. None of the studies indicated that old, "aged" Biochar in soils or substrates will increase the risk for N2O losses. The Biochar-compost (I) still had significantly reduced N2O emissions, or was the same as the control. However, its biological activity (respiration) was significantly increased (122% of ctrl). In contrast, the fresh Biochar addition significantly reduced N2O emissions to 39% of the control, accompanied by significantly reduced respiration rates (50% of ctrl.). The kiln-area soil (II), compared to the corresponding adjacent forest soil (both at 60% of their respective WHCmax), did not exhibit higher N2O emissions after N-fertilization over the course of one month. The

  12. Long-term cost-effectiveness of initiating treatment for painful diabetic neuropathy with pregabalin, duloxetine, gabapentin, or desipramine.

    PubMed

    Bellows, Brandon K; Nelson, Richard E; Oderda, Gary M; LaFleur, Joanne

    2016-01-01

    Painful diabetic neuropathy (PDN) affects nearly half of patients with diabetes. The objective of this study was to compare the cost-effectiveness of starting patients with PDN on pregabalin (PRE), duloxetine (DUL), gabapentin (GABA), or desipramine (DES) over a 10-year time horizon from the perspective of third-party payers in the United States. A Markov model was used to compare the costs (2013 $US) and effectiveness (quality-adjusted life-years [QALYs]) of first-line PDN treatments in 10,000 patients using microsimulation. Costs and QALYs were discounted at 3% annually. Probabilities and utilities were derived from the published literature. Costs were average wholesale price for drugs and national estimates for office visits and hospitalizations. One-way and probabilistic (PSA) sensitivity analyses were used to examine parameter uncertainty. Starting with PRE was dominated by DUL as DUL cost less and was more effective. Starting with GABA was extendedly dominated by a combination of DES and DUL. DES and DUL cost $23,468 and $25,979, while yielding 3.05 and 3.16 QALYs, respectively. The incremental cost-effectiveness ratio for DUL compared with DES was $22,867/QALY gained. One-way sensitivity analysis showed that the model was most sensitive to the adherence threshold and utility for mild pain. PSA showed that, at a willingness-to-pay (WTP) of $50,000/QALY, DUL was the most cost-effective option in 56.3% of the simulations, DES in 29.2%, GABA in 14.4%, and PRE in 0.1%. Starting with DUL is the most cost-effective option for PDN when WTP is greater than $22,867/QALY. Decision makers may consider starting with DUL for PDN patients. PMID:26397932

  13. Long-term calorie restriction decreases metabolic cost of movement and prevents decrease of physical activity during aging in the rhesus monkeys

    PubMed Central

    Yamada, Yosuke; Colman, Ricki J; Kemnitz, Joseph W.; Baum, Scott T.; Anderson, Rozalyn M.; Weindruch, Richard; Schoeller, Dale A.

    2013-01-01

    Background Short-term (<1 year) calorie restriction (CR) has been reported to decrease physical activity and metabolic rate in humans and non-human primate models; however, studies examining the very long-term (>10 year) effect of CR on these parameters are lacking. Objective The objective of this study was to examine metabolic and behavioral adaptations to long-term CR longitudinally in rhesus macaques. Design Eighteen (10 male, 8 female) control (C) and 24 (14 male, 10 female) age matched CR rhesus monkeys between 19.6 and 31.9 years old were examined after 13 and 18 years of moderate adult-onset CR. Energy expenditure (EE) was examined by doubly labeled water (DLW; TEE) and respiratory chamber (24hrEE). Physical activity was assessed both by metabolic equivalent (MET) in a respiratory chamber and by an accelerometer. Metabolic cost of movements during 24h were also calculated. Age and fat-free mass were included as covariates. Results Adjusted total and 24hr EE were not different between C and CR. Sleeping metabolic rate was significantly lower, and physical activity level was higher in CR than in C independent from the CR-induced changes in body composition. The duration of physical activity above 1.6 METs was significantly higher in CR than in C, and CR had significantly higher accelerometer activity counts than C. Metabolic cost of movements during 24h were significantly lower in CR than in C. The accelerometer activity counts were significantly decreased after seven years in C animals, but not in CR animals. Conclusions The results suggest that long-term CR decreases basal metabolic rate, but maintains higher physical activity with lower metabolic cost of movements compared with C. PMID:23954367

  14. Managing Threat, Cost, and Incentive to Kill: The Short- and Long-Term Effects of Intervention in Mass Killings

    ERIC Educational Resources Information Center

    Kathman, Jacob D.; Wood, Reed M.

    2011-01-01

    How do third-party interventions affect the severity of mass killings? The authors theorize that episodes of mass killing are the consequence of two factors: (1) the threat perceptions of the perpetrators and (2) the cost of implementing genocidal policies relative to other alternatives. To reduce genocidal hostilities, interveners must address…

  15. Long-term effects of penicillin resistance and fitness cost on pneumococcal transmission dynamics in a developed setting

    PubMed Central

    Tilevik, Diana

    2016-01-01

    Background The increasing prevalence of penicillin non-susceptible pneumococci (PNSP) throughout the world threatens successful treatment of infections caused by this important bacterial pathogen. The rate at which PNSP clones spread in the community is thought to mainly be determined by two key determinants; the volume of penicillin use and the magnitude of the fitness cost in the absence of treatment. The aim of the study was to determine the impacts of penicillin consumption and fitness cost on pneumococcal transmission dynamics in a developed country setting. Methods An individual-based network model based on real-life demographic data was constructed and applied in a developed country setting (Sweden). A population structure with transmission of carriage taking place within relevant mixing groups, i.e. families, day care groups, school classes, and other close contacts, was considered to properly assess the transmission dynamics for susceptible and PNSP clones. Several scenarios were simulated and model outcomes were statistically analysed. Results Model simulations predicted that with an outpatient penicillin use corresponding to the sales in Sweden 2010 (118 recipes per 1,000 inhabitants per year), the magnitude of a fitness cost for resistance must be at least 5% to offset the advantage of penicillin resistance. Moreover, even if there is a fitness cost associated with penicillin resistance, a considerable reduction of penicillin usage appears to be required to significantly decrease the incidence of PNSP in a community. Conclusion The frequency of PNSP clones is hard to reverse by simply reducing the penicillin consumption even if there is a biological cost associated with resistance. However, because penicillin usage does promote further spread of PNSP clones, it is important to keep down penicillin consumption considering future resistance problems. PMID:27206408

  16. Medicaid program; premiums and cost sharing. Final rule with comment period.

    PubMed

    2010-05-28

    This final rule revises the November 25, 2008 final rule entitled, "Medicaid Programs; Premiums and Cost Sharing (73 FR 71828)," to address public comments received during reopened comment periods, and to reflect relevant statutory changes made in section 5006(a) of the American Recovery and Reinvestment Act of 2009 (the Recovery Act). This revised final rule implements and interprets section 1916A of the Social Security Act (the Act), which was added by sections 6041, 6042, and 6043 of the Deficit Reduction Act of 2005 (DRA), amended by section 405(a)(1) of the Tax Relief and Health Care Act of 2006 (TRHCA) and further amended by section 5006(a) of the American Recovery and Reinvestment Act of 2009 (the Recovery Act). These provisions increase State flexibility to impose premiums and cost sharing for coverage of certain individuals whose family income exceeds specified levels. This revised rule also provides a further opportunity for public comment on revisions made to implement and interpret section 5006(a) of the Recovery Act. The Recovery Act prohibits States from charging premiums and cost sharing under Medicaid to Indians furnished items or services directly by the Indian Health Service, Indian Tribes, Tribal Organizations, or Urban Indian Organizations or through referral under contract health services. PMID:20509237

  17. Long-term healthcare use and costs in patients with stable coronary artery disease: a population-based cohort using linked health records (CALIBER)

    PubMed Central

    Walker, Simon; Asaria, Miqdad; Manca, Andrea; Palmer, Stephen; Gale, Chris P.; Shah, Anoop Dinesh; Abrams, Keith R.; Crowther, Michael; Timmis, Adam; Hemingway, Harry; Sculpher, Mark

    2016-01-01

    Aims To examine long-term healthcare utilization and costs of patients with stable coronary artery disease (SCAD). Methods and results Linked cohort study of 94 966 patients with SCAD in England, 1 January 2001 to 31 March 2010, identified from primary care, secondary care, disease, and death registries. Resource use and costs, and cost predictors by time and 5-year cardiovascular disease (CVD) risk profile were estimated using generalized linear models. Coronary heart disease hospitalizations were 20.5% in the first year and 66% in the year following a non-fatal (myocardial infarction, ischaemic or haemorrhagic stroke) event. Mean healthcare costs were £3133 per patient in the first year and £10 377 in the year following a non-fatal event. First-year predictors of cost included sex (mean cost £549 lower in females), SCAD diagnosis (non-ST-elevation myocardial infarction cost £656 more than stable angina), and co-morbidities (heart failure cost £657 more per patient). Compared with lower risk patients (5-year CVD risk 3.5%), those of higher risk (5-year CVD risk 44.2%) had higher 5-year costs (£23 393 vs. £9335) and lower lifetime costs (£43 020 vs. £116 888). Conclusion Patients with SCAD incur substantial healthcare utilization and costs, which varies and may be predicted by 5-year CVD risk profile. Higher risk patients have higher initial but lower lifetime costs than lower risk patients as a result of shorter life expectancy. Improved cardiovascular survivorship among an ageing CVD population is likely to require stratified care in anticipation of the burgeoning demand. PMID:27042338

  18. Long-term exposure of the isopod Porcellionides pruinosus to nickel: Costs in the energy budget and detoxification enzymes.

    PubMed

    Ferreira, Nuno G C; Cardoso, Diogo N; Morgado, Rui; Soares, Amadeu M V M; Loureiro, Susana

    2015-09-01

    Terrestrial isopods from the species Porcellionides pruinosus were exposed to the maximum allowed nickel concentration in the Canadian framework guideline (50 mg Ni/kg soil) and to 5× this concentration (250 mg Ni/kg soil). The exposure lasted for 28 days and was followed by a recovery period of 14 days where organisms were changed to clean soil. Organisms were sampled after 24 h, 48 h, 96 h, 7 days, 14 days, 21 days, and 28 days of exposure, and at days 35 and 42 during the recovery period. For each sampling time the acetylcholinesterase (AChE), glutathione-S-transferases (GST), catalase (CAT), lactate dehydrogenase (LDH) activities were determined as well as lipid peroxidation rate (LPO) along with lipids, carbohydrates, proteins content, energy available (Ea), energy consumption (Ec) and cellular energy allocation (CEA). The integrated biomarker response (IBR) was calculated for each sampling time as well as for each one of the above parameters. In addition, mortality was also recorded throughout the assay. The results obtained showed that nickel induced oxidative stress, evidenced by results on GST, GPx, CAT or LPO, but also on changes in the energy reserves content of these organisms. In addition, this study showed that these organisms possess a specific strategy to handle nickel toxicity. In this case, biomarkers were associated with costs in the energy budget, and the increase of energy reserves has a compensation for that cost. PMID:25985212

  19. JNK1 ablation in mice confers long-term metabolic protection from diet-induced obesity at the cost of moderate skin oxidative damage.

    PubMed

    Becattini, Barbara; Zani, Fabio; Breasson, Ludovic; Sardi, Claudia; D'Agostino, Vito Giuseppe; Choo, Min-Kyung; Provenzani, Alessandro; Park, Jin Mo; Solinas, Giovanni

    2016-09-01

    Obesity and insulin resistance are associated with oxidative stress, which may be implicated in the progression of obesity-related diseases. The kinase JNK1 has emerged as a promising drug target for the treatment of obesity and type 2 diabetes. JNK1 is also a key mediator of the oxidative stress response, which can promote cell death or survival, depending on the magnitude and context of its activation. In this article, we describe a study in which the long-term effects of JNK1 inactivation on glucose homeostasis and oxidative stress in obese mice were investigated for the first time. Mice lacking JNK1 (JNK1(-/-)) were fed an obesogenic high-fat diet (HFD) for a long period. JNK1(-/-) mice fed an HFD for the long term had reduced expression of antioxidant genes in their skin, more skin oxidative damage, and increased epidermal thickness and inflammation compared with the effects in control wild-type mice. However, we also observed that the protection from obesity, adipose tissue inflammation, steatosis, and insulin resistance, conferred by JNK1 ablation, was sustained over a long period and was paralleled by decreased oxidative damage in fat and liver. We conclude that compounds targeting JNK1 activity in brain and adipose tissue, which do not accumulate in the skin, may be safer and most effective.-Becattini, B., Zani, F., Breasson, L., Sardi, C., D'Agostino, V. G., Choo, M.-K., Provenzani, A., Park, J. M., Solinas, G. JNK1 ablation in mice confers long-term metabolic protection from diet-induced obesity at the cost of moderate skin oxidative damage. PMID:27230858

  20. A Low-cost data-logging platform for long-term field sensor deployment in caves

    NASA Astrophysics Data System (ADS)

    Cruz, M. A.; Myre, J. M.; Covington, M. D.

    2014-12-01

    Active karst systems are notoriously inhospitable environments for humans and equipment. Caves require equipment to cope with high humidity, high velocity flows, submersion, sediment loads, and harassment from local fauna. Equipment taken into caves is often considered "consumable" due to the extreme nature of cave environments and the difficulty of transport. Further, because many interesting monitoring locations within caves can be considered remote, it is ideal for electronic monitoring platforms to require minimal maintenance of parts and power supplies. To partially address the challenge of scientifically monitoring such environments, we have developed an arduino based platform for environmental monitoring of cave systems. The arduino is a general purpose open source microcontroller that is easily programmed with only a basic knowledge of the C programming language. The arduino is capable of controlling digital and analog electronics in a modular fashion. Using this capability, we have created a platform for monitoring CO2 levels in cave systems that costs one-tenth of a comparable commercial system while using a fraction of the power. The modular nature of the arduino system allows the incorporation of additional environmental sensors in the future.

  1. Long-Term Realism and Cost-Effectiveness: Primary Prevention in Combatting Cancer and Associated Inequalities Worldwide

    PubMed Central

    Bray, Freddie; Jemal, Ahmedin; Torre, Lindsey A.; Forman, David; Vineis, Paolo

    2015-01-01

    The global figure of 14 million new cancer cases in 2012 is projected to rise to almost 22 million by 2030, with the burden in low- and middle-income countries (LMICs) shifting from 59% to 65% of all cancer cases worldwide over this time. While the overheads of cancer care are set to rapidly increase in all countries worldwide irrespective of income, the limited resources to treat and manage the growing number of cancer patients in LMICs threaten national economic development. Current data collated in the recent second edition of The Cancer Atlas by the American Cancer Society and International Agency for Research on Cancer show that a substantial proportion of cancers are preventable and that prevention is cost-effective. Therefore, cancer control strategies within countries must prioritize primary and secondary prevention, alongside cancer management and palliative care and integrate these measures into existing health care plans. There are many examples of the effectiveness of prevention in terms of declining cancer rates and major risk factors, including an 80% decrease in liver cancer incidence rates among children and young adults following universal infant hepatitis B vaccination in Taiwan and a 46% reduction in smoking prevalence in Brazil after the implementation of a more aggressive tobacco control program beginning in 1989. Prevention can bring rich dividends in net savings but actions must be promoted and implemented. The successful approaches to combatting certain infectious diseases provide a model for implementing cancer prevention, particularly in LMICs, via the utilization of existing infrastructures for multiple purposes. PMID:26424777

  2. Knee Joint Distraction Compared to Total Knee Arthroplasty for Treatment of End Stage Osteoarthritis: Simulating Long-Term Outcomes and Cost-Effectiveness

    PubMed Central

    van der Woude, J. A. D.; Nair, S. C.; Custers, R. J. H.; van Laar, J. M.; Kuchuck, N. O.; Lafeber, F. P. J. G.; Welsing, P. M. J.

    2016-01-01

    Objective In end-stage knee osteoarthritis the treatment of choice is total knee arthroplasty (TKA). An alternative treatment is knee joint distraction (KJD), suggested to postpone TKA. Several studies reported significant and prolonged clinical improvement of KJD. To make an appropriate decision regarding the position of this treatment, a cost-effectiveness and cost-utility analysis from healthcare perspective for different age and gender categories was performed. Methods A treatment strategy starting with TKA and a strategy starting with KJD for patients of different age and gender was simulated. To extrapolate outcomes to long-term health and economic outcomes a Markov (Health state) model was used. The number of surgeries, QALYs, and treatment costs per strategy were calculated. Costs-effectiveness is expressed using the cost-effectiveness plane and cost-effectiveness acceptability curves. Results Starting with KJD the number of knee replacing procedures could be reduced, most clearly in the younger age categories; especially revision surgery. This resulted in the KJD strategy being dominant (more effective with cost-savings) in about 80% of simulations (with only inferiority in about 1%) in these age categories when compared to TKA. At a willingness to pay of 20.000 Euro per QALY gained, the probability of starting with KJD to be cost-effective compared to starting with a TKA was already found to be over 75% for all age categories and over 90–95% for the younger age categories. Conclusion A treatment strategy starting with knee joint distraction for knee osteoarthritis has a large potential for being a cost-effective intervention, especially for the relatively young patient. PMID:27171268

  3. Long-term Cost-Effectiveness of Diagnostic Tests for Assessing Stable Chest Pain: Modeled Analysis of Anatomical and Functional Strategies.

    PubMed

    Bertoldi, Eduardo G; Stella, Steffan F; Rohde, Luis E; Polanczyk, Carisi A

    2016-05-01

    Several tests exist for diagnosing coronary artery disease, with varying accuracy and cost. We sought to provide cost-effectiveness information to aid physicians and decision-makers in selecting the most appropriate testing strategy. We used the state-transitions (Markov) model from the Brazilian public health system perspective with a lifetime horizon. Diagnostic strategies were based on exercise electrocardiography (Ex-ECG), stress echocardiography (ECHO), single-photon emission computed tomography (SPECT), computed tomography coronary angiography (CTA), or stress cardiac magnetic resonance imaging (C-MRI) as the initial test. Systematic review provided input data for test accuracy and long-term prognosis. Cost data were derived from the Brazilian public health system. Diagnostic test strategy had a small but measurable impact in quality-adjusted life-years gained. Switching from Ex-ECG to CTA-based strategies improved outcomes at an incremental cost-effectiveness ratio of 3100 international dollars per quality-adjusted life-year. ECHO-based strategies resulted in cost and effectiveness almost identical to CTA, and SPECT-based strategies were dominated because of their much higher cost. Strategies based on stress C-MRI were most effective, but the incremental cost-effectiveness ratio vs CTA was higher than the proposed willingness-to-pay threshold. Invasive strategies were dominant in the high pretest probability setting. Sensitivity analysis showed that results were sensitive to costs of CTA, ECHO, and C-MRI. Coronary CT is cost-effective for the diagnosis of coronary artery disease and should be included in the Brazilian public health system. Stress ECHO has a similar performance and is an acceptable alternative for most patients, but invasive strategies should be reserved for patients at high risk. PMID:27080921

  4. State trends in premiums and deductibles, 2003-2010: the need for action to address rising costs.

    PubMed

    Schoen, Cathy; Fryer, Ashley-Kay; Collins, Sara R; Radley, David C

    2011-11-01

    Rapidly rising health insurance costs continue to strain the budgets of U.S. families and employers. This issue brief analyzes changes in private employer-based health premiums and deductibles for all states from 2003 to 2010, and finds total premiums for family coverage increased 50 percent across states and employee annual share of premiums increased by 63 percent over these seven years. At the same time, per-person deductibles doubled in large, as well as small, firms. If premium trends continue at the rate prior to enactment of the Affordable Care Act, the average premium for family coverage will rise 72 percent by 2020, to nearly $24,000. Health reform offers the potential to reduce insurance cost growth while improving financial protections. If efforts succeed in slowing annual premium growth by 1 percentage point, by 2020 employers and families together would save $2,161 annually for family coverage, compared with projected premiums at historical rates of increase. PMID:22097393

  5. Long-Term Effectiveness and Cost-Effectiveness of Metformin Combined with Liraglutide or Exenatide for Type 2 Diabetes Mellitus Based on the CORE Diabetes Model Study

    PubMed Central

    Zhang, Xuesong; Liu, Sisi; Li, Yukun; Wang, Yan; Tian, Meimei; Liu, Guoqiang

    2016-01-01

    Background Type 2 diabetes mellitus (T2DM) is associated with β cell impairment. Agonists of the glucagon-like peptide 1 (GLP-1) receptor (such as liraglutide and exenatide) can increase the number of pancreatic β cells and improve cell function. These drugs contribute to the long-term control of T2DM. Objective To evaluate the cost-effectiveness of metformin combined with liraglutide or exenatide in Chinese patient with T2DM. Methods Patients with T2DM from the Third Hospital of Hebei Medical University were treated with oral metformin combined with liraglutide (0.6 mg/day, could be increased by 0.6 mg weekly until 1.2 or 1.8 mg) or exenatide (5 μg bid for four weeks, increased to 10 μg bid). The computer simulation model CORE was used to calculate the 30-year expected life expectancy, quality-adjusted life years (QALY), direct costs, HbA1c levels, body mass index (BMI), and the incidence of cardiovascular, renal, and ocular complications of T2DM. Patients were followed up for 52 weeks. Medication costs were calculated according to retail prices in China. A 3% annual discount was adopted in this study. Results The 30-year simulation showed that the total direct medical costs were lower using liraglutide compared to exenatide by 2130 RMB/QALY yearly, while the expected life expectancy and QALY were increased by 0.471 years and 0.388, respectively, using liraglutide with an incremental cost-effectiveness of -11,550 RMB/QALYs. Conclusion Liraglutide 1.2 mg/day was superior to exenatide 10 μg bid with respect to cost-effectiveness in Chinese patients with T2DM. PMID:27304904

  6. Locked into Copenhagen pledges - Implications of short-term emission targets for the cost and feasibility of long-term climate goals

    SciTech Connect

    Riahi, Keywan; Kriegler, Elmar; Johnson, Nils; Bertram, Christoph; den Elzen, Michel; Eom, Jiyong; Schaeffer, Michiel; Edmonds, James A.; Isaac, Morna; Krey, Volker; Longden, Thomas; Luderer, Gunnar; Mejean, Aurelie; McCollum, David; Mima, Silvana; Turton, Hal; Van Vuuren, Detlef; Wada, Kenichi; Bosetti, Valentina; Capros, Pantelis; Criqui, Patrick; Hamdi-Cherif, Meriem; Kainuma, M.; Edenhofer, Ottmar

    2015-01-01

    This paper provides an overview of the AMPERE intermodeling comparison with focus on the implications of near-term policies for the costs and attainability of long-term climate objectives. Ten modeling teams participated in the project to explore the consequences of global emissions following the proposed policy stringency of the national pledges from the Copenhagen Accord and Cancún Agreements to 2030. Specific features compared to earlier assessments are the explicit consideration of near-term 2030 emissions targets as well as the systematic sensitivity analysis for the availability and potential of mitigation technologies. Our estimates show that a 2030 mitigation effort comparable to the pledges would result in a further "lock-in" of the energy system into fossil fuels and thus impede the required energy transformation to reach low greenhouse-gas stabilization levels (450ppm CO2e). Major implications include significant increases in mitigation costs, increased risk that low stabilization targets become unattainable, and reduced chances of staying below the proposed temperature change target of 2C. With respect to technologies, we find that following the pledge pathways to 2030 would narrow policy choices, and increases the risks that some currently optional technologies, such as nuclear or carbon capture and storage (CCS), will become "a must" by 2030.

  7. Long-term use and cost-effectiveness of secondary prevention drugs for heart disease in Western Australian seniors (WAMACH): a study protocol

    PubMed Central

    Gunnell, Anthony S; Knuiman, Matthew W; Geelhoed, Elizabeth; Hobbs, Michael S T; Katzenellenbogen, Judith M; Hung, Joseph; Rankin, Jamie M; Nedkoff, Lee; Briffa, Thomas G; Ortiz, Michael; Gillies, Malcolm; Cordingley, Anne; Messer, Mitch; Gardner, Christian; Lopez, Derrick; Atkins, Emily; Mai, Qun; Sanfilippo, Frank M

    2014-01-01

    Introduction Secondary prevention drugs for cardiac disease have been demonstrated by clinical trials to be effective in reducing future cardiovascular and mortality events (WAMACH is the Western Australian Medication Adherence and Costs in Heart disease study). Hence, most countries have adopted health policies and guidelines for the use of these drugs, and included them in government subsidised drug lists to encourage their use. However, suboptimal prescribing and non-adherence to these drugs remains a universal problem. Our study will investigate trends in dispensing patterns of drugs for secondary prevention of cardiovascular events and will also identify factors influencing these patterns. It will also assess the clinical and economic consequences of non-adherence and the cost-effectiveness of using these drugs. Methods and analysis This population-based cohort study will use longitudinal data on almost 40 000 people aged 65 years or older who were hospitalised in Western Australia between 2003 and 2008 for coronary heart disease, heart failure or atrial fibrillation. Linking of several State and Federal government administrative data sets will provide person-based information on drugs dispensed precardiac and postcardiac event, reasons for hospital admission, emergency department visits, mortality and medical visits. Dispensed drug trends will be described, drug adherence measured and their association with future all-cause/cardiovascular events will be estimated. The cost-effectiveness of these long-term therapies for cardiac disease and the impact of adherence will be evaluated. Ethics and dissemination Human Research Ethics Committee (HREC) approvals have been obtained from the Department of Health (Western Australian #2011/62 and Federal) and the University of Western Australia (RA/4/1/1130), in addition to HREC approvals from all participating hospitals. Findings will be published in peer-reviewed medical journals and presented at local, national and

  8. 47 CFR 54.303 - Long term support.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 47 Telecommunication 3 2010-10-01 2010-10-01 false Long term support. 54.303 Section 54.303... SERVICE Universal Service Support for High Cost Areas § 54.303 Long term support. (a) Beginning January 1... shall receive Long Term Support. Beginning July 1, 2004, no carrier shall receive Long Term Support....

  9. 47 CFR 54.303 - Long term support.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 47 Telecommunication 3 2011-10-01 2011-10-01 false Long term support. 54.303 Section 54.303... SERVICE Universal Service Support for High Cost Areas § 54.303 Long term support. (a) Beginning January 1... shall receive Long Term Support. Beginning July 1, 2004, no carrier shall receive Long Term Support....

  10. Long-term room-temperature hydrazine/air fuel cells based on low-cost nanotextured Cu-Ni catalysts

    NASA Astrophysics Data System (ADS)

    Filanovsky, Boris; Granot, Eran; Presman, Igor; Kuras, Iliya; Patolsky, Fernando

    2014-01-01

    We present here a long-term room-temperature (RT) direct-liquid hydrazine/air fuel cell device. This hydrazine/air fuel cell is based on low-cost easily-prepared nanotextured Cu-Ni anodes as the hydrazine (Hz) catalyst, combined with a commercial anion-exchange membrane film and a commercial air cathode. In addition, our hydrazine/air fuel cell consists on an improved novel design that results in remarkably high mechanical and chemical stabilities for long periods of operation. This hydrazine/air fuel cell can operates continuously for about ∼2000 h (limited mainly by cathode and membrane deterioration) with continuous fuel supply, and supplies about 0.58 V at 1 A (14.3 mA cm-2, with a discharge efficiency of about 70% (drift is less than 0.01% h-1), and appears to be suitable for mass production. The use of optimally-combined multi-metal electrodes suggests the possibility to create novel catalysts of improved electrochemical efficiency and stability. Our fuel cell devices can find broad applications in different civilian and military field mobile and stationary uses, for instance, in future fuel-cell operated vehicles and stationary back-up power electrical stations.

  11. 47 CFR 32.4200 - Long term debt and funded debt.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 47 Telecommunication 2 2011-10-01 2011-10-01 false Long term debt and funded debt. 32.4200 Section....4200 Long term debt and funded debt. (a) This account shall include: (1) The total face amount of... more than one year from date of issue. (2) The premium associated with all classes of long-term...

  12. 47 CFR 32.4200 - Long term debt and funded debt.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 47 Telecommunication 2 2013-10-01 2013-10-01 false Long term debt and funded debt. 32.4200 Section....4200 Long term debt and funded debt. (a) This account shall include: (1) The total face amount of... more than one year from date of issue. (2) The premium associated with all classes of long-term...

  13. 47 CFR 32.4200 - Long term debt and funded debt.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 47 Telecommunication 2 2012-10-01 2012-10-01 false Long term debt and funded debt. 32.4200 Section....4200 Long term debt and funded debt. (a) This account shall include: (1) The total face amount of... more than one year from date of issue. (2) The premium associated with all classes of long-term...

  14. 47 CFR 32.4200 - Long term debt and funded debt.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 47 Telecommunication 2 2010-10-01 2010-10-01 false Long term debt and funded debt. 32.4200 Section....4200 Long term debt and funded debt. (a) This account shall include: (1) The total face amount of... more than one year from date of issue. (2) The premium associated with all classes of long-term...

  15. 47 CFR 32.4200 - Long term debt and funded debt.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 47 Telecommunication 2 2014-10-01 2014-10-01 false Long term debt and funded debt. 32.4200 Section....4200 Long term debt and funded debt. (a) This account shall include: (1) The total face amount of... more than one year from date of issue. (2) The premium associated with all classes of long-term...

  16. PGE(1) treatment of severe intermittent claudication (short-term versus long-term, associated with exercise)--efficacy and costs in a 20-week, randomized trial.

    PubMed

    Belcaro, G; Nicolaides, A N; Agus, G; Cesarone, M R; Geroulakos, G; Pellegrini, L; De Sanctis, M T; Incandela, L; Ricci, A; Mondani, P; De Angelis, R; Ippolito, E; Barsotti, A; Vasdekis, S; Ledda, A; Christopoulos, D; Errichi, B M; Helmis, H; Cornelli, U; Ramaswami, G; Dugall, M; Bucci, M; Martines, G; Ferrari, P G; Corsi, M; Di Francescantonio, D

    2000-08-01

    The efficacy, safety, and cost of prostaglandin E1 (PGE1) in the treatment of severe intermittent claudication was studied comparing a long-term treatment protocol (LTP) with a short-term treatment protocol (STP) in a randomized 20-week study. The study included 980 patients (883 completed the study) with an average total walking distance of 85.5 +/-10 m (range 22-119). Phase 1 was a 2-week run-in phase (no treatment) for both protocols. In LTP, phase 2 was the main treatment phase. In the LTP, treatment was performed with 2-hour infusions (60 microg PGE1, 5 days each week for 4 weeks. In phase 3 (4-week interval period) PGE1 was administered twice a week (same dosage). In phase 4 (monitoring lasting 3 months, from week 9 to 20) no drugs were used. In STP phase 2 treatment was performed in 2 days by a 2-hour infusion (first day: morning 20 microg, afternoon 40 microg; second day morning and afternoon 60 microg). The reduced dosage was used only at the first cycle (week 0) to evaluate tolerability or side effects. Full dosage (60 microg bid) was used for all other cycles. The same cycle was repeated at the beginning of weeks 4, 8, and 12. The observation period was between weeks 12 and 20. A treadmill test was performed at inclusion, at the beginning of each phase, and at the end of 20th week. A similar progressive physical training plan (based on walking) and a reduction in risk factors levels plan was used in both groups. Intention-to-treat analysis indicated an increase in walking distance, which improved at 4 weeks and at 20 weeks in the STP more than in the LTP group. At 4 weeks the variation (increase) in pain-free walking (PFWD) was 167.8% (of the initial value) in the LTP group and 185% in the STP group (p<0.05). At 4 weeks the variation (increase) in total walking distance (TWD) was 227.6% of the initial value in the LTP group and 289% in the STP group (p<0.05). At 20 weeks the increase in PFWD was 496% of the initial value in the LTP group vs 643% in the

  17. 42 CFR 447.74 - Alternative premium and cost sharing protections for individuals with family incomes above 150...

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 4 2013-10-01 2013-10-01 false Alternative premium and cost sharing protections for individuals with family incomes above 150 percent of the FPL. 447.74 Section 447.74 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED)...

  18. 42 CFR 447.71 - Alternative premium and cost sharing exemptions and protections for individuals with family...

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 4 2013-10-01 2013-10-01 false Alternative premium and cost sharing exemptions and... outpatient department or other alternative non-emergency services health care provider in the geographic area... Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN...

  19. 42 CFR 447.74 - Alternative premium and cost sharing protections for individuals with family incomes above 150...

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 4 2011-10-01 2011-10-01 false Alternative premium and cost sharing protections for individuals with family incomes above 150 percent of the FPL. 447.74 Section 447.74 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED)...

  20. 42 CFR 447.71 - Alternative premium and cost sharing exemptions and protections for individuals with family...

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 4 2011-10-01 2011-10-01 false Alternative premium and cost sharing exemptions and... outpatient department or other alternative non-emergency services health care provider in the geographic area... Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN...

  1. 42 CFR 447.71 - Alternative premium and cost sharing exemptions and protections for individuals with family...

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 4 2012-10-01 2012-10-01 false Alternative premium and cost sharing exemptions and... outpatient department or other alternative non-emergency services health care provider in the geographic area... Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN...

  2. 42 CFR 447.74 - Alternative premium and cost sharing protections for individuals with family incomes above 150...

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 4 2012-10-01 2012-10-01 false Alternative premium and cost sharing protections for individuals with family incomes above 150 percent of the FPL. 447.74 Section 447.74 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED)...

  3. 42 CFR 422.270 - Incorrect collections of premiums and cost-sharing.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ...) Means amounts that- (A) Exceed the limits approved under § 422.262; (B) In the case of an MA private fee-for-service plan, exceed the MA monthly basic beneficiary premium or the MA monthly supplemental premium submitted under § 422.262; and (C) In the case of an MA MSA plan, exceed the MA...

  4. 42 CFR 422.270 - Incorrect collections of premiums and cost-sharing.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ...) Means amounts that- (A) Exceed the limits approved under § 422.262; (B) In the case of an MA private fee-for-service plan, exceed the MA monthly basic beneficiary premium or the MA monthly supplemental premium submitted under § 422.262; and (C) In the case of an MA MSA plan, exceed the MA...

  5. 42 CFR 422.270 - Incorrect collections of premiums and cost-sharing.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ...) Means amounts that- (A) Exceed the limits approved under § 422.262; (B) In the case of an MA private fee-for-service plan, exceed the MA monthly basic beneficiary premium or the MA monthly supplemental premium submitted under § 422.262; and (C) In the case of an MA MSA plan, exceed the MA...

  6. 42 CFR 422.270 - Incorrect collections of premiums and cost-sharing.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM MEDICARE ADVANTAGE PROGRAM Submission of Bids... the MA organization is going out of business or terminating its MA contract for an MA plan(s). (2... future premiums or by a combination of premium adjustment and lump-sum payments. (3) Refund when...

  7. Long-term testing

    NASA Astrophysics Data System (ADS)

    Ferber, M.; Graves, G. A., Jr.

    Land-based gas turbines are significantly different from automotive gas turbines in that they are designed to operate for 50,000 h or greater (compared to 5,000-10,000 h). The primary goal of this research is to determine the long-term survivability of ceramic materials for industrial gas turbine applications. Research activities in this program focus on the evaluation of the static tensile creep and stress rupture (SR) behavior of three commercially available structural ceramics which have been identified by the gas turbine manufacturers as leading candidates for use in industrial gas turbines. For each material investigated, a minimum of three temperatures and four stresses will be used to establish the stress and temperature sensitivities of the creep and SR behavior. Because existing data for many candidate structural ceramics are limited to testing times less than 2,000 h, this program will focus on extending these data to times on the order of 10,000 h, which represents the lower limit of operating time anticipated for ceramic blades and vanes in gas turbine engines. A secondary goal of the program will be to investigate the possibility of enhancing life prediction estimates by combining interrupted tensile SR tests and tensile dynamic fatigue tests in which tensile strength is measured as a function of stressing rate. The third goal of this program will be to investigate the effects of water vapor upon the SR behavior of the three structural ceramics chosen for the static tensile studies by measuring the flexural strength as a function of stressing rate at three temperatures.

  8. Long-term testing

    SciTech Connect

    Ferber, M.; Graves, G.A. Jr.

    1994-12-31

    Land-based gas turbines are significantly different from automotive gas turbines in that they are designed to operate for 50,000 h or greater (compared to 5,000--10,000 h). The primary goal of this research is to determine the long-term survivability of ceramic materials for industrial gas turbine applications. Research activities in this program focus on the evaluation of the static tensile creep and stress rupture (SR) behavior of three commercially available structural ceramics which have been identified by the gas turbine manufacturers as leading candidates for use in industrial gas turbines. For each material investigated, a minimum of three temperatures and four stresses will be used to establish the stress and temperature sensitivities of the creep and SR behavior. Because existing data for many candidate structural ceramics are limited to testing times less than 2,000 h, this program will focus on extending these data to times on the order of 10,000 h, which represents the lower limit of operating time anticipated for ceramic blades and vanes in gas turbine engines. A secondary goal of the program will be to investigate the possibility of enhancing life prediction estimates by combining interrupted tensile SR tests and tensile dynamic fatigue tests in which tensile strength is measured as a function of stressing rate. The third goal of this program will be to investigate the effects of water vapor upon the SR behavior of the three structural ceramics chosen for the static tensile studies by measuring the flexural strength as a function of stressing rate at three temperatures.

  9. 5 CFR 875.301 - Is there a Government contribution toward premiums?

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 5 Administrative Personnel 2 2010-01-01 2010-01-01 false Is there a Government contribution toward premiums? 875.301 Section 875.301 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) CIVIL SERVICE REGULATIONS (CONTINUED) FEDERAL LONG TERM CARE INSURANCE PROGRAM Cost § 875.301 Is there...

  10. 5 CFR 875.302 - What are the options for making premium payments?

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 5 Administrative Personnel 2 2010-01-01 2010-01-01 false What are the options for making premium payments? 875.302 Section 875.302 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) CIVIL SERVICE REGULATIONS (CONTINUED) FEDERAL LONG TERM CARE INSURANCE PROGRAM Cost § 875.302 What are...

  11. 5 CFR 875.303 - How are premium payment errors corrected?

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 5 Administrative Personnel 2 2010-01-01 2010-01-01 false How are premium payment errors corrected? 875.303 Section 875.303 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) CIVIL SERVICE REGULATIONS (CONTINUED) FEDERAL LONG TERM CARE INSURANCE PROGRAM Cost § 875.303 How are...

  12. Insurer Competition In Federally Run Marketplaces Is Associated With Lower Premiums.

    PubMed

    Jacobs, Paul D; Banthin, Jessica S; Trachtman, Samuel

    2015-12-01

    Federal subsidies for health insurance premiums sold through the Marketplaces are tied to the cost of the benchmark plan, the second-lowest-cost silver plan. According to economic theory, the presence of more competitors should lead to lower premiums, implying smaller federal outlays for premium subsidies. The long-term impact of the Affordable Care Act on government spending will depend on the cost of these premium subsidies over time, with insurer participation and the level of competition likely to influence those costs. We studied insurer participation and premiums during the first two years of the Marketplaces. We found that the addition of a single insurer in a county was associated with a 1.2 percent lower premium for the average silver plan and a 3.5 percent lower premium for the benchmark plan in the federally run Marketplaces. We found that the effect of insurer entry was muted after two or three additional entrants. These findings suggest that increased insurer participation in the federally run Marketplaces reduces federal payments for premium subsidies. PMID:26643622

  13. 46 CFR Sec. 3 - Premiums.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 46 Shipping 8 2012-10-01 2012-10-01 false Premiums. Sec. 3 Section 3 Shipping MARITIME... Premiums. The bonds provided for shall be furnished without cost to the National Shipping Authority, but the cost of the premiums of such bonds shall be included in the overhead expense of the General Agent....

  14. 46 CFR Sec. 3 - Premiums.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 46 Shipping 8 2010-10-01 2010-10-01 false Premiums. Sec. 3 Section 3 Shipping MARITIME... Premiums. The bonds provided for shall be furnished without cost to the National Shipping Authority, but the cost of the premiums of such bonds shall be included in the overhead expense of the General Agent....

  15. 46 CFR Sec. 3 - Premiums.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 46 Shipping 8 2013-10-01 2013-10-01 false Premiums. Sec. 3 Section 3 Shipping MARITIME... Premiums. The bonds provided for shall be furnished without cost to the National Shipping Authority, but the cost of the premiums of such bonds shall be included in the overhead expense of the General Agent....

  16. 46 CFR Sec. 3 - Premiums.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 46 Shipping 8 2011-10-01 2011-10-01 false Premiums. Sec. 3 Section 3 Shipping MARITIME... Premiums. The bonds provided for shall be furnished without cost to the National Shipping Authority, but the cost of the premiums of such bonds shall be included in the overhead expense of the General Agent....

  17. 46 CFR Sec. 3 - Premiums.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 46 Shipping 8 2014-10-01 2014-10-01 false Premiums. Sec. 3 Section 3 Shipping MARITIME... Premiums. The bonds provided for shall be furnished without cost to the National Shipping Authority, but the cost of the premiums of such bonds shall be included in the overhead expense of the General Agent....

  18. Long-term environmental stewardship.

    SciTech Connect

    Nagy, Michael David

    2010-08-01

    The purpose of this Supplemental Information Source Document is to effectively describe Long-Term Environmental Stewardship (LTES) at Sandia National Laboratories/New Mexico (SNL/NM). More specifically, this document describes the LTES and Long-Term Stewardship (LTS) Programs, distinguishes between the LTES and LTS Programs, and summarizes the current status of the Environmental Restoration (ER) Project.

  19. Presynaptic long-term plasticity

    PubMed Central

    Yang, Ying; Calakos, Nicole

    2013-01-01

    Long-term synaptic plasticity is a major cellular substrate for learning, memory, and behavioral adaptation. Although early examples of long-term synaptic plasticity described a mechanism by which postsynaptic signal transduction was potentiated, it is now apparent that there is a vast array of mechanisms for long-term synaptic plasticity that involve modifications to either or both the presynaptic terminal and postsynaptic site. In this article, we discuss current and evolving approaches to identify presynaptic mechanisms as well as discuss their limitations. We next provide examples of the diverse circuits in which presynaptic forms of long-term synaptic plasticity have been described and discuss the potential contribution this form of plasticity might add to circuit function. Finally, we examine the present evidence for the molecular pathways and cellular events underlying presynaptic long-term synaptic plasticity. PMID:24146648

  20. Long Term Surface Salinity Measurements

    NASA Technical Reports Server (NTRS)

    Schmitt, Raymond W.; Brown, Neil L.

    2005-01-01

    Our long-term goal is to establish a reliable system for monitoring surface salinity around the global ocean. Salinity is a strong indicator of the freshwater cycle and has a great influence on upper ocean stratification. Global salinity measurements have potential to improve climate forecasts if an observation system can be developed. This project is developing a new internal field conductivity cell that can be protected from biological fouling for two years. Combined with a temperature sensor, this foul-proof cell can be deployed widely on surface drifters. A reliable in-situ network of surface salinity sensors will be an important adjunct to the salinity sensing satellite AQUARIUS to be deployed by NASA in 2009. A new internal-field conductivity cell has been developed by N Brown, along with new electronics. This sensor system has been combined with a temperature sensor to make a conductivity - temperature (UT) sensor suitable for deployment on drifters. The basic sensor concepts have been proven on a high resolution CTD. A simpler (lower cost) circuit has been built for this application. A protection mechanism for the conductivity cell that includes antifouling protection has also been designed and built. Mr. A.Walsh of our commercial partner E-Paint has designed and delivered time-release formulations of antifoulants for our application. Mr. G. Williams of partner Clearwater Instrumentation advised on power and communication issues and supplied surface drifters for testing.

  1. Long-term care financing: options for the future.

    PubMed

    Mulvey, Janemarie; Li, Annelise

    2002-01-01

    The aging of the baby boomers will have an enormous impact on the future of long-term care costs. This article projects the magnitude of that impact, discusses sources of financing, and considers the cost and feasibility of three options for financing future long-term care services. The authors investigate the alternatives of increasing personal savings, raising payroll taxes and expanding employer-sponsored private long-term care insurance coverage, respectively. PMID:12004582

  2. Long term complications of diabetes

    MedlinePlus

    ... this page: //medlineplus.gov/ency/patientinstructions/000327.htm Long term complications of diabetes To use the sharing ... sores and infections. If it goes on too long, your toes, foot, or leg may need to ...

  3. Abdominal Pain, Long-Term

    MedlinePlus

    MENU Return to Web version Abdominal Pain, Long-term See complete list of charts. Ongoing or recurrent abdominal pain, also called chronic pain, may be difficult to diagnose, causing frustration for ...

  4. The Long-Term Effectiveness of Reading Recovery and the Cost-Efficiency of Reading Recovery Relative to the Learning Disabled Classification Rate

    ERIC Educational Resources Information Center

    Galluzzo, Charles A.

    2010-01-01

    There is a great deal of research supporting Reading Recovery as a successful reading intervention program that assists below level first graders readers in closing the gap in reading at the same level of their average peers. There is a lack of research that analyses the cost-effectiveness of the Reading Recovery program compared to the cost in…

  5. An economic model demonstrating the long-term cost benefits of incorporating fertility control into wild horse (Equus caballus) management programs on public lands in the United States.

    PubMed

    de Seve, Charles W; Griffin, Stephanie L Boyles

    2013-12-01

    In recent years, the Bureau of Land Management's (BLM) Wild Horse and Burro Management program costs have increased dramatically due to a rise in the number of animals removed from public lands coupled with significantly decreased adoption rates. To assist with development and implementation of effective, cost-containing management programs, a robust economic model to project the costs and optimize outcomes of various management scenarios was created. For example, preliminary demonstration model runs show that by gradually replacing "removal-only" programs with contraception-and-removal programs on one hypothetical Herd Management Area (HMA), the BLM could save about US$8 million over 12 years while maintaining an area target population of 874 horses. Because the BLM estimates that more than 38,000 wild horses roam on 179 HMAs in the United States, the use of this economic model could result in a cost-savings of tens of millions of dollars if applied broadly across all HMAs. PMID:24437083

  6. Impact of hospitalizations for bronchiolitis in preterm infants on long-term health care costs in Italy: a retrospective case-control study

    PubMed Central

    Roggeri, Daniela Paola; Roggeri, Alessandro; Rossi, Elisa; Cataudella, Salvatore; Martini, Nello

    2016-01-01

    Purpose Bronchiolitis is an acute inflammatory injury of the bronchioles, and is the most frequent cause of hospitalization for lower respiratory tract infections in preterm infants. This was a retrospective, observational, case-control study conducted in Italy, based on administrative database analysis. The aim of this study was to evaluate differences in health care costs of preterm infants with and without early hospitalization for bronchiolitis. Patients and methods Preterm infants born in the period between January 1, 2009 and December 31, 2010 and hospitalized for bronchiolitis in the first year of life were selected from the ARNO Observatory database and observed for the first 4 years of life. These preterm infants were compared (paired 1–3) with preterm infants who were not hospitalized for bronchiolitis in the first year of life and with similar characteristics. Only direct health care costs reimbursed by the Italian National Health Service were considered for this study (drugs, hospitalizations, and diagnostic/therapeutic procedures). Results Of 40,823 newborns in the accrual period, 863 were preterm with no evidence of prophylaxis, and 22 preterm infants were hospitalized for bronchiolitis (cases) and paired with 62 controls. Overall, cases had 74% higher average cost per infant in the first 4 years of life than controls (18,624€ versus 10,189€, respectively). The major cost drivers were hospitalizations, accounting for >90% in both the populations. The increase in total yearly health care cost between cases and controls remained substantial even in the fourth year of life for all cost items. A relevant increase in hospitalizations and drug consumption linked to respiratory tract diseases was noted in infants hospitalized for bronchiolitis during the entire follow-up period. Conclusion Preterm infants hospitalized for bronchiolitis in the first year of life were associated with increased resource consumption and costs throughout the entire period

  7. Long-term socio-economic consequences and health care costs of poliomyelitis: a historical cohort study involving 3606 polio patients.

    PubMed

    Nielsen, Nete Munk; Kay, Lise; Wanscher, Benedikte; Ibsen, Rikke; Kjellberg, Jakob; Jennum, Poul

    2016-06-01

    Worldwide 10-20 million individuals are living with disabilities after acute poliomyelitis. However, very little is known about the socio-economic consequences and health care costs of poliomyelitis. We carried out a historical register-based study including 3606 individuals hospitalised for poliomyelitis in Copenhagen, Denmark 1940-1954, and 13,795 age and gender-matched Danes. Participants were followed from 1980 until 2012, and family, socio-economic conditions and health care costs were evaluated in different age groups using chi-squared tests, boot-strapped t tests or hazard ratios (HR) calculated in Cox-regression models. The analyses were performed separately for paralytic and non-paralytic polio survivors and their controls, respectively. Compared with controls a higher percentage of paralytic polio survivors remained childless, whereas no difference was observed for non-paralytic polio survivors. The educational level among paralytic as well as non-paralytic polio survivors was higher than that among their controls, employment rate at the ages of 40, 50 and 60 years was slightly lower, whereas total income in the age intervals of 31-40, 41-50 and 51-60 years were similar to controls. Paralytic and non-paralytic polio survivors had a 2.5 [HR = 2.52 (95 % confidence interval (CI); 2.29-2.77)] and 1.4 [HR = 1.35 (95 % CI; 1.23-1.49)]-fold higher risk, respectively, of receiving disability pension compared with controls. Personal health care costs were considerably higher in all age groups in both groups of polio survivors. Individuals with a history of poliomyelitis are well educated, have a slightly lower employment rate, an income similar to controls, but a considerably higher cost in the health care system. PMID:27083562

  8. 42 CFR 447.55 - Premiums.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 4 2014-10-01 2014-10-01 false Premiums. 447.55 Section 447.55 Public Health... ASSISTANCE PROGRAMS PAYMENTS FOR SERVICES Payments: General Provisions Medicaid Premiums and Cost Sharing § 447.55 Premiums. (a) The agency may impose premiums upon individuals whose income exceeds 150...

  9. Titanium for long-term tritium storage

    SciTech Connect

    Heung, L.K.

    1994-12-01

    Due to the reduction of nuclear weapon stockpile, there will be an excess of tritium returned from the field. The excess tritium needs to be stored for future use, which might be several years away. A safe and cost effective means for long term storage of tritium is needed. Storing tritium in a solid metal tritide is preferred to storing tritium as a gas, because a metal tritide can store tritium in a compact form and the stored tritium will not be released until heat is applied to increase its temperature to several hundred degrees centigrade. Storing tritium as a tritide is safer and more cost effective than as a gas. Several candidate metal hydride materials have been evaluated for long term tritium storage. They include uranium, La-Ni-Al alloys, zirconium and titanium. The criteria used include material cost, radioactivity, stability to air, storage capacity, storage pressure, loading and unloading conditions, and helium retention. Titanium has the best combination of properties and is recommended for long term tritium storage.

  10. Long Term Illness and Wages

    ERIC Educational Resources Information Center

    Sandy, Robert; Elliott, Robert R.

    2005-01-01

    Long-term illness (LTI) is a more prevalent workplace risk than fatal accidents but there is virtually no evidence for compensating differentials for a broad measure of LTI. In 1990 almost 3.4 percent of the U.K. adult population suffered from a LTI caused solely by their working conditions. This paper provides the first estimates of compensating…

  11. In-lake measures for phosphorus control: The most feasible and cost-effective solution for long-term management of water quality in urban lakes.

    PubMed

    Huser, Brian J; Futter, Martyn; Lee, Jeff T; Perniel, Mike

    2016-06-15

    Both in-lake and catchment measures designed to reduce phosphorus (P) loading were implemented as part of a 12.3 million USD restoration project for the Minneapolis Chain of lakes in Minnesota (USA). Treatment wetlands, 'in-pipe' measures, and in-lake aluminum sulfate (alum) treatment were applied to restore water quality in the four urban lakes. Different alum dosing methods led to between 4 and 20+ (modeled) years of water quality improvements in these lakes after treatment and only one of the four lakes continues to meet water quality goals approximately 25 years after the project started. Due to limited space and poor performance, reduction of total external loads was low (1-13%) for three lakes. Changes to internal P sediment release rates after application of alum correlated well with epilimnetic total P (TP) concentrations in these lakes, indicating that improvements in water quality were mainly driven by reduced internal loading via in-lake measures. Substantial reductions to external P loading were only achieved at Cedar Lake (49%) via conversion of an existing natural area to a treatment wetland, but even Cedar Lake is no longer meeting management goals. When expressed in terms of dollars spent per unit P removed, in lake alum treatment was on average 50 times more effective than in-catchment measures. The results of this study indicate that substantial external nutrient reductions may not be adequate to sustainably maintain water quality in urban lakes and that continued in-lake management of P accumulated in lake sediment will not only be necessary, but will also be more cost efficient relative to in-catchment measures. PMID:26298078

  12. Long-term data archiving

    SciTech Connect

    Moore, David Steven

    2009-01-01

    Long term data archiving has much value for chemists, not only to retain access to research and product development records, but also to enable new developments and new discoveries. There are some recent regulatory requirements (e.g., FDA 21 CFR Part 11), but good science and good business both benefit regardless. A particular example of the benefits of and need for long term data archiving is the management of data from spectroscopic laboratory instruments. The sheer amount of spectroscopic data is increasing at a scary rate, and the pressures to archive come from the expense to create the data (or recreate it if it is lost) as well as its high information content. The goal of long-term data archiving is to save and organize instrument data files as well as any needed meta data (such as sample ID, LIMS information, operator, date, time, instrument conditions, sample type, excitation details, environmental parameters, etc.). This editorial explores the issues involved in long-term data archiving using the example of Raman spectral databases. There are at present several such databases, including common data format libraries and proprietary libraries. However, such databases and libraries should ultimately satisfy stringent criteria for long term data archiving, including readability for long times into the future, robustness to changes in computer hardware and operating systems, and use of public domain data formats. The latter criterion implies the data format should be platform independent and the tools to create the data format should be easily and publicly obtainable or developable. Several examples of attempts at spectral libraries exist, such as the ASTM ANDI format, and the JCAMP-DX format. On the other hand, proprietary library spectra can be exchanged and manipulated using proprietary tools. As the above examples have deficiencies according to the three long term data archiving criteria, Extensible Markup Language (XML; a product of the World Wide Web

  13. Service Use and Costs for People with Long-Term Neurological Conditions in the First Year following Discharge from In-Patient Neuro-Rehabilitation: A Longitudinal Cohort Study

    PubMed Central

    Jackson, Diana; McCrone, Paul; Mosweu, Iris; Siegert, Richard; Turner-Stokes, Lynne

    2014-01-01

    Background Knowledge of the configuration and costs of community rehabilitation and support for people with long-term neurological conditions (LTNCs) is needed to inform future service development and resource allocation. In a multicentre prospective cohort study evaluating community service delivery during the year post-discharge from in-patient neuro-rehabilitation, a key objective was to determine service use, costs, and predictors of these costs. Methods Patients consecutively admitted over one year to all nine London specialised (Level 1) in-patient neuro-rehabilitation units were recruited on discharge. They or their carers completed postal/web-based questionnaires at discharge and six and twelve months later, providing demographic data and measures of impairment, disability, service needs and provision. This paper describes health and social care service use, informal care and associated costs. Regression models using non-parametric boot-strapping identified predictors of costs over time. Results Overall, 152 patients provided consistent data. Mean formal service costs fell significantly from £13,290 (sd £19,369) during the first six months to £9,335 (sd £19,036) from six-twelve months, (t = 2.35, P<0.05), mainly due to declining health service use. At six months, informal care was received on average for 8.2 hours/day, mean cost £14,615 (sd 23,305), comprising 52% of overall care costs. By twelve months, it had increased to 8.8 hours per day, mean cost £15,468 (sd £25,534), accounting for 62% of overall care costs. Being younger and more disabled predicted higher formal care costs, explaining 32% and 30% of the variation in costs respectively at six and twelve months. Conclusion Community services for people with LTNCs carry substantial costs that shift from health to social care over time, increasing the burden on families. Prioritising rehabilitation services towards those in greatest need could limit access to others needing on-going support

  14. Complex home care: Part 2- family annual income, insurance premium, and out-of-pocket expenses.

    PubMed

    Piamjariyakul, Ubolrat; Yadrich, Donna Macan; Ross, Vicki M; Smith, Carol E; Clements, Faye; Williams, Arthur R

    2010-01-01

    Annual costs paid by families for intravenous infusion of home parenteral nutrition (HPN) health insurance premiums, deductibles, co-payments for health services, and the wide range of out-of-pocket home health care expenses are significant. The costs of managing complex chronic care at home cannot be completely understood until all out-of-pocket costs have been defined, described, and tabulated. Non-reimbursed and out-of-pocket costs paid by families over years for complex chronic care negatively impact the financial stability of families. National health care reform must take into account the long-term financial burdens of families caring for those with complex home care. Any changes that may increase the out-of-pocket costs or health insurance costs to these families can also have a negative long-term impact on society when greater numbers of patients declare bankruptcy or qualify for medical disability. PMID:21158253

  15. Stapedectomy - long-term report.

    PubMed

    Shea, J J

    1982-01-01

    The long-term results with large fenestra stapedectomy with vein graft and Teflon piston are compared with results with the small fenestra stapedectomy with teflon piston directly into the vestibule. There were 1,943 operations in the former group and 2,155 in the latter when compared in 1970. One hundred consecutive patients from the beginning of each group with follow-up to present were compared. Results were generally the same with no great change in 15 and 20 years as compared to those at 5 years. The complication of perilymph fistula was caused by creating an opening in the footplate much larger than the prosthesis and was eliminated by interposing a living oval window seal if the opening was much larger than the prosthesis and a flap of lining membrane from the promontory when it was not. Other factors that influence a good result are discussed, including the type and the diameter of the piston used, the type of living oval window seal and the method of attachment to the incus. The small fenestra operation was found to be superior to the large, not only for the hearing gain achieved, but the case of performance and the freedom from complications due to migration of the prosthesis and/or the oval window seal. At present we have done about all that can be done for the conductive components. What remains is the sensorineural component which our studies indicate may be due to an autoimmune response. PMID:6897157

  16. Clinical effectiveness and cost-effectiveness results from the randomised controlled Trial of Oral Mandibular Advancement Devices for Obstructive sleep apnoea-hypopnoea (TOMADO) and long-term economic analysis of oral devices and continuous positive airway pressure.

    PubMed Central

    Sharples, Linda; Glover, Matthew; Clutterbuck-James, Abigail; Bennett, Maxine; Jordan, Jake; Chadwick, Rebecca; Pittman, Marcus; East, Clare; Cameron, Malcolm; Davies, Mike; Oscroft, Nick; Smith, Ian; Morrell, Mary; Fox-Rushby, Julia; Quinnell, Timothy

    2014-01-01

    BACKGROUND Obstructive sleep apnoea-hypopnoea (OSAH) causes excessive daytime sleepiness (EDS), impairs quality of life (QoL) and increases cardiovascular disease and road traffic accident risks. Continuous positive airway pressure (CPAP) treatment is clinically effective but undermined by intolerance, and its cost-effectiveness is borderline in milder cases. Mandibular advancement devices (MADs) are another option, but evidence is lacking regarding their clinical effectiveness and cost-effectiveness in milder disease. OBJECTIVES (1) Conduct a randomised controlled trial (RCT) examining the clinical effectiveness and cost-effectiveness of MADs against no treatment in mild to moderate OSAH. (2) Update systematic reviews and an existing health economic decision model with data from the Trial of Oral Mandibular Advancement Devices for Obstructive sleep apnoea-hypopnoea (TOMADO) and newly published results to better inform long-term clinical effectiveness and cost-effectiveness of MADs and CPAP in mild to moderate OSAH. TOMADO A crossover RCT comparing clinical effectiveness and cost-effectiveness of three MADs: self-moulded [SleepPro 1™ (SP1); Meditas Ltd, Winchester, UK]; semibespoke [SleepPro 2™ (SP2); Meditas Ltd, Winchester, UK]; and fully bespoke [bespoke MAD (bMAD); NHS Oral-Maxillofacial Laboratory, Addenbrooke's Hospital, Cambridge, UK] against no treatment, in 90 adults with mild to moderate OSAH. All devices improved primary outcome [apnoea-hypopnoea index (AHI)] compared with no treatment: relative risk 0.74 [95% confidence interval (CI) 0.62 to 0.89] for SP1; relative risk 0.67 (95% CI 0.59 to 0.76) for SP2; and relative risk 0.64 (95% CI 0.55 to 0.76) for bMAD (p < 0.001). Differences between MADs were not significant. Sleepiness [as measured by the Epworth Sleepiness Scale (ESS)] was scored 1.51 [95% CI 0.73 to 2.29 (SP1)] to 2.37 [95% CI 1.53 to 3.22 (bMAD)] lower than no treatment (p < 0.001), with SP2 and bMAD significantly better than SP1

  17. [An evaluation of net carbon sink effect and cost/benefits of a rice-rape rotation ecosystem under long-term fertilization from Tai Lake region of China].

    PubMed

    Li, Jie-Jing; Pan, Gen-Xing; Zhang, Xu-Hui; Fei, Qing-Hua; Li, Zhi-Peng; Zhou, Ping; Zheng, Ju-Feng; Qiu, Duo-Sheng

    2009-07-01

    Taking a long-term fertilized rice-rape rotation system in Taihu Lake as test objective, its annual C balance and economic benefit were estimated, based on the measurement of past years grain yield, litter C content, and field CO2 emission as well as the investigation of material and management inputs. The calculated annual C sink under different fertilizations ranged from 0.9 t C x hm(-2) x a(-1) to 7.5 t C x hm(-2) x a(-1), and the net C sink effect under combined inorganic/organic fertilization was three folds as that under chemical fertilization. The C cost of material input ranged from 0.37 t C x hm(-2) x a(-1) to 1.13 t C x hm(-2) x a(-1), and that of management input ranged from 1.69 t C x hm(-2) x a(-1) to 1.83 t C x hm(-2) x a(-1). The annual economic benefit ranged from 5.8 x 10(3) CNY x hm(-2) x a(-1) to 16.5 x 10(3) CNY x hm(-2) x a(-1), and was 2.1 times higher under combined fertilization than under chemical fertilization. Comparing with that under chemical fertilization, the marginal cost for per ton C sink under combined inorganic/organic fertilization was estimated as 217.1 CNY x t(-1) C, very close to the C price of 20 Euro x t(-1) C in the EU. In sum, under combined inorganic/organic fertilization, this rice paddy ecosystem could not only have higher productivity, but also present greater net C sink effect and higher economic benefit, compared with under chemical fertilizer fertilization. PMID:19899468

  18. 42 CFR 447.56 - Limitations on premiums and cost sharing.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... chapter (Breast and Cervical Cancer). (2) The agency may not impose cost sharing for the following... providers. (1) Except as provided under paragraphs (c)(2) and (c)(3) of this section, the agency must reduce..., the agency may not reduce the payment it makes to a provider, including an Indian health care...

  19. 42 CFR 600.505 - Premiums.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... the premium of the applicable benchmark plan, as defined in 26 CFR 1.36B-3(f). The State must assure... 42 Public Health 5 2014-10-01 2014-10-01 false Premiums. 600.505 Section 600.505 Public Health... REQUIREMENTS, PREMIUM AND COST SHARING, ALLOTMENTS, AND RECONCILATION (Eff. 1-1-15) Enrollee...

  20. Advanced long term cryogenic storage systems

    NASA Technical Reports Server (NTRS)

    Brown, Norman S.

    1987-01-01

    Long term, cryogenic fluid storage facilities will be required to support future space programs such as the space-based Orbital Transfer Vehicle (OTV), Telescopes, and Laser Systems. An orbital liquid oxygen/liquid hydrogen storage system with an initial capacity of approximately 200,000 lb will be required. The storage facility tank design must have the capability of fluid acquisition in microgravity and limit cryogen boiloff due to environmental heating. Cryogenic boiloff management features, minimizing Earth-to-orbit transportation costs, will include advanced thick multilayer insulation/integrated vapor cooled shield concepts, low conductance support structures, and refrigeration/reliquefaction systems. Contracted study efforts are under way to develop storage system designs, technology plans, test article hardware designs, and develop plans for ground/flight testing.

  1. Strategies to meet the need for long-term data.

    PubMed

    Chalmers, John; Woodward, Mark; Borghi, Claudio; Manolis, Athanasios; Mancia, Giuseppe

    2016-08-01

    Chronic diseases afflict patients for many years, often to the end of life, and there is increasing need for estimating lifelong risk and for evaluating the effects of treatment in the long term. Yet recommendations for lifelong treatment are most frequently based on findings from randomized clinical trials lasting only a few years. There is therefore a clear need for much longer term data, and here we present the advantages and disadvantages of many strategies, including the use of long-term posttrial follow-up, of long-term prospective cohort studies, registry databases, and of administrative databases. We also emphasize the need for long-term cost-effectiveness studies. One of the most promising strategies comes from linkage of data gathered through the ever-expanding pool of administrative databases worldwide with data from other sources, including randomized trials and the many forms of observational study. PMID:27270189

  2. The market for long-term care services.

    PubMed

    Grabowski, David C

    2008-01-01

    Although a large literature has established the importance of market and regulatory forces within the long-term care sector, current research in this field is limited by a series of data, measurement, and methodological issues. This paper provides a comprehensive review of these issues with an emphasis on identifying initiatives that will increase the volume and quality of long-term care research. Recommendations include: the construction of standard measures of long-term care market boundaries, the broader dissemination of market and regulatory data, the linkage of survey-based data with market measures, the encouragement of further market-based studies of noninstitutional long-term care settings, and the standardization of Medicaid cost data. PMID:18524292

  3. 12 CFR 217.101 - Premiums on deposits.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... merchandise, the total cost (including taxes, shipping, warehousing, packaging, and handling costs) does not... the total cost of a premium, including shipping, warehousing, packaging, and handling costs, does...

  4. Economic evaluation in long-term clinical trials.

    PubMed

    Hlatky, Mark A; Boothroyd, Derek B; Johnstone, Iain M

    2002-10-15

    Economic endpoints have been increasingly included in long-term clinical trials, but they pose several methodologic challenges, including how best to collect, describe, analyse and interpret medical cost data. Cost of care can be measured by converting billed charges, performing detailed micro-costing studies, or by measuring use of key resources and assigning cost weights to each resource. The latter method is most commonly used, with cost weights based either on empirical regression models or administratively determined reimbursement rates. In long-term studies, monetary units should be adjusted to reflect cost inflation and discounting. The temporal pattern of accumulating costs can be described using a modification of the Kaplan-Meier curve. Regression analyses to evaluate factors associated with cost are best performed on the log of costs due to their typically skewed distribution.Cost-effectiveness analysis attempts to measure the value of a new therapy by calculating the difference in cost between the new therapy and the standard therapy, divided by the difference in benefit between the new therapy and the standard therapy. The cost-effectiveness ratio based on the results of a randomized trial may change substantially with longer follow-up intervals, particularly for therapies that are initially expensive but eventually improve survival. A model that projects long-term patterns of cost and survival expected beyond the end of completed follow-up can provide an important perspective in the setting of limited trial duration. PMID:12325104

  5. Review of risk premium methodology

    SciTech Connect

    Bittner, C.

    1995-12-31

    Over the last few years, the Iowa Utilities Board (IUB) has used a simple risk premium method as supplemental evidence in determining the cost of equity in rate cases. The Board method has mainly been to add 250 to 350 basis points risk premium to an A-rated utility bond average. Recently, the Board has expressed concern that an update of the risk premium range is warranted. Is an update needed? The 250 to 350 basis points, when first adopted, apparently reflected a specific record at that time. It is not cast in stone nor invariate with time. For a number of reasons, periodic updating is reasonable and proper. First, during periods of extremely high or extremely low capital costs, commissions` desire for stability of rates and avoidance of subsequent rate cases triggered by more normal credit shifts commissions` attention from the discounted cash flow (DCF) {open_quotes}snap-shot{close_quotes} of capital costs to the broader {open_quotes}time-series perspective{close_quotes} of the risk premium method. It is essentially a judgment that the current capital cost, at times of market extremes, is not necessarily the best representative equity cost to use for prospective rates. Nevertheless, a risk premium method is a market-based method, with some tie, via the debt rate, to current market conditions. In any case, during such times when the risk premium method is given more usage, it makes sense to refine or update, if needed, the Board`s risk premium methodology.

  6. LONG-TERM MONITORING SENSOR NETWORK

    SciTech Connect

    Stephen P. Farrington; John W. Haas; Neal Van Wyck

    2003-10-16

    Long-term monitoring (LTM) associated with subsurface contamination sites is a key element of Long Term Stewardship and Legacy Management across the Department of Energy (DOE) complex. However, both within the DOE and elsewhere, LTM is an expensive endeavor, often exceeding the costs of the remediation phase of a clean-up project. The primary contributors to LTM costs are associated with labor. Sample collection, storage, preparation, analysis, and reporting can add a significant financial burden to project expense when extended over many years. Development of unattended, in situ monitoring networks capable of providing quantitative data satisfactory to regulatory concerns has the potential to significantly reduce LTM costs. But survival and dependable operation in a difficult environment is a common obstacle to widespread use across the DOE complex or elsewhere. Deploying almost any sensor in the subsurface for extended periods of time will expose it to chemical and microbial degradation. Over the time-scales required for in situ LTM, even the most advanced sensor systems may be rendered useless. Frequent replacement or servicing (cleaning) of sensors is expensive and labor intensive, offsetting most, if not all, of the cost savings realized with unattended, in situ sensors. To enable facile, remote monitoring of contaminants and other subsurface parameters over prolonged periods, Applied Research Associates, Inc has been working to develop an advanced LTM sensor network consisting of three key elements: (1) an anti-fouling sensor chamber that can accommodate a variety of chemical and physical measurement devices based on electrochemical, optical and other techniques; (2) two rapid, cost effective, and gentle means of emplacing sensor packages either at precise locations directly in the subsurface or in pre-existing monitoring wells; and (3) a web browser-based data acquisition and control system (WebDACS) utilizing field-networked microprocessor-controlled smart

  7. 47 CFR 32.4300 - Other long-term liabilities and deferred credits.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 47 Telecommunication 2 2010-10-01 2010-10-01 false Other long-term liabilities and deferred... Sheet Accounts § 32.4300 Other long-term liabilities and deferred credits. (a) This account shall... benefits, deferred compensation costs and other long-term liabilities not provided for...

  8. 47 CFR 32.4300 - Other long-term liabilities and deferred credits.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 47 Telecommunication 2 2012-10-01 2012-10-01 false Other long-term liabilities and deferred... Sheet Accounts § 32.4300 Other long-term liabilities and deferred credits. (a) This account shall... benefits, deferred compensation costs and other long-term liabilities not provided for...

  9. 47 CFR 32.4300 - Other long-term liabilities and deferred credits.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 47 Telecommunication 2 2014-10-01 2014-10-01 false Other long-term liabilities and deferred... Sheet Accounts § 32.4300 Other long-term liabilities and deferred credits. (a) This account shall... benefits, deferred compensation costs and other long-term liabilities not provided for...

  10. 47 CFR 32.4300 - Other long-term liabilities and deferred credits.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 47 Telecommunication 2 2013-10-01 2013-10-01 false Other long-term liabilities and deferred... Sheet Accounts § 32.4300 Other long-term liabilities and deferred credits. (a) This account shall... benefits, deferred compensation costs and other long-term liabilities not provided for...

  11. 47 CFR 32.4300 - Other long-term liabilities and deferred credits.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 47 Telecommunication 2 2011-10-01 2011-10-01 false Other long-term liabilities and deferred... Sheet Accounts § 32.4300 Other long-term liabilities and deferred credits. (a) This account shall... benefits, deferred compensation costs and other long-term liabilities not provided for...

  12. Why make premium diesel?

    SciTech Connect

    Pipenger, G.G.

    1997-01-01

    In the last issue of Hart`s Fuel Technology & Management (Vol. 6, No. 6, pp. 62-64), a discussion of the evolution of premium diesel fuels in the US and Europe was begun. Cetane and ignition improvers were discussed. In this concluding article, different additive components such as fuel stabilizers, corrosion inhibitors and lubricity additives are reviewed--all of which are key components of any top-quality diesel fuel today. An excerpt from {open_quotes}The Making of Premium Diesel,{close_quotes} which categorizes (costs, benefits, dosage rates) the additives necessary to improve diesel quality is presented.

  13. Long-term solar-terrestrial observations

    NASA Technical Reports Server (NTRS)

    1988-01-01

    The results of an 18-month study of the requirements for long-term monitoring and archiving of solar-terrestrial data is presented. The value of long-term solar-terrestrial observations is discussed together with parameters, associated measurements, and observational problem areas in each of the solar-terrestrial links (the sun, the interplanetary medium, the magnetosphere, and the thermosphere-ionosphere). Some recommendations are offered for coordinated planning for long-term solar-terrestrial observations.

  14. Private Financing Options for Long-term Care

    PubMed Central

    Brody, Barbara L.; Simon, Harold J.; Smallwood, Dennis E.

    1987-01-01

    Private financing for long-term care now comes almost exclusively from out-of-pocket payments. Long-term-care costs quickly impoverish most elderly, resulting in Medicaid dependency. The consequences are profound for the western Sun Belt with its rapidly growing elderly population. Key private financing options are long-term-care individual retirement accounts (LTC/IRAs), home equity conversion, social-health maintenance organizations and long-term-care insurance. Study of data from the past half century suggests that the LTC/IRA approach would prove unsatisfactory for the purpose despite the intuitive appeal of this mechanism. Experience with home equity conversions is still very limited, and unresolved questions limit this approach to the role of a reserve option for now. While promising, social-health maintenance organizations are still in the experimental stages and not yet commercially available. Long-term-care insurance is currently sold on a thin market and emphasizes nursing home coverage. New approaches to private financing through long-term-care insurance seem to offer the best approach for immediate implementation. PMID:3118576

  15. LONG TERM IN SITU DISPOSAL ENGINEERING STUDY

    SciTech Connect

    ADAMS; CARLSON; BROCKMAN

    2003-07-23

    Patent application pulled per Ken Norris (FH General Counsel). The objective of this study is to devise methods, produce conceptual designs, examine and select alternatives, and estimate costs for the demonstration of long-term (300-year) in situ disposal of an existing waste disposal site. The demonstration site selected is the 216-A-24 Crib near the 200 East Area. The site contains a fission product inventory and has experienced plant, animal, and inadvertent than intrusion. Of the potential intrusive events and transport pathways at the site, potential human intrusion has been given primary consideration in barrier design. Intrusion by wind, plants, and animals has been given secondary consideration. Groundwater modeling for a number of barrier configurations has been carried out to help select a barrier that will minimize water infiltration and waste/water contact time. The estimated effective lifetime and cost of 20 barrier schemes, using a variety of materials, have been evaluated. The schemes studied include single component surface barriers, multicomponent barriers, and massively injected grout barriers. Five barriers with high estimated effective lifetimes and relatively low costs have been selected for detailed evaluation. They are basalt riprap barriers, massive soil barriers, salt basin barriers, multi-component fine/coarse barriers, and cemented basalt barriers. A variety of materials and configurations for marking the site have also been considered. A decision analysis was completed to select a barrier scheme for demonstration. The analysis indicated that the basalt riprap alternative would be the preferred choice for a full-scale demonstration. The recommended approach is to demonstrate the basalt riprap barrier at the 216-A-24 Crib as soon as possible. Methods and costs of assessing effectiveness of the demonstration are also described. Preliminary design modifications and costs for applying the five selected barrier schemes to other site types are

  16. Long-term preservation of Anammox bacteria

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Deposit of useful microorganisms in culture collections requires long-term preservation and successful reactivation techniques. The goal of this study was to develop a simple preservation protocol for the long-term storage and reactivation of the anammox biomass. To achieve this, anammox biomass w...

  17. Long Term Preservation of Digital Information.

    ERIC Educational Resources Information Center

    Lorie, Raymond A.

    The preservation of digital data for the long term presents a variety of challenges from technical to social and organizational. The technical challenge is to ensure that the information, generated today, can survive long term changes in storage media, devices, and data formats. This paper presents a novel approach to the problem. It distinguishes…

  18. Virtual Models of Long-Term Care

    ERIC Educational Resources Information Center

    Phenice, Lillian A.; Griffore, Robert J.

    2012-01-01

    Nursing homes, assisted living facilities and home-care organizations, use web sites to describe their services to potential consumers. This virtual ethnographic study developed models representing how potential consumers may understand this information using data from web sites of 69 long-term-care providers. The content of long-term-care web…

  19. 42 CFR 447.71 - Alternative premium and cost sharing exemptions and protections for individuals with family...

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... protections for individuals with family incomes at or below 100 percent of the FPL. 447.71 Section 447.71... protections for individuals with family incomes at or below 100 percent of the FPL. (a) The State may not impose premiums under the State plan on individuals whose family income is at or below 100 percent of...

  20. 42 CFR 447.74 - Alternative premium and cost sharing protections for individuals with family incomes above 150...

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... for individuals with family incomes above 150 percent of the FPL. 447.74 Section 447.74 Public Health... family incomes above 150 percent of the FPL. (a) States may impose premiums under the State plan consistent with the aggregate limits set forth in § 447.78(a) on individuals whose family income exceeds...

  1. Robotics for Long-Term Monitoring

    SciTech Connect

    Shahin, Sarkis; Duran, Celso

    2002-07-01

    While long-term monitoring and stewardship means many things to many people, DOE has defined it as The physical controls, institutions, information, and other mechanisms needed to ensure protection of people and the environment at sites where DOE has completed or plans to complete cleanup (e.g., landfill closures, remedial actions, and facility stabilization). Across the United States, there are thousands of contaminated sites with multiple contaminants released from multiple sources where contaminants have transported and commingled. The U.S. government and U.S. industry are responsible for most of the contamination and are landowners of many of these contaminated properties. These sites must be surveyed periodically for various criteria including structural deterioration, water intrusion, integrity of storage containers, atmospheric conditions, and hazardous substance release. The surveys, however, are intrusive, time-consuming, and expensive and expose survey personnel to radioactive contamination. In long-term monitoring, there's a need for an automated system that will gather and report data from sensors without costly human labor. In most cases, a SCADA (Supervisory Control and Data Acquisition) unit is used to collect and report data from a remote location. A SCADA unit consists of an embedded computer with data acquisition capabilities. The unit can be configured with various sensors placed in different areas of the site to be monitored. A system of this type is static, i.e., the sensors, once placed, cannot be moved to other locations within the site. For those applications where the number of sampling locations would require too many sensors, or where exact location of future problems is unknown, a mobile sensing platform is an ideal solution. In many facilities that undergo regular inspections, the number of video cameras and air monitors required to eliminate the need for human inspections is very large and far too costly. HCET's remote harsh

  2. Going Solar Yields Long-Term Economical, Educational Benefits

    ERIC Educational Resources Information Center

    von Moos, Brian

    2009-01-01

    Going solar is not an easy decision, but a long-term investment with a potentially substantial up-front cost. While some schools have enough capital in reserve, can raise bond money, or can solicit sufficient donations, many schools rely on creative financial programs to make a solar energy system economically feasible. Thinking about going solar…

  3. 49 CFR 260.15 - Credit risk premium.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... pay to the Administrator a Credit Risk Premium adequate to cover that portion of the subsidy cost not... cover the entire subsidy cost. (b) The amount of the Credit Risk Premium required for each direct loan... cost of each loan is accurate, the aggregate of Credit Risk Premiums associated with each cohort...

  4. 49 CFR 260.15 - Credit risk premium.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... pay to the Administrator a Credit Risk Premium adequate to cover that portion of the subsidy cost not... cover the entire subsidy cost. (b) The amount of the Credit Risk Premium required for each direct loan... cost of each loan is accurate, the aggregate of Credit Risk Premiums associated with each cohort...

  5. Several Factors Responsible For The Recent Slowdown In Premium Growth In Employer-Sponsored Insurance.

    PubMed

    Vistnes, Jessica; Selden, Thomas M; Zawacki, Alice

    2015-12-01

    Containing growth in health care spending is important to the long-term fiscal health of the United States. Researchers have been seeking to identify which factors behind the recent spending slowdown might continue to have an impact after the economy has fully recovered from the Great Recession (2007-09). We extended this inquiry by decomposing trends in the growth of private-sector employer-sponsored insurance premiums. Using data for 2001-13 from the Medical Expenditure Panel Survey-Insurance Component and a combination of cell- and regression-based decomposition methods, we found that the slowdown in premium growth that preceded the recession reflected declining growth rates in per policyholder premiums. For 2009-11, however, the dominant contributors to the slowdown were factors underlying declining employee enrollment: a sharp downturn in employment in 2009, followed by eroding offer and eligibility rates. Growth in per policyholder premiums slowed in 2012 and 2013 compared to the preceding few years. Like other researchers, we found that a substantial portion of premium growth remained unexplained. However, it is likely driven, in part, by growth in the underlying cost of medical care. PMID:26643623

  6. Long-term adequacy of metal resources

    USGS Publications Warehouse

    Singer, D.A.

    1977-01-01

    Although the earth's crust contains vast quantities of metals, extraction technologies and associated costs are inextricably bound to three fundamental geological factors - the amount of metal available in the earth's crust in each range of grades, the mineralogical form and chemical state of the metal, and the spatial distribution of the metal. The energy required to recover a given amount of metal increases substantially as grade declines. Most metal is produced from sulphide or oxide minerals, whereas most metal in the crust may be locked in the structures of the more refractory silicates. Recovery from silicate minerals could require orders of magnitude more energy than that used at present as also could exploitation of small, widely scattered or thin, deeply buried deposits. Although specific information on the fundamental factors is not available, each factor must in turn tend to further restrict exploitation. Independence of average grade and tonnage for many deposit types further reduces the availability of rock as a source of metal. In the long term, effects of these factors will be large increases in price for many metals. ?? 1977.

  7. Long-term survival following emergency abdominal aortic aneurysm repair.

    PubMed

    Milner, Q J; Burchett, K R

    2000-05-01

    Survival following emergency surgery for ruptured abdominal aortic aneurysm remains poor and is in stark contrast to that for elective repair. We have carried out a 5-year retrospective observational study to determine the long-term (5-year) survival of patients following emergency surgery for ruptured abdominal aortic aneurysm at a district general hospital in East Anglia. A total of 99 patients presented to the operating theatre for emergency repair of ruptured abdominal aortic aneurysm in this 5-year study period. In-hospital mortality was 70% and was unchanged over the 5 years. Overall long-term survival in those patients discharged from hospital was good. The ICU cost per long-term survivor was calculated to be pound sterling 36750. PMID:10792133

  8. Rural long-term care work, gender, and restructuring.

    PubMed

    Leach, Belinda; Joseph, Gillian

    2011-06-01

    Restructuring--the introduction of changes that alter the way health care is delivered for maximum efficiency and least cost--layered with rurality and with rural gender ideologies and practices, results in rural long-term care settings that have particular consequences for the women working in them, and for the residents and communities that they serve. This research investigated how rurality affects the implementation of patient classification in Ontario long-term care homes. Methods involved interviews and focus groups with front-line long-term care workers, administrators, and key participants. The findings revealed that rural long-term care delivery takes place when a restructured work environment intersects with gender ideologies and practices that take on particular characteristics when developed and sustained in a rural context. These factors shape the labor market and working conditions for rural women. We argue that this produces a uniquely rural experience for long-term care workers and conclude that those implementing classification systems must consider contextual factors as well as practical and financial exigencies. PMID:24650670

  9. A new long-term care manifesto.

    PubMed

    Kane, Robert L

    2015-04-01

    This article argues for a fresh look at how we provide long-term care (LTC) for older persons. Essentially, LTC offers a compensatory service that responds to frailty. Policy debate around LTC centers on costs, but we are paying for something we really don't want. Building societal enthusiasm (or even support) for LTC will require re-inventing and re-branding. LTC has three basic components: personal care, housing, and health care (primarily chronic disease management). They can be delivered in a variety of settings. It is rare to find all three done well simultaneously. Personal care (PC) needs to be both competent and compassionate. Housing must provide at least minimal amenities and foster autonomy; when travel time for PC raises costs dramatically, some form of clustered housing may be needed. Health care must be proactive, aimed at preventing exacerbations of chronic disease and resultant hospitalizations. Enhancing preferences means allowing taking informed risks. Payment incentives should reward both quality of care and quality of life, but positive outcomes must be defined as slowing decline. Paying for services but not for housing under Medicaid would automatically level the playing field between nursing homes (NH) and community-based services. Regulations should achieve greater parity between NH and community care and include both positive and negative feedback. Providing post-acute care should be separate from LTC. Using the tripartite LTC framework, we can create innovative flexible approaches to providing needed services for frail older persons in formats that are both desirable and affordable. Such care will be more socially desirable and hence worth paying for. PMID:26035606

  10. Mental Health in Long Term Care Settings.

    ERIC Educational Resources Information Center

    Shore, Herbert

    1978-01-01

    There are many ways in which long-term care facilities attempt to cope with the mental health problems of the elderly. The author reviews five factors crucial to effective care for the aged in these facilities. (Author/RK)

  11. Asthma Medicines: Long-Term Control

    MedlinePlus

    ... Español Text Size Email Print Share Asthma Medicines: Long-term Control Page Content Article Body Corticosteroids Synthetic ... and sprinkle forms are available for young children. Long-Acting Beta2-Agonists Medications in the beta 2 - ...

  12. Long Term Effects of Food Poisoning

    MedlinePlus

    ... develop chronic arthritis. Brain and nerve damage A Listeria infection can lead to meningitis, an inflammation of ... brain. If a newborn infant is infected with Listeria , long-term consequences may include mental retardation, seizures, ...

  13. Long-Term Economic Benefits of Preschool Services and the Potential Impact of Privatization.

    ERIC Educational Resources Information Center

    Kendall, Earline D.

    This paper addresses the importance of a high quality preschool education for children living in poverty, the long-term effects of such an educational experience, the long-term economic benefits to the children enrolled and their families, and the potential impact of privatization on preschool services. The cost-effectiveness and cost-benefits of…

  14. Long-Term Care Insurance: Coverage Varies Widely in a Developing Market. Report to the Chairman, Subcommittee on Health and Long-Term Care, Select Committeee on Aging, House of Representatives.

    ERIC Educational Resources Information Center

    General Accounting Office, Washington, DC. Div. of Human Resources.

    In response to a request by Congressman Claude Pepper, the General Accounting Office (GAO) conducted a study to examine the private long-term care insurance market. The GAO analyzed the premiums, benefits, and limitations of 33 policies offered by 25 insurers in 1986. The GAO assessed the potential for abuse in this market by surveying state…

  15. European Long-Term Care Programs: Lessons for Community Living Assistance Services and Supports?

    PubMed Central

    Nadash, Pamela; Doty, Pamela; Mahoney, Kevin J; von Schwanenflugel, Matthias

    2012-01-01

    Objective To uncover lessons from abroad for Community Living Assistance Services and Supports (CLASS), a federally run voluntary public long-term care (LTC) insurance program created under the Accountable Care Act of 2010. Data Sources Program administrators and policy researchers from Austria, England, France, Germany, and the Netherlands. Study Design Qualitative methods focused on key parameters of cash for care: how programs set benefit levels; project expenditures; control administrative costs; regulate the use of benefits; and protect workers. Data Collection/Extraction Methods Structured discussions were conducted during an international conference of LTC experts, followed by personal meetings and individual correspondence. Principal Findings Germany's self-financing mandate and tight targeting of benefits have resulted in a solvent program with low premiums. Black markets for care are likely in the absence of regulation; France addresses this via a unique system ensuing legal payment of workers. Conclusions Programs in the five countries studied have lessons, both positive and negative, relevant to CLASS design. PMID:22091672

  16. Long-term Multiwavelength Observations of Polars

    NASA Astrophysics Data System (ADS)

    Santana, Joshua; Mason, Paul A.

    2016-06-01

    Polars are cataclysmic variables with the highest magnetic field strengths (10-250 MG). Matter is accreted after being funneled by the strong magnetic field of the white dwarf. We perform a meta-study of multi-wavelength data of polars. Many polars have been observed in surveys, such as SDSS, 2MASS, ROSAT, just to name a few. Some polars have now been detected by the JVLA, part of an expanding class of radio CVs. A large subset of polars have long-term optical light curves from CRTS and AAVSO. We suggest that the long term light curves of polars display a variety of signature behaviors and may be grouped accordingly. Additional characteristics such a binary period, magnetic field strengths, X-ray properties, and distance estimates are examined in context with long-term observations.

  17. Fusion energy in context: its fitness for the long term.

    PubMed

    Holdren, J P

    1978-04-14

    Long-term limits to growth in energy will be imposed not by inability to expand supply, but by the rising environmental and social costs of doing so. These costs will therefore be central issues in choosing long-term options. Fusion, like solar energy, is not one possibility but many, some with very attractive environmental characteristics and others perhaps little better in these regards than fission. None of the fusion options will be cheap, and none is likely to be widely available before the year 2010. The most attractive forms of fusion may require greater investments of time and money to achieve, but they are the real reason for wanting fusion at all. PMID:17818794

  18. Scenarios for long-term analysis

    SciTech Connect

    Wolbers, Stephen; /Fermilab

    2009-01-01

    Data Preservation and Long-Term Analysis of High Energy Physics (HEP) Experiments data is described and summarized in this talk. The summary covers information presented at the First Workshop on Data Preservation and Long-Term Analysis. Experiments representing e{sup +}e{sup -} collisions (LEP, B Factories and CLEO), ep collisions (H1 and ZEUS), p{bar p} collisions (CDF and D0) and others presented interesting information related to utilizing the large datasets collected over many years at these HEP facilities. Many questions and issues remain to be explored.

  19. Long-Term Use of Benzodiazepines

    PubMed Central

    Potts, Nicholas L.S.; Krishnan, K. Ranga R.

    1992-01-01

    Problems associated with physical dependence and abuse of benzodiazepines by a small percentage of patients have reduced their popularity from the most commonly prescribed psychoactive drug in the 1970s to being prescribed for mainly short periods. Patients who benefit from long-term benzodiazepine use are nearly ignored by the medical community as a whole. This article details what patient population can improve from long-term benzodiazepine therapy, the risks and benefits of treatment, and how to select appropriate candidates. PMID:21229127

  20. Long-term Outcomes after Severe Shock

    PubMed Central

    Pratt, Cristina M.; Hirshberg, Eliotte L.; Jones, Jason P.; Kuttler, Kathryn G.; Lanspa, Michael J.; Wilson, Emily L.; Hopkins, Ramona O.; Brown, Samuel M.

    2014-01-01

    Background Severe shock is a life-threatening condition with very high short-term mortality. Whether the long-term outcomes among survivors of severe shock are similar to long-term outcomes of other critical illness survivors is unknown. We therefore sought to assess long-term survival and functional outcomes among 90-day survivors of severe shock and determine whether clinical predictors were associated with outcomes. Methods Seventy-six patients who were alive 90 days after severe shock (received ≥1 mcg/kg/min of norepinephrine equivalent) were eligible for the study. We measured three-year survival and long-term functional outcomes using the Medical Outcomes Study 36-Item Short-Form Health Survey, the EuroQOL 5-D-3L, the Hospital Anxiety and Depression Scale, the Impact of Event Scale-Revised and an employment instrument. We also assessed the relationship between in-hospital predictors and long-term outcomes. Results The mean long-term survival was 5.1 years: 82% (62/76) of patients survived, of whom 49 were eligible for follow-up. Patients who died were older than patients who survived. Thirty-six patients completed a telephone interview a mean of five years after hospital admission. The patients’ Physical Functioning scores were below US population norms (p<0.001), whereas mental health scores were similar to population norms. Nineteen percent of the patients had symptoms of depression, 39% had symptoms of anxiety and 8% had symptoms of posttraumatic stress disorder. Thirty-six percent were disabled, and 17% were working full time. Conclusions Early survivors of severe shock had a high three-year survival rate. Patients’ long term physical and psychological outcomes were similar to those reported for cohorts of less severely ill ICU survivors. Anxiety and depression were relatively common, but only a few patients had symptoms of posttraumatic stress disorder. This study supports the observation that acute illness severity does not determine long-term

  1. Health reform: setting the agenda for long term care.

    PubMed

    Hatch, O G; Wofford, H; Willging, P R; Pomeroy, E

    1993-06-01

    The White House Task Force on National Health Care Reform, headed by First Lady Hillary Rodham Clinton, is expected to release its prescription for health care reform this month. From the outset, Clinton's mandate was clear: to provide universal coverage while reining in costs for delivering quality health care. Before President Clinton was even sworn into office, he had outlined the major principles that would shape the health reform debate. Global budgeting would establish limits on all health care expenditures, thereby containing health costs. Under a system of managed competition, employers would form health alliances for consumers to negotiate for cost-effective health care at the community level. So far, a basic approach to health care reform has emerged. A key element is universal coverage--with an emphasis on acute, preventive, and mental health care. Other likely pieces are employer-employee contributions to health care plans, laws that guarantee continued coverage if an individual changes jobs or becomes ill, and health insurance alliances that would help assure individual access to low-cost health care. What still is not clear is the extent to which long term care will be included in the basic benefits package. A confidential report circulated by the task force last month includes four options for long term care: incremental Medicaid reform; a new federal/state program to replace Medicaid; a social insurance program for home and community-based services; or full social insurance for long term care. Some work group members have identified an additional option: prefunded long term care insurance.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:10126659

  2. The coevolution of long-term pair bonds and cooperation.

    PubMed

    Song, Z; Feldman, M W

    2013-05-01

    The evolution of social traits may not only depend on but also change the social structure of the population. In particular, the evolution of pairwise cooperation, such as biparental care, depends on the pair-matching distribution of the population, and the latter often emerges as a collective outcome of individual pair-bonding traits, which are also under selection. Here, we develop an analytical model and individual-based simulations to study the coevolution of long-term pair bonds and cooperation in parental care, where partners play a Snowdrift game in each breeding season. We illustrate that long-term pair bonds may coevolve with cooperation when bonding cost is below a threshold. As long-term pair bonds lead to assortative interactions through pair-matching dynamics, they may promote the prevalence of cooperation. In addition to the pay-off matrix of a single game, the evolutionarily stable equilibrium also depends on bonding cost and accidental divorce rate, and it is determined by a form of balancing selection because the benefit from pair-bond maintenance diminishes as the frequency of cooperators increases. Our findings highlight the importance of ecological factors affecting social bonding cost and stability in understanding the coevolution of social behaviour and social structures, which may lead to the diversity of biological social systems. PMID:23496797

  3. Long Term Care Aide. Course Outline.

    ERIC Educational Resources Information Center

    Wilbee, Judy

    This course outline is intended to assist the instructor in the development of a curriculum for a long-term care aide program by specifying one component of the curriculum--the objectives. These objectives, or competencies expected as outcomes for student performance on completion of the program, describe the capabilities an individual must…

  4. Who Recommends Long-Term Care Matters

    ERIC Educational Resources Information Center

    Kane, Robert L.; Bershadsky, Boris; Bershadsky, Julie

    2006-01-01

    Purpose: Making good consumer decisions requires having good information. This study compared long-term-care recommendations among various types of health professionals. Design and Methods: We gave randomly varied scenarios to a convenience national sample of 211 professionals from varying disciplines and work locations. For each scenario, we…

  5. Long-term fixed income market structure

    NASA Astrophysics Data System (ADS)

    Grilli, Luca

    2004-02-01

    Long-term fixed income market securities present a strong positive correlation in daily returns. By using a metrical approach and considering “modified” time series, I show how it is possible to show a more complex structure which depends strictly on the maturity date.

  6. Professionalism in Long-Term Care Settings

    ERIC Educational Resources Information Center

    Lubinski, Rosemary

    2006-01-01

    Speech-language pathologists who serve elders in a variety of long-term care settings have a variety of professional skills and responsibilities. Fundamental to quality service is knowledge of aging and communication changes and disorders associated with this process, institutional alternatives, and the changing nature of today's elders in…

  7. LONG TERM HYDROLOGICAL IMPACT ASSESSMENT (LTHIA)

    EPA Science Inventory

    LTHIA is a universal Urban Sprawl analysis tool that is available to all at no charge through the Internet. It estimates impacts on runoff, recharge and nonpoint source pollution resulting from past or proposed land use changes. It gives long-term average annual runoff for a lan...

  8. NATIONAL LONG TERM CARE SURVEY (NLTCS)

    EPA Science Inventory

    National Long Term Care Surveys (NLTCS) are surveys of the entire aged population with a particular emphasis on the functionally impaired. Longitudinal study of the health and well-being of elderly Americans. Information about the population of chronically disabled elderly person...

  9. Long-Term Memory and Learning

    ERIC Educational Resources Information Center

    Crossland, John

    2011-01-01

    The English National Curriculum Programmes of Study emphasise the importance of knowledge, understanding and skills, and teachers are well versed in structuring learning in those terms. Research outcomes into how long-term memory is stored and retrieved provide support for structuring learning in this way. Four further messages are added to the…

  10. Long-Term Stability of Social Participation

    ERIC Educational Resources Information Center

    Hyyppa, Markku T.; Maki, Juhani; Alanen, Erkki; Impivaara, Olli; Aromaa, Arpo

    2008-01-01

    The long-term stability of social participation was investigated in a representative urban population of 415 men and 579 women who had taken part in the nationwide Mini-Finland Health Survey in the years 1978-1980 and were re-examined 20 years later. Stability was assessed by means of the following tracking coefficients: kappa, proportion of…

  11. Multi-objective, multi-level, multi-dimensional least-cost planning for long-term electric power generation development in the least-developing countries: A case study of Sudan

    NASA Astrophysics Data System (ADS)

    Elhag, Hussein Adam

    This research argues that the United States' version of the Ḻeast-C&barbelow;ost P&barbelow;lanning (LCP) for electric power long-term development is insufficient to fully accommodate the problems associated with planning for this sub-sector in the Ḻeast-Ḏeveloping C&barbelow;ountries (LDC's). This insufficiency is due to diverse and often conflicting objectives among these countries' national and socio-economic development priorities. It then suggests a modified LCP framework, to be based on multi-objective decision-making process, to integrate the objectives of the electric power sub-sector with those of broad social and national economic development concerns. This modified approach has termed by this research as the M&barbelow;ulti-O&barbelow;bjective Ḻeast-C&barbelow;ost P&barbelow;lanning (MOLCP). The solution of this model was based on the analysis of two other models, which are supportive and created specifically for the analysis of this research, and based on valid weighting methods. The first is the P&barbelow;rioritization Ḏecision-M&barbelow;aking model (PDM) which was actually based on the Analytical Hierarchy Process technique. The function of this model is to allocate the limited domestic energy resources among all energy-consuming sectors on the basis of the availability or scarcity of other energy substitutes for primary energy sources mainly used in each sector. The outcome of this model determines the type and amount of fuels that would be available for each sector, including electric power generation. This, in turn, would indeed determine the type of generating technologies that might be introduced in the long-term power development. In the second model, nine objectives, subsuming twenty seven associated attributes, are evaluated by means of the M&barbelow;ulti-O&barbelow;bjective M&barbelow;ulti-Ḏimensional Ḏecision-M&barbelow;aking model (MOMDM). Since not all the objectives enjoy the same load of importance to the planning

  12. Architecture analysis for European Long-Term Archiving EO systems

    NASA Astrophysics Data System (ADS)

    Garcia Gil, I.; Perez Moreno, R.; Perez Navarro, O.; Leone, R.

    2012-04-01

    . The definition of the architecture is linked to the study of the operational concept, so another driver for the architecture definition will be minimizing the cost for long-term operations, both at European and ESA PDGS level.

  13. 42 CFR 423.780 - Premium subsidy.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 3 2013-10-01 2013-10-01 false Premium subsidy. 423.780 Section 423.780 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM (CONTINUED) VOLUNTARY MEDICARE PRESCRIPTION DRUG BENEFIT Premiums and Cost-Sharing Subsidies for Low-Income Individuals §...

  14. The Present, Mid-Term, and Long-Term Supply Curves for Tellurium; and Updates in the Results from NREL's CdTe PV Module Manufacturing Cost Model (Presentation)

    SciTech Connect

    Woodhouse, M.; Goodrich, A.; Redlinger, M.; Lokanc, M.; Eggert, R.

    2013-09-01

    For those PV technologies that rely upon Te, In, and Ga, first-order observations and calculations hint that there may be resource constraints that could inhibit their successful deployment at a SunShot level. These are only first-order approximations, however, and the possibility for an expansion in global Te, In, and Ga supplies needs to be considered in the event that there are upward revisions in their demand and prices.In this study, we examine the current, mid-term, and long-term prospects of Tellurium (Te) for use in PV. We find that the current global supply base of Te would support <10 GW of annual traditional CdTe PV manufacturing production. But as for the possibility that the supply base for Te might be expanded, after compiling several preliminary cumulative availability curves we find that there may be significant upside potential in the supply base for this element - principally vis a vis increasing demand and higher prices. Primarily by reducing the Tellurium intensity in manufacturing and by increasing the recovery efficiency of Te in Cu refining processes, we calculate that it may prove affordable to PV manufacturers to expand the supply base for Te such that 100 GW, or greater, of annual CdTe PV production is possible in the 2030 - 2050 timeframe.

  15. 49 CFR 260.15 - Credit risk premium.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 49 Transportation 4 2013-10-01 2013-10-01 false Credit risk premium. 260.15 Section 260.15... REHABILITATION AND IMPROVEMENT FINANCING PROGRAM Overview § 260.15 Credit risk premium. (a) Where available... pay to the Administrator a Credit Risk Premium adequate to cover that portion of the subsidy cost...

  16. 49 CFR 260.15 - Credit risk premium.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 49 Transportation 4 2014-10-01 2014-10-01 false Credit risk premium. 260.15 Section 260.15... REHABILITATION AND IMPROVEMENT FINANCING PROGRAM Overview § 260.15 Credit risk premium. (a) Where available... pay to the Administrator a Credit Risk Premium adequate to cover that portion of the subsidy cost...

  17. 49 CFR 260.15 - Credit risk premium.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 49 Transportation 4 2010-10-01 2010-10-01 false Credit risk premium. 260.15 Section 260.15... REHABILITATION AND IMPROVEMENT FINANCING PROGRAM Overview § 260.15 Credit risk premium. (a) Where available... pay to the Administrator a Credit Risk Premium adequate to cover that portion of the subsidy cost...

  18. 24 CFR 221.254 - Mortgage insurance premiums.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 24 Housing and Urban Development 2 2014-04-01 2014-04-01 false Mortgage insurance premiums. 221... Cost Homes § 221.254 Mortgage insurance premiums. (a) All of the provisions of §§ 203.260 through 203.295 of this chapter relating to mortgage insurance premiums shall apply to mortgages insured...

  19. 24 CFR 221.254 - Mortgage insurance premiums.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 24 Housing and Urban Development 2 2010-04-01 2010-04-01 false Mortgage insurance premiums. 221... Cost Homes § 221.254 Mortgage insurance premiums. (a) All of the provisions of §§ 203.260 through 203.295 of this chapter relating to mortgage insurance premiums shall apply to mortgages insured...

  20. 24 CFR 221.254 - Mortgage insurance premiums.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 24 Housing and Urban Development 2 2011-04-01 2011-04-01 false Mortgage insurance premiums. 221... Cost Homes § 221.254 Mortgage insurance premiums. (a) All of the provisions of §§ 203.260 through 203.295 of this chapter relating to mortgage insurance premiums shall apply to mortgages insured...

  1. 5 CFR 870.405 - Direct premium payments.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 5 Administrative Personnel 2 2012-01-01 2012-01-01 false Direct premium payments. 870.405 Section... (CONTINUED) FEDERAL EMPLOYEES' GROUP LIFE INSURANCE PROGRAM Cost of Insurance § 870.405 Direct premium...' Retirement System) have been able to make direct premium payments if their annuity became too small to...

  2. 5 CFR 870.405 - Direct premium payments.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 5 Administrative Personnel 2 2013-01-01 2013-01-01 false Direct premium payments. 870.405 Section... (CONTINUED) FEDERAL EMPLOYEES' GROUP LIFE INSURANCE PROGRAM Cost of Insurance § 870.405 Direct premium...' Retirement System) have been able to make direct premium payments if their annuity became too small to...

  3. 5 CFR 870.405 - Direct premium payments.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 5 Administrative Personnel 2 2014-01-01 2014-01-01 false Direct premium payments. 870.405 Section... (CONTINUED) FEDERAL EMPLOYEES' GROUP LIFE INSURANCE PROGRAM Cost of Insurance § 870.405 Direct premium...' Retirement System) have been able to make direct premium payments if their annuity became too small to...

  4. 5 CFR 870.405 - Direct premium payments.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 5 Administrative Personnel 2 2010-01-01 2010-01-01 false Direct premium payments. 870.405 Section... (CONTINUED) FEDERAL EMPLOYEES' GROUP LIFE INSURANCE PROGRAM Cost of Insurance § 870.405 Direct premium...' Retirement System) have been able to make direct premium payments if their annuity became too small to...

  5. 24 CFR 221.254 - Mortgage insurance premiums.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 24 Housing and Urban Development 2 2013-04-01 2013-04-01 false Mortgage insurance premiums. 221... Cost Homes § 221.254 Mortgage insurance premiums. (a) All of the provisions of §§ 203.260 through 203.295 of this chapter relating to mortgage insurance premiums shall apply to mortgages insured...

  6. 5 CFR 870.405 - Direct premium payments.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 5 Administrative Personnel 2 2011-01-01 2011-01-01 false Direct premium payments. 870.405 Section... (CONTINUED) FEDERAL EMPLOYEES' GROUP LIFE INSURANCE PROGRAM Cost of Insurance § 870.405 Direct premium...' Retirement System) have been able to make direct premium payments if their annuity became too small to...

  7. 24 CFR 221.254 - Mortgage insurance premiums.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 24 Housing and Urban Development 2 2012-04-01 2012-04-01 false Mortgage insurance premiums. 221... Cost Homes § 221.254 Mortgage insurance premiums. (a) All of the provisions of §§ 203.260 through 203.295 of this chapter relating to mortgage insurance premiums shall apply to mortgages insured...

  8. Long-term assessment of residential radon-mitigation systems

    SciTech Connect

    Nitschke, I.A.; Clarkin, M.E. ); Rizzuto, J.E. ); Brennan, T. ); Osborne, M. )

    1988-01-01

    In New York State a survey in 1982-83 discovered fourteen houses with moderately high natural radon levels, and in early 1984 low-cost radon mitigation systems were installed in these houses. The radon reduction techniques included sealing cracks, sealing and sub-slab depressurization, isolating and venting unpaved crawl-spaces, and installing heat-recovery ventilators. These mitigation systems represent some of the earliest systems installed in the United States using low-cost common residential construction materials and methods. In this report, the authors discuss how they returned to these installations, inspected the longevity of the various components of the systems and assessed their long-term effectiveness.

  9. Archiving Primary Data: Solutions for Long-Term Studies.

    PubMed

    Mills, James A; Teplitsky, Céline; Arroyo, Beatriz; Charmantier, Anne; Becker, Peter H; Birkhead, Tim R; Bize, Pierre; Blumstein, Daniel T; Bonenfant, Christophe; Boutin, Stan; Bushuev, Andrey; Cam, Emmanuelle; Cockburn, Andrew; Côté, Steeve D; Coulson, John C; Daunt, Francis; Dingemanse, Niels J; Doligez, Blandine; Drummond, Hugh; Espie, Richard H M; Festa-Bianchet, Marco; Frentiu, Francesca; Fitzpatrick, John W; Furness, Robert W; Garant, Dany; Gauthier, Gilles; Grant, Peter R; Griesser, Michael; Gustafsson, Lars; Hansson, Bengt; Harris, Michael P; Jiguet, Frédéric; Kjellander, Petter; Korpimäki, Erkki; Krebs, Charles J; Lens, Luc; Linnell, John D C; Low, Matthew; McAdam, Andrew; Margalida, Antoni; Merilä, Juha; Møller, Anders P; Nakagawa, Shinichi; Nilsson, Jan-Åke; Nisbet, Ian C T; van Noordwijk, Arie J; Oro, Daniel; Pärt, Tomas; Pelletier, Fanie; Potti, Jaime; Pujol, Benoit; Réale, Denis; Rockwell, Robert F; Ropert-Coudert, Yan; Roulin, Alexandre; Sedinger, James S; Swenson, Jon E; Thébaud, Christophe; Visser, Marcel E; Wanless, Sarah; Westneat, David F; Wilson, Alastair J; Zedrosser, Andreas

    2015-10-01

    The recent trend for journals to require open access to primary data included in publications has been embraced by many biologists, but has caused apprehension amongst researchers engaged in long-term ecological and evolutionary studies. A worldwide survey of 73 principal investigators (Pls) with long-term studies revealed positive attitudes towards sharing data with the agreement or involvement of the PI, and 93% of PIs have historically shared data. Only 8% were in favor of uncontrolled, open access to primary data while 63% expressed serious concern. We present here their viewpoint on an issue that can have non-trivial scientific consequences. We discuss potential costs of public data archiving and provide possible solutions to meet the needs of journals and researchers. PMID:26411615

  10. Long term mortality in burned children

    PubMed Central

    Stamboulian, Daniel; Lede, Roberto

    2015-01-01

    Studies about risk factors for mortality in burn children are scarce and are even less in the follow up of this population across time. Usually, after complete event attendance, children are not follow-up as risk patients, burn injury affects all facets of life. Integration of professionals from different disciplines has enabled burn centers to develop collaborative methods of assessing the quality of care delivered to patients with burns. In this editorial we comment the paper of Duke et al. The authors highlight the importance of maintaining a long-term monitoring of children who suffered burns. The importance of this original study is to promote the reconsideration of clinical guides of long-term follow-up of burn patients. PMID:26835375

  11. Long term mortality in burned children.

    PubMed

    Rosanova, María Teresa; Stamboulian, Daniel; Lede, Roberto

    2015-07-01

    Studies about risk factors for mortality in burn children are scarce and are even less in the follow up of this population across time. Usually, after complete event attendance, children are not follow-up as risk patients, burn injury affects all facets of life. Integration of professionals from different disciplines has enabled burn centers to develop collaborative methods of assessing the quality of care delivered to patients with burns. In this editorial we comment the paper of Duke et al. The authors highlight the importance of maintaining a long-term monitoring of children who suffered burns. The importance of this original study is to promote the reconsideration of clinical guides of long-term follow-up of burn patients. PMID:26835375

  12. Long-term safety of retinoid therapy.

    PubMed

    Vahlquist, A

    1992-12-01

    The concern about long-term toxicity of oral synthetic retinoids has developed because many patients, especially those with genodermatoses, require lifelong therapy. Several organ systems are at risk, especially the hepatic, skeletal, and cardiovascular systems. Although acute hepatotoxicity is a rare side effect of etretinate and acitretin therapy, prospective studies have not demonstrated chronic liver toxicity. The frequency of bone changes induced by retinoids is difficult to estimate, because this adverse effect is usually asymptomatic and requires x-ray or scintigraphic examination for detection. Atherosclerosis develops in many patients who receive long-term retinoid therapy, but the extent to which the process is aggravated by drug-induced hyperlipidemia is not known. Many patients have now been treated with either etretinate or isotretinoin continuously for as many as 15 years and have not developed any signs of severe chronic toxicity. However, continued intense surveillance is recommended for patients expected to require lifelong therapy. PMID:1460122

  13. [Taiwan long-term care insurance and the evolution of long-term care in Japan].

    PubMed

    Huang, Hui-Wen; Liu, Shu-Hui; Pai, Yu-Chu

    2010-08-01

    The proportion of elderly (65 years of age and older) in Taiwan has exceeded 10% since 2008. With more elderly, the number of patients suffering from dementia and disabilities has also been rapidly increasing. Japan also has been facing increasing demand for long-term care due to an aging society. Prior to 2000, social welfare programs in Japan, working to cope with changing needs, typically provided insufficient services, and geriatric patients were hospitalized unnecessarily, wasting medical resources and causing undue patient hardship. In response, Japan launched its long-term care insurance program in April 2000. Under the program, city, town and village-based organizations should take responsibility for providing care to the elderly in their place of residence. The program significantly improved previous financial shortfalls and long-term care supply and demand has been met by existing social welfare organization resources. In Taiwan, the provision of long-term care by county / city authorities has proven inconsistent, with performance deemed poor after its first decade of long-term care operations. Service was found to be affected by differences in available resources and insufficient long-term care administration. The cultures of Taiwan and Japan are similar. The authors visited the Japan Long-Term Care Insurance Institute in August 2009. Main issues involved in the implementation and evolution of the Japan long-term Care Insurance are reported on in this paper. We hope such may be useful information to those working to develop long-term care programs in Taiwan. PMID:20661859

  14. Long-term orbital lifetime predictions

    NASA Astrophysics Data System (ADS)

    Dreher, P. E.; Lyons, A. T.

    1990-10-01

    Long-term orbital lifetime predictions are analyzed. Predictions were made for three satellites: the Solar Max Mission (SMM), the Long Duration Exposure Facility (LDEF), and the Pegasus Boiler Plate (BP). A technique is discussed for determining an appropriate ballistic coefficient to use in the lifetime prediction. The orbital decay rate should be monitored regularly. Ballistic coefficient updates should be done whenever there is a significant change in the actual decay rate or in the solar activity prediction.

  15. Long-term sequelae of electrical injury

    PubMed Central

    Wesner, Marni L.; Hickie, John

    2013-01-01

    Abstract Objective To summarize the current evidence-based knowledge about the long-term sequelae of injuries from electrical current. Quality of evidence MEDLINE was searched for English-language articles published in the past 20 years using the following search terms: electrical, injuries, wound, trauma, accident, sequelae, long-term, follow-up, and aftereffects. For obvious reasons, it is unethical to randomly study electrical injury in controlled clinical trials. By necessity, this topic is addressed in less-rigorous observational and retrospective work and case studies. Therefore, the strength of the literature pertaining to the long-term sequelae of electrical injury is impaired by the necessity of retrospective methods and case studies that typically describe small cohorts. Main message There are 2 possible consequences of electrical injury: the person either survives or dies. For those who survive electrical injury, the immediate consequences are usually obvious and often require extensive medical intervention. The long-term sequelae of the electrical injury might be more subtle, pervasive, and less well defined, but can include neurologic, psychological, and physical symptoms. In the field of compensation medicine, determining causation and attributing outcome to an injury that might not result in objective clinical findings becomes a considerable challenge. Conclusion The appearance of these consequences of electrical injury might be substantially delayed, with onset 1 to 5 or more years after the electrical injury. This poses a problem for patients and health care workers, making it hard to ascribe symptoms to a remote injury when they might not arise until well after the incident event. PMID:24029506

  16. Long-term Variation of AGNs

    NASA Astrophysics Data System (ADS)

    Fan, J. H.; Xie, G. Z.; Adam, G.; Copin, Y.; Lin, R. G.; Bai, J. M.; Quin, Y. P.

    In this paper we will present the long-term variation in the optical and the infrared bands for some selected AGNs. 1. Some new optical data observed by us have been presented for BL Lacertae (1995-1996) and OJ 287 (1994-1995), and new infrared data are presented for OJ 287 (Nov=2E 1995), which corresponds to the second optical peak (Sillanpaa et al. 1996; Takalo et al. 1996) and during last outburst. 2. For objects with long term observations, the Jurkevich's method has been used to analyses the long-term variation period. It is interesting that the reported periods of AGNs are of the similar value of about 10 years: 3C 345 11.4 years (Webb et al. 1988), 3C 120 15 years (Belokon et al. 1987; Hagen-Thorn et al. 1997), ON 231 13.6 years (Liu et al. 1995), OJ 287 12 years (Sillanpaa et al. 1988; Kidger et al. 1992), PKS 0735+178 14 years (Fan et al. 1997), NGC 4151 15 years (Fan et al. 1998a), BL Lacertae 14.0 years (Fan et al. 1998b). Is the mechanism for the long-term variation the same for different AGNs? 3. The DCF method has been adopted to analysis the variation correlation in the optical and infrared bands for BL Lac object OJ 287, the results show that these two bands are strongly correlated, which suggest that the emission mechanism in the two bands is the same. 4. For the optical and infrared bands, the maximum variations are correlated.

  17. Long-term home hemodialysis in children

    PubMed Central

    Borra, Sonia; Kaye, Michael

    1971-01-01

    Experience with chronic hemodialysis as a definitive form of therapy is described for six children aged 11 to 15 years at the onset. Duration on dialysis in the home has been between one and 4½ years. All patients are alive and rehabilitated without serious complications. It is concluded that although transplantation is the most desirable form of treatment for children, long-term hemodialysis is an alternative acceptable second choice. ImagesFIG. 2 PMID:5150193

  18. Long-term consequences of anorexia nervosa.

    PubMed

    Meczekalski, Blazej; Podfigurna-Stopa, Agnieszka; Katulski, Krzysztof

    2013-07-01

    Anorexia nervosa (AN) is a psychiatric disorder that occurs mainly in female adolescents and young women. The obsessive fear of weight gain, critically limited food intake and neuroendocrine aberrations characteristic of AN have both short- and long-term consequences for the reproductive, cardiovascular, gastrointestinal and skeletal systems. Neuroendocrine changes include impairment of gonadotropin releasing-hormone (GnRH) pulsatile secretion and changes in neuropeptide activity at the hypothalamic level, which cause profound hypoestrogenism. AN is related to a decrease in bone mass density, which can lead to osteopenia and osteoporosis and a significant increase in fracture risk in later life. Rates of birth complications and low birth weight may be higher in women with previous AN. The condition is associated with fertility problems, unplanned pregnancies and generally negative attitudes to pregnancy. During pregnancy, women with the condition have higher rates of hyperemesis gravidarum, anaemia and obstetric complications, as well as impaired weight gain and compromised intrauterine foetal growth. It is reported that 80% of AN patients are affected by a cardiac complications such as sinus bradycardia, a prolonged QT interval on electrocardiography, arrythmias, myocardial mass modification and hypotension. A decrease in bone mineral density (BMD) is one of the most important medical consequences of AN. Reduced BMD may subsequently lead to a three- to seven-fold increased risk of spontaneous fractures. Untreated AN is associated with a significant increase in the risk of death. Better detection and sophisticated therapy should prevent the long-term consequences of this disorder. The aims of treatment are not only recovery but also prophylaxis and relief of the long-term effects of this disorder. Further investigations of the long-term disease risk are needed. PMID:23706279

  19. [Long-term survival after severe trauma].

    PubMed

    Mutschler, W; Mutschler, M; Graw, M; Lefering, R

    2016-07-01

    Long-term survival after severe trauma is rarely addressed in German trauma journals although knowledge of life expectancy and identification of factors contributing to increased mortality are important for lifetime care management, development of service models, and targeting health promotion and prevention interventions. As reliable data in Germany are lacking, we compiled data mainly from the USA and Australia to describe life expectancy, risk factors, and predictors of outcome in patients experiencing traumatic spinal cord injury, traumatic brain injury, and polytrauma. Two years after trauma, life expectancy in all three categories was significantly lower than that of the general population. It depends strongly on severity of disability, age, and gender and is quantifiable. Whereas improvements in medical care have led to a marked decline in short-term mortality, surprisingly long-term survival in severe trauma has not changed over the past 30 years. Therefore, there is need to intensify long-term trauma patient care and to find new strategies to limit primary damage. PMID:27342106

  20. Long-Term Monitoring Research Needs: A DOE Perspective

    NASA Astrophysics Data System (ADS)

    Moore, B.; Davis, C. B.

    2002-05-01

    The U.S. Department of Energy's Office of Environmental Management is responsible for dealing with the nation's legacy of Cold War radioactive and hazardous waste and contamination. Major efforts are underway to deal with this legacy; these are expected to last up to decades and cost up to billions of dollars at some sites. At all sites, however, active remediation must eventually cease; if hazards then remain, the site must enter into a long-term stewardship mode. In this talk we discuss aspects of long-term monitoring pertinent to DOE sites, focusing on challenges to be faced, specific goals or targets to be met, and research needs to be addressed in order to enable DOE to meet its long-term stewardship obligations. DOE LTM research needs fall into three major categories: doing what we can do now much more efficiently; doing things we cannot do now; and proving the validity of our monitoring programs. Given the enormity of the DOE obligations, it will be highly desirable to develop much more efficient monitoring paradigms. Doing so will demand developing autonomous, remote monitoring networks of in situ sensors capable of replacing (or at least supplementing to a large extent) conventional groundwater and soil gas sampling and analysis programs. The challenges involved range from basic science (e.g., inventing in situ sensors for TCE that do not demand routine maintenance) to engineering (attaining superior reliability in data reporting in remote networks) to ergonomics (developing decent ways of selecting and presenting the "right" information from the monitoring network) to regulatory affairs (presenting convincing evidence that the more efficient systems actually provide superior monitoring). We explore these challenges in some detail, focusing on the "long" in long-term monitoring as it applies to DOE sites. Monitoring system performance validation and, ultimately, regulator and stakeholder acceptance of site closure and long-term stewardship plans depend

  1. Long-term views on hydro O M

    SciTech Connect

    Hocker, C. )

    1991-06-01

    Like the proverbial iceberg, at least 90 percent of the effort, costs, and headaches of owning a hydroelectric plant is usually hidden from view in the unglamorous, but essential, category of operations and maintenance (O M). While the processing of planning, designing, and constructing a plant may command more attention and excitement, and the economic benefits of ownership may be more satisfying, the day-in, day-out work of O M is a key component in the long-term success of a hydro plant. With project lives of between 50 and 100 years, running a hydro plant can be an extremely long-lived venture requiring an equally long-term approach to O M. Hydro O M experts in the US and Canada generally agree that successful O M requires a long-term view. Representatives of government agencies, investor-owned utilities, and private non-utility hydro owners contacted for this article all share similar perspectives, experiences, and methods for dealing with O M problems.

  2. Results of a Survey of Long-Term Archiving Implementations

    NASA Astrophysics Data System (ADS)

    Gurman, Joseph B.; Spencer, Jennifer L.

    2015-04-01

    NASA’s Heliophysics Data Management Policy calls for discipline-specific “final archives,” which will be responsible for the long-term archiving and service of Heliophysics mission data. Long-term archival functions, such as periodic revalidation of the data and migration to newer storage media when appropriate, have never been part of the Solar Data Analysis Center core capabilities. We also recognize that the largest space solar physics data set, the SDO AIA and HMI data at the Stanford Joint Science and Operations Center (JSOC), will eventually need preservation and long-term access, as will the potentially much larger data archive of DKIST observations. We have carried out a study of data archiving best practices in other disciplines and organizations, including NASA’s Space Physics Data Facility (SPDF), the National Institute of Standards and Technology (NIST), and private industry, and report on the lessons learned and possible cost models. We seek input from the broader solar physics community on the relative value of various levels of preservation effort.

  3. Premium coal water fuel (CWF)

    SciTech Connect

    Huettenhain, H.; Chari, M.V.

    1998-04-01

    Bechtel, together with Amax Research and Development Center (Amax R&D), recently completed a study which provides cost estimates for the commercial production of premium quality coal water fuel (CWF). The study was part of US Department of Energy program {open_quotes}Engineering Development of Advanced Physical Fine Coal Cleaning for Premium Fuel Applications{close_quotes}. Two plant scenarios to clean coal are addressed in the study, one using advanced column froth flotation to the clean coal and the other, selective agglomeration technology. This paper presents the study results.

  4. Premium coal water fuel (CWF)

    SciTech Connect

    Huettenhain, H.; Chari, M.V.

    1998-07-01

    Bechtel, together with Amax Research and Development Center (Amax R and D), recently completed a study which provides cost estimates for the commercial production of premium quality coal water fuel (CWF). The study was part of US Department of Energy program ``Engineering Development of Advanced Physical Fine Coal Cleaning for Premium Fuel Applications''. Two plant scenarios to clean coal are addressed in the study, one using advanced column froth flotation to the clean coal and the other, selective agglomeration technology. This paper presents the study results.

  5. Long-term EARLINET dust observations

    NASA Astrophysics Data System (ADS)

    Mona, Lucia; Amiridis, Vassilis; Amodeo, Aldo; Binietoglou, Ioannis; D'Amico, Giuseppe; Schwarz, Anja; Papagiannopoulos, Nikolaos; Papayannis, Alexandros; Sicard, Michael; Comeron, Adolfo; Pappalardo, Gelsomina

    2015-04-01

    Systematic observations of Saharan dust events over Europe are performed from May 2000 by EARLINET, the European Aerosol Research LIdar NETwork. EARLINET is a coordinated network of stations that make use of advanced lidar methods for the vertical profiling of aerosols. The backbone of EARLINET network is a common schedule for performing the measurements and the quality assurance of instruments/data. Particular attention is paid to monitoring the Saharan dust intrusions over the European continent. The geographical distribution of the EARLINET stations is particularly appealing for the dust observation, with stations located all around the Mediterranean and in the center of the Mediterranean (Italian stations) where dust intrusions are frequent, and with several stations in the central Europe where dust penetrates occasionally. All aerosol backscatter and extinction profiles related to observations collected during these alerts are grouped in the devoted "Saharan dust" category of the EARLINET database. This category consists of about 4700 files (as of December 2013). Case studies involving several stations around Europe selected from this long-term database have been provided the opportunity to investigate dust modification processes during transport over the continent. More important, the long term EARLINET dust monitoring allows the investigation of the horizontal and vertical extent of dust outbreaks over Europe and the climatological analysis of dust optical intensive and extensive properties at continental scale. This long-term database is also a unique tool for a systematic comparison with dust model outputs and satellite-derived dust products. Because of the relevance for both dust modeling and satellite retrievals improvement, results about desert dust layers extensive properties as a function of season and source regions are investigated and will be presented at the conference. First comparisons with models outputs and CALIPSO dust products will be

  6. Timber beams subjected to long - term loading

    NASA Astrophysics Data System (ADS)

    Sógel, K.

    2010-09-01

    Wood is a significant structural material, which is often used for timber bearing structures. Elements of timber structures must especially satisfy safety requirements, which are expressed by the ultimate limit states in the established standards. The structure must also satisfy the serviceability limit states. Local and global deformations make it impossible for the structure to serve the purpose it was designed for. It is important to take the deflections and their possible increase into account in the design to provide a structure which can be used during the whole period of service. Based on earlier examinations, it is known that a timber element over the course of long-term loading shows creep behavior. The structure of wood is able to adapt to the conditions of the surrounding environment. The properties of wood are especially affected by the relative humidity of the air and then by the type, intensity and duration of the loading. The most important factors affecting the serviceability of timber structures are volume changes caused by humidity and additional deflections caused by the effects of long-term loading. These phenomena emphasize the importance of serviceability limit states for timber structures. The paper deals with a long-term experimental investigation of timber girders that are currently often used. The aim was to obtain the deflection curves and mark the time dependence and the final deflections. The paper will also define the approximations for simulating the time-dependent deflections and obtain the creep coefficients for calculating the final deflections of the girders investigated.

  7. [Long-term treatment with amiodarone].

    PubMed

    Baedeker, W; Goedel-Meinen, L; Schmidt, G; Hofmann, M; Barthel, P; Blömer, H

    1991-02-01

    The aim of this study was to investigate the efficacy and the side effects of a long-term treatment with amiodarone. We analyzed the data of 41 patients in whom amiodarone therapy had been initiated between 1974 and 1984. Twenty-one patients had dilative cardiomyopathy, 14 patients had chronic myocardial infarction, four patients suffered from WPW syndrome with intermittent atrial fibrillation, one patient had aortic valve surgery, whereas in one patient there was no clinical evidence of a heart disease. All patients had salvos of ventricular extrasystoles, ventricular tachycardia or documented intermittent ventricular fibrillation. There have been seven drop-outs up to the present time. In each patient, the lowest antiarrhythmically effective dose was applied, which was generally higher in patients with low ejection fraction. Effective treatment of the ventricular tachycardia was achieved in 55-92% of patients and did not depend on the duration of treatment. In 10 patients in whom amiodarone therapy had to be stopped for various reasons. Sudden cardiac death was slightly more frequent than in the 24 patients treated with amiodarone, though the difference was not significant. In cases with a history of syncope the prognosis was poor, even with amiodarone therapy. Due to side effects, a dosage reduction or discontinuation of amiodarone treatment became necessary in 14 patients. Amiodarone proved to be an effective drug also for the long-term treatment of ventricular tachycardia, and possibly for the prevention of sudden cardiac death. With the exception of blue skin color, there was no accumulation of side effects, even during long-term treatment of several years. PMID:1711739

  8. Long Term Archiving and CCSDS Standards

    NASA Astrophysics Data System (ADS)

    Boucon, Danièle

    This article presents some conceptual and implementation CCSDS -Consultative Committee for Space Data Systemsstandards for long term archiving. It focuses on the most recent one, the Producer Archive Interface Specification (PAIS) standard. This standard, currently available as a draft on the CCSDS web site, will be published by the beginning of 2014. It will enable the Producer to share with the Archive a sufficiently precise and unambiguous formal definition of the Digital Objects to be produced and transferred, by means of a model. It will also enable a precise definition of the packaging of these objects in the form of Submission Information Packages (SIPs), including the order in which they should be transferred.

  9. Long-Term Wind Power Variability

    SciTech Connect

    Wan, Y. H.

    2012-01-01

    The National Renewable Energy Laboratory started collecting wind power data from large commercial wind power plants (WPPs) in southwest Minnesota with dedicated dataloggers and communication links in the spring of 2000. Over the years, additional WPPs in other areas were added to and removed from the data collection effort. The longest data stream of actual wind plant output is more than 10 years. The resulting data have been used to analyze wind power fluctuations, frequency distribution of changes, the effects of spatial diversity, and wind power ancillary services. This report uses the multi-year wind power data to examine long-term wind power variability.

  10. Long-term outcomes in multiple gestations.

    PubMed

    Rand, Larry; Eddleman, Keith A; Stone, Joanne

    2005-06-01

    Children born from a multiple gestation are at increased risk for cerebral palsy, learning disability, and language and neurobehavioral deficits. With the increased incidence of multiple pregnancies and use of assisted reproductive technology (ART), these issues are more commonly affecting parents. Long-term outcomes are a critical part of preconceptual and early pregnancy counseling for parents faced with a multiple gestation or considering ART, and the provider should be well versed on issues surrounding zygosity, gestational age, higher-order multiples, and the effects of options such as multifetal pregnancy reduction. PMID:15922795

  11. Long-Term Solar Irradiance Variability

    NASA Technical Reports Server (NTRS)

    Pap, J. M.

    1996-01-01

    Measurements of the solar energy throughout the solar spectrum and understanding its variability provide important information about the physical processes and structural changes in the solar interior and in the solar atmosphere...The aim of this paper is to discuss the solar-cycle-related long-term changes in solar total and UV irradiances. The spaceborne irradiance observations are compared to ground-based indices of solar magnetic activity, such as the Photometric Sunspot Index, full disk magnetic flux, and the Mt. Wilson Magnetic Plage Strength Index.

  12. Performance considerations in long-term spaceflight

    NASA Technical Reports Server (NTRS)

    Akins, F. R.

    1979-01-01

    Maintenance of skilled performance during extended space flight is of critical importance to both the health and safety of crew members and to the overall success of mission goals. An examination of long term effects and performance requirements is therefore a factor of immense importance to the planning of future missions. Factors that were investigated include: definition of performance categories to be investigated; methods for assessing and predicting performance levels; in-flight factors which can affect performance; and factors pertinent to the maintenance of skilled performance.

  13. Human Behaviour in Long-Term Missions

    NASA Technical Reports Server (NTRS)

    1997-01-01

    In this session, Session WP1, the discussion focuses on the following topics: Psychological Support for International Space Station Mission; Psycho-social Training for Man in Space; Study of the Physiological Adaptation of the Crew During A 135-Day Space Simulation; Interpersonal Relationships in Space Simulation, The Long-Term Bed Rest in Head-Down Tilt Position; Psychological Adaptation in Groups of Varying Sizes and Environments; Deviance Among Expeditioners, Defining the Off-Nominal Act in Space and Polar Field Analogs; Getting Effective Sleep in the Space-Station Environment; Human Sleep and Circadian Rhythms are Altered During Spaceflight; and Methodological Approach to Study of Cosmonauts Errors and Its Instrumental Support.

  14. Transitions of elders between long-term care and hospitals.

    PubMed

    Naylor, Mary D; Kurtzman, Ellen T; Pauly, Mark V

    2009-08-01

    Elderly long-term care recipients who require acute hospitalizations must navigate a fragmented system with poor "handoffs," often resulting in negative outcomes. This article makes the case that reducing preventable hospitalizations and improving transitions to and from hospitals will enhance health care quality and outcomes among these elders. Immediate action targeting diffusion of evidence-based care is recommended to decrease avoidable rehospitalizations and achieve cost savings. Policy changes are needed to address barriers to high-quality transitional care, including deficits in health professionals' and caregivers' knowledge and resources, regulatory obstacles, and inadequate financial incentives and clinical information systems. PMID:20026453

  15. Sleep facilitates long-term face adaptation.

    PubMed

    Ditye, Thomas; Javadi, Amir Homayoun; Carbon, Claus-Christian; Walsh, Vincent

    2013-10-22

    Adaptation is an automatic neural mechanism supporting the optimization of visual processing on the basis of previous experiences. While the short-term effects of adaptation on behaviour and physiology have been studied extensively, perceptual long-term changes associated with adaptation are still poorly understood. Here, we show that the integration of adaptation-dependent long-term shifts in neural function is facilitated by sleep. Perceptual shifts induced by adaptation to a distorted image of a famous person were larger in a group of participants who had slept (experiment 1) or merely napped for 90 min (experiment 2) during the interval between adaptation and test compared with controls who stayed awake. Participants' individual rapid eye movement sleep duration predicted the size of post-sleep behavioural adaptation effects. Our data suggest that sleep prevented decay of adaptation in a way that is qualitatively different from the effects of reduced visual interference known as 'storage'. In the light of the well-established link between sleep and memory consolidation, our findings link the perceptual mechanisms of sensory adaptation--which are usually not considered to play a relevant role in mnemonic processes--with learning and memory, and at the same time reveal a new function of sleep in cognition. PMID:23986109

  16. Long term perfusion system supporting adipogenesis

    PubMed Central

    Abbott, Rosalyn D.; Raja, Waseem K.; Wang, Rebecca Y.; Stinson, Jordan A.; Glettig, Dean L.; Burke, Kelly A.; Kaplan, David L.

    2015-01-01

    Adipose tissue engineered models are needed to enhance our understanding of disease mechanisms and for soft tissue regenerative strategies. Perfusion systems generate more physiologically relevant and sustainable adipose tissue models, however adipocytes have unique properties that make culturing them in a perfusion environment challenging. In this paper we describe the methods involved in the development of two perfusion culture systems (2D and 3D) to test their applicability for long term in vitro adipogenic cultures. It was hypothesized that a silk protein biomaterial scaffold would provide a 3D framework, in combination with perfusion flow, to generate a more physiologically relevant sustainable adipose tissue engineered model than 2D cell culture. Consistent with other studies evaluating 2D and 3D culture systems for adipogenesis we found that both systems successfully model adipogensis, however 3D culture systems were more robust, providing the mechanical structure required to contain the large, fragile adipocytes that were lost in 2D perfused culture systems. 3D perfusion also stimulated greater lipogenesis and lipolysis and resulted in decreased secretion of LDH compared to 2D perfusion. Regardless of culture configuration (2D or 3D) greater glycerol was secreted with the increased nutritional supply provided by perfusion of fresh media. These results are promising for adipose tissue engineering applications including long term cultures for studying disease mechanisms and regenerative approaches, where both acute (days to weeks) and chronic (weeks to months) cultivation are critical for useful insight. PMID:25843606

  17. Long Term Changes in the Polar Vortices

    NASA Astrophysics Data System (ADS)

    Braathen, Geir O.

    2016-04-01

    As the amount of halogens in the stratosphere is slowly declining and the ozone layer slowly recovers it is of interest to see how the meteorological conditions in the vortex develop over the long term since such changes might alter the foreseen ozone recovery. In conjunction with the publication of the WMO Antarctic and Arctic Ozone Bulletins, WMO has acquired the ERA Interim global reanalysis data set for several meteorological parameters. This data set goes from 1979 - present. These long time series of data can be used for several useful studies of the long term development of the polar vortices. Several "environmental indicators" for vortex change have been calculated, and a climatology, as well as trends, for these parameters will be presented. These indicators can act as yardsticks and will be useful for understanding past and future changes in the polar vortices and how these changes affect polar ozone depletion. Examples of indicators are: vortex mean temperature, vortex minimum temperature, vortex mean PV, vortex "importance" (PV*area), vortex break-up time, mean and maximum wind speed. Data for both the north and south polar vortices have been analysed at several isentropic levels from 350 to 850 K. A possible link between changes in PV and sudden stratospheric warmings will be investigated, and the results presented. The unusual meteorological conditions of the 2015 south polar vortex and the 2010/11 and 2015/16 north polar vortices will be compared to other recent years.

  18. Long-Term Care Policy: Singapore's Experience.

    PubMed

    Chin, Chee Wei Winston; Phua, Kai-Hong

    2016-01-01

    Singapore, like many developed countries, is facing the challenge of a rapidly aging population and the increasing need to provide long-term care (LTC) services for elderly in the community. The Singapore government's philosophy on care for the elderly is that the family should be the first line of support, and it has relied on voluntary welfare organizations (VWOs) or charities for the bulk of LTC service provision. For LTC financing, it has emphasized the principles of co-payment and targeting of state support to the low-income population through means-tested government subsidies. It has also instituted ElderShield, a national severe disability insurance scheme. This paper discusses some of the challenges facing LTC policy in Singapore, particularly the presence of perverse financial incentives for hospitalization, the pitfalls of over-reliance on VWOs, and the challenges facing informal family caregivers. It discusses the role of private LTC insurance in LTC financing, bearing in mind demand- and supply-side failures that have plagued the private LTC insurance market. It suggests the need for more standardized needs assessment and portable LTC benefits, with reference to the Japanese Long-Term Care Insurance program, and also discusses the need to provide more support to informal family caregivers. PMID:26808468

  19. Long term changes in the polar vortices

    NASA Astrophysics Data System (ADS)

    Braathen, Geir O.

    2015-04-01

    As the amount of halogens in the stratosphere is slowly declining and the ozone layer slowly recovers it is of interest to see how the meteorological conditions in the vortex develop over the long term since such changes might alter the foreseen ozone recovery. In conjunction with the publication of the WMO Antarctic and Arctic Ozone Bulletins, WMO has acquired the ERA Interim global reanalysis data set for several meteorological parameters. This data set goes from 1979 - present. These long time series of data can be used for several useful studies of the long term development of the polar vortices. Several "environmental indicators" for vortex change have been calculated, and a climatology, as well as trends, for these parameters will be presented. These indicators can act as yardsticks and will be useful for understanding past and future changes in the polar vortices and how these changes affect polar ozone depletion. Examples of indicators are: vortex mean temperature, vortex minimum temperature, vortex mean PV, vortex "importance" (PV*area), vortex break-up time, mean and maximum wind speed. Data for both the north and south polar vortices have been analysed at several isentropic levels from 350 to 850 K. A possible link between changes in PV and sudden stratospheric warmings will be investigated, and the results presented.

  20. Long-term intracranial pressure monitoring.

    PubMed

    de Jong, D A; Maas, A I; den Ouden, A H; de Lange, S A

    Continuous or intermittent measurement of intracranial pressure (ICP) is important in patients at risk for raised ICP. Indications exist for short- and long-term measurements. The various methods used for short-term monitoring are discussed with their relative advantages and disadvantages. For long-term measurements of ICP use of a completely implantable telemetric epidural pressure transducer is indicated. No such device is commercially available. We have developed an inexpensive passive telemetric transducer for this purpose. Results obtained up till now have demonstrated its reliability for measurements of two to three months duration. The life span of the device is limited by degrading of the epoxy utilized for sealing of the titanium pressure sensing part to the radiolucent ceramic cap of the transducer, causing leakage of water into the transducer and false low measurements. Because of these problems new hermetic sealing techniques were tested. Both active metal brazing and glass bonding yielded good results and hermetic sealing could be obtained. The metal to ceramic bonding presented is generally applicable within the design of implants. Besides the technical progress reported, the experience with clinical use in 12 patients is presented. PMID:6674738

  1. A long-term experimental case study of the ecological effectiveness and cost effectiveness of invasive plant management in achieving conservation goals: bitou bush control in booderee national park in eastern australia.

    PubMed

    Lindenmayer, David B; Wood, Jeff; MacGregor, Christopher; Buckley, Yvonne M; Dexter, Nicholas; Fortescue, Martin; Hobbs, Richard J; Catford, Jane A

    2015-01-01

    Invasive plant management is often justified in terms of conservation goals, yet progress is rarely assessed against these broader goals, instead focussing on short-term reductions of the invader as a measure of success. Key questions commonly remain unanswered including whether invader removal reverses invader impacts and whether management itself has negative ecosystem impacts. We addressed these knowledge gaps using a seven year experimental investigation of Bitou Bush, Chrysanthemoides monilifera subsp. rotundata. Our case study took advantage of the realities of applied management interventions for Bitou Bush to assess whether it is a driver or passenger of environmental change, and quantified conservation benefits relative to management costs of different treatment regimes. Among treatments examined, spraying with herbicide followed by burning and subsequent re-spraying (spray-fire-spray) proved the most effective for reducing the number of individuals and cover of Bitou Bush. Other treatment regimes (e.g. fire followed by spraying, or two fires in succession) were less effective or even exacerbated Bitou Bush invasion. The spray-fire-spray regime did not increase susceptibility of treated areas to re-invasion by Bitou Bush or other exotic species. This regime significantly reduced plant species richness and cover, but these effects were short-lived. The spray-fire-spray regime was the most cost-effective approach to controlling a highly invasive species and facilitating restoration of native plant species richness to levels characteristic of uninvaded sites. We provide a decision tree to guide management, where recommended actions depend on the outcome of post-treatment monitoring and performance against objectives. Critical to success is avoiding partial treatments and treatment sequences that may exacerbate invasive species impacts. We also show the value of taking advantage of unplanned events, such as wildfires, to achieve management objectives at

  2. A Long-Term Experimental Case Study of the Ecological Effectiveness and Cost Effectiveness of Invasive Plant Management in Achieving Conservation Goals: Bitou Bush Control in Booderee National Park in Eastern Australia

    PubMed Central

    Lindenmayer, David B.; Wood, Jeff; MacGregor, Christopher; Buckley, Yvonne M.; Dexter, Nicholas; Fortescue, Martin; Hobbs, Richard J.; Catford, Jane A.

    2015-01-01

    Invasive plant management is often justified in terms of conservation goals, yet progress is rarely assessed against these broader goals, instead focussing on short-term reductions of the invader as a measure of success. Key questions commonly remain unanswered including whether invader removal reverses invader impacts and whether management itself has negative ecosystem impacts. We addressed these knowledge gaps using a seven year experimental investigation of Bitou Bush, Chrysanthemoides monilifera subsp. rotundata. Our case study took advantage of the realities of applied management interventions for Bitou Bush to assess whether it is a driver or passenger of environmental change, and quantified conservation benefits relative to management costs of different treatment regimes. Among treatments examined, spraying with herbicide followed by burning and subsequent re-spraying (spray-fire-spray) proved the most effective for reducing the number of individuals and cover of Bitou Bush. Other treatment regimes (e.g. fire followed by spraying, or two fires in succession) were less effective or even exacerbated Bitou Bush invasion. The spray-fire-spray regime did not increase susceptibility of treated areas to re-invasion by Bitou Bush or other exotic species. This regime significantly reduced plant species richness and cover, but these effects were short-lived. The spray-fire-spray regime was the most cost-effective approach to controlling a highly invasive species and facilitating restoration of native plant species richness to levels characteristic of uninvaded sites. We provide a decision tree to guide management, where recommended actions depend on the outcome of post-treatment monitoring and performance against objectives. Critical to success is avoiding partial treatments and treatment sequences that may exacerbate invasive species impacts. We also show the value of taking advantage of unplanned events, such as wildfires, to achieve management objectives at

  3. Managing soils for long-term productivity

    PubMed Central

    Syers, J. K.

    1997-01-01

    Meeting the goal of long-term agricultural productivity requires that soil degradation be halted and reversed. Soil fertility decline is a key factor in soil degradation and is probably the major cause of declining crop yields. There is evidence that the contribution of declining soil fertility to soil degradation has been underestimated.
    Sensitivity to soil degradation is implicit in the assessment of the sustainability of land management practices, with wide recognition of the fact that soils vary in their ability to resist change and recover subsequent to stress. The concept of resilience in relation to sustainability requires further elaboration and evaluation.
    In the context of soil degradation, a decline in soil fertility is primarily interpreted as the depletion of organic matter and plant nutrients. Despite a higher turnover rate of organic matter in the tropics there is no intrinsic difference between the organic matter content of soils from tropical and temperate regions. The level of organic matter in a soil is closely related to the above and below ground inputs. In the absence of adequate organic material inputs and where cultivation is continuous, soil organic matter declines progressively. Maintaining the quantity and quality of soil organic matter should be a guiding principle in developing management practices.
    Soil microbial biomass serves as an important reservoir of nitrogen (N), phosphorus (P) and sulphur (S), and regulates the cycling of organic matter and nutrients. Because of its high turnover rate, microbial biomass reacts quickly to changes in management and is a sensitive indicator for monitoring and predicting changes in soil organic matter. Modelling techniques have been reasonably successful in predicting changes in soil organic matter with different organic material inputs, but there is little information from the tropics.
    Nutrient depletion through harvested crop components and residue removal, and by leaching and soil

  4. NICE guidance on long-term sickness and incapacity.

    PubMed

    Gabbay, Mark; Taylor, Lorraine; Sheppard, Linda; Hillage, Jim; Bambra, Clare; Ford, Fiona; Preece, Richard; Taske, Nichole; Kelly, Michael P

    2011-03-01

    Long-term sickness absence and incapacity benefits (disability pension) rates have increased across industrialised countries. Effective measures are needed to support return to work. The recommendations of this guidance were informed by the most appropriate available evidence of effectiveness and cost-effectiveness. Public health evidence was provided by research using a variety of study designs that attempted to determine the outcome of a particular intervention by evaluating status before and after the intervention had been effected, and was not limited to randomised control trials. Where the evidence base was depleted or underdeveloped, expert witnesses were called to give their opinion on the best available evidence and emerging interventions. The process enabled challenge and contestability from stakeholder groups at different points as the guidance was developed. Forty-five heterogeneous studies were included in the review of interventions to reduce long-term sickness absence and transitions from short-term to long-term absence (mainly covering the former and also mainly examining musculoskeletal conditions). The analysis of evidence was restricted to descriptive synthesis. Three general themes emerged from an analysis of the studies that were more likely to report positive results: early interventions; multidisciplinary approaches; and interventions with a workplace component. Two further reviews were undertaken, one on interventions to reduce the re-occurrence of sickness absence, which identified seven studies on lower back pain, and concluded that early intervention and direct workplace input are important factors. The final evidence review focused on six studies of interventions for those in receipt of incapacity benefit. The evidence was that work-focused interviews coupled with access to tailored support are effective and cost-effective interventions. Practitioners should consider the impact of interventions and management options on work ability for

  5. NICE guidance on long-term sickness and incapacity

    PubMed Central

    Gabbay, Mark; Taylor, Lorraine; Sheppard, Linda; Hillage, Jim; Bambra, Clare; Ford, Fiona; Preece, Richard; Taske, Nichole; Kelly, Michael P

    2011-01-01

    Long-term sickness absence and incapacity benefits (disability pension) rates have increased across industrialised countries. Effective measures are needed to support return to work. The recommendations of this guidance were informed by the most appropriate available evidence of effectiveness and cost-effectiveness. Public health evidence was provided by research using a variety of study designs that attempted to determine the outcome of a particular intervention by evaluating status before and after the intervention had been effected, and was not limited to randomised control trials. Where the evidence base was depleted or underdeveloped, expert witnesses were called to give their opinion on the best available evidence and emerging interventions. The process enabled challenge and contestability from stakeholder groups at different points as the guidance was developed. Forty-five heterogeneous studies were included in the review of interventions to reduce long-term sickness absence and transitions from short-term to long-term absence (mainly covering the former and also mainly examining musculoskeletal conditions). The analysis of evidence was restricted to descriptive synthesis. Three general themes emerged from an analysis of the studies that were more likely to report positive results: early interventions; multidisciplinary approaches; and interventions with a workplace component. Two further reviews were undertaken, one on interventions to reduce the re-occurrence of sickness absence, which identified seven studies on lower back pain, and concluded that early intervention and direct workplace input are important factors. The final evidence review focused on six studies of interventions for those in receipt of incapacity benefit. The evidence was that work-focused interviews coupled with access to tailored support are effective and cost-effective interventions. Practitioners should consider the impact of interventions and management options on work ability for

  6. Long-term priming of visual search prevails against the passage of time and counteracting instructions.

    PubMed

    Kruijne, Wouter; Meeter, Martijn

    2016-08-01

    Studies on intertrial priming have shown that in visual search experiments, the preceding trial automatically affects search performance: facilitating it when the target features repeat and giving rise to switch costs when they change-so-called (short-term) intertrial priming. These effects also occur at longer time scales: When 1 of 2 possible target colors is more frequent during an experiment block, this results in a prolonged and persistent facilitation for the color that was biased, long after the frequency bias is gone-so-called long-term priming. In this study, we explore the robustness of such long-term priming. In Experiment 1, participants were fully informed of the bias and instructed to prioritize the other unbiased color. Despite these instructions, long-term priming of the biased color persisted in this block, suggesting that guidance by long-term priming is an implicit effect. In Experiment 2, long-term priming was built up in 1 experimental session and was then assessed in a second session a week later. Long-term priming persisted across this week, emphasizing that long-term priming is truly a phenomenon of long-term memory. The results support the view that priming results from the automatic and implicit retrieval of memory traces of past trials. (PsycINFO Database Record PMID:26866654

  7. Health Insurance Marketplaces: Premium Trends in Rural Areas.

    PubMed

    Barker, Abigail R; Kemper, Leah M; McBride, Timothy D; Meuller, Keith J

    2016-05-01

    Since 2014, when the Health Insurance Marketplaces (HIMs) authorized by the Patient Protection and Affordable Care Act (ACA) were implemented, considerable premium changes have been observed in the marketplaces across the 50 states and the District of Columbia. This policy brief assesses the changes in average HIM plan premiums from 2014 to 2016, before accounting for subsidies, with an emphasis on the widening variation across rural and urban places. Since this brief focuses on premiums without accounting for subsidies, this is not intended to be an analysis of the "affordability" of ACA premiums, as that would require assessment of premiums, cost-sharing adjustments, and other factors. PMID:27416649

  8. Long-term U. S. energy outlook

    SciTech Connect

    Friesen, G.

    1984-01-01

    Each year Chase Econometrics offers its clients a brief summary of the assumptions underlying the long-term energy forecast for the U.S. To illustrate the uncertainty involved in forecasting for the period to the year 2000, they choose to compare forecasts with some recent projections prepared by the Department of Energy's Office of Policy, Planning and Analysis for the annual National Energy Policy Plan supplement. Particular emphasis is placed on Scenario B, which is the mid-range reference case. As the introduction to the supplement emphasizes, the NEPP projections should not be considered a statement of the policy goals of the Reagan Administration. They represent an analysis of the possible evolution of U.S. energy markets, given current information and existing policies. The purpose of providing Scenario B as a reference case as well as Scenarios A and C as alternate cases is to show the sensitivity of oil price projections to small swings in energy demand.

  9. Long-term control of root growth

    DOEpatents

    Burton, Frederick G.; Cataldo, Dominic A.; Cline, John F.; Skiens, W. Eugene

    1992-05-26

    A method and system for long-term control of root growth without killing the plants bearing those roots involves incorporating a 2,6-dinitroaniline in a polymer and disposing the polymer in an area in which root control is desired. This results in controlled release of the substituted aniline herbicide over a period of many years. Herbicides of this class have the property of preventing root elongation without translocating into other parts of the plant. The herbicide may be encapsulated in the polymer or mixed with it. The polymer-herbicide mixture may be formed into pellets, sheets, pipe gaskets, pipes for carrying water, or various other forms. The invention may be applied to other protection of buried hazardous wastes, protection of underground pipes, prevention of root intrusion beneath slabs, the dwarfing of trees or shrubs and other applications. The preferred herbicide is 4-difluoromethyl-N,N-dipropyl-2,6-dinitro-aniline, commonly known as trifluralin.

  10. Long-term control of root growth

    SciTech Connect

    Burton, F.G.; Cataldo, D.A.; Cline, J.F.; Skiens, W.E.

    1992-05-26

    A method and system for long-term control of root growth without killing the plants bearing those roots involves incorporating a 2,6-dinitroaniline in a polymer and disposing the polymer in an area in which root control is desired. This results in controlled release of the substituted aniline herbicide over a period of many years. Herbicides of this class have the property of preventing root elongation without translocating into other parts of the plant. The herbicide may be encapsulated in the polymer or mixed with it. The polymer-herbicide mixture may be formed into pellets, sheets, pipe gaskets, pipes for carrying water, or various other forms. The invention may be applied to other protection of buried hazardous wastes, protection of underground pipes, prevention of root intrusion beneath slabs, the dwarfing of trees or shrubs and other applications. The preferred herbicide is 4-difluoromethyl-N,N-dipropyl-2,6-dinitro-aniline, commonly known as trifluralin. 7 figs.

  11. Long term thermoelectric module testing system.

    PubMed

    D'Angelo, Jonathan; Hogan, Timothy

    2009-10-01

    Thermoelectric generators can be used for converting waste heat into electric power. Significant interest in developing new materials in recent years has led to the discovery of several promising thermoelectrics, however, there can be considerable challenges in developing the materials into working devices. Testing and feedback is needed at each step to gain valuable information for identification of difficulties, quality of the materials and modules, repeatability in fabrication, and longevity of the devices. This paper describes a long-term module testing system for monitoring the output power of a module over extended testing times. To evaluate the system, we have tested commercially available thermoelectric modules over a one month time period. PMID:19895086

  12. Withdrawal from long-term benzodiazepine treatment.

    PubMed Central

    Petursson, H; Lader, M H

    1981-01-01

    Long-term, normal-dose benzodiazepine treatment was discontinued in 16 patients who were suspected of being dependent on their medication. The withdrawal was gradual, placebo-controlled, and double-blind. All the patients experienced some form of withdrawal reaction, which ranged from anxiety and dysphoria to moderate affective and perceptual changes. Symptom ratings rose as the drugs were discontinued, but usually subsided to prewithdrawal levels over the next two to four weeks. Other features of the withdrawal included disturbance of sleep and appetite and noticeable weight loss. Electroencephalography showed appreciable reduction in fast-wave activity as the drugs were withdrawn, and an improvement in psychological performance was recorded by the Digit Symbol Substitution Test. Because of the risk of dependence on benzodiazepines these agents should probably not be given as regular daily treatment for chronic anxiety. PMID:6114776

  13. Long term performance of radon mitigation systems

    SciTech Connect

    Prill, R.; Fisk, W.J.

    2002-03-01

    Researchers installed radon mitigation systems in 12 houses in Spokane, Washington and Coeur d'Alene, Idaho during the heating season 1985--1986 and continued to monitor indoor radon quarterly and annually for ten years. The mitigation systems included active sub-slab ventilation, basement over-pressurization, and crawlspace isolation and ventilation. The occupants reported various operational problems with these early mitigation systems. The long-term radon measurements were essential to track the effectiveness of the mitigation systems over time. All 12 homes were visited during the second year of the study, while a second set 5 homes was visited during the fifth year to determine the cause(s) of increased radon in the homes. During these visits, the mitigation systems were inspected and measurements of system performance were made. Maintenance and modifications were performed to improve system performance in these homes.

  14. Managing Records for the Long Term - 12363

    SciTech Connect

    Montgomery, John V.; Gueretta, Jeanie

    2012-07-01

    The U.S. Department of Energy (DOE) is responsible for managing vast amounts of information documenting historical and current operations. This information is critical to the operations of the DOE Office of Legacy Management. Managing legacy records and information is challenging in terms of accessibility and changing technology. The Office of Legacy Management is meeting these challenges by making records and information management an organizational priority. The Office of Legacy Management mission is to manage DOE post-closure responsibilities at former Cold War weapons sites to ensure the future protection of human health and the environment. These responsibilities include environmental stewardship and long-term preservation and management of operational and environmental cleanup records associated with each site. A primary organizational goal for the Office of Legacy Management is to 'Preserve, Protect, and Share Records and Information'. Managing records for long-term preservation is an important responsibility. Adequate and dedicated resources and management support are required to perform this responsibility successfully. Records tell the story of an organization and may be required to defend an organization in court, provide historical information, identify lessons learned, or provide valuable information for researchers. Loss of records or the inability to retrieve records because of poor records management processes can have serious consequences and even lead to an organisation's downfall. Organizations must invest time and resources to establish a good records management program because of its significance to the organization as a whole. The Office of Legacy Management will continue to research and apply innovative ways of doing business to ensure that the organization stays at the forefront of effective records and information management. DOE is committed to preserving records that document our nation's Cold War legacy, and the Office of Legacy

  15. Long-term dynamics of Typha populations

    USGS Publications Warehouse

    Grace, J.B.; Wetzel, R.G.

    1998-01-01

    The zonation of Typha populations in an experimental pond in Michigan was re-examined 15 years after the original sampling to gain insight into the long-term dynamics. Current distributions of Typha populations were also examined in additional experimental ponds at the site that have been maintained for 23 years. The zonation between T. latifolia and T. angustifolia in the previously studied pond 15 years after the initial sampling revealed that the density and distribution of shoots had not changed significantly. Thus, it appears that previously reported results (based on 7- year old populations) have remained consistent over time. Additional insight into the interaction between these two taxa was sought by comparing mixed and monoculture stands in five experimental ponds that have remained undisturbed for their 23-year history. The maximum depth of T. latifolia, the shallow- water species, was not significantly reduced when growing in the presence of the more flood tolerant T. angustifolia. In contrast, the minimum depth of T. angustifolia was reduced from 0 to 37 cm when in the presence of T. latifolia. When total populations were compared between monoculture and mixed stands, the average density of T. angustifolia shoots was 59.4 percent lower in mixed stands while the density of T. latifolia was 32 percent lower, with T. angustifolia most affected at shallow depths (reduced by 92 percent) and T. latifolia most affected at the deepest depths (reduced by 60 percent). These long-term observations indicate that competitive displacement between Typha taxa has remained stable over time.

  16. Multiobjective long-term planning of biopharmaceutical manufacturing facilities.

    PubMed

    Lakhdar, K; Savery, J; Papageorgiou, L G; Farid, S S

    2007-01-01

    Biopharmaceutical companies with large portfolios of clinical and commercial products typically need to allocate production across several multiproduct facilities, including third party contract manufacturers. This poses several capacity planning challenges which are further complicated by the need to satisfy different stakeholders often with conflicting objectives. This work addresses the question of how a biopharmaceutical manufacturer can make better long-term capacity planning decisions given multiple strategic criteria such as cost, risk, customer service level, and capacity utilization targets. A long-term planning model that allows for multiple facilities and accounts for multiple objectives via goal programming is developed. An industrial case study based on a large scale biopharmaceutical manufacturer is used to illustrate the functionality of the model. A single objective model is used to identify how best to use existing capacity so as to maximize profits for different demand scenarios. Mitigating risk due to unforeseen circumstances by including a dual facility constraint is shown to be a reasonable strategy at base case demand levels but unacceptable if demands are 150% higher than expected. The capacity analysis identifies where existing capacity fails to meet demands given the constraints. A multiobjective model is used to demonstrate how key performance measures change given different decision making policies where different weights are assigned to cost, customer service level, and utilization targets. The analysis demonstrates that a high profit can still be achieved while meeting key targets more closely. The sensitivity of the optimal solution to different limits on the targets is illustrated. PMID:17924645

  17. 42 CFR 447.72 - Alternative premium and cost sharing exemptions and protections for individuals with family...

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... protections for individuals with family incomes above 100 percent but at or below 150 percent of the FPL. 447... sharing exemptions and protections for individuals with family incomes above 100 percent but at or below... whose family income exceeds 100 percent, but does not exceed 150 percent, of the FPL. (b) Cost...

  18. Long-term potentiation and long-term depression: a clinical perspective

    PubMed Central

    Bliss, Timothy V.P.; Cooke, Sam F

    2011-01-01

    Long-term potentiation and long-term depression are enduring changes in synaptic strength, induced by specific patterns of synaptic activity, that have received much attention as cellular models of information storage in the central nervous system. Work in a number of brain regions, from the spinal cord to the cerebral cortex, and in many animal species, ranging from invertebrates to humans, has demonstrated a reliable capacity for chemical synapses to undergo lasting changes in efficacy in response to a variety of induction protocols. In addition to their physiological relevance, long-term potentiation and depression may have important clinical applications. A growing insight into the molecular mechanisms underlying these processes, and technological advances in non-invasive manipulation of brain activity, now puts us at the threshold of harnessing long-term potentiation and depression and other forms of synaptic, cellular and circuit plasticity to manipulate synaptic strength in the human nervous system. Drugs may be used to erase or treat pathological synaptic states and non-invasive stimulation devices may be used to artificially induce synaptic plasticity to ameliorate conditions arising from disrupted synaptic drive. These approaches hold promise for the treatment of a variety of neurological conditions, including neuropathic pain, epilepsy, depression, amblyopia, tinnitus and stroke. PMID:21779718

  19. Automated long-term scheduling for the SOFIA airborne observatory

    NASA Astrophysics Data System (ADS)

    Civeit, Thomas

    The NASA Stratospheric Observatory for Infrared Astronomy (SOFIA) is a joint US/German project to develop and operate a gyro-stabilized 2.5-meter telescope in a Boeing 747SP. SOFIA's first science observations were made in December 2010. During 2011, SOFIA accomplished 30 flights in the “ Early Science” program as well as a deployment to Germany. The next observing period, known as Cycle 1, is scheduled to begin in late fall 2012. It includes 46 science flights grouped in four multi-week observing campaigns spread through a 13-month span. Automation of the flight scheduling process offers a major challenge to the SOFIA mission operations. First because it is needed to mitigate its relatively high cost per unit observing time compared to space-borne missions. Second because automated scheduling techniques available for ground-based and space-based telescopes are inappropriate for an airborne observatory. Although serious attempts have been made in the past to solve part of the problem, until recently mission operations staff was still manually scheduling flights. We present in this paper a new automated solution for generating SOFIA's long-term schedules. We describe the constraints that should be satisfied to solve the SOFIA scheduling problem in the context of real operations. We establish key formulas required to efficiently calculate the aircraft course over ground when evaluating flight schedules. We describe the foundations of the SOFIA long-term scheduler, the constraint representation, and the random search based algorithm that generates observation and instrument schedules. Finally, we report on how the new long-term scheduler has been used in operations to date.

  20. Automated Long - Term Scheduling for the SOFIA Airborne Observatory

    NASA Technical Reports Server (NTRS)

    Civeit, Thomas

    2013-01-01

    The NASA Stratospheric Observatory for Infrared Astronomy (SOFIA) is a joint US/German project to develop and operate a gyro-stabilized 2.5-meter telescope in a Boeing 747SP. SOFIA's first science observations were made in December 2010. During 2011, SOFIA accomplished 30 flights in the "Early Science" program as well as a deployment to Germany. The new observing period, known as Cycle 1, is scheduled to begin in 2012. It includes 46 science flights grouped in four multi-week observing campaigns spread through a 13-month span. Automation of the flight scheduling process offers a major challenge to the SOFIA mission operations. First because it is needed to mitigate its relatively high cost per unit observing time compared to space-borne missions. Second because automated scheduling techniques available for ground-based and space-based telescopes are inappropriate for an airborne observatory. Although serious attempts have been made in the past to solve part of the problem, until recently mission operations staff was still manually scheduling flights. We present in this paper a new automated solution for generating SOFIA long-term schedules that will be used in operations from the Cycle 1 observing period. We describe the constraints that should be satisfied to solve the SOFIA scheduling problem in the context of real operations. We establish key formulas required to efficiently calculate the aircraft course over ground when evaluating flight schedules. We describe the foundations of the SOFIA long-term scheduler, the constraint representation, and the random search based algorithm that generates observation and instrument schedules. Finally, we report on how the new long-term scheduler has been used in operations to date.

  1. Treatment for childhood cancer -- long-term risks

    MedlinePlus

    ... ency/patientinstructions/000849.htm Treatment for childhood cancer - long-term risks To use the sharing features on ... has. Being aware of your child's risk of long-term health problems can help you follow-up ...

  2. Long-term corrosion testing pan.

    SciTech Connect

    Wall, Frederick Douglas; Brown, Neil R.

    2008-08-01

    This document describes the testing and facility requirements to support the Yucca Mountain Project long-term corrosion testing needs. The purpose of this document is to describe a corrosion testing program that will (a) reduce model uncertainty and variability, (b) reduce the reliance upon overly conservative assumptions, and (c) improve model defensibility. Test matrices were developed for 17 topical areas (tasks): each matrix corresponds to a specific test activity that is a subset of the total work performed in a task. A future document will identify which of these activities are considered to be performance confirmation activities. Detailed matrices are provided for FY08, FY09 and FY10 and rough order estimates are provided for FY11-17. Criteria for the selection of appropriate test facilities were developed through a meeting of Lead Lab and DOE personnel on October 16-17, 2007. These criteria were applied to the testing activities and recommendations were made for the facility types appropriate to carry out each activity. The facility requirements for each activity were assessed and activities were identified that can not be performed with currently available facilities. Based on this assessment, a total of approximately 10,000 square feet of facility space is recommended to meet all future testing needs, given that all testing is consolidated to a single location. This report is a revision to SAND2007-7027 to address DOE comments and add a series of tests to address NWTRB recommendations.

  3. Long-term corrosion testing plan.

    SciTech Connect

    Wall, Frederick Douglas; Brown, Neil R.

    2009-02-01

    This document describes the testing and facility requirements to support the Yucca Mountain Project long-term corrosion testing program. The purpose of this document is to describe a corrosion testing program that will (a) reduce model uncertainty and variability, (b) reduce the reliance upon overly conservative assumptions, and (c) improve model defensibility. Test matrices were developed for 17 topical areas (tasks): each matrix corresponds to a specific test activity that is a subset of the total work performed in a task. A future document will identify which of these activities are considered to be performance confirmation activities. Detailed matrices are provided for FY08, FY09 and FY10 and rough order estimates are provided for FY11-17. Criteria for the selection of appropriate test facilities were developed through a meeting of Lead Lab and DOE personnel on October 16-17, 2007. These criteria were applied to the testing activities and recommendations were made for the facility types appropriate to carry out each activity. The facility requirements for each activity were assessed and activities were identified that can not be performed with currently available facilities. Based on this assessment, a total of approximately 10,000 square feet of facility space is recommended to accommodate all future testing, given that all testing is consolidated to a single location. This report is a revision to SAND2008-4922 to address DOE comments.

  4. Transuranic waste: long-term planning

    SciTech Connect

    Young, K.C.

    1985-07-01

    Societal concerns for the safe handling and disposal of toxic waste are behind many of the regulations and the control measures in effect today. Transuranic waste, a specific category of toxic (radioactive) waste, serves as a good example of how regulations and controls impact changes in waste processing - and vice versa. As problems would arise with waste processing, changes would be instituted. These changes improved techniques for handling and disposal of transuranic waste, reduced the risk of breached containment, and were usually linked with regulatory changes. Today, however, we face a greater public awareness of and concern for toxic waste control; thus, we must anticipate potential problems and work on resolving them before they can become real problems. System safety analyses are valuable aids in long-term planning for operations involving transuranic as well as other toxic materials. Examples of specific system safety analytical methods demonstrate how problems can be anticipated and resolution initiated in a timely manner having minimal impacts upon allocation of resource and operational goals. 7 refs., 1 fig.

  5. Long-term predictions using natural analogues

    SciTech Connect

    Ewing, R.C.

    1995-09-01

    One of the unique and scientifically most challenging aspects of nuclear waste isolation is the extrapolation of short-term laboratory data (hours to years) to the long time periods (10{sup 3}-10{sup 5} years) required by regulatory agencies for performance assessment. The direct validation of these extrapolations is not possible, but methods must be developed to demonstrate compliance with government regulations and to satisfy the lay public that there is a demonstrable and reasonable basis for accepting the long-term extrapolations. Natural systems (e.g., {open_quotes}natural analogues{close_quotes}) provide perhaps the only means of partial {open_quotes}validation,{close_quotes} as well as data that may be used directly in the models that are used in the extrapolation. Natural systems provide data on very large spatial (nm to km) and temporal (10{sup 3}-10{sup 8} years) scales and in highly complex terranes in which unknown synergisms may affect radionuclide migration. This paper reviews the application (and most importantly, the limitations) of data from natural analogue systems to the {open_quotes}validation{close_quotes} of performance assessments.

  6. [Long term adherence to HAART in Senegal].

    PubMed

    Bastard, M; Fall, M Basty Koita

    2014-10-01

    Adherence is one of the main predictors of antiretroviral treatment success. A governmental initiative was launched in 1998 for HIV-infected patients in Senegal to provide access to highly active antiretroviral therapy (HAART). Adherence measurements, defined as pills taken/pills prescribed, were assessed between November 1999 and June 2010 using a pill count along with a questionnaire for 330 patients. Predictors of adherence and identification of adherence trajectories were explored through latent class mixed model. We also performed a survival analysis using Cox proportional hazard model. Three adherence behaviours were revealed as well as a better adherence for women. A third of patients had a high adherence trajectory over time and a third had an intermediate one. Male gender and low adherence behaviour over time were independently associated with a higher mortality rate. This study shows that an overall good adherence can be obtained in the long term in Senegal, suggests a better adherence for women and points out a large subsample of patients with intermediate level of adherence behaviour who are at risk for developing resistance to antiretroviral drugs. PMID:24615434

  7. Long-term outcome in aqueductal stenosis.

    PubMed

    Villani, R; Tomei, G; Gaini, S M; Grimoldi, N; Spagnoli, D; Bello, L

    1995-03-01

    In this study, 78 patients with aqueductal stenosis were submitted to detailed neurodevelopmental assessment with a follow-up of 5-25 years. Sixty-eight percent of patients were categorized as normal; they either attended normal school courses or had regular jobs. Among these, 34% had some motor abnormalities (ataxia, mild hemiparesis, visual disturbances). Twenty-four percent (19 cases) were moderately disabled (trainable retardation) and 8% (6 cases) were severely handicapped. Epilepsy was observed in 13% of the cases. Incidence of recurrent and generalized seizures paralleled neurodevelopmental outcome (5% in normal, 16% in moderately disabled and 50% in severely disabled patients). Endocrine dysfunctions were evident in 28% of the cases and were characterized by precocious or delayed puberty, amenorrhea and somatic underdevelopment. No patient with ventricular enlargement and a cortical mantle width below 20 mm showed a good outcome. Large ventricles were compatible with normal mental development when compensated with a corresponding cranial vault enlargement. In patients with normal mental status and motor abnormalities, long-term CT scan findings revealed the presence of focal brain abnormalities (poroencephaly, brain atrophy, calcifications, extracerebral collections). PMID:7773981

  8. Alpine Soils as long-term Bioindicators

    NASA Astrophysics Data System (ADS)

    Nestroy, O.

    2009-04-01

    Alpine soils as long-term bioindicators The introductory words concern the definitions and peculiarities of alpine soils and their position in the Austrian Soil Classification 2000 in comparison with the World Reference Base for Soil Resources 2006. The important parameters for genesis and threats for these soils in steep and high positions are discussed. It must be emphasized that the main threats are the very different kinds of erosion e.g. by water, wind and snow, and also by skiing (end of season) as well as and mountain-biking (mainly summer-sport). Due the very slow regeneration and - in this connection - due to the very slow changes of the soil entities, these soils give an utmost importance as a long-time bioindicator. With regard to the climate change one can assume an increase in the content of organic matter on site, but also an increase of erosion and mass movement on the other site, e. g. in kind of "plaiken" (soil slide) as result of an increasing intensity of rainfall. It lies partly in our hands to diminish the number and the intensity of the threats, we can influence the soil development, but the result to reach a new ecological equilibrium is very long - in case of alpine soil more than two generations.

  9. Neurological long term consequences of deep diving.

    PubMed Central

    Todnem, K; Nyland, H; Skeidsvoll, H; Svihus, R; Rinck, P; Kambestad, B K; Riise, T; Aarli, J A

    1991-01-01

    Forty commercial saturation divers, mean age 34.9 (range 24-49) years, were examined one to seven years after their last deep dive (190-500 metres of seawater). Four had by then lost their divers' licence because of neurological problems. Twenty seven (68%) had been selected by neurological examination and electroencephalography before the deep dives. The control group consisted of 100 men, mean age 34.0 (range 22-48) years. The divers reported significantly more symptoms from the nervous system. Concentration difficulties and paraesthesia in feet and hands were common. They had more abnormal neurological findings by neurological examination compatible with dysfunction in the lumbar spinal cord or roots. They also had a larger proportion of abnormal electroencephalograms than the controls. The neurological symptoms and findings were highly significantly correlated with exposure to deep diving (depth included), but even more significantly correlated to air and saturation diving and prevalence of decompression sickness. Visual evoked potentials, brainstem auditory evoked potentials, and magnetic resonance imaging of the brain did not show more abnormal findings in the divers. Four (10%) divers had had episodes of cerebral dysfunction during or after the dives; two had had seizures, one had had transitory cerebral ischaemia and one had had transitory global amnesia. It is concluded that deep diving may have a long term effect on the nervous system of the divers. PMID:2025592

  10. Long term prediction of flood occurrence

    NASA Astrophysics Data System (ADS)

    Aguilar, Cristina; Montanari, Alberto; José Polo, María

    2016-05-01

    How long a river remembers its past is still an open question. Perturbations occurring in large catchments may impact the flow regime for several weeks and months, therefore providing a physical explanation for the occasional tendency of floods to occur in clusters. The research question explored in this paper may be stated as follows: can higher than usual river discharges in the low flow season be associated to a higher probability of floods in the subsequent high flow season? The physical explanation for such association may be related to the presence of higher soil moisture storage at the beginning of the high flow season, which may induce lower infiltration rates and therefore higher river runoff. Another possible explanation is persistence of climate, due to presence of long-term properties in atmospheric circulation. We focus on the Po River at Pontelagoscuro, whose catchment area amounts to 71 000 km2. We look at the stochastic connection between average river flows in the pre-flood season and the peak flows in the flood season by using a bivariate probability distribution. We found that the shape of the flood frequency distribution is significantly impacted by the river flow regime in the low flow season. The proposed technique, which can be classified as a data assimilation approach, may allow one to reduce the uncertainty associated to the estimation of the flood probability.

  11. The long-term variability of Vega

    NASA Astrophysics Data System (ADS)

    Butkovskaya, V.; Plachinda, S.; Valyavin, G.; Baklanova, D.; Lee, B.-C.

    2011-12-01

    Over the time of 60 years Vega (α Lyrae = HD 172167, A0V) has been generally accepted as a standard star in the near-infrared, optical, and ultraviolet regions. But is the spectrophotometric standard Vega really non-variable star? Researchers give very different answers to this question. We aim to search a periodicity in our results of spectropolarimetric study of Vega, namely periodic variations in equivalent width of the spectral lines and longitudinal magnetic field measurements. High-accuracy spectropolarimetric observations of Vega have been performed during 26 nights from 1997 to 2010 using the Coudé spectrograph of the 2.6-m Shain reflector at the Crimean Astrophysical Observatory (CrAO, Ukraine) and during 4 nights in 2007 and 2008 using the echelle spectrograph BOES at the Bohyunsan Optical Astronomy Observatory (BOAO, South Korea). The long-term (year-to-year) variability of Vega was confirmed. It was concluded that this variability does not have magnetic nature. The paper is dedicated to the memory of V.P. Merezhin.

  12. Long-term intraperitoneal insulin delivery.

    PubMed Central

    Pitt, H A; Saudek, C D; Zacur, H A

    1992-01-01

    Over the past 5 years, 21 patients with insulin-dependent diabetes mellitus have been managed at the Johns Hopkins Medical Institutions with variable rate, remotely controlled implanted insulin pumps. To date, nearly 70 patient-years of experience has been gained with intraperitoneal delivery of a new U-400 insulin with a surfactant. All 21 patients are alive after a mean of 39.3 months (range, 10 to 65 months) after insulin pump implantation. Nineteen of the 21 patients remain on intraperitoneal insulin, for a 5-year actuarial system survival of 90%. Glucose control was improved, especially during the first 16 months after pump implantation, without an increased incidence of severe hypoglycemia. Catheter blockage has been a significant problem, occurring in nine of the 21 patients (43%). Catheter occlusion has been successfully managed, however, with laparoscopic repair in seven of 10 attempts or with catheter change in four of five patients. Nevertheless, quality of life and patient acceptance remain excellent. Moreover, pre-existing nephropathy, neuropathy, and retinopathy have been surprisingly stable. With an aggressive policy of catheter change or laparoscopic clearance of catheter blockage, long-term intraperitoneal insulin delivery is now a safe and effective treatment for type I diabetics. PMID:1417197

  13. Intermediate- and long-term earthquake prediction.

    PubMed

    Sykes, L R

    1996-04-30

    Progress in long- and intermediate-term earthquake prediction is reviewed emphasizing results from California. Earthquake prediction as a scientific discipline is still in its infancy. Probabilistic estimates that segments of several faults in California will be the sites of large shocks in the next 30 years are now generally accepted and widely used. Several examples are presented of changes in rates of moderate-size earthquakes and seismic moment release on time scales of a few to 30 years that occurred prior to large shocks. A distinction is made between large earthquakes that rupture the entire downdip width of the outer brittle part of the earth's crust and small shocks that do not. Large events occur quasi-periodically in time along a fault segment and happen much more often than predicted from the rates of small shocks along that segment. I am moderately optimistic about improving predictions of large events for time scales of a few to 30 years although little work of that type is currently underway in the United States. Precursory effects, like the changes in stress they reflect, should be examined from a tensorial rather than a scalar perspective. A broad pattern of increased numbers of moderate-size shocks in southern California since 1986 resembles the pattern in the 25 years before the great 1906 earthquake. Since it may be a long-term precursor to a great event on the southern San Andreas fault, that area deserves detailed intensified study. PMID:11607658

  14. Intermediate- and long-term earthquake prediction.

    PubMed Central

    Sykes, L R

    1996-01-01

    Progress in long- and intermediate-term earthquake prediction is reviewed emphasizing results from California. Earthquake prediction as a scientific discipline is still in its infancy. Probabilistic estimates that segments of several faults in California will be the sites of large shocks in the next 30 years are now generally accepted and widely used. Several examples are presented of changes in rates of moderate-size earthquakes and seismic moment release on time scales of a few to 30 years that occurred prior to large shocks. A distinction is made between large earthquakes that rupture the entire downdip width of the outer brittle part of the earth's crust and small shocks that do not. Large events occur quasi-periodically in time along a fault segment and happen much more often than predicted from the rates of small shocks along that segment. I am moderately optimistic about improving predictions of large events for time scales of a few to 30 years although little work of that type is currently underway in the United States. Precursory effects, like the changes in stress they reflect, should be examined from a tensorial rather than a scalar perspective. A broad pattern of increased numbers of moderate-size shocks in southern California since 1986 resembles the pattern in the 25 years before the great 1906 earthquake. Since it may be a long-term precursor to a great event on the southern San Andreas fault, that area deserves detailed intensified study. Images Fig. 1 PMID:11607658

  15. Long Term Storage of Lyophilized Liposomal Formulations

    PubMed Central

    Payton, N.M.; Wempe, M.F.; Xu, Y.; Anchordoquy, T.J.

    2014-01-01

    Because aqueous liposomal formulations containing multiply unsaturated lipids are susceptible to chemical degradation, these formulations are often lyophilized. Despite their limited chemical stability, interest in the use of multiply unsaturated lipids to promote intracellular delivery has increased considerably in recent years. The goal of the current study was to examine the long term storage stability of lyophilized formulations containing lipids with increasing levels of unsaturation, and various strategies which can be employed to improve stability. Aqueous lipid-trehalose formulations containing 1,2-dilinolenoyl-sn-glycero-3-phosphocholine (DLPC), 1,2-dilinoleoyl-sn-glycero-3-phosphocholine (DLinPC) or 1,2-dioleoyl-sn-glycero-3-phosphocholine (DOPC) were lyophilized and stored at temperatures ranging from 4°C to 60°C. We observed that the lipid degradation rate increased as the storage temperature and unsaturation level were increased. Even the cleanest sugars which are available commercially contain iron contaminants, and it was observed that the chelation of these iron contaminants significantly improved the stability of DLPC during storage. However, the glass transition temperature of the sugar which was included in the formulation, the reduction of the oxygen in the aqueous sample prior to lyophilization, the inclusion of helper lipids (i.e., cholesterol), and the rate of freezing did not significantly improve stability. PMID:25308534

  16. 22 CFR 228.12 - Long-term leases.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 22 Foreign Relations 1 2011-04-01 2011-04-01 false Long-term leases. 228.12 Section 228.12 Foreign... Transactions for USAID Financing § 228.12 Long-term leases. Any commodity obtained under a long-term lease..., a long-term lease is defined as a single lease of more than 180 days, or repetitive or...

  17. 22 CFR 228.12 - Long-term leases.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Long-term leases. 228.12 Section 228.12 Foreign... Transactions for USAID Financing § 228.12 Long-term leases. Any commodity obtained under a long-term lease..., a long-term lease is defined as a single lease of more than 180 days, or repetitive or...

  18. 26 CFR 1.460-1 - Long-term contracts.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 26 Internal Revenue 6 2011-04-01 2011-04-01 false Long-term contracts. 1.460-1 Section 1.460-1...) INCOME TAXES (CONTINUED) Taxable Year for Which Items of Gross Income Included § 1.460-1 Long-term... the manufacture, building, installation, or construction of property is a long-term contract...

  19. 22 CFR 228.18 - Long-term leases.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 22 Foreign Relations 1 2012-04-01 2012-04-01 false Long-term leases. 228.18 Section 228.18 Foreign Relations AGENCY FOR INTERNATIONAL DEVELOPMENT RULES FOR PROCUREMENT OF COMMODITIES AND SERVICES FINANCED BY... USAID Financing § 228.18 Long-term leases. Any commodity obtained under a long-term lease agreement...

  20. 26 CFR 1.460-1 - Long-term contracts.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 26 Internal Revenue 6 2014-04-01 2014-04-01 false Long-term contracts. 1.460-1 Section 1.460-1...) INCOME TAXES (CONTINUED) Taxable Year for Which Items of Gross Income Included § 1.460-1 Long-term... the manufacture, building, installation, or construction of property is a long-term contract...

  1. 22 CFR 228.18 - Long-term leases.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 22 Foreign Relations 1 2014-04-01 2014-04-01 false Long-term leases. 228.18 Section 228.18 Foreign Relations AGENCY FOR INTERNATIONAL DEVELOPMENT RULES FOR PROCUREMENT OF COMMODITIES AND SERVICES FINANCED BY... USAID Financing § 228.18 Long-term leases. Any commodity obtained under a long-term lease agreement...

  2. 26 CFR 1.460-1 - Long-term contracts.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 26 Internal Revenue 6 2013-04-01 2013-04-01 false Long-term contracts. 1.460-1 Section 1.460-1...) INCOME TAXES (CONTINUED) Taxable Year for Which Items of Gross Income Included § 1.460-1 Long-term... the manufacture, building, installation, or construction of property is a long-term contract...

  3. 17 CFR 256.224 - Other long-term debt.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 17 Commodity and Securities Exchanges 3 2011-04-01 2011-04-01 false Other long-term debt. 256.224 Section 256.224 Commodity and Securities Exchanges SECURITIES AND EXCHANGE COMMISSION (CONTINUED) UNIFORM... COMPANY ACT OF 1935 6. Long-Term Debt § 256.224 Other long-term debt. This account shall include all...

  4. 17 CFR 256.224 - Other long-term debt.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 17 Commodity and Securities Exchanges 3 2010-04-01 2010-04-01 false Other long-term debt. 256.224 Section 256.224 Commodity and Securities Exchanges SECURITIES AND EXCHANGE COMMISSION (CONTINUED) UNIFORM... COMPANY ACT OF 1935 6. Long-Term Debt § 256.224 Other long-term debt. This account shall include all...

  5. 22 CFR 228.18 - Long-term leases.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 22 Foreign Relations 1 2013-04-01 2013-04-01 false Long-term leases. 228.18 Section 228.18 Foreign Relations AGENCY FOR INTERNATIONAL DEVELOPMENT RULES FOR PROCUREMENT OF COMMODITIES AND SERVICES FINANCED BY... USAID Financing § 228.18 Long-term leases. Any commodity obtained under a long-term lease agreement...

  6. 3 CFR - Long-Term Gulf Coast Restoration Support Plan

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 3 The President 1 2011-01-01 2011-01-01 false Long-Term Gulf Coast Restoration Support Plan Presidential Documents Other Presidential Documents Memorandum of June 30, 2010 Long-Term Gulf Coast... help the Gulf Coast and its people recover from this tragedy. A long-term plan to restore the...

  7. 78 FR 36449 - State Long-Term Care Ombudsman Program

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-06-18

    ... HUMAN SERVICES Administration on Aging 45 CFR Parts 1321 and 1327 RIN 0985-AA08 State Long-Term Care... request for comments, to implement provisions of the Older Americans Act, the State Long-Term Care... determining State compliance in carrying out the Long-Term Care Ombudsman program functions. This...

  8. [Long-term care services in Spain: an overview].

    PubMed

    Casado-Marín, David

    2006-03-01

    To date, both in Spain and virtually all the other European Union (EU) countries, dependency has been seen to be a fundamentally private problem to be dealt with by the family concerned. In this way, whether through informal carers or contracted professionals, in the domestic environment or in care homes, it is the dependent person themselves and their families who currently bear the majority of the costs. In light of this, current concern lies in the social change that is coming on, mainly the accelerated aging process and the increased participation of middle-aged women in the labour market, which heighten the need for collective organisation of that which until now has been resolved within family circles. In this context, at the same time that the Government announces to issue a <Long Term Care Law> by the end of 2005, our paper briefly analyzes what we consider the four crucial issues in this area: the current scope of dependency problems and its possible future evolution, the characteristics of the current spanish long-term care system and its main problems; the role that health services should have in the dependency issue; and finally, the benefits and drawbacks of the main alternatives that the Administration could manage in case it intends to increase its involvement in this field. PMID:16539976

  9. Adapting Advances in Remediation Science to Long-Term Surveillance

    SciTech Connect

    Peterson, Dave

    2006-03-01

    Several facets of groundwater remediation stand to gain from the advances made during recent years in disciplines that contribute to remediation science. Engineered remedies designed to aggressively remove subsurface contamination should benefit from this progress, and more passive cleanup methods and the long-term monitoring of such passive approaches may benefit equally well if not more. The U.S. Department of Energy Office of Legacy Management (LM) has adopted a strategic plan that is designed to take advantage of technological improvements in the monitoring and assessment of both active and passive groundwater remedies. Flexible adaptation of new technologies, as they become available, to long-term surveillance at LM sites is expected to reduce site stewardship costs while ensuring the future protection of human health and the environment. Some of the technologies are expected to come from government initiatives that focus on the needs of subsurface monitoring. Additional progress in monitoring science will likely result from continual improvements in our understanding of contaminant fate-and-transport processes in the groundwater and the vadose zone.

  10. Long-term stability of polymeric integrated optical components

    NASA Astrophysics Data System (ADS)

    Kwong, Wing-Ying

    2006-02-01

    Traditionally, glass has been a suitable waveguide material and passive integrated optical circuits in glass substrates are widely used as passive components. Long-term tests of optical glass flats with a high level of internal stress revealed gradual systematic-change with time to produce inconsistent results. Since long-term stability has been the primary concern for users of specific applications, investigations of instabilities in various optical materials have been carried out via measurements and tests. From the development of the integrated optical systems' point-of-view, polymers are promising candidates that possess excellent compatibility with all other materials and their associated processes. Polymeric materials offer large refractive-index contrasts, high performance, environmental stability, simple low-cost fabrication and may be processed by unconventional forming techniques. Polymer technologies can be designed to form stress-free films, so that stress-induced losses can be eliminated. Optical polymers may also be tailored to meet specific requirements for optical waveguide devices and can be highly transparent in such a way that they are not a limiting factor in components' lifetime. In this paper, tests results and characteristics of polymeric materials shall be reviewed; different types of polymer are detail-studied and a brief analysis shall be presented. Examples of passive polymeric integrated optical components are single-mode splitters, couplers, polarizers, routers, gratings, bend waveguides, power dividers, wavelength filters and wavelength multiplexers/de-multiplexers, which may find applications in the optical communication and the telecommunication industries.

  11. Long-term global nuclear energy and fuel cycle strategies

    SciTech Connect

    Krakowski, R.A.

    1997-09-24

    The Global Nuclear Vision Project is examining, using scenario building techniques, a range of long-term nuclear energy futures. The exploration and assessment of optimal nuclear fuel-cycle and material strategies is an essential element of the study. To this end, an established global E{sup 3} (energy/economics/environmental) model has been adopted and modified with a simplified, but comprehensive and multi-regional, nuclear energy module. Consistent nuclear energy scenarios are constructed using this multi-regional E{sup 3} model, wherein future demands for nuclear power are projected in price competition with other energy sources under a wide range of long-term demographic (population, workforce size and productivity), economic (price-, population-, and income-determined demand for energy services, price- and population-modified GNP, resource depletion, world-market fossil energy prices), policy (taxes, tariffs, sanctions), and top-level technological (energy intensity and end-use efficiency improvements) drivers. Using the framework provided by the global E{sup 3} model, the impacts of both external and internal drivers are investigated. The ability to connect external and internal drivers through this modeling framework allows the study of impacts and tradeoffs between fossil- versus nuclear-fuel burning, that includes interactions between cost, environmental, proliferation, resource, and policy issues.

  12. Scientific Understanding from Long Term Observations: Insights from the Long Term Ecological Research (LTER) Program

    NASA Astrophysics Data System (ADS)

    Gosz, J.

    2001-12-01

    The network dedicated to Long Term Ecological Research (LTER) in the United States has grown to 24 sites since it was formed in 1980. Long-term research and monitoring are performed on parameters thatare basic to all ecosystems and are required to understand patterns, processes, and relationship to change. Collectively, the sites in the LTER Network provide opportunities to contrast marine, coastal, and continental regions, the full range of climatic gradients existing in North America, and aquatic and terrestrial habitats in a range of ecosystem types. The combination of common core areas and long-term research and monitoring in many habitats have allowed unprecedented abilities to understand and compare complex temporal and spatial dynamics associated with issues like climate change, effects of pollution, biodiversity and landuse. For example, McMurdo Dry Valley in the Antarctic has demonstrated an increase in glacier mass since 1993 which coincides with a period of cooler than normal summers and more than average snowfall. In contrast, the Bonanza Creek and Toolik Lake sites in Alaska have recorded a warming period unprecedented in the past 200 years. Nitrogen deposition effects have been identified through long-term watershed studies on biogeochemical cycles, especially at Coweeta Hydrological Lab, Harvard Forest, and the Hubbard Brook Experimental Forest. In aquatic systems, such as the Northern Temperate Lakes site, long-term data revealed time lags in effects of invaders and disturbance on lake communities. Biological recovery from an effect such as lake acidification was shown to lag behind chemical recovery. The long-term changes documented over 2 decades have been instrumental in influencing management practices in many of the LTER areas. In Puerto Rico, the Luquillo LTER demonstrated that dams obstruct migrations of fish and freshwater shrimp and water abstraction at low flows can completely obliterate downstream migration of juveniles and damage

  13. The economics of long-term global climate change

    SciTech Connect

    Not Available

    1990-09-01

    This report is intended to provide an overview of economic issues and research relevant to possible, long-term global climate change. It is primarily a critical survey, not a statement of Administration or Department policy. This report should serve to indicate that economic analysis of global change is in its infancy few assertions about costs or benefits can be made with confidence. The state of the literature precludes any attempt to produce anything like a comprehensive benefit-cost analysis. Moreover, almost all the quantitative estimates regarding physical and economic effects in this report, as well as many of the qualitative assertions, are controversial. Section I provides background on greenhouse gas emissions and their likely climatic effects and on available policy instruments. Section II considers the costs of living with global change, assuming no substantial efforts to reduce greenhouse gas emissions. Section III considers costs of reducing these emissions, though the available literature does not contain estimates of the costs of policies that would, on the assumptions of current climate models, prevent climate change altogether. The individual sections are not entirely compartmentalized, but can be read independently if necessary.

  14. Long term cultivation of larger benthic Foraminifera

    NASA Astrophysics Data System (ADS)

    Wöger, Julia; Eder, Wolfgang; Kinoshita, Shunichi; Antonino, Briguglio; Carles, Ferrandes-Cañadell; Hohenegger, Johann

    2015-04-01

    Benthic Foraminifera are used in a variety of applications employing numerous different methods, i.e. ecological monitoring, studying the effects of ocean acidification, reconstructing palaeo-bathymetry or investigating palaeo-salinity and palaeo-temperature to name only a few. To refine our understanding of ecological influences on larger benthic foraminiferal biology and to review inferences from field observations, culture experiments have become an indispensable tool. While culture experiments on smaller benthic foraminifera have become increasingly frequent in the past century, reports of the cultivation of symbiont bearing larger Foraminifera are rare. Generally, cultivation experiments can be divided into two groups: Culturing of populations and cultivation of single specimens allowing individual investigation. The latter differ form the former by several restrictions resulting from the need to limit individual motility without abridging microenvironmental conditions in the Foraminiferans artificial habitat, necessary to enable the individual to development as unfettered as possible. In this study we present first experiences and preliminary results of the long-term cultivation of larger benthic Foraminifera conducted at the 'Tropical Biosphere Research Station Sesoko Island, University of the Ryukyus', Japan, trying to reproduce natural conditions as closely as possible. Individuals of three species of larger benthic Foraminifera (Heterostegina depressa, Palaeonummulites venosus and Operculina complanata) have been cultured since April 2014. At the time of the general assembly the cultivation experiments will have been going on for more than one year, with the aim to investigate growth rates, longevities and reproduction strategies for comparison with results statistically inferred from application of the of the 'natural laboratory' method. The most important factor influencing foraminiferal health and development was found to be light intensity and light

  15. Long-term Behavior of DNAPL Residuals

    NASA Astrophysics Data System (ADS)

    Liu, Y.; Illangasekare, T.; Kitanidis, P. K.

    2012-12-01

    Understanding and being able to predict the long-term behavior of DNAPL (i.e., TCE) residuals in the source zone are significant in the evaluation of plume spreading. We apply both theoretical analysis and pore-scale simulations to investigate the mass transfer and the effect of reductive dechlorination, in which the contaminant behaves as electron acceptor. At the upfront of the source zone, where the boundary layer has not fully developed, the mass transfer increases as a power-law function of the Peclet number, and is enhanced by biodegradation. These results are consistent with past findings. Under certain conditions, further downstream inside the source zone, the rate of dissolution is slower due to the diluted mass from upstream. Widely applied first-order biodegradation implicitly assumes that the reaction solely depends on the concentration of the contaminant. However, in the slow dilution region, the limitation of electron donor on biodegradation is not negligible. For the reaction between an electron donor and an electron acceptor with intrinsic second-order kinetics, the late-time bio-reaction demonstrates a first-order decay macroscopically with respect to the mass of electron donor, not with respect to that of the contaminant. The late-time decay rate only depends on the intrinsic rate and the solubility of the contaminant. During the intermediate time, affecting by both the concentrations of electron donor and electron acceptor, the first-order decay is not valid. We show that the electron donor decays as exp(-t^2), instead of exp(-t). Moreover, the intermediate-time decay rate is a function of the spatial distribution of DNAPL residuals and the initial conditions.he relationship of the Sherwood number and Peclet number (Comparison of pore-scale simulations and best-fitting curve) he decay of electron donor as a function of t^2

  16. Modeling Maintenance of Long-Term Potentiation in Clustered Synapses: Long-Term Memory without Bistability

    PubMed Central

    Smolen, Paul

    2015-01-01

    Memories are stored, at least partly, as patterns of strong synapses. Given molecular turnover, how can synapses maintain strong for the years that memories can persist? Some models postulate that biochemical bistability maintains strong synapses. However, bistability should give a bimodal distribution of synaptic strength or weight, whereas current data show unimodal distributions for weights and for a correlated variable, dendritic spine volume. Thus it is important for models to simulate both unimodal distributions and long-term memory persistence. Here a model is developed that connects ongoing, competing processes of synaptic growth and weakening to stochastic processes of receptor insertion and removal in dendritic spines. The model simulates long-term (>1 yr) persistence of groups of strong synapses. A unimodal weight distribution results. For stability of this distribution it proved essential to incorporate resource competition between synapses organized into small clusters. With competition, these clusters are stable for years. These simulations concur with recent data to support the “clustered plasticity hypothesis” which suggests clusters, rather than single synaptic contacts, may be a fundamental unit for storage of long-term memory. The model makes empirical predictions and may provide a framework to investigate mechanisms maintaining the balance between synaptic plasticity and stability of memory. PMID:25945261

  17. The prospects for prepaid long-term care: the Arizona Medicaid experiment.

    PubMed

    Williams, F G; Phoenix, D; Kirkman-Liff, B L

    1989-01-01

    Arizona is adding long-term care to its prepaid, capitated alternative to Medicaid. This article discusses the potential for this major cost-control experiment. Experience suggests that those able to quality for long-term care will fare better than the poor did in the previous system. However, limiting eligibility will be the primary means of controlling costs; significant price competition is not likely to develop. The bidding process will serve more to transfer risk to contract providers than to improve program efficiency. Potential cost savings will be more than offset by an increased identification of need. PMID:2507624

  18. Long-term Preservation of Data Analysis Capabilities

    NASA Astrophysics Data System (ADS)

    Gabriel, C.; Arviset, C.; Ibarra, A.; Pollock, A.

    2015-09-01

    While the long-term preservation of scientific data obtained by large astrophysics missions is ensured through science archives, the issue of data analysis software preservation has hardly been addressed. Efforts by large data centres have contributed so far to maintain some instrument or mission-specific data reduction packages on top of high-level general purpose data analysis software. However, it is always difficult to keep software alive without support and maintenance once the active phase of a mission is over. This is especially difficult in the budgetary model followed by space agencies. We discuss the importance of extending the lifetime of dedicated data analysis packages and review diverse strategies under development at ESA using new paradigms such as Virtual Machines, Cloud Computing, and Software as a Service for making possible full availability of data analysis and calibration software for decades at minimal cost.

  19. Long-term oxygen therapy--state of the art.

    PubMed

    Flenley, D C

    1983-07-01

    Long-term oxygen therapy prolongs life in adults with chronic hypoxia caused by chronic bronchitis and emphysema who have cor pulmonale, pulmonary hypertension, and secondary polycythemia ('blue bloaters'). Good results require oxygen therapy for more than 15 hours and preferably 20-24 hours per day. The oxygen concentrator, delivering 1 to 3 l/min of oxygen by nasal prongs, is probably the most cost-effective method of providing this therapy. Dangers of the therapy include fires and burning of patients who smoke, and this is a contraindication to treatment. Excessive CO2 retention during sleep should not result from controlled low-dose oxygen therapy unless the patient also has an obstructive sleep apnea syndrome. Oxygen therapy during sleep may prevent hypoxemic episodes in blue bloaters, and it may thus reverse their pulmonary hypertension, which probably potentiates the risk of right-heart failure and cor pulmonale. PMID:10315396

  20. Long-Term Lunar Radiation Degradation Effects on Materials

    NASA Technical Reports Server (NTRS)

    Rojdev, Kristina; ORourke, Mary Jane; Koontz, Steve; Alred, John; Hill, Charles; Devivar, Rodrigo; Morera-Felix, Shakira; Atwell, William; Nutt, Steve; Sabbann, Leslie

    2010-01-01

    The National Aeronautics and Space Administration (NASA) is focused on developing technologies for extending human presence beyond low Earth orbit. These technologies are to advance the state-of-the-art and provide for longer duration missions outside the protection of Earth's magnetosphere. One technology of great interest for large structures is advanced composite materials, due to their weight and cost savings, enhanced radiation protection for the crew, and potential for performance improvements when compared with existing metals. However, these materials have not been characterized for the interplanetary space environment, and particularly the effects of high energy radiation, which is known to cause damage to polymeric materials. Therefore, a study focusing on a lunar habitation element was undertaken to investigate the integrity of potential structural composite materials after exposure to a long-term lunar radiation environment. An overview of the study results are presented, along with a discussion of recommended future work.

  1. Medicaid claims history of Florida long-term care facility residents hospitalized for pressure ulcers.

    PubMed

    Baker, J

    1996-01-01

    The purpose of this study was to identify patterns of admission, discharge, and readmission between hospital and long-term care facility among a group of Florida long-term care facility residents with pressure ulcers whose care was paid for by Medicaid. A patient-specific, longitudinal claims history database was constructed from data provided by the Florida Department of Health and Rehabilitative Services. This database was used to determine and analyze hospital admissions for pressure ulcer care among Medicaid recipients cared for in a long-term care facility. Analysis of the data determined that more than half of the Medicaid-covered long-term care facility residents who formed the target study group (54.57%) had multiple hospital admissions associated with pressure ulcers. Pressure ulcer hospital admissions amounted to a program cost of $9.9 million. PMID:8704846

  2. Long-Term Space Astrophysics Program

    NASA Technical Reports Server (NTRS)

    Nowark, Michael A.

    2001-01-01

    This is the final report for our Long-Term Space Astrophysics Program (NRA 94-OSS-12) grant NAG 5-3225. The proposal is entitled 'Spectral and Temporal Properties of Black Hole Candidates', and began funding in May 1995, and ran through 31 Aug 2000. The project summary from the original proposal was as follows: 'We will study the spectral and temporal properties of black hole candidates (BHC) by using data from archival sources (e.g., EXOSAT, Ginga, ROSAT) and proposed follow-up observations with modern instruments (e.g., ASCA, XTE). Our spectral studies will focus on identifying the basic characteristics and luminosities of the emission components in the various 'states' of BHC. We hope to understand and quantify the global energetics of these states. Our temporal studies will focus on expanding and classifying our knowledge of BHC variability properties in each state. We will explore the nature of quasi-periodic oscillations in BHC. We will combine our spectral and temporal studies by analyzing time lags and variability coherence between energy channels. In addition, we will investigate ways of correlating observed variability behavior with specific emission components.' We have accomplished many of these goals laid out within the original proposal. As originally proposed, we have utilized both archival and proprietary satellite data. In terms of archival data, we have utilized data from the Advanced Satellite for Cosmology and Astrophysics (ASCA), ROSAT, and the Rossi X-ray Timing Explorer (RXTE). We also obtained proprietary data from ASCA, RXTE, and the Extreme Ultraviolet Explorer (EUVE). In terms of sources, we have examined a wide variety of both galactic black hole candidates and extra-galactic black holes. For the galactic black holes we have observed and analyzed both the low/hard state and the high/soft state. We have performed both spectral and timing analyses on all of these objects. In addition, we have also examined a number of neutron stars or

  3. Long term property prediction of polyethylene nanocomposites

    NASA Astrophysics Data System (ADS)

    Shaito, Ali Al-Abed

    properties of the nanocomposites was analyzed by examining tensile and creep-recovery behavior of the films at temperatures in the range of 25 to -100°C. Within the measured temperature range, the materials showed a nonlinear temperature dependent response. The time-temperature superposition principle was successfully used to predict the long term behavior of LLDPE nanocomposites.

  4. LOP- LONG-TERM ORBIT PREDICTOR

    NASA Technical Reports Server (NTRS)

    Kwok, J. H.

    1994-01-01

    The Long-Term Orbit Predictor (LOP) trajectory propagation program is a useful tool in lifetime analysis of orbiting spacecraft. LOP is suitable for studying planetary orbit missions with reconnaissance (flyby) and exploratory (mapping) trajectories. Sample data is included for a geosynchronous station drift cycle study, a Venus radar mapping strategy, a frozen orbit about Mars, and a repeat ground trace orbit. LOP uses the variation-of-parameters method in formulating the equations of motion. Terms involving the mean anomaly are removed from numerical integrations so that large step sizes, on the order of days, are possible. Consequently, LOP executes much faster than programs based on Cowell's method, such as the companion program ASAP (the Artificial Satellite Analysis Program, NPO-17522, also available through COSMIC). The program uses a force model with a gravity field of up to 21 by 21, lunisolar perturbation, drag, and solar radiation pressure. The input includes classical orbital elements (either mean or oscillating), orbital elements of the sun relative to the planet, reference time and dates, drag coefficients, gravitational constants, planet radius, rotation rate. The printed output contains the classical elements for each time step or event step, and additional orbital data such as true anomaly, eccentric anomaly, latitude, longitude, periapsis altitude, and the rate of change per day of certain elements. Selected output is additionally written to a plot file for postprocessing by the user. LOP is written in FORTRAN 77 for batch execution on IBM PC compatibles running MS-DOS with a minimum of 256K RAM. Recompiling the source requires the Lahey F77 v2.2 compiler. The LOP package includes examples that use LOTUS 1-2-3 for graphical displays, but any graphics software package should be able to handle the ASCII plot file. The program is available on two 5.25 inch 360K MS-DOS format diskettes. The program was written in 1986 and last updated in 1989. LOP is

  5. Long term prognosis of reactive salmonella arthritis

    PubMed Central

    Leirisalo-Repo, M; Helenius, P; Hannu, T; Lehtinen, A; Kreula, J; Taavitsainen, M; Koskimies, S

    1997-01-01

    OBJECTIVES—Reactive joint complications triggered by salmonella gastroenteritis are increasingly reported, but the outcome and long term prognosis of the patients is incompletely known. This study looked at the prognosis of salmonella arthritis in patients hospitalised in 1970-1986.
METHODS—Hospital records from two hospitals in southern Finland were screened for patients with the discharge diagnosis of salmonellosis or reactive, postinfectious arthritis or Reiter's disease. For the patients with confirmed diagnosis of reactive salmonella arthritis, data about the acute disease were collected from the hospital records. A follow up study was performed.
RESULTS—There were 63 patients (28 women, 35 men, mean age 36.5 years) with salmonella arthritis. Urethritis occurred in 27%, eye inflammation in 13%, and low back pain in 44% of the patients. HLA-B27 was present in 88%. More men than women were HLA-B27 positive. HLA-B27 positive patients had higher erythrocyte sedimentation rate (mean 80.9 v 46.5 mm 1st h, p = 0.0180). Also, extra-articular features and radiological sacroiliitis were seen only in HLA-B27 positive patients. A follow up study was performed on 50 patients mean 11.0 (range 5-22 years) later. Twenty patients had recovered completely. Ten patients had mild joint symptoms, 11 patients had had a new acute transient arthritis, and five acute iritis. Eight patients had developed chronic spondyloarthropathy. Radiological sacroiliitis was seen in six of 44 patients, more frequently in male than in female patients (32% v 0%; p = 0.0289). Recurrent or chronic arthritis, iritis or radiological sacroiliitis developed only in HLA-B27 positive patients.
CONCLUSION—Joint symptoms are common after reactive salmonella arthritis. HLA-B27 contributes to the severity of acute disease and to the late prognosis.

 PMID:9370874

  6. Long-term socioeconomic impacts of flooding in Bangladesh

    NASA Astrophysics Data System (ADS)

    Jina, A.

    2013-05-01

    affected by hazards. In order to prevent households from falling further into, and potentially being trapped, in poverty, we argue that long-term impacts be considered in addition to the short-term that currently garner most policy attention. The hidden cost that we identify increases the estimated cost of these disasters, and also implies a new paradigm in disaster management policy - one that seeks to decrease vulnerability before an event, rather than deal with the consequences afterwards.;

  7. Accounting Rule Targets Benefits in Public Sector. Districts, Others Must Tally Long-Term Obligations

    ERIC Educational Resources Information Center

    Jacobson, Linda

    2006-01-01

    Deadlines are looming for school districts and other public employers to comply with a new financial-reporting rule on the long-term costs for health and other insurance benefits that have been promised to employees. For the first time, local, state, and federal agencies will have to disclose future benefit costs in current budgets, a requirement…

  8. Long Term Accommodation Planning in a Major Australian Institute of Technology.

    ERIC Educational Resources Information Center

    Hoadley, J. A.; Sharma, R. D.

    1982-01-01

    A system for long-term planning for facility needs and arrangement is described. A cost objective was established, and factors in the decision making were weighted: functional arrangement, efficient use of space, flexibility of any plan, minimization of cost, equity of arrangements for different groups, and balance between available space and…

  9. Long-term evolution is surprisingly predictable in lattice proteins

    PubMed Central

    Palmer, Michael E.; Moudgil, Arnav; Feldman, Marcus W.

    2013-01-01

    It has long been debated whether natural selection acts primarily upon individual organisms, or whether it also commonly acts upon higher-level entities such as lineages. Two arguments against the effectiveness of long-term selection on lineages have been (i) that long-term evolutionary outcomes will not be sufficiently predictable to support a meaningful long-term fitness and (ii) that short-term selection on organisms will almost always overpower long-term selection. Here, we use a computational model of protein folding and binding called ‘lattice proteins’. We quantify the long-term evolutionary success of lineages with two metrics called the k-fitness and k-survivability. We show that long-term outcomes are surprisingly predictable in this model: only a small fraction of the possible outcomes are ever realized in multiple replicates. Furthermore, the long-term fitness of a lineage depends only partly on its short-term fitness; other factors are also important, including the ‘evolvability’ of a lineage—its capacity to produce adaptive variation. In a system with a distinct short-term and long-term fitness, evolution need not be ‘short-sighted’: lineages may be selected for their long-term properties, sometimes in opposition to short-term selection. Similar evolutionary basins of attraction have been observed in vivo, suggesting that natural biological lineages will also have a predictive long-term fitness. PMID:23466559

  10. 41 CFR 301-11.14 - How is my daily lodging rate computed when I rent lodging on a long-term basis?

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... rate computed when I rent lodging on a long-term basis? 301-11.14 Section 301-11.14 Public Contracts... computed when I rent lodging on a long-term basis? When you obtain lodging on a long-term basis (e.g., weekly or monthly) your daily lodging rate is computed by dividing the total lodging cost by the...

  11. 41 CFR 301-11.14 - How is my daily lodging rate computed when I rent lodging on a long-term basis?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... rate computed when I rent lodging on a long-term basis? 301-11.14 Section 301-11.14 Public Contracts... computed when I rent lodging on a long-term basis? When you obtain lodging on a long-term basis (e.g., weekly or monthly) your daily lodging rate is computed by dividing the total lodging cost by the...

  12. 41 CFR 301-11.14 - How is my daily lodging rate computed when I rent lodging on a long-term basis?

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... rate computed when I rent lodging on a long-term basis? 301-11.14 Section 301-11.14 Public Contracts... computed when I rent lodging on a long-term basis? When you obtain lodging on a long-term basis (e.g., weekly or monthly) your daily lodging rate is computed by dividing the total lodging cost by the...

  13. 41 CFR 301-11.14 - How is my daily lodging rate computed when I rent lodging on a long-term basis?

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... rate computed when I rent lodging on a long-term basis? 301-11.14 Section 301-11.14 Public Contracts... computed when I rent lodging on a long-term basis? When you obtain lodging on a long-term basis (e.g., weekly or monthly) your daily lodging rate is computed by dividing the total lodging cost by the...

  14. Long-term ozone monitoring from space

    NASA Astrophysics Data System (ADS)

    Ahmad, S.; Johnson, J.; Serafino, G.; McPeters, R.

    Ultraviolet Spectrometer (SBUV), are archived at the Goddard DAAC and are freely available to the public. Standard products from TOMS include daily global total ozone and effective UV reflectivity of the earth-atmosphere system. Data products from future upper atmospheric research missions, e.g., the Ozone Monitoring Instrument (OMI), the Microwave Limb Sounder (MLS), and the High Resolution Dynamics Limb Sounder (HIRDLS) aboard Aura, will also be archived at the Goddard DAAC. For ozone trend analysis, a long-term data set consisting of over twenty years of ozone measurements from space and some value added research products have been produced by the NASA Goddard Space Flight Center scientists (Atmospheric Chemistry and Dynamics Branch/ Code 916) and are made available to the research community (http://code916.gsfc.nasa.gov). Examples of some of these research products are:1) daily erythermal UV exposure -estimates of harmful UV-B radiation at the surface, 2) an index to track the global transport of ash and sulfur dioxide resulting from volcanic eruptions, 3) another index to track smoke emanating from large fires and dust plumes originating from desert regions, 4) aerosol optical depth, 5) tropospheric ozone obtained from cloud-slicing techniques, and 6) a merged total ozone data product consisting of monthly mean ozone merged from six satellite instruments. The Upper Atmospheric Data Support Team has been providing science and data support to assist users in accessing and using the upper atmospheric data products. A number of tools for data access, subsetting, reprojection and mapping of orbital (Level-2) products, visualization of global gridded (Level-3) products, and data analysis have been developed at the Goddard DAAC and are freely available to the data user (http://daac.gsfc.nasa.gov) This presentation will provide highlights of the standard and value-added ozone and ancillary products, and the data services provided by the DAAC Upper Atmosphere Data Support Team.

  15. Long-term Ozone monitoring from space

    NASA Astrophysics Data System (ADS)

    Ahmad, S.; Johnson, J.; Serafino, G.; McPeters, R.

    Ultraviolet Spectrometer (SBUV), are archived at the Goddard DAAC and are freely available to the public. Standard products from TOMS include daily global total ozone and effective UV reflectivity of the earth-atmosphere system. Data products from future upper atmospheric research missions, e.g., the Ozone Monitoring Instrument (OMI), the Microwave Limb Sounder (MLS), and the High Resolution Dynamics Limb Sounder (HIRDLS) aboard Aura, will also be archived at the Goddard DAAC. For ozone trend analysis, a long-term data set consisting of over twenty years of ozone measurements from space and some value added research products have been produced by the NASA Goddard Space Flight Center scientists (Atmospheric Chemistry and Dynamics Branch/ Code 916) and are made available to the research community (http://code916.gsfc.nasa.gov). Examples of some of these research products are:1) daily erythermal UV exposure -estimates of harmful UV-B radiation at the surface, 2) an index to track the global transport of ash and sulfur dioxide resulting from volcanic eruptions, 3) another index to track smoke emanating from large fires and dust plumes originating from desert regions, 4) aerosol optical depth, 5) tropospheric ozone obtained from cloud-slicing techniques, and 6) a merged total ozone data product consisting of monthly mean ozone merged from six satellite instruments. The Upper Atmospheric Data Support Team has been providing science and data support to assist users in accessing and using the upper atmospheric data products. A number of tools for data access, subsetting, reprojection and mapping of orbital (Level-2) products, visualization of global gridded (Level-3) products, and data analysis have been developed at the Goddard DAAC and are freely available to the data user (http://daac.gsfc.nasa.gov) This presentation will provide highlights of the standard and value-added ozone and ancillary products, and the data services provided by the DAAC Upper Atmosphere Data Support Team.

  16. Long-term goals for solar thermal technology

    NASA Astrophysics Data System (ADS)

    Williams, T. A.; Dirks, J. A.; Brown, D. R.

    1985-05-01

    Long-term performance and cost goals for three solar thermal technologies are discussed. Pacific Northwest Laboratory (PNL) developed these goals in support of the Draft Five Year Research and Development Plan for the National Solar Thermal Technology Program (DOE 1984b). These technology goals are intended to provide targets that, if met, will lead to the widespread use of solar thermal technologies in the marketplace. Goals were developed for three technologies and two applications: central receiver and dish technologies for utility-generated electricity applications, and central receiver, dish, and trough technologies for industrial process heat applications. These technologies and applications were chosen because they are the primary technologies and applications that have been researched by DOE in the past. System goals were developed through analysis of future price projections for energy sources competing with solar thermal in the middle-to-late 1990's time frame. The system goals selected were levelized energy costs of 0.05/kWh for electricity and $9/MBtu for industrial process heat (1984 $). Component goals established to meet system goals were developed based upon projections of solar thermal component performance and cost which could be achieved in the same time frame.

  17. Long-term goals for solar thermal technology

    SciTech Connect

    Williams, T.A.; Dirks, J.A.; Brown, D.R.

    1985-05-01

    This document describes long-term performance and cost goals for three solar thermal technologies. Pacific Northwest Laboratory (PNL) developed these goals in support of the Draft Five Year Research and Development Plan for the National Solar Thermal Technology Program (DOE 1984b). These technology goals are intended to provide targets that, if met, will lead to the widespread use of solar thermal technologies in the marketplace. Goals were developed for three technologies and two applications: central receiver and dish technologies for utility-generated electricity applications, and central receiver, dish, and trough technologies for industrial process heat applications. These technologies and applications were chosen because they are the primary technologies and applications that have been researched by DOE in the past. System goals were developed through analysis of future price projections for energy sources competing with solar thermal in the middle-to-late 1990's time frame. The system goals selected were levelized energy costs of $0.05/kWh for electricity and $9/MBtu for industrial process heat (1984 $). Component goals established to meet system goals were developed based upon projections of solar thermal component performance and cost which could be achieved in the same time frame.

  18. Long-term metapopulation study of the Glanville fritillary butterfly (Melitaea cinxia): survey methods, data management, and long-term population trends

    PubMed Central

    Ojanen, Sami P; Nieminen, Marko; Meyke, Evgeniy; Pöyry, Juha; Hanski, Ilkka

    2013-01-01

    Long-term observational studies conducted at large (regional) spatial scales contribute to better understanding of landscape effects on population and evolutionary dynamics, including the conditions that affect long-term viability of species, but large-scale studies are expensive and logistically challenging to keep running for a long time. Here, we describe the long-term metapopulation study of the Glanville fritillary butterfly (Melitaea cinxia) that has been conducted since 1991 in a large network of 4000 habitat patches (dry meadows) within a study area of 50 by 70 km in the Åland Islands in Finland. We explain how the landscape structure has been described, including definition, delimitation, and mapping of the habitat patches; methods of field survey, including the logistics, cost, and reliability of the survey; and data management using the EarthCape biodiversity platform. We describe the long-term metapopulation dynamics of the Glanville fritillary based on the survey. There has been no long-term change in the overall size of the metapopulation, but the level of spatial synchrony and hence the amplitude of fluctuations in year-to-year metapopulation dynamics have increased over the years, possibly due to increasing frequency of exceptional weather conditions. We discuss the added value of large-scale and long-term population studies, but also emphasize the need to integrate more targeted experimental studies in the context of long-term observational studies. For instance, in the case of the Glanville fritillary project, the long-term study has produced an opportunity to sample individuals for experiments from local populations with a known demographic history. These studies have demonstrated striking differences in dispersal rate and other life-history traits of individuals from newly established local populations (the offspring of colonizers) versus individuals from old, established local populations. The long-term observational study has stimulated the

  19. Stochastic Induction of Long-Term Potentiation and Long-Term Depression.

    PubMed

    Antunes, G; Roque, A C; Simoes-de-Souza, F M

    2016-01-01

    Long-term depression (LTD) and long-term potentiation (LTP) of granule-Purkinje cell synapses are persistent synaptic alterations induced by high and low rises of the intracellular calcium ion concentration ([Ca(2+)]), respectively. The occurrence of LTD involves the activation of a positive feedback loop formed by protein kinase C, phospholipase A2, and the extracellular signal-regulated protein kinase pathway, and its expression comprises the reduction of the population of synaptic AMPA receptors. Recently, a stochastic computational model of these signalling processes demonstrated that, in single synapses, LTD is probabilistic and bistable. Here, we expanded this model to simulate LTP, which requires protein phosphatases and the increase in the population of synaptic AMPA receptors. Our results indicated that, in single synapses, while LTD is bistable, LTP is gradual. Ca(2+) induced both processes stochastically. The magnitudes of the Ca(2+) signals and the states of the signalling network regulated the likelihood of LTP and LTD and defined dynamic macroscopic Ca(2+) thresholds for the synaptic modifications in populations of synapses according to an inverse Bienenstock, Cooper and Munro (BCM) rule or a sigmoidal function. In conclusion, our model presents a unifying mechanism that explains the macroscopic properties of LTP and LTD from their dynamics in single synapses. PMID:27485552

  20. Stochastic Induction of Long-Term Potentiation and Long-Term Depression

    PubMed Central

    Antunes, G.; Roque, A. C.; Simoes-de-Souza, F. M.

    2016-01-01

    Long-term depression (LTD) and long-term potentiation (LTP) of granule-Purkinje cell synapses are persistent synaptic alterations induced by high and low rises of the intracellular calcium ion concentration ([Ca2+]), respectively. The occurrence of LTD involves the activation of a positive feedback loop formed by protein kinase C, phospholipase A2, and the extracellular signal-regulated protein kinase pathway, and its expression comprises the reduction of the population of synaptic AMPA receptors. Recently, a stochastic computational model of these signalling processes demonstrated that, in single synapses, LTD is probabilistic and bistable. Here, we expanded this model to simulate LTP, which requires protein phosphatases and the increase in the population of synaptic AMPA receptors. Our results indicated that, in single synapses, while LTD is bistable, LTP is gradual. Ca2+ induced both processes stochastically. The magnitudes of the Ca2+ signals and the states of the signalling network regulated the likelihood of LTP and LTD and defined dynamic macroscopic Ca2+ thresholds for the synaptic modifications in populations of synapses according to an inverse Bienenstock, Cooper and Munro (BCM) rule or a sigmoidal function. In conclusion, our model presents a unifying mechanism that explains the macroscopic properties of LTP and LTD from their dynamics in single synapses. PMID:27485552

  1. Long term fuel scheduling linear programming

    SciTech Connect

    Asgarpoor, S. . Dept. of Electrical Engineering); Gul, N. )

    1992-01-01

    This paper presents an application of linear programming (LP) revised simplex method in order to solve the fuel scheduling problem. A regression method is applied to determine the polynomial cost curves, and a separable programming technique is used to linearize the objective function and the constraints for LP application. Results based on sample data obtained from Omaha Public Power District (OPPD) are presented to demonstrate the LP application to this problem.

  2. Long-Term Monitoring of Permeable Reactive Barriers - Progress Report

    SciTech Connect

    Liang, L.

    2001-04-12

    The purpose of this project is to conduct collaborative research to evaluate and maximize the effectiveness of permeable reactive barriers (PRBs) with a broad-based working group including representatives from the U.S. Department of Energy (DOE), U.S. Department of Defense (DoD), and the U.S. Environmental Protection Agency (EPA). The Naval Facilities Engineering Service Center (NFESC) and its project partner, Battelle, are leading the DoD effort with funding from DoD's Environmental Security Technology Certification Program (ESTCP) and Strategic Environmental Research and Development Program (SERDP). Oak Ridge National Laboratory (ORNL) is coordinating the DOE effort with support from Subsurface Contaminant Focus Area (SCFA), a research program under DOEs Office of Science and Technology. The National Risk Management Research Laboratory's Subsurface Protection and Remediation Division is leading EPA's effort. The combined effort of these three agencies allows the evaluation of a large number of sites. Documents generated by this joint project will be reviewed by the participating agencies' principal investigators, the Permeable Barriers Group of the Remediation Technologies Development Forum (RTDF), and the Interstate Technology and Regulatory Cooperation (ITRC). The technical objectives of this project are to collect and review existing field data at selected PRB sites, identify data gaps, conduct additional measurements, and provide recommendations to DOE users on suitable long-term monitoring strategies. The specific objectives are to (1) evaluate geochemical and hydraulic performance of PRBs, (2) develop guidelines for hydraulic and geochemical characterization/monitoring, and (3) devise and implement long-term monitoring strategies through the use of hydrological and geochemical models. Accomplishing these objectives will provide valuable information regarding the optimum configuration and lifetime of barriers at specific sites. It will also permit

  3. Enhanced Polyhydroxybutyrate Production for Long-Term Spaceflight Applications

    NASA Technical Reports Server (NTRS)

    Putman, Ryan J.; Rahman, Asif; Miller, Charles D.; Hadi, Masood Z.

    2015-01-01

    Synthetic biology holds the promise of advancing long term space fight by the production of medicine, food, materials, and energy. One such application of synthetic biology is the production of biomaterials, specifically polyhydroxyalkanoates (PHAs), using purposed organisms such as Escherichia coli. PHAs are a group of biodegradable bioplastics that are produced by a wide variety of naturally occurring microorganisms, mainly as an energy storage intermediate. PHAs have similar melting point to polypropylene and a Youngs modulus close to polystyrene. Due to limited resources and cost of transportation, large-scale extraction of biologically produced products in situ is extremely cumbersome during space flight. To that end, we are developing a secretion systems for exporting PHA from the cell in order to reduce unit operations. PHAs granules deposited inside bacteria are typically associated with proteins bound to the granule surface. Phasin, a granule bound protein, was targeted for type I secretion by fusion with HlyA signal peptide for indirect secretion of PHAs. In order to validate our secretion strategy, a green fluorescent protein (GFP) was tagged to the PHA polymerase enzyme (phaC), this three part gene cassette consists of phaA and phaB and are required for PHA production. Producing PHAs in situ during space flight or planet colonization will enable mission success by providing a valuable source of biomaterials that can have many potential applications thereby reducing resupply requirements. Biologically produced PHAs can be used in additive manufacturing such as three dimensional (3D) printing to create products that can be made on demand during space flight. After exceeding their lifetime, the PHAs could be melted and recycled back to 3D print other products. We will discuss some of our long term goals of this approach.

  4. Long-Term Monitoring of Global Climate Forcings and Feedbacks

    NASA Technical Reports Server (NTRS)

    Hansen, J. (Editor); Rossow, W. (Editor); Fung, I. (Editor)

    1993-01-01

    A workshop on Long-Term Monitoring of Global Climate Forcings and Feedbacks was held February 3-4, 1992, at NASA's Goddard Institute for Space Studies to discuss the measurements required to interpret long-term global temperature changes, to critique the proposed contributions of a series of small satellites (Climsat), and to identify needed complementary monitoring. The workshop concluded that long-term (several decades) of continuous monitoring of the major climate forcings and feedbacks is essential for understanding long-term climate change.

  5. Biocompatibility of Ti-alloys for long-term implantation.

    PubMed

    Abdel-Hady Gepreel, Mohamed; Niinomi, Mitsuo

    2013-04-01

    The design of new low-cost Ti-alloys with high biocompatibility for implant applications, using ubiquitous alloying elements in order to establish the strategic method for suppressing utilization of rare metals, is a challenge. To meet the demands of longer human life and implantation in younger patients, the development of novel metallic alloys for biomedical applications is aiming at providing structural materials with excellent chemical, mechanical and biological biocompatibility. It is, therefore, likely that the next generation of structural materials for replacing hard human tissue would be of those Ti-alloys that do not contain any of the cytotoxic elements, elements suspected of causing neurological disorders or elements that have allergic effect. Among the other mechanical properties, the low Young's modulus alloys have been given a special attention recently, in order to avoid the occurrence of stress shielding after implantation. Therefore, many Ti-alloys were developed consisting of biocompatible elements such as Ti, Zr, Nb, Mo, and Ta, and showed excellent mechanical properties including low Young's modulus. However, a recent attention was directed towards the development of low cost-alloys that have a minimum amount of the high melting point and high cost rare-earth elements such as Ta, Nb, Mo, and W. This comes with substituting these metals with the common low cost, low melting point and biocompatible metals such as Fe, Mn, Sn, and Si, while keeping excellent mechanical properties without deterioration. Therefore, the investigation of mechanical and biological biocompatibility of those low-cost Ti-alloys is highly recommended now lead towards commercial alloys with excellent biocompatibility for long-term implantation. PMID:23507261

  6. 49 CFR 260.17 - Credit risk premium analysis.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 49 Transportation 4 2014-10-01 2014-10-01 false Credit risk premium analysis. 260.17 Section 260... Financial Assistance § 260.17 Credit risk premium analysis. (a) When Federal appropriations are not available to cover the total subsidy cost, the Administrator will determine the Credit Risk...

  7. 49 CFR 260.17 - Credit risk premium analysis.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 49 Transportation 4 2013-10-01 2013-10-01 false Credit risk premium analysis. 260.17 Section 260... Financial Assistance § 260.17 Credit risk premium analysis. (a) When Federal appropriations are not available to cover the total subsidy cost, the Administrator will determine the Credit Risk...

  8. 49 CFR 260.17 - Credit risk premium analysis.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 49 Transportation 4 2011-10-01 2011-10-01 false Credit risk premium analysis. 260.17 Section 260... Financial Assistance § 260.17 Credit risk premium analysis. (a) When Federal appropriations are not available to cover the total subsidy cost, the Administrator will determine the Credit Risk...

  9. 42 CFR 447.66 - General alternative premium protections.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 4 2013-10-01 2013-10-01 false General alternative premium protections. 447.66 Section 447.66 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS PAYMENTS FOR SERVICES Payments: General Provisions Alternative Premiums and Cost Sharing Under...

  10. 42 CFR 447.66 - General alternative premium protections.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 4 2012-10-01 2012-10-01 false General alternative premium protections. 447.66 Section 447.66 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS PAYMENTS FOR SERVICES Payments: General Provisions Alternative Premiums and Cost Sharing Under...

  11. 49 CFR 260.17 - Credit risk premium analysis.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 49 Transportation 4 2012-10-01 2012-10-01 false Credit risk premium analysis. 260.17 Section 260... Financial Assistance § 260.17 Credit risk premium analysis. (a) When Federal appropriations are not available to cover the total subsidy cost, the Administrator will determine the Credit Risk...

  12. The Pupil Premium: Next Steps

    ERIC Educational Resources Information Center

    Sutton Trust, 2015

    2015-01-01

    The pupil premium was introduced by the Coalition government in April 2011 to provide additional funding for disadvantaged pupils. The main difference between the premium and previous funding for disadvantaged pupils is that the premium is linked to individual pupils. On July 1, 2015, The Pupil Premium Summit organized by the Education Endowment…

  13. Ensuring climate information guides long-term development

    NASA Astrophysics Data System (ADS)

    Jones, Lindsey; Dougill, Andrew; Jones, Richard G.; Steynor, Anna; Watkiss, Paul; Kane, Cheikh; Koelle, Bettina; Moufouma-Okia, Wilfran; Padgham, Jon; Ranger, Nicola; Roux, Jean-Pierre; Suarez, Pablo; Tanner, Thomas; Vincent, Katharine

    2015-09-01

    Many sub-Saharan countries are failing to include climate information in long-term development planning. Ensuring climate-resilient development requires a step change in how medium- to long-term climate information is produced, communicated and utilized in sub-Saharan Africa and elsewhere.

  14. Long Term Agroecosystem Research in the southern plains

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The Southern Plains (SP) site of the Long Term Agroecosystem Research (LTAR) network is headquartered at USDA-ARS’s Grazinglands Research Laboratory (GRL) in El Reno, Oklahoma. The GRL was established in 1948. A long-term watershed and climate research program was established in the Little Washita ...

  15. 41 CFR 51-6.3 - Long-term procurements.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 41 Public Contracts and Property Management 1 2012-07-01 2009-07-01 true Long-term procurements. 51-6.3 Section 51-6.3 Public Contracts and Property Management Other Provisions Relating to Public... § 51-6.3 Long-term procurements. (a) Contracting activities are encouraged to investigate...

  16. 41 CFR 51-6.3 - Long-term procurements.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 41 Public Contracts and Property Management 1 2013-07-01 2013-07-01 false Long-term procurements. 51-6.3 Section 51-6.3 Public Contracts and Property Management Other Provisions Relating to Public... § 51-6.3 Long-term procurements. (a) Contracting activities are encouraged to investigate...

  17. 7 CFR 1773.44 - Long-term debt.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 12 2011-01-01 2011-01-01 false Long-term debt. 1773.44 Section 1773.44 Agriculture... (CONTINUED) POLICY ON AUDITS OF RUS BORROWERS RUS Required Audit Procedures and Documentation § 1773.44 Long... 691, Confirmation Schedule—Long-term Obligation to RUS as of; or RTB Form 12, Confirmation...

  18. 7 CFR 1773.44 - Long-term debt.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 12 2010-01-01 2010-01-01 false Long-term debt. 1773.44 Section 1773.44 Agriculture... (CONTINUED) POLICY ON AUDITS OF RUS BORROWERS RUS Required Audit Procedures and Documentation § 1773.44 Long... 691, Confirmation Schedule—Long-term Obligation to RUS as of; or RTB Form 12, Confirmation...

  19. 7 CFR 1773.44 - Long-term debt.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 7 Agriculture 12 2012-01-01 2012-01-01 false Long-term debt. 1773.44 Section 1773.44 Agriculture... (CONTINUED) POLICY ON AUDITS OF RUS BORROWERS RUS Required Audit Procedures and Documentation § 1773.44 Long... 691, Confirmation Schedule—Long-term Obligation to RUS as of; or RTB Form 12, Confirmation...

  20. 7 CFR 1773.44 - Long-term debt.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 12 2014-01-01 2013-01-01 true Long-term debt. 1773.44 Section 1773.44 Agriculture... (CONTINUED) POLICY ON AUDITS OF RUS BORROWERS RUS Required Audit Procedures and Documentation § 1773.44 Long... 691, Confirmation Schedule—Long-term Obligation to RUS as of; or RTB Form 12, Confirmation...

  1. 7 CFR 1773.44 - Long-term debt.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 7 Agriculture 12 2013-01-01 2013-01-01 false Long-term debt. 1773.44 Section 1773.44 Agriculture... (CONTINUED) POLICY ON AUDITS OF RUS BORROWERS RUS Required Audit Procedures and Documentation § 1773.44 Long... 691, Confirmation Schedule—Long-term Obligation to RUS as of; or RTB Form 12, Confirmation...

  2. 41 CFR 51-6.3 - Long-term procurements.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 41 Public Contracts and Property Management 1 2010-07-01 2010-07-01 true Long-term procurements. 51-6.3 Section 51-6.3 Public Contracts and Property Management Other Provisions Relating to Public... § 51-6.3 Long-term procurements. (a) Contracting activities are encouraged to investigate...

  3. 41 CFR 51-6.3 - Long-term procurements.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 41 Public Contracts and Property Management 1 2011-07-01 2009-07-01 true Long-term procurements. 51-6.3 Section 51-6.3 Public Contracts and Property Management Other Provisions Relating to Public... § 51-6.3 Long-term procurements. (a) Contracting activities are encouraged to investigate...

  4. 41 CFR 51-6.3 - Long-term procurements.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 41 Public Contracts and Property Management 1 2014-07-01 2014-07-01 false Long-term procurements. 51-6.3 Section 51-6.3 Public Contracts and Property Management Other Provisions Relating to Public... § 51-6.3 Long-term procurements. (a) Contracting activities are encouraged to investigate...

  5. Standards for Psychological Services in Long-Term Care Facilities.

    ERIC Educational Resources Information Center

    Morrow-Howell, Nancy; Lichtenberg, Peter A.; Smith, Michael; Frazer, Deborah; Molinari, Victor; Rosowsky, Erlene; Crose, Royda; Stillwell, Nick; Kramer, Nanette; Hartman-Stein, Paula; Qualls, Sara; Salamon, Michael; Duffy, Michael; Parr, Joyce; Gallagher-Thompson, Dolores

    1998-01-01

    Describes the development of standards for psychological practice in long-term care facilities. The standards, which were developed by Psychologists in Long-Term Care, address provider characteristics, methods of referral, assessment practices, treatment, and ethical issues. Offers suggestions for use of the standards. (MKA)

  6. [Developing the core competencies of long-term care professionals].

    PubMed

    Chen, Huey-Tzy; Lee, Kuang-Ting

    2012-12-01

    Longer average life expectancies and an ageing society have made long-term care an urgent and important issue in Taiwan. Although the implementation of Long-Term Care Ten-year Project four years ago has begun showing success in terms of assessing Taiwan's needs in terms of long-term care services and resources, there has been little forward progress in terms of training, recruiting and maintaining more competent professionals in the long-term care sector. This paper explores the current state of long-term care competency in Taiwan and educational strategies in place to improve the competency of long-term care professionals. Results indicate that the term geriatric competency embraces sub-competencies in direct care, communication, assessment, teamwork, cultural sensitivities and career care competencies. The term long-term care competency embraces the sub-competencies of supervision, management, information technology, resource management, and organizational skill. As a main contributor to effective long-term care, the nursing profession must employ effective strategies to develop competency-based education. Also, the profession must have an adequate supply of competent manpower to effectively respond to Taiwan's aging society. PMID:23212250

  7. Helping People Make Better Long-Term-Care Decisions

    ERIC Educational Resources Information Center

    Kane, Robert L.; Boston, Krista; Chilvers, Mary

    2007-01-01

    Purpose: The purpose of this article is to describe an innovative online system to support long-term-care decision making. Design and Methods: The Long-Term Care Choices tool is a web-based system that uses expert opinion and structures decision making. Results: The system has been well accepted, and most users find it easy to use. Implications:…

  8. LONG TERM CARE FACILITIES: A CORNUCOPIA OF VIRAL PATHOGENS

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Our study sought to determine the frequency and types of respiratory viruses circulating in 33 Boston long term care facilities during a three year period and correlate rates of infection with serum zinc levels. Participants were residents of long term care that had previously participated in a tria...

  9. Developmental Dyslexia and Explicit Long-Term Memory

    ERIC Educational Resources Information Center

    Menghini, Deny; Carlesimo, Giovanni Augusto; Marotta, Luigi; Finzi, Alessandra; Vicari, Stefano

    2010-01-01

    The reduced verbal long-term memory capacities often reported in dyslexics are generally interpreted as a consequence of their deficit in phonological coding. The present study was aimed at evaluating whether the learning deficit exhibited by dyslexics was restricted only to the verbal component of the long-term memory abilities or also involved…

  10. Long-term trends in precipitation and surface water chemistry

    Technology Transfer Automated Retrieval System (TEKTRAN)

    This chapter shows long-term data and trends in precipitation and surface water chemistry for each site. It contains a brief introduction to the topic, and methods of measurements, selection of variables, and their data source. It consists primarily of a large number of figures showing long-term da...

  11. Factors Affecting Long-Term Abstinence from Substances Use

    ERIC Educational Resources Information Center

    Elsheikh, Salah Elgaily

    2008-01-01

    Objective: The purpose of this study is to explore the attitudes of abstainers from drug use that relate to the factors leading to long-term abstinence. Materials and Methods: Cross-sectional study was carried out in Al-Amal Hospital to examine, which attitudes of abstainers related to long-term abstinence. A random survey was conducted on 62…

  12. Long Term Degradation of Polyimide Composites

    NASA Technical Reports Server (NTRS)

    Patekar, Kaustubh A.; McManus, Hugh L.

    1998-01-01

    The durability of polymer matrix composites exposed to harsh environments is a major concern. Surface degradation and damage are observed in polyimide composites used in air at 125-300 C. It is believed that diffusion of oxygen into the material and oxidative chemical reactions are responsible. Previous work has characterized and modeled diffusion behavior, and thermogravimetric analyses (TGAS) have been carried out in nitrogen, air, and oxygen to provide quantitative information on thermal and oxidative reactions. However, the model developed using these data did not successfully extrapolate TGA data down to conditions seen in service. A test program that focuses on lower temperatures and makes use of isothermal tests was undertaken to achieve a better understanding of the degradation reactions under use conditions. A new, low-cost technique was developed to collect chemical degradation data for isothermal tests lasting over 200 hours in the temperature range 125-300 C. Results indicate complex behavior not captured by the previous model, including the presence of weight-adding reactions. Weight gain reactions dominated in the 125-225 C temperature range, while weight loss reactions dominated beyond 225 C. The data obtained from isothermal tests and earlier TGAs is used to develop an advanced model of the material behavior.

  13. Combating computer crimes: A long term strategy

    SciTech Connect

    Kizza, J.M.

    1994-12-31

    Computer crimes are a new kind of crime less than twenty years old, but in these twenty years or so the computer crime rate has risen alarmingly, costing society billions of dollars annually. In software alone this figure is in billions; software piracy in USA resulted in a loss of 2.9 billion dollars in 1989 and 2.4 billion dollars in 1990. The problem is growing rapidly with a steadily increasing use of computers by the public. The number of people using computers in the USA in the last 10 years either at work or at home has jumped from almost zero to about 40 per cent of the population. In the next decade this number may approach 80 percent. With such widespread use of computers at work and home together with the ever increasing number of local, national, and international networks, computer crimes are expected to sky rocket, and if no adequate means are devised to combat these crimes now, the future promises to be no less frightening than the present.

  14. The relationship between interannual and long-term cloud feedbacks

    SciTech Connect

    Zhou, Chen; Zelinka, Mark D.; Dessler, Andrew E.; Klein, Stephen A.

    2015-12-11

    The analyses of Coupled Model Intercomparison Project phase 5 simulations suggest that climate models with more positive cloud feedback in response to interannual climate fluctuations also have more positive cloud feedback in response to long-term global warming. Ensemble mean vertical profiles of cloud change in response to interannual and long-term surface warming are similar, and the ensemble mean cloud feedback is positive on both timescales. However, the average long-term cloud feedback is smaller than the interannual cloud feedback, likely due to differences in surface warming pattern on the two timescales. Low cloud cover (LCC) change in response to interannual and long-term global surface warming is found to be well correlated across models and explains over half of the covariance between interannual and long-term cloud feedback. In conclusion, the intermodel correlation of LCC across timescales likely results from model-specific sensitivities of LCC to sea surface warming.

  15. Long-term variation of energetic electron precipitation

    NASA Astrophysics Data System (ADS)

    Asikainen, Timo

    2015-04-01

    The long-term evolution of energetic electron precipitation (EEP) is of considerable interest, e.g., because of its atmospheric and climatic effects. However, the long-term evolution of EEP over several solar cycles has been problematic due to the lack of reliable long-term data. The NOAA/POES satellites have measured energetic particles for more than 35 years. This dataset has been used widely but it has been plagued by several instrumental problems, which have restricted its use for long-term studies. However, we have recently corrected and recalibrated the entire NOAA/POES energetic particle dataset. Using this unique dataset we present here an overview of the long-term evolution of EEP paying particular attention to the role of different types of solar wind disturbances in driving the EEP.

  16. Prenatally diagnosed urinary tract abnormalities: long-term outcome.

    PubMed

    Thomas, D F M

    2008-06-01

    The long-term outcomes of prenatally detected uropathies are poorly documented. Limited data on fetal intervention show a possible reduction in early mortality from pulmonary hypoplasia, but no beneficial effect on long-term prognosis for renal function. Prenatally detected vesicoureteric reflux (VUR) is characterised by males with high-grade primary reflux, who are at long-term risk of renal impairment. Prenatal diagnosis and surgical intervention have contributed to a reduction in long-term morbidity in children with pelviureteric junction (PUJ) obstruction. By the same token, many children have almost certainly undergone unnecessary early pyeloplasty for an obstruction that would have resolved spontaneously. Multicystic dysplastic kidney (MCDK) carries a low (1%) risk of hypertension in childhood. The limited evidence on the long-term outcome of mild dilatation (pelvicaliectasis) indicates this is a largely innocent finding, which carries no increased risk of morbidity. PMID:18037084

  17. Long-Term Dynamics of Autonomous Fractional Differential Equations

    NASA Astrophysics Data System (ADS)

    Liu, Tao; Xu, Wei; Xu, Yong; Han, Qun

    This paper aims to investigate long-term dynamic behaviors of autonomous fractional differential equations with effective numerical method. The long-term dynamic behaviors predict where systems are heading after long-term evolution. We make some modification and transplant cell mapping methods to autonomous fractional differential equations. The mapping time duration of cell mapping is enlarged to deal with the long memory effect. Three illustrative examples, i.e. fractional Lotka-Volterra equation, fractional van der Pol oscillator and fractional Duffing equation, are studied with our revised generalized cell mapping method. We obtain long-term dynamics, such as attractors, basins of attraction, and saddles. Compared with some existing stability and numerical results, the validity of our method is verified. Furthermore, we find that the fractional order has its effect on the long-term dynamics of autonomous fractional differential equations.

  18. Environmental Management Long-Term Stewardship Transition Guidance

    SciTech Connect

    Kristofferson, Keith

    2001-11-01

    Long-term stewardship consists of those actions necessary to maintain and demonstrate continued protection of human health and the environment after the completion of facility cleanup. Long-term stewardship is administered and overseen by the U.S. Department of Energy Environmental Management Office of Science and Technology. This report describes the background of long-term stewardship and gives general guidance about considerations when ownership and/or responsibility of a site should be transferred to a long-term stewardship program. This guidance document will assist the U.S. Department of Energy in: (a) ensuring that the long-term stewardship program leads transition planning with respect to facility and site areas, and (b) describing the classes and types of criteria and data required to initiate transition for areas and sites where the facility mission has ended and cleanup is complete.

  19. Long-term monitoring of marine gas leakage

    NASA Astrophysics Data System (ADS)

    Spickenbom, Kai; Faber, Eckhard; Poggenburg, Jürgen; Seeger, Christian; Furche, Markus

    2010-05-01

    The sequestration of CO2 in sub-seabed geological formations is one of the Carbon Capture and Storage (CCS) strategies currently under study. Although offshore operations are significantly more expensive than comparable onshore operations, the growing public resistance against onshore CCS projects makes sub-seabed storage a promising option. Even after a thorough review of the geological setting, there is always the possibility of leakage from the reservoir. As part of the EU-financed project CO2ReMoVe (Research, Monitoring, Verification), which aims to develop innovative research and technologies for monitoring and verification of carbon dioxide geological storage, we are working on the development of submarine long-term gas flow monitoring systems. The basic design of the monitoring system builds on our experience in volcano monitoring. Early prototypes were composed of a raft floating on the surface of a mud volcano, carrying sensors for CO2 flux and concentration, data storage and transmission, and power supply by battery-buffered solar panels. The system was modified for installation in open sea by using a buoy instead of a raft and a funnel on the seafloor to collect the gas, connected by a flexible tube. This setup provides a cost-effective solution for shallow waters. However, a buoy interferes with ship traffic, and it is also difficult to adapt this design to greater water depths. These requirements can best be complied by a completely submersed system. A system for unattended long-term monitoring in a marine environment has to be extremely durable. Therefore, we focussed on developing a mechanically and electrically as simple setup as possible, which has the additional advantage of low cost. The system consists of a funnel-shaped gas collector, a sensor head and pressure housings for electronics and power supply. Since this setup is inexpensive, it can be deployed in numbers to cover larger areas. By addition of multi-channel data loggers, data

  20. A Long-Term View on Perovskite Optoelectronics.

    PubMed

    Docampo, Pablo; Bein, Thomas

    2016-02-16

    Recently, metal halide perovskite materials have become an exciting topic of research for scientists of a wide variety of backgrounds. Perovskites have found application in many fields, starting from photovoltaics and now also making an impact in light-emitting applications. This new class of materials has proven so interesting since it can be easily solution processed while exhibiting materials properties approaching the best inorganic optoelectronic materials such as GaAs and Si. In photovoltaics, in only 3 years, efficiencies have rapidly increased from an initial value of 3.8% to over 20% in recent reports for the commonly employed methylammonium lead iodide (MAPI) perovskite. The first light emitting diodes and light-emitting electrochemical cells have been developed already exhibiting internal quantum efficiencies exceeding 15% for the former and tunable light emission spectra. Despite their processing advantages, perovskite optoelectronic materials suffer from several drawbacks that need to be overcome before the technology becomes industrially relevant and hence achieve long-term application. Chief among these are the sensitivity of the structure toward moisture and crystal phase transitions in the device operation regime, unreliable device performance dictated by the operation history of the device, that is, hysteresis, the inherent toxicity of the structure, and the high cost of the employed charge selective contacts. In this Account, we highlight recent advances toward the long-term viability of perovskite photovoltaics. We identify material decomposition routes and suggest strategies to prevent damage to the structure. In particular, we focus on the effect of moisture upon the structure and stabilization of the material to avoid phase transitions in the solar cell operating range. Furthermore, we show strategies to achieve low-cost chemistries for the development of hole transporters for perovskite solar cells, necessary to be able to compete with other

  1. Predictable Unpredictability: the Problem with Basing Medicare Policy on Long-Term Financial Forecasting.

    PubMed

    Glied, Sherry; Zaylor, Abigail

    2015-07-01

    The authors assess how Medicare financing and projections of future costs have changed since 2000. They also assess the impact of legislative reforms on the sources and levels of financing and compare cost forecasts made at different times. Although the aging U.S. population and rising health care costs are expected to increase the share of gross domestic product devoted to Medicare, changes made in the program over the past decade have helped stabilize Medicare's financial outlook--even as benefits have been expanded. Long-term forecasting uncertainty should make policymakers and beneficiaries wary of dramatic changes to the program in the near term that are intended to alter its long-term forecast: the range of error associated with cost forecasts rises as the forecast window lengthens. Instead, policymakers should focus on the immediate policy window, taking steps to reduce the current burden of Medicare costs by containing spending today. PMID:26219117

  2. Abstracts 1987. New Horizons in Long Term Care: A Report on the Long Term Care Research and Demonstration Projects.

    ERIC Educational Resources Information Center

    Illinois State Dept. of Public Aid, Springfield.

    This booklet provides a description of 14 projects which were awarded funds during fiscal year 1987 for collaborative research in long-term care to find new ways to treat long-term care patients in Illinois nursing homes. It includes the organization or institution receiving the award, an abstract of the research proposal, and the name of the…

  3. The Womanly World of Long Term Care: The Plight of the Long Term Care Worker. Gray Paper.

    ERIC Educational Resources Information Center

    Older Women's League, Washington, DC.

    Long-term care workers (those who are paid to provide custodial care for long-term patients in nursing homes or at home) must care for a growing number of increasingly disabled or dependent persons. They are working for agencies and institutions under growing pressure to increase productivity. They face new training and competency requirements,…

  4. Premium IOLs in Glaucoma

    PubMed Central

    Bhartiya, Shibal; Sharma, Anuj

    2013-01-01

    ABSTRACT Advanced technology or premium intraocular lenses have been developed to meet the patient expectations of perfect distance and near vision without the need for spectacles. Careful patient selection is critical when implanting these implants. This brief review focusses mainly on multifocal and toric IOLs and their application and limitations in patients with glaucoma. How to cite this article: Ichhpujani P, Bhartiya S, Sharma A. Premium IOLs in Glaucoma. J Current Glau Prac 2013;7(2): 54-57. PMID:26997783

  5. Long-Term Stewardship Baseline Report and Transition Guidance

    SciTech Connect

    Kristofferson, Keith

    2001-11-01

    Long-term stewardship consists of those actions necessary to maintain and demonstrate continued protection of human health and the environment after facility cleanup is complete. As the Department of Energy’s (DOE) lead laboratory for environmental management programs, the Idaho National Engineering and Environmental Laboratory (INEEL) administers DOE’s long-term stewardship science and technology efforts. The INEEL provides DOE with technical, and scientific expertise needed to oversee its long-term environmental management obligations complexwide. Long-term stewardship is administered and overseen by the Environmental Management Office of Science and Technology. The INEEL Long-Term Stewardship Program is currently developing the management structures and plans to complete INEEL-specific, long-term stewardship obligations. This guidance document (1) assists in ensuring that the program leads transition planning for the INEEL with respect to facility and site areas and (2) describes the classes and types of criteria and data required to initiate transition for areas and sites where the facility mission has ended and cleanup is complete. Additionally, this document summarizes current information on INEEL facilities, structures, and release sites likely to enter long-term stewardship at the completion of DOE’s cleanup mission. This document is not intended to function as a discrete checklist or local procedure to determine readiness to transition. It is an overarching document meant as guidance in implementing specific transition procedures. Several documents formed the foundation upon which this guidance was developed. Principal among these documents was the Long-Term Stewardship Draft Technical Baseline; A Report to Congress on Long-Term Stewardship, Volumes I and II; Infrastructure Long-Range Plan; Comprehensive Facility Land Use Plan; INEEL End-State Plan; and INEEL Institutional Plan.

  6. Global recycling services for short and long term risk reduction

    SciTech Connect

    Arslan, M.; Grygiel, J.M.; Drevon, C.; Lelievre, F.; Lesage, M.; Vincent, O.

    2013-07-01

    New schemes are being developed by AREVA in order to provide global solutions for safe and non-proliferating management of used fuels, thereby significantly contributing to overall risks reduction and sustainable nuclear development. Utilities are thereby provided with a service through which they will be able to send their used fuels and only get returned vitrified and compacted waste, the only waste remaining after reprocessing. This waste is stable, standard and has demonstrated capability for very long term interim storage. They are provided as well with associated facilities and all necessary services for storage in a demonstrated safely manner. Recycled fuels, in particular MOX, would be used either in existing LWRs or in a very limited number of full MOX reactors (like the EPR reactor), located in selected countries, that will recycle MOX so as to downgrade the isotopic quality of the Pu inventories in a significant manner. Reprocessed uranium also can be recycled. These schemes, on top of offering demonstrated operational advantages and a responsible approach, result into optimized economics for all shareholders of the scheme, as part of reactor financing (under Opex or Capex form) will be secured thanks to the value of the recycled flows. It also increases fuel cost predictability as recycled fuel is not subject to market fluctuations as much and allows, in a limited span of time, for clear risk mitigation. (authors)

  7. Intrauterine devices. The optimal long-term contraceptive method?

    PubMed

    Fortney, J A; Feldblum, P J; Raymond, E G

    1999-03-01

    This study reviews literatures on the effectiveness, safety, cost and technical ease of IUD use as compared with Norplant and surgical sterilization. Findings revealed that IUDs are highly effective, safe and relatively inexpensive methods of contraception that may offer advantages for some women over other long-term methods, such as sterilization and Norplant. IUDs provide protection against pregnancy comparable to that provided by female sterilization, and they may be more effective than Norplant. IUDs have a long duration of effectiveness: the copper T 380A is effective for at least 10 years, and the levonorgestrel (LNG) IUD seems to be effective for at least 7 years. Norplant is effective for only 5 years. Both types of IUD can disturb menstrual bleeding patterns, although the patterns of bleeding are different. Copper IUDs often increase blood loss, whereas the LNG IUD, like Norplant, substantially reduces menstrual bleeding. The most important adverse outcome associated with IUD use is higher rates of pelvic inflammatory disease; careful attention to proper insertion techniques can reduce this risk substantially, and LNG IUDs may cause no increase in risk. IUDs, like both sterilization and Norplant, provide no protection against sexually transmitted diseases. PMID:10202746

  8. Recognition of ships for long-term tracking

    NASA Astrophysics Data System (ADS)

    van den Broek, Sebastiaan P.; Bouma, Henri; Veerman, Henny E. T.; Benoist, Koen W.; den Hollander, Richard J. M.; Schwering, Piet B. W.

    2014-06-01

    Long-term tracking is important for maritime situational awareness to identify currently observed ships as earlier encounters. In cases of, for example, piracy and smuggling, past location and behavior analysis are useful to determine whether a ship is of interest. Furthermore, it is beneficial to make this assessment with sensors (such as cameras) at a distance, to avoid costs of bringing an own asset closer to the ship for verification. The emphasis of the research presented in this paper, is on the use of several feature extraction and matching methods for recognizing ships from electro-optical imagery within different categories of vessels. We compared central moments, SIFT with localization and SIFT with Fisher Vectors. From the evaluation on imagery of ships, an indication of discriminative power is obtained between and within different categories of ships. This is used to assess the usefulness in persistent tracking, from short intervals (track improvement) to larger intervals (re-identifying ships). The result of this assessment on real data is used in a simulation environment to determine how track continuity is improved. The simulations showed that even limited recognition will improve tracking, connecting both tracks at short intervals as well as over several days.

  9. What nursing diagnoses do nurses use in long term care?

    PubMed

    Daly, J M; Maas, M; Buckwalter, K

    1995-01-01

    The results of this survey validate that the NANDA nursing diagnoses classification is appropriate for use in long term care. Although ninety three percent of the current NANDA nursing diagnoses are used in practice, there remains a need for the development and testing of additional nursing diagnoses to describe patient problems encountered in long term care. Nurses in education and practice settings must work collaboratively to continue to identify, refine and validate the nursing diagnoses that are most appropriate for frail, older and/or chronically ill residents of long term care facilities. PMID:7648273

  10. Space ventures and society long-term perspectives

    NASA Technical Reports Server (NTRS)

    Brown, W. M.

    1985-01-01

    A futuristic evaluation of mankind's potential long term future in space is presented. Progress in space will not be inhibited by shortages of the Earth's physical resources, since long term economic growth will be focused on ways to constrain industrial productivity by changing social values, management styles, or government competence. Future technological progress is likely to accelerate with an emphasis on international cooperation, making possible such large joint projects as lunar colonies or space stations on Mars. The long term future in space looks exceedingly bright even in relatively pessimistic scenarios. The principal driving forces will be technological progress, commercial and public-oriented satellites, space industrialization, space travel, and eventually space colonization.

  11. Long-term Monitoring Plan for the Central Nevada Test Area

    SciTech Connect

    Hassan, Ahmed E

    2004-01-01

    This report discusses the long-term monitoring strategy developed for the Central Nevada Test Area (CNTA), where the Faultless underground nuclear test was conducted. It includes a thorough literature review of monitoring well network design. A multi-staged approach for development of the long-term monitoring well network for CNTA is proposed, incorporating a number of issues, including uncertainty of the subsurface environment, cost, selection of well locations, etc. The first stage is to use hydrogeologic expertise combined with model simulations and probability based approaches to select the first set of monitoring wells. The second stage will be based on an optimum design methodology that uses a suitable statistical approach, combined with an optimization approach, to augment the initial set of wells and develop the final long-term monitoring network.

  12. Constraints on Long-Term Seismic Hazard From Vulnerable Stalagmites

    NASA Astrophysics Data System (ADS)

    Gribovszki, Katalin; Bokelmann, Götz; Mónus, Péter; Kovács, Károly; Konecny, Pavel; Lednicka, Marketa; Bednárik, Martin; Brimich, Ladislav

    2015-04-01

    Earthquakes hit urban centers in Europe infrequently, but occasionally with disastrous effects. This raises the important issue for society, how to react to the natural hazard: potential damages are huge, but infrastructure costs for addressing these hazards are huge as well. Furthermore, seismic hazard is only one of the many hazards facing society. Societal means need to be distributed in a reasonable manner - to assure that all of these hazards (natural as well as societal) are addressed appropriately. Obtaining an unbiased view of seismic hazard (and risk) is very important therefore. In principle, the best way to test PSHA models is to compare with observations that are entirely independent of the procedure used to produce the PSHA models. Arguably, the most valuable information in this context should be information on long-term hazard, namely maximum intensities (or magnitudes) occuring over time intervals that are at least as long as a seismic cycle - if that exists. Such information would be very valuable, even if it concerned only a single site, namely that of a particularly sensitive infrastructure. Such a request may seem hopeless - but it is not. Long-term information can in principle be gained from intact stalagmites in natural caves. These have survived all earthquakes that have occurred, over thousands of years - depending on the age of the stalagmite. Their "survival" requires that the horizontal ground acceleration has never exceeded a certain critical value within that period. We are focusing here on case studies in Austria, which has moderate seismicity, but a well-documented history of major earthquake-induced damage, e.g., Villach in 1348 and 1690, Vienna in 1590, Leoben in 1794, and Innsbruck in 1551, 1572, and 1589. Seismic intensities have reached levels up to 10. It is clearly important to know which "worst-case" damages to expect. We have identified sets of particularly sensitive stalagmites in the general vicinity of two major cities in

  13. Modulation of working memory updating: Does long-term memory lexical association matter?

    PubMed

    Artuso, Caterina; Palladino, Paola

    2016-02-01

    The aim of the present study was to investigate how working memory updating for verbal material is modulated by enduring properties of long-term memory. Two coexisting perspectives that account for the relation between long-term representation and short-term performance were addressed. First, evidence suggests that performance is more closely linked to lexical properties, that is, co-occurrences within the language. Conversely, other evidence suggests that performance is linked more to long-term representations which do not entail lexical/linguistic representations. Our aim was to investigate how these two kinds of long-term memory associations (i.e., lexical or nonlexical) modulate ongoing working memory activity. Therefore, we manipulated (between participants) the strength of the association in letters based on either frequency of co-occurrences (lexical) or contiguity along the sequence of the alphabet (nonlexical). Results showed a cost in working memory updating for strongly lexically associated stimuli only. Our findings advance knowledge of how lexical long-term memory associations between consonants affect working memory updating and, in turn, contribute to the study of factors which impact the updating process across memory systems. PMID:26323831

  14. Closer to home (or home alone?) The British Columbia long-term care system in transition.

    PubMed Central

    Brody, B L; Simon, H J; Stadler, K L

    1997-01-01

    Finding ways to organize and deliver long-term care that provides for quality of life at an affordable price is of increasing importance as the population ages, family size decreases, and women enter the workforce. For the past 2 decades, British Columbia has provided a model system that has apparently avoided disruptive conflicts. Although formal users' complaints are rare, this study--based on focus groups and interviews with users, their families, and advocates--identified problems users encountered toward resolving concerns about the structure, process, and outcome of long-term care. We present these findings in the context of British Columbia's current devolution from provincial to regional control that aims to save costs and keep disabled elderly persons in the community. British Columbia may be continuing to lead the way in meeting the needs of its burgeoning elderly population for long-term care. Study findings have implications for the development of US long-term care policy by pointing to the value of obtaining users' views of long-term care to identify both obvious and more subtle trouble spots. PMID:9392982

  15. Zambia : long-term generation expansion study - executive summary.

    SciTech Connect

    Conzelmann, G.; Koritarov, V.; Buehring, W.; Veselka, T.; Decision and Information Sciences

    2008-02-28

    The objective of this study is to analyze possible long-term development options of the Zambian electric power system in the period up to 2015. The analysis involved the hydro operations studies of the Zambezi river basin and the systems planning studies for the least-cost generation expansion planning. Two well-known and widely accepted computer models were used in the analysis: PC-VALORAGUA model for the hydro operations and optimization studies and the WASP-III Plus model for the optimization of long-term system development. The WASP-III Plus model is a part of the Argonne National Laboratory's Energy and Power Evaluation Model (ENPEP). The analysis was conducted in close collaboration with the Zambia Electricity Supply Corporation (ZESCO). On the initiative from The World Bank, the sponsor of the study, ZESCO formed a team of experts that participated in the analysis and were trained in the use of computer models. Both models were transferred to ZESCO free of charge and installed on several computers in the ZESCO corporate offices in Lusaka. In September-October 1995, two members of the ZESCO National Team participated in a 4-week training course at Argonne National Laboratory near Chicago, U.S.A., focusing on the long-term system expansion planning using the WASP and VALORAGUA models. The hydropower operations studies were performed for the whole Zambezi river basin, including the full installation of the Kariba power station, and the Cahora Bassa hydro power station in Mozambique. The analysis also included possible future projects such as Itezhi-Tezhi, Kafue Gorge Lower, and Batoka Gorge power stations. As hydropower operations studies served to determine the operational characteristics of the existing and future hydro power plants, it was necessary to simulate the whole Zambezi river basin in order to take into account all interactions and mutual influences between the hydro power plants. In addition, it allowed for the optimization of reservoir management

  16. Osteoporosis management in long-term care. Survey of Ontario physicians.

    PubMed Central

    McKercher, H. G.; Crilly, R. G.; Kloseck, M.

    2000-01-01

    OBJECTIVE: To survey physicians in Ontario regarding their approach to diagnosis and treatment of osteoporosis among residents of long-term care facilities. DESIGN: Mailed questionnaire covering physician demographics; current clinical practice relating to osteoporosis; and perceived barriers to prevention, diagnosis, and treatment of the disease. SETTING: Long-term care facilities in Ontario. PARTICIPANTS: Medical directors of long-term care facilities. MAIN OUTCOME MEASURES: Demographic variables; physician attitudes; and practices concerning awareness, diagnosis, and treatment of osteoporosis. RESULTS: Respondents returned 275 of 490 questionnaires, for a response rate of 56.1%. Most respondents (92.4%) were family physicians; 28.7% were caring for more than 100 patients in long-term care. Most (85.8%) saw from one to 10 hip fractures yearly in their practices. Although 49.6% of respondents estimated the prevalence of osteoporosis to be 40% to 80% among their long-term care patients, 45.5% said that they did not routinely assess their patients for the disease, and 26.8% do not routinely treat it. Half (50.9%) of physicians would treat patients at high risk based on clinical history; 47.9% if patients had a vertebral compression fracture on plain x-ray examination; 43.8% if patients were highly functional; 42.0% if osteoporosis were confirmed with bone mineral densitometry; and 30.0% if patients had a recent fracture. Perceived barriers to initiating treatment included cost of therapy, patient or family reluctance to accept therapy, and time or cost of diagnosis. CONCLUSION: Although physicians are aware that patients in long-term care facilities are at high risk for osteoporosis and hip fractures, the disease remains underdiagnosed and undertreated. PMID:11143582

  17. Long-term monitoring for nanomedicine implants and drugs

    NASA Astrophysics Data System (ADS)

    Kendall, Michaela; Lynch, Iseult

    2016-03-01

    Increasing globalization means that traditional occupational epidemiological approaches may no longer apply, suggesting a need for an alternative model to assess the long-term impact of nanomaterial exposure on health.

  18. Earth's Long-Term Warming Trend, 1880-2015

    NASA Video Gallery

    This visualization illustrates Earth’s long-term warming trend, showing temperature changes from 1880 to 2015 as a rolling five-year average. Orange colors represent temperatures that are warmer th...

  19. Long-term Career Goals for Professional Women in Agriculture.

    ERIC Educational Resources Information Center

    Klepper, Betty

    1986-01-01

    Encourages the formation of long-term career goals for women in agronomy. Offers perspectives and practical suggestions for obtaining positions, maintaining professional credentials, and managing personal and career related obligations. (ML)

  20. Kids' Mild Brain Injury Can Have Long-Term Effects

    MedlinePlus

    ... medlineplus.gov/news/fullstory_160606.html Kids' Mild Brain Injury Can Have Long-Term Effects Early head ... 000 Swedes who suffered at least one traumatic brain injury (TBI) before age 25 with their unaffected ...

  1. The Long Term Agroecosystem Research Network - Shared research strategy

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Agriculture faces tremendous challenges in meeting multiple societal goals, including a safe and plentiful food supply; climate change adaptation and mitigation; supplying sources of bioenergy; improving water, air, and soil quality; and maintaining biodiversity. The Long Term Agroecosystem Research...

  2. Long-term Outcomes of Childhood Onset Nephrotic Syndrome

    PubMed Central

    Hjorten, Rebecca; Anwar, Zohra; Reidy, Kimberly Jean

    2016-01-01

    There are limited studies on long-term outcomes of childhood onset nephrotic syndrome (NS). A majority of children with NS have steroid-sensitive nephrotic syndrome (SSNS). Steroid-resistant nephrotic syndrome (SRNS) is associated with a high risk of developing end-stage renal disease. Biomarkers and analysis of genetic mutations may provide new information for prognosis in SRNS. Frequently relapsing and steroid-dependent NS is associated with long-term complications, including dyslipidemia, cataracts, osteoporosis and fractures, obesity, impaired growth, and infertility. Long-term complications of SSNS are likely to be under-recognized. There remain many gaps in our knowledge of long-term outcomes of childhood NS, and further study is indicated. PMID:27252935

  3. Long term combination treatment for severe idiopathic pulmonary arterial hypertension

    PubMed Central

    Affuso, Flora; Cirillo, Plinio; Ruvolo, Antonio; Carlomagno, Guido; Fazio, Serafino

    2010-01-01

    We report the long-term follow-up of 3 cases of severe idiopathic pulmonary arterial hypertension, in whom tadalafil plus sitaxentan combination therapy improved the clinical condition and exercise performance without any relevant adverse event. PMID:21160759

  4. Long-Term Quiescent Fibroblast Cells Transit into Senescence

    PubMed Central

    Marthandan, Shiva; Priebe, Steffen; Hemmerich, Peter; Klement, Karolin; Diekmann, Stephan

    2014-01-01

    Cellular senescence is described to be a consequence of telomere erosion during the replicative life span of primary human cells. Quiescence should therefore not contribute to cellular aging but rather extend lifespan. Here we tested this hypothesis and demonstrate that cultured long-term quiescent human fibroblasts transit into senescence due to similar cellular mechanisms with similar dynamics and with a similar maximum life span as proliferating controls, even under physiological oxygen conditions. Both, long-term quiescent and senescent fibroblasts almost completely fail to undergo apoptosis. The transition of long-term quiescent fibroblasts into senescence is also independent of HES1 which protects short-term quiescent cells from becoming senescent. Most significantly, DNA damage accumulates during senescence as well as during long-term quiescence at physiological oxygen levels. We suggest that telomere-independent, potentially maintenance driven gradual induction of cellular senescence during quiescence is a counterbalance to tumor development. PMID:25531649

  5. Long-Term Ecological Monitoring Field Sampling Plan for 2007

    SciTech Connect

    T. Haney R. VanHorn

    2007-07-31

    This field sampling plan describes the field investigations planned for the Long-Term Ecological Monitoring Project at the Idaho National Laboratory Site in 2007. This plan and the Quality Assurance Project Plan for Waste Area Groups 1, 2, 3, 4, 5, 6, 7, 10, and Removal Actions constitute the sampling and analysis plan supporting long-term ecological monitoring sampling in 2007. The data collected under this plan will become part of the long-term ecological monitoring data set that is being collected annually. The data will be used t determine the requirements for the subsequent long-term ecological monitoring. This plan guides the 2007 investigations, including sampling, quality assurance, quality control, analytical procedures, and data management. As such, this plan will help to ensure that the resulting monitoring data will be scientifically valid, defensible, and of known and acceptable quality.

  6. Influenza in long-term care facilities: preventable, detectable, treatable.

    PubMed

    Mossad, Sherif B

    2009-09-01

    Influenza in long-term care facilities is an ever more challenging problem. Vaccination of residents and health care workers is the most important preventive measure. Although vaccine efficacy has been questioned, the preponderance of data favors vaccination. Antiviral resistance complicates postexposure chemoprophylaxis and treatment. Factors that limit the choice of antiviral agents in this patient population include limited vaccine supplies and impaired dexterity and confusion in long-term care residents. PMID:19726556

  7. Endoscopic Management of Attic Cholesteatoma: Long-Term Results.

    PubMed

    Alicandri-Ciufelli, Matteo; Marchioni, Daniele; Kakehata, Seiji; Presutti, Livio; Villari, Domenico

    2016-10-01

    The main application of endoscopic surgery relies on the middle ear cholesteatoma surgical treatment, although for a definitive validation and acceptance by scientific community, long-term results are needed about recurrent and residual rates of the pathology. The aim of the present paper was to analyze the single institution experience with the long-term results of surgical treatment of attic cholesteatoma. PMID:27565391

  8. Maintaining Engagement in Long-term Interventions with Relational Agents

    PubMed Central

    Bickmore, Timothy; Schulman, Daniel; Yin, Langxuan

    2011-01-01

    We discuss issues in designing virtual humans for applications which require long-term voluntary use, and the problem of maintaining engagement with users over time. Concepts and theories related to engagement from a variety of disciplines are reviewed. We describe a platform for conducting studies into long-term interactions between humans and virtual agents, and present the results of two longitudinal randomized controlled experiments in which the effect of manipulations of agent behavior on user engagement was assessed. PMID:21318052

  9. Long-term effects of sludge application to land

    SciTech Connect

    Geertsema, W.S. ); Knocke, W.R.; Novak, J.T.; Dove, D. . Dept. of Civil Engineering)

    1994-11-01

    The purpose of this study was to evaluate the long-term environmental effects of applying alum sludge to land. Investigations at the original field site included soil analysis, soil water monitoring, groundwater monitoring, and analysis of tissues from pine needles. No long-term (30 months) effects were observed, and the authors conclude that alum coagulant sludges can be applied to forest lands at loading rates of at least 1.5 to 2.5% by dry weight without adverse effect.

  10. Commentary: The Broader Context of Long-Term Care Ethics.

    PubMed

    Lesandrini, Jason; O'Connell, Carol

    2016-07-01

    Ethical issues in long-term care settings, although having received attention in the literature, have not in our opinion received the appropriate level they require. Thus, we applaud the Cambridge Quarterly for publishing this case. We can attest to the significance of ethical issues arising in long-term care facilities, as Mr. Hope's case is all too familiar to those practicing in these settings. What is unique about this case is that an actual ethics consult was made in a long-term care setting. We have seen very little in the published literature on the use of ethics structures in long-term care populations. Our experience is that these healthcare settings are ripe for ethical concerns and that providers, patients, families, and staff need/desire ethics resources to actively and preventively address ethical concerns. The popular press has begun to recognize the ethical issues involved in long-term care settings and the need for ethics structures. Recently, in California a nurse refused to initiate CPR for an elderly patient in a senior residence. In that case, the nurse was quoted as saying that the facility had a policy that nurses were not to start CPR for elderly patients. 1 Although this case is not exactly the same as that of Mr. Hope, it highlights the need for developing robust ethics program infrastructures in long-term care settings that work toward addressing ethical issues through policy, education, and active consultation. PMID:27348841

  11. Which care? Whose responsibility? And why family? A Confucian account of long-term care for the elderly.

    PubMed

    Fan, Ruiping

    2007-01-01

    Across the world, socio-economic forces are shifting the locus of long-term care from the family to institutional settings, producing significant moral, not just financial costs. This essay explores these costs and the distortions in the role of the family they involve. These reflections offer grounds for critically questioning the extent to which moral concerns regarding long-term care in Hong Kong and in mainland China are the same as those voiced in the United States, although family resemblances surely exist. Chinese moral values such as virtue and filial piety embedded in a Confucian moral and social context cannot be recast without distortion in terms of modern Western European notions. The essay concludes that the Confucian resources must be taken seriously in order to develop an authentic Chinese bioethics of long-term care and a defensible approach to long-term care policy for contemporary society in general and Chinese society in particular. PMID:17924274

  12. Long-term care legislation: an issue of concern for nurse practitioners.

    PubMed

    Jennings, J P

    1989-01-01

    Comprehensive long-term care policy has many hurdles to overcome before it becomes a reality. The biggest hurdle is the price tag! Estimates range from $6 billion (Pepper's home-care bill) to $46 billion (Stark's long-term care coverage bill). Congressional insiders predict that federal long-term care coverage must contain "pay-as-you-go" financing to win congressional passage. The medicare catastrophic health care act is cited by many in the Congress as establishing the precedent for self-financing of new federal benefits. In a pay-as-you-go era in public spending, any new program can only come from trimming existing programs and shifting those funds to new programs or from generating new revenues. The latter could result from increased beneficiary cost-sharing, an increase in the medicare payroll tax, or by eliminating the $45,000 cap on income exposed to the current 1.45% medicare payroll tax. Federal proposals to date build on existing medicare and medicaid programs. In them, quality assurance measures have been strengthened, consumer input encouraged, and a new layer of bureaucracy established to screen potential clients and provide case-management services. The scope of services is broad in most of the current proposals, and reimbursement is provided for respite care to allow family care givers relief and assistance. Access to nurse practitioners' services is an important feature of Kennedy's Lifecare proposal and is the focus of lobbying efforts for all public and private proposals. It is time for nurse practitioners to become involved in long-term care legislation. This may be initiated by reviewing current proposals and long-term care packages offered by major insurance companies. Any future long-term care benefit should bear the imprint of the nurse practitioner's professional perspective and the profession's commitment to humane, caring health policy. PMID:2517223

  13. 24 CFR 232.805 - Insurance premiums.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 24 Housing and Urban Development 2 2014-04-01 2014-04-01 false Insurance premiums. 232.805 Section... FACILITIES Contract Rights and Obligations Premiums § 232.805 Insurance premiums. (a) First premium. The... insurance premium equal to one percent of the original face amount of the note. (b) Second premium....

  14. 29 CFR 4006.3 - Premium rate.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 29 Labor 9 2013-07-01 2013-07-01 false Premium rate. 4006.3 Section 4006.3 Labor Regulations Relating to Labor (Continued) PENSION BENEFIT GUARANTY CORPORATION PREMIUMS PREMIUM RATES § 4006.3 Premium... (dealing with premiums for certain terminated single-employer plans), the premium paid for basic...

  15. 29 CFR 4006.3 - Premium rate.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 29 Labor 9 2014-07-01 2014-07-01 false Premium rate. 4006.3 Section 4006.3 Labor Regulations Relating to Labor (Continued) PENSION BENEFIT GUARANTY CORPORATION PREMIUMS PREMIUM RATES § 4006.3 Premium... (dealing with premiums for certain terminated single-employer plans), the premium paid for basic...

  16. 29 CFR 4006.3 - Premium rate.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 29 Labor 9 2012-07-01 2012-07-01 false Premium rate. 4006.3 Section 4006.3 Labor Regulations Relating to Labor (Continued) PENSION BENEFIT GUARANTY CORPORATION PREMIUMS PREMIUM RATES § 4006.3 Premium... (dealing with premiums for certain terminated single-employer plans), the premium paid for basic...

  17. 24 CFR 232.805 - Insurance premiums.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 24 Housing and Urban Development 2 2013-04-01 2013-04-01 false Insurance premiums. 232.805 Section... FACILITIES Contract Rights and Obligations Premiums § 232.805 Insurance premiums. (a) First premium. The... insurance premium equal to one percent of the original face amount of the note. (b) Second premium....

  18. 24 CFR 241.805 - Insurance premiums.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 24 Housing and Urban Development 2 2014-04-01 2014-04-01 false Insurance premiums. 241.805 Section... Without a HUD-Insured or HUD-Held Mortgage Premiums § 241.805 Insurance premiums. (a) First premium. The... insurance premium equal to one percent of the original face amount of the note. (b) Second premium....

  19. 24 CFR 241.805 - Insurance premiums.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 24 Housing and Urban Development 2 2013-04-01 2013-04-01 false Insurance premiums. 241.805 Section... Without a HUD-Insured or HUD-Held Mortgage Premiums § 241.805 Insurance premiums. (a) First premium. The... insurance premium equal to one percent of the original face amount of the note. (b) Second premium....

  20. 24 CFR 241.805 - Insurance premiums.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 24 Housing and Urban Development 2 2012-04-01 2012-04-01 false Insurance premiums. 241.805 Section... Without a HUD-Insured or HUD-Held Mortgage Premiums § 241.805 Insurance premiums. (a) First premium. The... insurance premium equal to one percent of the original face amount of the note. (b) Second premium....

  1. 29 CFR 4006.3 - Premium rate.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 29 Labor 9 2011-07-01 2011-07-01 false Premium rate. 4006.3 Section 4006.3 Labor Regulations Relating to Labor (Continued) PENSION BENEFIT GUARANTY CORPORATION PREMIUMS PREMIUM RATES § 4006.3 Premium... (dealing with premiums for certain terminated single-employer plans), the premium paid for basic...

  2. 24 CFR 232.805 - Insurance premiums.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 24 Housing and Urban Development 2 2012-04-01 2012-04-01 false Insurance premiums. 232.805 Section... FACILITIES Contract Rights and Obligations Premiums § 232.805 Insurance premiums. (a) First premium. The... insurance premium equal to one percent of the original face amount of the note. (b) Second premium....

  3. Long-term flow monitoring of submarine gas emanations

    NASA Astrophysics Data System (ADS)

    Spickenbom, K.; Faber, E.; Poggenburg, J.; Seeger, C.

    2009-04-01

    One of the Carbon Capture and Storage (CCS) strategies currently under study is the sequestration of CO2 in sub-seabed geological formations. Even after a thorough review of the geological setting, there is the possibility of leaks from the reservoirs. As part of the EU-financed project CO2ReMoVe (Research, Monitoring, Verification), which aims to develop innovative research and technologies for monitoring and verification of carbon dioxide geological storage, we are working on the development of submarine long-term gas flow monitoring systems. Technically, however, these systems are not limited to CO2 but can be used for monitoring of any free gas emission (bubbles) on the seafloor. The basic design of the gas flow sensor system was derived from former prototypes developed for monitoring CO2 and CH4 on mud volcanoes in Azerbaijan. This design was composed of a raft floating on the surface above the gas vent to collect the bubbles. Sensors for CO2 flux and concentration and electronics for data storage and transmission were mounted on the raft, together with battery-buffered solar panels for power supply. The system was modified for installation in open sea by using a buoy instead of a raft and a funnel on the seafloor to collect the gas, which is then guided above water level through a flexible tube. Besides some technical problems (condensed water in the tube, movement of the buoys due to waves leading to biased measurement of flow rates), this setup provides a cost-effective solution for shallow waters. However, a buoy interferes with ship traffic, and it is also difficult to adapt this design to greater water depths. These requirements can best be complied by a completely submersed system. To allow unattended long-term monitoring in a submarine environment, such a system has to be extremely durable. Therefore, we focussed on developing a mechanically and electrically as simple setup as possible, which has the additional advantage of low cost. The system

  4. Innovative Strategy For Long Term Monitoring Of Metal And Radionuclide Plumes

    SciTech Connect

    Eddy-Dilek, Carol; Millings, Margaret R.; Looney, Brian B.; Denham, Miles E.

    2014-01-08

    Many government and private industry sites that were once contaminated with radioactive and chemical wastes cannot be cleaned up enough to permit unrestricted human access. The sites will require long term management, in some cases indefinitely, leaving site owners with the challenge of protecting human health and environmental quality at these "legacy" sites. Long-term monitoring of groundwater contamination is one of the largest projected costs in the life cycle of environmental management at the Savannah River Site, the larger DOE complex, and many large federal and private sites. There is a need to optimize the performance and manage the cost of long term surveillance and monitoring at their sites. Currently, SRNL is initiating a pilot field test using alternative protocols for long term monitoring of metals and radionuclides. A key component of the approach is that monitoring efforts are focused on measurement of low cost metrics related to hydrologic and chemical conditions that control contaminant migration. The strategy combines careful monitoring of hydrologic boundary conditions with measurement of master variables such as chemical surrogates along with a smaller number of standard well analyses. In plumes contaminated with metals, master variables control the chemistry of the groundwater system, and include redox variables (ORP, DO, chemicals), pH, specific conductivity, biological community (breakdown/decay products), and temperature. Significant changes in these variables will result in conditions whereby the plume may not be stable and therefore can be used to predict possible plume migration. Conversely, concentration measurements for all types of contaminants in groundwater are a lagging indicator plume movement - major changes contaminant concentrations indicate that contamination has migrated. An approach based on measurement of master variables and explicit monitoring of hydrologic boundary conditions combined with traditional metrics should lead

  5. Long Term Degradation of Resin for High Temperature Composites

    NASA Technical Reports Server (NTRS)

    Patekar, Kaustubh A.

    2000-01-01

    The durability of polymer matrix composites exposed to harsh environments is a major concern. Surface degradation and damage are observed in polyimide composites used in air at 125 to 300 C. It is believed that diffusion of oxygen into the material and oxidative chemical reactions in the matrix are responsible. Previous work has characterized and modeled diffusion behavior, and thermogravimetric analyses (TGAs) have been carried out in nitrogen, air, and oxygen to provide quantitative information on thermal and oxidative reactions. However, the model developed using these data was not able to capture behavior seen in isothermal tests, especially those of long duration. A test program that focuses on lower temperatures and makes use of isothermal tests was undertaken to achieve a better understanding of the degradation reactions under use conditions. A new low-cost technique was developed to collect chemical degradation data for isothermal tests lasting over 200 hr in the temperature range 125 to 300 C. Results indicate complex behavior not captured by the previous TGA tests, including the presence of weight-adding reactions. Weight gain reactions dominated in the 125 to 225 C temperature range, while weight loss reactions dominated beyond 225 C. The data obtained from isothermal tests was used to develop a new model of the material behavior. This model was able to fully capture the behavior seen in the tests up to 275 C. Correlation of the current model with both isothermal data at 300 C and high rate TGA test data is mediocre. At 300 C and above, the reaction mechanisms appear to change. Attempts (which failed) to measure non-oxidative degradation indicate that oxidative reactions dominate the degradation at low temperatures. Based on this work, long term isothermal testing in an oxidative atmosphere is recommended for studying the degradation behavior of this class of materials.

  6. Long-term prognosis of patients with surgical wound infections.

    PubMed

    Poulsen, K B; Gottschau, A

    1997-10-01

    This study examined if surgical wound infections (SWI) result in a severe prognosis regarding general health and increase the consumption of social resources. A group of 1301 patients were interviewed by self-administered questionnaires during 1993-1994, while operated during hospitalization in seven Danish hospitals. These patients were followed up at least once by similar questionnaires at a median time of 5.5 and 10.0 months postoperatively. The consequences of surgically diagnosed SWI were analyzed in a hospital cohort of 58 infected patients and 648 controls. Postdischarge infections were analyzed in a patient cohort of 263 cases and 767 controls. Changes in health was measured by the General Health Questionnaire, Activities of Daily Living index, and self-assessed health. Consumption of resources were estimated by reliance on assistance from family and friends, use of home services, and contacts to doctors. It was found that the long-term prognosis of general health was unaffected by SWIs. However significantly increased social dependence was found for patients with SWIs compared to uninfected patients. Almost one-fourth of the operations were complicated by an SWI. Most of the infections were recognized only after discharge and were thought to be of minor importance, which may explain why no chronic impairment of the health was found for patients with an SWI. A bias toward no-effect may have been introduced if patients with severe SWIs abstained from participation. The societal cost of care for patients with minor infections seems to be large. The causal relation between outcome and SWI needs to be further investigated. PMID:9327669

  7. Wastewater treatment by soil infiltration: Long-term phosphorus removal.

    PubMed

    Eveborn, David; Kong, Deguo; Gustafsson, Jon Petter

    2012-10-01

    Phosphorus (P) leaching from on-site wastewater treatment systems may contribute to eutrophication. In developed countries the most common on-site treatment technique is septic systems with soil infiltration. However, the current knowledge about long term P removal in soil treatment systems is not well developed and the data used for estimation of P losses from such systems are unreliable. In this study we sampled four filter beds from community-scale soil treatment systems with an age of between 14 and 22years to determine the long-term P removal and to investigate the chemical mechanisms behind the observed removal. For one site the long-term P removal was calculated using a mass balance approach. After analysis of the accumulated P, it was estimated that on average 12% of the long-term P load had been removed by the bed material. This indicates a low overall capacity of soil treatment systems to remove phosphorus. Batch experiments and chemical speciation modelling indicated that calcium phosphate precipitation was not an important long-term P removal mechanism, with the possible exception of one of the sites. More likely, the P removal was induced by AlPO(4) precipitation and/or sorption to poorly ordered aluminium compounds, as evidenced by strong relationships between oxalate-extractable Al and P. PMID:22982614

  8. The relationship between interannual and long-term cloud feedbacks

    DOE PAGESBeta

    Zhou, Chen; Zelinka, Mark D.; Dessler, Andrew E.; Klein, Stephen A.

    2015-12-11

    The analyses of Coupled Model Intercomparison Project phase 5 simulations suggest that climate models with more positive cloud feedback in response to interannual climate fluctuations also have more positive cloud feedback in response to long-term global warming. Ensemble mean vertical profiles of cloud change in response to interannual and long-term surface warming are similar, and the ensemble mean cloud feedback is positive on both timescales. However, the average long-term cloud feedback is smaller than the interannual cloud feedback, likely due to differences in surface warming pattern on the two timescales. Low cloud cover (LCC) change in response to interannual andmore » long-term global surface warming is found to be well correlated across models and explains over half of the covariance between interannual and long-term cloud feedback. In conclusion, the intermodel correlation of LCC across timescales likely results from model-specific sensitivities of LCC to sea surface warming.« less

  9. Long-Term Stewardship Program Science and Technology Requirements

    SciTech Connect

    Joan McDonald

    2002-09-01

    Many of the United States’ hazardous and radioactively contaminated waste sites will not be sufficiently remediated to allow unrestricted land use because funding and technology limitations preclude cleanup to pristine conditions. This means that after cleanup is completed, the Department of Energy will have long-term stewardship responsibilities to monitor and safeguard more than 100 sites that still contain residual contamination. Long-term stewardship encompasses all physical and institutional controls, institutions, information, and other mechanisms required to protect human health and the environment from the hazards remaining. The Department of Energy Long-Term Stewardship National Program is in the early stages of development, so considerable planning is still required to identify all the specific roles and responsibilities, policies, and activities needed over the next few years to support the program’s mission. The Idaho National Engineering and Environmental Laboratory was tasked with leading the development of Science and Technology within the Long-Term Stewardship National Program. As part of that role, a task was undertaken to identify the existing science and technology related requirements, identify gaps and conflicts that exist, and make recommendations to the Department of Energy for future requirements related to science and technology requirements for long-term stewardship. This work is summarized in this document.

  10. Method for Water Management Considering Long-term Probabilistic Forecasts

    NASA Astrophysics Data System (ADS)

    Hwang, J.; Kang, J.; Suh, A. S.

    2015-12-01

    This research is aimed at predicting the monthly inflow of the Andong-dam basin in South Korea using long-term probabilistic forecasts to apply long-term forecasts to water management. Forecasted Cumulative Distribution Functions (CDFs) of monthly precipitation are plotted by combining the range of monthly precipitation based on proper Probability Density Function (PDF) in past data with probabilistic forecasts in each category. Ensembles of inflow are estimated by entering generated ensembles of precipitation based on the CDFs into the 'abcd' water budget model. The bias and RMSE between averages in past data and observed inflow are compared to them in forecasted ensembles. In our results, the bias and RMSE of average precipitation in the forecasted ensemble are bigger than in past data, whereas the average inflow in the forecasted ensemble is smaller than in past data. This result could be used for reference data to apply long-term forecasts to water management, because of the limit in the number of forecasted data for verification and differences between the Andong-dam basin and the forecasted regions. This research has significance by suggesting a method of applying probabilistic information in climate variables from long-term forecasts to water management in Korea. Original data of a climate model, which produces long-term probabilistic forecasts should be verified directly as input data of a water budget model in the future, so that a more scientific response in water management against uncertainty of climate change could be reached.

  11. Characteristics of Long-Term Survivors of Epithelial Ovarian Cancer

    PubMed Central

    Cress, Rosemary D.; Chen, Yingjia S.; Morris, Cyllene R.; Petersen, Megan; Leiserowitz, Gary S.

    2015-01-01

    Objective To identify characteristics associated with long-term survival forepithelial ovarian cancer patients using the California Cancer Registry. Methods A descriptive analysis of survival of all California residents diagnosed with epithelial ovarian cancer between 1994 and 2001 was conducted using patients identified through the cancer registry with follow up through 2011. Characteristics of the patients who survived more than 10 years (long-term survivors) were compared to three other cohorts: patients who survived less than 2 years, those who survived at least 2 but no more than 5 years, and those who survived at least 5 but no more than 10 years. Results A total of 3,582 out of 11,541 (31% CI=30.2%, 31.8%) of the patients survived more than 10 years. Younger age, early stage, low-grade, and non-serous histology were significant predictors of long-term survival, but long-term survivors also included women with high-risk cancer. Conclusion Long-term survival is not unusual in patients with epithelial ovarian cancer, even in those with high-risk disease. Many of the prognostic factors are well known, but it remains to be determined why some patients with advanced stage high-grade cancers survive longer than others with the same histology. These findings are important for patient counseling. PMID:26244529

  12. Wastewater treatment by soil infiltration: Long-term phosphorus removal

    NASA Astrophysics Data System (ADS)

    Eveborn, David; Kong, Deguo; Gustafsson, Jon Petter

    2012-10-01

    Phosphorus (P) leaching from on-site wastewater treatment systems may contribute to eutrophication. In developed countries the most common on-site treatment technique is septic systems with soil infiltration. However, the current knowledge about long term P removal in soil treatment systems is not well developed and the data used for estimation of P losses from such systems are unreliable. In this study we sampled four filter beds from community-scale soil treatment systems with an age of between 14 and 22 years to determine the long-term P removal and to investigate the chemical mechanisms behind the observed removal. For one site the long-term P removal was calculated using a mass balance approach. After analysis of the accumulated P, it was estimated that on average 12% of the long-term P load had been removed by the bed material. This indicates a low overall capacity of soil treatment systems to remove phosphorus. Batch experiments and chemical speciation modelling indicated that calcium phosphate precipitation was not an important long-term P removal mechanism, with the possible exception of one of the sites. More likely, the P removal was induced by AlPO4 precipitation and/or sorption to poorly ordered aluminium compounds, as evidenced by strong relationships between oxalate-extractable Al and P.

  13. Short- and long-term (trophic) purinergic signalling.

    PubMed

    Burnstock, Geoffrey

    2016-08-01

    There is long-term (trophic) purinergic signalling involving cell proliferation, differentiation, motility and death in the development and regeneration of most systems of the body, in addition to fast purinergic signalling in neurotransmission, neuromodulation and secretion. It is not always easy to distinguish between short- and long-term signalling. For example, adenosine triphosphate (ATP) can sometimes act as a short-term trigger for long-term trophic events that become evident days or even weeks after the original challenge. Examples of short-term purinergic signalling during sympathetic, parasympathetic and enteric neuromuscular transmission and in synaptic transmission in ganglia and in the central nervous system are described, as well as in neuromodulation and secretion. Long-term trophic signalling is described in the immune/defence system, stratified epithelia in visceral organs and skin, embryological development, bone formation and resorption and in cancer. It is likely that the increase in intracellular Ca(2+) in response to both P2X and P2Y purinoceptor activation participates in many short- and long-term physiological effects.This article is part of the themed issue 'Evolution brings Ca(2+) and ATP together to control life and death'. PMID:27377731

  14. Common Calibration Source for Monitoring Long-term Ozone Trends

    NASA Technical Reports Server (NTRS)

    Kowalewski, Matthew

    2004-01-01

    Accurate long-term satellite measurements are crucial for monitoring the recovery of the ozone layer. The slow pace of the recovery and limited lifetimes of satellite monitoring instruments demands that datasets from multiple observation systems be combined to provide the long-term accuracy needed. A fundamental component of accurately monitoring long-term trends is the calibration of these various instruments. NASA s Radiometric Calibration and Development Facility at the Goddard Space Flight Center has provided resources to minimize calibration biases between multiple instruments through the use of a common calibration source and standardized procedures traceable to national standards. The Facility s 50 cm barium sulfate integrating sphere has been used as a common calibration source for both US and international satellite instruments, including the Total Ozone Mapping Spectrometer (TOMS), Solar Backscatter Ultraviolet 2 (SBUV/2) instruments, Shuttle SBUV (SSBUV), Ozone Mapping Instrument (OMI), Global Ozone Monitoring Experiment (GOME) (ESA), Scanning Imaging SpectroMeter for Atmospheric ChartographY (SCIAMACHY) (ESA), and others. We will discuss the advantages of using a common calibration source and its effects on long-term ozone data sets. In addition, sphere calibration results from various instruments will be presented to demonstrate the accuracy of the long-term characterization of the source itself.

  15. An European framework for the long term preservation of EO data

    NASA Astrophysics Data System (ADS)

    Forcada, E.; Albani, M.; Beruti, V.

    2009-04-01

    The need for accessing historical Earth Observation (EO) data series strongly increased in the last ten years, mainly for long term science and environmental monitoring applications. This trend is likely to increase even more in the future in particular for the growing interest on global change monitoring that requires data time-series spanning 20 years and more, and for the need to support the United Nations Framework Convention on Climate Change (UNFCCC). Content of EO data archives is extending from a few years to decades and their scientific value is continuously increasing hence is well recognized the need to preserve them without time limitation and to keep the archived EO data well accessible and exploitable as they constitute a humankind asset. The large amount of new Earth Observation missions upcoming in the next years will moreover lead to a major increase of EO data volumes. This fact, together with the increased demands from the scientific user community, marks a challenge for Earth Observation satellite operators, Space Agencies and EO data providers regarding coherent data preservation and optimum availability and accessibility of the different data products. Traditionally in Europe, there has been poor cooperation in this field with no common approach for long term preservation and access to EO space data even if cooperation and sharing are key aspects to be pursued for the benefit of the user community. Single organizations have difficulties to afford data preservation in the long term that calls for the need of optimising costs and efforts, identifying commonalities. In 2006, the European Space Agency (ESA) initiated a coordination action to share among all the European (and Canadian) stakeholders a common approach to the long term preservation of Earth Observation data. During 2007, the Agency started consultations with its Member States presenting an EO Long Term Data Preservation (LTDP) strategy targeting the preservation of all European

  16. Sexuality and Physical Intimacy in Long Term Care

    PubMed Central

    Lichtenberg, Peter A.

    2015-01-01

    Sexuality and sexual needs in older adults remains a neglected area of clinical intervention, particularly so in long term care settings. Because older adults in medical rehabilitation and long term care beds present with significant frailties, and often significant neurocognitive disorders it makes it difficult for occupational therapists and other staff to evaluate the capacity of an older adult resident to participate in sexual relationships. The current paper reviews the current literature on sexuality and aging, examines some of the clinical practices and guidelines regarding sexual expression in long term care and presents two case examples. A semi-structured interview and decision tree is presented to assist therapists in making careful and informed decisions and thereby balancing needs for protection with needs for autonomy. PMID:24354331

  17. Long-term urological outcomes in cloacal anomalies.

    PubMed

    Caldwell, Brian T; Wilcox, Duncan T

    2016-04-01

    Cloacal anomalies are the most complex and severe form of congenital anorectal malformations (ARM) and urogenital malformations, and it has been well documented that increased severity of ARM leads to worse outcomes. While short-term data on persistent cloaca are available, a paucity of data on long-term outcomes exists, largely because of a lack of uniform terminology, inclusion with other ARM and evolution of the operative technique. On comprehensive review of the published literature on long-term urological outcomes in patients with cloacal anomalies, we found a significant risk of chronic kidney disease and incontinence, however, with improvements in surgical technique, outcomes have improved. Continence often requires intermittent catheterization and in some cases, bladder augmentation. The complexity of cloacal malformations and associated anomalies make long-term multidisciplinary follow-up imperative. PMID:26969235

  18. Data Analysis in the LOFAR Long Term Archive

    NASA Astrophysics Data System (ADS)

    Holties, H. A.; van Diepen, G.; van Dok, D.; Dijkstra, F.; Loose, M.; Renting, G. A.; Schrijvers, C.; Vriend, W.-J.

    2012-09-01

    The LOFAR Long Term Archive (LTA) is a distributed information system that provides integrated services for data analysis as well as long term preservation of astronomical datasets and their provenance. The data analysis capabilities are provided by a federated system that integrates a central catalog and client user interfaces provided by Astro-Wise with processing pipelines running on Grid based and University HPC clusters. The framework used for data analysis ensures that proper authorization and access rules are applied and that generated data products are ingested into the storage part of the Long Term Archive. The ingest process includes information about data provenance. This paper presents the architecture of the processing framework of the LTA.

  19. Forecasting demand for long-term care services.

    PubMed Central

    Lane, D; Uyeno, D; Stark, A; Kliewer, E; Gutman, G

    1985-01-01

    This article analyzes three methods used to forecast the transition of long-term care clients through a variety of possible home and facility placements and levels of care. The test population (N = 1,653) is derived from the larger population of clients admitted in 1978 to British Columbia's newly established Long-Term Care program. The investigators have accumulated 5 years of service-generated data on moves, discharges, and deaths of these clients. Results show that the first-order Markov chain with stationary transition probabilities yields a superior forecast to state-by-state moving average growth and state-by-state regression analyses. The results of these analyses indicate that the Markov method should receive serious consideration as a tool for resource planning and allocation in long-term care. PMID:3932260

  20. [Long-term evolution and complications of eating disorders].

    PubMed

    Nicolas, Isabelle

    2008-01-31

    Eating disorders long-term evolution is good in 50% of cases, middle in 25% (recovery from eating disorders, but still psychological suffering) and bad in 25% of cases, with chronic eating disorders, anxious or depressive comorbid disorder, and bad consequences in social patients' life. Anorexia nervosa has a considerably worse long-term outcome than bulimia nervosa or binge eating disorders. Never the less, purging bulimia nervosa is often associated with other impulsive symptoms, such as addictions and suicide attempts. Chronic undernutrition leads to main long-term medical complications of eating disorders: linear growth in adolescents with anorexia nervosa, infertility, and osteoporosis. These complications need a specific medical follow up, at least once a year, added to the psychiatric and psychotherapist follow-up. PMID:18361276

  1. Long-term Internship through Cooperative Education with Regional Industries

    NASA Astrophysics Data System (ADS)

    Takahashi, Kenzo; Hase, Hiroyuki

    The long term internship is one of special educational programs for graduate students of Graduate School of Engineering in University of Fukui. This is a collaborative program between university and industries where selected post-graduate students are dispatched to companies for a long term and educated in real business environments. It is the final goal of the program to develop sophisticated specialists who would be able to catch the business strategy in industries and solve any problems by themselves. The program is managed in a semester (6 months) and contains 1.5 month prior education of preliminary special knowledge, ethics and secrecy, about 3 month dispatch with long-term internship, and 1.5 month post-education for complementary education and presentation. This paper presents the effect of this program which has been evolving since 2005.

  2. Long-term multipactor discharge in multicarrier systems

    SciTech Connect

    Anza, S.; Vicente, C.; Gimeno, B.; Boria, V. E.; Armendariz, J.

    2007-08-15

    A new mechanism of long-term multipactor in multicarrier systems is studied employing both analytical and numerical methods. In particular, the investigation is focused on the impact that a realistic secondary emission yield at low energies produces on the development of long term multipactor. A novel analytical model for this interperiod charge accumulation is presented using the traditional multipactor theory for parallel plates, and approximating the multicarrier signal as a single-carrier signal modulated by a pulsed signal envelope. The analytical predictions are verified by numerical simulations for a typical rectangular waveguide. The analytical and numerical results demonstrate that the susceptibility of the system to develop a long-term multipactor discharge increases with higher values of low-energy secondary emission yield.

  3. Stirling engine - Approach for long-term durability assessment

    NASA Technical Reports Server (NTRS)

    Tong, Michael T.; Bartolotta, Paul A.; Halford, Gary R.; Freed, Alan D.

    1992-01-01

    The approach employed by NASA Lewis for the long-term durability assessment of the Stirling engine hot-section components is summarized. The approach consists of: preliminary structural assessment; development of a viscoplastic constitutive model to accurately determine material behavior under high-temperature thermomechanical loads; an experimental program to characterize material constants for the viscoplastic constitutive model; finite-element thermal analysis and structural analysis using a viscoplastic constitutive model to obtain stress/strain/temperature at the critical location of the hot-section components for life assessment; and development of a life prediction model applicable for long-term durability assessment at high temperatures. The approach should aid in the provision of long-term structural durability and reliability of Stirling engines.

  4. Long-term Use of Opioids for Complex Chronic Pain

    PubMed Central

    Von Korff, Michael R.

    2014-01-01

    Increased opioid prescribing for back pain and other chronic musculoskeletal pain conditions has been accompanied by dramatic increases in prescription opioid addiction and fatal overdose. Opioid-related risks appear to increase with dose. While short-term randomized trials of opioids for chronic pain have found modest analgesic benefits (a one-third reduction in pain intensity on average), the long-term safety and effectiveness of opioids for chronic musculoskeletal pain is unknown. Given the lack of large, long-term randomized trials, recent epidemiologic data suggests the need for caution when considering long-term use of opioids to manage chronic musculoskeletal pain, particularly at higher dosage levels. Principles for achieving more selective and cautious use of opioids for chronic musculoskeletal pain are proposed. PMID:24315147

  5. Winning market positioning strategies for long term care facilities.

    PubMed

    Higgins, L F; Weinstein, K; Arndt, K

    1997-01-01

    The decision to develop an aggressive marketing strategy for its long term care facility has become a priority for the management of a one-hundred bed facility in the Rocky Mountain West. Financial success and lasting competitiveness require that the facility in question (Deer Haven) establish itself as the preferred provider of long term care for its target market. By performing a marketing communications audit, Deer Haven evaluated its present market position and created a strategy for solidifying and dramatizing this position. After an overview of present conditions in the industry, we offer a seven step process that provides practical guidance for positioning a long term care facility. We conclude by providing an example application. PMID:10179063

  6. The long-term alteration of borosilicate waste glasses

    SciTech Connect

    Ebert, W.L.; Bates, J.K.; Bradley, C.R.; Buck, E.C.; Dietz, N.L.; Brown, N.R.

    1993-06-01

    Prediction of the long-term durability of glass waste forms under potential disposal conditions is based on a mechanistic model of glass corrosion which has been derived from short-term laboratory tests. The model of glass reaction that has evolved identifies the hydrolysis of an Si-0 bond to release silicic acid as the step which controls the long-term glass reactivity. This reaction step is initially fast under dilute solution conditions, but slows as the silicic acid concentration in solution increases. An increase in the solution concentrations of glass components will occur with progressive glass corrosion, and so the solutions which contact waste glasses over long reaction times will have high concentrations of glass components. Therefore, the glass reactivity is usually expected to decrease with the reaction progress as the contacting solution becomes more concentrated. The corrosion behavior of glasses contacted by highly concentrated solutions must be characterized to assess the long-term glass stability.

  7. Energy scavenging for long-term deployable wireless sensor networks.

    PubMed

    Mathúna, Cian O; O'Donnell, Terence; Martinez-Catala, Rafael V; Rohan, James; O'Flynn, Brendan

    2008-05-15

    The coming decade will see the rapid emergence of low cost, intelligent, wireless sensors and their widespread deployment throughout our environment. While wearable systems will operate over communications ranges of less than a meter, building management systems will operate with inter-node communications ranges of the order of meters to tens of meters and remote environmental monitoring systems will require communications systems and associated energy systems that will allow reliable operation over kilometers. Autonomous power should allow wireless sensor nodes to operate in a "deploy and forget" mode. The use of rechargeable battery technology is problematic due to battery lifetime issues related to node power budget, battery self-discharge, number of recharge cycles and long-term environmental impact. Duty cycling of wireless sensor nodes with long "SLEEP" times minimises energy usage. A case study of a multi-sensor, wireless, building management system operating using the Zigbee protocol demonstrates that, even with a 1 min cycle time for an 864 ms "ACTIVE" mode, the sensor module is already in SLEEP mode for almost 99% of the time. For a 20-min cycle time, the energy utilisation in SLEEP mode exceeds the ACTIVE mode energy by almost a factor of three and thus dominates the module energy utilisation thereby providing the ultimate limit to the power system lifetime. Energy harvesting techniques can deliver energy densities of 7.5 mW/cm(2) from outdoor solar, 100 microW/cm(2) from indoor lighting, 100 microW/cm(3) from vibrational energy and 60 microW/cm(2) from thermal energy typically found in a building environment. A truly autonomous, "deploy and forget" battery-less system can be achieved by scaling the energy harvesting system to provide all the system energy needs. In the building management case study discussed, for duty cycles of less than 0.07% (i.e. in ACTIVE mode for 0.864 s every 20 min), energy harvester device dimensions of approximately 2 cm on a

  8. Tradeoff between short-term and long-term adaptation in a changing environment.

    PubMed

    Forster, Robert; Wilke, Claus O

    2005-10-01

    We investigate the competition dynamics of two microbial or viral strains that live in an environment that switches periodically between two states. One of the strains is adapted to the long-term environment, but pays a short-term cost, while the other is adapted to the short-term environment and pays a cost in the long term. We explore the tradeoff between these alternative strategies in extensive numerical simulations and present a simple analytic model that can predict the outcome of these competitions as a function of the mutation rate and the time scale of the environmental changes. Our model is relevant for arboviruses, which alternate between different host species on a regular basis. PMID:16383435

  9. Fast and long term lipid droplet tracking with CARS microscopy.

    PubMed

    Jüngst, Christian; Winterhalder, Martin J; Zumbusch, Andreas

    2011-06-01

    Photobleaching of organic fluorophores commonly used in fluorescence microscopy puts a limit to the number of images which can be acquired. Label-free imaging techniques therefore offer advantages both for rapid image acquisition and for long-term observations. CARS microscopy is a label-free imaging technique offering molecule specific contrast. Here we demonstrate that CARS microscopy allows video-rate tracking of intracellular transport of lipid droplets, but also continuous long-term observation of cells over several hours. PMID:21445955

  10. [Long-term effects of uterine cesarean section scar].

    PubMed

    Tihtonen, Kati; Nyberg, Reita

    2014-01-01

    During the last few decades the cesarean delivery rate has been around 15% in Finland. It has remained moderate compared with USA where 30% of women deliver by cesarean section. Compared with vaginal delivery, cesarean section is associated with a three- to sixfold risk of severe complications. Furthermore, it increases also long term gynecological morbidity, including intermenstrual bleeding, chronic pelvic pain and risk of secondary infertility. Scar pregnancy, uterine rupture, placenta previa and accrete are known risks after cesarean section. Because cesarean delivery is associated with increased long-term morbidity, the decision of performing cesarean section should always be carefully considered. PMID:24730196

  11. Leadership: the Winnipeg Community and Long-Term Care Authority.

    PubMed

    Suski, M; Hack, T; Heaman, M

    1999-01-01

    The Winnipeg Community and Long Term Care Authority (WCA) was established in 1998 under the Regional Health Authorities Act of the Province of Manitoba. The WCA's role is to provide for the successful integration of Winnipeg's community-based healthcare delivery services through its three main portfolios: Community Care and Public Health, Home Care and Mental Health, and Long Term Care and Specialized Services. The WCA is dedicated to building a quality health future for Winnipeg. Various initiatives undertaken in the pursuit of quality are described. PMID:10538544

  12. [Drug-eluting stents: long-term safety].

    PubMed

    Karpov, Iu A; Samko, A N; Buza, V V

    2009-01-01

    The review concerns the problem of late thromboses of drug-eluting stents and their influence on late prognosis of the patients; presents long-term results of the trial of sirolimus-eluting stents implanted to patients with coronary heart disease; analyses mechanisms of development of late stent thrombosis, data from different meta-analyses and registers comparing long-term outcomes in patients with implanted sirolimus-eluting stents and metallic stents; suggests risk factors of late thromboses of drug-eluting stents; presents original evidence on 3.5-year follow-up of patients with implanted sirolimus-eluting stents and metallic stents. PMID:19537584

  13. Early sound deprivation and long-term hearing.

    PubMed

    Welsh, L W; Welsh, J J; Healy, M P

    1996-11-01

    The long-term effects of hearing loss in early life were analyzed by tests of central auditory function. A majority of individuals failed the Compressed Speech identification with statistically significant results. There was an impact on a minority of individuals evaluated by Dichotic Sentences; little impairment was noted through Speech Reception in Noise. Delayed maturation of the central auditory complex may improve these findings, although during the period of investigation a negative impact was measured. Other issues of diagnosis, remediation, and the consequences of short- and long-term deafness are discussed. PMID:8916863

  14. Long-term preservation of native arteriovenous dialysis fistulas.

    PubMed

    Mallios, Alexandros; Costanzo, Alessandro; Boura, Benoit; Combes, Myriam; Alomran, Faris; de Blic, Romain; Jennings, William C

    2014-04-01

    Preservation of native arteriovenous fistulas (AVFs) in the long term can be technically challenging. Various anatomic or functional problems can occur and multiple open and/or endovascular interventions may be required for extended preservation of native accesses. In this report, we review vascular access maintenance in a 72-year-old woman during a 5-year period. Multiple complications of her native radiocephalic AVF included recurrent occlusions, a central venous stent fracture and symptomatic venous outflow stenosis. We present this case to illustrate the various techniques and combination of approaches used in the long-term preservation of a native AVF. PMID:24360937

  15. Instrumentation of bridges for long-term performance monitoring

    NASA Astrophysics Data System (ADS)

    Feng, Maria Q.; Kim, Doo-Kie; Sheng, Li-Hong; Fiji, Leonard M.; Kim, Yoo J.

    2001-08-01

    As the state of the art in bridge design is advancing toward the performance-based design, it becomes increasingly important to monitor and evaluate the long-term structural performance of bridges, including strains in critical structural members, soil pressures on the abutment back walls and footings, accelerations on the decks and bents, etc. Such information is essential in developing new performance criteria for design. In this research, sensor systems for long-term structural performance monitoring have been installed on two new highway bridges on Orange County, California: the Jamboree Road Overcrossing and the West Street On-Ramp.

  16. Long-term noise statistics from the Gulf of Mexico

    NASA Astrophysics Data System (ADS)

    Eller, Anthony I.; Ioup, George E.; Ioup, Juliette W.; Larue, James P.

    2003-04-01

    Long-term, omnidirectional acoustic noise measurements were conducted in the northeastern Gulf of Mexico during the summer of 2001. These efforts were a part of the Littoral Acoustic Demonstration Center project, Phase I. Initial looks at the noise time series, processed in standard one-third-octave bands from 10 to 5000 Hz, show noise levels that differ substantially from customary deep-water noise spectra. Contributing factors to this highly dynamic noise environment are an abundance of marine mammal emissions and various industrial noises. Results presented here address long-term temporal variability, temporal coherence times, the fluctuation spectrum, and coherence of fluctuations across the frequency spectrum. [Research supported by ONR.

  17. Long-term plasma exchange in pediatric CIDP.

    PubMed

    Lucchetta, Marta; Vidal, Enrico; Sartori, Stefano; Campagnolo, Marta; Torre, Chiara Dalla; Marson, Piero; Manara, Renzo; Briani, Chiara

    2015-12-01

    Therapeutic plasma exchange (TPE) is not frequently used in chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) because it usually gives only a short-term benefit. We report on a 16-year-old boy with renal insufficiency undergoing hemodialysis who developed CIDP and underwent TPE with dramatic long-term response to therapy. Nerve ultrasound and MRI findings are also reported. In our patient TPE was chosen because he was already undergoing hemodialysis. Though it is not considered a first-line therapy in pediatric CIDP, TPE may be a good therapeutic choice also in long-term period. PMID:25663075

  18. The assessment of long-term orbital debris models

    NASA Technical Reports Server (NTRS)

    Jonas, F. M.; Yates, K. W.

    1992-01-01

    Existing long-term orbital debris models are assessed as a first step in the Air Force's effort to develop an Air Force long-term orbital debris model which can perform the following functions: (1) operate with the necessary accuracy at the relevant altitudes and orbital parameters; (2) benefit from new Air Force and non-Air Force debris measurements; and (3) accommodate current and future Air Force space scenarios. Model assessment results are shown for the NASA engineering model. The status of the NASA EVOLVE model assessment is discussed.

  19. [Long-term-management of organ transplant recipients].

    PubMed

    Bürger, Christin; Schmidt, Martina; Maschmeier, Miriam; Stella, Jaqueline; Hüsing, Anna; Wilms, Christian; Schmidt, Hartmut Hans-Jürgen; Kabar, Iyad

    2016-07-01

    Due to advances in immunosuppressive therapy and surgical techniques, survival rates after solid organ transplantation have constantly improved over the last decades. In long-term care after transplantation, physicians need to focus as much on diagnosis and treatment of allograft-related complications as they should consider comorbidities and evaluate risk-factors and adverse events of immunosuppressive agents to prevent secondary diseases. In particular, cardiovascular and metabolic diseases, malignancy and infection play a major role in long-term survival. Therefore, screening of organ transplant recipients in regard to these complications and adverse events is a crucial part of follow up in these patients. PMID:27359310

  20. Towards community-based integrated care: trends and issues in Japan's long-term care policy

    PubMed Central

    Morikawa, Mie

    2014-01-01

    Introduction In 2000, Japan implemented a mandatory long-term care insurance system. With the rapid growth of the system, problems became apparent. Several critical alterations were made to long-term care insurance system, particularly with respect to integrated care. Methods This paper elucidates the policy trends that led to the reforms of the long-term care insurance system, which included new concepts of ‘integrated care’ and ‘community-based care’, an agenda of cost containment and service streamlining, and coordination with medical care. Results Community-based integrated care, as envisaged in the long-term care policy, includes not only the integration of medical care into service provision but also the inclusion of the informal mutual aid, oversight of for-profit providers by an administration that ensures users are not exploited and coordination between systems that cover different geographical areas. Conclusions Japan's experience in community-based care integration suggests that this project requires multi-faceted care integration in local communities. In the future, it will be necessary to conduct empirical assessments of the effectiveness of these measures. PMID:24605073

  1. Identifying Feasible Physical Activity Programs for Long-Term Care Homes in the Ontario Context

    PubMed Central

    Shakeel, Saad; Newhouse, Ian; Malik, Ali; Heckman, George

    2015-01-01

    Background Structured exercise programs for frail institutionalized seniors have shown improvement in physical, functional, and psychological health of this population. However, the ‘feasibility’ of implementation of such programs in real settings is seldom discussed. The purpose of this systematic review was to gauge feasibility of exercise and falls prevention programs from the perspective of long-term care homes in Ontario, given the recent changes in funding for publically funded physiotherapy services. Method Six electronic databases were searched by two independent researchers for randomized controlled trials that targeted long-term care residents and included exercise as an independent component of the intervention. Results A total of 39 studies were included in this review. A majority of these interventions were led by physiotherapist(s), carried out three times per week for 30–45 minutes per session. However, a few group-based interventions that were led by long-term care staff, volunteers, or trained non-exercise specialists were identified that also required minimal equipment. Conclusion This systematic review has identified ‘feasible’ physical activity and falls prevention programs that required minimal investment in staff and equipment, and demonstrated positive outcomes. Implementation of such programs represents cost-effective means of providing long-term care residents with meaningful gains in physical, psychological, and social health. PMID:26180563

  2. Long-term results of compartmental arthroplasties of the knee: Long term results of partial knee arthroplasty.

    PubMed

    Parratte, S; Ollivier, M; Lunebourg, A; Abdel, M P; Argenson, J-N

    2015-10-01

    Partial knee arthroplasty (PKA), either medial or lateral unicompartmental knee artroplasty (UKA) or patellofemoral arthroplasty (PFA) are a good option in suitable patients and have the advantages of reduced operative trauma, preservation of both cruciate ligaments and bone stock, and restoration of normal kinematics within the knee joint. However, questions remain concerning long-term survival. The goal of this review article was to present the long-term results of medial and lateral UKA, PFA and combined compartmental arthroplasty for multicompartmental disease. Medium- and long-term studies suggest reasonable outcomes at ten years with survival greater than 95% in UKA performed for medial osteoarthritis or osteonecrosis, and similarly for lateral UKA, particularly when fixed-bearing implants are used. Disappointing long-term outcomes have been observed with the first generation of patellofemoral implants, as well as early Bi-Uni (i.e., combined medial and lateral UKA) or Bicompartmental (combined UKA and PFA) implants due to design and fixation issues. Promising short- and med-term results with the newer generations of PFAs and bicompartmental arthroplasties will require long-term confirmation. PMID:26430081

  3. The impact of private long-term care insurance on the use of long-term care.

    PubMed

    Li, Yong; Jensen, Gail A

    2011-01-01

    This paper investigates the effects of privately purchased long-term care insurance (LTCI) on three major types of long-term care services: nursing home care, paid home care, and informal care received from Family and friends. Using 2002-2008 data from the ongoing Health and Retirement Study, we analyze the determinants of long-term care utilization simultaneously with the determinants of holding LTCI. We find that LTCI has modest effects on the likelihood of using long-term care services. For the very frail elderly, private LTCI enhances their access to nursing home care. For those with moderate disability, LTCI makes it more likely that they can remain at home and receive home care services, instead of going to a nursing home. We find no evidence that formal care substitutes for informal care in the presence of LTCI. These findings suggest that if LTCI becomes much more prevalent in the future, many older adults will be able to choose the type of long-term care arrangement that best suits their needs. PMID:21634261

  4. 42 CFR 412.536 - Special payment provisions for long-term care hospitals and satellites of long-term care...

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... hospitals and satellites of long-term care hospitals that discharged Medicare patients admitted from a hospital not located in the same building or on the same campus as the long-term care hospital or satellite... payment provisions for long-term care hospitals and satellites of long-term care hospitals that...

  5. 42 CFR 412.536 - Special payment provisions for long-term care hospitals and satellites of long-term care...

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... hospitals and satellites of long-term care hospitals that discharged Medicare patients admitted from a hospital not located in the same building or on the same campus as the long-term care hospital or satellite... payment provisions for long-term care hospitals and satellites of long-term care hospitals that...

  6. 42 CFR 412.536 - Special payment provisions for long-term care hospitals and satellites of long-term care...

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... hospitals and satellites of long-term care hospitals that discharged Medicare patients admitted from a hospital not located in the same building or on the same campus as the long-term care hospital or satellite... payment provisions for long-term care hospitals and satellites of long-term care hospitals that...

  7. 42 CFR 412.536 - Special payment provisions for long-term care hospitals and satellites of long-term care...

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... hospitals and satellites of long-term care hospitals that discharged Medicare patients admitted from a hospital not located in the same building or on the same campus as the long-term care hospital or satellite... payment provisions for long-term care hospitals and satellites of long-term care hospitals that...

  8. Non-uniform composite representation of hydroelectric systems for long-term hydrothermal scheduling

    SciTech Connect

    Cruz, G. da Jr.; Soares, S.

    1995-12-31

    This paper presents a non-uniform composite representation of hydroelectric systems for use in long-term hydrothermal scheduling. This representation was developed from reservoir operational rules based on optimal reservoir trajectories obtained with a deterministic hydrothermal scheduling algorithm. A test system consisting of {tau} large hydroelectric plants of the Southeast Brazilian Power System with 12,572 MW of installed power capacity was selected for a case study. Operational cost comparisons with the classical uniform composite representation reveal significant savings.

  9. How much insurance is enough? What to look for in a long term care insurance policy.

    PubMed

    Polniaszek, S

    1992-01-01

    LTC insurance is a valuable financial tool to help pay for pending LTC. However, LTC insurance is not for everyone. For those who could benefit from a policy, questions arise as to how much to buy and what consumer options to purchase in a policy. Insurance is most appropriate for couples with assets of $110,000 or more, excluding their house, car, and personal belongings. Single persons with a need to protect assets should have at least $40,000 in assets. These individuals have smaller need for LTC insurance to protect assets for their children. How much insurance to buy depends on the cost of LTC and the financial resources of the person. Premiums for LTC insurance are level. A company cannot raise the premiums for an individual, but may request an increase for a class of people. With the potential that premiums may increase and that buying power of income may decline, the policy should be affordable both at time of purchase and in future. Policies pay a specified benefit amount for a specified benefit period. In deciding how much insurance to buy, it is advisable to buy a higher benefit amount for a shorter benefit period. This provides the greatest likelihood of receiving the policy's maximum benefit. The deductible amount should be between 20 and 100 days. In selecting a policy, the most important criterion is the company itself.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:10118522

  10. Current Perspectives on Long-term Obesity Pharmacotherapy.

    PubMed

    Wharton, Sean

    2016-04-01

    Approximately 1 in 4 adult Canadians are obese and, thus, are at an elevated risk for developing type 2 diabetes, cardiovascular disease and other conditions. Current treatment guidelines recommend that obese individuals lose 5% to 10% of their starting weights to minimize the risk factors for cardiovascular disease and reduce the risk for developing type 2 diabetes or hypertension. All obesity-management strategies involve lifestyle management, but few patients will lose a significant amount of weight and manage to keep it off over the long term using just this strategy. Bariatric surgery is associated with significant long-term weight loss but is restricted to subjects with very high body mass indices, who often wait many years to undergo the procedure. Recent breakthroughs in understanding the mechanisms underlying the development and maintenance of elevated body fat have led to the arrival of new obesity pharmacotherapies. These novel antiobesity therapies, which work by reducing energy intake or through increasing satiety, decreasing hunger, or reducing absorption of calories, may be used indefinitely once patients have demonstrated significant responses (usually defined as ≥5% weight loss) over the first 12 weeks of treatment. To date, 2 long-term obesity pharmacotherapies have been approved and are available in Canada: liraglutide and orlistat. Here, I summarize the mechanisms and clinical features of medications for long-term obesity management that are available in Canada, as well as those available in other jurisdictions or are currently in development. PMID:26507402

  11. Immediate and Long-Term Impacts of Child Sexual Abuse.

    ERIC Educational Resources Information Center

    Briere, John N.; Elliott, Diana M.

    1994-01-01

    Summarizes what is currently known about the potential, immediate, and long-term impact of child sexual abuse. The various problems and symptoms described in the literature on child sexual abuse are reviewed in a series of broad categories including posttraumatic stress, cognitive distortions, emotional pain, avoidance, an impaired sense of self,…

  12. Relating Granger causality to long-term causal effects

    NASA Astrophysics Data System (ADS)

    Smirnov, Dmitry A.; Mokhov, Igor I.

    2015-10-01

    In estimation of causal couplings between observed processes, it is important to characterize coupling roles at various time scales. The widely used Granger causality reflects short-term effects: it shows how strongly perturbations of a current state of one process affect near future states of another process, and it quantifies that via prediction improvement (PI) in autoregressive models. However, it is often more important to evaluate the effects of coupling on long-term statistics, e.g., to find out how strongly the presence of coupling changes the variance of a driven process as compared to an uncoupled case. No general relationships between Granger causality and such long-term effects are known. Here, we pose the problem of relating these two types of coupling characteristics, and we solve it for a class of stochastic systems. Namely, for overdamped linear oscillators, we rigorously derive that the above long-term effect is proportional to the short-term effects, with the proportionality coefficient depending on the prediction interval and relaxation times. We reveal that this coefficient is typically considerably greater than unity so that small normalized PI values may well correspond to quite large long-term effects of coupling. The applicability of the derived relationship to wider classes of systems, its limitations, and its value for further research are discussed. To give a real-world example, we analyze couplings between large-scale climatic processes related to sea surface temperature variations in equatorial Pacific and North Atlantic regions.

  13. Long-Term Care: Common Issues and Unknowns

    ERIC Educational Resources Information Center

    Swartz, Katherine; Miake, Naoko; Farag, Nadine

    2012-01-01

    All industrialized countries are grappling with a common problem--how to provide assistance of various kinds to their rapidly aging populations. The problem for countries searching for models of efficient and high-quality long-term care (LTC) policies is that fewer than a dozen countries have government-organized, formal LTC policies. Relatively…

  14. Long-Term Repetition Priming of Briefly Identified Objects

    ERIC Educational Resources Information Center

    Breuer, Andreas T.; Masson, Michael E. J.; Cohen, Anna-Lisa; Lindsay, D. Stephen

    2009-01-01

    The authors provide evidence that long-term memory encoding can occur for briefly viewed objects in a rapid serial visual presentation list, contrary to claims that the brief presentation and quick succession of objects prevent encoding by disrupting a memory consolidation process that requires hundreds of milliseconds of uninterrupted processing.…

  15. Long-Term Effects of Neurofeedback Treatment in Autism

    ERIC Educational Resources Information Center

    Kouijzer, Mirjam E. J.; de Moor, Jan M. H.; Gerrits, Berrie J. L.; Buitelaar, Jan K.; van Schie, Hein T.

    2009-01-01

    Previously we demonstrated significant improvement of executive functions and social behavior in children with autism spectrum disorders (ASD) treated with 40 sessions of EEG neurofeedback in a nonrandomized waiting list control group design. In this paper we extend these findings by reporting the long-term results of neurofeedback treatment in…

  16. 40 CFR 52.29 - Visibility long-term strategies.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... ascribed to them in the Clean Air Act, or in the protection of visibility program (40 CFR 51.301). (c) Long... 40 Protection of Environment 3 2011-07-01 2011-07-01 false Visibility long-term strategies. 52.29... (CONTINUED) APPROVAL AND PROMULGATION OF IMPLEMENTATION PLANS General Provisions § 52.29 Visibility...

  17. 40 CFR 52.29 - Visibility long-term strategies.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... ascribed to them in the Clean Air Act, or in the protection of visibility program (40 CFR 51.301). (c) Long... 40 Protection of Environment 3 2013-07-01 2013-07-01 false Visibility long-term strategies. 52.29... (CONTINUED) APPROVAL AND PROMULGATION OF IMPLEMENTATION PLANS General Provisions § 52.29 Visibility...

  18. 40 CFR 52.29 - Visibility long-term strategies.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... ascribed to them in the Clean Air Act, or in the protection of visibility program (40 CFR 51.301). (c) Long... 40 Protection of Environment 3 2014-07-01 2014-07-01 false Visibility long-term strategies. 52.29... (CONTINUED) APPROVAL AND PROMULGATION OF IMPLEMENTATION PLANS General Provisions § 52.29 Visibility...

  19. 40 CFR 52.29 - Visibility long-term strategies.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... ascribed to them in the Clean Air Act, or in the protection of visibility program (40 CFR 51.301). (c) Long... 40 Protection of Environment 3 2012-07-01 2012-07-01 false Visibility long-term strategies. 52.29... (CONTINUED) APPROVAL AND PROMULGATION OF IMPLEMENTATION PLANS General Provisions § 52.29 Visibility...

  20. 40 CFR 52.29 - Visibility long-term strategies.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... ascribed to them in the Clean Air Act, or in the protection of visibility program (40 CFR 51.301). (c) Long... 40 Protection of Environment 3 2010-07-01 2010-07-01 false Visibility long-term strategies. 52.29... (CONTINUED) APPROVAL AND PROMULGATION OF IMPLEMENTATION PLANS General Provisions § 52.29 Visibility...

  1. The Long-Term Effects of Youth Unemployment

    ERIC Educational Resources Information Center

    Mroz, Thomas A.; Savage, Timothy H.

    2006-01-01

    Using NLSY data, we examine the long-term effects of youth unemployment on later labor market outcomes. Involuntary unemployment may yield suboptimal investments in human capital in the short run. A theoretical model of dynamic human capital investment predicts a rational "catch-up" response. Using semiparametric techniques to control for the…

  2. Long-term functionalization of optical resonance sensor spots

    NASA Astrophysics Data System (ADS)

    Saetchnikov, Vladimir A.; Tcherniavskaia, Elina A.; Saetchnikov, Anton V.; Schweiger, Gustav; Ostendorf, Andreas

    2016-04-01

    New approach to increase density of sensing units for higher precision as well as the selectivity of biological components under investigation in microcavity evanescent wave optical sensor systems is proposed. Long-term functionalization results of array sensor cells by different agents are represented.

  3. Long-Term Psychosomatic Effects of Biofeedback vs. Relaxation Training.

    ERIC Educational Resources Information Center

    Nowlis, David P.; Borzone, Ximena C.

    Differences were compared in the short-term and long-term responses of subjects with headache, insomnia, or hypertension to biofeedback training, relaxation, or a combination of both. Headache sufferers, insomniacs, and hypertensives were randomly assigned in equal numbers to biofeedback, relaxation training or a record-keeping control. Over 2…

  4. The Basics of Long-Term Debt Issuance and Management

    ERIC Educational Resources Information Center

    Van Meter, Christine M.

    2011-01-01

    Issuing long-term debt can be a complex, multifaceted process. Although the process varies by stare, typically the school business official and the district solicitor work with the financing ream, which includes a financial adviser, bond counsel, underwriter, raring agency, and possibly a bond insurance agent, paying agent, and architect.…

  5. Using Technology in Reggio-Inspired Long-Term Projects.

    ERIC Educational Resources Information Center

    Trepanier-Street, Mary L.; Hong, Seong B.; Bauer, Jennifer C.

    2001-01-01

    Describes examples of use of technology in the implementation and documentation of long-term projects conducted as a part of the Reggio Emilia preschool curriculum. Considers use of digital camera, videotapes, and video prints; documentation of graphics with the computer scanner; use of computer software as a tool for representing ideas; and use…

  6. An Empirical Study of Long Term Effects of Education.

    ERIC Educational Resources Information Center

    Harnqvist, Kjell

    A large-scale study of Swedish men and women, each of whose intelligence level at age 13 was above the 25th percentile and whose father's education was only at the elementary level, was conducted in order to determine what educational level the participants had achieved and to study long-term effects of schooling. Subjects were sent questionnaires…

  7. Long-Term Marriage and Late-Life Divorce.

    ERIC Educational Resources Information Center

    Peters, Elana

    Projections, based on current rates, are that 40% of recent marriages will end in divorce. To investigate the factors associated with long term marriage stability and satisfaction among elderly persons, 60 California older adults (30 married, 30 divorced) were interviewed about their perceptions of the role of companionship, alternatives to…

  8. Post-Learning Arousal Change and Long-Term Retention.

    ERIC Educational Resources Information Center

    Kumar, V.K.; Farley, Frank H.

    This study examined the effects on long-term retention of variations in intensity and of temporal parameters of arousal following a single learning trial in a paired-associate task. The subjects were 56 female university students. Intensity of arousal was manipulated by using two levels of white noise--75 decibels and 90 decibels sound pressure…

  9. Consolidation of Long-Term Memory: Evidence and Alternatives

    ERIC Educational Resources Information Center

    Meeter, Martijn; Murre, Jaap M. J.

    2004-01-01

    Memory loss in retrograde amnesia has long been held to be larger for recent periods than for remote periods, a pattern usually referred to as the Ribot gradient. One explanation for this gradient is consolidation of long-term memories. Several computational models of such a process have shown how consolidation can explain characteristics of…

  10. Children's Long-Term Memory for Autobiographical Events.

    ERIC Educational Resources Information Center

    Peterson, Carole

    2002-01-01

    Traces the origins of children's autobiographical memories, discussing research on infantile amnesia and young children's memory skills. Focuses on studies of children's long-term memory for autobiographical events that investigate delays of 1-2 years and delays of 4 years or more. Reports that a few studies have documented remarkably robust…

  11. Effects of Acute Exercise on Long-Term Memory

    ERIC Educational Resources Information Center

    Labban, Jeffrey D.; Etnier, Jennifer L.

    2011-01-01

    In this study, we tested the effect of acute exercise on long-term memory, specifically the timing of exercise relative to the memory challenge. We assessed memory via paragraph recall, in which participants listened to two paragraphs (exposure) and recounted them following a 35-min delay. Participants (n = 48) were randomly assigned to one of…

  12. Long-Term Outcome in Pyridoxine-Dependent Epilepsy

    ERIC Educational Resources Information Center

    Bok, Levinus A.; Halbertsma, Feico J..; Houterman, Saskia; Wevers, Ron A.; Vreeswijk, Charlotte; Jakobs, Cornelis; Struys, Eduard; van der Hoeven, Johan H.; Sival, Deborah A.; Willemsen, Michel A.

    2012-01-01

    Aim: The long-term outcome of the Dutch pyridoxine-dependent epilepsy cohort and correlations between patient characteristics and follow-up data were retrospectively studied. Method: Fourteen patients recruited from a national reference laboratory were included (four males, 10 females, from 11 families; median age at assessment 6y; range 2y…

  13. Long-Term Parental Illness and Children: Perils and Promises.

    ERIC Educational Resources Information Center

    Johnston, Mona; And Others

    1992-01-01

    Discusses effects of long-term parental illness, focusing on effects on children. Describes effects on family homeostasis and family coping mechanisms. Discusses school counselor's role in bringing about a more balanced viewpoint of power and sharing within the family. Recommends establishing a strong therapeutic bond, assessing what the child is…

  14. A Plea for Long-term Orientation in Organizations

    NASA Astrophysics Data System (ADS)

    Schwaninger, Markus; Ambroz, Kristjan

    2010-11-01

    The stress field between short- and long-term orientations is the epitome of organizational problematics: In many enterprises the latter is dominated by the former. The consequences of a dominant short-term orientation are negative in the best case, but the cases that result in destruction and catastrophe are legion. Few sustainable solutions for the conflict between the short- and long-term perspectives have been developed, and among those concerned many have not sufficiently reflected on this shortfall, or even become aware of it. Frequently, practical constraints obstruct a balance between short- and long-term orientations. The aim of this contribution is to enquire into this dilemma and to find a way of coping with it. Any progress in that direction would help to further the viability of organizations and the quality of life within them. As a pertinent contribution we present the Model of Systemic Control, a framework with a long-term view for the governance of organizations. Even though we are emphasizing the conceptual aspect, our theoretical statement is underpinned by an empirical approach and simulation experiments.

  15. Long-term field studies: positive impacts and unintended consequences.

    PubMed

    Strier, Karen B

    2010-09-01

    Long-term field studies of wild primates can have far-reaching impacts that transcend their contributions to science. These impacts can benefit not only the study animals, study areas, and local human communities, but they can also have unintended, potentially negative consequences. Examples of some of the positive impacts from the Northern Muriqui Project of Caratinga, in Minas Gerais, Brazil, include contributions to conservation efforts on behalf of this critically endangered species, capacity building through the training of Brazilian students, and employment opportunities for local people through our collaboration with a locally administered NGO that is facilitating ecotourism, education, and reforestation programs. Some concerns about unintended consequences of the research include the effects of our trails and trail traffic on surrounding vegetation and other aspects of the environmental "footprints" that both long-term researchers and short-term visitors may leave. In addition, although precautions against potential health risks from routine exposure to human observers are now standard protocol, little is known about the other ways in which our long-term research presence can affect the primates' experiences or alter their perceptions of their social and ecological environments. Risk analysis, which weighs both the positive and negative impacts can provide useful perspectives for addressing the ethical considerations that can arise during long-term field studies. PMID:20653002

  16. Gender-Based Violence in India: Long-Term Trends

    ERIC Educational Resources Information Center

    Simister, John; Mehta, Parnika S.

    2010-01-01

    This article examines long-term trends in Indian society regarding domestic violence between husband and wife, and attitudes to such violence. This article analyzes crime data and uses data from several Indian household surveys: "Work Attitudes and Spending" surveys (1992 to 2007); "World Values Survey" (1990, 1995, 2001, and 2006); and…

  17. Long-Term Effects of Peace Workshops in Protracted Conflicts

    ERIC Educational Resources Information Center

    Malhotra, Deepak; Liyanage, Sumanasiri

    2005-01-01

    The current study evaluates the efficacy of an intensive four-day contact intervention (a peace workshop) organized in Sri Lanka and represents an initial step toward understanding the long-term impact of such interventions on attitudes and behaviors in the context of protracted ethnic conflict. Compared with two control groups, the participant…

  18. Long-Term Adaptation to Institutionalization in Dementia Caregivers

    ERIC Educational Resources Information Center

    Gaugler, Joseph E.; Pot, Anne Margriet; Zarit, Steven H.

    2007-01-01

    Purpose: Longitudinal research in dementia has acknowledged the importance of transitions during the course of family caregiving. However, long-term adaptation to institutionalization has received little attention. This study attempts to describe caregivers' adaptation (changes in stress, well-being, and psychosocial resources) to placement up to…

  19. The Insider's Experience of Long-Term Peer Victimisation

    ERIC Educational Resources Information Center

    Mackay, Graham J.; Carey, Timothy A.; Stevens, Bruce

    2011-01-01

    Bullying in schools continues to be a problem despite the best efforts of educators, researchers, and clinicians. Of most concern for the present study is that some children experience long-term victimisation by their peers. To improve our understanding in this area, the phenomenology of being bullied over the course of the school year was…

  20. Managing Tribal Assets: Developing Long-Term Strategic Plans.

    ERIC Educational Resources Information Center

    Anderson, Joseph S.; Smith, Dean Howard

    1998-01-01

    The National Executive Education Program for Native American Leadership and the Center for American Indian Economic Development developed a method to help tribes create a long-term strategic community-development plan. Based on integrated analysis of six community subsystems, the method includes extensive interviews, secondary research, a workshop…