Science.gov

Sample records for serving vulnerable patients

  1. Leaf size serves as a proxy for xylem vulnerability to cavitation in plantation trees.

    PubMed

    Schreiber, Stefan G; Hacke, Uwe G; Chamberland, Sabrina; Lowe, Christopher W; Kamelchuk, David; Bräutigam, Katharina; Campbell, Malcolm M; Thomas, Barb R

    2016-02-01

    Hybrid poplars are an important renewable forest resource known for their high productivity. At the same time, they are highly vulnerable to water stress. Identifying traits that can serve as indicators for growth performance remains an important task, particularly under field conditions. Understanding which trait combinations translate to improved productivity is key in order to satisfy the demand for poplar wood in an uncertain future climate. In this study, we compared hydraulic and leaf traits among five hybrid poplar clones at 10 plantations in central Alberta. We also assessed the variation of these traits between 2- to 3-year-old branches from the lower to mid-crown and current-year long shoots from the mid to upper crown. Our results showed that (1) hybrid poplars differed in key hydraulic parameters between branch type, (2) variation of hydraulic traits among clones was relatively large for some clones and less for others, and (3) strong relationships between measured hydraulic traits, such as vessel diameter, cavitation resistance, xylem-specific and leaf-specific conductivity and leaf area, were observed. Our results suggest that leaf size could serve as an additional screening tool when selecting for drought-tolerant genotypes in forest management and tree improvement programmes. PMID:26177991

  2. Use of the NatureServe Climate Change Vulnerability Index as an Assessment Tool for Reptiles and Amphibians: Lessons Learned

    NASA Astrophysics Data System (ADS)

    Tuberville, Tracey D.; Andrews, Kimberly M.; Sperry, Jinelle H.; Grosse, Andrew M.

    2015-10-01

    Climate change threatens biodiversity globally, yet it can be challenging to predict which species may be most vulnerable. Given the scope of the problem, it is imperative to rapidly assess vulnerability and identify actions to decrease risk. Although a variety of tools have been developed to assess climate change vulnerability, few have been evaluated with regard to their suitability for certain taxonomic groups. Due to their ectothermic physiology, low vagility, and strong association with temporary wetlands, reptiles and amphibians may be particularly vulnerable relative to other groups. Here, we evaluate use of the NatureServe Climate Change Vulnerability Index (CCVI) to assess a large suite of herpetofauna from the Sand Hills Ecoregion of the southeastern United States. Although data were frequently lacking for certain variables (e.g., phenological response to climate change, genetic variation), sufficient data were available to evaluate all 117 species. Sensitivity analyses indicated that results were highly dependent on size of assessment area and climate scenario selection. In addition, several ecological traits common in, but relatively unique to, herpetofauna are likely to contribute to their vulnerability and need special consideration during the scoring process. Despite some limitations, the NatureServe CCVI was a useful tool for screening large numbers of reptile and amphibian species. We provide general recommendations as to how the CCVI tool's application to herpetofauna can be improved through more specific guidance to the user regarding how to incorporate unique physiological and behavioral traits into scoring existing sensitivity factors and through modification to the assessment tool itself.

  3. Use of the NatureServe Climate Change Vulnerability Index as an Assessment Tool for Reptiles and Amphibians: Lessons Learned.

    PubMed

    Tuberville, Tracey D; Andrews, Kimberly M; Sperry, Jinelle H; Grosse, Andrew M

    2015-10-01

    Climate change threatens biodiversity globally, yet it can be challenging to predict which species may be most vulnerable. Given the scope of the problem, it is imperative to rapidly assess vulnerability and identify actions to decrease risk. Although a variety of tools have been developed to assess climate change vulnerability, few have been evaluated with regard to their suitability for certain taxonomic groups. Due to their ectothermic physiology, low vagility, and strong association with temporary wetlands, reptiles and amphibians may be particularly vulnerable relative to other groups. Here, we evaluate use of the NatureServe Climate Change Vulnerability Index (CCVI) to assess a large suite of herpetofauna from the Sand Hills Ecoregion of the southeastern United States. Although data were frequently lacking for certain variables (e.g., phenological response to climate change, genetic variation), sufficient data were available to evaluate all 117 species. Sensitivity analyses indicated that results were highly dependent on size of assessment area and climate scenario selection. In addition, several ecological traits common in, but relatively unique to, herpetofauna are likely to contribute to their vulnerability and need special consideration during the scoring process. Despite some limitations, the NatureServe CCVI was a useful tool for screening large numbers of reptile and amphibian species. We provide general recommendations as to how the CCVI tool's application to herpetofauna can be improved through more specific guidance to the user regarding how to incorporate unique physiological and behavioral traits into scoring existing sensitivity factors and through modification to the assessment tool itself. PMID:25971738

  4. Vulnerability

    NASA Technical Reports Server (NTRS)

    Taback, I.

    1979-01-01

    The discussion of vulnerability begins with a description of some of the electrical characteristics of fibers before definiting how vulnerability calculations are done. The vulnerability results secured to date are presented. The discussion touches on post exposure vulnerability. After a description of some shock hazard work now underway, the discussion leads into a description of the planned effort and some preliminary conclusions are presented.

  5. What influences dental students to serve special care patients?

    PubMed

    Baumeister, Sebastian E; Davidson, Pamela L; Carreon, Daisy C; Nakazono, Terry T; Gutierrez, John J; Andersen, Ronald M

    2007-01-01

    This study examines factors associated with graduating dental students' motivation to deliver services to special care patients. We investigated community context and student characteristics, which would influence potential behavior. Higher percentages of older adults and low-income residents in the community were positively correlated with interest in serving special care populations. Factors which correlated with individual student characteristics included having a father with at least a college education, a higher number of weeks spent in extramural clinical rotations, preparedness to provide care to disabled patients, and service orientation and socially conscious attitudes. Frail elderly and disabled persons have limited access to dental care, which is compounded by a shortage of skilled dental professionals who are willing to treat these populations. Our findings suggest that interest in special care dentistry is partly conditioned by the dental school's demographic and dental market context. This study is important to dental educators and policymakers because the challenge of providing care to the "special patient" will increase in the future. PMID:17388225

  6. Vulnerability.

    PubMed

    Cunha, Thiago; Garrafa, Volnei

    2016-04-01

    Collating the concepts of vulnerability through five regional perspectives on bioethics from the United States, Europe, Latin America, Africa, and Asia, this article proposes a means of integration between the different approaches in order to seek a theoretical and normative basis for the field of global bioethics. It argues that only through opening continuous, critical, and self-critical dialogue within the international bioethical community will it be possible to achieve a sufficiently global understanding of vulnerability that is capable of identifying the means needed for addressing the conditions that leave certain groups and individuals more susceptible to "wounding" than others. PMID:26957445

  7. Responding to vulnerability in old age: patient-centred care.

    PubMed

    Abley, Clare

    Patient-centred care is a term widely used in health policy and is familiar to staff as a principle or commonly agreed approach to care. However, nursing and multidisciplinary teams often do not agree how it should be provided for older patients. This article outlines three different models of patient-centred care applicable to the care of older people. The article also explores the concept of vulnerability in old age, highlighting differences between the perspectives of older people and those of professionals and how clinical practice can be improved to achieve a more patient-centred approach. The links between patient-centred care and vulnerability in old age are considered along with the implications of this for clinical practice. PMID:23240515

  8. Clinical research centre serves 70,000 patients annually.

    PubMed

    1992-01-01

    The Bangladesh, ICDDR,B's Clinical Research Center (CPR) is described since its inception in 1960 as the former Dhaka Hospital. As 1 of 4 divisions, the CRC has increased admissions for diarrheal diseases, which is associated with the respect earned within the population, and averages 70,000/year. Included in the discussion is consideration of the objectives of the CRC and its predecessor, patient care, research, training, physical facilities, and new and other activities. Early research objectives were to find a better protocol for treatment of diarrheal diseases. Cholera and other diarrheal disease findings contributed to the formulation of an iv fluid for the treatment of severely dehydrated patients. Oral rehydration therapy (ORT) research was also conducted at the center. The cholera death rate with treatment has been reduced to 1%. 70% of patients are children under 15 years old and 65% have some malnutrition. Patients in general come from Dhaka city and suburbs, but they also come from outside the district. Current research focuses on clinical management and basic pathophysiological and nutritional issues; efforts are underway to develop a super oral rehydration solution to improve special diets, and to determine successful implementation strategies. Medical, paramedical, and health workers are trained in establishing diarrheal treatment and training programs in other locations and in research methodologies. The Public Health Institutes has increased capacity to include a 60-bed inpatient ward, an intensive care unit of 12 beds, a 120-bed observation unit, a 30-bed research ward, and a traveler's clinic. The research ward also has an office and laboratory facility and endoscopic facilities with computers, icemakers, centrifuge, deep freezers, and a biological safety hood for sample processing and storage. During epidemics the facilities are still inadequate. Water supply and air cooling and electronic precision weighing scales are available. The Child Health

  9. Aspects of vulnerable patients and informed consent in clinical trials

    PubMed Central

    Kuthning, Maria; Hundt, Ferdinand

    2013-01-01

    Scope: To discuss the rationale behind informed consent in clinical trials focusing on vulnerable patients from a European and German viewpoint. Methods: Scientific literature search via PubMed, Medline, Google. Results: Voluntary informed consent is the cornerstone of policies regulating clinical trials. To enroll a patient into a clinical trial without having obtained written and signed consent is to be considered as a serious issue in the conduct of a clinical trial. Development of ethical guidance for physicians started before Christ Era with the Hippocratic Oath. Main function of consent, as articulated in all guidelines developed for clinical research, is to facilitate an individual’s freedom of choice, respect autonomy, and thus to ensure welfare of the participants in clinical trials. Minors are unable to provide legally binding informed consent, this issue is addressed through a combination of parental permission and minor’s assent. Illiteracy is a critical problem that affects all corners of our earth; it has no boundaries and exists among every race and ethnicity, age group, and economic class. New strategies to improve communication with patients including the use of videotapes or animated cartoon illustrations could be taught. Finally the time with the potential participant seems to be the best way to improve understanding. Conclusion: Discovery of life saving and life enhancing new treatments requires partnership that is based on good communication and trust between patients and researchers, sponsors, ethics committees, authorities, lawyers and politicians so that vulnerable patients can benefit from the results of well controlled clinical trials. PMID:23346043

  10. Neurocognitive Vulnerability: Suicidal and Homicidal Behaviours in Patients With Schizophrenia

    PubMed Central

    Richard-Devantoy, Stéphane; Orsat, Manuel; Dumais, Alexandre; Turecki, Gustavo; Jollant, Fabrice

    2014-01-01

    Objective Schizophrenia is associated with an increase in the risk of both homicide and suicide. The objectives of this study were to systematically review all published articles that examined the relation between neurocognitive deficits and suicidal or homicidal behaviours in schizophrenia, and to identify vulnerabilities in suicidal and homicidal behaviour that may share a common pathway in schizophrenia. Methods: A systematic review of the literature was performed using MEDLINE to include all studies published up to August 31, 2012. Results: Among the 1760 studies, 7 neuropsychological and 12 brain imaging studies met the selection criteria and were included in the final analysis. The neuropsychological and functional neuroimaging studies were inconclusive. The structural imaging studies reported various alterations in patients with schizophrenia and a history of homicidal behaviour, including: reduced inferior frontal and temporal cortices, increased mediodorsal white matter, and increased amygdala volumes. Patients with a history of suicidal acts showed volumetric reductions in left orbitofrontal and superior temporal cortices, while right amygdala volume was increased, though, these findings have rarely been replicated. Finally, no study has directly compared neurocognitive markers of suicidal and homicidal risk. Conclusion: These results suggest that brain alterations, in addition to those associated with schizophrenia, may predispose some patients to a higher risk of homicide or suicide in particular circumstances. Moreover, some of these alterations may be shared between homicidal and suicidal patients. However, owing to several limitations, including the small number of available studies, no firm conclusions can be drawn and further investigations are necessary. PMID:24444320

  11. Support of vulnerable patients throughout TB treatment in the UK.

    PubMed

    Potter, J L; Inamdar, L; Okereke, E; Collinson, S; Dukes, R; Mandelbaum, M

    2016-06-01

    Despite well-established treatment regimens, tuberculosis (TB) remains a public health burden; it disproportionately affects poor and marginalized populations who may not have access to social support, including migrants, homeless people and those dependent on drugs or alcohol. There is a clearly demonstrated need for housing and other appropriate social support, as part of a package of integrated clinical and social care. However, TB prevention and control efforts in the UK often do not address the specific vulnerabilities of these groups and it can be a challenge to support the continued TB treatment of these underserved populations. This challenge is exacerbated by complex issues concerning funding, immigration and the law. In this paper, we have reviewed current UK guidance and legislation, discussed several case studies and highlighted examples of existing models of community support for TB patients. Finally, we lay out our recommendations for ensuring a co-ordinated, whole system approach to successful TB treatment. PMID:25889386

  12. Developing Dental Students' Awareness of Health Care Disparities and Desire to Serve Vulnerable Populations Through Service-Learning.

    PubMed

    Behar-Horenstein, Linda S; Feng, Xiaoying; Roberts, Kellie W; Gibbs, Micaela; Catalanotto, Frank A; Hudson-Vassell, Charisse M

    2015-10-01

    Service-learning in dental education helps students integrate knowledge with practice in an underserved community setting. The aim of this study was to explore how a service-learning experience affected a small group of dental students' beliefs about cultural competence, professionalism, career development, desire to practice in a community service setting, and perceptions about access and disparities issues. Prior to beginning their first year of dental school, five first-year dental students at one U.S. dental school participated in a six-week service-learning program in which they interned at one of three at-risk settings in order to experience health care delivery there. After the program, 60 reflective writing assignments completed by the participants were analyzed using grounded theory methods; interviews with the students were used to corroborate the findings from that analysis. Seven themes identified in the journal reflections and interview findings showed enhanced awareness of social health care issues and patient differences, as well as a social justice orientation and desire to address disparities. Building on this study, future research should explore the curricular components of service-learning programs to ensure students receive ample opportunity to reflect upon their experiences in order to integrate previously held assumptions with their newfound knowledge. PMID:26427778

  13. Defining the non-vulnerable and vulnerable patients with computed tomography coronary angiography: evaluation of atherosclerotic plaque burden and composition.

    PubMed

    Rodriguez-Granillo, Gaston A; Carrascosa, Patricia; Bruining, Nico; Waksman, Ron; Garcia-Garcia, Hector M

    2016-05-01

    The shift from coronary plaque stability to plaque instability remains poorly understood despite enormous efforts and expenditures have been assigned to the study of the subject. On the other hand, there have been serious advances in imaging helping us to characterizenon-vulnerable patients The latter has much more value in the clinical decision-making process since it provides high certainty that the patient's probability of a future acute event is low and treatment decisions should be made accordingly. Although coronary plaque rupture is still recognized as the main source of acute thrombotic events, numerous studies have shown that the prediction of events on an individual basis is far more complex and demands a more open approach aimed at characterizing patient risk rather than assessing the risk of thrombosis of a single plaque. Computed tomography coronary angiography (CTCA) has the ability to evaluate non-invasively the extent, burden, severity, and characteristics of coronary artery disease (CAD) and has a close relationship to intravascular ultrasound. On the basis of an excellent negative predictive value with an annualized event rate of ∼0.20% assessed over more than 6000 patients, thus providing a 5-year warranty period, CTCA has been identified as the finest non-invasive tool to exclude CAD. This means that CTCA is able to reliably characterize the non-vulnerable patient. Conversely, in the past few years, several studies have attempted to establish CTCA-derived predictors of acute coronary syndromes, both from a lesion level and a patient level basis with very low positive predictive value, thus questioning the vulnerable patient/plaque concept. PMID:26903599

  14. Can Erectile Dysfunction in Young Patients Serve as a Surrogate Marker for Coronary Artery Disease?

    PubMed Central

    Dattatrya, Kaje Yogesh; Gorakhnath, Wagaska Vinayak; kiran, Patwardhan Sujata

    2015-01-01

    Introduction Early diagnosis and expeditious management of coronary artery disease (CAD) has a rewarding survival benefit. Aim To study whether erectile dysfunction (ED) serves as a surrogate marker for CAD in a young patient. Settings and Design Males (n=207) between ages 20-60 years with ED were evaluated prospectively for risk factors for CAD. Materials and Methods Blood Glucose Levels (BGL) fasting and post meal), lipid profile (LP) and 12 lead electrocardiogram (ECG) was done in all of them. International Index of Erectile Function-5 (IEF-5) was used for the evaluation of ED. Those with abnormal parameters were assessed by cardiologists by echocardiography, stress test and if necessary coronary angiography (Non-Invasive or Invasive). Statistical Analysis All the data were analysed using SPSS. 16 statistical software (SPSS Inc., Chicago, IL, USA). All data are expressed as mean and standard deviation. The Student’s t-test was used to compare means between groups, and the chi-square test was used to compare proportions between the groups. P-value <0.05 was considered statistically significant. All confidence intervals (CIs) are two tailed and calculated at the 0.05 level. Results Out of 207, 149 patients had at least one abnormal screening parameter. All underwent cardiology consultation and 2D ECHO and Stress test. Thirty six patients underwent coronary angiography. CAD was found in 22 patients. Of these, 19 patients had severe ED. Nine patients were between 20-40 years of age (13.23%). All 9 young patients had deranged LP; severe ED. Six patients were smokers while nobody was hypertensive. Conclusion ED serves as a surrogate marker for CAD in young patients (p=0.001). Presence of risk factors and lab abnormalities in young patients with ED warrants a cardiology referral to detect CAD. PMID:26674799

  15. The validity of Psychosis Proneness Scales as vulnerability indicators in recent-onset schizophrenia patients.

    PubMed

    Horan, William P; Reise, Steven P; Subotnik, Kenneth L; Ventura, Joseph; Nuechterlein, Keith H

    2008-03-01

    The Psychosis Proneness Scales developed by the Chapmans and colleagues [Chapman, J.P., Chapman, L.J., Kwapil, T.R. Scales for the measurement of schizotypy. In: Raine., A., Lencz, T., Mednick, S.A., (Eds.). Schizotypal Personality. New York: Cambridge University Press, 1995. pp. 79-109] are widely used to identify non-patient individuals who are hypothesized to possess heightened vulnerability to schizophrenia and related psychopathology. Yet surprisingly little is known about whether schizophrenia patients themselves show abnormalities on these scales across different clinical states, as would be expected for vulnerability indicators. Scores on four of the Psychosis Proneness Scales were evaluated at three assessment points over a 15-month period in healthy controls (n=54) and in recent-onset schizophrenia patients (n=72) who experienced symptom fluctuations across assessments. Patients showed steady elevations on the Physical Anhedonia Scale across time and clinical state, consistent with a stable vulnerability indicator. Patients had higher scores on the Perceptual Aberration and Magical Ideation Scales than controls throughout the follow-up period but scores also changed across clinical states, consistent with a mediating vulnerability indicator. Patients had higher scores on the Impulsive Non-Conformity Scale than controls only during a psychotic state, reflecting an episode indicator. The longitudinal characteristics of these scales in people who are actually diagnosed with schizophrenia provide key evidence for the validity of three commonly used psychometric indicators of vulnerability to psychosis. PMID:18221857

  16. Development of a multivariable model to predict vulnerability in older American patients hospitalised with cardiovascular disease

    PubMed Central

    Bell, Susan P; Schnelle, John; Nwosu, Samuel K; Schildcrout, Jonathan; Goggins, Kathryn; Cawthon, Courtney; Mixon, Amanda S; Vasilevskis, Eduard E; Kripalani, Sunil

    2015-01-01

    Objectives To identify vulnerable cardiovascular patients in the hospital using a self-reported function-based screening tool. Participants Prospective observational cohort study of 445 individuals aged ≥65 years admitted to a university medical centre hospital within the USA with acute coronary syndrome and/or decompensated heart failure. Methods Participants completed an inperson interview during hospitalisation, which included vulnerable functional status using the Vulnerable Elders Survey (VES-13), sociodemographic, healthcare utilisation practices and clinical patient-specific measures. A multivariable proportional odds logistic regression model examined associations between VES-13 and prior healthcare utilisation, as well as other coincident medical and psychosocial risk factors for poor outcomes in cardiovascular disease. Results Vulnerability was highly prevalent (54%) and associated with a higher number of clinic visits, emergency room visits and hospitalisations (all p<0.001). A multivariable analysis demonstrating a 1-point increase in VES-13 (vulnerability) was independently associated with being female (OR 1.55, p=0.030), diagnosis of heart failure (OR 3.11, p<0.001), prior hospitalisations (OR 1.30, p<0.001), low social support (OR 1.42, p=0.007) and depression (p<0.001). A lower VES-13 score (lower vulnerability) was associated with increased health literacy (OR 0.70, p=0.002). Conclusions Vulnerability to functional decline is highly prevalent in hospitalised older cardiovascular patients and was associated with patient risk factors for adverse outcomes and an increased use of healthcare services. PMID:26316650

  17. Neonatal anesthesia: how we manage our most vulnerable patients

    PubMed Central

    2015-01-01

    Neonates undergoing surgery are at higher risk than older children for anesthesia-related adverse events. During the perioperative period, the maintenance of optimal hemodynamics in these patients is challenging and requires a thorough understanding of neonatal physiology and pharmacology. Data from animals and human cohort studies have shown relation of the currently used anesthetics may associate with neurotoxic brain injury that lead to later neurodevelopmental impairment in the developing brain. In this review, the unique neonatal physiologic and pharmacologic features and anesthesia-related neurotoxicity will be discussed. PMID:26495052

  18. Report of the ASHP Task Force on Caring for Patients Served by Specialty Suppliers.

    PubMed

    Caselnova, Dominick; Donley, Kathy; Ehlers, Diane; Hyduk, Amy E; Koontz, Susannah E; Nowobilski-Vasilios, Anna; Pawlicki, Kathleen S; Poikonen, John C; Poremba, Art C; Sasser, Cathy L; Schell, Kenneth H; Schwab, Jay L; Swinarski, Dave; Chen, David; Kirschenbaum, Bonnie; Armitstead, John

    2010-10-01

    Task Force recommendations are discussed in more detail in eAppendix A (available at www.ajhp.org). What follows is a brief summary of those recommendations. In very abbreviated terms, the Task Force suggested that ASHP: 1. Consider creating and maintaining a Web resource center on ASHP's website to provide information about restricted drug distributions systems (RDDSs), risk evaluation and mitigation strategies (REMSs), risk assessment and minimization plans (RiskMAPs), and specialty suppliers and products. 2. Provide comprehensive education to members, other health professionals, regulators, third-party payers, patients, and other stakeholders about RDDSs, REMSs, RiskMAPs, and specialty suppliers and products. 3. Develop policies to advocate that a. Pharmacists serve as the institutional leaders in compliance and utilization challenges of safely managing externally supplied medications and related drug administration devices, b. Agencies, organizations, and associations that influence the distribution, sale, and dispensing of medications under these alternative distribution models address issues these models create in continuity of care, reimbursement, and patient safety, c. The Centers for Medicare and Medicaid Services and the Joint Commission develop standards and interpretations that accommodate hospital use of these products and devices when currently available technology (e.g., cold-chain storage, e-pedigree) is used to ensure patient safety, d. Group purchasing organizations negotiate contractual arrangements for specialty pharmaceuticals for both acquisition costs and distribution arrangements, and e. Information technology (IT) be used to resolve issues created by alternative distribution models and that ASHP work with IT vendors to ensure that programs are designed to meet the needs of these evolving models. 4. Quantify through research, perhaps in cooperation with entities such as the Agency for Healthcare Research and Quality, the Institute of

  19. Older, vulnerable patient view: a pilot and feasibility study of the patient measure of safety (PMOS) with patients in Australia

    PubMed Central

    Taylor, Natalie; Hogden, Emily; Clay-Williams, Robyn; Li, Zhicheng; Lawton, Rebecca; Braithwaite, Jeffrey

    2016-01-01

    Objectives The UK-developed patient measure of safety (PMOS) is a validated tool which captures patient perceptions of safety in hospitals. We aimed (1) to investigate the extent to which the PMOS is appropriate for use with stroke, acute myocardial infarction (AMI) and hip fracture patients in Australian hospitals and (2) to pilot the PMOS for use in a large-scale, national study ‘Deepening our Understanding of Quality in Australia’ (DUQuA). Participants Stroke, AMI and hip fracture patients (n=34) receiving care in 3 wards in 1 large hospital. Methods 2 phases were conducted. First, a ‘think aloud’ study was used to determine the validity of PMOS with this population in an international setting, and to make amendments based on patient feedback. The second phase tested the revised measure to establish the internal consistency reliability of the revised subscales, and piloted the recruitment and administration processes to ensure feasibility of the PMOS for use in DUQuA. Results Of the 43 questions in the PMOS, 13 (30%) were amended based on issues patients highlighted for improvement in phase 1. In phase 2, a total of 34 patients were approached and 29 included, with a mean age of 71.3 years (SD=16.39). Internal consistency reliability was established using interitem correlation and Cronbach's α for all but 1 subscale. The most and least favourably rated aspects of safety differed between the 3 wards. A study log was categorised into 10 key feasibility factors, including liaising with wards to understand operational procedures and identify patterns of patient discharge. Conclusions Capturing patient perceptions of care is crucial in improving patient safety. The revised PMOS is appropriate for use with vulnerable older adult groups. The findings from this study have informed key decisions made for the deployment of this measure as part of the DUQuA study. PMID:27279478

  20. 42 CFR 412.106 - Special treatment: Hospitals that serve a disproportionate share of low-income patients.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... disproportionate share of low-income patients. 412.106 Section 412.106 Public Health CENTERS FOR MEDICARE... section, if a hospital serves a disproportionate number of low-income patients, its DRG revenues for.... Editorial Note: For Federal Register citations affecting § 412.106, see the List of CFR Sections...

  1. Narcissistic vulnerability is a common cause for depression in patients with Gilles de la Tourette syndrome.

    PubMed

    Trillini, Morounke O; Müller-Vahl, Kirsten R

    2015-12-15

    The aim of this study was to assess for the first time different dimensions of narcissistic self-regulation in a large cohort of adult patients with Gilles de la Tourette syndrome (GTS) (n=50). From preliminary studies it is suggested that narcissistic personality trait and disorder, respectively, are relatively uncommon and occur in only 6-10% of GTS patients. In this study we used the Narcissism Inventory (NI), a 163-items questionnaire that measures four different dimensions of narcissism. The main result was that the prevalence of narcissism strongly depends on the subtype of narcissism: while the vulnerable narcissism ("threatened self" and "hypochondriac self") was common, the "classic narcissistic self" (grandiose narcissism) was rare. From our data an association between comorbid depression and increased values of the "threatened self" and comorbid OCD with increased values of the "hypochondriac self" is suggested. Narcissism correlated positively with the personality domain neuroticism and had a significantly negative impact on patients' quality of life. Therefore it can be speculated that vulnerable narcissism is - among several others - one cause for depression in patients with GTS. These findings may open new psychotherapeutic perspectives in the treatment of depression in patients with GTS. PMID:26548979

  2. Medicare home health payment reform may jeopardize access for clinically complex and socially vulnerable patients.

    PubMed

    Rosati, Robert J; Russell, David; Peng, Timothy; Brickner, Carlin; Kurowski, Daniel; Christopher, Mary Ann; Sheehan, Kathleen M

    2014-06-01

    The Affordable Care Act directed Medicare to update its home health prospective payment system to reflect more recent data on costs and use of services-an exercise known as rebasing. As a result, the Centers for Medicare and Medicaid Services will reduce home health payments 3.5 percent per year in the period 2014-17. To determine the impact that these reductions could have on beneficiaries using home health care, we examined the Medicare reimbursement margins and the use of services in a national sample of 96,621 episodes of care provided by twenty-six not-for-profit home health agencies in 2011. We found that patients with clinically complex conditions and social vulnerability factors, such as living alone, had substantially higher service delivery costs than other home health patients. Thus, the socially vulnerable patients with complex conditions represent less profit-lower-to-negative Medicare margins-for home health agencies. This financial disincentive could reduce such patients' access to care as Medicare payments decline. Policy makers should consider the unique characteristics of these patients and ensure their continued access to Medicare's home health services when planning rebasing and future adjustments to the prospective payment system. PMID:24889943

  3. Feeling “overloaded” and “shortcomings”: milieu therapists’ experiences of vulnerability in caring for severely mentally ill patients

    PubMed Central

    Bachmann, Liv; Michaelsen, Ragnhild A; Vatne, Solfrid

    2016-01-01

    Background Milieu therapists’ relationships with patients with severe mental illnesses are viewed as challenging. Elucidating vulnerability from their perspective in daily face-to-face encounters with patients might contribute to extending our knowledge about milieu therapists’ vulnerability and the dynamics of the interaction between patients in mental health services and expertise in building caring and therapeutic relationships. The aim of this project was to study educated milieu therapists’ experiences of their own vulnerability in their interactions with patients in mental health services. Materials and methods The data collection method was focus-group interviews. Thirteen part-time master’s in mental health students (eight nurses, three social workers, two social educators) participated. All participants had experience with community or specialized mental health services (2–8 years). Results The milieu therapists mainly related their experiences of vulnerability to negative feelings elicited by challenging work conditions, disclosed as two main themes: 1) “overloaded”, by the possibility of being physically and mentally hurt and the burdens of long-lasting close relationships; milieu therapists were extremely vulnerable because of their difficulty in protecting themselves; and 2) “shortcomings”, connected to feelings of despair associated with not acting in concordance with their professional standards and insecurity about their skills to handle challenging situations, which was a threat to their professional integrity. There seemed to be coherence between vulnerability and professional inauthenticity. A misunderstanding that professionalism refers to altruism seems to increase milieu therapist vulnerability. Conclusion Vulnerability in health care is of interest to multiple disciplines, and is of relevance for knowledge development in higher education. Extended knowledge and understanding about milieu therapists’ vulnerability might

  4. Vulnerability of husband and wife caregivers of Alzheimer disease patients to caregiving stressors.

    PubMed

    Croog, S H; Sudilovsky, A; Burleson, J A; Baume, R M

    2001-01-01

    This study assessed relationships between problem behaviors in 199 Alzheimer Disease patients and vulnerability factors in the well being and emotional health of their spouse caregivers. Among caregiver wives and the younger caregiver husbands (64 years old and under) the volume of patient problem behavior was significantly negatively associated with total scores on a summary well being measure. The association was not found within the older husband caregiver group. Considering five subdimensions of the summary well being scale (Anxiety, Depressive Symptoms, Positive Well Being, Vitality and General Health), correlational analyses showed that the total patient problems measure appeared to have impact primarily among wife caregivers, particularly those 64 years old and under. Multiple regression analyses showed that one patient problem behavior category, Emotional Lability, was the single strongest predictor of impaired well being of the caregiver among all five subdimensions of the caregiver well being measure. Although Destructive Behavior of the patient was not significant by itself, an Age by Destructive Behavior interaction showed that high levels of patient Destructive Behavior predicted high levels of Depression, Anxiety, and low levels of Positive Well Being more among younger caregivers. Husband caregivers had significantly higher Anxiety scores than wife caregivers. These findings document how particular patient problem behaviors can affect caregivers. They point up as well how both gender and age may help target which caregivers are most vulnerable to the stress of specific Alzheimer patient behavior problems. They also suggest the utility of examining specific dimensions of well being rather than a total score alone for purposes of understanding the relationship of particular patient behavior problems to caregiver emotional and physical health. PMID:11723371

  5. Overcoming barriers to osteoporosis care in vulnerable elderly patients with hip fractures.

    PubMed

    Switzer, Julie A; Jaglal, Susan; Bogoch, Earl R

    2009-07-01

    Indications for and benefits of providing osteoporosis (OP) care for hip fracture patients have become widely understood. The hip fracture patient is frequently over age 80 years, minimally ambulatory, has multiple medical comorbidities, and has cognitive impairment. Patient barriers to initiation of effective OP treatment include: age, dementia, medical comorbidities, polypharmacy, lack of adherence with treatment, alcohol abuse, postoperative delirium, language barriers, inadequate social support, and socioeconomic status. In a large teaching hospital, 244 patients presented with hip fracture over 2 years: 72% were female and 64% were over age 80. Forty percent had been diagnosed with dementia; another 29% had other severe medical comorbidities.Opportunities for OP diagnosis and treatment are numerous. In acute care hospitals, coordinator facilitated programs are effective for identification, education, assessment, referral, and treatment of underlying OP in fracture patients. System modifications may include an automated care path or automatic specialist referral for hip fracture patients. In the rehabilitation hospital, the patients are in a more stable condition, there is a focus on the recent fracture, and there are opportunities to initiate OP treatment and to promote adherence. In long-term care, dietary intake including calcium and vitamin D supplementation and persistence with pharmacotherapy can be monitored. Patient education and referral to the family physician for osteoporosis investigation and treatment have improved patient knowledge and diagnosis, but the reported impact on treatment has been limited.Effective OP care for the vulnerable hip fracture patient should be initiated early but may be complex and require coordination. In addition to calcium and vitamin D supplementation, most patients in this category have an indication for aminobisphosphonate therapy. Liaison between the orthopaedic team and the discharge destination caregivers, an

  6. The Spatial Distribution of Plaque Vulnerabilities in Patients with Acute Myocardial Infarction

    PubMed Central

    Zheng, Guian; Li, Yuxin; Takayama, Tadateru; Nishida, Toshihiko; Sudo, Mitsumasa; Haruta, Hironori; Fukamachi, Daisuke; Okubo, Kimie; Higuchi, Yoshiharu; Hiro, Takafumi; Saito, Satoshi; Hirayama, Atsushi

    2016-01-01

    Objective Although the plaque characteristics have been recognized in patients with acute myocardial infarction (AMI), the plaque spatial distribution is not well clarified. Using color-mapping intravascular ultrasound (iMAP-IVUS), we examined culprit lesions to clarify plaque morphology, composition and spatial distribution of the sites of potential vulnerability. Methods Sixty-eight culprit lesions in 64 consecutive AMI patients who underwent angiography and IVUS examinations before intervention were analyzed. Plaque morphology and composition were quantified with iMAP-IVUS. The spatial distribution of the sites of potential vulnerability was assessed with longitudinal reconstruction of the consecutive IVUS images. The plaque characteristics were also compared between ruptured and non-ruptured lesions, and between totally occlusive (TO) and non-TO lesions. Results The sites with maximum necrotic area (maxNA), maximum plaque burden (maxPB) and most severely narrowed (minimal luminal area, MLA) were recognized vulnerability. In the majority of cases, maxNA sites were proximal to the maxPB sites, and MLA sites were distal to the maxNA and maxPB sites. Ruptures usually occurred close to maxNA sites and proximal to maxPB and MLA sites. The average distance from the site of rupture to the maxNA site was 0.33 ± 4.04 mm. Ruptured lesions showed significant vessel remodeling, greater plaque volume, and greater lipidic volume compared to those of non-ruptured lesions. Both the length and plaque burden (PB) of TO lesions were greater than those of non-TO lesions. Conclusions Instead of overlapping on maxPB sites, most maxNA sites are proximal to the maxPB sites and are the sites most likely to rupture. Plaque morphology and composition play critical roles in plaque rupture and coronary occlusion. PMID:27031514

  7. Specific vulnerability of face perception to noise: A similar effect in schizophrenia patients and healthy individuals

    PubMed Central

    Chen, Yue; McBain, Ryan; Norton, Daniel

    2014-01-01

    Face perception plays a foundational role in the social world. This perceptual ability is deficient in schizophrenia. A noise-filtering mechanism is essential for perceptual processing. It remains unclear as to whether a specific noise-filtering mechanism is implicated in the face perception problem or a general noise-filtering mechanism is involved which also mediates non-face visual perception problems associated with this psychiatric disorder. This study examined and compared the effects of external noise on the performance of face discrimination and car discrimination in schizophrenia patients (n=25) and healthy controls (n=27). Superimposing the external visual noise on face or car stimuli elevated perceptual thresholds (i.e. degraded performance levels) for both face and car discrimination. However, the effect of noise was significantly larger on face than on car discrimination, both in patients and controls. This pattern of results suggests specific vulnerability of face processing to noise in healthy individuals and those with schizophrenia. PMID:25500350

  8. Library Services to Hospital Patients and Handicapped Readers Section. Libraries Serving the General Public Division. Papers.

    ERIC Educational Resources Information Center

    International Federation of Library Associations, The Hague (Netherlands).

    Papers on library services to hospital personnel, hospital patients, and housebound or handicapped persons, which were presented at the 1983 International Federation of Library Associations (IFLA) conference, include: (1) "Education and Training for Health Care Librarianship," in which Antonia J. Bunch (United Kingdom) discusses the scope of and…

  9. Osteogenic Monocytes within the Coronary Circulation and their Association with Plaque Vulnerability in Patients with Early Atherosclerosis

    PubMed Central

    Collin, Julia; Gössl, Mario; Matsuo, Yoshiki; Cilluffo, Rebecca R.; Flammer, Andreas J.; Loeffler, Darrell; Lennon, Ryan J.; Simari, Robert D.; Spoon, Daniel B.; Erbel, Raimund; Lerman, Lilach O.; Khosla, Sundeep; Lerman, Amir

    2014-01-01

    Objectives This study tests the hypothesis that circulating mononuclear cells expressing osteocalcin (OCN) and bone alkaline phosphatase (BAP) are associated with distinct plaque tissue components in patients with early coronary atherosclerosis. Background Plaque characteristics implying vulnerability develop at the earliest stage of coronary atherosclerosis. Increasing evidence indicates that cells from the myeloid lineage might serve as important mediators of destabilization. Plaque burden and its components were assessed regarding their relationship to monocytes carrying both pro-inflammatory (CD14) and osteogenic surface markers OCN and BAP. Methods Twenty-three patients with angiographically non-obstructive coronary artery disease underwent coronary endothelial function assessment and virtual histology-intravascular ultrasound of the left coronary artery. Plaque composition was characterized in the total segment (TS) and in the target lesion (TL) containing the highest amount of plaque burden. Blood samples were collected simultaneously from the aorta and the coronary sinus. Circulating cell counts were then identified from each sample and a gradient across the coronary circulation was determined. Results Circulating CD14+/BAP+/OCN+ monocytes correlate with the extent of necrotic core and calcification (r=0.53, p=0.010; r=0.55, p=0.006, respectively). Importantly, coronary retention of CD14+/OCN+ cells also correlate with the amount of necrotic core and calcification (r=0.61, p=0.003; r=0.61, p=0.003) respectively. Conclusions Our study links CD14+/BAP+/OCN+ monocytes to the pathologic remodeling of the coronary circulation and therefore associates these cells with plaque destabilization in patients with early coronary atherosclerosis. PMID:25482280

  10. Implementing the Ten Steps for Successful Breastfeeding in Hospitals Serving Low-Wealth Patients

    PubMed Central

    Taylor, Emily C.; Nickel, Nathan C.

    2012-01-01

    Objectives. The Ten Steps to Successful Breastfeeding is a proven approach to support breastfeeding in maternity settings; however, scant literature exists on the relative impact and interpretation of each step on breastfeeding. We assessed the Ten Steps and their relationship with in-hospital breastfeeding rates at facilities serving low-wealth populations and explored the outcomes to identify step-specific actions. Methods. We present descriptive and nonparametric comparisons and qualitative findings to examine the relationship between the Ten Steps and breastfeeding rates from each hospital using baseline data collection. Results. Some steps (1-policy, 2-training, 4-skin-to-skin, 6-no supplements, and 9-no artificial nipples, followed by 3-prenatal counseling, 7-rooming-in) reflected differences in relative baseline breastfeeding rates between settings. Key informant interviews revealed misunderstanding of some steps. Conclusions. Self-appraisal may be less valid when not all elements of the criteria for evaluating Step implementation may be fully understood. Limited exposure and understanding may lead to self-appraisal errors, resulting in scores that are not reflective of actual practices. Nonetheless, the indication that breastfeeding rates may be better mirrored by a defined subset of steps may provide some constructive insight toward prioritizing implementation activities and simplifying assessment. These issues will be further explored in the next phase of this study. PMID:23078473

  11. HLA alleles may serve as a tool to discriminate atypical type 2 diabetic patients

    PubMed Central

    Fernández, Mariana; Fabregat, Matías; Javiel, Gerardo; Mimbacas, Adriana

    2014-01-01

    AIM: To investigate whether the presence of human leukocyte antigen (HLA) marker could add new information to discriminated atypical diabetic type 2 patients. METHODS: We analyzed 199 patients initially diagnosed as type 2 diabetes who are treated in special care diabetes clinics (3rd level). This population was classified in “atypical” (sample A) and “classic” (sample B) according to HLA typing. We consider “classic patient” when has absence of type 1 diabetes associated HLA alleles and no difficulties in their diagnosis and treatments. By the other hand, we considered “atypical patient” when show type 1 diabetes associated HLA alleles and difficulties in their diagnosis and treatments. The standard protocol Asociacion Latinoamericana de Diabetes 2006 was used for patients follow up. To analyze differences between both populations in paraclinical parameters we used unpaired t tests and contingence tables. Bivariate and multivariate analyses were carried out using the SPSS software program. In all studies we assume differences statistically significant, with a P-value < 0.05 corrected and 95%CI. RESULTS: The typing HLA in the “atypical” populations show that 92.47% patients presented at list one type 1 diabetes associated HLA alleles (DQB1*0201-0302 and DR 3-4) and 7.53% had two of its. The results showed for categorical variables (family history, presence or absence of hypertension and/or dyslipidemia, reason for initial consultation) the only difference found was at dyslipidemia (OR = 0.45, 0.243 < OD < 0.822 (P < 0.001). In relation to continuous variables we found significant differences between atypical vs classic only in cholesterol (5.07 ± 1.1 vs 5.56 ± 1.5, P < 0.05), high density lipoproteins (1.23 ± 0.3 vs 1.33 ± 0.3, P < 0.05) and low density lipoproteins (2.86 ± 0.9 vs 3.38 ± 1.7, P < 0.01). None of the variables had discriminating power when logistic regression was done. CONCLUSION: We propose an algorithm including HLA

  12. Social vulnerability in paediatric dentistry: an overview of ethical considerations of therapeutic patient education.

    PubMed

    Trentesaux, Thomas; Delfosse, Caroline; Rousset, Monique Marie; Hervé, Christian; Hamel, Olivier

    2014-03-01

    Dental caries is a multifactorial condition that remains a major public health issue in high income countries. The prevalence of dental caries in children has markedly declined in most countries over the past 30 years. However, the disease continues to affect a vulnerable population defined as a high-risk group. As many public health policies are inefficient in dealing with this underprivileged group, it is necessary to find other strategies to decrease the incidence and the burden of dental caries. Defining dental caries as a chronic disease enables us to develop the concept of 'therapeutic patient education.' It is meant to train patients to self-manage or adapt treatment to their particular chronic disease and to cope with new processes and skills. The purpose of this paper is to propose a new approach to dental caries, in particular to early childhood caries. That should decrease the gravity and prevalence of the disease in this specific population. As a result, this new approach could increase the quality of life of many children both in terms of function and aesthetics. PMID:24318642

  13. Serving Communities.

    ERIC Educational Resources Information Center

    Brook, Les, Ed.

    This book contains 15 articles about various aspects of community further education (FE) programs in Great Britain, including program rationales/benefits, administration, and delivery. The following articles are included: "Foreword" (Bradshaw); "Commitment to Community Is Good Business and Practical Politics" (Brook); "Can We Serve Communities in…

  14. Serving Families.

    ERIC Educational Resources Information Center

    Link, Geoffrey; Beggs, Marjorie; Seiderman, Ethel

    Parent Services Project (PSP), the first comprehensive program of resources and mental health activities for parents offered at child care centers in the San Francisco Bay Area (California), has expanded to centers in six states, serving over 19,000 families. This report describes the program's history, aims, and achievements, along with specific…

  15. Screening for Vulnerability in Older Cancer Patients: The ONCODAGE Prospective Multicenter Cohort Study

    PubMed Central

    Soubeyran, Pierre; Bellera, Carine; Goyard, Jean; Heitz, Damien; Curé, Hervé; Rousselot, Hubert; Albrand, Gilles; Servent, Véronique; Jean, Olivier Saint; van Praagh, Isabelle; Kurtz, Jean-Emmanuel; Périn, Stéphane; Verhaeghe, Jean-Luc; Terret, Catherine; Desauw, Christophe; Girre, Véronique; Mertens, Cécile; Mathoulin-Pélissier, Simone; Rainfray, Muriel

    2014-01-01

    Background Geriatric Assessment is an appropriate method for identifying older cancer patients at risk of life-threatening events during therapy. Yet, it is underused in practice, mainly because it is time- and resource-consuming. This study aims to identify the best screening tool to identify older cancer patients requiring geriatric assessment by comparing the performance of two short assessment tools the G8 and the Vulnerable Elders Survey (VES-13). Patients and Methods The diagnostic accuracy of the G8 and the (VES-13) were evaluated in a prospective cohort study of 1674 cancer patients accrued before treatment in 23 health care facilities. 1435 were eligible and evaluable. Outcome measures were multidimensional geriatric assessment (MGA), sensitivity (primary), specificity, negative and positive predictive values and likelihood ratios of the G8 and VES-13, and predictive factors of 1-year survival rate. Results Patient median age was 78.2 years (70-98) with a majority of females (69.8%), various types of cancer including 53.9% breast, and 75.8% Performance Status 0-1. Impaired MGA, G8, and VES-13 were 80.2%, 68.4%, and 60.2%, respectively. Mean time to complete G8 or VES-13 was about five minutes. Reproducibility of the two questionnaires was good. G8 appeared more sensitive (76.5% versus 68.7%, P =  0.0046) whereas VES-13 was more specific (74.3% versus 64.4%, P<0.0001). Abnormal G8 score (HR = 2.72), advanced stage (HR = 3.30), male sex (HR = 2.69) and poor Performance Status (HR = 3.28) were independent prognostic factors of 1-year survival. Conclusion With good sensitivity and independent prognostic value on 1-year survival, the G8 questionnaire is currently one of the best screening tools available to identify older cancer patients requiring geriatric assessment, and we believe it should be implemented broadly in daily practice. Continuous research efforts should be pursued to refine the selection process of older cancer patients

  16. Serum miR-128-2 serves as a prognostic marker for patients with hepatocellular carcinoma.

    PubMed

    Zhuang, Liping; Xu, Litao; Wang, Peng; Meng, Zhiqiang

    2015-01-01

    Circulating miRNAs are promising biomarkers for predicting the aggressiveness of hepatocellular carcinoma (HCC). We aimed to identify differentially expressed miRNAs in the serum of HCC patients with different Barcelona Clinic Liver Cancer (BCLC) stage, and to investigate the potential of serum miRNAs as biomarkers for patient outcomes. In the discovery stage, TaqMan Low-Density Array was used to test the difference in levels of serum miRNAs between 20 patients with portal vein tumor thrombosis (PVTT) and 20 patients without PVTT. The detected serum miRNAs then were validated in 182 patients. Fifteen serum miRNAs showed more than two-fold higher expression in patients with PVTT, and miR-128-2 was found to be significantly up-regulated and was selected for further validation. In the validation stage, patients were divided into two groups with low or high serum miR-128-2 using the median expression level of all 182 cases as the cut-off point. Kaplan-Meier analysis revealed that patients with low level of serum miR-128-2 had favorable trends of survival (log rank = 13.031, p < 0.001). The median survivals for patients with a low and high level of serum miR-128-2 were 625 (95% CI, 527-722) days and 426 (95% CI, 362-491) days, respectively. MiR-128-2 was also an independent factor of overall survival (p = 0.001, HR 2.793, 95%CI 1.550, 5.033). Serum levels of the ubiquitously expressed miR-128-2 showed no significant correlation with parameters of liver damage or liver function. In addition, expressions of miR-128-2 in HCC tissues were up-regulated in comparison with adjacent non-tumor tissues. In conclusion, serum level of miR-128-2 serves as a noninvasive biomarker for the overall survival of patients with hepatocellular carcinoma. PMID:25642945

  17. Academic health centers and community health centers partnering to build a system of care for vulnerable patients: lessons from Carolina Health Net.

    PubMed

    Denham, Amy C; Hay, Sherry S; Steiner, Beat D; Newton, Warren P

    2013-05-01

    Academic health centers (AHCs) are challenged to meet their core missions in a time of strain on the health care system from rising costs, an aging population, increased rates of chronic disease, and growing numbers of uninsured patients. AHCs should be leaders in developing creative solutions to these challenges and training future leaders in new models of care. The authors present a case study describing the development, implementation, and early results of Carolina Health Net, a partnership between an AHC and a community health center to manage the most vulnerable uninsured by providing access to primary care medical homes and care management systems. This partnership was formed in 2008 to help transform the delivery of health care for the uninsured. As a result, 4,400 uninsured patients have been connected to primary care services. Emergency department use by enrolled patients has decreased. Patients have begun accessing subspecialty care within the medical home. More than 2,200 uninsured patients have been assisted to enroll in Medicaid. The experience of Carolina Health Net demonstrates that developing a system of care with primary care and wrap-around services such as pharmacy and case management can improve the cost-effectiveness and quality of care, thereby helping AHCs meet their broader missions. This project can serve as a model for other AHCs looking to partner with community-based providers to improve care and control costs for underserved populations. PMID:23524915

  18. Restoration of root surface caries in vulnerable elderly patients: a review of the literature.

    PubMed

    Amer, R S; Kolker, J L

    2013-01-01

    The authors conducted a review to evaluate the current literature addressing root surface caries treatment in the vulnerable elderly, to identify any gaps in the literature that will need to be addressed in the future. The authors conducted a literature search of the electronic databases using MEDLINE, PubMed, to identify original clinical research articles regarding treatment of root caries lesions, with emphasis on research focused on the vulnerable elderly. Five articles were clinical studies of root caries restorations. Only one was conducted on a vulnerable elderly population. The results of the literature review show that there is a need for further studies addressing the restorative needs of the vulnerable elderly. With the aging of the American population, more research is needed to provide adequate care to this population. At this time, glass ionomers are a good treatment option. PMID:23600986

  19. Regional vulnerability in Huntington's disease: fMRI-guided molecular analysis in patients and a mouse model of disease.

    PubMed

    Lewandowski, Nicole M; Bordelon, Yvette; Brickman, Adam M; Angulo, Sergio; Khan, Usman; Muraskin, Jordan; Griffith, Erica Y; Wasserman, Paula; Menalled, Liliana; Vonsattel, Jean Paul; Marder, Karen; Small, Scott A; Moreno, Herman

    2013-04-01

    Although the huntingtin gene is expressed in brain throughout life, phenotypically Huntington's disease (HD) begins only in midlife and affects specific brain regions. Here, to investigate regional vulnerability in the disease, we used functional magnetic resonance imaging (fMRI) to translationally link studies in patients with a mouse model of disease. Using fMRI, we mapped cerebral blood volume (CBV) in three groups: HD patients, symptom-free carriers of the huntingtin genetic mutation, and age-matched controls. In contrast to a region in the anterior caudate, in which dysfunction was linked to genotype independent of phenotype, a region in the posterior body of the caudate was differentially associated with disease phenotype. Guided by these observations, we harvested regions from the anterior and posterior body of the caudate in postmortem control and HD human brain tissue. Gene-expression profiling identified two molecules whose expression levels were most strongly correlated with regional vulnerability - protein phosphatase 1 regulatory subunit 7 (PPP1R7) and Wnt inhibitory factor-1 (WIF-1). To verify and potentially extend these findings, we turned to the YAC128 (C57BL/6J) HD transgenic mice. By fMRI we longitudinally mapped CBV in transgenic and wildtype (WT) mice, and over time, abnormally low fMRI signal emerged selectively in the dorsal striatum. A relatively unaffected brain region, primary somatosensory cortex (S1), was used as a control. Both dorsal striatum and S1 were harvested from transgenic and WT mice and molecular analysis confirmed that PPP1R7 deficiency was strongly correlated with the phenotype. Together, converging findings in human HD patients and this HD mouse model suggest a functional pattern of caudate vulnerability and that variation in expression levels of herein identified molecules correlate with this pattern of vulnerability. PMID:23220414

  20. Vulnerabilities in Older Patients when Cancer Treatment is Initiated: Does a Cognitive Impairment Impact the Two-Year Survival?

    PubMed Central

    Borghgraef, Cindy; Etienne, Anne-Marie; Merckaert, Isabelle; Paesmans, Marianne; Reynaert, Christine; Roos, Myriam; Slachmuylder, Jean-Louis; Vandenbossche, Sandrine; Bron, Dominique; Razavi, Darius

    2016-01-01

    Introduction Dementia is a known predictor of shorter survival times in older cancer patients. However, no empirical evidence is available to determine how much a cognitive impairment shortens survival in older patients when cancer treatment is initiated. Purpose To longitudinally investigate how much a cognitive impairment detected at the initiation of cancer treatment influences survival of older patients during a two-year follow-up duration and to compare the predictive value of a cognitive impairment on patients survival with the predictive value of other vulnerabilities associated with older age. Methods Three hundred and fifty-seven consecutive patients (≥65 years old) admitted for breast, prostate, or colorectal cancer surgeries were prospectively recruited. A cognitive impairment was assessed with the Montreal Cognitive Assessment (MoCA<26). Socio-demographic, disease-related, and geriatric vulnerabilities were assessed using validated tools. Univariate and subsequent multivariate Cox proportional hazards models stratified for diagnosis (breast/prostate cancer versus colorectal cancer) and disease status (metastatic versus non-metastatic) were used. Results A cognitive impairment was detected in 46% (n = 163) of patients. Survival was significantly influenced by a cognitive impairment (HR = 6.13; 95% confidence interval [CI] = 2.07–18.09; p = 0.001), a loss in instrumental autonomy (IADL ≤7) (HR = 3.06; 95% CI = 1.31–7.11; p = 0.009) and fatigue (Mob-T<5) (HR = 5.98; 95% CI = 2.47–14.44; p <0.001). Conclusions During the two years following cancer treatment initiation, older patients with a cognitive impairment were up to six times more likely to die than patients without. Older patients should be screened for cognitive impairments at cancer treatment initiation to enable interventions to reduce morbidity and mortality. Further studies should address processes underlying the relationship between cognitive impairments and an increased risk of dying

  1. Vulnerable patients going to court: a psychiatrist's guide to special measures

    PubMed Central

    Cooper, Penny; Grace, Janet

    2016-01-01

    There have been significant changes to how vulnerable people are treated in the court system, including the introduction of special measures to support people both as witness and as accused. This paper summarises the use of special measures and their application to people with mental health diagnoses or cognitive impairment. PMID:27512594

  2. Vulnerable patients going to court: a psychiatrist's guide to special measures.

    PubMed

    Cooper, Penny; Grace, Janet

    2016-08-01

    There have been significant changes to how vulnerable people are treated in the court system, including the introduction of special measures to support people both as witness and as accused. This paper summarises the use of special measures and their application to people with mental health diagnoses or cognitive impairment. PMID:27512594

  3. 42 CFR 412.106 - Special treatment: Hospitals that serve a disproportionate share of low-income patients.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ..., see the List of CFR Sections Affected, which appears in the Finding Aids section of the printed volume... 42 Public Health 2 2014-10-01 2014-10-01 false Special treatment: Hospitals that serve a... INPATIENT HOSPITAL SERVICES Special Treatment of Certain Facilities Under the Prospective Payment System...

  4. 42 CFR 412.106 - Special treatment: Hospitals that serve a disproportionate share of low-income patients.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... affecting § 412.106, see the List of CFR Sections Affected, which appears in the Finding Aids section of the... 42 Public Health 2 2013-10-01 2013-10-01 false Special treatment: Hospitals that serve a... INPATIENT HOSPITAL SERVICES Special Treatment of Certain Facilities Under the Prospective Payment System...

  5. 42 CFR 412.106 - Special treatment: Hospitals that serve a disproportionate share of low-income patients.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... citations affecting § 412.106, see the List of CFR Sections Affected, which appears in the Finding Aids... 42 Public Health 2 2012-10-01 2012-10-01 false Special treatment: Hospitals that serve a... INPATIENT HOSPITAL SERVICES Special Treatment of Certain Facilities Under the Prospective Payment System...

  6. 42 CFR 412.106 - Special treatment: Hospitals that serve a disproportionate share of low-income patients.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... citations affecting § 412.106, see the List of CFR Sections Affected, which appears in the Finding Aids... 42 Public Health 2 2011-10-01 2011-10-01 false Special treatment: Hospitals that serve a... INPATIENT HOSPITAL SERVICES Special Treatment of Certain Facilities Under the Prospective Payment System...

  7. [Experience of surgical care administration to patients with closed abdominal trauma, serving on the ships of the Navy].

    PubMed

    Pleskach, V V; Mosyagin, I G

    2016-02-01

    The analysis of surgical care administration to personnel, serving on ships of the Navy of Russia and performing different tasks in off-shore maritime and ocean zones in 2012-2013 showed that there is a requirement to create seven additional ship groups of specialized medical care: on the Northern Fleet--2, on the Pacific Fleet--2, on the Baltic Fleet--1, on the Black Sea Fleet--1, on the Caspian Flotilla--1. There is also a reasonable requirement to include anaesthesiologist and nurse anaesthetist into these groups. PMID:27263212

  8. Morphological and Stress Vulnerability Indices for Human Coronary Plaques and Their Correlations with Cap Thickness and Lipid Percent: An IVUS-Based Fluid-Structure Interaction Multi-patient Study

    PubMed Central

    Wang, Liang; Zheng, Jie; Maehara, Akiko; Yang, Chun; Billiar, Kristen L.; Wu, Zheyang; Bach, Richard; Muccigrosso, David; Mintz, Gary S.; Tang, Dalin

    2015-01-01

    Plaque vulnerability, defined as the likelihood that a plaque would rupture, is difficult to quantify due to lack of in vivo plaque rupture data. Morphological and stress-based plaque vulnerability indices were introduced as alternatives to obtain quantitative vulnerability assessment. Correlations between these indices and key plaque features were investigated. In vivo intravascular ultrasound (IVUS) data were acquired from 14 patients and IVUS-based 3D fluid-structure interaction (FSI) coronary plaque models with cyclic bending were constructed to obtain plaque wall stress/strain and flow shear stress for analysis. For the 617 slices from the 14 patients, lipid percentage, min cap thickness, critical plaque wall stress (CPWS), strain (CPWSn) and flow shear stress (CFSS) were recorded, and cap index, lipid index and morphological index were assigned to each slice using methods consistent with American Heart Association (AHA) plaque classification schemes. A stress index was introduced based on CPWS. Linear Mixed-Effects (LME) models were used to analyze the correlations between the mechanical and morphological indices and key morphological factors associated with plaque rupture. Our results indicated that for all 617 slices, CPWS correlated with min cap thickness, cap index, morphological index with r = -0.6414, 0.7852, and 0.7411 respectively (p<0.0001). The correlation between CPWS and lipid percentage, lipid index were weaker (r = 0.2445, r = 0.2338, p<0.0001). Stress index correlated with cap index, lipid index, morphological index positively with r = 0.8185, 0.3067, and 0.7715, respectively, all with p<0.0001. For all 617 slices, the stress index has 66.77% agreement with morphological index. Morphological and stress indices may serve as quantitative plaque vulnerability assessment supported by their strong correlations with morphological features associated with plaque rupture. Differences between the two indices may lead to better plaque assessment schemes

  9. Cognitive Vulnerability in Patients with Generalized Anxiety Disorder, Dysthymic Disorder and Normal Individuals

    PubMed Central

    Al-Ghorabaie, Fateme Moin; Noferesti, Azam; Fadaee, Mahdi; Ganji, Nima

    2016-01-01

    Aim: The purpose of this study was to assess cognitive vulnerability and response style in clinical and normal individuals. Method: A sample of 90 individuals was selected for each of the 3 groups of Generalized Anxiety disorder, Dysthymic disorder and normal individuals. They completed MCQ and RSQ. Results: Results analyzed by MANOVA and post hoc showed significant differences among groups. Dysthymic group and GAD reported higher scores on cognitive confidence compared to the normal group. Individuals with GAD showed highly negative beliefs about need to control thought, compared to the other groups, but in cognitive self-consciousness they have no differences with the normal group. In regard to uncontrollability, danger and positive beliefs, GAD group had higher levels than the other groups. Although normal and GAD group didn’t show any significant differences in response style, there was a significant difference between Dysthymic group and other groups in all response styles. Discussion: Beliefs and meta-cognitive strategies can be distinguished between clinical and non clinical individuals. Also, findings support the Self-Regulatory Executive Function model. PMID:27045393

  10. New York's role as a center for health care: an analysis of nonresident patients served by New York City hospitals.

    PubMed

    Finkler, S; Knickman, J; Krasner, M; Szapiro, N

    1986-10-01

    Patients who reside outside of New York City have long been an important segment of the patient population at New York City hospitals. Each year, as far back as systematic data are available, approximately 10 percent of all patients at New York City hospitals have been non residents. Increasing competition and changing reimbursement policies compel hospitals in New York City to assess their role in caring for these patients and its economic implications. This report provides a comprehensive assessment of the characteristics of nonresident patients and their significance to the city's hospitals. Using data from all New York City hospitals, the report analyzes the demographics, insurance coverage, and case-mix characteristics of nonresident and resident patients. And, using more detailed data from New York University Medical Center and Columbia-Presbyterian Medical Center, it addresses the financial and reimbursement policy questions posed by the care of nonresident patients. The key findings of the report are as follows: A total of 115,307 nonresidents were hospitalized in New York City in 1982; this figure represents 10.4 percent of all patients in city hospitals. Over 80 percent of nonresident patients come from 14 counties surrounding New York City. Nonresident patients are a crucial component of the patient population at six hospitals that are the principal affiliates of a medical school and the six specialty hospitals. At academic health centers, nonresidents represent 25 percent of all inpatients; at the specialty hospitals, they represent 36 percent. Manhattan hospitals account for 69 percent of all nonresident discharges in the city. Outside of Manhattan, only Montefiore Medical Center and Long Island Jewish Medical Center have substantial numbers of nonresident patients. Among nonresident patients, 75 percent of admissions are scheduled in advance and 72 percent of hospital stays are for surgical procedures. In contrast, among resident patients, only 50

  11. A Highly Expressed Human Protein, Apolipoprotein B-100, Serves as an Autoantigen in a Subgroup of Patients With Lyme Disease.

    PubMed

    Crowley, Jameson T; Drouin, Elise E; Pianta, Annalisa; Strle, Klemen; Wang, Qi; Costello, Catherine E; Steere, Allen C

    2015-12-01

    To discover novel autoantigens associated with Lyme arthritis (LA), we identified T-cell epitopes presented in vivo by human leukocyte antigen (HLA)-DR molecules in patients' inflamed synovial tissue or joint fluid and tested each epitope for autoreactivity. Using this approach, we identified the highly expressed human protein, apolipoprotein B-100 (apoB-100), as a target of T- and B-cell responses in a subgroup of LA patients. Additionally, the joint fluid of these patients had markedly elevated levels of apoB-100 protein, which may contribute to its autoantigenicity. In patients with antibiotic-refractory LA, the magnitude of apoB-100 antibody responses correlated with increased numbers of plasma cells in synovial tissue, greater numbers and activation of endothelial cells, and more synovial fibroblast proliferation. Thus, a subset of LA patients have high levels of apoB-100 in their joints and autoreactive T- and B-cell responses to the protein, which likely contributes to pathogenic autoimmunity in patients with antibiotic-refractory LA. PMID:26014802

  12. Guidelines for Libraries Serving Hospital Patients and Disabled People in the Community. IFLA Professional Reports, No. 2.

    ERIC Educational Resources Information Center

    International Federation of Library Associations, The Hague (Netherlands).

    These guidelines are based on the experiences of a number of librarians working in the area of library services for hospital patients and disabled people in the community, as well as work done previously by a number of national library associations. The guidelines indicate the essential features of services to disabled people and suggest…

  13. The Challenge and Opportunity of Capturing Patient Reported Measures of Rheumatoid Arthritis Disease Activity in Vulnerable Populations with Limited Health Literacy and Limited English Proficiency.

    PubMed

    Hirsh, Joel M

    2016-05-01

    Limited health literacy and limited English proficiency are widely prevalent and contribute to rheumatoid arthritis (RA) health care disparities. The RA Patient Global Assessment of Disease Activity often introduces complexity to the health care encounters of patients and research subjects with limited health literacy and limited English proficiency. Important work is being done to ensure that patient-reported outcomes are validated and appropriate for diverse and vulnerable populations. PMID:27133494

  14. How practice contributes to trolley food waste. A qualitative study among staff involved in serving meals to hospital patients.

    PubMed

    Ofei, K T; Holst, M; Rasmussen, H H; Mikkelsen, B E

    2014-12-01

    This study investigated the generation of trolley food waste at the ward level in a hospital in order to provide recommendations for how practice could be changed to reduce food waste. Three separate focus group discussions were held with four nurses, four dietitians and four service assistants engaged in food service. Furthermore, single qualitative interviews were conducted with a nurse, a dietitian and two service assistants. Observations of procedures around trolley food serving were carried out during lunch and supper for a total of 10 weekdays in two different wards. All unserved food items discarded as waste were weighed after each service. Analysis of interview and observation data revealed five key themes. The findings indicate that trolley food waste generation is a practice embedded within the limitations related to the procedures of meal ordering. This includes portion size choices and delivery, communication, tools for menu information, portioning and monitoring of food waste, as well as the use of unserved food. Considering positive changes to these can be a way forward to develop strategies to reduce trolley food waste at the ward level. PMID:25108237

  15. Integrated Patient-Derived Models Delineate Individualized Therapeutic Vulnerabilities of Pancreatic Cancer.

    PubMed

    Witkiewicz, Agnieszka K; Balaji, Uthra; Eslinger, Cody; McMillan, Elizabeth; Conway, William; Posner, Bruce; Mills, Gordon B; O'Reilly, Eileen M; Knudsen, Erik S

    2016-08-16

    Pancreatic ductal adenocarcinoma (PDAC) harbors the worst prognosis of any common solid tumor, and multiple failed clinical trials indicate therapeutic recalcitrance. Here, we use exome sequencing of patient tumors and find multiple conserved genetic alterations. However, the majority of tumors exhibit no clearly defined therapeutic target. High-throughput drug screens using patient-derived cell lines found rare examples of sensitivity to monotherapy, with most models requiring combination therapy. Using PDX models, we confirmed the effectiveness and selectivity of the identified treatment responses. Out of more than 500 single and combination drug regimens tested, no single treatment was effective for the majority of PDAC tumors, and each case had unique sensitivity profiles that could not be predicted using genetic analyses. These data indicate a shortcoming of reliance on genetic analysis to predict efficacy of currently available agents against PDAC and suggest that sensitivity profiling of patient-derived models could inform personalized therapy design for PDAC. PMID:27498862

  16. 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

  17. Carbapenem-resistant Enterobacteriaceae: A menace to our most vulnerable patients

    PubMed Central

    PEREZ, FEDERICO; VAN DUIN, DAVID

    2014-01-01

    The emergence of carbapenem-resistant Enterobacteriaceae (CRE) highlights the importance of effective antibiotics to maintain the safety of our health care system. Clinicians will encounter CRE as a cause of difficult-to-treat and often fatal infections in hospitalized patients. We review the mechanisms of carbapenem resistance, the dissemination and clinical impact of these resistant organisms, and challenges to their detection, treatment, and control. PMID:23547093

  18. Relation between Anemia and Vulnerable Coronary Plaque Components in Patients with Acute Coronary Syndrome: Virtual Histology-Intravascular Ultrasound Analysis

    PubMed Central

    Hong, Young Joon; Choi, Yun Ha; Song, Jin A; Kim, Dong Han; Lee, Ki Hong; Yamanaka, Futoshi; Lee, Min Goo; Park, Keun Ho; Sim, Doo Sun; Yoon, Nam Sik; Yoon, Hyun Ju; Kim, Kye Hun; Park, Hyung Wook; Kim, Ju Han; Ahn, Youngkeun; Cho, Jeong Gwan; Park, Jong Chun; Kang, Jung Chaee

    2012-01-01

    The aim of the present study was to evaluate the plaque components and the predictors of thin-cap fibroatheroma (TCFA) in anemic patients with acute coronary syndrome using virtual histology-intravascular ultrasound (VH-IVUS). Anemia was defined according to criteria of the World Health Organization, (i.e. , hemoglobin levels < 13 g/dL in men and < 12 g/dL in women) and we compared VH-IVUS findings between anemia group (171 patients, 260 lesions) and non-anemia group (569 patients, 881 lesions). Anemia group had greater % necrotic core (NC) volume (21% ± 9% vs 19% ± 9%, P = 0.001) compared with non-anemia group. Hemoglobin level correlated negatively with absolute NC volume (r = -0.235, P < 0.001) and %NC volume (r = -0.209, P < 0.001). Independent predictors of TCFA by multivariate analysis were diabetes mellitus (odds ratio [OR], 2.213; 95% confidence interval [CI], 1.403-3.612, P = 0.006), high-sensitivity C-reactive protein (OR, 1.143; 95% CI, 1.058-1.304, P = 0.012), microalbuminuria (albumin levels of 30 to 300 mg/g of creatinine) (OR, 2.124; 95% CI, 1.041-3.214, P = 0.018), and anemia (OR: 2.112; 95% CI 1.022-3.208, P = 0.028). VH-IVUS analysis demonstrates that anemia at the time of clinical presentation is associated with vulnerable plaque component in patients with acute coronary syndrome. PMID:22468099

  19. Vulnerability of white matter to insult during childhood: evidence from patients treated for medulloblastoma.

    PubMed

    Moxon-Emre, Iska; Bouffet, Eric; Taylor, Michael D; Laperriere, Normand; Sharpe, Michael B; Laughlin, Suzanne; Bartels, Ute; Scantlebury, Nadia; Law, Nicole; Malkin, David; Skocic, Jovanka; Richard, Logan; Mabbott, Donald J

    2016-07-01

    OBJECTIVE Craniospinal irradiation damages the white matter in children treated for medulloblastoma, but the treatment-intensity effects are unclear. In a cross-sectional retrospective study, the effects of treatment with the least intensive radiation protocol versus protocols that delivered more radiation to the brain, in addition to the effects of continuous radiation dose, on white matter architecture were evaluated. METHODS Diffusion tensor imaging was used to assess fractional anisotropy, mean diffusivity, radial diffusivity, and axial diffusivity. First, regional white matter analyses and tract-based spatial statistics were conducted in 34 medulloblastoma patients and 38 healthy controls. Patients were stratified according to those treated with 1) the least intensive radiation protocol, specifically reduced-dose craniospinal irradiation plus a boost to the tumor bed only (n = 17), or 2) any other dose and boost combination that delivered more radiation to the brain, which was also termed the "all-other-treatments" group (n = 17), and comprised patients treated with standard-dose craniospinal irradiation plus a posterior fossa boost, standard-dose craniospinal irradiation plus a tumor bed boost, or reduced-dose craniospinal irradiation plus a posterior fossa boost. Second, voxel-wise dose-distribution analyses were conducted on a separate cohort of medulloblastoma patients (n = 15). RESULTS The all-other-treatments group, but not the reduced-dose craniospinal irradiation plus tumor bed group, had lower fractional anisotropy and higher radial diffusivity than controls in all brain regions (all p < 0.05). The reduced-dose craniospinal irradiation plus tumor bed boost group had higher fractional anisotropy (p = 0.05) and lower radial diffusivity (p = 0.04) in the temporal region, and higher fractional anisotropy in the frontal region (p = 0.04), than the all-other-treatments group. Linear mixed-effects modeling revealed that the dose and age at diagnosis together

  20. Vulnerable Plaque

    MedlinePlus

    ... all vulnerable plaque ruptures, and researchers at the Texas Heart Institute are looking at ways to determine ... comments. Terms of Use and Privacy Policy © Copyright Texas Heart Institute All rights reserved.

  1. Executive (Dys)Functioning and Impulsivity as Possible Vulnerability Factors for Aggression in Forensic Patients.

    PubMed

    Tonnaer, Franca; Cima, Maaike; Arntz, Arnoud

    2016-04-01

    This study investigated whether executive dysfunction and impulsivity are both predictors of reactive aggression and is the first to use behavioral assessment of aggression in response to provocation by means of a personalized boxing body opponent bag giving harassing feedback. Aggressive behavior, self-reported aggression, executive functioning (ie, working memory, flexibility, and divided attention), and impulsivity dimensions (i.e., Sensation Seeking, Impulsive Decision Making, and [inadequate] Response Inhibition) were measured in 44 incarcerated psychiatric patients. Results show that both executive functioning (working memory) and impulsivity (Impulsive Decision Making) predicted self-reported reactive aggression, whereas Response Inhibition was the only predictor for reactive aggressive behavioral responses. The study suggests that Response Inhibition is a stronger predictor of reactive aggressive behavior than executive capacities of working memory, flexibility, and divided attention. Therefore, future research should investigate whether (inadequate) Response Inhibition could also be a valuable predictor for violent recidivism. PMID:26894312

  2. Effects of Self-Management Support on Structure, Process, and Outcomes Among Vulnerable Patients With Diabetes

    PubMed Central

    Schillinger, Dean; Handley, Margaret; Wang, Frances; Hammer, Hali

    2009-01-01

    OBJECTIVE Despite the importance of self-management support (SMS), few studies have compared SMS interventions, involved diverse populations, or entailed implementation in safety net settings. We examined the effects of two SMS strategies across outcomes corresponding to the Chronic Care Model. RESEARCH DESIGN AND METHODS A total of 339 outpatients with poorly controlled diabetes from county-run clinics were enrolled in a three-arm trial. Participants, more than half of whom spoke limited English, were uninsured, and/or had less than a high school education, were randomly assigned to usual care, interactive weekly automated telephone self-management support with nurse follow-up (ATSM), or monthly group medical visits with physician and health educator facilitation (GMV). We measured 1-year changes in structure (Patient Assessment of Chronic Illness Care [PACIC]), communication processes (Interpersonal Processes of Care [IPC]), and outcomes (behavioral, functional, and metabolic). RESULTS Compared with the usual care group, the ATSM and GMV groups showed improvements in PACIC, with effect sizes of 0.48 and 0.50, respectively (P < 0.01). Only the ATSM group showed improvements in IPC (effect sizes 0.40 vs. usual care and 0.25 vs. GMV, P < 0.05). Both SMS arms showed improvements in self-management behavior versus the usual care arm (P < 0.05), with gains being greater for the ATSM group than for the GMV group (effect size 0.27, P = 0.02). The ATSM group had fewer bed days per month than the usual care group (−1.7 days, P = 0.05) and the GMV group (−2.3 days, P < 0.01) and less interference with daily activities than the usual care group (odds ratio 0.37, P = 0.02). We observed no differences in A1C change. CONCLUSIONS Patient-centered SMS improves certain aspects of diabetes care and positively influences self-management behavior. ATSM seems to be a more effective communication vehicle than GMV in improving behavior and quality of life. PMID:19131469

  3. Fleshing out vulnerability.

    PubMed

    Tavaglione, Nicolas; Martin, Angela K; Mezger, Nathalie; Durieux-Paillard, Sophie; François, Anne; Jackson, Yves; Hurst, Samia A

    2015-02-01

    In the literature on medical ethics, it is generally admitted that vulnerable persons or groups deserve special attention, care or protection. One can define vulnerable persons as those having a greater likelihood of being wronged - that is, of being denied adequate satisfaction of certain legitimate claims. The conjunction of these two points entails what we call the Special Protection Thesis. It asserts that persons with a greater likelihood of being denied adequate satisfaction of their legitimate claims deserve special attention, care or protection. Such a thesis remains vague, however, as long as we do not know what legitimate claims are. This article aims at dispelling this vagueness by exploring what claims we have in relation to health care - thus fleshing out a claim-based conception of vulnerability. We argue that the Special Protection Thesis must be enriched as follows: If individual or group X has a greater likelihood of being denied adequate satisfaction of some of their legitimate claims to (i) physical integrity, (ii) autonomy, (iii) freedom, (iv) social provision, (v) impartial quality of government, (vi) social bases of self-respect or (vii) communal belonging, then X deserves special attention, care or protection. With this improved understanding of vulnerability, vulnerability talk in healthcare ethics can escape vagueness and serve as an adequate basis for practice. PMID:24602115

  4. MiR-486 and miR-92a Identified in Circulating HDL Discriminate between Stable and Vulnerable Coronary Artery Disease Patients

    PubMed Central

    Sanda, Gabriela M.; Carnuta, Mihaela G.; Stancu, Camelia S.; Popescu, Andreea C.; Popescu, Mihaela R.; Vlad, Adelina; Dimulescu, Doina R.; Simionescu, Maya; Sima, Anca V.

    2015-01-01

    Small non-coding microRNAs (miRNAs) are implicated in gene regulation, including those involved in coronary artery disease (CAD). Our aim was to identify whether specific serum miRNAs present in the circulating lipoproteins (Lp) are associated with stable or vulnerable CAD patients. A cardiovascular disease-focused screening array was used to assess miRNAs distribution in sera collected from 95 CAD patients: 30 with stable angina (SA), 39 with unstable angina (UA), 26 at one month after myocardial infarction (MI) and 16 healthy control subjects. We found that miR-486, miR-92a and miR-122 presented the highest expression in CAD sera. These miRNA together with miR-125a, miR-146a and miR-33a were further individually analyzed by TaqMan assays. The results were consistent with PCR-array screening data that all of these miRNAs were significantly increased in CAD patients compared to controls. Using a binary logistic regression model, we established that miR-486 and miR-92a in association with some high-density lipoprotein (HDL) components can designate vulnerable CAD patients. Further, all classes of Lp were isolated from sera by density gradient ultracentrifugation. Analysis of the selected miRNAs in each Lp class showed that they were associated mainly with HDL, miR-486 and miR-92a having the highest levels. In UA and MI patients, miR-486 prevailed in HDL2, while miR-92a prevailed in HDL3, and their levels discriminate between stable and vulnerable CAD patients. We identified two circulating miRNAs that in association with some lipid metabolism biomarkers can be used as an additional tool to designate vulnerable CAD patients. PMID:26485305

  5. Plasma levels of tumor necrosis factor-α in adolescent idiopathic scoliosis patients serve as a predictor for the incidence of early postoperative cognitive dysfunction following orthopedic surgery

    PubMed Central

    ZHENG, XU; MA, ZHENGLIANG; GU, XIAOPING

    2015-01-01

    The aim of the present study was to evaluate whether the levels of the plasma biomarkers, cortisol, interleukin (IL)-1β, IL-6, IL-10 and tumor necrosis factor (TNF)-α, change in adolescent idiopathic scoliosis patients with postoperative cognitive dysfunction (POCD); thus, may serve as predictive factors for POCD. In total, 75 adolescent scoliosis patients, aged between 11 and 18 years and categorized as American Society of Anesthesiologists classification I or II, were scheduled for orthopedic surgery with general anesthesia. Blood samples were collected on the day of admission and at day 2 following surgery. The plasma levels of IL-1β, IL-6, IL-10 and TNF-α were measured using an enzyme-linked immunosorbent assay, while the concentrations of cortisol were determined using a radioimmunoassay. Cognitive function was assessed one day prior to and at day 7 following the surgery in a quiet room with the guidance of a Chinese version protocol. In total, 66 patients completed the sample collection and neurocognitive tests. According to the criteria for the diagnosis of POCD, 19 patients (28.8%) developed POCD within seven days of surgery. No statistically significant differences were observed in the baseline concentrations of cortisol, TNF-α, IL-1β, IL-10 or IL-6 between the POCD and non-POCD groups. However, the baseline plasma level of TNF-α on day 2 in the POCD group was found to be higher compared with the non-POCD group. In addition, at day 2 after surgery, the concentration of cortisol in the non-POCD group was higher compared with the POCD group. Therefore, the plasma level of TNF-α in adolescent idiopathic scoliosis patients at day 2 following orthopedic surgery may be a predictor for the incidence of early POCD. PMID:25780449

  6. Serving Vulnerable Families: The Important Work of Head Start Programs

    ERIC Educational Resources Information Center

    Vinci, Yasmina

    2012-01-01

    The Obama Administration's most recent regulation on designation renewal of Early/Head Start grantees opens opportunities for early childhood programs in some communities to compete with existing grantees for the federal funding. Understanding some of the behind-the-scenes work that goes into Head Start may be helpful to centers deciding whether…

  7. Comparing the effect of a decision aid plus patient navigation with usual care on colorectal cancer screening completion in vulnerable populations: study protocol for a randomized controlled trial

    PubMed Central

    2014-01-01

    Background Screening can reduce colorectal cancer (CRC) incidence and mortality. However, screening is underutilized in vulnerable patient populations, particularly among Latinos. Patient-directed decision aids can increase CRC screening knowledge, self-efficacy, and intent; however, their effect on actual screening test completion tends to be modest. This is probably because decision aids do not address some of the patient-specific barriers that prevent successful completion of CRC screening in these populations. These individual barriers might be addressed though patient navigation interventions. This study will test a combined decision aid and patient navigator intervention on screening completion in diverse populations of vulnerable primary care patients. Methods/Design We will conduct a multisite, randomized controlled trial with patient-level randomization. Planned enrollment is 300 patients aged 50 to 75 years at average CRC risk presenting for appointments at two primary clinics in North Carolina and New Mexico. Intervention participants will view a video decision aid immediately before the clinic visit. The 14 to 16 minute video presents information about fecal occult blood tests and colonoscopy and will be viewed on a portable computer tablet in English or Spanish. Clinic-based patient navigators are bilingual and bicultural and will provide both face-to-face and telephone-based navigation. Control participants will view an unrelated food safety video and receive usual care. The primary outcome is completion of a CRC screening test at six months. Planned subgroup analyses include examining intervention effectiveness in Latinos, who will be oversampled. Secondarily, the trial will evaluate the intervention effects on knowledge of CRC screening, self-efficacy, intent, and patient-provider communication. The study will also examine whether patient ethnicity, acculturation, language preference, or health insurance status moderate the intervention effect on

  8. Assessment of Atrial Fibrillation and Vulnerability in Patients with Wolff-Parkinson-White Syndrome Using Two-Dimensional Speckle Tracking Echocardiography

    PubMed Central

    Li, Jing-Jie; Wei, Fang; Chen, Ju-Gang; Yu, Yan-Wei; Gu, Hong-Yue; Jiang, Rui; Wu, Xiu-Li; Sun, Qian

    2014-01-01

    Purpose The aim was to assess atrial fibrillation (AF) and vulnerability in Wolff-Parkinson-White (WPW) syndrome patients using two-dimensional speckle tracking echocardiography (2D-STE). Methods All patients were examined via transthoracic echocardiography and 2D-STE in order to assess atrial function 7 days before and 10 days after RF catheter ablation. A postoperative 3-month follow-up was performed via outpatient visit or telephone calls. Results Results showed significant differences in both body mass index (BMI) and supraventricular tachycardia (SVT) duration between WPW patients and DAVNP patients (both P<0.05). Echocardiography revealed that the maximum left atrial volume (LAVmax) and the left ventricular mass index (LVMI) in diastole increased noticeably in patients with WPW compared to patients with DAVNP both before and after ablation (all P<0.05). Before ablation, there were obvious differences in the levels of SRs, SRe, and SRa from the 4-chamber view (LA) in the WPW patients group compared with patients in the DAVNP group (all P<0.05). In the AF group, there were significant differences in the levels of systolic strain rate (SRs), early diastolic strain rate (SRe), and late diastolic strain rate (SRa) from the 4-chamber view (LA) both before and after ablation (all P<0.05). In the non-AF group, there were decreased SRe levels from the 4-chamber view (LA/RA) pre-ablation compared to post-ablation (all P<0.05). Conclusion Our findings provide convincing evidence that WPW syndrome may result in increased atrial vulnerability and contribute to the development of AF. Further, RF catheter ablation of AAV pathway can potentially improve atrial function in WPW syndrome patients. Two-dimensional speckle tracking echocardiography imaging in WPW patients would be necessary in the evaluation and improvement of the overall function of RF catheter ablation in a long-term follow-up period. PMID:25397668

  9. A Helpful Serving

    ERIC Educational Resources Information Center

    Rockower, David

    2006-01-01

    This article briefly describes how a fifth-grade class collaborated with a downtown diner for several months and then actually ran the restaurant for four hours. Through the Chatters Cafe, a local high school cafe that serves as a culinary arts training ground for high school students, fifth graders had the opportunity to prepare and serve dinner…

  10. Implementing the ten steps to successful breastfeeding in multiple hospitals serving low-wealth patients in the US: innovative research design and baseline findings

    PubMed Central

    2013-01-01

    Background The Ten Steps to Successful Breastfeeding are maternity practices proven to support successful achievement of exclusive breastfeeding. They also are the basis for the WHO/UNICEF Baby-Friendly Hospital Initiative (BFHI). This study explores implementation of these steps in hospitals that serve predominantly low wealth populations. Methods A quasi-experimental design with mixed methods for data collection and analysis was included within an intervention project. We compared the impact of a modified Ten Steps implementation approach to a control group. The intervention was carried out in hospitals where: 1) BFHI designation was not necessarily under consideration, and 2) the majority of the patient population was low wealth, i.e., eligible for Medicaid. Hospitals in the research aspect of this project were systematically assigned to one of two groups: Initial Intervention or Initial Control/Later Intervention. This paper includes analyses from the baseline data collection, which consisted of an eSurvey (i.e., Carolina B-KAP), Maternity Practices in Infant Nutrition and Care survey tool (mPINC), the BFHI Self-Appraisal, key informant interviews, breastfeeding data, and formatted feedback discussion. Results Comparability was ensured by statistical and non-parametric tests of baseline characteristics of the two groups. Additional findings of interest included: 1) a universal lack of consistent breastfeeding records and statistics for regular monitoring/review, 2) widespread misinterpretation of associated terminology, 3) health care providers’ reported practices not necessarily reflective of their knowledge and attitudes, and 4) specific steps were found to be associated with hospital breastfeeding rates. A comprehensive set of facilitators and obstacles to initiation of the Ten Steps emerged, and hospital-specific practice change challenges were identified. Discussion This is one of the first studies to examine introduction of the Ten Steps in multiple

  11. Legal physician-assisted suicide in Oregon and The Netherlands: evidence concerning the impact on patients in vulnerable groups--another perspective on Oregon's data.

    PubMed

    Finlay, I G; George, R

    2011-03-01

    Battin et al examined data on deaths from physician-assisted suicide (PAS) in Oregon and on PAS and voluntary euthanasia (VE) in The Netherlands. This paper reviews the methodology used in their examination and questions the conclusions drawn from it-namely, that there is for the most part 'no evidence of heightened risk' to vulnerable people from the legalisation of PAS or VE. This critique focuses on the evidence about PAS in Oregon. It suggests that vulnerability to PAS cannot be categorised simply by reference to race, gender or other socioeconomic status and that the impetus to seek PAS derives from factors, including emotional state, reactions to loss, personality type and situation and possibly to PAS contagion, all factors that apply across the social spectrum. It also argues, on the basis of official reports from the Oregon Health Department on the working of the Oregon Death with Dignity Act since 2008, that, contrary to the conclusions drawn by Battin et al, the highest resort to PAS in Oregon is among the elderly and, on the basis of research published since Battin et al reported, that there is reason to believe that some terminally ill patients in Oregon are taking their own lives with lethal drugs supplied by doctors despite having had depression at the time when they were assessed and cleared for PAS. PMID:21071568

  12. Primary Care Provider Perceptions of the Effectiveness of Two Self-Management Support Programs for Vulnerable Patients with Diabetes

    PubMed Central

    Ratanawongsa, Neda; Bhandari, Vijay K; Handley, Margaret; Rundall, Thomas; Hammer, Hali; Schillinger, Dean

    2012-01-01

    Background Primary care providers (PCPs) in safety net settings face barriers to optimizing care for patients with diabetes. We conducted this study to assess PCPs' perspectives on the effectiveness of two language-concordant diabetes self-management support programs. Methods One year postintervention, we surveyed PCPs whose patients with diabetes participated in a three-arm multiclinic randomized controlled trial comparing usual care (UC), weekly automated telephone self-management (ATSM) support with nurse care management, and monthly group medical visits (GMVs). We compared PCP perspectives on patient activation to create and achieve goals, quality of care, and barriers to care using regression models accounting for within-PCP clustering. Results Of 113 eligible PCPs caring for 330 enrolled patients, 87 PCPs (77%) responded to surveys about 245 (74%) enrolled patients. Intervention patients were more likely to be perceived by PCPs as activated to create and achieve goals for chronic care when compared with UC patients (standardized effect size, ATSM vs UC, +0.41, p = 0.01; GMV vs UC, +0.31, p = 0.05). Primary care providers rated quality of care as higher for patients exposed to ATSM compared to UC (odds ratio 3.6, p < 0.01). Compared with GMV patients, ATSM patients were more likely to be perceived by PCPs as overcoming barriers related to limited English proficiency (82% ATSM vs 44% GMV, p = 0.01) and managing medications (80% ATSM vs 53% GMV, p = 0.01). Conclusions Primary care providers perceived that patients receiving ATSM support had overcome barriers, participated more actively, and received higher quality diabetes care. These views of clinician stakeholders lend additional evidence for the potential to upscale ATSM more broadly to support PCPs in their care of diverse, multilinguistic populations. PMID:22401329

  13. National Vulnerability Database (NVD)

    National Institute of Standards and Technology Data Gateway

    National Vulnerability Database (NVD) (Web, free access)   NVD is a comprehensive cyber security vulnerability database that integrates all publicly available U.S. Government vulnerability resources and provides references to industry resources. It is based on and synchronized with the CVE vulnerability naming standard.

  14. [Aging and becoming vulnerable].

    PubMed

    Monod, Stéfanie; Sautebin, Annelore

    2009-11-18

    "The vulnerable are those whose autonomy, dignity and integrity are capable of being threatened". Based on this ethical definition of vulnerability, four risk factors of vulnerability might be identified among elderly persons, and are described in this article: the functional limitation, the loss of autonomy, the social precariousness and the restriction of access to medical care. A clinical case of elderly abuse is presented to illustrate vulnerability. Finally, some recommendations to lower the risk of vulnerability in elderly persons are proposed. PMID:20052868

  15. HIV-AIDS Patients' Evaluation of Health Information on the Internet: The Digital Divide and Vulnerability to Fraudulent Claims

    ERIC Educational Resources Information Center

    Benotsch, Eric G.; Kalichman, Seth; Weinhardt, Lance S.

    2004-01-01

    Access to health information on the Internet has revolutionized how medical patients learn about their illnesses. Valuable information can be found online; however, many health Web sites contain inaccurate or misleading information. The authors surveyed 324 adults with HIV concerning their Internet use for obtaining health information. Health…

  16. Vulnerability and Trustworthiness.

    PubMed

    Barnard, David

    2016-04-01

    Although recent literature on professionalism in healthcare abounds in recommended character traits, attitudes, or behaviors, with a few exceptions, the recommendations are untethered to any serious consideration of the contours and ethical demands of the healing relationship. This article offers an approach based on the professional's commitment to trustworthiness in response to the vulnerability of those seeking professional help. Because our willingness and ability to trust health professionals or healthcare institutions are affected by our personality, culture, race, age, prior experiences with illness and healthcare, and socioeconomic and political circumstances-"the social determinants of trust"-the attitudes and behaviors that actually do gain trust are patient and context specific. Therefore, in addition to the commitment to cultivating attitudes and behaviors that embody trustworthiness, professionalism also includes the commitment to actually gaining a patient's or family's trust by learning, through individualized dialogue, which conditions would win their justified trust, given their particular history and social situation. PMID:26957454

  17. Selected Cytokines Serve as Potential Biomarkers for Predicting Liver Inflammation and Fibrosis in Chronic Hepatitis B Patients With Normal to Mildly Elevated Aminotransferases.

    PubMed

    Deng, Yong-Qiong; Zhao, Hong; Ma, An-Lin; Zhou, Ji-Yuan; Xie, Shi-Bin; Zhang, Xu-Qing; Zhang, Da-Zhi; Xie, Qing; Zhang, Guo; Shang, Jia; Cheng, Jun; Zhao, Wei-Feng; Zou, Zhi-Qiang; Zhang, Ming-Xiang; Wang, Gui-Qiang

    2015-11-01

    Previous studies of small cohorts have implicated several circulating cytokines with progression of chronic hepatitis B (CHB). However, to date there have been no reliable biomarkers for assessing histological liver damage in CHB patients with normal or mildly elevated alanine aminotransferase (ALT). The aim of the present study was to investigate the association between circulating cytokines and histological liver damage in a large cohort. Also, this study was designed to assess the utility of circulating cytokines in diagnosing liver inflammation and fibrosis in CHB patients with ALT less than 2 times the upper limit of normal range (ULN). A total of 227 CHB patients were prospectively enrolled. All patients underwent liver biopsy and staging by Ishak system. Patients with at least moderate inflammation showed significantly higher levels of CXCL-11, CXCL-10, and interleukin (IL)-2 receptor (R) than patients with less than moderate inflammation (P < 0.001). Patients with significant fibrosis had higher levels of IL-8 (P = 0.027), transforming growth factor alpha (TGF-α) (P = 0.011), IL-2R (P = 0.002), and CXCL-11 (P = 0.032) than the group without significant fibrosis. In addition, 31.8% and 29.1% of 151 patients with ALT < 2 × ULN had at least moderate inflammation and significant fibrosis, respectively. Multivariate analysis demonstrated that CXCL-11 was independently associated with at least moderate inflammation, and TGF-α and IL-2R independently correlated with significant fibrosis in patients with ALT < 2 × ULN. Based on certain cytokines and clinical parameters, an inflammation-index and fib-index were developed, which showed areas under the receiver operating characteristics curve (AUROC) of 0.75 (95% CI 0.66-0.84) for at least moderate inflammation and 0.82 (95% CI 0.75-0.90) for significant fibrosis, correspondingly. Compared to existing scores, fib-index was significantly superior to aspartate aminotransferase

  18. Genetic Variations of PIP4K2A Confer Vulnerability to Poor Antipsychotic Response in Severely Ill Schizophrenia Patients

    PubMed Central

    Kaur, Harpreet; Jajodia, Ajay; Grover, Sandeep; Baghel, Ruchi; Gupta, Meenal; Jain, Sanjeev; Kukreti, Ritushree

    2014-01-01

    Literature suggests that disease severity and neurotransmitter signaling pathway genes can accurately identify antipsychotic response in schizophrenia patients. However, putative role of signaling molecules has not been tested in schizophrenia patients based on severity of illness, despite its biological plausibility. In the present study we investigated the possible association of polymorphisms from five candidate genes RGS4, SLC6A3, PIP4K2A, BDNF, PI4KA with response to antipsychotic in variably ill schizophrenia patients. Thus in present study, a total 53 SNPs on the basis of previous reports and functional grounds were examined for their association with antipsychotic response in 423 schizophrenia patients segregated into low and high severity groups. Additionally, haplotype, diplotype, multivariate logistic regression and multifactor-dimensionality reduction (MDR) analyses were performed. Furthermore, observed associations were investigated in atypical monotherapy (n = 355) and risperidone (n = 260) treated subgroups. All associations were estimated as odds ratio (OR) and 95% confidence interval (CI) and test for multiple corrections was applied. Single locus analysis showed significant association of nine variants from SLC6A3, PIP4K2A and BDNF genes with incomplete antipsychotic response in schizophrenia patients with high severity. We identified significant association of six marker diplotype ATTGCT/ATTGCT (rs746203-rs10828317-rs7094131-rs2296624-rs11013052-rs1409396) of PIP4K2A gene in incomplete responders (corrected p-value = 0.001; adjusted-OR = 3.19, 95%-CI = 1.46–6.98) with high severity. These associations were further observed in atypical monotherapy and risperidone sub-groups. MDR approach identified gene-gene interaction among BDNF_rs7103411-BDNF_rs1491851-SLC6A3_rs40184 in severely ill incomplete responders (OR = 7.91, 95%-CI = 4.08–15.36). While RGS4_rs2842026-SLC6A3_rs2975226 interacted synergistically in

  19. Depression and anxiety in patients with and without same-sex attraction: differences in clinical expression, lifestyle factors, and vulnerability indicators

    PubMed Central

    Bos, Henny M W; Boschloo, Lynn; Schoevers, Robert A; Sandfort, Theo G M

    2015-01-01

    Background The aim of this study was to compare clinical expressions (severity and loneliness), lifestyle factors (substance use), and vulnerability indicators (stressful childhood experiences) in patients with any same-sex attraction versus heterosexual patients diagnosed with depression and/or anxiety disorder. Little is known about this, even though it is now well documented that depression and anxiety are more prevalent among persons with same-sex attraction. Method Data, derived from the Netherlands Study of Depression and Anxiety (NESDA), allowed us to compare patients with a same-sex (n = 122) and an exclusively opposite-sex (n = 1658) attraction. Persons with same-sex attraction included persons who were attracted to both sexes. Data were collected by means of the Composite International Diagnostic Interview and paper-and pencil questionnaires. Results Seven percent of the patients reported any same-sex orientation. Clinical expression of depression and anxiety did not differ in relation to sexual attraction. Regarding substance use, same-sex attracted women reported more drug use than heterosexual women (drug use: 16.2% vs. 6.6%, P = 0.003). Regarding stressful childhood experiences, men with any same-sex attraction reported more sexual abuse during childhood than men with a heterosexual orientation (20.4% vs. 8.5%, P = 0.005). Conclusions For women with same-sex attraction substance use (especially illicit drug use) might be a coping mechanism to deal with existing symptoms or with the minority stressors they have to deal with; for same-sex attracted men stressful childhood experiences might reflect an aspect of etiology. PMID:26445702

  20. Software Vulnerability Taxonomy Consolidation

    SciTech Connect

    Polepeddi, S

    2004-12-08

    In today's environment, computers and networks are increasing exposed to a number of software vulnerabilities. Information about these vulnerabilities is collected and disseminated via various large publicly available databases such as BugTraq, OSVDB and ICAT. Each of these databases, individually, do not cover all aspects of a vulnerability and lack a standard format among them, making it difficult for end-users to easily compare various vulnerabilities. A central database of vulnerabilities has not been available until today for a number of reasons, such as the non-uniform methods by which current vulnerability database providers receive information, disagreement over which features of a particular vulnerability are important and how best to present them, and the non-utility of the information presented in many databases. The goal of this software vulnerability taxonomy consolidation project is to address the need for a universally accepted vulnerability taxonomy that classifies vulnerabilities in an unambiguous manner. A consolidated vulnerability database (CVDB) was implemented that coalesces and organizes vulnerability data from disparate data sources. Based on the work done in this paper, there is strong evidence that a consolidated taxonomy encompassing and organizing all relevant data can be achieved. However, three primary obstacles remain: lack of referencing a common ''primary key'', un-structured and free-form descriptions of necessary vulnerability data, and lack of data on all aspects of a vulnerability. This work has only considered data that can be unambiguously extracted from various data sources by straightforward parsers. It is felt that even with the use of more advanced, information mining tools, which can wade through the sea of unstructured vulnerability data, this current integration methodology would still provide repeatable, unambiguous, and exhaustive results. Though the goal of coalescing all available data, which would be of use to

  1. Usefulness of High-Sensitive Troponin Elevation After Effort Stress to Unveil Vulnerable Myocardium in Patients With Heart Failure.

    PubMed

    Pastormerlo, Luigi Emilio; Agazio, Assunta; Benelli, Eleonora; Gabutti, Alessandra; Poletti, Roberta; Prontera, Concetta; Clerico, Aldo; Emdin, Michele; Passino, Claudio

    2015-08-15

    Elevation of resting high-sensitivity troponin (hs-Tn) holds prognostic value in heart failure (HF), but its pathophysiological meaning is unclear. We aimed to investigate hs-Tn elevation after maximal exercise in patients with systolic HF and its neurohormonal and hemodynamic correlates: 30 patients diagnosed with systolic HF (left ventricular ejection fraction 32 ± 8%, mean ± SD), on guideline-directed medical therapy and not recognized inducible ischemia, underwent maximal cardiopulmonary stress test, with assay of plasma N-terminal proB-type natriuretic peptide (NT-proBNP), norepinephrine (NE), and hs-TnT (hs-TnT) at baseline, peak, and 1 and 4 hours after exercise. Cardiac output (CO) was measured during effort, with a rebreathing technique. The natural logarithm of the ratio between percentage (%) increase in CO and NT-proBNP (ln[CO%/NT-proBNP% increase]) was evaluated, as a noninvasive estimate of Frank-Starling adaptation to effort, with NT-proBNP variation considered as a surrogate of end-diastolic left ventricular pressure variation. Hs-TnT increased during exercise with a 4-hour peak (p = 0.001); 10 patients had hs-TnT increase >20%. Patients with Hs-TnT increase >20% were more symptomatic at rest (p = 0.039) and showed greater NE at peak exercise (p = 0.003) and less ln[CO%/NT-proBNP% increase] (p = 0.034). A lower ln[CO%/NT-proBNP% increase] correlated with greater NE at peak exercise (r = -0.430, p = 0.018). In conclusion, acute troponin elevation after maximal exercise was detected in 1/3 of this series. The association of troponin release with NE, CO, and NT-proBNP changes after effort suggests a pathophysiological link among transient hemodynamic overload, adrenergic activation, and myocardial cell damage, likely identifying a clinical subset at greater risk for HF progression. PMID:26089013

  2. Meeting the needs of vulnerable patients: The need for team working across general practice and community nursing services

    PubMed Central

    While, Alison E

    2014-01-01

    General practitioners and district nurses have a long history of providing care outside the hospital setting. With health care increasingly moving out of the hospital setting, there are more opportunities for general practitioners and district nurses to work together to meet the health needs of the local population. However, the reduction in qualified specialist practitioner district nurses over the last decade is concerning. The need for an effective district nursing service has been recognised by the Department of Health in their own model – the nature of district nursing work, often over a long period, enables relationships to develop with the patient, family and informal carers as a basis for anticipatory care to manage long-term conditions. Communication and understanding of the role are central to enhance effective working between general practitioners and district nurses, which can be fostered by engagement in community-oriented integrated care and case management. PMID:25949736

  3. What Does Vulnerability Mean?

    ERIC Educational Resources Information Center

    Parley, Fiona F

    2011-01-01

    Protection of those deemed vulnerable has received increasing attention since 2000. This article reports on care staff views of vulnerability using original data from a research study (Parley. "Vulnerability and abuse: an exploration of views of care staff working with people who have learning disabilities," PhD Thesis, 2007) in which care staff…

  4. Optimization of psychopharmacotherapy for schizophrenia in a male, locked, non-acute unit serving for persistently ill patients over one year.

    PubMed

    Suzuki, Takefumi; Uchida, Hiroyuki; Takeuchi, Hiroyoshi; Tsunoda, Kenichi; Ishizuki, Tomomi; Mimura, Masaru

    2015-07-30

    We describe real-world psychopharmacological treatment in a Japanese, male, closed psychiatric unit where clozapie was still unavailable. Fifty-five persistently-ill patients with schizophrenia (ICD-10), mean ± S.D. age: 57.5 ± 13.0 y.o., duration of illness and admissions: 30.9 ± 15.2 years and 20.7 ± 14.5 years, respectively) treated longitudinally were evaluated. The rule was to treat with a simplest possible psychotropic regimen without polypharmacy. Compared to the baseline, the number and dose of antipsychotics were reduced from 1.9 to 1.1 and 1012 mg/day to 607 mg/day, respectively. The number of total psychotropics was minimized from 4.7 to 2.1, with a simplified once or twice daily dosing. Overall, the CGI-Severity and FACT-Sz (global functioning) improved slightly from 5.8 to 5.5 and 28.7 to 32.6, respectively. Of note, no patients got worse in comparison with the baseline clinical presentation. Forty-four patients were successfully treated with a single antipsychotic; only seven needed two antipsychotics simultaneously while 36 had been treated with antipsychotic polypharmacy at baseline. Benzodiazepines (mostly lorazepam) and antiparkinsonian drugs were prescribed in 28 and only two, respectively. Nineteen needed adjunctive valproate (average blood levels: 99.3 ± 21.8 μg/mL) and nine used lithium (0.61 ± 0.26 mEq/L). Optimization of psychopharmacotherapy is still possible for difficult-to-treat patients and, while augmentation of an antipsychotic with mood stabilizers is frequently needed, antipsychotic polypharmacy should be exceptional. PMID:25935376

  5. Variation in resistance traits, phylogenetic backgrounds, and virulence genotypes among Escherichia coli clinical isolates from adjacent hospital campuses serving distinct patient populations.

    PubMed

    Drawz, Sarah M; Porter, Stephen; Kuskowski, Michael A; Johnston, Brian; Clabots, Connie; Kline, Susan; Ferrieri, Patricia; Johnson, James R

    2015-09-01

    Escherichia coli sequence type 13 (ST131), an emergent cause of multidrug-resistant extraintestinal infections, has important phylogenetic subsets, notably the H30 and H30Rx subclones, with distinctive resistance profiles and, possibly, clinical associations. To clarify the local prevalence of these ST131 subclones and their associations with antimicrobial resistance, ecological source, and virulence traits, we extensively characterized 233 consecutive E. coli clinical isolates (July and August 2013) from the University of Minnesota Medical Center-Fairview Infectious Diseases and Diagnostic Laboratory, Minneapolis, MN, which serves three adjacent facilities (a children's hospital and low- and high-acuity adult facilities). ST131 accounted for 26% of the study isolates (more than any other clonal group), was distributed similarly by facility, and was closely associated with ciprofloxacin resistance and extended-spectrum β-lactamase (ESBL) production. The H30 and H30Rx subclones accounted for most ST131 isolates and for the association of ST131 with fluoroquinolone resistance and ESBL production. Unlike ST131 per se, these subclones were distributed differentially by hospital, being most prevalent at the high-acuity adult facility and were absent from the children's hospital. The virulence gene profiles of ST131 and its subclones were distinctive and more extensive than those of other fluoroquinolone-resistant or ESBL-producing isolates. Within ST131, bla CTX-M-15 was confined to H30Rx isolates and other bla CTX-M variants to non-Rx H30 isolates. Pulsed-field gel electrophoresis documented a predominance of globally distributed pulsotypes and no local outbreak pattern. These findings help clarify the epidemiology, ecology, and bacterial correlates of the H30 and H30Rx ST131 subclones by documenting a high overall prevalence but significant segregation by facility, strong associations with fluoroquinolone resistance and specific ESBL variants, and distinctive

  6. Variation in Resistance Traits, Phylogenetic Backgrounds, and Virulence Genotypes among Escherichia coli Clinical Isolates from Adjacent Hospital Campuses Serving Distinct Patient Populations

    PubMed Central

    Porter, Stephen; Kuskowski, Michael A.; Johnston, Brian; Clabots, Connie; Kline, Susan; Ferrieri, Patricia; Johnson, James R.

    2015-01-01

    Escherichia coli sequence type 13 (ST131), an emergent cause of multidrug-resistant extraintestinal infections, has important phylogenetic subsets, notably the H30 and H30Rx subclones, with distinctive resistance profiles and, possibly, clinical associations. To clarify the local prevalence of these ST131 subclones and their associations with antimicrobial resistance, ecological source, and virulence traits, we extensively characterized 233 consecutive E. coli clinical isolates (July and August 2013) from the University of Minnesota Medical Center-Fairview Infectious Diseases and Diagnostic Laboratory, Minneapolis, MN, which serves three adjacent facilities (a children's hospital and low- and high-acuity adult facilities). ST131 accounted for 26% of the study isolates (more than any other clonal group), was distributed similarly by facility, and was closely associated with ciprofloxacin resistance and extended-spectrum β-lactamase (ESBL) production. The H30 and H30Rx subclones accounted for most ST131 isolates and for the association of ST131 with fluoroquinolone resistance and ESBL production. Unlike ST131 per se, these subclones were distributed differentially by hospital, being most prevalent at the high-acuity adult facility and were absent from the children's hospital. The virulence gene profiles of ST131 and its subclones were distinctive and more extensive than those of other fluoroquinolone-resistant or ESBL-producing isolates. Within ST131, blaCTX-M-15 was confined to H30Rx isolates and other blaCTX-M variants to non-Rx H30 isolates. Pulsed-field gel electrophoresis documented a predominance of globally distributed pulsotypes and no local outbreak pattern. These findings help clarify the epidemiology, ecology, and bacterial correlates of the H30 and H30Rx ST131 subclones by documenting a high overall prevalence but significant segregation by facility, strong associations with fluoroquinolone resistance and specific ESBL variants, and distinctive virulence

  7. Mitochondrial Vulnerability and Increased Susceptibility to Nutrient-Induced Cytotoxicity in Fibroblasts from Leigh Syndrome French Canadian Patients

    PubMed Central

    Burelle, Yan; Thompson Legault, Julie; Boucher, Gabrielle; Morin, Charles; Coderre, Lise; Des Rosiers, Christine

    2015-01-01

    nature of the diets, particularly excess fat intake, as well as on the use of antioxidants in patients with LSFC and, possibly, other COX defects. PMID:25835550

  8. Pre-Exposure Prophylaxis (PrEP) for Safer Conception Among Serodifferent Couples: Findings from Healthcare Providers Serving Patients with HIV in Seven US Cities.

    PubMed

    Finocchario-Kessler, Sarah; Champassak, Sofie; Hoyt, Mary Jo; Short, William; Chakraborty, Rana; Weber, Shannon; Levison, Judy; Phillips, Joanne; Storm, Deborah; Anderson, Jean

    2016-03-01

    Pre-exposure prophylaxis (PrEP) can reduce the risk of HIV transmission among serodifferent couples trying to conceive, yet provider knowledge, attitudes, and experience utilizing PrEP for this purpose are largely unexamined. Trained interviewers conducted phone interviews with healthcare providers treating patients with HIV in seven cities (Atlanta, Baltimore, Houston, Kansas City, Newark, Philadelphia, and San Francisco, N = 85 total). Quantitative and qualitative data were analyzed to describe experience, concerns, and perceived barriers to prescribing PrEP for safer conception. Providers (67.1% female, 43 mean years of age, 70.4% white, 10 mean years treating HIV+ patients, 56% in academic vs. community facilities, 62.2% MD) discussed both benefits and concerns of PrEP for safer conception among serodifferent couples. Only 18.8% of providers reported experience prescribing PrEP, 74.2% were willing to prescribe it under ideal circumstances, and 7.0% were not comfortable prescribing PrEP. Benefits included added protection and a greater sense of control for the HIV-negative partner. Concerns were categorized as clinical, system-level, cost, or behavioral. Significant differences in provider characteristics existed across sites, but experience with PrEP for safer conception did not, p = 0.14. Despite limited experience, most providers were open to recommending PrEP for safer conception as long as patients understood the range of concerns and could make informed decisions. Strategies to identify and link serodifferent couples to PrEP services and clinical guidance specific to PrEP for safer conception are needed. PMID:26824425

  9. Rationale and design of the SERVE-HF study: treatment of sleep-disordered breathing with predominant central sleep apnoea with adaptive servo-ventilation in patients with chronic heart failure

    PubMed Central

    Cowie, Martin R.; Woehrle, Holger; Wegscheider, Karl; Angermann, Christiane; d'Ortho, Marie-Pia; Erdmann, Erland; Levy, Patrick; Simonds, Anita; Somers, Virend K.; Zannad, Faiez; Teschler, Helmut

    2013-01-01

    Aims Central sleep apnoea/Cheyne–Stokes respiration (CSA/CSR) is a risk factor for increased mortality and morbidity in heart failure (HF). Adaptive servo-ventilation (ASV) is a non-invasive ventilation modality for the treatment of CSA/CSR in patients with HF. Methods SERVE-HF is a multinational, multicentre, randomized, parallel trial designed to assess the effects of addition of ASV (PaceWave™, AutoSet CS™; ResMed) to optimal medical management compared with medical management alone (control group) in patients with symptomatic chronic HF, LVEF ≤45%, and predominant CSA. The trial is based on an event-driven group sequential design, and the final analysis will be performed when 651 events have been observed or the study is terminated at one of the two interim analyses. The aim is to randomize ∼1200 patients to be followed for a minimum of 2 years. Patients are to stay in the trial up to study termination. The first patient was randomized in February 2008 and the study is expected to end mid 2015. The primary combined endpoint is the time to first event of all-cause death, unplanned hospitalization (or unplanned prolongation of a planned hospitalization) for worsening (chronic) HF, cardiac transplantation, resuscitation of sudden cardiac arrest, or appropriate life-saving shock for ventricular fibrillation or fast ventricular tachycardia in implantable cardioverter defibrillator patients. Perspectives The SERVE-HF study is a randomized study that will provide important data on the effect of treatment with ASV on morbidity and mortality, as well as the cost-effectiveness of this therapy, in patients with chronic HF and predominantly CSA/CSR. Trial registration ISRCTN19572887 PMID:23535165

  10. Building Capacity for Trauma Intervention across Child-Serving Systems

    ERIC Educational Resources Information Center

    Chinitz, Susan; Stettler, Erin M.; Giammanco, Denise; Silverman, Marian; Briggs, Rahil D.; Loeb, Joanne

    2010-01-01

    Infants most vulnerable to trauma are often the least able to access interventions. Universal child-serving systems, such as primary pediatrics, early care and education, and the child welfare system, can offer a port of entry for millions of children annually for trauma-related supports and services. However, practitioners in these systems have…

  11. Tailoring Care to Vulnerable Populations by Incorporating Social Determinants of Health: the Veterans Health Administration’s “Homeless Patient Aligned Care Team” Program

    PubMed Central

    Johnson, Erin E.; Aiello, Riccardo; Kane, Vincent; Pape, Lisa

    2016-01-01

    Introduction Although the clinical consequences of homelessness are well described, less is known about the role for health care systems in improving clinical and social outcomes for the homeless. We described the national implementation of a “homeless medical home” initiative in the Veterans Health Administration (VHA) and correlated patient health outcomes with characteristics of high-performing sites. Methods We conducted an observational study of 33 VHA facilities with homeless medical homes and patient- aligned care teams that served more than 14,000 patients. We correlated site-specific health care performance data for the 3,543 homeless veterans enrolled in the program from October 2013 through March 2014, including those receiving ambulatory or acute health care services during the 6 months prior to enrollment in our study and 6 months post-enrollment with corresponding survey data on the Homeless Patient Aligned Care Team (H-PACT) program implementation. We defined high performance as high rates of ambulatory care and reduced use of acute care services. Results More than 96% of VHA patients enrolled in these programs were concurrently receiving VHA homeless services. Of the 33 sites studied, 82% provided hygiene care (on-site showers, hygiene kits, and laundry), 76% provided transportation, and 55% had an on-site clothes pantry; 42% had a food pantry and provided on-site meals or other food assistance. Six-month patterns of acute-care use pre-enrollment and post-enrollment for 3,543 consecutively enrolled patients showed a 19.0% reduction in emergency department use and a 34.7% reduction in hospitalizations. Three features were significantly associated with high performance: 1) higher staffing ratios than other sites, 1) integration of social supports and social services into clinical care, and 3) outreach to and integration with community agencies. Conclusion Integrating social determinants of health into clinical care can be effective for high

  12. May serum levels of advanced oxidized protein products serve as a prognostic marker of disease duration in patients with idiopathic Parkinson's disease?

    PubMed

    García-Moreno, José-Manuel; Martín de Pablos, Angel; García-Sánchez, María-Isabel; Méndez-Lucena, Carolina; Damas-Hermoso, Fátima; Rus, Macarena; Chacón, José; Fernández, Emilio

    2013-04-10

    Protein and amine halogenation is a type of oxidative stress induced by phagocytic overstimulation, and its role in Parkinson's disease (PD) has not been discerned. We have detected that advanced oxidized protein products, markers of protein halogenation, are reliably enhanced in serum of patients with PD (n=60) relative to control subjects (n=45, p<0.012), and to a lesser extent in the cerebrospinal fluid. Amine halogenation, as evaluated through 3-chlorotyrosine, is not affected. Mieloperoxidase and hydrogen peroxide levels, halogenative factors of phagocytes, are devoid of changes. Levels of advanced oxidized protein products are progressively reduced over time, and the duration of PD is larger in the Hoehn-Yahr-stage-2/3 patients (n=34) with low serum levels (R(2)=0.0145, p<0.003). Levodopa treatment contributes to this reduction (R(2)=0.259, p<0.001). These protein products are not cytotoxic, unlike 3-chlorotyrosine, but they are known to form inflammatory mediators after conjugation with serum albumin. Our observations lead to the hypothesis that the serum level of advanced oxidized protein products is a prognostic marker of PD duration, and these oxidized proteins could participate in the development of parkinsonian neurodegeneration. PMID:23121480

  13. Serving Bowl Selection Biases the Amount of Food Served

    ERIC Educational Resources Information Center

    van Kleef, Ellen; Shimizu, Mitsuru; Wansink, Brian

    2012-01-01

    Objective: To determine how common serving bowls containing food for multiple persons influence serving behavior and consumption and whether they do so independently of satiation and food evaluation. Methods: In this between-subjects experiment, 68 participants were randomly assigned to either a group serving pasta from a large-sized bowl (6.9-L…

  14. How Strong Is the Primary Care Safety Net? Assessing the Ability of Federally Qualified Health Centers to Serve as Patient-Centered Medical Homes.

    PubMed

    Ryan, Jamie; Riley, Pamela; Abrams, Melinda; Nocon, Robert

    2015-09-01

    By expanding access to affordable insurance coverage for millions of Americans, the Affordable Care Act will likely increase demand for the services provided by federally qualified health centers (FQHCs), which provide an important source of care in low-income communities. A pair of Commonwealth Fund surveys asked health center leaders about their ability to function as medical homes. Survey findings show that between 2009 and 2013, the percentage of centers exhibiting medium or high levels of medical home capability almost doubled, from 32 percent to 62 percent. The greatest improvement was reported in patient tracking and care management. Despite this increased capability, health centers reported diminished ability to coordinate care with providers outside of the practice, particularly specialists. Ongoing federal funding and technical support for medical home transformation will be needed to ensure that FQHCs can fulfill their mission of providing high-quality, comprehensive care to low-income and minority populations. PMID:26372972

  15. Chromodomain-helicase-DNA binding protein 5, 7 and pronecrotic mixed lineage kinase domain-like protein serve as potential prognostic biomarkers in patients with resected pancreatic adenocarcinomas

    PubMed Central

    Seldon, Crystal S; Colbert, Lauren E; Hall, William A; Fisher, Sarah B; Yu, David S; Landry, Jerome C

    2016-01-01

    Pancreatic cancer is one of the deadliest cancers with a very poor prognosis. Recently, there has been a significant increase in research directed towards identifying potential biomarkers that can be used to diagnose and provide prognostic information for pancreatic cancer. These markers can be used clinically to optimize and personalize therapy for individual patients. In this review, we focused on 3 biomarkers involved in the DNA damage response pathway and the necroptosis pathway: Chromodomain-helicase-DNA binding protein 5, chromodomain-helicase-DNA binding protein 7, and mixed lineage kinase domain-like protein. The aim of this article is to review present literature provided for these biomarkers and current studies in which their effectiveness as prognostic biomarkers are analyzed in order to determine their future use as biomarkers in clinical medicine. Based on the data presented, these biomarkers warrant further investigation, and should be validated in future studies. PMID:27096031

  16. Safeguarding vulnerable adults.

    PubMed

    Griffith, Richard

    Nurses have a professional duty to safeguard vulnerable adults from abuse under the provisions of the Nursing and Midwifery Council's (NMC) revised Code (2015). With adult abuse continuing to increase, all members of the nursing team are well placed to identify and take action to safeguard the vulnerable. This article sets out how the Care Act 2014 seeks to improve the safeguarding of vulnerable adults and the role of nurses in that process. PMID:26153813

  17. Lessons about vulnerability assessments.

    SciTech Connect

    Johnston, R. G.

    2004-01-01

    The Vulnerability Assessment Team (VAT) at Los Alamos National Laboratory believes that physical security can only be optimized through the use of effective vulnerability assessments. As a result of conducting vulnerability assessments on hundreds of different security devices and systems in the last few years, we have identified some of the attributes of effective assessments. These, along with our recommendations and observations about vulnerability assessments, are summarized in this paper. While our work has primarily involved physical security (in contrast to, for example, computer, network, or information security), our experiences may have applicability to other types of security as well.

  18. Emerging Hispanic-Serving Institutions (HSIs): Serving Latino Students

    ERIC Educational Resources Information Center

    Santiago, Deborah A.; Andrade, Sally J.

    2010-01-01

    In this fifth brief in "Excelencia" in Education's series on Hispanic-Serving Institutions (HSIs) the focus is on the methods and strategies that are producing successful results in a growing sector of colleges and universities we call, "Emerging" Hispanic-Serving Institutions. These Emerging HSIs are institutions that currently do not meet the…

  19. SERVE-HF: More Questions Than Answers.

    PubMed

    Javaheri, Shahrokh; Brown, Lee K; Randerath, Winfried; Khayat, Rami

    2016-04-01

    The recent online publication of the SERVE-HF trial that evaluated the effect of treating central sleep apnea (CSA) with an adaptive servoventilation (ASV) device in patients with heart failure and reduced ejection fraction (HFrEF) has raised serious concerns about the safety of ASV in these patients. Not only was ASV ineffective but post hoc analysis found excess cardiovascular mortality in treated patients. The authors cited as one explanation an unfounded notion that CSA is a compensatory mechanism with a protective effect in HFrEF patients. We believe that there are several possible considerations that are more likely to explain the results of SERVE-HF. In this commentary, we consider methodological issues including the use of a previous-generation ASV device that constrained therapeutic settings to choices that are no longer in wide clinical use. Patient selection, data collection, and treatment adherence as well as group crossovers were not discussed in the trial as potential confounding factors. We have developed alternative reasons that could potentially explain the results and that can be explored by post hoc analysis of the SERVE-HF data. We believe that our analysis is of critical value to the field and of particular importance to clinicians treating these patients. PMID:26836904

  20. S100A9 and ORM1 serve as predictors of therapeutic response and prognostic factors in advanced extranodal NK/T cell lymphoma patients treated with pegaspargase/gemcitabine

    PubMed Central

    Zhou, Zhiyuan; Li, Zhaoming; Sun, Zhenchang; Zhang, Xudong; Lu, Lisha; Wang, Yingjun; Zhang, Mingzhi

    2016-01-01

    Pegaspargase combined with gemcitabine have greatly improved the outcomes of advanced extranodal NK/T cell lymphoma (ENKL). However, patients frequently undergo recurrent disease due to chemoresistance, and few predictive parameters are available. The present study explored potential biomarkers to predict the therapeutic response of advanced ENKL treated with pegaspargase/gemcitabine and evaluate the prognostic significance. Through serum proteomic analysis, we identified 61 upregulated and 22 downregulated proteins in nonresponders compared with responders. We further validated that patients with unfavourable treatment outcomes displayed higher levels of S100A9 and ORM1 via enzyme-linked immunosorbent assay (ELISA). Moreover, the sensitivity and specificity for detecting refractory patients were 81.5% and 71.4% for S100A9 > 62.0 ng/ml, 85.2% and 77.1% for ORM1 > 1436 ug/ml, 100% and 57.1% for S100A9 combined with ORM1. Furthermore, in multivariate analysis elevated levels of S100A9 were associated with poor 2-year OS (40.2% vs. 76.6%, RR = 2.92, p = 0.005) and 2-year PFS (33.1% vs. 61.1%, RR = 2.61 p = 0.011). High ORM1 also predicted inferior 2-year OS (38.7% vs.76.1, RR = 2.46, p = 0.023) and 2-year PFS (18.4% vs. 73.2%, RR = 2.86, p = 0.009). Our results indicated that S100A9 and ORM1 could serve as reliable predictors of therapeutic response and independent prognostic factors of survival in advanced ENKL patients treated with pegaspargase/gemcitabine. PMID:27021626

  1. Could Local Dynamic Stability Serve as an Early Predictor of Falls in Patients with Moderate Neurological Gait Disorders? A Reliability and Comparison Study in Healthy Individuals and in Patients with Paresis of the Lower Extremities

    PubMed Central

    Reynard, Fabienne; Vuadens, Philippe; Deriaz, Olivier; Terrier, Philippe

    2014-01-01

    Falls while walking are frequent in patients with muscular dysfunction resulting from neurological disorders. Falls induce injuries that may lead to deconditioning and disabilities, which further increase the risk of falling. Therefore, an early gait stability index would be useful to evaluate patients in order to prevent the occurrence of future falls. Derived from chaos theory, local dynamic stability (LDS), defined by the maximal Lyapunov exponent, assesses the sensitivity of a dynamic system to small perturbations. LDS has already been used for fall risk prediction in elderly people. The aim of the present study was to provide information to facilitate future researches regarding gait stability in patients with neurological gait disorders. The main objectives were 1) to evaluate the intra-session repeatability of LDS in patients and 2) to assess the discriminative power of LDS to differentiate between healthy individuals and neurological patients. Eighty-three patients with mild to moderate neurological disorders associated with paresis of the lower extremities and 40 healthy controls participated in the study. The participants performed 2×30 s walking wearing a 3D accelerometer attached to the lower back, from which 2×35 steps were extracted. LDS was defined as the average exponential rate of divergence among trajectories in a reconstructed state-space that reflected the gait dynamics. LDS assessed along the medio-lateral axis offered the highest repeatability and discriminative power. Intra-session repeatability (intraclass correlation coefficient between the two repetitions) in the patients was 0.89 and the smallest detectable difference was 16%. LDS was substantially lower in the patients than in the controls (33% relative difference, standardized effect size 2.3). LDS measured in short over-ground walking tests seems sufficiently reliable. LDS exhibits good discriminative power to differentiate fall-prone individuals and opens up the possibility of

  2. Facility Environmental Vulnerability Assessment

    SciTech Connect

    Van Hoesen, S.D.

    2001-07-09

    From mid-April through the end of June 2001, a Facility Environmental Vulnerability Assessment (FEVA) was performed at Oak Ridge National Laboratory (ORNL). The primary goal of this FEVA was to establish an environmental vulnerability baseline at ORNL that could be used to support the Laboratory planning process and place environmental vulnerabilities in perspective. The information developed during the FEVA was intended to provide the basis for management to initiate immediate, near-term, and long-term actions to respond to the identified vulnerabilities. It was expected that further evaluation of the vulnerabilities identified during the FEVA could be carried out to support a more quantitative characterization of the sources, evaluation of contaminant pathways, and definition of risks. The FEVA was modeled after the Battelle-supported response to the problems identified at the High Flux Beam Reactor at Brookhaven National Laboratory. This FEVA report satisfies Corrective Action 3A1 contained in the Corrective Action Plan in Response to Independent Review of the High Flux Isotope Reactor Tritium Leak at the Oak Ridge National Laboratory, submitted to the Department of Energy (DOE) ORNL Site Office Manager on April 16, 2001. This assessment successfully achieved its primary goal as defined by Laboratory management. The assessment team was able to develop information about sources and pathway analyses although the following factors impacted the team's ability to provide additional quantitative information: the complexity and scope of the facilities, infrastructure, and programs; the significantly degraded physical condition of the facilities and infrastructure; the large number of known environmental vulnerabilities; the scope of legacy contamination issues [not currently addressed in the Environmental Management (EM) Program]; the lack of facility process and environmental pathway analysis performed by the accountable line management or facility owner; and poor

  3. Energy vulnerability relationships

    SciTech Connect

    Shaw, B.R.; Boesen, J.L.

    1998-02-01

    The US consumption of crude oil resources has been a steadily growing indicator of the vitality and strength of the US economy. At the same time import diversity has also been a rapidly developing dimension of the import picture. In the early 1970`s, embargoes of crude oil from Organization of Producing and Exporting Countries (OPEC) created economic and political havoc due to a significant lack of diversity and a unique set of economic, political and domestic regulatory circumstances. The continued rise of imports has again led to concerns over the security of our crude oil resource but threats to this system must be considered in light of the diversity and current setting of imported oil. This report develops several important issues concerning vulnerability to the disruption of oil imports: (1) The Middle East is not the major supplier of oil to the United States, (2) The US is not vulnerable to having its entire import stream disrupted, (3) Even in stable countries, there exist vulnerabilities to disruption of the export stream of oil, (4) Vulnerability reduction requires a focus on international solutions, and (5) DOE program and policy development must reflect the requirements of the diverse supply. Does this increasing proportion of imported oil create a {open_quotes}dependence{close_quotes}? Does this increasing proportion of imported oil present a vulnerability to {open_quotes}price shocks{close_quotes} and the tremendous dislocations experienced during the 1970`s? Finally, what is the vulnerability of supply disruptions from the current sources of imported oil? If oil is considered to be a finite, rapidly depleting resource, then the answers to these questions must be {open_quotes}yes.{close_quotes} However, if the supply of oil is expanding, and not limited, then dependence is relative to regional supply sources.

  4. Meals Served in Public Schools.

    ERIC Educational Resources Information Center

    Vivigal, Lisa

    The Physicians Committee for Responsible Medicine (PCRM) contacted public school districts around the United States to determine if they offered low-fat, healthful meals. The PCRM ranked the schools according to whether they served low-fat and vegetarian meals daily, whether these meals varied through the week, and whether children needed to…

  5. Offer Versus Serve. Training Manual.

    ERIC Educational Resources Information Center

    New York State Education Dept., Albany. Bureau of Health and Drug Education and Services.

    A growing awareness about food supplies, food shortages, and conservation of natural resources has resulted in public concern over food waste within the National School Lunch Program. Prior to 1976, all participating students were required to take all five items offered on a planned menu. In October 1975, the Offer v. Serve Provision was enacted…

  6. Plutonium Vulnerability Management Plan

    SciTech Connect

    1995-03-01

    This Plutonium Vulnerability Management Plan describes the Department of Energy`s response to the vulnerabilities identified in the Plutonium Working Group Report which are a result of the cessation of nuclear weapons production. The responses contained in this document are only part of an overall, coordinated approach designed to enable the Department to accelerate conversion of all nuclear materials, including plutonium, to forms suitable for safe, interim storage. The overall actions being taken are discussed in detail in the Department`s Implementation Plan in response to the Defense Nuclear Facilities Safety Board (DNFSB) Recommendation 94-1. This is included as Attachment B.

  7. Vulnerability of dynamic systems

    NASA Technical Reports Server (NTRS)

    Siljak, D. D.

    1976-01-01

    Directed graphs are associated with dynamic systems in order to determine in any given system if each state can be reached by at least one input (input reachability), or can each state reach at least one output (output reachability). Then, the structural perturbations of a dynamic system are identified as lines or points removals from the corresponding digraph, and a system is considered vulnerable at those lines or points of the digraph whose removal destroys its input or output reachability. A suitable framework is formulated for resolving the problems of reachability and vulnerability which applies to both linear and nonlinear systems alike.

  8. Vulnerabilities in snakebites in Sao Paulo, Brazil

    PubMed Central

    Bertolozzi, Maria Rita; Scatena, Camila Morato da Conceição; França, Francisco Oscar de Siqueira

    2015-01-01

    ABSTRACT OBJECTIVE To describe elements of vulnerability of victims of snakebite. METHODS This qualitative, descriptive, cross-sectional study had, as theoretical framework, the concept of vulnerability in individual, social, and programmatic dimensions. We interviewed 21 patients admitted into a hospital specialized in the care of accidents caused by venomous animals. The interviews were analyzed according to a discourse analysis technique. RESULTS Patients were mainly young men, living in remote countryside areas, where health services frequently have limited resources. We found social and individual conditions of vulnerability, such as precarious schooling, low professional qualification, housing without access to piped water, no sewage treated, and no regular garbage collection, and lack of knowledge on this health problem. Regarding the programmatic dimension, we found limited accessibility to the health services that could affect the prognosis and the frequency of sequelae and deaths. CONCLUSIONS Considering such vulnerabilities evoke the need to improve the program for control the Accidents by Venomous Animals and the training of health workers, we highlight the potential use of the concept of vulnerability, which may amplify the understanding and the recommendations for the practice and education related to snakebites. PMID:26603351

  9. Biological Vulnerability to Alcoholism.

    ERIC Educational Resources Information Center

    Schuckit, Marc A.

    1987-01-01

    Reviews the role of biological factors in the risk for alcoholism. Notes the importance of the definition of primary alcoholism and highlights data indicating that this disorder is genetically influenced. In studies of men at high risk for the future development of alcoholism, vulnerability shows up in reactions to ethanol brain wave amplitude and…

  10. Delinquent Recidivists: Vulnerable Children.

    ERIC Educational Resources Information Center

    Moore, Roslyn; And Others

    1984-01-01

    This study examines the relationship between vulnerability factors and recidivism of juvenile offenders. Four factors are identified which distinguish recedivists from nonrecidivists in a sample of 96 first offenders matched by age and sex. Results are discussed from an epidemiological and early intervention perspective. (Author/BS)

  11. Vulnerability to Climate Change in Rural Nicaragua

    NASA Astrophysics Data System (ADS)

    Byrne, T. R.; Townshend, I.; Byrne, J. M.; McDaniel, S. A.

    2013-12-01

    While there is a growing recognition of the impact that climate change may have on human development, there has been a shift in focus from an impacts-led assessment approach towards a vulnerability-led assessment approach. This research operationalizes the IPCC's definition of vulnerability in a sub-national assessment to understand how different factors that shape vulnerability to climate change vary spatially across rural Nicaragua. The research utilizes the Food and Agriculture Organization of the United Nations' (FAO UN) CropWat model to evaluate how the annual yield of two of Nicaragua's staple crops may change under projected changes in temperature and precipitation. This analysis of agricultural sensitivity under exposure to climate change is then overlain with an indicator-based assessment of adaptive capacity in rural Nicaraguan farming households. Adaptive capacity was evaluated using household survey data from the 2001 National Household Survey on Living Standards Measurement, which was provided to us by the FAO UN. The result is a map representing current vulnerability to future climate change, and can serve as a basis for targeting policy interventions in rural Nicaragua.

  12. Understanding the Safeguarding Vulnerable Groups Act 2006.

    PubMed

    Griffith, Richard; Tengnah, Cassam

    2009-07-01

    The Safeguarding Vulnerable Groups Act 2006 was enacted as a result of the Government adopting the recommendations of the Bichard Inquiry (2004), that looked into the circumstances surrounding the death of two children in Soham in 2002. The 2006 Act provides a new vetting and barring scheme to replace the existing arrangements for safeguarding children and vulnerable adults from harm, or the risk of harm, by employees and volunteers whose work gives them significant access to these vulnerable groups. The Act extends statutory vetting and barring schemes to the health service as well as the social care sector. It is therefore important that district nurses are aware of the provisions of the Act and the timetable for implementation. This will enable them to better understand their legal duties, in order to protect themselves from liability and to protect their patients from abuse. PMID:19597384

  13. Delinquent recidivists: Vulnerable children.

    PubMed

    Moore, R; Pauker, J D; Moore, T E

    1984-10-01

    This study examines the relationship between vulnerability factors and recidivism by testing the hypothesis that first offenders who repeat delinquencies display more high-risk factors than those who do not repeat delinquencies. Four factors are identified which distinguish recidivists from nonrecidivists in a sample of first offenders matched by age and sex. Results are discussed from an epidemiological and early-intervention perspective. PMID:24306838

  14. Neuroimaging of the Vulnerable Plaque

    PubMed Central

    Lovblad, Karl-Olof; Mendes-Pereira, Vitor; Garibotto, Valentina; Assal, Frédéric; Willi, Jean-Pierre; Stztajzel, Roman; Ratib, Osman; Vargas, Maria Isabel

    2015-01-01

    Plaque vulnerability due to inflammation has been shown to be a participating factor in the degenerative process in the arterial wall that contributes to stenosis and embolism. This is believed to have an important role to play also in the genesis of stroke or cerebrovascular diseases. In order to appropriately screen patients for treatment, there is an absolute need to directly or indirectly visualize both the normal carotid and the suspected plaque. This can be done with a variety of techniques ranging from ultrasound to computed tomography (CT) and magnetic resonance imaging (MRI). In addition to angiographic techniques, direct imaging of the plaque can be done either by ultrasound or by the so-called molecular imaging techniques, i.e. positron emission tomography (PET). These findings, together with other clinical and paraclinical parameters should finally guide the therapeutic choice. PMID:24188487

  15. The Role of Microvolt T-Wave Alternans to Assess Arrhythmia Vulnerability Among Patients with Heart Failure and Systolic Dysfunction: Primary Results from the TWA SCD-HeFT Substudy

    PubMed Central

    Gold, Michael R; Ip, John H; Costantini, Otto; Poole, Jeanne E; McNulty, Steven; Mark, Daniel B; Lee, Kerry L; Bardy, Gust H

    2009-01-01

    Background Sudden cardiac death remains a leading cause of mortality despite advances in medical treatment for the prevention of ischemic heart disease and heart failure. Recent studies showed a benefit of ICD implantation, but appropriate shocks for ventricular tachyarrhythmias were only noted in a minority of patients during 4-5 years of follow-up. Accordingly, better risk stratification is needed to optimize patient selection. In this regard microvolt T-wave alternans (TWA) has emerged as a potentially useful measure of arrhythmia vulnerability, but it has not been evaluated previously in a prospective randomized trial of ICD therapy. Methods and Results This investigation was a prospective substudy of the SCD-HeFT trial including 490 patients at 37 clinical sites. TWA tests were classified by blinded readers as + (37%), - (22%), or indeterminate (41%) by standard criteria. The composite primary endpoint was the first occurrence of any of the following events: sudden cardiac death, sustained ventricular tachycardia/fibrillation or appropriate ICD discharge. During a median follow-up of 30 months, there were no significant differences in event rates between TWA + or − patients (Hazard ratio 1.24, p=0.56, [CI 0.60, 2.59]), or TWA − and non − (+ and indeterminate) subjects (Hazard ratio 1.28, p=0.46, CI [0.65, 2.53]). Similar results were obtained including or excluding patients randomized to amiodarone in the analyses. Conclusions TWA testing did not predict arrhythmic events or mortality in SCD-HeFT, although a small reduction of events (20-25%) among TWA − patients cannot be excluded given the sample size of this study. Accordingly, these results suggest that TWA is not useful to help make clinical decisions regarding ICD therapy among patients with heart failure and left ventricular systolic dysfunction. PMID:18955671

  16. Reduction of Behavioral Psychological Symptoms of Dementia by Multimodal Comprehensive Care for Vulnerable Geriatric Patients in an Acute Care Hospital: A Case Series

    PubMed Central

    Honda, Miwako; Ito, Mio; Ishikawa, Shogo; Takebayashi, Yoichi; Tierney, Lawrence

    2016-01-01

    Management of Behavioral and Psychological Symptoms of Dementia (BPSD) is a key challenge in geriatric dementia care. A multimodal comprehensive care methodology, Humanitude, with eye contact, verbal communication, and touch as its elements, was provided to three geriatric dementia patients for whom conventional nursing care failed in an acute care hospital. Each episode was evaluated by video analysis. All patients had advanced dementia with BPSD. Failure of care was identified by patient's shouting, screaming, or abrupt movements of limbs. In this case series, conventional care failed for all three patients. Each element of care communication was much shorter than in Humanitude care, which was accepted by the patients. The average of the elements performed during the care was eye contact 0.6%, verbal communication 15.7%, and touch 0.1% in conventional care and 12.5%, 54.8%, and 44.5% in Humanitude care, respectively. The duration of aggressive behavior of each patient during care was 25.0%, 25.4%, and 66.3% in conventional care and 0%, 0%, and 0.3% in Humanitude, respectively. In our case series, conventional care was provided by less eye contact, verbal communication, and touch. The multimodal comprehensive care approach, Humanitude, decreased BPSD and showed success by patients' acceptance of care. PMID:27069478

  17. A Systematic Review of Patients' Experiences in Communicating with Primary Care Physicians: Intercultural Encounters and a Balance between Vulnerability and Integrity.

    PubMed

    Rocque, Rhea; Leanza, Yvan

    2015-01-01

    Communication difficulties persist between patients and physicians. In order to improve care, patients' experiences of this communication must be understood. The main objective of this study is to synthesize qualitative studies exploring patients' experiences in communicating with a primary care physician. A secondary objective is to explore specific factors pertaining to ethnic minority or majority patients and their influence on patients' experiences of communication. Pertinent health and social sciences electronic databases were searched systematically (PubMed, Cinahl, PsychNet, and IBSS). Fifty-seven articles were included in the review on the basis of being qualitative studies targeting patients' experiences of communication with a primary care physician. The meta-ethnography method for qualitative studies was used to interpret data and the COREQ checklist was used to evaluate the quality of included studies. Three concepts emerged from analyses: negative experiences, positive experiences, and outcomes of communication. Negative experiences related to being treated with disrespect, experiencing pressure due to time constraints, and feeling helpless due to the dominance of biomedical culture in the medical encounter. Positive experiences are attributed to certain relational skills, technical skills, as well as certain approaches to care privileged by the physician. Outcomes of communication depend on patients' evaluation of the consultation. Four categories of specific factors exerted mainly a negative influence on consultations for ethnic minorities: language barriers, discrimination, differing values, and acculturation. Ethnic majorities also raised specific factors influencing their experience: differing values and discrimination. Findings of this review are limited by the fact that more than half of the studies did not explore cultural aspects relating to this experience. Future research should address these aspects in more detail. In conclusion, all

  18. An Integrated Approach for Urban Earthquake Vulnerability Analyses

    NASA Astrophysics Data System (ADS)

    Düzgün, H. S.; Yücemen, M. S.; Kalaycioglu, H. S.

    2009-04-01

    -economical, structural, coastal, ground condition, organizational vulnerabilities, as well as accessibility to critical services within the framework. The proposed framework has the following eight components: Seismic hazard analysis, soil response analysis, tsunami inundation analysis, structural vulnerability analysis, socio-economic vulnerability analysis, accessibility to critical services, GIS-based integrated vulnerability assessment, and visualization of vulnerabilities in 3D virtual city model The integrated model for various vulnerabilities obtained for the urban area is developed in GIS environment by using individual vulnerability assessments for considered elements at risk and serve for establishing the backbone of the spatial decision support system. The stages followed in the model are: Determination of a common mapping unit for each aspect of urban earthquake vulnerability, formation of a geo-database for the vulnerabilities, evaluation of urban vulnerability based on multi attribute utility theory with various weighting algorithms, mapping of the evaluated integrated earthquake risk in geographic information systems (GIS) in the neighborhood scale. The framework is also applicable to larger geographical mapping scales, for example, the building scale. When illustrating the results in building scale, 3-D visualizations with remote sensing data is used so that decision-makers can easily interpret the outputs. The proposed vulnerability assessment framework is flexible and can easily be applied to urban environments at various geographical scales with different mapping units. The obtained total vulnerability maps for the urban area provide a baseline for the development of risk reduction strategies for the decision makers. Moreover, as several aspects of elements at risk for an urban area is considered through vulnerability analyses, effect on changes in vulnerability conditions on the total can easily be determined. The developed approach also enables decision makers to

  19. Vulnerability Assessment of Selected Buildings Designated as Shelters: Dominica.

    ERIC Educational Resources Information Center

    Agency for International Development (IDCA), Washington, DC.

    Educational facilities in the Caribbean often serve roles as shelters during natural hazards, but they often sustain as much damage as other buildings. This study investigated the physical vulnerability of schools located on Dominica to wind forces, torrential rain, and seismic forces in order to provide relevant local agencies with some of the…

  20. Vulnerability Assessment of Selected Buildings Designated as Shelters: Grenada.

    ERIC Educational Resources Information Center

    Gibbs, Tony

    Educational facilities in the Caribbean often serve as shelters during natural hazards, but they often sustain as much damage as other buildings. This study investigated the physical vulnerability of schools, located in Grenada, to wind forces, torrential rain, and seismic forces in order to provide relevant local agencies with some of the input…

  1. Vulnerability Assessment of Selected Buildings Designated as Shelters: Anguilla.

    ERIC Educational Resources Information Center

    Gibbs, Tony

    Educational facilities in the Caribbean often serve roles as shelters during natural hazards, but they often sustain as much damage as other buildings. This study investigated the physical vulnerability of schools located on Anguilla to wind forces, torrential rain, and seismic forces in order to provide relevant local agencies with some of the…

  2. Reduced cardiac autonomic response to deep breathing: A heritable vulnerability trait in patients with schizophrenia and their healthy first-degree relatives.

    PubMed

    Liu, Yu-Wen; Tzeng, Nian-Sheng; Yeh, Chin-Bin; Kuo, Terry B J; Huang, San-Yuan; Chang, Chuan-Chia; Chang, Hsin-An

    2016-09-30

    Reduced resting heart rate variability (HRV) has been observed in patients with schizophrenia and their relatives, suggesting genetic predispositions. However, findings have not been consistent. We assessed cardiac autonomic response to deep breathing in first-degree relatives of patients with schizophrenia (n=45; 26 female; aged 39.69±14.82 years). Data were compared to healthy controls (n=45; 26 female; aged 38.27±9.79 years) matched for age, gender, body mass index and physical activity as well as to unmedicated patients with acute schizophrenia (n=45; 25 female; aged 37.31±12.65 years). Electrocardiograms were recorded under supine resting and deep-breathing conditions (10-12breaths/min). We measured HRV components including variance, low-frequency (LF) power, which may reflect baroreflex function, high-frequency (HF) power, which reflects cardiac parasympathetic activity, and LF/HF ratio, which may reflect sympatho-vagal balance. Patients rather than relatives exhibited lower resting-state HRV (variance, LF, and HF) than controls. As expected, deep breathing induced an increase in variance and HF-HRV in controls. However, such a response was significantly reduced in both patients and their relatives. In conclusion, the diminished cardiac autonomic reactivity to deep breathing seen in patients and their unaffected relatives indicates that this pattern of cardiac autonomic dysregulation may be regarded as a genetic trait marker for schizophrenia. PMID:27442977

  3. Beyond 'vulnerable groups': contexts and dynamics of vulnerability.

    PubMed

    Zarowsky, Christina; Haddad, Slim; Nguyen, Vinh-Kim

    2013-03-01

    This paper reviews approaches to vulnerability in public health, introducing a series of 10 papers addressing vulnerability in health in Africa. We understand vulnerability as simultaneously a condition and a process. Social inequalities are manifest in and exacerbate three key dimensions of vulnerability: the initial level of wellbeing, the degree of exposure to risk, and the capacity to manage risk effectively. We stress the dynamic interactions linking material and social deprivation, poverty, powerlessness and ill health: risks or shocks and their health impacts are intimately interconnected and reinforce each other in a cycle which in the absence of effective interventions, increases vulnerability. An inductive process which does not begin with an a priori definition or measurement of 'vulnerability' and which does not assume the existence of fixed 'vulnerable groups' allowed us both to re-affirm core aspects of existing conceptual frameworks, and to engage in new ways with literature specifically addressing vulnerability and resilience at the population level as well as with literature - for example in ecology, and on the concept of frailty in research on aging - with which researchers on health and poverty in Africa may not be familiar. We invite conceptual and empirical work on vulnerability in complex systems frameworks. These perspectives emphasize contexts and nonlinear causality thus supporting analyses of vulnerability and resilience as both markers and emergent properties of dynamic interactions. We accept a working definition of vulnerability, and recognize that some definable groups of people are more likely than others to suffer harm from exposure to health risks. But we suggest that the real work - at both intellectual and policy/political levels - lies in understanding and responding to the dynamics, meanings and power relations underlying actual instances and processes of vulnerability and harm. PMID:23549696

  4. Vulnerability of weighted networks

    NASA Astrophysics Data System (ADS)

    Dall'Asta, Luca; Barrat, Alain; Barthélemy, Marc; Vespignani, Alessandro

    2006-04-01

    In real networks complex topological features are often associated with a diversity of interactions as measured by the weights of the links. Moreover, spatial constraints may also play an important role, resulting in a complex interplay between topology, weight, and geography. In order to study the vulnerability of such networks to intentional attacks, these attributes must therefore be considered along with the topological quantities. In order to tackle this issue, we consider the case of the worldwide airport network, which is a weighted heterogeneous network whose evolution and structure are influenced by traffic and geographical constraints. We first characterize relevant topological and weighted centrality measures and then use these quantities as selection criteria for the removal of vertices. We consider different attack strategies and different measures of the damage achieved in the network. The analysis of weighted properties shows that centrality driven attacks are capable of shattering the network's communication or transport properties even at a very low level of damage in the connectivity pattern. The inclusion of weight and traffic therefore provides evidence for the extreme vulnerability of complex networks to any targeted strategy and the need for them to be considered as key features in the finding and development of defensive strategies.

  5. A preliminary analysis of quantifying computer security vulnerability data in "the wild"

    NASA Astrophysics Data System (ADS)

    Farris, Katheryn A.; McNamara, Sean R.; Goldstein, Adam; Cybenko, George

    2016-05-01

    A system of computers, networks and software has some level of vulnerability exposure that puts it at risk to criminal hackers. Presently, most vulnerability research uses data from software vendors, and the National Vulnerability Database (NVD). We propose an alternative path forward through grounding our analysis in data from the operational information security community, i.e. vulnerability data from "the wild". In this paper, we propose a vulnerability data parsing algorithm and an in-depth univariate and multivariate analysis of the vulnerability arrival and deletion process (also referred to as the vulnerability birth-death process). We find that vulnerability arrivals are best characterized by the log-normal distribution and vulnerability deletions are best characterized by the exponential distribution. These distributions can serve as prior probabilities for future Bayesian analysis. We also find that over 22% of the deleted vulnerability data have a rate of zero, and that the arrival vulnerability data is always greater than zero. Finally, we quantify and visualize the dependencies between vulnerability arrivals and deletions through a bivariate scatterplot and statistical observations.

  6. Serving the world's poor, profitably.

    PubMed

    Prahalad, C K; Hammond, Allen

    2002-09-01

    By stimulating commerce and development at the bottom of the economic pyramid, multi-nationals could radically improve the lives of billions of people and help create a more stable, less dangerous world. Achieving this goal does not require MNCs to spearhead global social-development initiatives for charitable purposes. They need only act in their own self-interest. How? The authors lay out the business case for entering the world's poorest markets. Fully 65% of the world's population earns less than $2,000 per year--that's 4 billion people. But despite the vastness of this market, it remains largely untapped. The reluctance to invest is easy to understand, but it is, by and large, based on outdated assumptions of the developing world. While individual incomes may be low, the aggregate buying power of poor communities is actually quite large, representing a substantial market in many countries for what some might consider luxury goods like satellite television and phone services. Prices, and margins, are often much higher in poor neighborhoods than in their middle-class counterparts. And new technologies are already steadily reducing the effects of corruption, illiteracy, inadequate infrastructure, and other such barriers. Because these markets are in the earliest stages of economic development, revenue growth for multi-nationals entering them can be extremely rapid. MNCs can also lower costs, not only through low-cost labor but by transferring operating efficiencies and innovations developed to serve their existing operations. Certainly, succeeding in such markets requires MNCs to think creatively. The biggest change, though, has to come from executives: Unless business leaders confront their own preconceptions--particularly about the value of high-volume, low-margin businesses--companies are unlikely to master the challenges or reap the rewards of these developing markets. PMID:12227146

  7. VuWiki: An Ontology-Based Semantic Wiki for Vulnerability Assessments

    NASA Astrophysics Data System (ADS)

    Khazai, Bijan; Kunz-Plapp, Tina; Büscher, Christian; Wegner, Antje

    2014-05-01

    vulnerability assessments with the possibility for any user to retrieve assessments using specific research criteria. Furthermore, Vuwiki can serve as a collaborative knowledge platform that allows for the active participation of those generating and using the knowledge represented in the wiki.

  8. Markers of vulnerability in schizophrenia

    PubMed Central

    Prelipceanu, D

    2009-01-01

    Vulnerability in schizophrenia is an integrative concept, which tries to explain the development of schizophrenia as an interaction between different individual susceptibility factors and environmental risk factors. Vulnerability markers used in genetic studies include biochemical indicators, neuroanatomical, neurophysiologic, and cognitive abnormalities. Among those, the most extensive studied markers were: evoked potentials, smooth pursuit eye movements, and attentional deficits. Some of the potential indicators presented in this paper satisfy most of the criteria necessary for a vulnerability marker, but none meets all of them. Nevertheless, they represent important markers of risk to schizophrenia. Key words: vulnerability, evoked potentials, eye movements, attentional deficits PMID:20108534

  9. Attending to social vulnerability when rationing pandemic resources.

    PubMed

    Vawter, Dorothy E; Garrett, J Eline; Gervais, Karen G; Prehn, Angela Witt; DeBruin, Debra A

    2011-01-01

    Pandemic plans are increasingly attending to groups experiencing health disparities and other social vulnerabilities. Although some pandemic guidance is silent on the issue, guidance that attends to socially vulnerable groups ranges widely, some procedural (often calling for public engagement), and some substantive. Public engagement objectives vary from merely educational to seeking reflective input into the ethical commitments that should guide pandemic planning and response. Some plans that concern rationing during a severe pandemic recommend ways to protect socially vulnerable groups without prioritizing access to scarce resources based on social vulnerability per se. The Minnesota Pandemic Ethics Project (MPEP), a public engagement project on rationing scarce health resources during a severe influenza pandemic, agrees and recommends an integrated set of ways to attend to the needs of socially vulnerable people and avoid exacerbation of health disparities during a severe influenza pandemic. Among other things, MPEP recommends: 1. Engaging socially vulnerable populations to clarify unique needs and effective strategies; 2. Engaging socially vulnerable populations to elicit ethical values and perspectives on rationing; 3. Rejecting rationing based on race, socioeconomic class, citizenship, quality of life, length of life-extension and first-come, first-served; 4. Prioritizing those in the general population for access to resources based on combinations of risk (of death or severe complications from influenza, exposure to influenza, transmitting influenza to vulnerable groups) and the likelihood of responding well to the resource in question. 5. Protecting critical infrastructures on which vulnerable populations and the general public rely; 6. Identifying and removing access barriers during pandemic planning and response; and 7. Collecting and promptly analyzing data during the pandemic to identify groups at disproportionate risk of influenza-related mortality and

  10. Common Control System Vulnerability

    SciTech Connect

    Trent Nelson

    2005-12-01

    The Control Systems Security Program and other programs within the Idaho National Laboratory have discovered a vulnerability common to control systems in all sectors that allows an attacker to penetrate most control systems, spoof the operator, and gain full control of targeted system elements. This vulnerability has been identified on several systems that have been evaluated at INL, and in each case a 100% success rate of completing the attack paths that lead to full system compromise was observed. Since these systems are employed in multiple critical infrastructure sectors, this vulnerability is deemed common to control systems in all sectors. Modern control systems architectures can be considered analogous to today's information networks, and as such are usually approached by attackers using a common attack methodology to penetrate deeper and deeper into the network. This approach often is composed of several phases, including gaining access to the control network, reconnaissance, profiling of vulnerabilities, launching attacks, escalating privilege, maintaining access, and obscuring or removing information that indicates that an intruder was on the system. With irrefutable proof that an external attack can lead to a compromise of a computing resource on the organization's business local area network (LAN), access to the control network is usually considered the first phase in the attack plan. Once the attacker gains access to the control network through direct connections and/or the business LAN, the second phase of reconnaissance begins with traffic analysis within the control domain. Thus, the communications between the workstations and the field device controllers can be monitored and evaluated, allowing an attacker to capture, analyze, and evaluate the commands sent among the control equipment. Through manipulation of the communication protocols of control systems (a process generally referred to as ''reverse engineering''), an attacker can then map out the

  11. Vendor System Vulnerability Testing Test Plan

    SciTech Connect

    James R. Davidson

    2005-01-01

    The Idaho National Laboratory (INL) prepared this generic test plan to provide clients (vendors, end users, program sponsors, etc.) with a sense of the scope and depth of vulnerability testing performed at the INL’s Supervisory Control and Data Acquisition (SCADA) Test Bed and to serve as an example of such a plan. Although this test plan specifically addresses vulnerability testing of systems applied to the energy sector (electric/power transmission and distribution and oil and gas systems), it is generic enough to be applied to control systems used in other critical infrastructures such as the transportation sector, water/waste water sector, or hazardous chemical production facilities. The SCADA Test Bed is established at the INL as a testing environment to evaluate the security vulnerabilities of SCADA systems, energy management systems (EMS), and distributed control systems. It now supports multiple programs sponsored by the U.S. Department of Energy, the U.S. Department of Homeland Security, other government agencies, and private sector clients. This particular test plan applies to testing conducted on a SCADA/EMS provided by a vendor. Before performing detailed vulnerability testing of a SCADA/EMS, an as delivered baseline examination of the system is conducted, to establish a starting point for all-subsequent testing. The series of baseline tests document factory delivered defaults, system configuration, and potential configuration changes to aid in the development of a security plan for in depth vulnerability testing. The baseline test document is provided to the System Provider,a who evaluates the baseline report and provides recommendations to the system configuration to enhance the security profile of the baseline system. Vulnerability testing is then conducted at the SCADA Test Bed, which provides an in-depth security analysis of the Vendor’s system.b a. The term System Provider replaces the name of the company/organization providing the system

  12. The Naïve nurse: revisiting vulnerability for nursing

    PubMed Central

    2012-01-01

    Background Nurses in the Western world have given considerable attention to the concept of vulnerability in recent decades. However, nurses have tended to view vulnerability from an individualistic perspective, and have rarely taken into account structural or collective dimensions of the concept. As the need grows for health workers to engage in the global health agenda, nurses must broaden earlier works on vulnerability, noting that conventional conceptualizations and practical applications on the notion of vulnerability warrant extension to include more collective conceptualizations thereby making a more complete understanding of vulnerability in nursing discourse. Discussion The purpose of this paper is to examine nursing contributions to the concept of vulnerability and consider how a broader perspective that includes socio-political dimensions may assist nurses to reach beyond the immediate milieu of the patient into the dominant social, political, and economic structures that produce and sustain vulnerability. Summary By broadening nurse’s conceptualization of vulnerability, nurses can obtain the consciousness needed to move beyond a peripheral role of nursing that has been dominantly situated within institutional settings to contribute in the larger arena of social, economic, political and global affairs. PMID:22520841

  13. The Vulnerability of Elderly Consumers.

    ERIC Educational Resources Information Center

    McGhee, Jerrie L.

    1983-01-01

    Reviews research on the vulnerability of the elderly to consumer fraud. Patterns of consumption, situational characteristics, education and product knowledge, psychological losses, social isolation, and psychosocial transitions influence the elderly's vulnerability and ability to cope with consumer abuse. Higher educational attainment and greater…

  14. CompuServe in the Classroom.

    ERIC Educational Resources Information Center

    Riedl, Richard

    1986-01-01

    Describes a student magazine publishing project in which the participating junior high school students accessed the information utility, CompuServe, to gather current and accurate background information for their magazine articles. Student use of CompuServe is described, and the value and costs of using CompuServe are discussed. (MBR)

  15. Social experience among vulnerable populations: conflicts and negotiations between chronic patients and their doctors seen as a challenge to medical practice.

    PubMed

    Waissman, R

    2010-11-01

    This article attempts to explore the impact of a chronic illness, end-stage renal disease, on the management of every day life between the actors involved: lay people, the affected children and their families and the medical personnel. The focus is on the nature and the process of interaction between these parties which are confronted from the onset of the illness with fundamental uncertainty concerning length of survival and the reliability of sophisticated technology such as dialysis techniques and transplantation. Within the framework of the organization of this serious illness, such interaction is concretized in the form of certain tasks to be accomplished. These constitute medical work which combines to shape the social relationships between lay people and professionals into confrontation. First, information was gathered from direct observation and fieldwork in two Units of Pediatric Nephrology located in two different hospitals in Paris. Fieldwork was followed by surveys using semi-structured interviews carried out among patients in a private clinic and the unit's personnel, medical and non medical, the families in their homes, and some adolescents in the units. Then questions were raised about strategies and negotiations, in order to reach an agreement as to when a conflict arises. The medical work is carried out in a context of changing situations, constantly called into question by the illness, and thus discovering a social order in which lay people become actors in these new situations. PMID:20979979

  16. We are vulnerable, too.

    PubMed

    2016-04-01

    My transition to becoming a student midwife has not been straightforward: I bring baggage. I was raped 11 years ago and buried it, so did not consider that becoming a midwife would pose any problems. Little did I know that this journey would make me question my own experiences of pregnancy and motherhood, and would bring the rape and subsequent termination to the forefront of my mind, forcing me to confront issues that I would have preferred to leave unearthed. Reading around the subject has helped me to understand emotions that have surfaced, and put a name to how I am feeling, yet certain procedures in practice make me uncomfortable. It is thought that 20 per cent of women aged 16-59 have experienced a sexual assault of some type since turning 16 (Rape Crisis 2015), so being sensitive to vulnerabilities faced by service users, students and colleagues is crucial. I do not make recommendations for practice, but the reference list provides a starting point for those who wish to read more extensively. PMID:27172678

  17. Identifying Frailty Among Vulnerable Populations

    PubMed Central

    Salem, Benissa E.; Nyamathi, Adeline; Phillips, Linda R.; Mentes, Janet; Sarkisian, Catherine; Brecht, Lynn

    2014-01-01

    Frailty is a significant public health issue which is experienced by homeless and other vulnerable adults; to date, a frailty framework has not been proposed to guide researchers who study this hard-to-reach population. The Frailty Framework among Homeless and other Vulnerable Populations (FFHVP) has been developed from empirical research and consultation with frailty experts in an effort to characterize antecedents, i.e. situational, health-related, behavioral, resource, biological, and environmental factors which contribute to physical, psychological and social frailty domains and impact adverse outcomes. As vulnerable populations continue to age, a greater understanding of frailty will enable the development of nursing interventions. PMID:24469090

  18. Safeguard Vulnerability Analysis Program (SVAP)

    SciTech Connect

    Gilman, F.M.; Dittmore, M.H.; Orvis, W.J.; Wahler, P.S.

    1980-06-23

    This report gives an overview of the Safeguard Vulnerability Analysis Program (SVAP) developed at Lawrence Livermore National Laboratory. SVAP was designed as an automated method of analyzing the safeguard systems at nuclear facilities for vulnerabilities relating to the theft or diversion of nuclear materials. SVAP addresses one class of safeguard threat: theft or diversion of nuclear materials by nonviolent insiders, acting individually or in collusion. SVAP is a user-oriented tool which uses an interactive input medium for preprocessing the large amounts of safeguards data. Its output includes concise summary data as well as detailed vulnerability information.

  19. Cognitive vulnerabilities as mediators between emotional abuse and depressive symptoms.

    PubMed

    Padilla Paredes, Patricia; Calvete, Esther

    2014-01-01

    This study tested whether childhood parental emotional abuse and peer emotional bullying serve as antecedents of depression in adolescence and identified the cognitive mechanisms involved in this process. It was hypothesized that the experience of emotional abuse would predict depressive symptoms via development of rumination and negative inferences. A 3-wave longitudinal study was carried out with 998 adolescents (471 girls and 526 boys) between 13 and 17 years of age. Results showed that emotional abuse by parents and peers at Time 1 predicted a worsening of several cognitive vulnerabilities at Time 2. In addition, brooding mediated between the experiences of abuse and the increase of depressive symptoms at Time 3. Thus, findings suggest that the experiences of childhood emotional abuse by parents and peers serve as antecedents to develop a negative cognitive style, vulnerability that, once developed, is a risk factor for the onset of depressive symptoms in adolescence. PMID:24292965

  20. Multimodal spectroscopy detects features of vulnerable atherosclerotic plaque

    PubMed Central

    Šćepanović, Obrad R.; Fitzmaurice, Maryann; Miller, Arnold; Kong, Chae-Ryon; Volynskaya, Zoya; Dasari, Ramachandra R.; Kramer, John R.; Feld, Michael S.

    2011-01-01

    Early detection and treatment of rupture-prone vulnerable atherosclerotic plaques is critical to reducing patient mortality associated with cardiovascular disease. The combination of reflectance, fluorescence, and Raman spectroscopy—termed multimodal spectroscopy (MMS)—provides detailed biochemical information about tissue and can detect vulnerable plaque features: thin fibrous cap (TFC), necrotic core (NC), superficial foam cells (SFC), and thrombus. Ex vivo MMS spectra are collected from 12 patients that underwent carotid endarterectomy or femoral bypass surgery. Data are collected by means of a unitary MMS optical fiber probe and a portable clinical instrument. Blinded histopathological analysis is used to assess the vulnerability of each spectrally evaluated artery lesion. Modeling of the ex vivo MMS spectra produce objective parameters that correlate with the presence of vulnerable plaque features: TFC with fluorescence parameters indicative of collagen presence; NC∕SFC with a combination of diffuse reflectance β-carotene∕ceroid absorption and the Raman spectral signature of lipids; and thrombus with its Raman signature. Using these parameters, suspected vulnerable plaques can be detected with a sensitivity of 96% and specificity of 72%. These encouraging results warrant the continued development of MMS as a catheter-based clinical diagnostic technique for early detection of vulnerable plaques. PMID:21280896

  1. Multimodal spectroscopy detects features of vulnerable atherosclerotic plaque

    NASA Astrophysics Data System (ADS)

    Šćepanović, Obrad R.; Fitzmaurice, Maryann; Miller, Arnold; Kong, Chae-Ryon; Volynskaya, Zoya; Dasari, Ramachandra R.; Kramer, John R.; Feld, Michael S.

    2011-01-01

    Early detection and treatment of rupture-prone vulnerable atherosclerotic plaques is critical to reducing patient mortality associated with cardiovascular disease. The combination of reflectance, fluorescence, and Raman spectroscopy-termed multimodal spectroscopy (MMS)-provides detailed biochemical information about tissue and can detect vulnerable plaque features: thin fibrous cap (TFC), necrotic core (NC), superficial foam cells (SFC), and thrombus. Ex vivo MMS spectra are collected from 12 patients that underwent carotid endarterectomy or femoral bypass surgery. Data are collected by means of a unitary MMS optical fiber probe and a portable clinical instrument. Blinded histopathological analysis is used to assess the vulnerability of each spectrally evaluated artery lesion. Modeling of the ex vivo MMS spectra produce objective parameters that correlate with the presence of vulnerable plaque features: TFC with fluorescence parameters indicative of collagen presence; NC/SFC with a combination of diffuse reflectance β-carotene/ceroid absorption and the Raman spectral signature of lipids; and thrombus with its Raman signature. Using these parameters, suspected vulnerable plaques can be detected with a sensitivity of 96% and specificity of 72%. These encouraging results warrant the continued development of MMS as a catheter-based clinical diagnostic technique for early detection of vulnerable plaques.

  2. Evaluating intensity parameters for debris flow vulnerability

    NASA Astrophysics Data System (ADS)

    Keiler, Margreth

    2014-05-01

    In mountain regions natural hazard processes such as debris flows or hyper-concentrated flows repeatedly lead to high damages. After an event, detailed documentation of the meteorological, hydrological and geomorphological indicators are standardized, and additional data on debris covering run out areas, indicators for processes velocity and transported volumes are gathered. Information on deposition height of debris is an important parameter to estimate the intensity of the process impacting the buildings and infrastructure and hence to establish vulnerability curves. However, the deposition height of mobilized material in settlements and on infrastructure is mostly not directly evaluated because recovery work starts immediately or even during the event leading to a removal of accumulated material. Different approaches exist to reconstruct deposition heights after torrent events, such as mind mapping, comparison of LIDAR-based DEM before and after the event as well as the reconstruction by using photo documentation and the estimation of deposition heights according to standardised elements at buildings and infrastructure. In our study, these different approaches to estimate deposition height and the spatial distribution of the accumulated material are applied and compared against each other by using the case study of the debris flow event in Brienz (Switzerland) which occurred during the serve flood events of August 2005 in the Alps. Within the analysis, different factors including overall costs and time consumption (manpower, equipment), accuracy and preciseness are compared and evaluated to establish optimal maps of the extent and deposition depth after torrent events and to integrate this information in the vulnerability analysis.

  3. Selected items from the Charcot-Marie-Tooth (CMT) Neuropathy Score and secondary clinical outcome measures serve as sensitive clinical markers of disease severity in CMT1A patients.

    PubMed

    Mannil, Manoj; Solari, Alessandra; Leha, Andreas; Pelayo-Negro, Ana L; Berciano, José; Schlotter-Weigel, Beate; Walter, Maggie C; Rautenstrauss, Bernd; Schnizer, Tuuli J; Schenone, Angelo; Seeman, Pavel; Kadian, Chandini; Schreiber, Olivia; Angarita, Natalia G; Fabrizi, Gian Maria; Gemignani, Franco; Padua, Luca; Santoro, Lucio; Quattrone, Aldo; Vita, Giuseppe; Calabrese, Daniela; Young, Peter; Laurà, Matilde; Haberlová, Jana; Mazanec, Radim; Paulus, Walter; Beissbarth, Tim; Shy, Michael E; Reilly, Mary M; Pareyson, Davide; Sereda, Michael W

    2014-11-01

    This study evaluates primary and secondary clinical outcome measures in Charcot-Marie-Tooth disease type 1A (CMT1A) with regard to their contribution towards discrimination of disease severity. The nine components of the composite Charcot-Marie-Tooth disease Neuropathy Score and six additional secondary clinical outcome measures were assessed in 479 adult patients with genetically proven CMT1A and 126 healthy controls. Using hierarchical clustering, we identified four significant clusters of patients according to clinical severity. We then tested the impact of each of the CMTNS components and of the secondary clinical parameters with regard to their power to differentiate these four clusters. The CMTNS components ulnar sensory nerve action potential (SNAP), pin sensibility, vibration and strength of arms did not increase the discriminant value of the remaining five CMTNS components (Ulnar compound motor action potential [CMAP], leg motor symptoms, arm motor symptoms, leg strength and sensory symptoms). However, three of the six additional clinical outcome measures - the 10m-timed walking test (T10MW), 9 hole-peg test (9HPT), and foot dorsal flexion dynamometry - further improved discrimination between severely and mildly affected patients. From these findings, we identified three different composite measures as score hypotheses and compared their discriminant power with that of the CMTNS. A composite of eight components CMAP, Motor symptoms legs, Motor symptoms arms, Strength of Legs, Sensory symptoms), displayed the strongest power to discriminate between the clusters. As a conclusion, five items from the CMTNS and three secondary clinical outcome measures improve the clinical assessment of patients with CMT1A significantly and are beneficial for upcoming clinical and therapeutic trials. PMID:25085517

  4. Assessing the Agricultural Vulnerability for India under Changing Climate

    NASA Astrophysics Data System (ADS)

    Sharma, Tarul; Vardhan Murari, Harsha; Karmakar, Subhankar; Ghosh, Subimal; Singh, Jitendra

    2016-04-01

    Global climate change has proven to show majorly negative impacts for the far future. These negative impacts adversely affect almost all the fields including agriculture, water resources, tourism, and marine ecosystem. Among these, the effects on agriculture are considered to be of prime importance since its regional impacts can directly affect the global food security. Under such lines, it becomes essential to understand how climate change directs agricultural production for a region along with its vulnerability. In India, rice and wheat are considered as major staple diet and hence understanding its production loss/gain due to regional vulnerability to climate change becomes necessary. Here, an attempt has been made to understand the agricultural vulnerability for rice and wheat, considering yield as a function of temperature and precipitation during growing period. In order to accomplish this objective, the ratio of actual to potential evapo-transpiration has been considered which serves as a reliable indicator; with more this ratio towards unity, less vulnerable will be the region. The current objective needs an integration of climatic, hydrological and agricultural parameters; that can be achieved by simulating a climate data driven hydrologic (Variable Infiltration Capacity, VIC) model and a crop (Decision Support System for Agrotechnology Transfer, DSSAT) model. The proposed framework is an attempt to derive a crop vulnerability map that can facilitate in strategizing adaption practices which can reduce the adverse impacts of climate change in future.

  5. 5 CFR 1203.14 - Serving documents.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... REVIEW OF RULES AND REGULATIONS OF THE OFFICE OF PERSONNEL MANAGEMENT Procedures for Review § 1203.14 Serving documents. (a) Parties. In every case, the person requesting regulation review must serve a copy... business office or home of each party or representative and leaving it with the party or representative,...

  6. [Mapping environmental vulnerability from ETM + data in the Yellow River Mouth Area].

    PubMed

    Wang, Rui-Yan; Yu, Zhen-Wen; Xia, Yan-Ling; Wang, Xiang-Feng; Zhao, Geng-Xing; Jiang, Shu-Qian

    2013-10-01

    The environmental vulnerability retrieval is important to support continuing data. The spatial distribution of regional environmental vulnerability was got through remote sensing retrieval. In view of soil and vegetation, the environmental vulnerability evaluation index system was built, and the environmental vulnerability of sampling points was calculated by the AHP-fuzzy method, then the correlation between the sampling points environmental vulnerability and ETM + spectral reflectance ratio including some kinds of conversion data was analyzed to determine the sensitive spectral parameters. Based on that, models of correlation analysis, traditional regression, BP neural network and support vector regression were taken to explain the quantitative relationship between the spectral reflectance and the environmental vulnerability. With this model, the environmental vulnerability distribution was retrieved in the Yellow River Mouth Area. The results showed that the correlation between the environmental vulnerability and the spring NDVI, the September NDVI and the spring brightness was better than others, so they were selected as the sensitive spectral parameters. The model precision result showed that in addition to the support vector model, the other model reached the significant level. While all the multi-variable regression was better than all one-variable regression, and the model accuracy of BP neural network was the best. This study will serve as a reliable theoretical reference for the large spatial scale environmental vulnerability estimation based on remote sensing data. PMID:24409741

  7. The Vulnerable Plaque: the Real Villain in Acute Coronary Syndromes

    PubMed Central

    Liang, Michael; Puri, Aniket; Devlin, Gerard

    2011-01-01

    The term "vulnerable plaque" refers to a vascular lesion that is prone to rupture and may result in life-threatening events which include myocardial infarction. It consists of thin-cap fibroatheroma and a large lipid core which is highly thrombogenic. Acute coronary syndromes often result from rupture of vulnerable plaques which frequently are only moderately stenosed and not visible by conventional angiography. Several invasive and non-invasive strategies have been developed to assess the burden of vulnerable plaques. Intravascular ultrasound provides a two-dimensional cross-sectional image of the arterial wall and can help assess the plaque burden and composition. Optical coherent tomography offers superior resolution over intravascular ultrasound. High-resolution magnetic resonance imaging provides non-invasive imaging for visualizing fibrous cap thickness and rupture in plaques. In addition, it may be of value in assessing the effects of treatments, such as lipid-lowering therapy. Technical issues however limit its clinical applicability. The role of multi-slice computed tomography, a well established screening tool for coronary artery disease, remains to be determined. Fractional flow reserve (FFR) may provide physiological functional assessment of plaque vulnerability; however, its role in the management of vulnerable plaque requires further studies. Treatment of the vulnerable patient may involve systemic therapy which currently include statins, ACE inhibitors, beta-blockers, aspirin, and calcium-channel blockers and in the future local therapeutic options such as drug-eluting stents or photodynamic therapy. PMID:21673834

  8. Are Vulnerability Disclosure Deadlines Justified?

    SciTech Connect

    Miles McQueen; Jason L. Wright; Lawrence Wellman

    2011-09-01

    Vulnerability research organizations Rapid7, Google Security team, and Zero Day Initiative recently imposed grace periods for public disclosure of vulnerabilities. The grace periods ranged from 45 to 182 days, after which disclosure might occur with or without an effective mitigation from the affected software vendor. At this time there is indirect evidence that the shorter grace periods of 45 and 60 days may not be practical. However, there is strong evidence that the recently announced Zero Day Initiative grace period of 182 days yields benefit in speeding up the patch creation process, and may be practical for many software products. Unfortunately, there is also evidence that the 182 day grace period results in more vulnerability announcements without an available patch.

  9. Food Chain Security and Vulnerability

    NASA Astrophysics Data System (ADS)

    Brunet, Sébastien; Delvenne, Pierre; Claisse, Frédéric

    In our contemporary societies, the food chain could be defined as a macro-technical system, which depends on a wide variety of actors and risks analysis methods. In this contribution, risks related to the food chain are defined in terms of "modern risks" (Beck 1992). The whole national economic sector of food production/distribution is vulnerable to a local accident, which can affect the functioning of food chain, the export programs and even the political system. Such a complex socio-technical environment is undoubtedly vulnerable to intentional act such as terrorism.

  10. Molecular Imaging of Plaque Vulnerability

    PubMed Central

    Tavakoli, Sina; Vashist, Aseem; Sadeghi, Mehran M.

    2014-01-01

    Over the past decade significant progress has been made in the development of novel imaging strategies focusing on the biology of the vessel wall for identification of vulnerable plaques. While the majority of these studies are still in the preclinical stage, few techniques (e.g., 18F-FDG and 18F-NaF PET imaging) have already been evaluated in clinical studies with promising results. Here, we will briefly review the pathobiology of atherosclerosis and discuss molecular imaging strategies that have been developed to target these events, with an emphasis on mechanisms that are associated with atherosclerotic plaque vulnerability. PMID:25124827

  11. Calories and fat per serving (image)

    MedlinePlus

    ... and stores the rest in the form of fat. A calorie is a calorie, whether it comes ... between them is the number of calories, nutrients, fat, and other ingredients in a typical serving . Calories ...

  12. Nursing Student Birth Doulas' Influence On the Childbearing Outcomes of Vulnerable Populations.

    PubMed

    Van Zandt, Shirley E; Kim, Soohyun; Erickson, Amanda

    2016-01-01

    Of 1,511 women served by nursing student birth doulas (Birth Companions) between 1998 and 2014, 34.5% were identified as vulnerable (refugees, non-English speakers, teens, low income, low education). This retrospective evaluation of the Birth Companions Program showed that vulnerable mothers had more epidurals and smaller babies, and attempted breastfeeding less frequently than nonvulnerable. There was no difference in the frequency of caesarean births, pitocin induction/augmentation, low birth weight, or preterm newborns among the vulnerable women. Birth Companion interventions may have a role in influencing these outcomes. The Birth Companions program will use this analysis to identify additional services for these populations. PMID:27383776

  13. [Vulnerability and National Health Service].

    PubMed

    Lima, Cristina

    2006-01-01

    to value life. The article concludes drawing attention to the need to invest in health education, which is just as important as the fair distribution of precious health care resources in reducing harmful risks to the most vulnerable patients. PMID:16987443

  14. Vulnerable Subjects: Why Does Informed Consent Matter?

    PubMed

    Goodwin, Michele

    2016-09-01

    This special issue of the Journal Law, Medicine & Ethics takes up the concern of informed consent, particularly in times of controversy. The dominant moral dilemmas that frame traditional bioethical concerns address medical experimentation on vulnerable subjects; physicians assisting their patients in suicide or euthanasia; scarce resource allocation and medical futility; human trials to develop drugs; organ and tissue donation; cloning; xenotransplantation; abortion; human enhancement; mandatory vaccination; and much more. The term "bioethics" provides a lens, language, and guideposts to the study of medical ethics. It is worth noting, however, that medical experimentation is neither new nor exclusive to one country. Authors in this issue address thorny subjects that span borders and patients: from matters dealing with children and vaccination to the language and perception of consent. PMID:27587443

  15. Measuring Vulnerability to Stereotype Threat

    ERIC Educational Resources Information Center

    Barnard, Lucy; Burley, Hansel; Olivarez, Arturo; Crooks, Steven

    2008-01-01

    Introduction: In this study, we examined the psychometric properties of an instrument intended to measure vulnerability to stereotype threat. Method: We revised the instrument through assessing score reliability and then examined a domain specific model using confirmatory factor analyses. After examining the responses of the total sample…

  16. US Vulnerability to Natural Disasters

    NASA Astrophysics Data System (ADS)

    van der Vink, G.; Apgar, S.; Batchelor, A.; Carter, C.; Gail, D.; Jarrett, A.; Levine, N.; Morgan, W.; Orlikowski, M.; Pray, T.; Raymar, M.; Siebert, A.; Shawa, T. W.; Wallace, C.

    2002-05-01

    Natural disasters result from the coincidence of natural events with the built environment. Our nation's infrastructure is growing at an exponential rate in many areas of high risk, and the Federal government's liability is increasing proportionally. By superimposing population density with predicted ground motion from earthquakes, historical hurricane tracks, historical tornado locations, and areas within the flood plain, we are able to identify locations of high vulnerability within the United States. We present a comprehensive map of disaster risk for the United States that is being produced for the Senate Natural Hazards Caucus. The map allows for the geographic comparison of natural disaster risk with past disaster declarations, the expenditure of Federal dollars for disaster relief, population increase, and variations of GDP. Every state is vulnerable to natural disasters. Although their frequency varies considerably, the annualized losses for disaster relief from hurricanes, earthquakes, and floods are approximately equivalent. While fast-growing states such as California and Florida remain highly vulnerable, changes in the occurrence of natural events combined with population increases are making areas such as Texas, North Carolina, and the East Coast increasingly vulnerable.

  17. Childhood Cancer and Vulnerability for Significant Academic Underachievement.

    ERIC Educational Resources Information Center

    Ott, Jeanne S.; And Others

    1982-01-01

    Learning difficulties related to childhood cancer were examined by comparison of 22 oncology patients and 22 children (6 to 17 years old) referred for psychiatric/psychological evaluation. Findings demonstrated, among children undergoing treatment of cancer, some academic vulnerabilities for which psychosocial aspects may not fully account.…

  18. Unipolar Depression, Life Context Vulnerabilities, and Drinking to Cope

    ERIC Educational Resources Information Center

    Holahan, Charles J.; Moos, Rudolf H.; Holahan, Carole K.; Cronkite, Ruth C.; Randall, Patrick K.

    2004-01-01

    This study followed baseline samples of 424 unipolar depressed patients and 424 community controls across 10 years to investigate the association between depression and alcohol-related coping and to examine how life context vulnerabilities underlie the risk for depressed individuals to rely on drinking to cope. Findings supported all hypotheses.…

  19. Osteocytes serve as a progenitor cell of osteosarcoma

    PubMed Central

    Sottnik, Joseph L; Campbell, Brittany; Mehra, Rohit; Behbahani-Nejad, Omid; Hall, Christopher L.; Keller, Evan T.

    2016-01-01

    Osteosarcoma (OSA) is the most common primary bone tumor in humans. However, the cell of origin of OSA is not clearly defined although there is evidence that osteoblasts may serve as OSA progenitors. The role of osteocytes, terminally differentiated osteoblasts, as OSA progenitors has yet to be described. Analysis of patient cDNA from publicly available microarray data revealed that patients with OSA have increased expression of dentin matrix phosphoprotein 1 (DMP1), a marker of osteocytes. Analysis of multiple murine, human, and canine OSA cell lines revealed DMP1 expression. To test the tumorigenic potential of osteocytes, MLO-Y4, an SV-40 immortalized murine osteocyte cell line, was injected into subcutaneous and orthotopic (intratibial) sites of mice. Tumor growth occurred in both locations. Orthotopic MLO-Y4 tumors produced mixed osteoblastic/osteolytic radiographic lesions; a hallmark of OSA. Together, these data demonstrate for the first time that osteocytes can serve as OSA progenitors. PMID:24700678

  20. Osteocytes serve as a progenitor cell of osteosarcoma.

    PubMed

    Sottnik, Joseph L; Campbell, Brittany; Mehra, Rohit; Behbahani-Nejad, Omid; Hall, Christopher L; Keller, Evan T

    2014-08-01

    Osteosarcoma (OSA) is the most common primary bone tumor in humans. However, the cell of origin of OSA is not clearly defined although there is evidence that osteoblasts may serve as OSA progenitors. The role of osteocytes, terminally differentiated osteoblasts, as OSA progenitors has yet to be described. Analysis of patient cDNA from publicly available microarray data revealed that patients with OSA have increased expression of dentin matrix phosphoprotein 1 (DMP1), a marker of osteocytes. Analysis of multiple murine, human, and canine OSA cell lines revealed DMP1 expression. To test the tumorigenic potential of osteocytes, MLO-Y4, a SV-40 immortalized murine osteocyte cell line, was injected into subcutaneous and orthotopic (intratibial) sites of mice. Tumor growth occurred in both locations. Orthotopic MLO-Y4 tumors produced mixed osteoblastic/osteolytic radiographic lesions; a hallmark of OSA. Together, these data demonstrate for the first time that osteocytes can serve as OSA progenitors. PMID:24700678

  1. A notational analysis of elite tennis serve and serve-return strategies on slow surface.

    PubMed

    Gillet, Eric; Leroy, David; Thouvarecq, Régis; Stein, Jean-François

    2009-03-01

    A notational analysis of singles events at the French Open Grand Slam tournament was undertaken in 2005 and 2006 to characterize the game patterns and strategies of serve and serve-return and to determine their influence on the point issue on a clay court surface. One hundred sixteen men's singles matches were video analyzed. The flat serve (57.6%), particularly down the "T" location (50.3%), allowed servers to win significantly more points than the topspin (24.1%) and slice serves (18.3%). When the topspin was the first serve strategy, servers kept a high percentage of points won from the serve (52.4%). This strategy was essentially used on the second serve (91.6%) by playing the "T" location in the deuce court and the wide zone in the advantage court. Returns to the central zone allowed receivers to win more points (73.3% on first serve and 65.9% on second serve) than plays to external locations. The results highlight the high impact of the first shots of all opponents on the rally. Even on clay, the slowest court surface, serves and serve-returns remain the strokes that most influence the match results in modern tennis games. PMID:19197212

  2. Global trends and vulnerabilities of mangrove forests

    NASA Astrophysics Data System (ADS)

    Simard, M.; Fatoyinbo, T. E.; Rivera-Monroy, V. H.; Castaneda, E.; Roy Chowdhury, R.

    2015-12-01

    Mangrove forests are located along Earth's coastlines and estuaries within tropical and subtropical latitudes. They provide numerous services functioning as an extraordinary carbon sequestration system and serving as habitat and nursery for fish, crustaceans and amphibians. To coastal populations, they provide livelihood, food, lumber and act as an effective protection against tsunamis, storm surges and hurricanes. Their vulnerability to sea level rise is strongly related to their extraordinary ability to accumulate soils, which is in part related to their productivity and therefore canopy structure. As a first step to understand their vulnerability, we seek to understand mangrove dependencies on environmental and geophysical setting. To achieve this, we mapped mangrove canopy height and above ground biomass (AGB) at the Global scale. To identify mangrove forests, existing maps derived from a collection of Landsat data around the 2000 era were used. Using the Shuttle Radar Topography Mission elevation data collected in February of 2000, we produced a Global map of mangrove canopy height. The estimated heights were validated with the ICESat/Geoscience Altimeter System (GLAS) and in situ field data. Most importantly, field data were also used to derive relationships between canopy height and AGB. While the geographical coverage of in situ data is limited, ICESat/GLAS data provided extensive geographical coverage with independent estimates of maximum canopy height. These estimates were used to calibrate SRTM-estimates of height at the Global scale. We found the difference between GLAS RH100 and SRTM resulted from several sources of uncertainty that are difficult to isolate. These include natural variations of canopy structure with time, system errors from GLAS and SRTM, geo-location errors and discrepancies in spatial resolution. The Global canopy height map was trnasormed into AGB using the field-derived allometry. Depending on the scale of analysis and geographical

  3. Plantar pressures in the tennis serve.

    PubMed

    Girard, Olivier; Eicher, Frank; Micallef, Jean-Paul; Millet, Grégoire

    2010-06-01

    In-shoe loading patterns were examined in each foot (back and front) separately during two types of tennis serve [first (or flat) and second (or twist) serve] and two service stance styles [foot-up (back foot is moved forward next to front foot for push-off) and foot-back (feet remain at the same relative level)]. Ten competitive tennis players completed five trials for each type of serve and service stance style in random order. Plantar pressure distribution was recorded using Pedar insoles divided into nine areas for analysis. Mean and peak pressures (+15.2%, P < 0.01 and +12.8%, P < 0.05) as well as maximal forces (+20.2%, P < 0.01) were higher under the lateral forefoot of the front foot in first than in second serves, while mean forces were higher (+17.2%, P < 0.05) under the lesser toes. Relative load was higher on the lateral forefoot (+20.4%, P < 0.05) but lower (-32.5%, P < 0.05) on the medial heel of the front foot with foot-up compared with foot-back stance. Using a foot-up stance, loading of the back foot was higher (+31.8%, P < 0.01) under the lateral mid-foot but lower (-29.9%, P < 0.01) under the medial forefoot. The type of serve and the stance style adopted have a significant effect on foot loading. Such findings might help improve mechanical efficiency of the serve. PMID:20496222

  4. Assessing European wild fire vulnerability

    NASA Astrophysics Data System (ADS)

    Oehler, F.; Oliveira, S.; Barredo, J. I.; Camia, A.; Ayanz, J. San Miguel; Pettenella, D.; Mavsar, R.

    2012-04-01

    Wild fire vulnerability is a measure of potential socio-economic damage caused by a fire in a specific area. As such it is an important component of long-term fire risk management, helping policy-makers take informed decisions about adequate expenditures for fire prevention and suppression, and to target those regions at highest risk. This paper presents a first approach to assess wild fire vulnerability at the European level. A conservative approach was chosen that assesses the cost of restoring the previous land cover after a potential fire. Based on the CORINE Land Cover, a restoration cost was established for each land cover class at country level, and an average restoration time was assigned according to the recovery capacity of the land cover. The damage caused by fire was then assessed by discounting the cost of restoring the previous land cover over the restoration period. Three different vulnerability scenarios were considered assuming low, medium and high fire severity causing different levels of damage. Over Europe, the potential damage of wild land fires ranges from 10 - 13, 732 Euro*ha-1*yr-1 for low fire severity, 32 - 45,772 Euro*ha-1*yr-1 for medium fire severity and 54 - 77,812 Euro*ha-1*yr-1 for high fire severity. The least vulnerable are natural grasslands, moors and heathland and sclerophyllous vegetation, while the highest cost occurs for restoring broad-leaved forest. Preliminary validation comparing these estimates with official damage assessments for past fires shows reasonable results. The restoration cost approach allows for a straightforward, data extensive assessment of fire vulnerability at European level. A disadvantage is the inherent simplification of the evaluation procedure with the underestimation of non-markets goods and services. Thus, a second approach has been developed, valuing individual wild land goods and services and assessing their annual flow which is lost for a certain period of time in case of a fire event. However

  5. Reentry Preparedness among Soon-to-be-Released Inmates and the Role of Time Served

    PubMed Central

    Wolff, Nancy; Shi, Jing; Schumann, Brooke E.

    2014-01-01

    Purpose While reentry funding is flowing into states, its target efficiency and effectiveness depends on whether it goes to the right people in the right ways. The purpose of this study was to examine whether and how the amount of time incarcerated affects reentry readiness. Materials and Methods A population-based survey was conducted. Approximately 4000 soon-to-be-released male inmates were drawn from a state correctional system. Readiness is described in terms of feeling ready and material, social, and treatment resources available for reentry by time served on current conviction (episode effect) and since age 18 (cumulative effect). Generalized hierarchical linear models were used to estimate the effects of demographic, criminological, and time served variables on reentry readiness outcomes. Results Reentry vulnerability increased with time served since turning 18 (cumulative effect) but not with time served on the current conviction (episode effect). Inmates serving more than 10 years since turning 18 were at greatest reentry risk. Conclusions The findings indicate that inmates who have served more prison time over their lifetime have more pronounced needs and risks suggesting that reentry funding be targeted towards those who have served more time over the course of their lifetime. PMID:24431474

  6. MID-ATLANTIC REGIONAL VULNERABILITY ASSESSMENT

    EPA Science Inventory

    ORD's Regional Vulnerability Assessment (REVA) Program is developing and demonstrating approaches to assess current and future environmental vulnerabilities so that risk management activities can be targeted. The sister program to EMA.P (Environmental Monitoring Assessment Progr...

  7. Vulnerabilities to misinformation in online pharmaceutical marketing

    PubMed Central

    De Freitas, Julian; Falls, Brian A; Haque, Omar S; Bursztajn, Harold J

    2013-01-01

    Given the large percentage of Internet users who search for health information online, pharmaceutical companies have invested significantly in online marketing of their products. Although online pharmaceutical marketing can potentially benefit both physicians and patients, it can also harm these groups by misleading them. Indeed, some pharmaceutical companies have been guilty of undue influence, which has threatened public health and trust. We conducted a review of the available literature on online pharmaceutical marketing, undue influence and the psychology of decision-making, in order to identify factors that contribute to Internet users’ vulnerability to online pharmaceutical misinformation. We find five converging factors: Internet dependence, excessive trust in the veracity of online information, unawareness of pharmaceutical company influence, social isolation and detail fixation. As the Internet continues to change, it is important that regulators keep in mind not only misinformation that surrounds new web technologies and their contents, but also the factors that make Internet users vulnerable to misinformation in the first place. Psychological components are a critical, although often neglected, risk factor for Internet users becoming misinformed upon exposure to online pharmaceutical marketing. Awareness of these psychological factors may help Internet users attentively and safely navigate an evolving web terrain. PMID:23761527

  8. Vulnerabilities to misinformation in online pharmaceutical marketing.

    PubMed

    De Freitas, Julian; Falls, Brian A; Haque, Omar S; Bursztajn, Harold J

    2013-05-01

    Given the large percentage of Internet users who search for health information online, pharmaceutical companies have invested significantly in online marketing of their products. Although online pharmaceutical marketing can potentially benefit both physicians and patients, it can also harm these groups by misleading them. Indeed, some pharmaceutical companies have been guilty of undue influence, which has threatened public health and trust. We conducted a review of the available literature on online pharmaceutical marketing, undue influence and the psychology of decision-making, in order to identify factors that contribute to Internet users' vulnerability to online pharmaceutical misinformation. We find five converging factors: Internet dependence, excessive trust in the veracity of online information, unawareness of pharmaceutical company influence, social isolation and detail fixation. As the Internet continues to change, it is important that regulators keep in mind not only misinformation that surrounds new web technologies and their contents, but also the factors that make Internet users vulnerable to misinformation in the first place. Psychological components are a critical, although often neglected, risk factor for Internet users becoming misinformed upon exposure to online pharmaceutical marketing. Awareness of these psychological factors may help Internet users attentively and safely navigate an evolving web terrain. PMID:23761527

  9. [Precarity, vulnerability, anticipating end-of-life care at home].

    PubMed

    Bonneval, Camille

    2016-02-01

    Many patients want to end their life at home. Care teams adapt to these wishes and organise a form of treatment which blends safety of care and the respect of the expectations of the patients and family members. When factors of precarity increase the vulnerability inherent to the end of life, caregivers anticipate and support as best as they can the difficulties encountered as testified by a hospital at home team in Dax. PMID:26861082

  10. Serving Stakeholders at a Small Regional University

    ERIC Educational Resources Information Center

    Burrage, Sean

    2015-01-01

    The Southeastern Oklahoma State University Honors Program serves a unique role in a small, rural setting such as Durant, Oklahoma. The honors program has a traditional mission in a university that offers a nontraditional setting and history within the context of higher education. The program thus offers special rewards to its students and to the…

  11. Science To Serve the Common Good.

    ERIC Educational Resources Information Center

    Brewer, Garry D.

    1997-01-01

    Reviews "Upstream: Salmon and Society in the Pacific Northwest", a report produced by a committee of the National Research Council that offers a model of a new and better approach to addressing environmental problems that could enable science to serve the common good. Demonstrates a successful approach to doing science and contributing to society.…

  12. Federal Assistance for Programs Serving the Handicapped.

    ERIC Educational Resources Information Center

    Office of Human Development (DHEW), Washington, DC. Office for Handicapped Individuals.

    Excerpted from the "1977 Catalog of Federal Domestic Assistance," the document describes federal programs and activities serving the handicapped or people working with or for them. Following initial sections which cover the Office for Handicapped Individuals and its clearinghouse, definitions, instructions for using the directory, and budget…

  13. "Gateway" Districts Struggle to Serve Immigrant Parents

    ERIC Educational Resources Information Center

    Maxwell, Lesli A.

    2012-01-01

    As thousands of communities--especially in the South--became booming gateways for immigrant families during the 1990s and the early years of the new century, public schools struggled with the unfamiliar task of serving the large numbers of English-learners arriving in their classrooms. Instructional programs were built from scratch. Districts had…

  14. Pyramid Servings Database (PSDB) for NHANES III

    Cancer.gov

    The National Cancer Institute developed a database to examine dietary data from the National Center for Health Statistics' Third National Health and Nutrition Examination Survey in terms of servings from each of United States Department of Agriculture's The Food Guide Pyramid's major and minor food groups.

  15. Graduate Students Serve Extension as Evaluation Consultants

    ERIC Educational Resources Information Center

    McClure, Megan; Fuhrman, Nicholas E.

    2011-01-01

    In an effort to provide graduate students at a distance with field-based learning experiences and evaluation resources to statewide Extension programs, 24 Master's students participating in a distance-delivered program evaluation course served as evaluation consultants for Extension programs. State evaluation specialists unable to conduct…

  16. Getting It Together: Serving the Adult Community.

    ERIC Educational Resources Information Center

    Bakshis, Robert D.

    1979-01-01

    Describes a community needs assessment survey conducted by the College of DuPage (Illinois) which served to advertise existing programs, provide public relations for the adult education council, and obtain measures of need for existing or expanded educational and leisure activities. (MB)

  17. Serving up Success! Team Nutrition Days, 1997.

    ERIC Educational Resources Information Center

    Food and Nutrition Service (USDA), Washington, DC.

    This publication presents success stories and actual activities from Team Nutrition Days 1997 to serve as a starting point for other schools wanting to create their own nutrition education activities. Team Nutrition Days was a 1-week celebration that used innovative, interactive activities to teach children that nutrition is the link between…

  18. How Finland Serves Gifted and Talented Pupils

    ERIC Educational Resources Information Center

    Tirri, Kirsi; Kuusisto, Elina

    2013-01-01

    The purpose of this article is to provide an overview of the ways gifted and talented pupils are served in Finland. The trend toward individualism and freedom of choice as well as national policy affecting gifted education are discussed. Empirical research on Finnish teachers' attitudes toward gifted education with respect to the national…

  19. Serving Rural Youth: A Regional Approach.

    ERIC Educational Resources Information Center

    Edington, Everett D.

    The regional approach as an alternative for meeting the needs of rural youth is discussed in comparison to the small school district which cannot possibly serve the broad spectrum of student needs in rural areas. The rural educational setting and its shortcomings are described as the lack of facilities, a lack of an obvious connection between…

  20. Serving Distant Learners through Instructional Technologies.

    ERIC Educational Resources Information Center

    Drea, John T.; Armistead, L. Pendleton

    John Wood Community College (JWCC) serves a district population of approximately 90,000 in a predominantly rural section of west-central Illinois. In an effort to address the needs of the rural long-distance learner, JWCC has implemented a variety of instructional delivery techniques. Since its inception, JWCC has contracted with other area…

  1. Making a Difference by Serving All Students

    ERIC Educational Resources Information Center

    Olley, Rivka I.

    2009-01-01

    Randi Brown came to school psychology almost as a family business. Her grandmother was a school psychologist and the first licensed psychologist in the state of New York. Randi graduated with a doctoral degree from Yeshiva University and has served students in Westchester County, New York, for 18 years. She exemplifies the dedication typical of so…

  2. Serving Business in an Information Economy.

    ERIC Educational Resources Information Center

    The Bookmark, 1988

    1988-01-01

    The 23 articles in this theme issue focus on various aspects of library services to business in an information economy: "Serving Business in an Information Economy" (C. Bain); "New York's Resurging Economy and State Economic Development Information" (R. G. Paolino); "Department of Economic Development Library: Services to Business" (B. S.…

  3. Treating the most vulnerable and costly in diabetes.

    PubMed

    Wagner, David V; Stoeckel, Maggie; E Tudor, Megan; Harris, Michael A

    2015-06-01

    Diabetic ketoacidosis (DKA) is associated with negative health outcomes and high costs for patients, families, and communities. Interventions developed to effectively reduce DKA and related costs should target the multiple risk factors associated with DKA and adherence difficulties. Certain demographic, psychological, and family factors are associated with increased risk for adherence problems and DKA. Individuals with a combination of risk factors (e.g., mental health problems, low socioeconomic status, high family conflict) may be particularly vulnerable to DKA. Although several different interventions have demonstrated promise in improving adherence and/or decreasing the risk of DKA, the generalizability of treatment results to those individuals most vulnerable to DKA is limited. Approaches which include multiple evidence-based components of care, are flexible in treatment delivery (e.g., home- and community-based, utilize technology), and target the multiple risk factors across relevant systems (e.g., individual, family, school, medical) are warranted to effectively reduce DKA in vulnerable populations. PMID:25877049

  4. Soil vulnerability for cesium transfer.

    PubMed

    Vandenhove, Hildegarde; Sweeck, Lieve

    2011-07-01

    The recent events at the Fukushima Daiichi nuclear power plant in Japan have raised questions about the accumulation of radionuclides in soils and the possible impacts on agriculture surrounding nuclear power plants. This article summarizes the knowledge gained after the nuclear power plant accident in Chernobyl, Ukraine, on how soil parameters influence soil vulnerability for radiocesium bioavailability, discusses some potential agrochemical countermeasures, and presents some predictions of radiocesium crop concentrations for areas affected by the Fukushima accident. PMID:21608116

  5. Vulnerability to coastal cholera ecology.

    PubMed

    Collins, Andrew E

    2003-10-01

    The battle to completely control cholera continues. Multiple strains, high levels of morbidity in some regions of the world, and a complex of influences on its distribution in people and the environment are accompanied by only rough resolution prediction of outbreaks. Uncertainty as to the most effective array of interventions for one of the most researched infectious diseases thwarts further progress in providing cost-effective solutions. Progress on the research front consistently points towards the importance of disease ecology, coastal environments, and the sea. However, evaluation of the link between cholera in people and environment can only be effective with analysis of human vulnerability to variable coastal cholera ecologies. As there are some clear links between the organism, cholera incidence and the sea, it is appropriate that cholera research should examine the nature of coastal population vulnerability to the disease. The paper reviews the cholera risks of human-environment interactions in coastal areas as one component of the evaluation of cholera management. This points to effective intervention through integrative knowledge of changing human and environmental ecologies, requiring improved detection, but also an acceptance of complex causality. The challenge is to identify indicators and interventions for case specific ecologies in variable locales of human vulnerability and disease hazard. Further work will therefore aim to explore improved surveillance and intervention across the socio-behavioural and ecological spectrum. Furthermore, the story of cholera continues to inform us about how we should more effectively view emergent and resurgent infectious disease hazards more generally. PMID:12927470

  6. Measuring vulnerability to disaster displacement

    NASA Astrophysics Data System (ADS)

    Brink, Susan A.; Khazai, Bijan; Power, Christopher; Wenzel, Friedemann

    2015-04-01

    Large scale disasters can cause devastating impacts in terms of population displacement. Between 2008 and 2013, on average 27 million people were displaced annually by disasters (Yonetani 2014). After large events such as hurricane Katrina or the Port-au-Prince earthquake, images of inadequate public shelter and concerns about large scale and often inequitable migration have been broadcast around the world. Population displacement can often be one of the most devastating and visible impacts of a natural disaster. Despite the importance of population displacement in disaster events, measures to understand the socio-economic vulnerability of a community often use broad metrics to estimate the total socio-economic risk of an event rather than focusing on the specific impacts that a community faces in a disaster. Population displacement is complex and multi-causal with the physical impact of a disaster interacting with vulnerability arising from the response, environmental issues (e.g., weather), cultural concerns (e.g., expectations of adequate shelter), and many individual factors (e.g., mobility, risk perception). In addition to the complexity of the causes, population displacement is difficult to measure because of the wide variety of different terms and definitions and its multi-dimensional nature. When we speak of severe population displacement, we may refer to a large number of displaced people, an extended length of displacement or associated difficulties such as poor shelter quality, risk of violence and crime in shelter communities, discrimination in aid, a lack of access to employment or other difficulties that can be associated with large scale population displacement. We have completed a thorough review of the literature on disaster population displacement. Research has been conducted on historic events to understand the types of negative impacts associated with population displacement and also the vulnerability of different groups to these impacts. We

  7. Patterns of Freshwater Species Richness, Endemism, and Vulnerability in California.

    PubMed

    Howard, Jeanette K; Klausmeyer, Kirk R; Fesenmyer, Kurt A; Furnish, Joseph; Gardali, Thomas; Grantham, Ted; Katz, Jacob V E; Kupferberg, Sarah; McIntyre, Patrick; Moyle, Peter B; Ode, Peter R; Peek, Ryan; Quiñones, Rebecca M; Rehn, Andrew C; Santos, Nick; Schoenig, Steve; Serpa, Larry; Shedd, Jackson D; Slusark, Joe; Viers, Joshua H; Wright, Amber; Morrison, Scott A

    2015-01-01

    The ranges and abundances of species that depend on freshwater habitats are declining worldwide. Efforts to counteract those trends are often hampered by a lack of information about species distribution and conservation status and are often strongly biased toward a few well-studied groups. We identified the 3,906 vascular plants, macroinvertebrates, and vertebrates native to California, USA, that depend on fresh water for at least one stage of their life history. We evaluated the conservation status for these taxa using existing government and non-governmental organization assessments (e.g., endangered species act, NatureServe), created a spatial database of locality observations or distribution information from ~400 data sources, and mapped patterns of richness, endemism, and vulnerability. Although nearly half of all taxa with conservation status (n = 1,939) are vulnerable to extinction, only 114 (6%) of those vulnerable taxa have a legal mandate for protection in the form of formal inclusion on a state or federal endangered species list. Endemic taxa are at greater risk than non-endemics, with 90% of the 927 endemic taxa vulnerable to extinction. Records with spatial data were available for a total of 2,276 species (61%). The patterns of species richness differ depending on the taxonomic group analyzed, but are similar across taxonomic level. No particular taxonomic group represents an umbrella for all species, but hotspots of high richness for listed species cover 40% of the hotspots for all other species and 58% of the hotspots for vulnerable freshwater species. By mapping freshwater species hotspots we show locations that represent the top priority for conservation action in the state. This study identifies opportunities to fill gaps in the evaluation of conservation status for freshwater taxa in California, to address the lack of occurrence information for nearly 40% of freshwater taxa and nearly 40% of watersheds in the state, and to implement adequate

  8. Patterns of Freshwater Species Richness, Endemism, and Vulnerability in California

    PubMed Central

    Furnish, Joseph; Gardali, Thomas; Grantham, Ted; Katz, Jacob V. E.; Kupferberg, Sarah; McIntyre, Patrick; Moyle, Peter B.; Ode, Peter R.; Peek, Ryan; Quiñones, Rebecca M.; Rehn, Andrew C.; Santos, Nick; Schoenig, Steve; Serpa, Larry; Shedd, Jackson D.; Slusark, Joe; Viers, Joshua H.; Wright, Amber; Morrison, Scott A.

    2015-01-01

    The ranges and abundances of species that depend on freshwater habitats are declining worldwide. Efforts to counteract those trends are often hampered by a lack of information about species distribution and conservation status and are often strongly biased toward a few well-studied groups. We identified the 3,906 vascular plants, macroinvertebrates, and vertebrates native to California, USA, that depend on fresh water for at least one stage of their life history. We evaluated the conservation status for these taxa using existing government and non-governmental organization assessments (e.g., endangered species act, NatureServe), created a spatial database of locality observations or distribution information from ~400 data sources, and mapped patterns of richness, endemism, and vulnerability. Although nearly half of all taxa with conservation status (n = 1,939) are vulnerable to extinction, only 114 (6%) of those vulnerable taxa have a legal mandate for protection in the form of formal inclusion on a state or federal endangered species list. Endemic taxa are at greater risk than non-endemics, with 90% of the 927 endemic taxa vulnerable to extinction. Records with spatial data were available for a total of 2,276 species (61%). The patterns of species richness differ depending on the taxonomic group analyzed, but are similar across taxonomic level. No particular taxonomic group represents an umbrella for all species, but hotspots of high richness for listed species cover 40% of the hotspots for all other species and 58% of the hotspots for vulnerable freshwater species. By mapping freshwater species hotspots we show locations that represent the top priority for conservation action in the state. This study identifies opportunities to fill gaps in the evaluation of conservation status for freshwater taxa in California, to address the lack of occurrence information for nearly 40% of freshwater taxa and nearly 40% of watersheds in the state, and to implement adequate

  9. Acquaintance molestation and youth-serving organizations.

    PubMed

    Lanning, Kenneth V; Dietz, Park

    2014-10-01

    This article is based not only on the research literature but also on the extensive field experience of the authors in consulting with investigators, attorneys, and organizations on the prevention, investigation, prosecution, and civil litigation of molestation of children within or in connection with youth-serving organizations. Acquaintance molesters have often pursued careers or sought out paid or volunteer work with organizations through which they can meet children. To address the problem of such offenders, it is necessary for youth-serving organizations to recognize the diversity of sexual activity, the phenomena of "nice-guy" offenders and compliant child victims, and the grooming/seduction process, each of which is reviewed here. The four most important protection practices for organizations are screening; management, and supervision; response to suspicions, allegations, and complaints; and prevention and awareness programs. The authors recommend general approaches to each of these and describe the reasons many organizations resist implementing available preventive measures. PMID:24860081

  10. Minority-Serving Institutions of Higher Education: Serving Communities, Revitalizing the Nation

    ERIC Educational Resources Information Center

    US Department of Housing and Urban Development, 2009

    2009-01-01

    Institutions of higher education (IHEs) that serve minority populations are unique both in their missions and in their day-to-day operations. Some of these colleges and universities are located in remote regions of the country, while others serve congested urban neighborhoods. Their constituents range from Native Americans, the country's oldest…

  11. Culturally Relevant Practices That "Serve" Students at a Hispanic Serving Institution

    ERIC Educational Resources Information Center

    Garcia, Gina A.; Okhidoi, Otgonjargal

    2015-01-01

    As institutions not founded to "serve" Latina/o students, Hispanic Serving Institutions (HSIs) must actively change their curricula and programs to meet the needs of their diverse population, including Latina/o, low income, and first generation students. Using a case study approach, including interviews and focus groups, this study…

  12. Emerging Hispanic-Serving Institutions (HSIs): Serving Latino Students. Executive Summary

    ERIC Educational Resources Information Center

    Excelencia in Education (NJ1), 2010

    2010-01-01

    The invention of Hispanic-serving Institutions (HSIs) in the 1980s was grounded in the theory that institutions enrolling a large concentration of Latino students would adapt their institutional practices to serve these students better. Specifically, critical mass theory suggests once a definable group reaches a certain size within an…

  13. Equipment for Hot-to-serve Foods

    NASA Technical Reports Server (NTRS)

    Smith, D. P.

    1985-01-01

    Patented surface heating devices with a much faster air-to-solid heat transfer rate than previous air ovens were developed. The accelerated surface heating can brown, sear or crisp much more rapidly than in conventional ovens so that partially prepared food can be finished quickly and tastefully immediately before serving. The crisp, freshly browned surfaces result from the faster heat transfer which does not dry out the food. The devices are then compared to convection ovens and microwave heating processes.

  14. NASA Goddard and Minority Serving Institutions

    NASA Astrophysics Data System (ADS)

    Nall, J.

    2005-12-01

    NASA's Goddard Space Flight Center has worked closely with Minority Serving Institutions for many years. The presenter will detail specific approaches with selected institutions, or types of colleges to offer what has worked, and what has not, methodologies employed to engage students and faculty in our programs, and how such program development and collaboration have proven mutually beneficial. An interactive session with the audience will seek to encourage partnership connections at the conference.

  15. The Spitzer Extragalactic Representative Volume Survey (SERVS)

    NASA Astrophysics Data System (ADS)

    Mauduit, Jean-Christophe; Lacy, M.; Farrah, D.; Surace, J.; Jarvis, M.; Oliver, S.; Maraston, C.; SERVS Team

    2012-01-01

    We present details of the Spitzer Extragalactic Representative Volume Survey (SERVS), an 18 square degrees medium-deep survey at 3.6 and 4.5 μm with the post-cryogenic Spitzer Space Telescope to ≈ 2 μJy (AB=23.1) depth of five highly observed astronomical fields (Elais-N1, Elais-S1, Lockman Hole, Chandra-Deep Fied South and XMM). Data will be made available to the community in the Spring of 2012. SERVS is designed to enable the study of galaxy evolution as a function of environment from z ≈ 5 to the present day, and is the first extragalactic survey both large enough and deep enough to put rare objects such as luminous quasars and galaxy clusters at z ≥ 1 into their cosmological context. SERVS is designed to overlap with several key surveys at optical, near- through far-infrared, submillimeter and radio wavelengths to provide a coherent picture of the formation of massive galaxies.

  16. A Peer-to-Peer Health Education Program for Vulnerable Children in Uganda

    ERIC Educational Resources Information Center

    Falk, Diane S.; Pettet, Kristen; Mpagi, Charles

    2016-01-01

    In this paper, children attending a U.S.-sponsored private primary school serving orphaned and vulnerable children in Uganda were interviewed in focus groups about their participation in a peer-to-peer health education program in which they used music, dance, poetry, art, and drama to convey health information. The children reported enhanced…

  17. Vulnerability Assessment of Selected Buildings Designated as Shelters: St. Kitts--Nevis.

    ERIC Educational Resources Information Center

    Gibbs, Tony

    Educational facilities in the Caribbean often serve roles as shelters during natural hazards, but they often sustain as much damage as other buildings. This study investigated the physical vulnerability of schools located on St. Kitts and Nevis to wind forces, torrential rain, and seismic forces in order to provide relevant local agencies with…

  18. Vulnerability Assessment of Selected Buildings Designated as Shelters: Antigua and Barbuda.

    ERIC Educational Resources Information Center

    Gibbs, Tony

    Educational facilities in the Caribbean often serve roles as shelters during natural hazards, but they often sustain as much damage as other buildings. This study investigated the physical vulnerability of schools located on Antigua and Barbuda to wind forces, torrential rain, and seismic forces in order to provide relevant local agencies with…

  19. Integrated Estimation of Seismic Physical Vulnerability of Tehran Using Rule Based Granular Computing

    NASA Astrophysics Data System (ADS)

    Sheikhian, H.; Delavar, M. R.; Stein, A.

    2015-08-01

    Tehran, the capital of Iran, is surrounded by the North Tehran fault, the Mosha fault and the Rey fault. This exposes the city to possibly huge earthquakes followed by dramatic human loss and physical damage, in particular as it contains a large number of non-standard constructions and aged buildings. Estimation of the likely consequences of an earthquake facilitates mitigation of these losses. Mitigation of the earthquake fatalities may be achieved by promoting awareness of earthquake vulnerability and implementation of seismic vulnerability reduction measures. In this research, granular computing using generality and absolute support for rule extraction is applied. It uses coverage and entropy for rule prioritization. These rules are combined to form a granule tree that shows the order and relation of the extracted rules. In this way the seismic physical vulnerability is assessed, integrating the effects of the three major known faults. Effective parameters considered in the physical seismic vulnerability assessment are slope, seismic intensity, height and age of the buildings. Experts were asked to predict seismic vulnerability for 100 randomly selected samples among more than 3000 statistical units in Tehran. The integrated experts' point of views serve as input into granular computing. Non-redundant covering rules preserve the consistency in the model, which resulted in 84% accuracy in the seismic vulnerability assessment based on the validation of the predicted test data against expected vulnerability degree. The study concluded that granular computing is a useful method to assess the effects of earthquakes in an earthquake prone area.

  20. Skylab Food Heating and Serving Tray

    NASA Technical Reports Server (NTRS)

    1970-01-01

    Shown here is the Skylab food heating and serving tray with food, drink, and utensils. The tray contained heating elements for preparing the individual food packets. The food on Skylab was a great improvement over that on earlier spaceflights. It was no longer necessary to squeeze liquified food from plastic tubes. Skylab's kitchen in the Orbital Workshop wardroom was so equipped that each crewman could select his own menu and prepare it to his own taste. The Marshall Space Flight Center had program management responsibility for the development of Skylab hardware and experiments.

  1. Mountain torrents: Quantifying vulnerability and assessing uncertainties

    PubMed Central

    Totschnig, Reinhold; Fuchs, Sven

    2013-01-01

    Vulnerability assessment for elements at risk is an important component in the framework of risk assessment. The vulnerability of buildings affected by torrent processes can be quantified by vulnerability functions that express a mathematical relationship between the degree of loss of individual elements at risk and the intensity of the impacting process. Based on data from the Austrian Alps, we extended a vulnerability curve for residential buildings affected by fluvial sediment transport processes to other torrent processes and other building types. With respect to this goal to merge different data based on different processes and building types, several statistical tests were conducted. The calculation of vulnerability functions was based on a nonlinear regression approach applying cumulative distribution functions. The results suggest that there is no need to distinguish between different sediment-laden torrent processes when assessing vulnerability of residential buildings towards torrent processes. The final vulnerability functions were further validated with data from the Italian Alps and different vulnerability functions presented in the literature. This comparison showed the wider applicability of the derived vulnerability functions. The uncertainty inherent to regression functions was quantified by the calculation of confidence bands. The derived vulnerability functions may be applied within the framework of risk management for mountain hazards within the European Alps. The method is transferable to other mountain regions if the input data needed are available. PMID:27087696

  2. [Genetic vulnerability of methamphetamine dependence].

    PubMed

    Moriya, Yuki; Kasahara, Yoshiyuki; Sora, Ichiro

    2013-08-01

    Methamphetamine (METH) dependence show strong familial and genetic influences in family and twin studies. METH exerts its reinforcing effects by modulating monoaminergic transmission, of which dopamine is supposed to be important. Previously, experimental animals were being used to identify mechanisms of action of METH that are related to its abuse and toxicity, and genetic mouse models have also been used to define genes that may predict risk for the development of drug addiction. We found that genetic variances of dopamine transporter, dopamine receptor, micro-opioid receptor, serotonin 1A receptor, serotonin 6 receptor, and adenosine 2A adenosine receptor could be vulnerability factors for METH dependence or psychosis in the Japanese population. Genetic analysis with a genome-wide association study (GWAS)-based approach has been successful for investigating the genetic influences of METH dependence and other complex features. Collaborative studies with JGIDA and NIDA/NIH have obtained the results that the genetic vulnerability to METH dependence contributes to other major drug addiction. The genetic studies for METH dependence might help to identify the risk of individuals and to develop treatments that take advantage of individual genetic information in the future. PMID:25069251

  3. An Eliminativist Approach to Vulnerability.

    PubMed

    Wrigley, Anthony

    2015-09-01

    The concept of vulnerability has been subject to numerous different interpretations but accounts are still beset with significant problems as to their adequacy, such as their contentious application or the lack of genuine explanatory role for the concept. The constant failure to provide a compelling conceptual analysis and satisfactory definition leaves the concept open to an eliminativist move whereby we can question whether we need the concept at all. I highlight problems with various kinds of approach and explain why a satisfactory account of vulnerability is unlikely ever to be offered if we wish the concept to play a genuinely explanatory role in bioethical contexts. I outline why an eliminativist position should be taken with regard to this concept in light of these concerns but mitigate some of the severity of this position by arguing that we can still make sense of retaining our widespread use of the term by viewing it as nothing more than a useful pragmatic linguistic device that acts as a marker to draw attention to certain kinds of issue. These issues will be entirely governed by other, better understood ethical concepts and theories. PMID:25425540

  4. Dynamics of immune system vulnerabilities

    NASA Astrophysics Data System (ADS)

    Stromberg, Sean P.

    The adaptive immune system can be viewed as a complex system, which adapts, over time, to reflect the history of infections experienced by the organism. Understanding its operation requires viewing it in terms of tradeoffs under constraints and evolutionary history. It typically displays "robust, yet fragile" behavior, meaning common tasks are robust to small changes but novel threats or changes in environment can have dire consequences. In this dissertation we use mechanistic models to study several biological processes: the immune response, the homeostasis of cells in the lymphatic system, and the process that normally prevents autoreactive cells from entering the lymphatic system. Using these models we then study the effects of these processes interacting. We show that the mechanisms that regulate the numbers of cells in the immune system, in conjunction with the immune response, can act to suppress autoreactive cells from proliferating, thus showing quantitatively how pathogenic infections can suppress autoimmune disease. We also show that over long periods of time this same effect can thin the repertoire of cells that defend against novel threats, leading to an age correlated vulnerability. This vulnerability is shown to be a consequence of system dynamics, not due to degradation of immune system components with age. Finally, modeling a specific tolerance mechanism that normally prevents autoimmune disease, in conjunction with models of the immune response and homeostasis we look at the consequences of the immune system mistakenly incorporating pathogenic molecules into its tolerizing mechanisms. The signature of this dynamic matches closely that of the dengue virus system.

  5. Scenarios for coastal vulnerability assessment

    USGS Publications Warehouse

    Nicholls, Robert J.; Woodroffe, Colin D.; Burkett, Virginia; Hay, John; Wong, Poh Poh; Nurse, Leonard

    2011-01-01

    Coastal vulnerability assessments tend to focus mainly on climate change and especially on sea-level rise. Assessment of the influence of nonclimatic environmental change or socioeconomic change is less well developed and these drivers are often completely ignored. Given that the most profound coastal changes of the twentieth century due to nonclimate drivers are likely to continue through the twenty-first century, this is a major omission. It may result in not only overstating the importance of climate change but also overlooking significant interactions of climate change and other drivers. To support the development of policies relating to climate change and coastal management, integrated assessments of climatic change in coastal areas are required, including the effects of all the relevant drivers. This chapter explores the development of scenarios (or "plausible futures") of relevant climate and nonclimate drivers that can be used for coastal analysis, with an emphasis on the nonclimate drivers. It shows the importance of analyzing the impacts of climate change and sea-level rise in a broader context of coastal change and all its drivers. This will improve the analysis of impacts, key vulnerabilities, and adaptation needs and, hence, inform climate and coastal policy. Stakeholder engagement is important in the development of scenarios, and the underlying assumptions need to be explicit, transparent, and open to scientific debate concerning their uncertainties/realism and likelihood.

  6. Vulnerability of network of networks

    NASA Astrophysics Data System (ADS)

    Havlin, S.; Kenett, D. Y.; Bashan, A.; Gao, J.; Stanley, H. E.

    2014-10-01

    Our dependence on networks - be they infrastructure, economic, social or others - leaves us prone to crises caused by the vulnerabilities of these networks. There is a great need to develop new methods to protect infrastructure networks and prevent cascade of failures (especially in cases of coupled networks). Terrorist attacks on transportation networks have traumatized modern societies. With a single blast, it has become possible to paralyze airline traffic, electric power supply, ground transportation or Internet communication. How, and at which cost can one restructure the network such that it will become more robust against malicious attacks? The gradual increase in attacks on the networks society depends on - Internet, mobile phone, transportation, air travel, banking, etc. - emphasize the need to develop new strategies to protect and defend these crucial networks of communication and infrastructure networks. One example is the threat of liquid explosives a few years ago, which completely shut down air travel for days, and has created extreme changes in regulations. Such threats and dangers warrant the need for new tools and strategies to defend critical infrastructure. In this paper we review recent advances in the theoretical understanding of the vulnerabilities of interdependent networks with and without spatial embedding, attack strategies and their affect on such networks of networks as well as recently developed strategies to optimize and repair failures caused by such attacks.

  7. Metadata for selecting or submitting generic seismic vulnerability functions via GEM's vulnerability database

    USGS Publications Warehouse

    Jaiswal, Kishor

    2013-01-01

    This memo lays out a procedure for the GEM software to offer an available vulnerability function for any acceptable set of attributes that the user specifies for a particular building category. The memo also provides general guidelines on how to submit the vulnerability or fragility functions to the GEM vulnerability repository, stipulating which attributes modelers must provide so that their vulnerability or fragility functions can be queried appropriately by the vulnerability database. An important objective is to provide users guidance on limitations and applicability by providing the associated modeling assumptions and applicability of each vulnerability or fragility function.

  8. An holistic view on aquifer vulnerability based on a distinction of different types of vulnerability

    NASA Astrophysics Data System (ADS)

    De Luca, Domenico Antonio; Lasagna, Manuela; Franchino, Elisa

    2016-04-01

    AN HOLISTIC VIEW ON AQUIFER VULNERABILITY BASED ON A DISTINCTION OF DIFFERENT TYPES OF VULNERABILITY D.A. De Luca1 , M. Lasagna1, E. Franchino1 1Department of Earth Sciences, University of Turin The concept of vulnerability is certainly useful in the field of groundwater protection. Nevertheless, within the scientific community, the definition of groundwater vulnerability is still debatable and not clear and conclusive. This is probably due to the fact that researchers often have very different experiences and education. A positive effect of it is a constant exchange of ideas, but there are also negative consequences and difficulties in deepening the issue. The different approaches are very important but they are usable only if the concept of vulnerability is standardized: thus, for the sake of clarity, a number of definitions should be laid down, based on the different types of vulnerability. These definitions can then provide the necessary holistic view for the aquifer vulnerability assessment. Nowadays vulnerability methods focus on the degree of vulnerability and the parameters needed for its evaluation, often neglecting to clarify what is the type of vulnerability the proposed methods are referred. The type of vulnerability, indeed, is both logically and hierarchically superior to the degree of vulnerability. More specifically the type of vulnerability represents the evaluation of the hydrogeological conditions considered in the vulnerability assessment and able to influence the way in which the contamination can take place. Currently the only distinction, based on of the type of vulnerability, is referred to intrinsic and specific vulnerability. Intrinsic vulnerability assesses the susceptibility of the receptor based on the natural properties of the land and subsurface; specific vulnerability also includes properties of the analyzed contaminant. This distinction is useful but not exhaustive. In addition to this, e.g., a distinction of vertical vulnerability

  9. Assessing human vulnerability: Daytime residential distribution as a vulnerability indicator

    NASA Astrophysics Data System (ADS)

    Gokesch, Karin; Promper, Catrin; Papathoma-Köhle, Maria; Glade, Thomas

    2014-05-01

    Natural hazard risk management is based on detailed information on potential impacts of natural hazards. Especially concerning fast onset hazards such as flash floods, earthquakes but also debris flows and landslides, knowing potential hotspots of impact to both, assets and human lives is essential. This information is important for emergency management and decision making in the response phase of the disaster management cycle. Emergency managers are in need of information regarding not only the number of humans being potentially affected but also the respective vulnerability of the group affected based on characteristics such as age, income, health condition, mobility, etc. regarding a certain hazard. The analysis presented focuses on the distribution of the population, assuming a certain pattern of people in a certain radius of action. The method applied is based on a regular pattern of movement of different groups of people and a pattern of presence in certain units, e.g. schools, businesses or residential buildings. The distribution is calculated on a minimum of available data including the average household size, as well as information on building types. The study area is located in the Southwest of Lower Austria, Austria. The city of Waidhofen/Ybbs can be regarded as a regional center providing basic infrastructure, shops and schools. The high concentration of buildings combining shops and residential units leads to a high damage potential throughout the whole study area. The presented results indicate the population distribution within the study area on an average working day. It is clear that explicitly high numbers of people are located in specific buildings (e.g. schools and hospitals) which also include highly vulnerable groups especially to fast onset hazards. The results provide emergency services with the information that they need in order to intervene directly where large numbers of victims or people that need to be evacuated are located. In this

  10. NV: Nessus Vulnerability Visualization for the Web

    SciTech Connect

    Harrison, Lane; Spahn, Riley B; Iannacone, Michael D; Downing, Evan P; Goodall, John R

    2012-01-01

    Network vulnerability is a critical component of network se- curity. Yet vulnerability analysis has received relatively lit- tle attention from the security visualization community. In this paper we describe nv, a web-based Nessus vulnerability visualization. Nv utilizes treemaps and linked histograms to allow system administrators to discover, analyze, and man- age vulnerabilities on their networks. In addition to visual- izing single Nessus scans, nv supports the analysis of sequen- tial scans by showing which vulnerabilities have been fixed, remain open, or are newly discovered. Nv was also designed to operate completely in-browser, to avoid sending sensitive data to outside servers. We discuss the design of nv, as well as provide case studies demonstrating vulnerability analysis workflows which include a multiple-node testbed and data from the 2011 VAST Challenge.

  11. Assessing the Security Vulnerabilities of Correctional Facilities

    SciTech Connect

    Morrison, G.S.; Spencer, D.S.

    1998-10-27

    The National Institute of Justice has tasked their Satellite Facility at Sandia National Laboratories and their Southeast Regional Technology Center in Charleston, South Carolina to devise new procedures and tools for helping correctional facilities to assess their security vulnerabilities. Thus, a team is visiting selected correctional facilities and performing vulnerability assessments. A vulnerability assessment helps to identi~ the easiest paths for inmate escape, for introduction of contraband such as drugs or weapons, for unexpected intrusion fi-om outside of the facility, and for the perpetration of violent acts on other inmates and correctional employees, In addition, the vulnerability assessment helps to quantify the security risks for the facility. From these initial assessments will come better procedures for performing vulnerability assessments in general at other correctional facilities, as well as the development of tools to assist with the performance of such vulnerability assessments.

  12. Measuring and incorporating vulnerability into conservation planning.

    PubMed

    Wilson, Kerrie; Pressey, Robert L; Newton, Adrian; Burgman, Mark; Possingham, Hugh; Weston, Chris

    2005-05-01

    Conservation planning is the process of locating and designing conservation areas to promote the persistence of biodiversity in situ. To do this, conservation areas must be able to mitigate at least some of the proximate threats to biodiversity. Information on threatening processes and the relative vulnerability of areas and natural features to these processes is therefore crucial for effective conservation planning. However, measuring and incorporating vulnerability into conservation planning have been problematic. We develop a conceptual framework of the role of vulnerability assessments in conservation planning and propose a definition of vulnerability that incorporates three dimensions: exposure, intensity, and impact. We review and categorize methods for assessing the vulnerability of areas and the features they contain and identify the relative strengths and weaknesses of each broad approach. Our review highlights the need for further development and evaluation of approaches to assess vulnerability and for comparisons of their relative effectiveness. PMID:15920667

  13. Assessing the security vulnerabilities of correctional facilities

    NASA Astrophysics Data System (ADS)

    Spencer, Debra D.; Morrison, G. Steve

    1998-12-01

    The National Institute of Justice has tasked their satellite facility at Sandia National Laboratories and their Southeast Regional Technology Center in Charleston, South Carolina to devise new procedures and tools for helping correctional facilities to assess their security vulnerabilities. Thus, a team is visiting selected correctional facilities and performing vulnerability assessments. A vulnerability assessment helps identify the easiest paths for inmate escape, for introduction of contraband such as drugs or weapons, for unexpected intrusion from outside of the facility, and for the perpetration of violent acts on other inmates and correctional employees. In addition, the vulnerability assessment helps to quantify the security risks for the facility. From these assessments will come better procedures for performing vulnerability assessments in general at other correctional facilities, as well as the development of tools to assist with the performance of such vulnerability assessments.

  14. Mining Bug Databases for Unidentified Software Vulnerabilities

    SciTech Connect

    Dumidu Wijayasekara; Milos Manic; Jason Wright; Miles McQueen

    2012-06-01

    Identifying software vulnerabilities is becoming more important as critical and sensitive systems increasingly rely on complex software systems. It has been suggested in previous work that some bugs are only identified as vulnerabilities long after the bug has been made public. These vulnerabilities are known as hidden impact vulnerabilities. This paper discusses the feasibility and necessity to mine common publicly available bug databases for vulnerabilities that are yet to be identified. We present bug database analysis of two well known and frequently used software packages, namely Linux kernel and MySQL. It is shown that for both Linux and MySQL, a significant portion of vulnerabilities that were discovered for the time period from January 2006 to April 2011 were hidden impact vulnerabilities. It is also shown that the percentage of hidden impact vulnerabilities has increased in the last two years, for both software packages. We then propose an improved hidden impact vulnerability identification methodology based on text mining bug databases, and conclude by discussing a few potential problems faced by such a classifier.

  15. Proposal of a Mediterranean Diet Serving Score

    PubMed Central

    Monteagudo, Celia; Mariscal-Arcas, Miguel; Rivas, Ana; Lorenzo-Tovar, María Luisa; Tur, Josep A.; Olea-Serrano, Fátima

    2015-01-01

    Background and Aims Numerous studies have demonstrated a relationship between Mediterranean Diet (MD) adherence and the prevention of cardiovascular diseases, cancer, and diabetes, etc. The study aim was to validate a novel instrument to measure MD adherence based on the consumption of food servings and food groups, and apply it in a female population from southern Spain and determining influential factors. Methods and Results The study included 1,155 women aged 12-83 yrs, classified as adolescents, adults, and over-60-yr-olds. All completed a validated semi-quantitative food frequency questionnaire (FFQ). The Mediterranean Dietary Serving Score (MDSS) is based on the latest update of the Mediterranean Diet Pyramid, using the recommended consumption frequency of foods and food groups; the MDSS ranges from 0 to 24. The discriminative power or correct subject classification capacity of the MDSS was analyzed with the Receiver Operating Characteristic (ROC) curve, using the MDS as reference method. Predictive factors for higher MDSS adherence were determined with a logistic regression model, adjusting for age. According to ROC curve analysis, MDSS evidenced a significant discriminative capacity between adherents and non-adherents to the MD pattern (optimal cutoff point=13.50; sensitivity=74%; specificity=48%). The mean MDSS was 12.45 (2.69) and was significantly higher with older age (p<0.001). Logistic regression analysis showed highest MD adherence by over 60-year-olds with low BMI and no habit of eating between meals. Conclusions The MDSS is an updated, easy, valid, and accurate instrument to assess MD adherence based on the consumption of foods and food groups per meal, day, and week. It may be useful in future nutritional education programs to prevent the early onset of chronic non-transmittable diseases in younger populations. PMID:26035442

  16. Vulnerabilities of children admitted to a pediatric inpatient care unit☆

    PubMed Central

    de Oliveira, Larissa Natacha; Breigeiron, Márcia Koja; Hallmann, Sofia; Witkowski, Maria Carolina

    2014-01-01

    OBJECTIVE: To identify the vulnerabilities of children admitted to a pediatric inpatient unit of a university hospital. METHODS: Cross-sectional, descriptive study from April to September 2013 with36 children aged 30 days to 12 years old, admitted to medical-surgical pediatric inpatient units of a university hospital and their caregivers. Data concerning sociocultural, socioeconomic and clinical context of children and their families were collected by interview with the child caregiver and from patients, records, and analyzed by descriptive statistics. RESULTS: Of the total sample, 97.1% (n=132) of children had at least one type of vulnerability, the majority related to the caregiver's level of education, followed by caregiver's financial situation, health history of the child, caregiver's family situation, use of alcohol, tobacco, and illicit drugs by the caregiver, family's living conditions, caregiver's schooling, and bonding between the caregiver and the child. Only 2.9% (n=4) of the children did not show any criteria to be classified in a category of vulnerability. CONCLUSIONS: Most children were classified has having a social vulnerability. It is imperative to create networks of support between the hospital and the primary healthcare service to promote healthcare practices directed to the needs of the child and family. PMID:25511001

  17. Saudis awaken to their vulnerability

    SciTech Connect

    Tinnin, D.B.

    1980-03-10

    Saudi Arabia is becoming aware that it is vulnerable to internal and external pressures which threaten its security. The strains of rapid modernization and threats from hostile neighbors are undermining the consensus which has held the widely diverse country together in a system of open communication. Influence by the Bedouin (ruling) and the ulama (religious) groups has predominated a traditional society determined to modernize and still remain conservative. Members of the ruling class are seeking to profit from the modernization process, but the common Saudi resists becoming an industrial laborer. Recent events in Mecca, Afghanistan and elsewhere illustrate how political pressures are affecting the country's leadership in the threat of armed conflicts over its oil supplies. (DCK)

  18. Proliferation Vulnerability Red Team report

    SciTech Connect

    Hinton, J.P.; Barnard, R.W.; Bennett, D.E.

    1996-10-01

    This report is the product of a four-month independent technical assessment of potential proliferation vulnerabilities associated with the plutonium disposition alternatives currently under review by DOE/MD. The scope of this MD-chartered/Sandia-led study was limited to technical considerations that could reduce proliferation resistance during various stages of the disposition processes below the Stored Weapon/Spent Fuel standards. Both overt and covert threats from host nation and unauthorized parties were considered. The results of this study will be integrated with complementary work by others into an overall Nonproliferation and Arms Control Assessment in support of a Secretarial Record of Decision later this year for disposition of surplus U.S. weapons plutonium.

  19. Attack Vulnerability of Network Controllability.

    PubMed

    Lu, Zhe-Ming; Li, Xin-Feng

    2016-01-01

    Controllability of complex networks has attracted much attention, and understanding the robustness of network controllability against potential attacks and failures is of practical significance. In this paper, we systematically investigate the attack vulnerability of network controllability for the canonical model networks as well as the real-world networks subject to attacks on nodes and edges. The attack strategies are selected based on degree and betweenness centralities calculated for either the initial network or the current network during the removal, among which random failure is as a comparison. It is found that the node-based strategies are often more harmful to the network controllability than the edge-based ones, and so are the recalculated strategies than their counterparts. The Barabási-Albert scale-free model, which has a highly biased structure, proves to be the most vulnerable of the tested model networks. In contrast, the Erdős-Rényi random model, which lacks structural bias, exhibits much better robustness to both node-based and edge-based attacks. We also survey the control robustness of 25 real-world networks, and the numerical results show that most real networks are control robust to random node failures, which has not been observed in the model networks. And the recalculated betweenness-based strategy is the most efficient way to harm the controllability of real-world networks. Besides, we find that the edge degree is not a good quantity to measure the importance of an edge in terms of network controllability. PMID:27588941

  20. Le Bistro serves up cultural change.

    PubMed

    Leggitt, Mark S; Potrepka, Virginia N; Kukolja, Teresa J

    2003-01-01

    Bristol Hospital, a 134-bed community health care system in Connecticut, has consistently been nationally ranked in the top tier of hospitals for its patient satisfaction scores. A key to this long-term distinction has been its commitment to a culture built around patient satisfaction and service excellence. Empowerment, vigilance, recognition, and celebration are the cultural cornerstones. The change has enabled the hospital to increase its market share, increase its satisfaction rankings, increase its employee retention, and enjoy consistent financial success. PMID:14649023

  1. Ultrasound-guided imaging of junctional adhesion molecule-A-targeted microbubbles identifies vulnerable plaque in rabbits.

    PubMed

    Zhang, Ya-Jun; Bai, Dan-Na; Du, Jing-Xi; Jin, Liang; Ma, Jing; Yang, Jia-Lei; Cai, Wen-Bin; Feng, Yang; Xing, Chang-Yang; Yuan, Li-Jun; Duan, Yun-You

    2016-07-01

    Identification of vulnerable atherosclerotic plaques by imaging the molecular characteristics is intensively studied recently, in which verification of specific markers is the critical step. JAM-A, a junctional membrane protein, is involved in the plaque formation, while it is unknown whether it can serve as a marker for vulnerable plaques. Vulnerable and stable plaques were created in rabbits with high cholesterol diet with or without partial ligation of carotid artery respectively. Significant higher JAM-A expression was found in vulnerable plaques than that in stable plaques. Furthermore, JAM-A was not only expressed in the endothelium, but also abundantly expressed in CD68-positive area. Next, JAM-A antibody conjugated microbubbles (MBJAM-A) or control IgG-conjugated microbubbles (MBC) were developed by conjugating the biotinylated antibodies to the streptavidin modified microbubbles, and visualization by contrast-enhance ultrasound (CEUS). Signal intensity of MBJAM-A was substantially enhanced and prolonged in the vulnerable plaque and some of the MBJAM-A was found colocalized with CD68 positive macrophages. In addition, cell model revealed that MBJAM-A were able to be phagocytized by activated macrophages. Taken together, we have found that increase of JAM-A serves as a marker for vulnerable plaques and targeted CEUS would be possibly a novel non-invasive molecular imaging method for plaque vulnerability. PMID:27088407

  2. Serving Data to the GLAST Users Community

    SciTech Connect

    Stephens, Thomas E.

    2007-07-12

    The scientific community will access the public GLAST data through the website of the GLAST Science Support Center (GSSC). For most data products the GSSC website will link to the NASA High Energy Astrophysics Science Archive Research Center's (HEASARC) Browse interface, which will actually serve the data. For example, data from the GLAST Burst Monitor (GBM) from a given burst will be packaged together and accessible through Browse. However, the photon and event data produced by the Large Area Telescope (LAT), GLAST's primary instrument, will be distributed through a custom GSSC interface. These data will be collected over the LAT's large field-of-view, usually while the LAT is scanning the sky, and thus photons from a particular direction cannot be attributed to a single 'observation' in the traditional sense. Users will request all photons detected from a region on the sky over a specified time and energy range. Through its website the GSSC will also provide long and short term science timelines, spacecraft position and attitude histories, exposure maps and other scientific data products. The different data products provided by the GSSC will be described.

  3. Biodiversity Information Serving Our Nation (BISON)

    USGS Publications Warehouse

    U.S. Geological Survey Core Science Analytics and Synthesis

    2013-01-01

    Researchers collect species occurrence data, records of an organism at a particular time in a particular place, as a primary or ancillary function of many biological field investigations. Presently, these data reside in numerous distributed systems and formats (including publications) and are consequently not being used to their full potential. As a step toward addressing this challenge, the Core Science Analytics and Synthesis (CSAS) program of the US Geological Survey (USGS) is developing Biodiversity Information Serving Our Nation (BISON), an integrated and permanent resource for biological occurrence data from the United States. BISON will leverage the accumulated human and infrastructural resources of the long-term USGS investment in research and information management and delivery. CSAS is also the U.S. Node of the Global Biodiversity Information Facility (GBIF), an international, government-initiated and funded effort focused on making biodiversity data freely available for scientific research, conservation and sustainable development. CSAS, with its partners at Department of Energy's Oak Ridge National Laboratory (ORNL), hosts a full mirror of the hundreds of millions of global records to which GBIF provides access. BISON has been initiated with the 110 million records GBIF makes available from the U.S. and is integrating millions more records from other sources each year.

  4. Oxytocin promotes group-serving dishonesty.

    PubMed

    Shalvi, Shaul; De Dreu, Carsten K W

    2014-04-15

    To protect and promote the well-being of others, humans may bend the truth and behave unethically. Here we link such tendencies to oxytocin, a neuropeptide known to promote affiliation and cooperation with others. Using a simple coin-toss prediction task in which participants could dishonestly report their performance levels to benefit their group's outcome, we tested the prediction that oxytocin increases group-serving dishonesty. A double-blind, placebo-controlled experiment allowing individuals to lie privately and anonymously to benefit themselves and fellow group members showed that healthy males (n = 60) receiving intranasal oxytocin, rather than placebo, lied more to benefit their group, and did so faster, yet did not necessarily do so because they expected reciprocal dishonesty from fellow group members. Treatment effects emerged when lying had financial consequences and money could be gained; when losses were at stake, individuals in placebo and oxytocin conditions lied to similar degrees. In a control condition (n = 60) in which dishonesty only benefited participants themselves, but not fellow group members, oxytocin did not influence lying. Together, these findings fit a functional perspective on morality revealing dishonesty to be plastic and rooted in evolved neurobiological circuitries, and align with work showing that oxytocin shifts the decision-maker's focus from self to group interests. These findings highlight the role of bonding and cooperation in shaping dishonesty, providing insight into when and why collaboration turns into corruption. PMID:24706799

  5. Oxytocin promotes group-serving dishonesty

    PubMed Central

    Shalvi, Shaul; De Dreu, Carsten K. W.

    2014-01-01

    To protect and promote the well-being of others, humans may bend the truth and behave unethically. Here we link such tendencies to oxytocin, a neuropeptide known to promote affiliation and cooperation with others. Using a simple coin-toss prediction task in which participants could dishonestly report their performance levels to benefit their group’s outcome, we tested the prediction that oxytocin increases group-serving dishonesty. A double-blind, placebo-controlled experiment allowing individuals to lie privately and anonymously to benefit themselves and fellow group members showed that healthy males (n = 60) receiving intranasal oxytocin, rather than placebo, lied more to benefit their group, and did so faster, yet did not necessarily do so because they expected reciprocal dishonesty from fellow group members. Treatment effects emerged when lying had financial consequences and money could be gained; when losses were at stake, individuals in placebo and oxytocin conditions lied to similar degrees. In a control condition (n = 60) in which dishonesty only benefited participants themselves, but not fellow group members, oxytocin did not influence lying. Together, these findings fit a functional perspective on morality revealing dishonesty to be plastic and rooted in evolved neurobiological circuitries, and align with work showing that oxytocin shifts the decision-maker’s focus from self to group interests. These findings highlight the role of bonding and cooperation in shaping dishonesty, providing insight into when and why collaboration turns into corruption. PMID:24706799

  6. SERV user`s guide. Final report

    SciTech Connect

    Koontz, M.D.; Bakhsh, H.; Lee, S.M.

    1995-01-01

    The Sizing of Energy Recovery Ventilator (SERV) software described in this manual is intended to size an energy recovery ventilator in new and existing single-family residences, based on ASHRAE guidelines for the rate at which outdoor air is to be delivered to an indoor space to ensure acceptable air quality. The user is asked to select a city that has climatic conditions most representative of the house under consideration. Other inputs required from the user include: (1) house leakiness and terrain sheltering factors; (2) estimated annual house energy costs; (3) number, capacity and weekly operation hours for vented exhaust fans; and (4) HVAC system COP/efficiency values. Default values (which the user can override) are provided for most input parameters, and help screens are provided to assist the user in determining appropriate input values. The program estimates the average air infiltration rates for summer and winter, and combines these calculations with estimates of ventilation due to intermittent use of exhaust fans in determining the baseline ventilation rate. An energy recovery ventilator is sized to provide any supplemental ventilation necessary to satisfy air change requirements imposed by ASHRAE Standard 62-1989 (Ventilation for Acceptable Air Quality). The program then calculates (1) the annual energy and associated cost for providing the supplemental ventilation, and (2) the relative impact of the added ventilation on indoor concentrations of four pollutants--carbon monoxide, nitrogen dioxide, formaldehyde and radon.

  7. Infrastructure Vulnerability Assessment Model (I-VAM).

    PubMed

    Ezell, Barry Charles

    2007-06-01

    Quantifying vulnerability to critical infrastructure has not been adequately addressed in the literature. Thus, the purpose of this article is to present a model that quantifies vulnerability. Vulnerability is defined as a measure of system susceptibility to threat scenarios. This article asserts that vulnerability is a condition of the system and it can be quantified using the Infrastructure Vulnerability Assessment Model (I-VAM). The model is presented and then applied to a medium-sized clean water system. The model requires subject matter experts (SMEs) to establish value functions and weights, and to assess protection measures of the system. Simulation is used to account for uncertainty in measurement, aggregate expert assessment, and to yield a vulnerability (Omega) density function. Results demonstrate that I-VAM is useful to decisionmakers who prefer quantification to qualitative treatment of vulnerability. I-VAM can be used to quantify vulnerability to other infrastructures, supervisory control and data acquisition systems (SCADA), and distributed control systems (DCS). PMID:17640208

  8. Predicting Vulnerability Risks Using Software Characteristics

    ERIC Educational Resources Information Center

    Roumani, Yaman

    2012-01-01

    Software vulnerabilities have been regarded as one of the key reasons for computer security breaches that have resulted in billions of dollars in losses per year (Telang and Wattal 2005). With the growth of the software industry and the Internet, the number of vulnerability attacks and the ease with which an attack can be made have increased. From…

  9. Design Vulnerability Assessments for Safeguards Sealing Systems

    SciTech Connect

    Brockman, Linda; Johnston, Roger; Kravtchenko, Victor; Undem, Halvor A.; Wishard, Bernard

    2010-08-11

    The International Atomic Energy Agency (the "Agency") engages in a rigorous equipment authorization process prior to deploying Safeguards instrumentation, including Safeguards sealing systems, for world-wide use. A positive result from a vulnerability assessment is one of the many requirements that must be met prior to instrumentation deployment. Given the long time period in the Safeguards instrumentation development cycle, the substantial Member State investments made, and the significant Agency staff time required, a negative result for the vulnerability assessment can result in the loss of time, considerable additional expense, or even the failure to deploy an instrument or sealing system at all. First suggested in 1998 by the General Physics Institute in Moscow, an approach that incorporates a design vulnerability assessment minimizes the risk of deployment failure by teaming a public sector vulnerability assessment team with the instrument or sealing system design team in order to identify, at the earliest possible design stage, inherent vulnerabilities. Involving the vulnerability assessors early and often in the design and development process avoids many of the problems inherent in evaluating security vulnerabilities only after the design is finalized. The disadvantages include increased costs and time to deployment. An improved pressure-sensitive adhesive label seal, called the "VOID-3 seal" was developed for the Agency using this design vulnerability assessment process.

  10. [Medical research and vulnerable subjects: unemployed people].

    PubMed

    Niebrój, Lesław

    2006-01-01

    Although the importance of medical research for the diagnosis and treatment of human diseases is unquestionable, the use of human subjects, however, still presents a complex ethical problem. Moral difficulties occur in particular when the medical research deals with vulnerable subjects. Vulnerable individuals are defined as those who experience diminished actual autonomy. Among the groups which should be considered as being vulnerable are usually listed the following: children, pregnant women, mentally or emotionally disabled, physically disabled, homeless, and institutionalized people. This study addresses key concerns that gave rise to the question of whether unemployed people had to be recognized as vulnerable subjects. The term "vulnerability" was clarified and it was assumed that the "vulnerability" of medical research subjects' had to be understood as a form of continuum from potential, through the circumstantial, temporal, episodic, permanent to inevitable vulnerability. The conclusion was drawn that unemployed people were, at least, potentially vulnerable subjects. Research involving unemployed people presents important moral challenges to researchers and should be undertaken very carefully, following special ethical guidelines. PMID:17441390

  11. Opportunistic Interruptions: Interactional Vulnerabilities Deriving from Linearization

    ERIC Educational Resources Information Center

    Gibson, David R.

    2005-01-01

    Speaking involves "linearizing" a message into a string of words. This process leaves us vulnerable to being interrupted in such a way that the aborted turn is a misrepresentation of the intended message. Further, because we linearize our messages in standard ways, we are recurrently vulnerable to interruptions at particular turn-construction…

  12. Vulnerable Youth and Transitions to Adulthood

    ERIC Educational Resources Information Center

    Xie, Rongbing; Sen, Bisakha; Foster, E. Michael

    2014-01-01

    This chapter focuses on vulnerable youth, the challenges they face during their transitions to adulthood, and the adverse effects of limited support systems on those transitions. The authors offer recommendations on how adult educators can help facilitate smooth transitions into adulthood for vulnerable youth.

  13. Environmental Health Related Socio-Spatial Inequalities: Identifying "Hotspots" of Environmental Burdens and Social Vulnerability.

    PubMed

    Shrestha, Rehana; Flacke, Johannes; Martinez, Javier; van Maarseveen, Martin

    2016-01-01

    Differential exposure to multiple environmental burdens and benefits and their distribution across a population with varying vulnerability can contribute heavily to health inequalities. Particularly relevant are areas with high cumulative burdens and high social vulnerability termed as "hotspots". This paper develops an index-based approach to assess these multiple burdens and benefits in combination with vulnerability factors at detailed intra-urban level. The method is applied to the city of Dortmund, Germany. Using non-spatial and spatial methods we assessed inequalities and identified "hotspot" areas in the city. We found modest inequalities burdening higher vulnerable groups in Dortmund (CI = -0.020 at p < 0.05). At the detailed intra-urban level, however, inequalities showed strong geographical patterns. Large numbers of "hotspots" exist in the northern part of the city compared to the southern part. A holistic assessment, particularly at a detailed local level, considering both environmental burdens and benefits and their distribution across the population with the different vulnerability, is essential to inform environmental justice debates and to mobilize local stakeholders. Locating "hotspot" areas at this detailed spatial level can serve as a basis to develop interventions that target vulnerable groups to ensure a health conducive equal environment. PMID:27409625

  14. Cybersecurity vulnerabilities in medical devices: a complex environment and multifaceted problem.

    PubMed

    Williams, Patricia Ah; Woodward, Andrew J

    2015-01-01

    The increased connectivity to existing computer networks has exposed medical devices to cybersecurity vulnerabilities from which they were previously shielded. For the prevention of cybersecurity incidents, it is important to recognize the complexity of the operational environment as well as to catalog the technical vulnerabilities. Cybersecurity protection is not just a technical issue; it is a richer and more intricate problem to solve. A review of the factors that contribute to such a potentially insecure environment, together with the identification of the vulnerabilities, is important for understanding why these vulnerabilities persist and what the solution space should look like. This multifaceted problem must be viewed from a systemic perspective if adequate protection is to be put in place and patient safety concerns addressed. This requires technical controls, governance, resilience measures, consolidated reporting, context expertise, regulation, and standards. It is evident that a coordinated, proactive approach to address this complex challenge is essential. In the interim, patient safety is under threat. PMID:26229513

  15. The promise and peril of accountable care for vulnerable populations: a framework for overcoming obstacles.

    PubMed

    Lewis, Valerie A; Larson, Bridget Kennedy; McClurg, Asha Belle; Boswell, Rebecca Goldman; Fisher, Elliott S

    2012-08-01

    Accountable care organizations (ACOs) are a promising payment model aimed at reducing costs while also improving the quality of care. However, there is a risk that vulnerable populations may not be fully incorporated into this new model. We define two distinct vulnerable populations, clinically at-risk and socially disadvantaged, and we discuss how ACOs may benefit each group. We provide a framework to use in considering challenges for both vulnerable patients and health systems on the path to accountable care. We identify policies that can help overcome these obstacles: strategies that support ACO formation in diverse settings and that monitor, measure, and reward the performance of providers that reach all patients, including vulnerable populations. PMID:22869656

  16. Cybersecurity vulnerabilities in medical devices: a complex environment and multifaceted problem

    PubMed Central

    Williams, Patricia AH; Woodward, Andrew J

    2015-01-01

    The increased connectivity to existing computer networks has exposed medical devices to cybersecurity vulnerabilities from which they were previously shielded. For the prevention of cybersecurity incidents, it is important to recognize the complexity of the operational environment as well as to catalog the technical vulnerabilities. Cybersecurity protection is not just a technical issue; it is a richer and more intricate problem to solve. A review of the factors that contribute to such a potentially insecure environment, together with the identification of the vulnerabilities, is important for understanding why these vulnerabilities persist and what the solution space should look like. This multifaceted problem must be viewed from a systemic perspective if adequate protection is to be put in place and patient safety concerns addressed. This requires technical controls, governance, resilience measures, consolidated reporting, context expertise, regulation, and standards. It is evident that a coordinated, proactive approach to address this complex challenge is essential. In the interim, patient safety is under threat. PMID:26229513

  17. Serving Those Who Serve: Meeting the Complex Needs of Students Returning Home from War

    ERIC Educational Resources Information Center

    Veislind, Emili

    2013-01-01

    As community colleges across the country strive to improve completion rates and serve a growing number of students returned home from war, the need for programs that meet the unique needs of veterans--including job training, social acclimation, referral programs for mental health counseling, and academic tutoring, to name a few--is more pressing…

  18. Offer versus Serve or Serve Only: Does Service Method Affect Elementary Children's Fruit and Vegetable Consumption?

    ERIC Educational Resources Information Center

    Goggans, Margaret Harbison; Lambert, Laurel; Chang, Yunhee

    2011-01-01

    Purpose/Objectives: The purpose of this study was to determine if the use of the Offer versus Serve (OVS) provision in the National School Lunch Program would result in a significant difference in fruit and vegetable consumption by fourth and fifth grade elementary students, and in plate waste cost. Methods: Weighed and visual plate waste data…

  19. How Online Schools Serve and Fail to Serve At-Risk Students

    ERIC Educational Resources Information Center

    Figueiredo-Brown, Regina

    2013-01-01

    Purpose: Online schools were initially designed to provide access to diverse courses to advanced and homeschooled students, however, many online schools now market their programs specifically to students whose needs place them at-risk in traditional schools. The capacity of technology to address any of the needs of under-served students is largely…

  20. Dermatitis artefacta in a vulnerable adult with a dissociative state.

    PubMed

    Ahmed, A; Bewley, A; Taylor, R

    2013-12-01

    Dermatitis artefacta (DA), a factitious skin disorder, often occurs as a response to traumatic life events or as a factitious behaviour, which may result in secondary gain. It can be difficult to get patients to engage with health services, and they seldom admit to causing the lesions themselves. The possibility of DA lesions occurring in dissociative states is less well known. We present a case of DA diagnosed in a vulnerable adult, who we believe caused the lesions during periods of dissociation. We discuss the way in which the concept of dissociation can provide an acceptable way of discussing the behaviour with patients and initiating psychological therapy. PMID:23758341

  1. Amyotrophic lateral sclerosis: cell vulnerability or system vulnerability?

    PubMed Central

    Talbot, Kevin

    2014-01-01

    Amyotrophic lateral sclerosis (ALS) is a complex neurodegenerative disease with clinical, pathological and genetic overlap with frontotemporal dementia (FTD). No longer viewed as one disease with a single unified cause, ALS is now considered to be a clinicopathological syndrome resulting from a complex convergence of genetic susceptibility, age-related loss of cellular homeostasis, and possible environmental influences. The rapid increase in recent years of the number of genes in which mutations have been associated with ALS has led to in vitro and in vivo models that have generated a wealth of data indicating disruption of specific biochemical pathways and sub-cellular compartments. Data implicating pathways including protein misfolding, mRNA splicing, oxidative stress, proteosome and mitochondrial dysfunction in the pathogenesis of ALS reinforce a disease model based on selective age-dependent vulnerability of a specific population of cells. To the clinical neurologist, however, ALS presents as a disease of focal onset and contiguous spread. Characteristic regional patterns of involvement and progression suggest that the disease does not proceed randomly but via a restricted number of anatomical pathways. These clinical observations combined with electrophysiological and brain-imaging studies underpin the concept of ALS at the macroscopic level as a ‘system degeneration’. This dichotomy between cellular and systems neurobiology raises the fundamental questions of what initiates the disease process in a specific anatomical site and how the disease is propagated. Is the essence of ALS a cell-to-cell transmission of pathology with, for example, a ‘prion-like’ mechanism, or does the cellular pathology follow degeneration of specific synaptic networks? Elucidating the interaction between cellular degeneration and system level degeneration will aid modeling of the disease in the earliest phases, improve the development of sensitive markers of disease

  2. [Nurses' autonomy and vulnerability in the Nursing Assistance Systematization practice].

    PubMed

    Menezes, Silvia Regina Tamae; Priel, Margareth Rose; Pereira, Luciane Lucio

    2011-08-01

    The objective of this study was to recognize the autonomy and vulnerability of nurses in the implementation of the Sistema da Assistência de Enfermagem (SAE) Nursing Care System through an integrative literature review, using content analysis. A survey was conducted, and 40 articles published between 1998 and 2008 were selected based on their relevance. Results showed two main categories of meaning: Benefits associated to the SAE practice (to patients, to the profession and to the institution) and Determinants for the Implementation of SAE (nurse's competence, training and education, record-instruments, infrastructure and collective sharing-construction). From the integration of the two categories, the highlights were the autonomy in acting with freedom and responsibility, science-based decision-making, and being valued for their social work, as well as the vulnerability expressed by interpersonal relationships, the wear generated by professional stress and the risk inherent to the service. PMID:21876898

  3. Development and implementation of a Bayesian-based aquifer vulnerability assessment in Florida

    USGS Publications Warehouse

    Arthur, J.D.; Wood, H.A.R.; Baker, A.E.; Cichon, J.R.; Raines, G.L.

    2007-01-01

    The Florida Aquifer Vulnerability Assessment (FAVA) was designed to provide a tool for environmental, regulatory, resource management, and planning professionals to facilitate protection of groundwater resources from surface sources of contamination. The FAVA project implements weights-of-evidence (WofE), a data-driven, Bayesian-probabilistic model to generate a series of maps reflecting relative aquifer vulnerability of Florida's principal aquifer systems. The vulnerability assessment process, from project design to map implementation is described herein in reference to the Floridan aquifer system (FAS). The WofE model calculates weighted relationships between hydrogeologic data layers that influence aquifer vulnerability and ambient groundwater parameters in wells that reflect relative degrees of vulnerability. Statewide model input data layers (evidential themes) include soil hydraulic conductivity, density of karst features, thickness of aquifer confinement, and hydraulic head difference between the FAS and the watertable. Wells with median dissolved nitrogen concentrations exceeding statistically established thresholds serve as training points in the WofE model. The resulting vulnerability map (response theme) reflects classified posterior probabilities based on spatial relationships between the evidential themes and training points. The response theme is subjected to extensive sensitivity and validation testing. Among the model validation techniques is calculation of a response theme based on a different water-quality indicator of relative recharge or vulnerability: dissolved oxygen. Successful implementation of the FAVA maps was facilitated by the overall project design, which included a needs assessment and iterative technical advisory committee input and review. Ongoing programs to protect Florida's springsheds have led to development of larger-scale WofE-based vulnerability assessments. Additional applications of the maps include land-use planning

  4. Serving the needs of our future population.

    PubMed

    Nagel, Catie; Lenton, Carrie

    2016-05-01

    Less than 30% of doctors, across The Organisation for Economic Co-operation and Development (OECD) and within the UK are currently working in generalist careers. Our population is ageing and increasingly, multi-morbidity is becoming the norm rather than the exception. With an increasing proportion of graduates opting for specialist careers, how can we best equip them to deal with the challenges they are likely to face without an exponential rise in the cost of care or increasing risk to patients? We propose an approach by which community placements are present from the early years of medical training and to seek opportunities for interprofessional learning and teaching, with emphasis on continuity of care and holism. By involving students in longitudinal placements and encouraging them to develop relationships with patients and their carers, they will be more likely to understand the value of continuity and the need to undertake a whole person approach, rather than what Oldham described as 'body part' medicine. It is hoped that through teaching, training, and role modelling, more students might opt for generalist careers, or the effects of increasing specialisation might be mitigated. PMID:27102844

  5. Determining Vulnerability Importance in Environmental Impact Assessment

    SciTech Connect

    Toro, Javier; Duarte, Oscar; Requena, Ignacio; Zamorano, Montserrat

    2012-01-15

    The concept of vulnerability has been used to describe the susceptibility of physical, biotic, and social systems to harm or hazard. In this sense, it is a tool that reduces the uncertainties of Environmental Impact Assessment (EIA) since it does not depend exclusively on the value assessments of the evaluator, but rather is based on the environmental state indicators of the site where the projects or activities are being carried out. The concept of vulnerability thus reduces the possibility that evaluators will subjectively interpret results, and be influenced by outside interests and pressures during projects. However, up until now, EIA has been hindered by a lack of effective methods. This research study analyzes the concept of vulnerability, defines Vulnerability Importance and proposes its inclusion in qualitative EIA methodology. The method used to quantify Vulnerability Importance is based on a set of environmental factors and indicators that provide a comprehensive overview of the environmental state. The results obtained in Colombia highlight the usefulness and objectivity of this method since there is a direct relation between this value and the environmental state of the departments analyzed. - Research Highlights: Black-Right-Pointing-Pointer The concept of vulnerability could be considered defining Vulnerability Importance included in qualitative EIA methodology. Black-Right-Pointing-Pointer The use of the concept of environmental vulnerability could reduce the subjectivity of qualitative methods of EIA. Black-Right-Pointing-Pointer A method to quantify the Vulnerability Importance proposed provides a comprehensive overview of the environmental state. Black-Right-Pointing-Pointer Results in Colombia highlight the usefulness and objectivity of this method.

  6. Early Brain Vulnerability in Wolfram Syndrome

    PubMed Central

    Hershey, Tamara; Lugar, Heather M.; Shimony, Joshua S.; Rutlin, Jerrel; Koller, Jonathan M.; Perantie, Dana C.; Paciorkowski, Alex R.; Eisenstein, Sarah A.; Permutt, M. Alan

    2012-01-01

    Wolfram Syndrome (WFS) is a rare autosomal recessive disease characterized by insulin-dependent diabetes mellitus, optic nerve atrophy, diabetes insipidus, deafness, and neurological dysfunction leading to death in mid-adulthood. WFS is caused by mutations in the WFS1 gene, which lead to endoplasmic reticulum (ER) stress-mediated cell death. Case studies have found widespread brain atrophy in late stage WFS. However, it is not known when in the disease course these brain abnormalities arise, and whether there is differential vulnerability across brain regions and tissue classes. To address this limitation, we quantified regional brain abnormalities across multiple imaging modalities in a cohort of young patients in relatively early stages of WFS. Children and young adults with WFS were evaluated with neurological, cognitive and structural magnetic resonance imaging measures. Compared to normative data, the WFS group had intact cognition, significant anxiety and depression, and gait abnormalities. Compared to healthy and type 1 diabetic control groups, the WFS group had smaller intracranial volume and preferentially affected gray matter volume and white matter microstructural integrity in the brainstem, cerebellum and optic radiations. Abnormalities were detected in even the youngest patients with mildest symptoms, and some measures did not follow the typical age-dependent developmental trajectory. These results establish that WFS is associated with smaller intracranial volume with specific abnormalities in the brainstem and cerebellum, even at the earliest stage of clinical symptoms. This pattern of abnormalities suggests that WFS has a pronounced impact on early brain development in addition to later neurodegenerative effects, representing a significant new insight into the WFS disease process. Longitudinal studies will be critical for confirming and expanding our understanding of the impact of ER stress dysregulation on brain development. PMID:22792385

  7. Understanding the Code: safeguarding vulnerable adults.

    PubMed

    Griffith, Richard

    2015-11-01

    Under the provisions of the Nursing and Midwifery Council's revised Code (2015) , all district and community nurses have a professional duty to safeguard vulnerable adults from abuse. With adult abuse continuing to increase, all members of the district and community nursing teams are well placed to identify and take action to safeguard the vulnerable. In this article, Richard Griffith explains how the Care Act 2014 seeks to improve the safeguarding of vulnerable adults and the role of district and community nurses in that process. PMID:26551387

  8. Nuclear material production cycle vulnerability analysis

    SciTech Connect

    Bott, T.F.

    1996-07-01

    This paper discusses a method for rapidly and systematically identifying vulnerable equipment in a nuclear material or similar production process and ranking that equipment according to its attractiveness to a malevolent attacker. A multistep approach was used in the analysis. First, the entire production cycle was modeled as a flow diagram. This flow diagram was analyzed using graph theoretical methods to identify processes in the production cycle and their locations. Models of processes that were judged to be particularly vulnerable based on the cycle analysis then were developed in greater detail to identify equipment in that process that is vulnerable to intentional damage.

  9. Individual and social vulnerabilities upon acquiring tuberculosis: a literature systematic review

    PubMed Central

    2014-01-01

    Tuberculosis is a contagious infectious disease mainly caused by the bacteria Mycobacterium tuberculosis that still meets the priority criteria - high magnitude, transcendence and vulnerability - due to the threat it poses to public health. When taking into consideration the vulnerability conditions that favor the onset of the disease, this article aimed to investigate the implications originated from individual and social vulnerability conditions in which tuberculosis patients are inserted. Databases like MEDLINE, LILACS and SciELO were searched in Portuguese, Spanish and English using the descriptors tuberculosis and vulnerability, and 183 articles were found. After the selection criterion was applied, there were 22 publications left to be discussed. Some of the aspects that characterize the vulnerability to tuberculosis are: low-income and low-education families, age, poor living conditions, chemical dependency, pre-existing conditions/aggravations like diabetes mellitus and malnutrition, indigenous communities, variables related to health professionals, intense border crossings and migration, difficulty in accessing information and health services and lack of knowledge on tuberculosis. Much as such aspects are present and favor the onset of the disease, several reports show high incidence rates of tuberculosis in low vulnerability places, suggesting that some factors related to the disease are still unclear. In conclusion, health promotion is important in order to disfavor such conditions or factors of vulnerability to tuberculosis, making them a primary target in the public health planning process and disease control. PMID:25067955

  10. Challenges and strategies for recruitment and retention of vulnerable research participants: promoting the benefits of participation.

    PubMed

    Gemmill, Robin; Williams, Anna Cathy; Cooke, Liz; Grant, Marcia

    2012-05-01

    The purpose of this article was to describe recruitment and retention of vulnerable hematopoietic cell transplant patients participating in a longitudinal intervention study. Utilizing Swanson's theory of caring model, nurse researchers facilitated patients' visualization of how study participation could enable them to share their experience and further clinical insights. PMID:20974092

  11. Partnering with those we serve: using experiential learning activities to support community nursing practice.

    PubMed

    Fries, Kathleen; Stewart, Julie G

    2012-01-01

    The concept of community is multidimensional and may include geographical boundaries and/or the shared interests of its members. Community nursing practice involves nurses, patients, and families who collaborate to address health issues and to promote positive health initiatives. Informed by community health theorists, experiential learning activities provide the structure to promote partnering in community nursing practice to achieve outcomes that benefit those who serve and those who are served. PMID:23061199

  12. Global health, vulnerable populations, and law.

    PubMed

    Benatar, Solomon R

    2013-01-01

    Given the fragility of individual and population wellbeing in an interdependent world threatened by many overlapping crises, the suggestion is made that new legal mechanisms have the robust potential to reduce human vulnerability locally and globally. PMID:23581656

  13. [Aged woman's vulnerability related to AIDS].

    PubMed

    Silva, Carla Marins; Lopes, Fernanda Maria do Valle Martins; Vargens, Octavio Muniz da Costa

    2010-09-01

    This article is a systhematic literature review including the period from 1994 to 2009, whose objective was to discuss the aged woman's vulnerability in relation to Acquired Imunodeficiency Syndrome (Aids). The search for scientific texts was accomplished in the following databases: Biblioteca Virtual em Saúde, Scientific Eletronic Library Online (SciELO), Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS) and Medical Literature Analysis and Retrieval System Online (MEDLINE). The descriptors used were vulnerability, woman and Aids. Eighteen texts were analyzed, including articles in scientific journals, thesis and dissertations. As a conclusion, it was noted that aged women and vulnerability to Aids are directly related, through gender characteristics including submission and that were built historical and socially. We consider as fundamental the development of studies which may generate publications accessible to women, in order to help them see themselves as persons vulnerable to Aids contagion just for being women. PMID:21574329

  14. Salt vulnerability assessment methodology for urban streams

    NASA Astrophysics Data System (ADS)

    Betts, A. R.; Gharabaghi, B.; McBean, E. A.

    2014-09-01

    De-icing agents such as road salts while used for winter road maintenance can cause negative effects on urban stream water quality and drinking water supplies. A new methodology using readily available spatial data to identify Salt Vulnerable Areas (SVAs) for urban streams is used to prioritize implementation of best management practices. The methodology calculates the probable chloride concentration statistics at specified points in the urban stream network and compares the results with known aquatic species exposure tolerance limits to characterize the vulnerability scores. The approach prioritizes implementation of best management practices to areas identified as vulnerable to road salt. The vulnerability assessment is performed on seven sites in four watersheds in the Greater Toronto Area and validated using the Hanlon Creek watershed in Guelph. The mean annual in-stream chloride concentration equation uses readily available spatial data - with province-wide coverage - that can be easily used in any urban watershed.

  15. Housing concerns of vulnerable older Canadians.

    PubMed

    Weeks, Lori E; LeBlanc, Kristal

    2010-09-01

    Preparing for the future housing needs of older adults is imperative in countries with an aging population, but little is known about these issues among vulnerable older adults. This study used a qualitative approach to identify key housing concerns in this group. A total of 84 vulnerable older adults including Aboriginal elders, those with various disabilities, and ethnic minorities participated in 10 focus groups. The Canadian Mortgage and Housing Corporation's (CMHC's) standards of core housing need provided a framework for data analysis, along with the identification of additional key housing themes across and within groups of vulnerable older adults. The results provide insight into preferred housing characteristics, regardless of housing form. Additionally, the results provide insight into how to support vulnerable older adults who choose to remain in their homes and communities and how to help ensure that appropriate housing is developed that meets the needs of this diverse population. PMID:20712917

  16. Camana, Peru, and Tsunami Vulnerability

    NASA Technical Reports Server (NTRS)

    2002-01-01

    A tsunami washed over the low-lying coastal resort region near Camana, southern Peru, following a strong earthquake on June 23, 2001. The earthquake was one of the most powerful of the last 35 years and had a magnitude of 8.4. After the initial quake, coastal residents witnessed a sudden drawdown of the ocean and knew a tsunami was imminent. They had less than 20 minutes to reach higher ground before the tsunami hit. Waves as high as 8 m came in four destructive surges reaching as far as 1.2 km inland. The dashed line marks the approximate area of tsunami inundation. Thousands of buildings were destroyed, and the combined earthquake and tsunami killed as many as 139 people. This image (ISS004-ESC-6128) was taken by astronauts onboard the International Space Station on 10 January 2002. It shows some of the reasons that the Camana area was so vulnerable to tsunami damage. The area has a 1 km band of coastal plain that is less than 5 m in elevation. Much of the plain can be seen by the bright green fields of irrigated agriculture that contrast with the light-colored desert high ground. Many of the tsunami-related deaths were workers in the onion fields in the coastal plain that were unwilling to leave their jobs before the end of the shift. A number of lives were spared because the tsunami occurred during the resort off-season, during the daylight when people could see the ocean drawdown, and during one of the lowest tides of the year. Information on the Tsunami that hit Camana can be found in a reports on the visit by the International Tsunami Survey Team and the USC Tsunami Research Lab. Earthquake Epicenter, Peru shows another image of the area. Image provided by the Earth Sciences and Image Analysis Laboratory at Johnson Space Center. Additional images taken by astronauts and cosmonauts can be viewed at the NASA-JSC Gateway to Astronaut Photography of Earth.

  17. Vulnerability assessment of mining subsidence hazards.

    PubMed

    Deck, Olivier; Verdel, Thierry; Salmon, Romuald

    2009-10-01

    Between 1996 and 1999, five mining subsidence events occurred in the iron-ore field in Lorraine, France, and damaged several hundred buildings. Because of the thousand hectares of undermined areas, an assessment of the vulnerability of buildings and land is necessary for risk management. Risk assessment methods changed from initial risk management decisions that took place immediately after the mining subsidence to the risk assessment studies that are currently under consideration. These changes reveal much about the complexity of the vulnerability concept and about difficulties in developing simple and relevant methods for its assessment. The objective of this article is to present this process, suggest improvements on the basis of theoretical definitions of the vulnerability, and give an operational example of vulnerability assessment in the seismic field. The vulnerability is divided into three components: weakness, stakes value, and resilience. Final improvements take into account these three components and constitute an original method of assessing the vulnerability of a city to subsidence. PMID:19473313

  18. Global Distributions of Vulnerability to Climate Change

    SciTech Connect

    Yohe, Gary; Malone, Elizabeth L.; Brenkert, Antoinette L.; Schlesinger, Michael; Meij, Henk; Xiaoshi, Xing

    2006-12-01

    Signatories of the United Nations Framework Convention on Climate Change (UNFCCC) have committed themselves to addressing the “specific needs and special circumstances of developing country parties, especially those that are particularly vulnerable to the adverse effects of climate change”.1 The Intergovernmental Panel on Climate Change (IPCC) has since concluded with high confidence that “developing countries will be more vulnerable to climate change than developed countries”.2 In their most recent report, however, the IPCC notes that “current knowledge of adaptation and adaptive capacity is insufficient for reliable prediction of adaptations” 3 because “the capacity to adapt varies considerably among regions, countries and socioeconomic groups and will vary over time”.4 Here, we respond to the apparent contradiction in these two statements by exploring how variation in adaptive capacity and climate impacts combine to influence the global distribution of vulnerability. We find that all countries will be vulnerable to climate change, even if their adaptive capacities are enhanced. Developing nations are most vulnerable to modest climate change. Reducing greenhouse-gas emissions would diminish their vulnerabilities significantly. Developed countries would benefit most from mitigation for moderate climate change. Extreme climate change overwhelms the abilities of all countries to adapt. These findings should inform both ongoing negotiations for the next commitment period of the Kyoto Protocol and emerging plans for implementing UNFCCC-sponsored adaptation funds.

  19. Molecular Imaging of Vulnerable Atherosclerotic Plaques in Animal Models.

    PubMed

    Gargiulo, Sara; Gramanzini, Matteo; Mancini, Marcello

    2016-01-01

    Atherosclerosis is characterized by intimal plaques of the arterial vessels that develop slowly and, in some cases, may undergo spontaneous rupture with subsequent heart attack or stroke. Currently, noninvasive diagnostic tools are inadequate to screen atherosclerotic lesions at high risk of acute complications. Therefore, the attention of the scientific community has been focused on the use of molecular imaging for identifying vulnerable plaques. Genetically engineered murine models such as ApoE(-/-) and ApoE(-/-)Fbn1C1039G(+/-) mice have been shown to be useful for testing new probes targeting biomarkers of relevant molecular processes for the characterization of vulnerable plaques, such as vascular endothelial growth factor receptor (VEGFR)-1, VEGFR-2, intercellular adhesion molecule (ICAM)-1, P-selectin, and integrins, and for the potential development of translational tools to identify high-risk patients who could benefit from early therapeutic interventions. This review summarizes the main animal models of vulnerable plaques, with an emphasis on genetically altered mice, and the state-of-the-art preclinical molecular imaging strategies. PMID:27618031

  20. Linking local vulnerability to climatic hazard damage assessment for integrated river basin management

    NASA Astrophysics Data System (ADS)

    Hung, Hung-Chih; Liu, Yi-Chung; Chien, Sung-Ying

    2015-04-01

    1. Background Major portions of areas in Asia are expected to increase exposure and vulnerability to climate change and weather extremes due to rapid urbanization and overdevelopment in hazard-prone areas. To prepare and confront the potential impacts of climate change and related hazard risk, many countries have implemented programs of integrated river basin management. This has led to an impending challenge for the police-makers in many developing countries to build effective mechanism to assess how the vulnerability distributes over river basins, and to understand how the local vulnerability links to climatic (climate-related) hazard damages and risks. However, the related studies have received relatively little attention. This study aims to examine whether geographic localities characterized by high vulnerability experience significantly more damages owing to onset weather extreme events at the river basin level, and to explain what vulnerability factors influence these damages or losses. 2. Methods and data An indicator-based assessment framework is constructed with the goal of identifying composite indicators (including exposure, biophysical, socioeconomic, land-use and adaptive capacity factors) that could serve as proxies for attributes of local vulnerability. This framework is applied by combining geographical information system (GIS) techniques with multicriteria decision analysis (MCDA) to evaluate and map integrated vulnerability to climatic hazards across river basins. Furthermore, to explain the relationship between vulnerability factors and disaster damages, we develop a disaster damage model (DDM) based on existing disaster impact theory. We then synthesize a Zero-Inflated Poisson regression model with a Tobit regression analysis to identify and examine how the disaster impacts and vulnerability factors connect to typhoon disaster damages and losses. To illustrate the proposed methodology, the study collects data on the vulnerability attributes of

  1. A Resource Booklet on Transitions: SERVEing Young Children Project.

    ERIC Educational Resources Information Center

    North Carolina Univ., Greensboro. School of Education.

    SERVE, the SouthEastern Regional Vision for Education, is a coalition of educators, business leaders, governors and policymakers seeking comprehensive and lasting improvement in education in the five southeastern states. SERVEing Young Children is the early childhood project within SERVE. The first section of this resource booklet introduces the…

  2. 7 CFR 1700.53 - Persons serving as Acting Administrator.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 11 2014-01-01 2014-01-01 false Persons serving as Acting Administrator. 1700.53... Persons serving as Acting Administrator. In accordance with procedures established in the RUS Continuity... disability of the Administrator, or in the event of a vacancy in the office of Administrator, serve as...

  3. Institutional Vulnerability/Opportunity Audit. Preconference Seminar Proceedings of the AIR Forum (Boston, Massachusetts, May 28-31, 1995).

    ERIC Educational Resources Information Center

    Morrison, James L.

    These proceedings report on a seminar held to determine the needs and wants served by the Association for Institutional Research (AIR) in regard to products and services provided by AIR to institutions and individuals. A vulnerability/opportunity audit was conducted to identify the strengths and weaknesses of the organization. Participants listed…

  4. Drought vulnerability assesssment and mapping in Morocco

    NASA Astrophysics Data System (ADS)

    Imani, Yasmina; Lahlou, Ouiam; Bennasser Alaoui, Si; Naumann, Gustavo; Barbosa, Paulo; Vogt, Juergen

    2014-05-01

    Drought vulnerability assessment and mapping in Morocco Authors: Yasmina Imani 1, Ouiam Lahlou 1, Si Bennasser Alaoui 1 Paulo Barbosa 2, Jurgen Vogt 2, Gustavo Naumann 2 1: Institut Agronomique et Vétérinaire Hassan II (IAV Hassan II), Rabat Morocco. 2: European Commission, Joint Research Centre (JRC), Institute for Environment and Sustainability (IES), Ispra, Italy. In Morocco, nearly 50% of the population lives in rural areas. They are mostly small subsistent farmers whose production depends almost entirely on rainfall. They are therefore very sensitive to drought episodes that may dramatically affect their incomes. Although, as a consequence of the increasing frequency, length and severity of drought episodes in the late 90's, the Moroccan government decided, to move on from a crisis to a risk management approach, drought management remains in practice mainly reactive and often ineffective. The lack of effectiveness of public policy is in part a consequence of the poor understanding of drought vulnerability at the rural community level, which prevents the development of efficient mitigation actions and adaptation strategies, tailored to the needs and specificities of each rural community. Thus, the aim of this study is to assess and map drought vulnerability at the rural commune level in the Oum Er-Rbia basin which is a very heterogeneous basin, showing a big variability of climates, landscapes, cropping systems and social habits. Agricultural data collected from the provincial and local administrations of Agriculture and socio-economic data from the National Department of Statistics were used to compute a composite vulnerability index (DVI) integrating four different components: (i) the renewable natural capacity, (ii) the economic capacity, (iii) human and civic resources, and (iv) infrastructure and technology. The drought vulnerability maps that were derived from the computation of the DVI shows that except very specific areas, most of the Oum er Rbia

  5. Which Stratum of Urban Elderly Is Most Vulnerable for Dementia?

    PubMed

    Moon, Yeonsil; Lee, Heeyoung; Namgung, Ok Kyoung; Han, Seol Heui

    2016-10-01

    Many factors associated with a patient's lifestyle may disrupt timely access to dementia diagnosis and management. The aim of this study was to compare characteristics of lifestyle factors at the time of initial evaluation for dementia across degrees of dementia, and to identify risk factors relating to late detection of dementia, in order to understand the various lifestyle barriers to timely recognition of the disease. We reviewed medical records of 1,409 subjects who were diagnosed as dementia among 35,723 inhabitants of Gwangjin-gu. Dementia severity was divided into three degrees. Age, sex, education, income, smoking, heavy drinking, physical activity, religion, and living conditions were evaluated. There was a significantly greater proportion of individuals who were old age, female, less educated, who had never smoked or drank heavily, without physical activity, with no religious activity and living with family other than spouse in the severe dementia group. The lifestyle risks of late detection were old age, lower education, less social interactions, less physical activity or living with family. We can define this group of patients as the vulnerable stratum to dementia evaluation. Health policy or community health services might find ways to better engage patients in this vulnerable stratum to dementia. PMID:27550494

  6. A knowledge integration approach to flood vulnerability

    NASA Astrophysics Data System (ADS)

    Mazzorana, Bruno; Fuchs, Sven

    2014-05-01

    Understanding, qualifying and quantifying vulnerability is an essential need for implementing effective and efficient flood risk mitigation strategies; in particular if possible synergies between different mitigation alternatives, such as active and passive measures, should be achieved. In order to combine different risk management options it is necessary to take an interdisciplinary approach to vulnerability reduction, and as a result the affected society may be willing to accept a certain degree of self-responsibility. However, due to differing mono-disciplinary approaches and regional foci undertaken until now, different aspects of vulnerability to natural hazards in general and to floods in particular remain uncovered and as a result the developed management options remain sub-optimal. Taking an even more fundamental viewpoint, the empirical vulnerability functions used in risk assessment specifically fail to capture physical principles of the damage-generating mechanisms to the build environment. The aim of this paper is to partially close this gap by discussing a balanced knowledge integration approach which can be used to resolve the multidisciplinary disorder in flood vulnerability research. Modelling techniques such as mathematical-physical modelling of the flood hazard impact to and response from the building envelope affected, and formative scenario analyses of possible consequences in terms of damage and loss are used in synergy to provide an enhanced understanding of vulnerability and to render the derived knowledge into interdisciplinary mitigation strategies. The outlined formal procedure allows for a convincing knowledge alignment of quantified, but partial, information about vulnerability as a result of the application of physical and engineering notions and valuable, but often underspecified, qualitative argumentation strings emerging from the adopted socio-economic viewpoint.

  7. SILENCING SHARAPOVA'S GRUNT IMPROVES THE PERCEPTION OF HER SERVE SPEED.

    PubMed

    Farhead, Nader; Punt, T David

    2015-06-01

    In recent years, grunting has become a familiar although generally unwelcome element of tennis. The behavior is considered to deny opponents the benefit of receiving optimal multi-sensory information in order to plan their own shots. The ability to make accurate serve-speed judgments of identical tennis serves presented on a computer screen, and accompanied by a grunt or not, was assessed among 38 participants (19 men). Accuracy and response time were measured. Analysis compared performance for below versus above average speed serves and for the grunt versus the no grunt condition. Grunting had a disruptive effect on serve-speed perception for below average serves, with most judged incorrectly to be above average. Response times for below average serves were also slower in the grunt condition. Grunting provides a complex perceptual challenge, and greater effort may be attributed to tennis serves with an accompanying grunt. PMID:26057416

  8. Structural vulnerability assessment using reliability of slabs in avalanche area

    NASA Astrophysics Data System (ADS)

    Favier, Philomène; Bertrand, David; Eckert, Nicolas; Naaim, Mohamed

    2013-04-01

    Improvement of risk assessment or hazard zoning requires a better understanding of the physical vulnerability of structures. To consider natural hazard issue such as snow avalanches, once the flow is characterized, highlight on the mechanical behaviour of the structure is a decisive step. A challenging approach is to quantify the physical vulnerability of impacted structures according to various avalanche loadings. The main objective of this presentation is to introduce methodology and outcomes regarding the assessment of vulnerability of reinforced concrete buildings using reliability methods. Reinforced concrete has been chosen as it is one of the usual material used to build structures exposed to potential avalanche loadings. In avalanche blue zones, structures have to resist to a pressure up to 30kPa. Thus, by providing systematic fragility relations linked to the global failure of the structure, this method may serve the avalanche risk assessment. To do so, a slab was numerically designed. It represented the avalanche facing wall of a house. Different configuration cases of the element in stake have been treated to quantify numerical aspects of the problem, such as the boundary conditions or the mechanical behaviour of the structure. The structure is analysed according to four different limit states, semi-local and global failures are considered to describe the slab behaviour. The first state is attained when cracks appear in the tensile zone, then the two next states are described consistent with the Eurocode, the final state is the total collapse of the structure characterized by the yield line theory. Failure probability is estimated in accordance to the reliability framework. Monte Carlo simulations were conducted to quantify the fragility to different loadings. Sensitivity of models in terms of input distributions were defined with statistical tools such as confidence intervals and Sobol's indexes. Conclusion and discussion of this work are established to

  9. Vulnerability of schools to floods in Nyando River catchment, Kenya.

    PubMed

    Ochola, Samuel O; Eitel, Bernhard; Olago, Daniel O

    2010-07-01

    This paper assesses the vulnerability of schools to floods in the Nyando River catchment (3,600 km(2)) in western Kenya and identifies measures needed to reduce this vulnerability. It surveys 130 schools in the lower reaches, where flooding is a recurrent phenomenon. Of the primary schools assessed, 40% were vulnerable, 48% were marginally vulnerable and 12% were not vulnerable. Of the secondary schools, 8% were vulnerable, 73% were marginally vulnerable and 19% were not vulnerable. Vulnerability to floods is due to a lack of funds, poor building standards, local topography, soil types and inadequate drainage. The Constituencies Development Fund (CDF), established in 2003, provides financial support to cover school construction and reconstruction costs; CDF Committees are expected to adopt school building standards. In an effort to promote safe and resilient construction and retrofitting to withstand floods, this paper presents vulnerability reduction strategies and recommendations for incorporating minimum standards in the on-going Primary School Infrastructure Programme Design. PMID:20298261

  10. Cyber/Physical Security Vulnerability Assessment Integration

    SciTech Connect

    MacDonald, Douglas G.; Clements, Samuel L.; Patrick, Scott W.; Perkins, Casey J.; Muller, George; Lancaster, Mary J.; Hutton, William J.

    2013-02-28

    Securing high value and critical assets is one of the biggest challenges facing this nation and others around the world. In modern integrated systems, there are four potential modes of attack available to an adversary: • physical only attack, • cyber only attack, • physical-enabled cyber attack, • cyber-enabled physical attack. Blended attacks involve an adversary working in one domain to reduce system effectiveness in another domain. This enables the attacker to penetrate further into the overall layered defenses. Existing vulnerability assessment (VA) processes and software tools which predict facility vulnerabilities typically evaluate the physical and cyber domains separately. Vulnerabilities which result from the integration of cyber-physical control systems are not well characterized and are often overlooked by existing assessment approaches. In this paper, we modified modification of the timely detection methodology, used for decades in physical security VAs, to include cyber components. The Physical and Cyber Risk Analysis Tool (PACRAT) prototype illustrates an integrated vulnerability assessment that includes cyber-physical interdependencies. Information about facility layout, network topology, and emplaced safeguards is used to evaluate how well suited a facility is to detect, delay, and respond to attacks, to identify the pathways most vulnerable to attack, and to evaluate how often safeguards are compromised for a given threat or adversary type. We have tested the PACRAT prototype on critical infrastructure facilities and the results are promising. Future work includes extending the model to prescribe the recommended security improvements via an automated cost-benefit analysis.

  11. Reactions to research participation in vulnerable subgroups.

    PubMed

    Widom, Cathy Spatz; Czaja, Sally J

    2005-01-01

    This paper describes the extent to which vulnerable individuals (defined by economic, social, psychological, physical health, and child maltreatment status) react to research participation. As part of an ongoing longitudinal study, participants (N=896) completed a lengthy and intrusive in-person interview and provided a small amount of blood through finger pricks. At the end of the interview, participants were asked eight questions about their reactions to the research experience. Vulnerable individuals in general agreed more strongly about having an emotional reaction, but were not less willing to continue to participate. In addition, psychologically vulnerable individuals more strongly agreed they would continue to participate, were treated with respect and dignity, and found their participation meaningful. Compared to whites, nonwhites reported stronger agreement about the meaningfulness of the research and the belief that their responses would be kept private. Like others, individuals vulnerable by virtue of their prisoner status or homelessness (past or current) agreed more strongly about having an emotional reaction to the interview, but otherwise did not differ in their reactions. These results suggest that researchers and institutional review boards should not be deterred from conducting research on sensitive topics with potentially vulnerable populations. PMID:16220625

  12. Quantitative assessment of the serve speed in tennis.

    PubMed

    Vaverka, Frantisek; Cernosek, Miroslav

    2016-01-01

    A method is presented for assessing the serve speeds of tennis players based on their body height. The research involved a sample of top world players (221 males and 215 females) who participated in the Grand Slam tournaments in 2008 and 2012. The method is based on the linear regression analysis of the association between the player's body height and the serve speed (fastest serve, average first-serve, and second-serve speed). The coefficient of serve speed (CSS) was calculated as the quotient of the measured and the theoretical value of the serve speed on a regression line relative to the player's body height. The CSS of >1, 1 and <1 indicate above-average, average, and below-average serve speeds, respectively, relative to the top world tennis players with the same body height. The CSS adds a new element to the already existing statistics about a tennis match, and provides additional information about the performance of tennis players. The CSS can be utilised e.g. for setting the target serve speed of a given player to achieve based on his/her body height, choosing the most appropriate match strategy against a particular player, and a long-term monitoring of the effectiveness of training focused on the serve speed. PMID:26879039

  13. The effects of increased serving sizes on consumption.

    PubMed

    Hydock, Chris; Wilson, Anne; Easwar, Karthik

    2016-06-01

    The US Food and Drug Administration recently revealed that it is considering modifying the Nutrition Facts Panels required on packaged foods. One proposed change is increasing serving sizes included on labels, which has two potential implications. Larger serving sizes could increase consumption if consumers use the serving sizes displayed as a reference point for their own consumption (McFerran et al., 2010). Alternatively, larger serving sizes that depict increased values of negative nutrients (e.g. calories) could lead consumers to perceive foods as less healthy, thereby reducing consumption (Russo et al., 1986). In study 1 (Online sample, N = 208, Mage = 32, SDage = 12), participants saw pictures of packaged food items and nutrition labels. The labels, depicted either the existing or larger serving size. Across all foods, larger serving sizes led to lower health perceptions. Labels with larger serving sizes were rated as more representative of typical consumption. Study 2 (Online sample, N = 347, Mage = 31, SDage = 10) used the same design as study 1, but required participants to virtually portion foods. While serving sizes did not impact the amount of food consumers portioned, those who saw labels with larger serving sizes estimated that they portioned out more calories. In study 3 (Student sample, N = 198, Mage = 20, SDage = 1), participants were given M&Ms to eat, paired with a nutritional label depicting either the current or a larger serving size, while participating in unrelated surveys. Participants presented with the larger serving size label consumed less than those presented with the current serving size label. Together, the results suggest that the proposed increase in serving sizes on Nutrition Facts Panels could lower consumption of high-calorie foods. PMID:26928789

  14. Mapping Regional Drought Vulnerability: a Case Study

    NASA Astrophysics Data System (ADS)

    Karamouz, M.; Zeynolabedin, A.; Olyaei, M. A.

    2015-12-01

    Drought is among the natural disaster that causes damages and affects many people's life in many part of the world including in Iran. Recently, some factors such as climate variability and the impact of climate change have influenced drought frequency and intensity in many parts of the world. Drought can be divided into four categories of meteorological, hydrological, agricultural and social-economic. In meteorological the important feature is lack of rainfall. In hydrological drought river flows and dam storage are considered. Lack of soil moisture is the key factor in agricultural droughts while in social-economic type of drought the relation between supply and demand and social-economic damages due to water deficiency is studied. While the first three types relates to the lack of some hydrological characteristics, social-economic type of drought is actually the consequence of other types expressed in monetary values. Many indices are used in assessing drought; each has its own advantages and disadvantages and can be used for specific types of drought. Therefore knowing the types of drought can provide a better understanding of shortages and their characteristics. Drought vulnerability is a concept which shows the likelihood of damages from hazard in a particular place by focusing on the system status prior to the disaster. Drought vulnerability has been viewed as a potential for losses in the region due to water deficiency at the time of drought. In this study the application of vulnerability concept in drought management in East Azarbaijan province in Iran is investigated by providing vulnerability maps which demonstrates spatial characteristics of drought vulnerability. In the first step, certain governing parameters in drought analysis such as precipitation, temperature, land use, topography, solar radiation and ground water elevation have been investigated in the region. They are described in details and calculated in suitable time series. Vulnerabilities

  15. A framework for modeling rail transport vulnerability

    SciTech Connect

    Peterson, Steven K; Church, Richard L.

    2008-01-01

    Railroads represent one of the most efficient methods of long-haul transport for bulk commodities, from coal to agricultural products. Over the past fifty years, the rail network has contracted while tonnage has increased. Service, geographically, has been abandoned along short haul routes and increased along major long haul routes, resulting in a network that is more streamlined. The current rail network may be very vulnerable to disruptions, like the failure of a trestle. This paper proposes a framework to model rail network vulnerability and gives an application of this modeling framework in analyzing rail network vulnerability for the State of Washington. It concludes with a number of policy related issues that need to be addressed in order to identify, plan, and mitigate the risks associated with the sudden loss of a bridge or trestle.

  16. Imaging Atherosclerosis and Vulnerable Plaque

    PubMed Central

    Sadeghi, Mehran M.; Glover, David K.; Lanza, Gregory M.; Fayad, Zahi A.; Johnson, Lynne L.

    2010-01-01

    Identifying patients at high risk for an acute cardiovascular event such as myocardial infarction or stroke and assessing the total atherosclerotic burden are clinically important. Currently available imaging modalities can delineate vascular wall anatomy and, with novel probes, target biologic processes important in plaque evolution and plaque stability. Expansion of the vessel wall involving remodeling of the extracellular matrix can be imaged, as can angiogenesis of the vasa vasorum, plaque inflammation, and fibrin deposits on early nonocclusive vascular thrombosis. Several imaging platforms are available for targeted vascular imaging to acquire information on both anatomy and pathobiology in the same imaging session using either hybrid technology (nuclear combined with CT) or MRI combined with novel probes targeting processes identified by molecular biology to be of importance. This article will discuss the current state of the art of these modalities and challenges to clinical translation. PMID:20395341

  17. Antiretroviral Drug Diversion Links Social Vulnerability to Poor Medication Adherence in Substance Abusing Populations

    PubMed Central

    Tsuyuki, Kiyomi; Surratt, Hilary L.

    2015-01-01

    Antiretroviral (ARV) medication diversion to the illicit market has been documented in South Florida, and linked to sub-optimal adherence in people living with HIV. ARV diversion reflects an unmet need for care in vulnerable populations that have difficulty engaging in consistent HIV care due to competing needs and co-morbidities. This study applies the Gelberg-Andersen Behavioral Model of Health Care Utilization for Vulnerable Populations to understand how social vulnerability is linked to ARV diversion and adherence. Cross-sectional data were collected from a targeted sample of vulnerable people living with HIV in South Florida between 2010 and 2012 (n=503). Structured interviews collected quantitative data on ARV diversion, access and utilization of care, and ARV adherence. Logistic regression was used to estimate the goodness-of-fit of additive models that test domain fit. Linear regression was used to estimate the effects of social vulnerability and ARV diversion on ARV adherence. The best fitting model to predict ARV diversion identifies having a low monthly income and unstable HIV care as salient enabling factors that promote ARV diversion. Importantly, health care need factors did not protect against ARV diversion, evidence that immediate competing needs are prioritized even in the face of poor health for this sample. We also find that ARV diversion provides a link between social vulnerability and sub-optimal ARV adherence, with ARV diversion and domains from the Behavioral Model explaining 25% of the variation in ARV adherence. Our analyses reveal great need to improve engagement in HIV care for vulnerable populations by strengthening enabling factors (e.g. patient-provider relationship) to improve retention in HIV care and ARV adherence for vulnerable populations. PMID:25893656

  18. Antiretroviral drug diversion links social vulnerability to poor medication adherence in substance abusing populations.

    PubMed

    Tsuyuki, Kiyomi; Surratt, Hilary L

    2015-05-01

    Antiretroviral (ARV) medication diversion to the illicit market has been documented in South Florida, and linked to sub-optimal adherence in people living with HIV. ARV diversion reflects an unmet need for care in vulnerable populations that have difficulty engaging in consistent HIV care due to competing needs and co-morbidities. This study applies the Gelberg-Andersen behavioral model of health care utilization for vulnerable populations to understand how social vulnerability is linked to ARV diversion and adherence. Cross-sectional data were collected from a targeted sample of vulnerable people living with HIV in South Florida between 2010 and 2012 (n = 503). Structured interviews collected quantitative data on ARV diversion, access and utilization of care, and ARV adherence. Logistic regression was used to estimate the goodness-of-fit of additive models that test domain fit. Linear regression was used to estimate the effects of social vulnerability and ARV diversion on ARV adherence. The best fitting model to predict ARV diversion identifies having a low monthly income and unstable HIV care as salient enabling factors that promote ARV diversion. Importantly, health care need factors did not protect against ARV diversion, evidence that immediate competing needs are prioritized even in the face of poor health for this sample. We also find that ARV diversion provides a link between social vulnerability and sub-optimal ARV adherence, with ARV diversion and domains from the Behavioral Model explaining 25 % of the variation in ARV adherence. Our analyses reveal great need to improve engagement in HIV care for vulnerable populations by strengthening enabling factors (e.g. patient-provider relationship) to improve retention in HIV care and ARV adherence for vulnerable populations. PMID:25893656

  19. Climate challenges, vulnerabilities, and food security

    PubMed Central

    Nelson, Margaret C.; Ingram, Scott E.; Dugmore, Andrew J.; Streeter, Richard; Peeples, Matthew A.; McGovern, Thomas H.; Hegmon, Michelle; Arneborg, Jette; Brewington, Seth; Spielmann, Katherine A.; Simpson, Ian A.; Strawhacker, Colleen; Comeau, Laura E. L.; Torvinen, Andrea; Madsen, Christian K.; Hambrecht, George; Smiarowski, Konrad

    2016-01-01

    This paper identifies rare climate challenges in the long-term history of seven areas, three in the subpolar North Atlantic Islands and four in the arid-to-semiarid deserts of the US Southwest. For each case, the vulnerability to food shortage before the climate challenge is quantified based on eight variables encompassing both environmental and social domains. These data are used to evaluate the relationship between the “weight” of vulnerability before a climate challenge and the nature of social change and food security following a challenge. The outcome of this work is directly applicable to debates about disaster management policy. PMID:26712017

  20. Assessment of Chemical and Radiological Vulnerabilities

    SciTech Connect

    SETH, S.S.

    2000-05-17

    Following the May 14, 1997 chemical explosion at Hanford's Plutonium Reclamation Facility, the Department of Energy Richland Operations Office and its prime contractor, Fluor Hanford, Inc., completed an extensive assessment to identify and address chemical and radiological safety vulnerabilities at all facilities under the Project Hanford Management Contract. This was a challenging undertaking because of the immense size of the problem, unique technical issues, and competing priorities. This paper focuses on the assessment process, including the criteria and methodology for data collection, evaluation, and risk-based scoring. It does not provide details on the facility-specific results and corrective actions, but discusses the approach taken to address the identified vulnerabilities.

  1. Microbiological Food Safety for Vulnerable People

    PubMed Central

    Lund, Barbara M.

    2015-01-01

    Foodborne pathogens are more likely to cause infection and to result in serious consequences in vulnerable people than in healthy adults. People with some increase in susceptibility may form nearly 20% of the population in the UK and the USA. Conditions leading to increased susceptibility are listed. The main factors leading to foodborne disease caused by major pathogens are outlined and examples are given of outbreaks resulting from these factors. Measures to prevent foodborne disease include procedures based on Hazard Analysis Critical Control Point principles and prerequisite programmes and, especially for vulnerable people, the use of lower-risk foods in place of higher-risk products. PMID:26308030

  2. Climate challenges, vulnerabilities, and food security.

    PubMed

    Nelson, Margaret C; Ingram, Scott E; Dugmore, Andrew J; Streeter, Richard; Peeples, Matthew A; McGovern, Thomas H; Hegmon, Michelle; Arneborg, Jette; Kintigh, Keith W; Brewington, Seth; Spielmann, Katherine A; Simpson, Ian A; Strawhacker, Colleen; Comeau, Laura E L; Torvinen, Andrea; Madsen, Christian K; Hambrecht, George; Smiarowski, Konrad

    2016-01-12

    This paper identifies rare climate challenges in the long-term history of seven areas, three in the subpolar North Atlantic Islands and four in the arid-to-semiarid deserts of the US Southwest. For each case, the vulnerability to food shortage before the climate challenge is quantified based on eight variables encompassing both environmental and social domains. These data are used to evaluate the relationship between the "weight" of vulnerability before a climate challenge and the nature of social change and food security following a challenge. The outcome of this work is directly applicable to debates about disaster management policy. PMID:26712017

  3. Public Health Consequences on Vulnerable Populations from Acute Chemical Releases

    PubMed Central

    Ruckart, Perri Zeitz; Orr, Maureen F.

    2008-01-01

    Data from a large, multi-state surveillance system on acute chemical releases were analyzed to describe the type of events that are potentially affecting vulnerable populations (children, elderly and hospitalized patients) in order to better prevent and plan for these types of incidents in the future. During 2003–2005, there were 231 events where vulnerable populations were within ¼ mile of the event and the area of impact was greater than 200 feet from the facility/point of release. Most events occurred on a weekday during times when day care centers or schools were likely to be in session. Equipment failure and human error caused a majority of the releases. Agencies involved in preparing for and responding to chemical emergencies should work with hospitals, nursing homes, day care centers, and schools to develop policies and procedures for initiating appropriate protective measures and managing the medical needs of patients. Chemical emergency response drills should involve the entire community to protect those that may be more susceptible to harm. PMID:21572842

  4. Optical coherence tomography for imaging the vulnerable plaque

    PubMed Central

    Tearney, Guillermo J.; Jang, Ik-Kyung; Bouma, Brett E.

    2009-01-01

    While our understanding of vulnerable coronary plaque is still at an early stage, the concept that certain types of plaques predispose patients to developing an acute myocardial infarction continues to be at the forefront of cardiology research. Intracoronary optical coherence tomography (OCT) has been developed to both identify and study these lesions due to its distinct resolution advantage over other imaging modalities. We review clinical research conducted at the Massachusetts General Hospital over the past five years to develop, validate, and utilize this technology to improve our understanding of vulnerable plaque. Our results show that intracoronary OCT may be safely conducted in patients and that it provides abundant information regarding plaque microscopic morphology, which is essential to the identification and study of high-risk lesions. Even though many basic biological, clinical, and technological challenges must be addressed prior to widespread use of this technology, the unique capabilities of OCT ensure that it will have a prominent role in shaping the future of cardiology. PMID:16674177

  5. The Occurrence and Prevention of Foodborne Disease in Vulnerable People

    PubMed Central

    O'Brien, Sarah J.

    2011-01-01

    Abstract In developed countries, such as the United Kingdom and the United States, between 15% and 20% of the population show greater susceptibility than the general population to foodborne disease. This proportion includes people with primary immunodeficiency, patients treated with radiation or with immunosuppressive drugs for cancer and diseases of the immune system, those with acquired immune-deficiency syndrome and diabetics, people suffering from liver or kidney disease or with excessive iron in the blood, pregnant women, infants, and the elderly. Malnutrition and use of antacids, particularly proton-pump inhibitors, also increase susceptibility. We review the occurrence of infection by foodborne pathogens in these groups of people and measures to prevent infection. The nature and use of low microbial diets to reduce the risk of foodborne disease in immunocompromised patients are very variable. Diets for vulnerable people in care should exclude higher-risk foods, and vulnerable people in the community should receive clear advice about food safety, in particular avoidance of higher-risk foods and substitution of safer, nutritious foods. PMID:21561383

  6. Optical coherence tomography for imaging the vulnerable plaque

    NASA Astrophysics Data System (ADS)

    Tearney, Guillermo J.; Jang, Ik-Kyung; Bouma, Brett E.

    2006-03-01

    While our understanding of vulnerable coronary plaque is still at an early stage, the concept that certain types of plaques predispose patients to developing an acute myocardial infarction continues to be at the forefront of cardiology research. Intracoronary optical coherence tomography (OCT) has been developed to both identify and study these lesions due to its distinct resolution advantage over other imaging modalities. We review clinical research conducted at the Massachusetts General Hospital over the past five years to develop, validate, and utilize this technology to improve our understanding of vulnerable plaque. Our results show that intracoronary OCT may be safely conducted in patients and that it provides abundant information regarding plaque microscopic morphology, which is essential to the identification and study of high-risk lesions. Even though many basic biological, clinical, and technological challenges must be addressed prior to widespread use of this technology, the unique capabilities of OCT ensure that it will have a prominent role in shaping the future of cardiology.

  7. Climate vulnerability of drinking water supplies

    NASA Astrophysics Data System (ADS)

    Selmeczi, Pál; Homolya, Emese; Rotárné Szalkai, Ágnes

    2016-04-01

    Extreme weather conditions in Hungary led to difficulties in drinking water management on diverse occasions in the past. Due to reduced water resources and the coexisting high demand for drinking water in dry summer periods the availability of a number of water supplies became insufficient therefore causing limitations in water access. In some other cases, as a result of floods and flash floods over karstic areas evolving in consequence of excessive precipitation, several water supplies had to be excluded in order to avoid the risk of infections. More frequent occurrence of extreme weather conditions and further possible changes in the future induce the necessity for an analysis of the vulnerability of drinking water resources to climate change. Since 95% of the total drinking water supply in Hungary originates from subsurface layers, significance of groundwater resources is outstanding. The aim of our work carried out in the frames of the NAGiS (National Adaptation Geo-information System) project was to build up a methodology for the study and determination of the vulnerability of drinking water supplies to climate. The task covered analyses of climatic parameters influencing drinking water supplies principally and hydrogeological characteristics of the geological media that significantly determines vulnerability. Effects on drinking water resources and their reduction or exclusion may imply societal and economic consequences therefore we extended the analyses to the investigation of possibilities concerning the adaptation capacity to changed conditions. We applied the CIVAS (Climate Impact and Vulnerability Assessment Scheme) model developed in the frames of the international climate research project CLAVIER (Climate Change and Variability: Impact on Central and Eastern Europe) to characterize climate vulnerability of drinking water supplies. The CIVAS model, being based on the combined evaluation of exposure, sensitivity and adaptability, provides a unified

  8. Metabolic vulnerabilities in endometrial cancer.

    PubMed

    Byrne, Frances L; Poon, Ivan K H; Modesitt, Susan C; Tomsig, Jose L; Chow, Jenny D Y; Healy, Marin E; Baker, William D; Atkins, Kristen A; Lancaster, Johnathan M; Marchion, Douglas C; Moley, Kelle H; Ravichandran, Kodi S; Slack-Davis, Jill K; Hoehn, Kyle L

    2014-10-15

    Women with metabolic disorders, including obesity and diabetes, have an increased risk of developing endometrial cancer. However, the metabolism of endometrial tumors themselves has been largely understudied. Comparing human endometrial tumors and cells with their nonmalignant counterparts, we found that upregulation of the glucose transporter GLUT6 was more closely associated with the cancer phenotype than other hallmark cancer genes, including hexokinase 2 and pyruvate kinase M2. Importantly, suppression of GLUT6 expression inhibited glycolysis and survival of endometrial cancer cells. Glycolysis and lipogenesis were also highly coupled with the cancer phenotype in patient samples and cells. To test whether targeting endometrial cancer metabolism could be exploited as a therapeutic strategy, we screened a panel of compounds known to target diverse metabolic pathways in endometrial cells. We identified that the glycolytic inhibitor, 3-bromopyruvate, is a powerful antagonist of lipogenesis through pyruvylation of CoA. We also provide evidence that 3-bromopyruvate promotes cell death via a necrotic mechanism that does not involve reactive oxygen species and that 3-bromopyruvate impaired the growth of endometrial cancer xenografts. PMID:25205105

  9. Drought vulnerability assessment for the agriculture: a case study for the west part of Slovenia

    NASA Astrophysics Data System (ADS)

    Slejko, M.; Gregorič, G.; Bergant, K.

    2009-04-01

    One of the main aspects of drought adaptation and planning is the assessment of vulnerability. Since agriculture is the primary sector affected by drought and is directly dependent on water availability, we have started with a pilot project in an important agricultural area in the west part of Slovenia. The project is a part of the activities of the Drought Management Centre for Southeastern Europe - DMCSEE. Drought in this area often results in significant economic, environmental, and social impacts. The significance of the impacts of drought on the agricultural sector is assessed taking into account the severity of the drought (magnitude and duration of the drought episode) and the vulnerability of the agricultural system. For that purpose we have developed a general method which can be used as a preliminary tool for assessing drought vulnerability in agriculture and that could be applied on the entire Southeastern Europe region. The approach was based on impact assessment and vulnerability model supported by geographic information system (GIS) software. We found out that factors influencing drought vulnerability were numerous, and the model application might depend on data availability. We have used appropriate and available digital data layers for climate, pedology, solar radiation, land use, irrigation infrastructure and other factors. The final product is a categorical map of agricultural drought vulnerability for the study area, which synthesizes a variety of data and serves as an indicator of areas deserving a detailed drought risk evaluation. It could aid regional decision makers in identifying appropriate mitigation and adaptation actions before the next drought event, lessen impacts of that event and allow sustainable development of the sector.

  10. Predicting risk in space: Genetic markers for differential vulnerability to sleep restriction

    NASA Astrophysics Data System (ADS)

    Goel, Namni; Dinges, David F.

    2012-08-01

    Several laboratories have found large, highly reliable individual differences in the magnitude of cognitive performance, fatigue and sleepiness, and sleep homeostatic vulnerability to acute total sleep deprivation and to chronic sleep restriction in healthy adults. Such individual differences in neurobehavioral performance are also observed in space flight as a result of sleep loss. The reasons for these stable phenotypic differential vulnerabilities are unknown: such differences are not yet accounted for by demographic factors, IQ or sleep need, and moreover, psychometric scales do not predict those individuals cognitively vulnerable to sleep loss. The stable, trait-like (phenotypic) inter-individual differences observed in response to sleep loss—with intraclass correlation coefficients accounting for 58-92% of the variance in neurobehavioral measures—point to an underlying genetic component. To this end, we utilized multi-day highly controlled laboratory studies to investigate the role of various common candidate gene variants—each independently—in relation to cumulative neurobehavioral and sleep homeostatic responses to sleep restriction. These data suggest that common genetic variations (polymorphisms) involved in sleep-wake, circadian, and cognitive regulation may serve as markers for prediction of inter-individual differences in sleep homeostatic and neurobehavioral vulnerability to sleep restriction in healthy adults. Identification of genetic predictors of differential vulnerability to sleep restriction—as determined from candidate gene studies—will help identify astronauts most in need of fatigue countermeasures in space flight and inform medical standards for obtaining adequate sleep in space. This review summarizes individual differences in neurobehavioral vulnerability to sleep deprivation and ongoing genetic efforts to identify markers of such differences.

  11. Retrieval from Memory: Vulnerable or Inviolable?

    ERIC Educational Resources Information Center

    Jones, Dylan M.; Marsh, John E.; Hughes, Robert W.

    2012-01-01

    We show that retrieval from semantic memory is vulnerable even to the mere presence of speech. Irrelevant speech impairs semantic fluency--namely, lexical retrieval cued by a semantic category name--but only if it is meaningful (forward speech compared to reversed speech or words compared to nonwords). Moreover, speech related semantically to the…

  12. Web vulnerability study of online pharmacy sites.

    PubMed

    Kuzma, Joanne

    2011-01-01

    Consumers are increasingly using online pharmacies, but these sites may not provide an adequate level of security with the consumers' personal data. There is a gap in this research addressing the problems of security vulnerabilities in this industry. The objective is to identify the level of web application security vulnerabilities in online pharmacies and the common types of flaws, thus expanding on prior studies. Technical, managerial and legal recommendations on how to mitigate security issues are presented. The proposed four-step method first consists of choosing an online testing tool. The next steps involve choosing a list of 60 online pharmacy sites to test, and then running the software analysis to compile a list of flaws. Finally, an in-depth analysis is performed on the types of web application vulnerabilities. The majority of sites had serious vulnerabilities, with the majority of flaws being cross-site scripting or old versions of software that have not been updated. A method is proposed for the securing of web pharmacy sites, using a multi-phased approach of technical and managerial techniques together with a thorough understanding of national legal requirements for securing systems. PMID:21208091

  13. CYBER/PHYSICAL SECURITY VULNERABILITY ASSESSMENT INTEGRATION

    SciTech Connect

    MacDonald, Douglas G.; Key, Brad; Clements, Samuel L.; Hutton, William J.; Craig, Philip A.; Patrick, Scott W.; Crawford, Cary E.

    2011-07-17

    This internally funded Laboratory-Directed R&D project by the Pacific Northwest National Laboratory, in conjunction with QinetiQ North America, is intended to identify and properly assess areas of overlap (and interaction) in the vulnerability assessment process between cyber security and physical protection. Existing vulnerability analysis (VA) processes and software tools exist, and these are heavily utilized in the determination of predicted vulnerability within the physical and cyber security domains. These determinations are normally performed independently of one another, and only interact on a superficial level. Both physical and cyber security subject matter experts have come to realize that though the various interactive elements exist, they are not currently quantified in most periodic security assessments. This endeavor aims to evaluate both physical and cyber VA techniques and provide a strategic approach to integrate the interdependent relationships of each into a single VA capability. This effort will also transform the existing suite of software currently utilized in the physical protection world to more accurately quantify the risk associated with a blended attack scenario. Performance databases will be created to support the characterization of the cyber security elements, and roll them into prototype software tools. This new methodology and software capability will enable analysts to better identify and assess the overall risk during a vulnerability analysis.

  14. Who's Vulnerable in Infant Child Care Centers?

    ERIC Educational Resources Information Center

    Kendall, Earline D.; Moukaddem, Virginia E.

    1992-01-01

    Maintains that infants and toddlers, parents, and child caregivers are vulnerable to a variety of infectious diseases from infant-toddler child care centers. These diseases include infectious diarrhea; rubella; cytomeglovirus; hepatitis A, and haemophilus influenza type B. Suggests ways to prevent the spread of such diseases. (BB)

  15. DEMONSTRATING APPLICATIONS OF REGIONAL VULNERABILITY ASSESSMENT

    EPA Science Inventory

    This task is designed to respond to 2 Congressional earmarks of $1,000,000 to the Canaan Valley Institute (CVI) to work in close coordination with the Regional Vulnerability Assessment (ReVA) initiative to develop research and educational tools using integrative technologies to p...

  16. Perceived Vulnerability to Disease Predicts Environmental Attitudes

    ERIC Educational Resources Information Center

    Prokop, Pavol; Kubiatko, Milan

    2014-01-01

    Investigating predictors of environmental attitudes may bring valuable benefits in terms of improving public awareness about biodiversity degradation and increased pro-environmental behaviour. Here we used an evolutionary approach to study environmental attitudes based on disease-threat model. We hypothesized that people vulnerable to diseases may…

  17. A physical approach on flood risk vulnerability

    NASA Astrophysics Data System (ADS)

    Mazzorana, Bruno; Fuchs, Sven; Keiler, Margreth

    2013-04-01

    The design of efficient flood risk mitigation strategies and their subsequent implementation relies on a careful vulnerability analysis of the elements exposed to flood hazard. Recently, extensive research efforts were undertaken to develop and refine empirical relationships linking the structural vulnerability of buildings to the intensity of the impacting water-related hazard processes. These empirical vulnerability functions allow for an estimation of the expected direct losses as a result of the hazard scenario on the basis of a spatially explicit representation of the process patterns and the elements at risk, and improve both risk assessments and cost-benefit analyses of planned mitigation strategies. However, due to the underlying empiricism of such vulnerability functions, the physics of the damage generating mechanisms remain unveiled, and, as such, the applicability of the empirical approach for planning hazard-proof residential buildings is rather limited. Therefore, we propose a conceptual assessment scheme to close this gap. This assessment scheme comprises distinct analytical steps: (a) modelling the process intensity and (b) the impact on the element at risk exposed, (c) the physical response of the building envelope, (d) the damage accounting and (f) the economic damage valuation. This dynamic assessment supports all relevant planning activities with respect to a minimisation of flood hazard losses, and can be implemented in the operational risk assessment procedure.

  18. Vulnerability--A New View of Schizophrenia

    ERIC Educational Resources Information Center

    Zubin, Joseph; Spring, Bonnie

    1977-01-01

    Although descriptive and etiological approaches to psychopathology have made notable advances, they seem to have reached a plateau. After reviewing the six approaches to etiology that now preempt the field--ecological, developmental, learning, genetic, internal environment, and neurophysiological models--a second-order model, vulnerability, is…

  19. Defining and Measuring Vulnerability in Young People.

    PubMed

    Arora, Shilpa Khanna; Shah, Dheeraj; Chaturvedi, Sanjay; Gupta, Piyush

    2015-01-01

    Adolescents and youth, together addressed as "young people", form the future building blocks of any society. They being most energetic and dynamic, tend to get involved in high-risk behaviors making themselves susceptible to criminal offences, accidents, physical injuries, emotional trauma, and medical problems - some of them extremely serious like transmission of human immunodeficiency virus (HIV). The concept of vulnerability is applicable to all the people who are more exposed to risks than their peers like the young people. In order to deal with social evils like criminal offences, domestic violence, sexual abuse, HIV, etc. we need to define vulnerability and understand the factors that influence it. This review also attempts to summarize the indicators of vulnerability and the data currently available to estimate its burden in India. Measuring the magnitude of vulnerability by means of certain indicators/variables might help us in devising tools to assess this poorly defined entity. This may also evolve a conceptual framework on which targeted remedial interventions can be devised and implemented. PMID:26170545

  20. Criminal injuries compensation: Protecting vulnerable applicants.

    PubMed

    Guthrie, Robert

    2015-09-01

    Each year large numbers of persons sustain injury as a consequence of criminal behaviour. All Australian jurisdictions provide State-funded compensation to those harmed in this way. In the case of vulnerable applicants, the Assessor must consider not simply the appropriate and fair amount of compensation, but also how a person will be affected by the payment of compensation. Often a vulnerable applicant will apply through a guardian or a public trustee, although many apply in person. This article examines the use of legislative provisions, rules, regulations and practices in the various Australian jurisdictions in relation to how vulnerable applicants may be protected and supported once an award of compensation is made in their favour. Most jurisdictions provide for a mechanism by which compensation may be held in trust where the Assessor considers that the applicant may be unable to manage his or her financial affairs in his or her best interests. This article explores what factors are taken into account by Assessors in the absence of and pursuant to legislative directions. It considers how the approach may vary across jurisdictions and creative approaches to financial protection of vulnerable applicants. PMID:26554206

  1. Evaluating Youth Work with Vulnerable Young People.

    ERIC Educational Resources Information Center

    Furlong, Andy; Cartmel, Fred; Powney, Janet; Hall, Stuart

    This report presents the results of an 18-month research project that studied the effectiveness of youth work with vulnerable young people. The research, representing six distinct geographical areas of Scotland characterized by disadvantage, focused on young people aged 13 to 16. In each neighborhood, the project examined the experiences of young…

  2. Chemical Safety Vulnerability Working Group Report

    SciTech Connect

    Not Available

    1994-09-01

    This report marks the culmination of a 4-month review conducted to identify chemical safety vulnerabilities existing at DOE facilities. This review is an integral part of DOE's efforts to raise its commitment to chemical safety to the same level as that for nuclear safety.

  3. Defining and Measuring Vulnerability in Young People

    PubMed Central

    Arora, Shilpa Khanna; Shah, Dheeraj; Chaturvedi, Sanjay; Gupta, Piyush

    2015-01-01

    Adolescents and youth, together addressed as “young people”, form the future building blocks of any society. They being most energetic and dynamic, tend to get involved in high-risk behaviors making themselves susceptible to criminal offences, accidents, physical injuries, emotional trauma, and medical problems — some of them extremely serious like transmission of human immunodeficiency virus (HIV). The concept of vulnerability is applicable to all the people who are more exposed to risks than their peers like the young people. In order to deal with social evils like criminal offences, domestic violence, sexual abuse, HIV, etc. we need to define vulnerability and understand the factors that influence it. This review also attempts to summarize the indicators of vulnerability and the data currently available to estimate its burden in India. Measuring the magnitude of vulnerability by means of certain indicators/variables might help us in devising tools to assess this poorly defined entity. This may also evolve a conceptual framework on which targeted remedial interventions can be devised and implemented. PMID:26170545

  4. African agriculture especially vulnerable to warming climate

    NASA Astrophysics Data System (ADS)

    Wendel, JoAnna

    2014-09-01

    Malnourishment across Africa could jump 40% by 2050 due to climate change, according to the Africa Agriculture Status Report 2014 (AASR), released on 2 September. With temperatures predicted to rise 1.5°C-2.5°C by midcentury, African smallholder farms, which are generally run by one family, are more vulnerable than ever, the report finds.

  5. Cosmopolitan Sensitivities, Vulnerability, and Global Englishes

    ERIC Educational Resources Information Center

    Jacobsen, Ushma Chauhan

    2015-01-01

    This paper is the outcome of an afterthought that assembles connections between three elements: the ambitions of cultivating cosmopolitan sensitivities that circulate vibrantly in connection with the internationalization of higher education, a course on Global Englishes at a Danish university and the sensation of vulnerability. It discusses the…

  6. REGIONAL VULNERABILITY ASSESSMENT: A CONCEPTUAL APPROACH

    EPA Science Inventory

    EPA's Regional Vulnerability Assessment (REVA) project is developing and testing an approach to conducting comparative ecological risk assessments at the regional scale. I't seeks an objective and quantifiable answer to answer the question, "What are the greatest threaten accompa...

  7. Nuclear material production cycle vulnerability analysis. Revision.

    SciTech Connect

    Bott, T.F.

    1996-10-01

    This paper discusses a method for rapidly and systematically identifying vulnerable equipment in a nuclear material or similar production process and ranking that equipment according to its attractiveness to a malevolent attacker. A multi-step approach was used in the analysis. First, the entire production cycle was modeled as a flow diagram. This flow diagram was analyzed using graph theoretical methods to identify processes in the production cycle and their locations. Models of processes that were judged to be particularly vulnerable based on the cycle analysis then were developed in greater detail to identify equipment in that process that is vulnerable to intentional damage. The information generated by this analysis may be used to devise protective features for critical equipment. The method uses directed graphs, fault trees, and evaluation matrices. Expert knowledge of plant engineers and operators is used to determine the critical equipment and evaluate its attractiveness to potential attackers. The vulnerability of equipment can be ranked and sorted according to any criterion desired and presented in a readily grasped format using matrices.

  8. [Vulnerability in adolescent health: contemporary issues].

    PubMed

    Silva, Marta Angélica Iossi; Mello, Flávia Carvalho Malta de; Mello, Débora Falleiros de; Ferriani, Maria das Graças Carvalho; Sampaio, Julliane Messias Cordeiro; Oliveira, Wanderlei Abadio de

    2014-02-01

    The objective of this exploratory study with a qualitative approach was to analyze how adolescents perceive reality in terms of vulnerability in respect to health. A total of 17 semi-structured interviews were staged with adolescents from two elementary-middle (k-8) schools in a city in the interior of São Paulo, Brazil. Content analysis was used to interpret the data, from which three thematic nuclei emerged. The results revealed that the adolescents understand the complex interaction between individual predisposition and health vulnerability, as well as the issues related to social structure, which contributes to strengthening the concept of vulnerability based on individual, social and programmatic logic. It was established that public policies, prevention and care provided during adolescence should not be guided by a single reference point, but instead by the plurality of the adolescent individuals concerning vulnerability in their dimensions, which should be acknowledged in order to break with the idea of the universality of the process of becoming an adolescent. PMID:24863838

  9. Seismic vulnerability assessments in risk analysis

    NASA Astrophysics Data System (ADS)

    Frolova, Nina; Larionov, Valery; Bonnin, Jean; Ugarov, Alexander

    2013-04-01

    The assessment of seismic vulnerability is a critical issue within natural and technological risk analysis. In general, there are three common types of methods used for development of vulnerability functions of different elements at risk: empirical, analytical and expert estimations. The paper addresses the empirical methods for seismic vulnerability estimation for residential buildings and industrial facilities. The results of engineering analysis of past earthquake consequences, as well as the statistical data on buildings behavior during strong earthquakes presented in the different seismic intensity scales, are used to verify the regional parameters of mathematical models in order to simulate physical and economic vulnerability for different building types classified according to seismic scale MMSK-86. Verified procedure has been used to estimate the physical and economic vulnerability of buildings and constructions against earthquakes for the Northern Caucasus Federal region of the Russian Federation and Krasnodar area, which are characterized by rather high level of seismic activity and high population density. In order to estimate expected damage states to buildings and constructions in the case of the earthquakes according to the OSR-97B (return period T=1,000 years) within big cities and towns, they were divided into unit sites and their coordinates were presented as dots located in the centers of unit sites. Then the indexes obtained for each unit site were summed up. The maps of physical vulnerability zoning for Northern Caucasus Federal region of the Russian Federation and Krasnodar area includes two elements: percent of different damage states for settlements with number of inhabitants less than 1,000 and vulnerability for cities and towns with number of inhabitants more than 1,000. The hypsometric scale is used to represent both elements on the maps. Taking into account the size of oil pipe line systems located in the highly active seismic zones in

  10. 32 CFR 516.13 - Assistance in serving process overseas.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 32 National Defense 3 2011-07-01 2009-07-01 true Assistance in serving process overseas. 516.13 Section 516.13 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY AID OF CIVIL AUTHORITIES AND PUBLIC RELATIONS LITIGATION Service of Process § 516.13 Assistance in serving process...

  11. The National Insurance Academy: Serving India's Insurance Professionals and Researchers

    ERIC Educational Resources Information Center

    Sane, Bhagyashree

    2011-01-01

    This article discusses how a special library can meet the needs of a specific industry. The author focuses on India's National Insurance Academy (NIA) Library, which serves the insurance industry of India and some neighboring countries. It is where the author serves as the chief librarian.

  12. On Their Own Terms: Two-Year Minority Serving Institutions

    ERIC Educational Resources Information Center

    Nguyen, Thai-Huy; Lundy-Wagner, Valerie; Castro Samayoa, Andrés; Gasman, Marybeth; Wilson, Audrey; Diggs, Desmond; Wolff, Melanie; Dávila, Carolina; Boland, William

    2015-01-01

    This report, published by the Center for Minority Serving Institutions in collaboration with CAPSEE, looks at the role of two-year Minority Serving Institutions (MSIs) in improving postsecondary access and degree completion for disadvantaged students in the United States. In doing so, it aims to prepare the groundwork for research that considers…

  13. 36 CFR 703.22 - Where to serve demands.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ....22 Section 703.22 Parks, Forests, and Public Property LIBRARY OF CONGRESS DISCLOSURE OR PRODUCTION OF... Where the Library Is Not a Party § 703.22 Where to serve demands. Requesting parties must serve..., Library of Congress, Washington, DC 20540. (b) For Law Library matters: Law Librarian, LM 240, Library...

  14. 36 CFR 703.22 - Where to serve demands.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ....22 Section 703.22 Parks, Forests, and Public Property LIBRARY OF CONGRESS DISCLOSURE OR PRODUCTION OF... Where the Library Is Not a Party § 703.22 Where to serve demands. Requesting parties must serve..., Library of Congress, Washington, DC 20540. (b) For Law Library matters: Law Librarian, LM 240, Library...

  15. 36 CFR 703.22 - Where to serve demands.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... Section 703.22 Parks, Forests, and Public Property LIBRARY OF CONGRESS DISCLOSURE OR PRODUCTION OF RECORDS... the Library Is Not a Party § 703.22 Where to serve demands. Requesting parties must serve subpoenas..., Library of Congress, Washington, DC 20540. (b) For Law Library matters: Law Librarian, LM 240, Library...

  16. Applying Buddhist Practices to Advocacy: The Advocacy-Serving Model

    ERIC Educational Resources Information Center

    Warren, Jane; Klepper, Konja K.; Lambert, Serena; Nunez, Johnna; Williams, Susan

    2011-01-01

    Creating and retaining empathic connections with the most disenfranchised among us can take a toll on the wellness of counselor advocates. The Advocacy-Serving Model is introduced as a creative approach to strengthening the ability of advocates to serve through enhancing awareness, focusing actions, and connecting to community. The model…

  17. 16 CFR 500.26 - Representations of servings, uses, applications.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... CFR part 10, by the Department of Commerce, quantitatively defining the meaning of the terms serving... net quantity (in terms of weight or mass, measure, or numerical count) of each such serving, use, or... to the total amount of object or objects to which the commodity may be applied or upon which or...

  18. 16 CFR 500.26 - Representations of servings, uses, applications.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... CFR part 10, by the Department of Commerce, quantitatively defining the meaning of the terms serving... net quantity (in terms of weight or mass, measure, or numerical count) of each such serving, use, or... to the total amount of object or objects to which the commodity may be applied or upon which or...

  19. External influences on children's self-served portions at meals

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Large portions promote intake among children, but little is known about external influences of the eating environment on children;s self-selected portion sizes. This research experimentally tested effects of the amount of entree available and serving spoon size on children's self-served entree porti...

  20. Inventing Hispanic-Serving Institutions (HSIs): The Basics

    ERIC Educational Resources Information Center

    Santiago, Deborah

    2006-01-01

    HSIs (Hispanic-Serving Institutions) are important institutions for Latinos, yet little research exists on them. This brief serves as a primer on the conditions and history behind their invention, the processes for identification, and the general institutional characteristics of HSIs. It also offers an overview of how these institutions are…

  1. 32 CFR 516.13 - Assistance in serving process overseas.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 32 National Defense 3 2010-07-01 2010-07-01 true Assistance in serving process overseas. 516.13 Section 516.13 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY AID OF CIVIL AUTHORITIES AND PUBLIC RELATIONS LITIGATION Service of Process § 516.13 Assistance in serving process...

  2. Mapping Hispanic-Serving Institutions: A Typology of Institutional Diversity

    ERIC Educational Resources Information Center

    Núñez, Anne-Marie; Crisp, Gloria; Elizondo, Diane

    2016-01-01

    Hispanic-Serving Institutions (HSIs), institutions that enroll at least 25% Hispanic students, are institutionally diverse, including a much wider array of institutional types than other Minority-Serving Institutions (MSIs). Furthermore, they have distinctive institutional characteristics from those typically emphasized in institutional typologies…

  3. Hispanic-Serving Institutions: What Are They? Where Are They?

    ERIC Educational Resources Information Center

    Laden, Berta Vigil

    2004-01-01

    Hispanic-serving educational institutions are receiving greater public attention as they continue to expand in number. Increasingly, more and more Latinos and other racial and ethnic students are enrolling in these institutions. Hispanic-Serving Institutions (HSIs) are public and private two- and four-year colleges and universities with Latino…

  4. School Administrator Quality in Minority-Serving Institutions

    ERIC Educational Resources Information Center

    Rodríguez, Mariela A.; Mullen, Carol A.; Allen, Tawannah G.

    2015-01-01

    This commentary brings together the topics of geographically-oriented diversity, minority-serving institutions, and educational leadership programs. The geospatial context for this discussion about school administrator quality focuses on Hispanic-serving institutions (HSIs) and historically Black colleges and universities (HBCUs) in the United…

  5. Estimation of Food Guide Pyramid Serving Sizes by College Students.

    ERIC Educational Resources Information Center

    Knaust, Gretchen; Foster, Irene M.

    2000-01-01

    College students (n=158) used the Food Guide Pyramid to select serving sizes on a questionnaire (73% had been instructed in its use). Overall mean scores (31% correct) indicated they generally did not know recommended serving sizes. Those who had read about or received instruction in the pyramid had higher mean scores. (SK)

  6. 76 FR 59499 - National Hispanic-Serving Institutions Week, 2011

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-26

    ... States of America the two hundred and thirty- sixth. (Presidential Sig.) [FR Doc. 2011-24888 Filed 9-23... Documents#0;#0; ] Proclamation 8718 of September 21, 2011 National Hispanic-Serving Institutions Week, 2011... National Hispanic-Serving Institutions (HSIs) Week, we renew our commitment to strengthening and...

  7. 13 CFR 142.20 - How are papers served?

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 13 Business Credit and Assistance 1 2013-01-01 2013-01-01 false How are papers served? 142.20... ACT REGULATIONS Hearing Provisions § 142.20 How are papers served? Except for service of a complaint or a notice of hearing under §§ 142.11 and 142.14(b) respectively, service of papers must be made...

  8. 45 CFR 2554.21 - How are papers served?

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 45 Public Welfare 4 2013-10-01 2013-10-01 false How are papers served? 2554.21 Section 2554.21... SERVICE PROGRAM FRAUD CIVIL REMEDIES ACT REGULATIONS Hearing Provisions § 2554.21 How are papers served... pleading and paper filed in the proceeding shall contain a caption setting forth the title of the...

  9. 13 CFR 142.20 - How are papers served?

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 13 Business Credit and Assistance 1 2010-01-01 2010-01-01 false How are papers served? 142.20... ACT REGULATIONS Hearing Provisions § 142.20 How are papers served? Except for service of a complaint or a notice of hearing under §§ 142.11 and 142.14(b) respectively, service of papers must be made...

  10. 45 CFR 2554.21 - How are papers served?

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 45 Public Welfare 4 2011-10-01 2011-10-01 false How are papers served? 2554.21 Section 2554.21... SERVICE PROGRAM FRAUD CIVIL REMEDIES ACT REGULATIONS Hearing Provisions § 2554.21 How are papers served... pleading and paper filed in the proceeding shall contain a caption setting forth the title of the...

  11. 13 CFR 142.20 - How are papers served?

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 13 Business Credit and Assistance 1 2012-01-01 2012-01-01 false How are papers served? 142.20... ACT REGULATIONS Hearing Provisions § 142.20 How are papers served? Except for service of a complaint or a notice of hearing under §§ 142.11 and 142.14(b) respectively, service of papers must be made...

  12. 13 CFR 142.20 - How are papers served?

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 13 Business Credit and Assistance 1 2011-01-01 2011-01-01 false How are papers served? 142.20... ACT REGULATIONS Hearing Provisions § 142.20 How are papers served? Except for service of a complaint or a notice of hearing under §§ 142.11 and 142.14(b) respectively, service of papers must be made...

  13. 13 CFR 142.20 - How are papers served?

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 13 Business Credit and Assistance 1 2014-01-01 2014-01-01 false How are papers served? 142.20... ACT REGULATIONS Hearing Provisions § 142.20 How are papers served? Except for service of a complaint or a notice of hearing under §§ 142.11 and 142.14(b) respectively, service of papers must be made...

  14. 45 CFR 2554.21 - How are papers served?

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 45 Public Welfare 4 2012-10-01 2012-10-01 false How are papers served? 2554.21 Section 2554.21... SERVICE PROGRAM FRAUD CIVIL REMEDIES ACT REGULATIONS Hearing Provisions § 2554.21 How are papers served... pleading and paper filed in the proceeding shall contain a caption setting forth the title of the...

  15. 45 CFR 2554.21 - How are papers served?

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 45 Public Welfare 4 2014-10-01 2014-10-01 false How are papers served? 2554.21 Section 2554.21... SERVICE PROGRAM FRAUD CIVIL REMEDIES ACT REGULATIONS Hearing Provisions § 2554.21 How are papers served... pleading and paper filed in the proceeding shall contain a caption setting forth the title of the...

  16. 45 CFR 2554.21 - How are papers served?

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 45 Public Welfare 4 2010-10-01 2010-10-01 false How are papers served? 2554.21 Section 2554.21... SERVICE PROGRAM FRAUD CIVIL REMEDIES ACT REGULATIONS Hearing Provisions § 2554.21 How are papers served... pleading and paper filed in the proceeding shall contain a caption setting forth the title of the...

  17. Contemporary carotid imaging: from degree of stenosis to plaque vulnerability.

    PubMed

    Brinjikji, Waleed; Huston, John; Rabinstein, Alejandro A; Kim, Gyeong-Moon; Lerman, Amir; Lanzino, Giuseppe

    2016-01-01

    Carotid artery stenosis is a well-established risk factor of ischemic stroke, contributing to up to 10%-20% of strokes or transient ischemic attacks. Many clinical trials over the last 20 years have used measurements of carotid artery stenosis as a means to risk stratify patients. However, with improvements in vascular imaging techniques such as CT angiography and MR angiography, ultrasonography, and PET/CT, it is now possible to risk stratify patients, not just on the degree of carotid artery stenosis but also on how vulnerable the plaque is to rupture, resulting in ischemic stroke. These imaging techniques are ushering in an emerging paradigm shift that allows for risk stratifications based on the presence of imaging features such as intraplaque hemorrhage (IPH), plaque ulceration, plaque neovascularity, fibrous cap thickness, and presence of a lipid-rich necrotic core (LRNC). It is important for the neurosurgeon to be aware of these new imaging techniques that allow for improved patient risk stratification and outcomes. For example, a patient with a low-grade stenosis but an ulcerated plaque may benefit more from a revascularization procedure than a patient with a stable 70% asymptomatic stenosis with a thick fibrous cap. This review summarizes the current state-of-the-art advances in carotid plaque imaging. Currently, MRI is the gold standard in carotid plaque imaging, with its high resolution and high sensitivity for identifying IPH, ulceration, LRNC, and inflammation. However, MRI is limited due to time constraints. CT also allows for high-resolution imaging and can accurately detect ulceration and calcification, but cannot reliably differentiate LRNC from IPH. PET/CT is an effective technique to identify active inflammation within the plaque, but it does not allow for assessment of anatomy, ulceration, IPH, or LRNC. Ultrasonography, with the aid of contrast enhancement, is a cost-effective technique to assess plaque morphology and characteristics, but it is

  18. Environmental Health Related Socio-Spatial Inequalities: Identifying “Hotspots” of Environmental Burdens and Social Vulnerability

    PubMed Central

    Shrestha, Rehana; Flacke, Johannes; Martinez, Javier; van Maarseveen, Martin

    2016-01-01

    Differential exposure to multiple environmental burdens and benefits and their distribution across a population with varying vulnerability can contribute heavily to health inequalities. Particularly relevant are areas with high cumulative burdens and high social vulnerability termed as “hotspots”. This paper develops an index-based approach to assess these multiple burdens and benefits in combination with vulnerability factors at detailed intra-urban level. The method is applied to the city of Dortmund, Germany. Using non-spatial and spatial methods we assessed inequalities and identified “hotspot” areas in the city. We found modest inequalities burdening higher vulnerable groups in Dortmund (CI = −0.020 at p < 0.05). At the detailed intra-urban level, however, inequalities showed strong geographical patterns. Large numbers of “hotspots” exist in the northern part of the city compared to the southern part. A holistic assessment, particularly at a detailed local level, considering both environmental burdens and benefits and their distribution across the population with the different vulnerability, is essential to inform environmental justice debates and to mobilize local stakeholders. Locating “hotspot” areas at this detailed spatial level can serve as a basis to develop interventions that target vulnerable groups to ensure a health conducive equal environment. PMID:27409625

  19. Protecting Vulnerable Research Subjects in Critical Care Trials: Enhancing the Informed Consent Process and Recommendations for Safeguards

    PubMed Central

    2011-01-01

    Although critically ill patients represent a vulnerable group of individuals, guidelines in research ethics assert that ethically acceptable research may proceed with such vulnerable subjects if additional safeguards are in place to minimize the risk of harm and exploitation. Such safeguards include the proper obtainment of informed consent that avoids the presence of the therapeutic misconception and the assessment of decisional capacity in critically ill patients recruited for research. Also discussed in this review are additional safeguards for such vulnerable subjects, as well as the issues involved with proxy consent. Heightened awareness to principles of ethics and provision of additional safeguards to enhance protections of vulnerable subjects would help to maintain the public trust in the research endeavor. PMID:21906335

  20. Age-Related Psychophysiological Vulnerability to Phenylalanine in Phenylketonuria

    PubMed Central

    Leuzzi, Vincenzo; Mannarelli, Daniela; Manti, Filippo; Pauletti, Caterina; Locuratolo, Nicoletta; Carducci, Carla; Carducci, Claudia; Vanacore, Nicola; Fattapposta, Francesco

    2014-01-01

    Background: Phenylketonuria (PKU) is caused by the inherited defect of the phenylalanine hydroxylase enzyme, which converts phenylalanine (Phe) into tyrosine (Tyr). Neonatal screening programs and early treatment have radically changed the natural history of PKU. Nevertheless, an increased risk of neurocognitive and psychiatric problems in adulthood remains a challenging aspect of the disease. In order to assess the vulnerability of complex skills to Phe, we explored: (a) the effect of a rapid increase in blood Phe levels on event-related potentials (ERP) in PKU subjects during their second decade of life; (b) the association (if existing) between psychophysiological and neurocognitive features. Methods: Seventeen early-treated PKU subjects, aged 10–20, underwent ERP [mismatch negativity, auditory P300, contingent negative variation (CNV), and Intensity Dependence of Auditory Evoked Potentials] recording before and 2 h after an oral loading of Phe. Neurocognitive functioning, historical and concurrent biochemical values of blood Phe, Tyr, and Phe/Tyr ratio, were all included in the statistical analysis. Results: Event-related potential components were normally detected in all the subjects. In subjects younger than 13 CNV amplitude, W2-CNV area, P3b latency, and reaction times in motor responses were negatively influenced by Phe-loading. Independently from the psychophysiological vulnerability, some neurocognitive skills were more impaired in younger patients. No correlation was found between biochemical alterations and neurocognitive and psychophysiological findings. Conclusion: The vulnerability of the emerging neurocognitive functions to Phe suggests a strict metabolic control in adolescents affected by PKU and a neurodevelopmental approach in the study of neurocognitive outcome in PKU. PMID:25003100

  1. The specificity of cognitive vulnerabilities to emotional disorders: anxiety sensitivity, looming vulnerability and explanatory style.

    PubMed

    Reardon, John M; Williams, Nathan L

    2007-01-01

    Mood and anxiety disorders share considerable phenomenological and diagnostic overlap. Several models have advanced the understanding of the phenomenological overlap of anxiety and depression; however, identification of disorder-specific etiological mechanisms remains elusive. Recently, research has advanced several cognitive vulnerability-stress models proposing that one's characteristic way of attending to, interpreting, and remembering negative events contributes vulnerability to psychopathology. These cognitive vulnerabilities may elucidate specific etiological mechanisms that distinguish mood and anxiety pathology. The present study examines the specificity of three cognitive vulnerability constructs, the looming cognitive style, anxiety sensitivity, and explanatory style, in the prediction of latent anxiety disorder symptoms and latent depression symptoms. Structural equation modeling analyses indicated that the looming cognitive style demonstrated specificity predicting only anxiety disorder symptoms whereas anxiety sensitivity and a pessimistic explanatory style predicted both anxiety disorder and mood disorder symptoms. Implications for future research are discussed. PMID:17070666

  2. Human Illness and the Experience of Vulnerability: A Summary and Reflection upon the Opening Keynote by His Grace Archbishop Emeritus Desmond Tutu

    ERIC Educational Resources Information Center

    Mazonde, Isaac N.

    2010-01-01

    In his speech, "Human Illness and the Experience of Vulnerability," Archbishop Tutu used his experience, eloquence and humour to emphasize the vulnerability of human beings during illness. The Archbishop emphasized the need for healthcare professionals to realize that patients are not simply numbers or cases, but fellow human beings who are in…

  3. Computational discovery of pathway-level genetic vulnerabilities in non-small-cell lung cancer | Office of Cancer Genomics

    Cancer.gov

    Novel approaches are needed for discovery of targeted therapies for non-small-cell lung cancer (NSCLC) that are specific to certain patients. Whole genome RNAi screening of lung cancer cell lines provides an ideal source for determining candidate drug targets. Unsupervised learning algorithms uncovered patterns of differential vulnerability across lung cancer cell lines to loss of functionally related genes. Such genetic vulnerabilities represent candidate targets for therapy and are found to be involved in splicing, translation and protein folding.

  4. Aircraft vulnerability analysis by modeling and simulation

    NASA Astrophysics Data System (ADS)

    Willers, Cornelius J.; Willers, Maria S.; de Waal, Alta

    2014-10-01

    Infrared missiles pose a significant threat to civilian and military aviation. ManPADS missiles are especially dangerous in the hands of rogue and undisciplined forces. Yet, not all the launched missiles hit their targets; the miss being either attributable to misuse of the weapon or to missile performance restrictions. This paper analyses some of the factors affecting aircraft vulnerability and demonstrates a structured analysis of the risk and aircraft vulnerability problem. The aircraft-missile engagement is a complex series of events, many of which are only partially understood. Aircraft and missile designers focus on the optimal design and performance of their respective systems, often testing only in a limited set of scenarios. Most missiles react to the contrast intensity, but the variability of the background is rarely considered. Finally, the vulnerability of the aircraft depends jointly on the missile's performance and the doctrine governing the missile's launch. These factors are considered in a holistic investigation. The view direction, altitude, time of day, sun position, latitude/longitude and terrain determine the background against which the aircraft is observed. Especially high gradients in sky radiance occur around the sun and on the horizon. This paper considers uncluttered background scenes (uniform terrain and clear sky) and presents examples of background radiance at all view angles across a sphere around the sensor. A detailed geometrical and spatially distributed radiometric model is used to model the aircraft. This model provides the signature at all possible view angles across the sphere around the aircraft. The signature is determined in absolute terms (no background) and in contrast terms (with background). It is shown that the background significantly affects the contrast signature as observed by the missile sensor. A simplified missile model is constructed by defining the thrust and mass profiles, maximum seeker tracking rate, maximum

  5. Review of tennis serve motion analysis and the biomechanics of three serve types with implications for injury.

    PubMed

    Abrams, Geoffrey D; Sheets, Alison L; Andriacchi, Thomas P; Safran, Marc R

    2011-11-01

    The tennis serve has the potential for musculoskeletal injury as it is an overhead motion and is performed repetitively during play. Early studies evaluating the biomechanics and injury potential of the tennis serve utilized skin-based marker technologies; however, markerless motion measurement systems have recently become available and have obviated some of the problems associated with the marker-based technology. The late cocking and early acceleration phases of the kinetic chain of the service motion produce the highest internal forces and pose the greatest risk of injury during the service motion. Previous biomechanical data on the tennis serve have primarily focused on the flat serve, with some data on the kick serve, and very little published data elucidating the biomechanics of the slice serve. This review discusses the injury potential of the tennis serve with respect to the four phases of the service motion, the history, and early findings of service motion evaluation, as well as biomechanical data detailing the differences between the three types of serves and how this may relate to injury prevention, rehabilitation, and return to play. PMID:22303788

  6. Surface vulnerability of cerebral cortex to major depressive disorder.

    PubMed

    Peng, Daihui; Shi, Feng; Li, Gang; Fralick, Drew; Shen, Ting; Qiu, Meihui; Liu, Jun; Jiang, Kaida; Shen, Dinggang; Fang, Yiru

    2015-01-01

    Major depressive disorder (MDD) is accompanied by atypical brain structure. This study first presents the alterations in the cortical surface of patients with MDD using multidimensional structural patterns that reflect different neurodevelopment. Sixteen first-episode, untreated patients with MDD and 16 matched healthy controls underwent a magnetic resonance imaging (MRI) scan. The cortical maps of thickness, surface area, and gyrification were examined using the surface-based morphometry (SBM) approach. Increase of cortical thickness was observed in the right posterior cingulate region and the parietal cortex involving the bilateral inferior, left superior parietal and right paracentral regions, while decreased thickness was noted in the parietal cortex including bilateral pars opercularis and left precentral region, as well as the left rostral-middle frontal regions in patients with MDD. Likewise, increased or decreased surface area was found in five sub-regions of the cingulate gyrus, parietal and frontal cortices (e.g., bilateral inferior parietal and superior frontal regions). In addition, MDD patients exhibited a significant hypergyrification in the right precentral and supramarginal region. This integrated structural assessment of cortical surface suggests that MDD patients have cortical alterations of the frontal, parietal and cingulate regions, indicating a vulnerability to MDD during earlier neurodevelopmental process. PMID:25793287

  7. Surface Vulnerability of Cerebral Cortex to Major Depressive Disorder

    PubMed Central

    Li, Gang; Fralick, Drew; Shen, Ting; Qiu, Meihui; Liu, Jun; Jiang, Kaida; Shen, Dinggang; Fang, Yiru

    2015-01-01

    Major depressive disorder (MDD) is accompanied by atypical brain structure. This study first presents the alterations in the cortical surface of patients with MDD using multidimensional structural patterns that reflect different neurodevelopment. Sixteen first-episode, untreated patients with MDD and 16 matched healthy controls underwent a magnetic resonance imaging (MRI) scan. The cortical maps of thickness, surface area, and gyrification were examined using the surface-based morphometry (SBM) approach. Increase of cortical thickness was observed in the right posterior cingulate region and the parietal cortex involving the bilateral inferior, left superior parietal and right paracentral regions, while decreased thickness was noted in the parietal cortex including bilateral pars opercularis and left precentral region, as well as the left rostral-middle frontal regions in patients with MDD. Likewise, increased or decreased surface area was found in five sub-regions of the cingulate gyrus, parietal and frontal cortices (e.g., bilateral inferior parietal and superior frontal regions). In addition, MDD patients exhibited a significant hypergyrification in the right precentral and supramarginal region. This integrated structural assessment of cortical surface suggests that MDD patients have cortical alterations of the frontal, parietal and cingulate regions, indicating a vulnerability to MDD during earlier neurodevelopmental process. PMID:25793287

  8. Reducing CKD risks among vulnerable populations in primary care.

    PubMed

    Greer, Raquel; Boulware, L Ebony

    2015-01-01

    Ethnic/racial and socioeconomic status disparities in the health-care and clinical outcomes of patients with chronic kidney disease (CKD) are pervasive. The vast majority of care to decrease incidence of CKD risk and progression occurs in primary care settings. High-quality primary care, therefore, represents a key strategy through which disparities in the incidence and progression of CKD may be eliminated. The Chronic Care Model provides a framework for the delivery of high-quality primary care for chronic diseases, and it is frequently used to guide health-care quality improvement initiatives. Evidence suggests that Chronic Care Model constructs, including provider and organizational quality improvement initiatives focused on team approaches to chronic care (eg, case management, community health workers), are effective in modifying patients' CKD risks among ethnic minority and low-income patients. Other Chronic Care Model constructs, including clinical information systems (eg, disease registries), decision support interventions, and the provision of patient-centered care have been shown to improve processes related to CKD care but with limited and/or mixed effects on patient outcomes. Few studies have examined the effect of these approaches on reducing disparities. Research is needed to examine the effectiveness of these strategies to eliminate CKD disparities among vulnerable populations. PMID:25573516

  9. Upper Limb Biomechanics During the Volleyball Serve and Spike

    PubMed Central

    Reeser, Jonathan C.; Fleisig, Glenn S.; Bolt, Becky; Ruan, Mianfang

    2010-01-01

    Background: The shoulder is the third-most commonly injured body part in volleyball, with the majority of shoulder problems resulting from chronic overuse. Hypothesis: Significant kinetic differences exist among specific types of volleyball serves and spikes. Study Design: Controlled laboratory study. Methods: Fourteen healthy female collegiate volleyball players performed 5 successful trials of 4 skills: 2 directional spikes, an off-speed roll shot, and the float serve. Volunteers who were competent in jump serves (n, 5) performed 5 trials of that skill. A 240-Hz 3-dimensional automatic digitizing system captured each trial. Multivariate analysis of variance and post hoc paired t tests were used to compare kinetic parameters for the shoulder and elbow across all the skills (except the jump serve). A similar statistical analysis was performed for upper extremity kinematics. Results: Forces, torques, and angular velocities at the shoulder and elbow were lowest for the roll shot and second-lowest for the float serve. No differences were detected between the cross-body and straight-ahead spikes. Although there was an insufficient number of participants to statistically analyze the jump serve, the data for it appear similar to those of the cross-body and straight-ahead spikes. Shoulder abduction at the instant of ball contact was approximately 130° for all skills, which is substantially greater than that previously reported for female athletes performing tennis serves or baseball pitches. Conclusion: Because shoulder kinetics were greatest during spiking, the volleyball player with symptoms of shoulder overuse may wish to reduce the number of repetitions performed during practice. Limiting the number of jump serves may also reduce the athlete’s risk of overuse-related shoulder dysfunction. Clinical Relevance: Volleyball-specific overhead skills, such as the spike and serve, produce considerable upper extremity force and torque, which may contribute to the risk of

  10. Empirical Estimates and Observations of 0Day Vulnerabilities

    SciTech Connect

    Miles A. McQueen; Trevor A. McQueen; Wayne F. Boyer; May R. Chaffin

    2009-01-01

    We define a 0Day vulnerability to be any vulnerability, in deployed software, that has been discovered by at least one person but has not yet been publicly announced or patched. These 0Day vulnerabilities are of particular interest when assessing the risk to a system from exploit of vulnerabilities which are not generally known to the public or, most importantly, to the owners of the system. Using the 0Day definition given above, we analyzed the 0Day lifespans of 491 vulnerabilities and conservatively estimated that in the worst year there were on average 2500 0Day vulnerabilities in existence on any given day. Then using a small but intriguing set of 15 0Day vulnerability lifespans representing the time from actual discovery to public disclosure, we made a more aggressive estimate. In this case, we estimated that in the worst year there were, on average, 4500 0Day vulnerabilities in existence on any given day.

  11. Evaluation of Equipment Vulnerability and Potential Shock Hazards. [carbon fibers

    NASA Technical Reports Server (NTRS)

    Taback, I.

    1980-01-01

    The vulnerability of electric equipment to carbon fibers released from aircraft accidents is investigated and the parameters affecting vulnerability are discussed. The shock hazard for a hypothetical set of accidents is computed.

  12. On the Library and Information Literacy Education of Vulnerable Groups

    ERIC Educational Resources Information Center

    Zhu, Tian-hui

    2009-01-01

    This paper defines and classifies vulnerable groups, elaborates the necessity of information literacy education of vulnerable groups, analyzes the feasibility for the library to carry out the education, and then discusses specific measures taken by the library to fulfill it.

  13. Vulnerability curves vs. vulnerability indicators: application of an indicator-based methodology for debris-flow hazards

    NASA Astrophysics Data System (ADS)

    Papathoma-Köhle, Maria

    2016-08-01

    The assessment of the physical vulnerability of elements at risk as part of the risk analysis is an essential aspect for the development of strategies and structural measures for risk reduction. Understanding, analysing and, if possible, quantifying physical vulnerability is a prerequisite for designing strategies and adopting tools for its reduction. The most common methods for assessing physical vulnerability are vulnerability matrices, vulnerability curves and vulnerability indicators; however, in most of the cases, these methods are used in a conflicting way rather than in combination. The article focuses on two of these methods: vulnerability curves and vulnerability indicators. Vulnerability curves express physical vulnerability as a function of the intensity of the process and the degree of loss, considering, in individual cases only, some structural characteristics of the affected buildings. However, a considerable amount of studies argue that vulnerability assessment should focus on the identification of these variables that influence the vulnerability of an element at risk (vulnerability indicators). In this study, an indicator-based methodology (IBM) for mountain hazards including debris flow (Kappes et al., 2012) is applied to a case study for debris flows in South Tyrol, where in the past a vulnerability curve has been developed. The relatively "new" indicator-based method is being scrutinised and recommendations for its improvement are outlined. The comparison of the two methodological approaches and their results is challenging since both methodological approaches deal with vulnerability in a different way. However, it is still possible to highlight their weaknesses and strengths, show clearly that both methodologies are necessary for the assessment of physical vulnerability and provide a preliminary "holistic methodological framework" for physical vulnerability assessment showing how the two approaches may be used in combination in the future.

  14. Applying mixed reality to simulate vulnerable populations for practicing clinical communication skills.

    PubMed

    Chuah, Joon Hao; Lok, Benjamin; Black, Erik

    2013-04-01

    Health sciences students often practice and are evaluated on interview and exam skills by working with standardized patients (people that role play having a disease or condition). However, standardized patients do not exist for certain vulnerable populations such as children and the intellectually disabled. As a result, students receive little to no exposure to vulnerable populations before becoming working professionals. To address this problem and thereby increase exposure to vulnerable populations, we propose using virtual humans to simulate members of vulnerable populations. We created a mixed reality pediatric patient that allowed students to practice pediatric developmental exams. Practicing several exams is necessary for students to understand how to properly interact with and correctly assess a variety of children. Practice also increases a student's confidence in performing the exam. Effective practice requires students to treat the virtual child realistically. Treating the child realistically might be affected by how the student and virtual child physically interact, so we created two object interaction interfaces - a natural interface and a mouse-based interface. We tested the complete mixed reality exam and also compared the two object interaction interfaces in a within-subjects user study with 22 participants. Our results showed that the participants accepted the virtual child as a child and treated it realistically. Participants also preferred the natural interface, but the interface did not affect how realistically participants treated the virtual child. PMID:23428437

  15. Strength and Vulnerability Integration (SAVI): A Model of Emotional Well-Being Across Adulthood

    PubMed Central

    Charles, Susan Turk

    2010-01-01

    The following paper presents the theoretical model of Strength and Vulnerability Integration (SAVI) to explain factors that influence emotion regulation and emotional well-being across adulthood. The model posits that trajectories of adult development are marked by age-related enhancement in the use of strategies that serve to avoid or limit exposure to negative stimuli, but age-related vulnerabilities in situations that elicit high levels of sustained emotional arousal. When older adults avoid or reduce exposure to emotional distress, they often respond better than younger adults; when they experience high levels of sustained emotional arousal, however, age-related advantages in emotional well-being are attenuated, and older adults are hypothesized to have greater difficulties returning to homeostasis. SAVI provides a testable model to understand the literature on emotion and aging and to predict trajectories of emotional experience across the adult life span. PMID:21038939

  16. The Vulnerable Faces of Pathological Gambling

    PubMed Central

    2005-01-01

    Pathological gambling is an emerging psychiatric disorder that has medical, psychiatric, and social consequences. Recently, research has been focusing on identifying which portions of the population are most vulnerable to developing problems related to ongoing gambling. Specific populations of interest have included adolescents, elderly, minorities, those with comorbid psychiatric or substance use disorders, and gender differences. Each group possesses unique biological, psychological, and/or social characteristics that confer a vulnerability to develop pathological gambling behaviors. Being able to recognize those who are at risk to become pathological gamblers is the first step toward developing effective prevention and early intervention programs. This is Part Two of a three-part series on pathological gambling. Part One appeared in the March issue of Psychiatry 2005. PMID:21179650

  17. Vulnerability, diversity and scarcity: on universal rights.

    PubMed

    Turner, Bryan Stanley; Dumas, Alex

    2013-11-01

    This article makes a contribution to the on-going debates about universalism and cultural relativism from the perspective of sociology. We argue that bioethics has a universal range because it relates to three shared human characteristics,--human vulnerability, institutional precariousness and scarcity of resources. These three components of our argument provide support for a related notion of 'weak foundationalism' that emphasizes the universality and interrelatedness of human experience, rather than their cultural differences. After presenting a theoretical position on vulnerability and human rights, we draw on recent criticism of this approach in order to paint a more nuanced picture. We conclude that the dichotomy between universalism and cultural relativism has some conceptual merit, but it also has obvious limitations when we consider the political economy of health and its impact on social inequality. PMID:23846549

  18. Modernization, weather variability, and vulnerability to famine.

    PubMed

    D'Alessandro, Simone

    2011-01-01

    This paper shows that under weather variability the transformation from a rural to an incomplete market economy can increase the vulnerability of peasants to famine. This can occur even if improvements in technology have raised agricultural productivity and made production less responsive to weather variability. Indeed, negative environmental shocks can produce a drop in wages that outweighs the increase in wages due to an equivalent positive environmental shock. Consequently, the amount of grain stored increases more slowly in good seasons than it decreases in bad ones. This paper gives new insights on the catastrophic effects produced by widespread droughts in India during the second half of the 19th century. Notwithstanding the introduction of new modes of production and the modernization of infrastructures, the interaction between environmental variability and new institutional arrangements might have contributed to increase the vulnerability of peasants to famine. PMID:22164874

  19. Neural mechanisms of stress resilience and vulnerability.

    PubMed

    Franklin, Tamara B; Saab, Bechara J; Mansuy, Isabelle M

    2012-09-01

    Exposure to stressful events can be differently perceived by individuals and can have persistent sequelae depending on the level of stress resilience or vulnerability of each person. The neural processes that underlie such clinically and socially important differences reside in the anatomical, functional, and molecular connectivity of the brain. Recent work has provided novel insight into some of the involved biological mechanisms that promises to help prevent and treat stress-related disorders. In this review, we focus on causal and mechanistic evidence implicating altered functions and connectivity of the neuroendocrine system, and of hippocampal, cortical, reward, and serotonergic circuits in the establishment and the maintenance of stress resilience and vulnerability. We also touch upon recent findings suggesting a role for epigenetic mechanisms and neurogenesis in these processes and briefly discuss promising avenues of future investigation. PMID:22958817

  20. 7 CFR 1150.134 - Nominee's agreement to serve.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... Agreements and Orders; Milk), DEPARTMENT OF AGRICULTURE DAIRY PROMOTION PROGRAM Dairy Promotion and Research Order National Dairy Promotion and Research Board § 1150.134 Nominee's agreement to serve. Any...

  1. 7 CFR 1150.134 - Nominee's agreement to serve.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... AGREEMENTS AND ORDERS; MILK), DEPARTMENT OF AGRICULTURE DAIRY PROMOTION PROGRAM Dairy Promotion and Research Order National Dairy Promotion and Research Board § 1150.134 Nominee's agreement to serve. Any...

  2. 25 CFR 214.22 - Serving of notices.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ..., OKLAHOMA, FOR MINING, EXCEPT OIL AND GAS § 214.22 Serving of notices. Wherever notice is provided for in... delivery of personal notice; but where the party is outside the State of Oklahoma the officer in charge...

  3. 25 CFR 214.22 - Serving of notices.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ..., OKLAHOMA, FOR MINING, EXCEPT OIL AND GAS § 214.22 Serving of notices. Wherever notice is provided for in... delivery of personal notice; but where the party is outside the State of Oklahoma the officer in charge...

  4. 25 CFR 214.22 - Serving of notices.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ..., OKLAHOMA, FOR MINING, EXCEPT OIL AND GAS § 214.22 Serving of notices. Wherever notice is provided for in... delivery of personal notice; but where the party is outside the State of Oklahoma the officer in charge...

  5. 7 CFR 1221.102 - Nominee's agreement to serve.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... SERVICE (MARKETING AGREEMENTS AND ORDERS; MISCELLANEOUS COMMODITIES), DEPARTMENT OF AGRICULTURE SORGHUM PROMOTION, RESEARCH, AND INFORMATION ORDER Sorghum Promotion, Research, and Information Order Sorghum... agreement to: (a) Serve on the Board if appointed; (b) Disclose any relationship with any sorghum...

  6. 7 CFR 1221.102 - Nominee's agreement to serve.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... SERVICE (MARKETING AGREEMENTS AND ORDERS; MISCELLANEOUS COMMODITIES), DEPARTMENT OF AGRICULTURE SORGHUM PROMOTION, RESEARCH, AND INFORMATION ORDER Sorghum Promotion, Research, and Information Order Sorghum... agreement to: (a) Serve on the Board if appointed; (b) Disclose any relationship with any sorghum...

  7. 7 CFR 1221.102 - Nominee's agreement to serve.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... SERVICE (MARKETING AGREEMENTS AND ORDERS; MISCELLANEOUS COMMODITIES), DEPARTMENT OF AGRICULTURE SORGHUM PROMOTION, RESEARCH, AND INFORMATION ORDER Sorghum Promotion, Research, and Information Order Sorghum... agreement to: (a) Serve on the Board if appointed; (b) Disclose any relationship with any sorghum...

  8. 13. ENGINE TEST CELL BUILDING INTERIOR. EQUIPMENT ROOM SERVING CELLS ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    13. ENGINE TEST CELL BUILDING INTERIOR. EQUIPMENT ROOM SERVING CELLS 2 AND 4. LOOKING SOUTHEAST. - Fairchild Air Force Base, Engine Test Cell Building, Near intersection of Arnold Street & George Avenue, Spokane, Spokane County, WA

  9. 7 CFR 1221.102 - Nominee's agreement to serve.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... SERVICE (MARKETING AGREEMENTS AND ORDERS; MISCELLANEOUS COMMODITIES), DEPARTMENT OF AGRICULTURE SORGHUM PROMOTION, RESEARCH, AND INFORMATION ORDER Sorghum Promotion, Research, and Information Order Sorghum... agreement to: (a) Serve on the Board if appointed; (b) Disclose any relationship with any sorghum...

  10. 4. 150105 PACIFIC AVE. SPRAGUE BUILDING (1889). THIS BUILDING SERVED ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    4. 1501-05 PACIFIC AVE. SPRAGUE BUILDING (1889). THIS BUILDING SERVED AS A MODEL FOR MOST OF THE 'JOBBERS' (FOODSTUFF WHOLESALERS) BUILDING IN TACOMA. - Union Depot Area Study, Tacoma, Pierce County, WA

  11. An Empirical Measure of Computer Security Strength for Vulnerability Remediation

    ERIC Educational Resources Information Center

    Villegas, Rafael

    2010-01-01

    Remediating all vulnerabilities on computer systems in a timely and cost effective manner is difficult given that the window of time between the announcement of a new vulnerability and an automated attack has decreased. Hence, organizations need to prioritize the vulnerability remediation process on their computer systems. The goal of this…

  12. Reconceptualizing Vulnerability in Personal Narrative Writing with Youths

    ERIC Educational Resources Information Center

    Johnson, Elisabeth

    2014-01-01

    Through a student/teacher classroom conflict, the author explores ways adults produce student writers as vulnerable. Drawing on post-structural concepts of adolescence, identity production, interrogation, and vulnerability, the author details how an English teacher invited students to perform vulnerability in personal narratives about issues like…

  13. 6 CFR 27.215 - Security vulnerability assessments.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 6 Domestic Security 1 2013-01-01 2013-01-01 false Security vulnerability assessments. 27.215... FACILITY ANTI-TERRORISM STANDARDS Chemical Facility Security Program § 27.215 Security vulnerability...-risk, the facility must complete a Security Vulnerability Assessment. A Security...

  14. Space Station Program threat and vulnerability analysis

    NASA Technical Reports Server (NTRS)

    Van Meter, Steven D.; Veatch, John D.

    1987-01-01

    An examination has been made of the physical security of the Space Station Program at the Kennedy Space Center in a peacetime environment, in order to furnish facility personnel with threat/vulnerability information. A risk-management approach is used to prioritize threat-target combinations that are characterized in terms of 'insiders' and 'outsiders'. Potential targets were identified and analyzed with a view to their attractiveness to an adversary, as well as to the consequentiality of the resulting damage.

  15. Seaside, Oregon, Tsunami Vulnerability Assessment Pilot Study

    NASA Astrophysics Data System (ADS)

    Dunbar, P. K.; Dominey-Howes, D.; Varner, J.

    2006-12-01

    The results of a pilot study to assess the risk from tsunamis for the Seaside-Gearhart, Oregon region will be presented. To determine the risk from tsunamis, it is first necessary to establish the hazard or probability that a tsunami of a particular magnitude will occur within a certain period of time. Tsunami inundation maps that provide 100-year and 500-year probabilistic tsunami wave height contours for the Seaside-Gearhart, Oregon, region were developed as part of an interagency Tsunami Pilot Study(1). These maps provided the probability of the tsunami hazard. The next step in determining risk is to determine the vulnerability or degree of loss resulting from the occurrence of tsunamis due to exposure and fragility. The tsunami vulnerability assessment methodology used in this study was developed by M. Papathoma and others(2). This model incorporates multiple factors (e.g. parameters related to the natural and built environments and socio-demographics) that contribute to tsunami vulnerability. Data provided with FEMA's HAZUS loss estimation software and Clatsop County, Oregon, tax assessment data were used as input to the model. The results, presented within a geographic information system, reveal the percentage of buildings in need of reinforcement and the population density in different inundation depth zones. These results can be used for tsunami mitigation, local planning, and for determining post-tsunami disaster response by emergency services. (1)Tsunami Pilot Study Working Group, Seaside, Oregon Tsunami Pilot Study--Modernization of FEMA Flood Hazard Maps, Joint NOAA/USGS/FEMA Special Report, U.S. National Oceanic and Atmospheric Administration, U.S. Geological Survey, U.S. Federal Emergency Management Agency, 2006, Final Draft. (2)Papathoma, M., D. Dominey-Howes, D.,Y. Zong, D. Smith, Assessing Tsunami Vulnerability, an example from Herakleio, Crete, Natural Hazards and Earth System Sciences, Vol. 3, 2003, p. 377-389.

  16. Mobile Phones and Psychosocial Therapies with Vulnerable People: a First State of the Art.

    PubMed

    Vázquez, Maria Yolanda García; Sexto, Carlos Ferrás; Rocha, Álvaro; Aguilera, Adrián

    2016-06-01

    Mobile phones are becoming a communication tool commonly used by people all over the world; and they are started to be adopted in psychosocial therapies involving vulnerable people. We are herein presenting the results of an academic literature review. We identified scientific papers published between 2006 and 2015 resorting to academic databases available on the Internet, applying a systematic selection method based on quality criteria. Secondly, we analysed contents, highlighting the scarcity of research involving vulnerable people. The available literature specialized in psychosocial therapies offers investigation results which involve mobile phones and patients in general, focusing particularly on the clinical psychology field and, to a lesser extent, on the social work field. Particularly significant are the investigation works developed in the United States. In the present paper we introduce a first "state of the art", identifying opportunities and also the limitations surrounding the use of mobile phones in psychosocial therapies targeting the vulnerable. Issues concerning privacy and data confidentiality, and the access of vulnerable people to mobile phones and how they use them, pose significant challenges; but they offer the opportunity to reach isolated or impoverished populations, or even to facilitate access to social and healthcare services. We close this paper formulating possible orientations, hypotheses and goals to design new investigation works involving vulnerable populations. PMID:27194134

  17. Vulnerability assessment using two complementary analysis tools

    SciTech Connect

    Paulus, W.K.

    1993-07-01

    To analyze the vulnerability of nuclear materials to theft or sabotage, Department of Energy facilities have been using, since 1989, a computer program called ASSESS, Analytic System and Software for Evaluation of Safeguards and Security. During the past year Sandia National Laboratories has begun using an additional program, SEES, Security Exercise Evaluation Simulation, enhancing the picture of vulnerability beyond what either program achieves alone. Assess analyzes all possible paths of attack on a target and, assuming that an attack occurs, ranks them by the probability that a response force of adequate size can interrupt the attack before theft or sabotage is accomplished. A Neutralization module pits, collectively, a security force against the interrupted adversary force in a fire fight and calculates the probability that the adversaries are defeated. SEES examines a single scenario and simulates in detail the interactions among all combatants. its output includes shots fired between shooter and target, and the hits and kills. Whereas ASSESS gives breadth of analysis, expressed statistically and performed relatively quickly, SEES adds depth of detail, modeling tactical behavior. ASSESS finds scenarios that exploit the greatest weakness of a facility. SEES explores these scenarios to demonstrate in detail how various tactics to nullify the attack might work out. Without ASSESS to find the facility weakness, it is difficult to focus SEES objectively on scenarios worth analyzing. Without SEES to simulate the details of response vs. adversary interaction, it is not possible to test tactical assumptions and hypotheses. Using both programs together, vulnerability analyses achieve both breadth and depth.

  18. Vulnerability assessment using two complementary analysis tools

    SciTech Connect

    Paulus, W.K.

    1993-07-01

    To analyze the vulnerability of nuclear materials to theft or sabotage, Department of Energy facilities have been using, since 1989, a computer program called ASSESS, Analytic System and Software for Evaluation of Safeguards and Security. During the past year Sandia National Laboratories has began using an additional program, SEES, Security Exercise Evaluation Simulation, enhancing the picture of vulnerability beyond what either program achieves alone. ASSESS analyzes all possible paths of attack on a target and, assuming that an attack occurs, ranks them by the probability that a response force of adequate size can interrupt the attack before theft or sabotage is accomplished. A Neutralization module pits, collectively, a security force against the interrupted adversary force in a fire fight and calculates the probability that the adversaries are defeated. SEES examines a single scenario and simulates in detail the interactions among all combatants. Its output includes shots fired between shooter and target, and the hits and kills. Whereas ASSESS gives breadth of analysis, expressed statistically and performed relatively quickly, SEES adds depth of detail, modeling tactical behavior. ASSESS finds scenarios that exploit the greatest weaknesses of a facility. SEES explores these scenarios to demonstrate in detail how various tactics to nullify the attack might work out. Without ASSESS to find the facility weaknesses, it is difficult to focus SEES objectively on scenarios worth analyzing. Without SEES to simulate the details of response vs. adversary interaction, it is not possible to test tactical assumptions and hypotheses. Using both programs together, vulnerability analyses achieve both breadth and depth.

  19. Growth of Necrotic Cores in Vulnerable Plaque

    NASA Astrophysics Data System (ADS)

    Fok, Pak-Wing

    2011-03-01

    Plaques are fatty deposits that grow mainly in arteries and develop as a result of a chronic inflammatory response. Plaques are called vulnerable when they are prone to mechanical rupture. Vulnerable Plaques (VPs) are characterized by lipid-rich, necrotic cores that are heavily infiltrated with macrophages. The rupture of VPs releases thrombogenic agents into the bloodstream, usually resulting in myocardial infarctions. We propose a quantitative model to predict the development of a plaque's necrotic core. By solving coupled reaction-diffusion equations for macrophages and dead cells, we explore the joint effects of hypoxic cell death and chemo-attraction to Ox-LDL, a molecule that is strongly linked to atherosclerosis. Our model predicts cores that have approximately the right size and shape. Normal mode analysis and subsequent calculation of the smallest eigenvalues allow us to compute the times required for the system to reach its steady state. This study allows us to make quantitative predictions for how quickly vulnerable plaques develop and how their growth depends on system parameters such as chemotactic coefficients and cell death rates.

  20. NASA's Research in Aircraft Vulnerability Mitigation

    NASA Technical Reports Server (NTRS)

    Allen, Cheryl L.

    2005-01-01

    Since its inception in 1958, the National Aeronautics and Space Administration s (NASA) role in civil aeronautics has been to develop high-risk, high-payoff technologies to meet critical national aviation challenges. Following the events of Sept. 11, 2001, NASA recognized that it now shared the responsibility for improving homeland security. The NASA Strategic Plan was modified to include requirements to enable a more secure air transportation system by investing in technologies and collaborating with other agencies, industry, and academia. NASA is conducting research to develop and advance innovative and commercially viable technologies that will reduce the vulnerability of aircraft to threats or hostile actions, and identify and inform users of potential vulnerabilities in a timely manner. Presented in this paper are research plans and preliminary status for mitigating the effects of damage due to direct attacks on civil transport aircraft. The NASA approach to mitigation includes: preventing loss of an aircraft due to a hit from man-portable air defense systems; developing fuel system technologies that prevent or minimize in-flight vulnerability to small arms or other projectiles; providing protection from electromagnetic energy attacks by detecting directed energy threats to aircraft and on/off-board systems; and minimizing the damage due to high-energy attacks (explosions and fire) by developing advanced lightweight, damage-resistant composites and structural concepts. An approach to preventing aircraft from being used as weapons of mass destruction will also be discussed.

  1. Reducing CKD risks among vulnerable populations in primary care

    PubMed Central

    Greer, Raquel; Boulware, Ebony

    2014-01-01

    Ethnic/racial and socioeconomic status disparities in the health care and clinical outcomes of patients with chronic kidney disease are pervasive. The vast majority of care to decrease incidence of CKD risk and progression occurs in primary care settings. High quality primary care therefore represents a key strategy through which disparities in the incidence and progression of CKD may be eliminated. The Chronic Care Model provides a framework for the delivery of high quality primary care for chronic diseases, and it is frequently used to guide health care quality improvement initiatives. Evidence suggests that Chronic Care Model constructs, including provider and organizational quality improvement initiatives focused on team approaches to chronic care (e.g., case management, community health workers), are effective in modifying patients’ CKD risks among ethnic minority and low income and patients. Other Chronic Care Model constructs, including clinical information systems (e.g., disease registries), decision support interventions, and the provision of patient centered care have been shown to improve processes related to CKD care but with limited and/or mixed effects on patient outcomes. Few studies have examined the effect of these approaches on reducing disparities. Research is needed to examine the effectiveness of these strategies to eliminate CKD disparities among vulnerable populations. PMID:25573516

  2. The efficacy of primary care for vulnerable population groups.

    PubMed Central

    Blumenthal, D; Mort, E; Edwards, J

    1995-01-01

    This article reviews the existing literature on the efficacy of primary care with an emphasis on the evaluation of primary care for vulnerable populations: groups whose demographic, geographic, or economic characteristics impede or prevent their access to health care services. A significant portion of the literature derives from studies of poor and underserved populations. However, to construct a more complete evaluation of primary care services, the authors cite literature that has examined both advantaged and disadvantaged populations. Even then the literature is incomplete, at best. The article describes a definition of primary care suitable for policy analysis and formulation, reviews evidence on the efficacy of care that meets that definition, and concludes that widespread use of primary care services is likely to result in improved patient satisfaction and health status. PMID:7721596

  3. Targeting LKB1 in cancer – exposing and exploiting vulnerabilities

    PubMed Central

    Momcilovic, M; Shackelford, D B

    2015-01-01

    The LKB1 tumour suppressor is a serine/threonine kinase that functions as master regulator of cell growth, metabolism, survival and polarity. LKB1 is frequently mutated in human cancers and research spanning the last two decades have begun decoding the cellular pathways deregulated following LKB1 inactivation. This work has led to the identification of vulnerabilities present in LKB1-deficient tumour cells. Pre-clinical studies have now identified therapeutic strategies targeting this subset of tumours that promise to benefit this large patient population harbouring LKB1 mutations. Here, we review the current efforts that are underway to translate pre-clinical discovery of therapeutic strategies targeting LKB1 mutant cancers into clinical practice. PMID:26196184

  4. Vulnerability-based evaluation of water supply design under climate change

    NASA Astrophysics Data System (ADS)

    Umit Taner, Mehmet; Ray, Patrick; Brown, Casey

    2015-04-01

    Long-lived water supply infrastructures are strategic investments in the developing world, serving the purpose of balancing water deficits compounded by both population growth and socio-economic development. Robust infrastructure design under climate change is compelling, and often addressed by focusing on the outcomes of climate model projections ('scenario-led' planning), or by identifying design options that are less vulnerable to a wide range of plausible futures ('vulnerability-based' planning). Decision-Scaling framework combines these two approaches by first applying a climate stress test on the system to explore vulnerabilities across many traces of the future, and then employing climate projections to inform the decision-making process. In this work, we develop decision scaling's nascent risk management concepts further, directing actions on vulnerabilities identified during the climate stress test. In the process, we present a new way to inform climate vulnerability space using climate projections, and demonstrate the use of multiple decision criteria to guide to a final design recommendation. The concepts are demonstrated for a water supply project in the Mombasa Province of Kenya, planned to provide domestic and irrigation supply. Six storage design capacities (from 40 to 140 million cubic meters) are explored through a stress test, under a large number climate traces representing both natural climate variability and plausible climate changes. Design outcomes are simulated over a 40-year planning period with a coupled hydrologic-water resources systems model and using standard reservoir operation rules. Resulting performance is expressed in terms of water supply reliability and economic efficiency. Ensemble climate projections are used for assigning conditional likelihoods to the climate traces using a statistical distance measure. The final design recommendations are presented and discussed for the decision criteria of expected regret, satisficing, and

  5. Vulnerability of Coastal Communities from Storm Surge and Flood Disasters

    PubMed Central

    Bathi, Jejal Reddy; Das, Himangshu S.

    2016-01-01

    Disasters in the form of coastal storms and hurricanes can be very destructive. Preparing for anticipated effects of such disasters can help reduce the public health and economic burden. Identifying vulnerable population groups can help prioritize resources for the most needed communities. This paper presents a quantitative framework for vulnerability measurement that incorporates both socioeconomic and flood inundation vulnerability. The approach is demonstrated for three coastal communities in Mississippi with census tracts being the study unit. The vulnerability results are illustrated as thematic maps for easy usage by planners and emergency responders to assist in prioritizing their actions to vulnerable populations during storm surge and flood disasters. PMID:26907313

  6. Vulnerability of Coastal Communities from Storm Surge and Flood Disasters.

    PubMed

    Bathi, Jejal Reddy; Das, Himangshu S

    2016-02-01

    Disasters in the form of coastal storms and hurricanes can be very destructive. Preparing for anticipated effects of such disasters can help reduce the public health and economic burden. Identifying vulnerable population groups can help prioritize resources for the most needed communities. This paper presents a quantitative framework for vulnerability measurement that incorporates both socioeconomic and flood inundation vulnerability. The approach is demonstrated for three coastal communities in Mississippi with census tracts being the study unit. The vulnerability results are illustrated as thematic maps for easy usage by planners and emergency responders to assist in prioritizing their actions to vulnerable populations during storm surge and flood disasters. PMID:26907313

  7. Vulnerabilities in GSM technology and feasibility of selected attacks

    NASA Astrophysics Data System (ADS)

    Voznak, M.; Prokes, M.; Sevcik, L.; Frnda, J.; Toral-Cruz, Homer; Jakovlev, Sergej; Fazio, Peppino; Mehic, M.; Mikulec, M.

    2015-05-01

    Global System for Mobile communication (GSM) is the most widespread technology for mobile communications in the world and serving over 7 billion users. Since first publication of system documentation there has been notified a potential safety problem's occurrence. Selected types of attacks, based on the analysis of the technical feasibility and the degree of risk of these weaknesses, were implemented and demonstrated in laboratory of the VSB-Technical University of Ostrava, Czech Republic. These vulnerabilities were analyzed and afterwards possible attacks were described. These attacks were implemented using open-source tools, software programmable radio USRP (Universal Software RadioPeripheral) and DVB-T (Digital Video Broadcasting - Terrestrial) receiver. GSM security architecture is being scrutinized since first public releases of its specification mainly pointing out weaknesses in authentication and ciphering mechanisms. This contribution also summarizes practically proofed and used scenarios that are performed using opensource software tools and variety of scripts mostly written in Python. Main goal of this paper is in analyzing security issues in GSM network and practical demonstration of selected attacks.

  8. "Zone of vulnerability" for radial nerve injury: anatomic study.

    PubMed

    Ashfaq Hasan, S; Rauls, Russell B; Cordell, Cari L; Bailey, Mark S; Nguyen, Thao

    2014-01-01

    The authors of this study sought improved understanding of the radial nerve course through the brachium and hypothesized that the most proximal aspect of the triceps tendon (PATT) serves as a useful superficial landmark for localizing the nerve. It was also hypothesized that a poorly appreciated area of vulnerability for nerve injury exists where the radial nerve runs along the lateral cortex of the humerus proximal to its transit through the lateral intermuscular septum (LIMS). The authors assessed 33 fresh-frozen cadaveric specimens. A 6.7-cm span of the nerve lies directly on the periosteum of the humerus before piercing the LIMS. The proximal 4.6~cm abuts the posterior cortex. The final 2.1~cm just proximal to the LIMS runs along the lateral cortex. The nerve at the posterior midline of the humerus is 2.3~cm proximal to the level of the PATT. The radial nerve lies directly on the lateral humeral cortex for 2~cm proximal to its transit through the LIMS. The PATT appears to be a consistent and practical superficial landmark to determine the location of the radial nerve from a posterior approach. PMID:24875341

  9. Determinants of choice, and vulnerability and recovery in addiction.

    PubMed

    Lamb, R J; Maguire, David R; Ginsburg, Brett C; Pinkston, Jonathan W; France, Charles P

    2016-06-01

    Addiction may be viewed as choice governed by competing contingencies. One factor impacting choice, particularly as it relates to addiction, is sensitivity to delayed rewards. Discounting of delayed rewards influences addiction vulnerability because of competition between relatively immediate gains of drug use, e.g. intoxication, versus relatively remote gains of abstinence, e.g. family stability. Factors modifying delay sensitivity can be modeled in the laboratory. For instance, increased delay sensitivity can be similarly observed in adolescent humans and non-human animals. Similarly, genetic factors influence delay sensitivity in humans and animals. Recovery from addiction may also be viewed as choice behavior. Thus, reinforcing alternative behavior facilitates recovery because reinforcing alternative behavior decreases the frequency of using drugs. How reinforcing alternative behavior influences recovery can also be modeled in the laboratory. For instance, relapse risk decreases as abstinence duration increases, and this decreasing risk can be modeled in animals using choice procedures. In summary, addiction in many respects can be conceptualized as a problem of choice. Animal models of choice disorders stand to increase our understanding of the core processes that establish and maintain addiction and serve as a proving ground for development of novel treatments. PMID:27083500

  10. Technological solution for vulnerable communities: How does its approach matter?

    NASA Astrophysics Data System (ADS)

    Sianipar, C. P. M.; Dowaki, K.; Yudoko, G.

    2014-06-01

    Vulnerability is an emerging term for both scientific communities and practitioners. Vulnerabilities attributed to a particular community are then aggregated to state it as a vulnerable community. Vulnerability-related study is recognized as an interdisciplinary one due to the complex characteristics of vulnerabilities in each contextual situation. In common understandings, technology is recognized as an interdisciplinary solution, making it possible for supporting any activity in eradicating vulnerability. This study aims to observe such possibilities. Literature survey is taken to investigate the interconnection between vulnerability eradication and technology. Brief comparison between several developing countries and particular focus on Indonesia become a medium of further investigation to reveal issues surrounding technology-related efforts for vulnerability eradication in vulnerable communities. The study reveals that developing countries, particularly Indonesia, tend to adopt approaches from Northern hemisphere, including transferring technologies from developed countries without proper propagation. It means that local knowledge and power are largely ignored in the pursuit of local problem solving for vulnerability eradication. These facts become a signpost to emphasize that approach in implementing technological solution for such purpose is the critical mechanism to ensure the success in every contextual situation. Then, looking at the results of this brief study, its emphasis indicates further requirements to shift the paradigm of typical community development to contextual community empowerment in order to ensure the continuity of every technological solution for a consistent eradication of local vulnerabilities, including possible changes of required approach alongside the shift.

  11. Not the usual suspects: addressing layers of vulnerability.

    PubMed

    Luna, Florencia; Vanderpoel, Sheryl

    2013-07-01

    This paper challenges the traditional account of vulnerability in healthcare which conceptualizes vulnerability as a list of identifiable subpopulations. This list of 'usual suspects', focusing on groups from lower resource settings, is a narrow account of vulnerability. In this article we argue that in certain circumstances middle-class individuals can be also rendered vulnerable. We propose a relational and layered account of vulnerability and explore this concept using the case study of cord blood (CB) banking. In the first section, two different approaches to 'vulnerability' are contrasted: categorical versus layered. In the second section, we describe CB banking and present a case study of CB banking in Argentina. We examine the types of pressure that middle-class pregnant women feel when considering CB collection and storage. In section three, we use the CB banking case study to critique the categorical approach to vulnerability: this model is unable to account for the ways in which these women are vulnerable. A layered account of vulnerability identifies several ways in which middle-class women are vulnerable. Finally, by utilizing the layered approach, this paper suggests how public health policies could be designed to overcome vulnerabilities. PMID:23718852

  12. Karst morphology and groundwater vulnerability of high alpine karst plateaus

    NASA Astrophysics Data System (ADS)

    Plan, Lukas; Decker, Kurt; Faber, Robert; Wagreich, Michael; Grasemann, Bernhard

    2009-07-01

    High alpine karst plateaus are recharge areas for major drinking water resources in the Alps and many other regions. Well-established methods for the vulnerability mapping of groundwater to contamination have not been applied to such areas yet. The paper characterises this karst type and shows that two common vulnerability assessment methods (COP and PI) classify most of the areas with high vulnerability classes. In the test site on the Hochschwab plateau (Northern Calcareous Alps, Austria), overlying layers are mostly absent, not protective or even enhance point recharge, where they have aquiclude character. The COP method classifies 82% of the area as highly or extremely vulnerable. The resulting maps are reasonable, but do not differentiate vulnerabilities to the extent that the results can be used for protective measures. An extension for the upper end of the vulnerability scale is presented that allows identifying ultra vulnerable areas. The proposed enhancement of the conventional approach points out that infiltration conditions are of key importance for vulnerability. The method accounts for karst genetical and hydrologic processes using qualitative and quantitative properties of karst depressions and sinking streams including parameters calculated from digital elevations models. The method is tested on the Hochschwab plateau where 1.7% of the area is delineated as ultra vulnerable. This differentiation could not be reached by the COP and PI methods. The resulting vulnerability map highlights spots of maximum vulnerability and the combination with a hazard map enables protective measures for a manageable area and number of sites.

  13. Evaluating regional vulnerability to climate change: purposes and methods

    SciTech Connect

    Malone, Elizabeth L.; Engle, Nathan L.

    2011-03-15

    As the emphasis in climate change research, international negotiations, and developing-country activities has shifted from mitigation to adaptation, vulnerability has emerged as a bridge between impacts on one side and the need for adaptive changes on the other. Still, the term vulnerability remains abstract, its meaning changing with the scale, focus, and purpose of each assessment. Understanding regional vulnerability has advanced over the past several decades, with studies using a combination of indicators, case studies and analogues, stakeholder-driven processes, and scenario-building methodologies. As regions become increasingly relevant scales of inquiry for bridging the aggregate and local, for every analysis, it is perhaps most appropriate to ask three “what” questions: “What/who is vulnerable?,” “What is vulnerability?,” and “Vulnerable to what?” The answers to these questions will yield different definitions of vulnerability as well as different methods for assessing it.

  14. Cultural knowledge and local vulnerability in African American communities

    NASA Astrophysics Data System (ADS)

    Miller Hesed, Christine D.; Paolisso, Michael

    2015-07-01

    Policymakers need to know what factors are most important in determining local vulnerability to facilitate effective adaptation to climate change. Quantitative vulnerability indices are helpful in this endeavour but are limited in their ability to capture subtle yet important aspects of vulnerability such as social networks, knowledge and access to resources. Working with three African American communities on Maryland’s Eastern Shore, we systematically elicit local cultural knowledge on climate change and connect it with a scientific vulnerability framework. The results of this study show that: a given social-ecological factor can substantially differ in the way in which it affects local vulnerability, even among communities with similar demographics and climate-related risks; and social and political isolation inhibits access to sources of adaptive capacity, thereby exacerbating local vulnerability. These results show that employing methods for analysing cultural knowledge can yield new insights to complement those generated by quantitative vulnerability indices.

  15. Influence of a Prolonged Tennis Match Play on Serve Biomechanics.

    PubMed

    Martin, Caroline; Bideau, Benoit; Delamarche, Paul; Kulpa, Richard

    2016-01-01

    The aim of this study was to quantify kinematic, kinetic and performance changes that occur in the serve throughout a prolonged tennis match play. Serves of eight male advanced tennis players were recorded with a motion capture system before, at mid-match, and after a 3-hour tennis match. Before and after each match, electromyographic data of 8 upper limb muscles obtained during isometric maximal voluntary contraction were compared to determine the presence of muscular fatigue. Vertical ground reaction forces, rating of perceived exertion, ball speed, and ball impact height were measured. Kinematic and upper limb kinetic variables were computed. The results show decrease in mean power frequency values for several upper limb muscles that is an indicator of local muscular fatigue. Decreases in serve ball speed, ball impact height, maximal angular velocities and an increase in rating of perceived exertion were also observed between the beginning and the end of the match. With fatigue, the majority of the upper limb joint kinetics decreases at the end of the match. No change in timing of maximal angular velocities was observed between the beginning and the end of the match. A prolonged tennis match play may induce fatigue in upper limb muscles, which decrease performance and cause changes in serve maximal angular velocities and joint kinetics. The consistency in timing of maximal angular velocities suggests that advanced tennis players are able to maintain the temporal pattern of their serve technique, in spite of the muscular fatigue development. PMID:27532421

  16. An 8-Stage Model for Evaluating the Tennis Serve

    PubMed Central

    Kovacs, Mark; Ellenbecker, Todd

    2011-01-01

    Background: The tennis serve is a complex stroke characterized by a series of segmental rotations involving the entire kinetic chain. Many overhead athletes use a basic 6-stage throwing model; however, the tennis serve does provide some differences. Evidence Acquisition: To support the present 8-stage descriptive model, data were gathered from PubMed and SPORTDiscus databases using keywords tennis and serve for publications between 1980 and 2010. Results: An 8-stage model of analysis for the tennis serve that includes 3 distinct phases—preparation, acceleration, and follow-through—provides a more tennis-specific analysis than that previously presented in the clinical tennis literature. When a serve is evaluated, the total body perspective is just as important as the individual segments alone. Conclusion: The 8-stage model provides a more in-depth analysis that should be utilized in all tennis players to help better understand areas of weakness, potential areas of injury, as well as components that can be improved for greater performance. PMID:23016050

  17. Extending Vulnerability Assessment to Include Life Stages Considerations

    PubMed Central

    Hodgson, Emma E.; Essington, Timothy E.; Kaplan, Isaac C.

    2016-01-01

    Species are experiencing a suite of novel stressors from anthropogenic activities that have impacts at multiple scales. Vulnerability assessment is one tool to evaluate the likely impacts that these stressors pose to species so that high-vulnerability cases can be identified and prioritized for monitoring, protection, or mitigation. Commonly used semi-quantitative methods lack a framework to explicitly account for differences in exposure to stressors and organism responses across life stages. Here we propose a modification to commonly used spatial vulnerability assessment methods that includes such an approach, using ocean acidification in the California Current as an illustrative case study. Life stage considerations were included by assessing vulnerability of each life stage to ocean acidification and were used to estimate population vulnerability in two ways. We set population vulnerability equal to: (1) the maximum stage vulnerability and (2) a weighted mean across all stages, with weights calculated using Lefkovitch matrix models. Vulnerability was found to vary across life stages for the six species explored in this case study: two krill–Euphausia pacifica and Thysanoessa spinifera, pteropod–Limacina helicina, pink shrimp–Pandalus jordani, Dungeness crab–Metacarcinus magister and Pacific hake–Merluccius productus. The maximum vulnerability estimates ranged from larval to subadult and adult stages with no consistent stage having maximum vulnerability across species. Similarly, integrated vulnerability metrics varied greatly across species. A comparison showed that some species had vulnerabilities that were similar between the two metrics, while other species’ vulnerabilities varied substantially between the two metrics. These differences primarily resulted from cases where the most vulnerable stage had a low relative weight. We compare these methods and explore circumstances where each method may be appropriate. PMID:27416031

  18. Extending Vulnerability Assessment to Include Life Stages Considerations.

    PubMed

    Hodgson, Emma E; Essington, Timothy E; Kaplan, Isaac C

    2016-01-01

    Species are experiencing a suite of novel stressors from anthropogenic activities that have impacts at multiple scales. Vulnerability assessment is one tool to evaluate the likely impacts that these stressors pose to species so that high-vulnerability cases can be identified and prioritized for monitoring, protection, or mitigation. Commonly used semi-quantitative methods lack a framework to explicitly account for differences in exposure to stressors and organism responses across life stages. Here we propose a modification to commonly used spatial vulnerability assessment methods that includes such an approach, using ocean acidification in the California Current as an illustrative case study. Life stage considerations were included by assessing vulnerability of each life stage to ocean acidification and were used to estimate population vulnerability in two ways. We set population vulnerability equal to: (1) the maximum stage vulnerability and (2) a weighted mean across all stages, with weights calculated using Lefkovitch matrix models. Vulnerability was found to vary across life stages for the six species explored in this case study: two krill-Euphausia pacifica and Thysanoessa spinifera, pteropod-Limacina helicina, pink shrimp-Pandalus jordani, Dungeness crab-Metacarcinus magister and Pacific hake-Merluccius productus. The maximum vulnerability estimates ranged from larval to subadult and adult stages with no consistent stage having maximum vulnerability across species. Similarly, integrated vulnerability metrics varied greatly across species. A comparison showed that some species had vulnerabilities that were similar between the two metrics, while other species' vulnerabilities varied substantially between the two metrics. These differences primarily resulted from cases where the most vulnerable stage had a low relative weight. We compare these methods and explore circumstances where each method may be appropriate. PMID:27416031

  19. The Cannabis Pathway to Non-Affective Psychosis may Reflect Less Neurobiological Vulnerability

    PubMed Central

    Løberg, Else-Marie; Helle, Siri; Nygård, Merethe; Berle, Jan Øystein; Kroken, Rune A.; Johnsen, Erik

    2014-01-01

    There is a high prevalence of cannabis use reported in non-affective psychosis. Early prospective longitudinal studies conclude that cannabis use is a risk factor for psychosis, and neurochemical studies on cannabis have suggested potential mechanisms for this effect. Recent advances in the field of neuroscience and genetics may have important implications for our understanding of this relationship. Importantly, we need to better understand the vulnerability × cannabis interaction to shed light on the mediators of cannabis as a risk factor for psychosis. Thus, the present study reviews recent literature on several variables relevant for understanding the relationship between cannabis and psychosis, including age of onset, cognition, brain functioning, family history, genetics, and neurological soft signs (NSS) in non-affective psychosis. Compared with non-using non-affective psychosis, the present review shows that there seem to be fewer stable cognitive deficits in patients with cannabis use and psychosis, in addition to fewer NSS and possibly more normalized brain functioning, indicating less neurobiological vulnerability for psychosis. There are, however, some familiar and genetic vulnerabilities present in the cannabis psychosis group, which may influence the cannabis pathway to psychosis by increasing sensitivity to cannabis. Furthermore, an earlier age of onset suggests a different pathway to psychosis in the cannabis-using patients. Two alternative vulnerability models are presented to integrate these seemingly paradoxical findings PMID:25477825

  20. The Cannabis Pathway to Non-Affective Psychosis may Reflect Less Neurobiological Vulnerability.

    PubMed

    Løberg, Else-Marie; Helle, Siri; Nygård, Merethe; Berle, Jan Øystein; Kroken, Rune A; Johnsen, Erik

    2014-01-01

    There is a high prevalence of cannabis use reported in non-affective psychosis. Early prospective longitudinal studies conclude that cannabis use is a risk factor for psychosis, and neurochemical studies on cannabis have suggested potential mechanisms for this effect. Recent advances in the field of neuroscience and genetics may have important implications for our understanding of this relationship. Importantly, we need to better understand the vulnerability × cannabis interaction to shed light on the mediators of cannabis as a risk factor for psychosis. Thus, the present study reviews recent literature on several variables relevant for understanding the relationship between cannabis and psychosis, including age of onset, cognition, brain functioning, family history, genetics, and neurological soft signs (NSS) in non-affective psychosis. Compared with non-using non-affective psychosis, the present review shows that there seem to be fewer stable cognitive deficits in patients with cannabis use and psychosis, in addition to fewer NSS and possibly more normalized brain functioning, indicating less neurobiological vulnerability for psychosis. There are, however, some familiar and genetic vulnerabilities present in the cannabis psychosis group, which may influence the cannabis pathway to psychosis by increasing sensitivity to cannabis. Furthermore, an earlier age of onset suggests a different pathway to psychosis in the cannabis-using patients. Two alternative vulnerability models are presented to integrate these seemingly paradoxical findings. PMID:25477825

  1. Assessing internal biophysical vulnerability to landslide hazards - a nested catchment approach: Xiangxi Watershed / Three Gorges Reservoir

    NASA Astrophysics Data System (ADS)

    Wiegand, Matthias; Seeber, Christoph; Hartmann, Heike; Xiang, Wei; King, Lorenz

    2010-05-01

    The Three Gorges dam construction was completed in 2006. Besides the international media, also the responsible authorities and various scholarly communities pay close attention to potential and actual environmental impacts related to the impoundment and development activities. The geo-environment within the Three Gorges region is highly conducive to landslides. Consequently, a scientific monitoring and risk mitigation system was established and is still under development. Risk analysis with regard to gravity driven mass movements is highly complex and strongly site specific - several aspects hamper a universal methodology applicable for landslide risk and site assessment. The interdisciplinary Sino-German Yangtze-Project Research co-operation aims, among others, to support the sustainable cultivation of the newly developed ecosystems within the Yangtze catchments. Land use change and increasing population growth are causing severe pressure on the scarce land resources. Landslides are acknowledged as important threat, hence vulnerability of certain landscape components have to be identified, quantified and monitored. A nested quantitative approach for vulnerability analysis is developed. The applied risk and vulnerability model understands risk as the product of hazard and vulnerability. Whereas vulnerability is characterized by: mass movement intensity and susceptibility of the respective element at risk. The watershed of Xiangxi river serves as study area. In general, catchment approaches intent and proved to be a functional geographical unit for successful integrated resources management. Several limitations with regard to data accessibility, availability and accuracy have to be considered due to restrictions of feasible scales. Comprehensive large-scale site investigations are confined to training areas for model calibration and validation. Remote sensing potentials are utilised for land use/ land cover change analysis and localization of selected elements

  2. Systemic vulnerability model for coastal erosion processes

    NASA Astrophysics Data System (ADS)

    Greco, M.; Martino, G.; Guariglia, A.

    2010-09-01

    Many coastal areas constitute an extraordinary environmental worth and economic value resource continuously exposed to an unceasing transformation due to climatic and anthropic factors. The pressure factor overloads carry out an amplification of environmental degradation and economic rent decrease of these territories producing a disruption of normal and anticipated community growth. This paper copes with coastal erosion problem by a systemic vulnerability model application and environmental indicators approach. Through the definition of an original indicator depending on the observed annual rate of coastal erosion and wave climate parameters, such an approach allow scenario generation and it is useful and powerful planning and management tool. The model has been applied on the test case of Ionian Coast of Basilicata Region located in the southern part of Italy, in the middle of Mediterranean basin. The littoral area is constituted of sandy shores of about 50 km length and 5 river deltas take place. Looking at the shoreline in terms of displacements, a shift of a coastal part is a function of grain size characteristics of the shore sands and of the wave climate. Therefore the selected index taking into account the energy stress affecting the shore area, characterizing the territorial system state and finalized to vulnerability estimation, is defined through the maximum annual erosion,tE, and the surface-wave parameters (H,T) corresponding to the wave-generated bottom orbital velocities higher than critical velocity matches with the bottom incipient transport condition. The resulting coefficient ? (? = tE? ? gH2-?T) is obviously dimensionless and represents the part of the available power in the seas, dissipated by erosion processes. If ? increases, the system integrity decreases and the system vulnerability increases. Available data, in terms of topographic/bathymetric information referred to the period 1873-2008, were utilized to derive tE by the use of a GIS

  3. Earthquakes, vulnerability and disaster risk: Georgia case

    NASA Astrophysics Data System (ADS)

    Tsereteli, Nino; Varazanashvili, Otar; Askan, Aysegul

    2015-04-01

    The Republic of Georgia, located on the East coast of the Black Sea, is prone to multiple natural hazards, the most dangerous and devastating of which are strong earthquakes. This work issues a call for advance planning and action to reduce natural disaster risks, notably seismic risk through the investigation of vulnerability and seismic hazard for Georgia. Ground motion prediction equations are essential for several purposes ranging from seismic design and analysis to probabilistic seismic hazard assessment. Seismic hazard maps were calculated based on modern approach of selecting and ranking global and regional ground motion prediction equation for region. We have also applied the host-to-target method in two regions in Georgia with different source mechanisms. According to the tectonic regime of the target areas, two different regions are chosen as host regions. One of them is the North Anatolian Fault zone in Turkey with the dominant strike-slip source mechanism while the other is Tabas in Iran with mostly events of reverse mechanism. We performed stochastic finite-fault simulations in both host and target areas and employed the hybrid-empirical method as introduced and outlined in Campbell (2003). An initial hybrid empirical ground motion model is developed for PGA and SA at selected periods for Georgia. An application of these coefficients for ground motion models have been used in probabilistic seismic hazard assessment. Intensity based vulnerability study were completed for Georgian buildings. Finally, Probabilistic seismic risk assessment in terms of structural damage and casualties were calculated. This methodology gave prediction of damage and casualty for a given probability of recurrence, based on a probabilistic seismic hazard model, population distribution, inventory, and vulnerability of buildings

  4. OutServe: an underground network stands up.

    PubMed

    Fulton, Brenda Sue

    2013-01-01

    From the perspective of an insider, this article explains how an underground network of actively-serving lesbian, gay, bisexual, and transgender (LGBT) military members was formed, and able to engage in the fight against the Don't Ask, Don't Tell policy. By providing the means to connect with one another within the constraints of the law, OutServe enabled the voices of gay and lesbian active military personnel to be heard. This new visibility informed the political debate surrounding the policy and played a role in the final days of Don't Ask, Don't Tell. PMID:23414270

  5. Ruptures of vulnerability: Linda Stein's Knight Series.

    PubMed

    Bible, Ann Vollmann

    2010-01-01

    Drawing on the work of Monique Wittig, this article understands Linda Stein's Knight Series as a lacunary writing communicating both her challenges to come to representation and her creative registration of subjectivity. The argument is grounded in an exploration of the rich interplay of power and vulnerability across the series as against the discourse of escapist fashion. Specifically, Stein's critical contradictions of inside and outside, conflated temporality, disjunctions between decoration and abstraction, and fluidity of sex and gender are examined. The discussion is elaborated through consideration of the work of Julia Kristeva, Elizabeth Grosz, and Hayao Miyazaki. PMID:20408009

  6. Why healthcare facilities are vulnerable to crime.

    PubMed

    Mikow-Porto, Victoria A; Smith, Thomas

    2013-01-01

    Although the public's view of healthcare facilities is that they are inherently safe and secure, administrators and staff members in hospitals are very aware that they could be vulnerable to an episode of violence at any time, according to the author. Today, crimes, including homicide, are an ever-present reality in healthcare facilities, they report, citing recent studies which attempt to explain why this is so. The article is based on the introduction to the IAHSS and IHSS Foundation 2012 Crime and Security Trends Survey. The complete survey is accessible to members in the Reference Section of the IAHSS web page. PMID:24020317

  7. Modelling farm vulnerability to flooding: A step toward vulnerability mitigation policies appraisal

    NASA Astrophysics Data System (ADS)

    Brémond, P.; Abrami, G.; Blanc, C.; Grelot, F.

    2009-04-01

    Recent catastrophic flood events such as Elbe in 2002 or Rhône in 2003 have shown limits of flood management policies relying on dykes protection: worsening of flood impacts downstream, increased damage by dykes rupture. Those events, among others, contributes to radical changes on the philosophy of flood prevention, with the promotion of new orientations for mitigating flood exposition. Two new trends may have a significant impact on rural areas: floodplain restoration and vulnerability mitigation. The Rhône River program, which is an contract of objectives signed between French Government and local collectivites, is highly illustrative of these new trends and their impact on agricultural sector. In this program, it appears that areas to be concerned by floodplain restoration are agricultural ones, because their supposed vulnerability to flood is expected to be less important to urban areas. As a consequence, agricultural sector is particularly concerned by planned actions on mitigation of assets vulnerability, an important part of the program (financial support of European Union of 7.5 Million euros). Mitigation of agricultural assets vulnerability reveals particularly interesting for two following reasons. Firstly, it is a way to maintain agricultural activities in floodplains yet existing, without promoting flood protection. Secondly, in case of floodplain restoration, vulnerability mitigation is a way for local authorities to compensate over-flooding impacts. In practice, local authorities may financially support farmers for implementing measures to mitigate their farm vulnerability. On the Rhône River, an important work has already been done to identify farm vulnerability to flooding, and propose measures to mitigate it. More than 3 000 farms exposed to flood risk have been identified representing 88 690 ha of agricultural areas which is estimated to generate damage between 400 and 800 Million euros depending on the season of occurrence for a catastrophic

  8. The Role of Narcissistic Vulnerability in Predicting Adult Posttraumatic Symptoms from Childhood Sexual Abuse.

    PubMed

    Bachar, Eytan; Canetti, Laura; Hadar, Hilit; Baruch, Julia; Dor, Yehuda; Freedman, Sara

    2015-10-01

    The aim of the present study is to determine whether narcissistic vulnerability can aid in clarifying the debate regarding the relationship between childhood sexual abuse (CSA) and adulthood adjustment to traumatic events. 157 survivors (mean age = 31.1, SD = 10.9) of a traumatic event (war activities and road and work accidents) were assessed 1 week, 1, and 4 months following the event. Of the 157 participants, 15 reported experiencing CSA, and 26 reported experiencing childhood physical abuse (CPA). In the first-week assessment, patients were administered the Narcissistic Vulnerability Scale (NVS) and the Beck Depression Inventory (BDI). In the follow-up assessments, subjects were interviewed on the Clinician-Administered PTSD Scale. Narcissistic vulnerability was found, both in 1- and 4-month follow-ups, to increase the likelihood of participants who experienced CSA to develop PTSD symptoms later in their adult life, when exposed to other additional trauma. Narcissistic vulnerability, in both follow-ups, did not increase the likelihood of participants who experienced CPA to develop PTSD symptoms later in their life when exposed to other additional trauma. The NVS predicted the development of PTSD symptoms in the whole sample, both in the 1- and 4-month follow-ups, above and beyond the prediction of the BDI. In other words, narcissistic vulnerability can add additional information above and beyond general negative emotionality. In conclusion, it is recommended to take into consideration the interplay between CSA and the individual's narcissistic vulnerability when assessing the long term effects of CSA such as acute or chronic PTSD. PMID:25410429

  9. Perspectives on contextual vulnerability in discourses of climate conflict

    NASA Astrophysics Data System (ADS)

    Okpara, U. T.; Stringer, L. C.; Dougill, A. J.

    2016-02-01

    The science of climate security and conflict is replete with controversies. Yet the increasing vulnerability of politically fragile countries to the security consequences of climate change is widely acknowledged. Although climate conflict reflects a continuum of conditional forces that coalesce around the notion of vulnerability, how different portrayals of vulnerability influence the discursive formation of climate conflict relations remains an exceptional but under-researched issue. This paper combines a systematic discourse analysis with a vulnerability interpretation diagnostic tool to explore (i) how discourses of climate conflict are constructed and represented, (ii) how vulnerability is communicated across discourse lines, and (iii) the strength of contextual vulnerability against a deterministic narrative of scarcity-induced conflict, such as that pertaining to land. Systematically characterising climate conflict discourses based on the central issues constructed, assumptions about mechanistic relationships, implicit normative judgements and vulnerability portrayals, provides a useful way of understanding where discourses differ. While discourses show a wide range of opinions "for" and "against" climate conflict relations, engagement with vulnerability has been less pronounced - except for the dominant context centrism discourse concerned about human security (particularly in Africa). In exploring this discourse, we observe an increasing sense of contextual vulnerability that is oriented towards a concern for complexity rather than predictability. The article concludes by illustrating that a turn towards contextual vulnerability thinking will help advance a constructivist theory-informed climate conflict scholarship that recognises historicity, specificity, and variability as crucial elements of contextual totalities of any area affected by climate conflict.

  10. Perspectives on contextual vulnerability in discourses of climate conflict

    NASA Astrophysics Data System (ADS)

    Okpara, U. T.; Stringer, L. C.; Dougill, A. J.

    2015-12-01

    The science of climate security and conflict is replete with controversies. Yet the increasing vulnerability of politically fragile countries to the security consequences of climate change is widely acknowledged. Although climate conflict reflects a continuum of conditional forces that coalesce around the notion of vulnerability, how different portrayals of vulnerability influence the discursive formation of climate conflict relations remains an exceptional but under-researched issue. This paper combines a systematic discourse analysis with a vulnerability interpretation diagnostic tool to explore: (i) how discourses of climate conflict are constructed and represented, (ii) how vulnerability is communicated across discourse lines, and (iii) the strength of contextual vulnerability against a deterministic narrative of scarcity-induced conflict, such as that pertaining to land. Systematically characterising climate conflict discourses based on the central issues constructed, assumptions about mechanistic relationships, implicit normative judgements and vulnerability portrayals, provides a useful way of understanding where discourses differ. While discourses show a wide range of opinions "for" and "against" climate conflict relations, engagement with vulnerability has been less pronounced - except for the dominant context centrism discourse concerned about human security (particularly in Africa). In exploring this discourse, we observe an increasing sense of contextual vulnerability that is oriented towards a concern for complexity rather than predictability. The article concludes by illustrating that a turn towards contextual vulnerability thinking will help advance a constructivist theory-informed climate conflict scholarship that recognises historicity, specificity and variability as crucial elements of contextual totalities of any area affected by climate conflict.

  11. Protecting and Respecting the Vulnerable: Existing Regulations or Further Protections?

    PubMed Central

    Solomon, Stephanie R.

    2013-01-01

    Scholars and policymakers continue to struggle over the meaning of the word “vulnerable” in the context of research ethics. One major reason for the stymied discussions regarding vulnerable populations is that there is no clear distinction between accounts of research vulnerabilities that exist for certain populations and discussions of research vulnerabilities that require special regulations in the context of research ethics policies. I suggest an analytic process by which to ascertain whether particular vulnerable populations should be contenders for additional regulatory protections. I apply this process to two vulnerable populations: the cognitively vulnerable and the economically vulnerable. I conclude that a subset of the cognitively vulnerable require extra protections while the economically vulnerable should be protected by implementing existing regulations more appropriately and rigorously. Unless or until the informed consent process is more adequately implemented and the distributive justice requirement of the Belmont Report is emphasized and operationalized, the economically disadvantaged will remain particularly vulnerable to the harm of exploitation in research. PMID:23329228

  12. Serving and Retraining Displaced Workers in California Community Colleges.

    ERIC Educational Resources Information Center

    Thor, Linda

    In spite of funding constraints and legislatively mandated growth caps, the California community colleges, as the major provider of occupational education in the state, must play a significant role in serving and retraining workers displaced by plant shutdowns and mass layoffs. In response to these problems, a study was conducted to identify the…

  13. Serving on Promotion and Tenure Committees: A Faculty Guide.

    ERIC Educational Resources Information Center

    Diamond, Robert M.

    This booklet is designed to assist faculty members in serving on promotion and tenure committees. Part 1 focuses on the general process and the role of the Promotion and Tenure Committee. It provides basic principles for Committee members to consider, raises significant issues, and introduces a comprehensive approach to documenting and assessing…

  14. 31. Tower interior, second story level, which served as tiny ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    31. Tower interior, second story level, which served as tiny bedroom for station operator; frame visible at far left originally housed cooler vented to exterior via louvers placed in window fenestration; view to northeast, 65mm lens with electronic flash illumination. - Southern Pacific Depot, 559 El Camino Real, San Carlos, San Mateo County, CA

  15. The large building to the left formerly served as open ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    The large building to the left formerly served as open hearth no. 3 steel making facility; it was erected in 1903; looking east - Bethlehem Steel Corporation, South Bethlehem Works, Open Hearth No. 3, Along Lehigh River, North of Fourth Street, West of Minsi Trail Bridge, Bethlehem, Northampton County, PA

  16. Educators as Serving Leaders in the Classroom and on Campus

    ERIC Educational Resources Information Center

    Bowman, Richard

    2014-01-01

    Counterintuitively, the more one develops as a leader, the less of a leader one becomes. What do great leaders do? Great leaders are ambitious first and foremost for the cause, the mission, the work--not themselves. Educators as "serving leaders" sense that every action they take, together with every decision that they make, either…

  17. Contextual Interference Effects in Learning Three Badminton Serves.

    ERIC Educational Resources Information Center

    Goode, Sinah; Magill, Richard A.

    1986-01-01

    This study was made to validate results obtained in laboratory research. Thirty female students learned three badminton serves in either a low, mixed, or high interference practice schedule and were given a retention and transfer test. Results are discussed. (Author/MT)

  18. Healthcare Leaders' Intention to Serve as Organizational Teachers

    ERIC Educational Resources Information Center

    Aggarwal, Sushma Kumari

    2014-01-01

    Today's organizational leaders are expected to actively participate and facilitate learning. A highly engaged and knowledgeable workforce, inspired by leaders, may increase the quality of service, and aid in maintaining and attracting loyal employees and customers. These leaders are now being asked to serve as organizational teachers. However,…

  19. Federal Assistance for Programs Serving the Handicapped. Third Edition.

    ERIC Educational Resources Information Center

    Office of Human Development (DHEW), Washington, DC. Office for Handicapped Individuals.

    The guide presents information on more than 200 federally assisted programs serving the handicapped. Information on uses and restrictions, types of assistance, eligibility requirements; application procedures, appropriations, program accomplishments, enabling legislation, and contact persons are listed for programs receiving four types of…

  20. The Cost of Serving Infants and Toddlers under Part C

    ERIC Educational Resources Information Center

    Johnson, Jean L.; Brown, Susan; Chang, Chuan; Nelson, Dawna; Mrazek, Susan

    2011-01-01

    To identify the per-child cost of providing Part C services, the authors analyzed extensive statewide expenditure data in Hawai'i to determine the monthly and annual costs of providing early intervention services to infants and toddlers and their families. Identified were the costs of serving children with various numbers and percentages of delay,…

  1. Pedagogy for Equity: Teaching in a Hispanic-Serving Institution

    ERIC Educational Resources Information Center

    Nunez, Anne-Marie; Ramalho, Elizabeth Murakami; Cuero, Kimberley K.

    2010-01-01

    Three female tenure-track faculty members at a Hispanic-Serving Institution explored how their cultural backgrounds inform their pedagogical approaches toward equity. They drew upon Mills's (1959) and Collins's (1993) frameworks to examine how their personal biographies, local social contexts, and broader systemic institutions affect their…

  2. The Motivation to Serve Others: Exploring Relations to Career Development

    ERIC Educational Resources Information Center

    Duffy, Ryan D.; Raque-Bogdan, Trisha L.

    2010-01-01

    The current study explored the relation between service motivation, or the desire to serve others through one's future career, and vocational outcomes across two studies. In the first study, using a sample of 225 undergraduate students, an instrument was developed to measure service motivation that demonstrated convergent and discriminant…

  3. 49 CFR 105.35 - Serving documents in PHMSA proceedings.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 49 Transportation 2 2010-10-01 2010-10-01 false Serving documents in PHMSA proceedings. 105.35 Section 105.35 Transportation Other Regulations Relating to Transportation PIPELINE AND HAZARDOUS MATERIALS SAFETY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION HAZARDOUS MATERIALS AND OIL TRANSPORTATION HAZARDOUS MATERIALS PROGRAM DEFINITIONS...

  4. International Organizations Serving Young Children: Part One of a Directory.

    ERIC Educational Resources Information Center

    Neugebauer, Roger

    2002-01-01

    This is part one of a directory of organizations serving children under the age of eight in more than one nation. Each entry consists of: (1) organization's name; (2) location; (3) Web site address; and (4) a description of the organization's structure, mission, and major areas of focus. (SD)

  5. 7 CFR 1230.53 - Nominee's agreement to serve.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 10 2011-01-01 2011-01-01 false Nominee's agreement to serve. 1230.53 Section 1230.53 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (MARKETING AGREEMENTS AND ORDERS; MISCELLANEOUS COMMODITIES), DEPARTMENT OF AGRICULTURE PORK PROMOTION, RESEARCH,...

  6. 7 CFR 1280.203 - Nominee's agreement to serve.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 10 2011-01-01 2011-01-01 false Nominee's agreement to serve. 1280.203 Section 1280.203 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (MARKETING AGREEMENTS AND ORDERS; MISCELLANEOUS COMMODITIES), DEPARTMENT OF AGRICULTURE...

  7. 7 CFR 1221.102 - Nominee's agreement to serve.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 10 2011-01-01 2011-01-01 false Nominee's agreement to serve. 1221.102 Section 1221.102 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (MARKETING AGREEMENTS AND ORDERS; MISCELLANEOUS COMMODITIES), DEPARTMENT OF AGRICULTURE...

  8. 7 CFR 1260.144 - Nominee's agreement to serve.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 10 2011-01-01 2011-01-01 false Nominee's agreement to serve. 1260.144 Section 1260.144 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (MARKETING AGREEMENTS AND ORDERS; MISCELLANEOUS COMMODITIES), DEPARTMENT OF AGRICULTURE...

  9. Staff Development While You Teach: Collaborating to Serve English Learners

    ERIC Educational Resources Information Center

    Walker, Constance; Edstam, Tina Scott

    2013-01-01

    This article examines the nature of a sustained staff development program for teachers serving English learners in elementary schools. It begins by exploring the need for learners to have optimum language and content development, and indicates that many U.S. grade-level and content area teachers have not been prepared to meet that need. Focusing…

  10. Using Offer versus Serve in the School Meals Initiative.

    ERIC Educational Resources Information Center

    Holliday, RoseAnna

    The goal of the Offer Versus Serve (OVS) option in the Healthy School Meals Initiative is to minimize plate waste and to encourage more food choices in school meal programs. This manual was designed for child nutrition programs as a tool in helping them meet the Healthy School Meals Initiative, in particular to assist them in identifying a…

  11. Competence in Serving Children: Credentials Protectionism and Public Policy.

    ERIC Educational Resources Information Center

    Koocher, Gerald P.

    Professional competency in psychologists wishing to treat children and families is an area of considerable concern and disagreement. Three types of practitioners comprise the bulk of the problem: clinical psychologists, who lack specific child-oriented training; developmental psychologists, who wish to serve children but lack traditional clinical…

  12. Exemplary Dissemination Programs for Intermediate Units Serving Rural Schools.

    ERIC Educational Resources Information Center

    Edington, Everett; Hays, Leonard

    Utilizing information derived from documents, site visits, correspondence, and personal interviews re: 6 intermediate education units serving rural schools which were initially identified via a mail survey, this report describes intermediate education units with exemplary information dissemination programs. Varying considerably, each program is…

  13. Serving styles of raw snack vegetables. What do children want?

    PubMed

    Olsen, Annemarie; Ritz, Christian; Kramer, Lisbet; Møller, Per

    2012-10-01

    The primary aim of this study was to investigate how serving styles of snack vegetables appeal to children, focusing on size and shape. A secondary aim was to investigate children's willingness to participate in fruit and vegetable subscription services at school, and how these could be designed. One hundred and thirty eight children aged 9-12 years indicated their liking for a snack meal comprising a combination of carrots, cucumber, and red pepper. The meal was presented in eight different serving styles: two sizes; small and ordinary, and four shapes; whole/chunk, slices, sticks, and figures (stars). Furthermore, children indicated their willingness to participate in vegetable subscription services, and answered specific questions on how they wanted such servings to be designed (including choice of stimuli and details regarding presentation style). Shape was very influential; children clearly preferred having their vegetables cut. Figures were liked the most, whereas no differences were observed between slices and sticks. Size only mattered for the whole/chunk, where the ordinary size was preferred. Children expressed high willingness to participate in vegetable subscription services. In conclusion, cutting vegetables in shapes children like can relatively easy be done by parents and producers alike, and children seem very interested in receiving such servings during school. PMID:22796947

  14. 7 CFR 905.29 - Inability of members to serve.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 8 2011-01-01 2011-01-01 false Inability of members to serve. 905.29 Section 905.29 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements and Orders; Fruits, Vegetables, Nuts), DEPARTMENT OF AGRICULTURE ORANGES, GRAPEFRUIT,...

  15. 7 CFR 905.29 - Inability of members to serve.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 8 2014-01-01 2014-01-01 false Inability of members to serve. 905.29 Section 905.29 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (MARKETING AGREEMENTS AND ORDERS; FRUITS, VEGETABLES, NUTS), DEPARTMENT OF AGRICULTURE ORANGES, GRAPEFRUIT,...

  16. 7 CFR 905.29 - Inability of members to serve.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 7 Agriculture 8 2012-01-01 2012-01-01 false Inability of members to serve. 905.29 Section 905.29 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements and Orders; Fruits, Vegetables, Nuts), DEPARTMENT OF AGRICULTURE ORANGES, GRAPEFRUIT,...

  17. 7 CFR 905.29 - Inability of members to serve.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 8 2010-01-01 2010-01-01 false Inability of members to serve. 905.29 Section 905.29 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements and Orders; Fruits, Vegetables, Nuts), DEPARTMENT OF AGRICULTURE ORANGES, GRAPEFRUIT,...

  18. 7 CFR 905.29 - Inability of members to serve.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 7 Agriculture 8 2013-01-01 2013-01-01 false Inability of members to serve. 905.29 Section 905.29 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (MARKETING AGREEMENTS AND ORDERS; FRUITS, VEGETABLES, NUTS), DEPARTMENT OF AGRICULTURE ORANGES, GRAPEFRUIT,...

  19. 16 CFR 500.26 - Representations of servings, uses, applications.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... CFR part 10, by the Department of Commerce, quantitatively defining the meaning of the terms serving... required statement of net contents (e.g., cupsful, tablespoonful, etc.), when such differing terms describe... the National Institute of Standards and Technology, Department of Commerce, Washington, DC 20899.)...

  20. How Much Is 1 Serving? | Smokefree.gov

    Cancer.gov

    Feeling like following the recommendations for healthy eating will have you tackling a mountain of broccoli? Not sure what “1 cup” of cereal looks like (and measuring your cereal every morning won’t fit into your routine)? Heard the news that over-sized bagels pack a mean punch with calories? Here are some general guidelines for what 1 serving looks like:

  1. Caregivers' attitudes regarding portion size served to Head Start children

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The purpose of this study was to identify caregivers' attitudes regarding amounts and types of foods served to Head Start preschoolers using qualitative methods. Researchers conducted 8 focus groups (4 African American; 4 Hispanic) with 33 African American and 29 Hispanic Head Start caregivers. Mode...

  2. Charter Schools: Whom Do They Serve, and How Well?

    ERIC Educational Resources Information Center

    Perkins-Gough, Deborah

    1997-01-01

    To help educators assess charter schools' effects on education, this article summarizes information from two studies: the U.S. Department of Education's ongoing National Study of Charter Schools and the Hudson Institute's 1996-97 Charter Schools in Action Project. Charter schools are growing in number, serving diverse student populations, and…

  3. Serving Wounded Warriors: Current Practices in Postsecondary Education

    ERIC Educational Resources Information Center

    Vance, Mary Lee; Miller, Wayne K., II

    2009-01-01

    From September to October 2009 the Association on Higher Education and Disabilities (AHEAD) invited anonymous voluntary responses from 2,500 members and affiliates to complete a 29-question online survey on current practices in postsecondary education for serving veterans with disabilities (wounded warriors). Two hundred and thirty seven complete…

  4. 16 CFR 500.26 - Representations of servings, uses, applications.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 16 Commercial Practices 1 2012-01-01 2012-01-01 false Representations of servings, uses, applications. 500.26 Section 500.26 Commercial Practices FEDERAL TRADE COMMISSION RULES, REGULATIONS, STATEMENT OF GENERAL POLICY OR INTERPRETATION AND EXEMPTIONS UNDER THE FAIR PACKAGING AND LABELING ACT REGULATIONS UNDER SECTION 4 OF THE FAIR PACKAGING...

  5. 16 CFR 500.26 - Representations of servings, uses, applications.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 16 Commercial Practices 1 2010-01-01 2010-01-01 false Representations of servings, uses, applications. 500.26 Section 500.26 Commercial Practices FEDERAL TRADE COMMISSION RULES, REGULATIONS, STATEMENT OF GENERAL POLICY OR INTERPRETATION AND EXEMPTIONS UNDER THE FAIR PACKAGING AND LABELING ACT REGULATIONS UNDER SECTION 4 OF THE FAIR PACKAGING...

  6. Serving on Your Local School Board: A Guide for Candidates

    ERIC Educational Resources Information Center

    Washington State School Directors' Association (NJ1), 2010

    2010-01-01

    Serving on a local school board has often been called "the toughest volunteer job in America." While it can be challenging at times, most school directors will tell you there are great rewards in helping students and giving back to your community. The contributions of each school director are critical to the board's overall effectiveness. This…

  7. 7 CFR 63.102 - Nominee's agreement to serve.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 3 2011-01-01 2011-01-01 false Nominee's agreement to serve. 63.102 Section 63.102 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing Practices), DEPARTMENT OF AGRICULTURE (CONTINUED) REGULATIONS AND STANDARDS UNDER THE AGRICULTURAL MARKETING ACT...

  8. 7 CFR 1280.203 - Nominee's agreement to serve.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 10 2014-01-01 2014-01-01 false Nominee's agreement to serve. 1280.203 Section 1280.203 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (MARKETING AGREEMENTS AND ORDERS; MISCELLANEOUS COMMODITIES), DEPARTMENT OF AGRICULTURE LAMB PROMOTION, RESEARCH, AND INFORMATION ORDER...

  9. Meal Pattern Requirements and Offer versus Serve Manual.

    ERIC Educational Resources Information Center

    Food and Nutrition Service (USDA), Washington, DC.

    This manual contains information on federal policy regarding meal-pattern requirements for school-nutrition programs. It also describes the Offer Versus Serve (OVS) provision, which allows students to decline either one or two food items they do not intend to eat in order to reduce food waste. The manual explains food components, gives examples of…

  10. The Hispanic-Serving Designation: Asset or Deficit?

    ERIC Educational Resources Information Center

    Allen, Kerri

    2006-01-01

    The U.S. Department of Education classifies a Hispanic-Serving Institution (HSI) as a non-profit institution that has at least a 25 percent Hispanic full-time equivalent enrollment. At least half of the Hispanic student population must also be low income. This is also known as Title V status. There are more than 200 American colleges and…

  11. Hispanic-Serving Institutions: Contributions and Challenges. Policy Brief

    ERIC Educational Resources Information Center

    Malcom-Piqueux, Lindsey E.; Lee, John Michael, Jr.

    2011-01-01

    This brief presents information about the characteristics of the nation's Hispanic-serving institutions (HSIs) and their students, as well as the HSIs' contributions to the educational attainment of the Latino population. The brief concludes by outlining some of the challenges faced by HSIs as they aim to meet their implied mission of serving…

  12. Latinos' Economic Recovery: Postsecondary Participation and Hispanic-Serving Institutions

    ERIC Educational Resources Information Center

    Gastic, Billie; Nieto, David Gonzalez

    2010-01-01

    The majority of Latinos currently enrolled in colleges and universities attend Hispanic-serving Institutions (HSIs), or those institutions where Latino undergraduate full-time equivalent enrollment equals or exceeds 25% of the student population. While HSIs only make up 7% of colleges and universities in the U.S., they enroll more than half of all…

  13. Hispanic-Serving Institutions and the Struggle for Cognitive Justice

    ERIC Educational Resources Information Center

    Garcia, Herman S.

    2012-01-01

    Hispanic-Serving Institution (HSI) colleges and universities were initiated as an enterprise for investing in the academy as a way to provide opportunities for Latin@ students. However, HSIs in colleges and universities have had measured success in that significant numbers of Latin@ students continue to leave campuses with unfinished business. An…

  14. 34 CFR 686.12 - Agreement to serve.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 34 CFR part 685. (Authority: 20 U.S.C. 1070g, et seq.) ..., DEPARTMENT OF EDUCATION (CONTINUED) TEACHER EDUCATION ASSISTANCE FOR COLLEGE AND HIGHER EDUCATION (TEACH... teaching service by— (1) Serving as a full-time teacher for a total of not less than four elementary...

  15. 34 CFR 686.12 - Agreement to serve.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 34 CFR part 685. (Authority: 20 U.S.C. 1070g, et seq.) ..., DEPARTMENT OF EDUCATION TEACHER EDUCATION ASSISTANCE FOR COLLEGE AND HIGHER EDUCATION (TEACH) GRANT PROGRAM... teaching service by— (1) Serving as a full-time teacher for a total of not less than four elementary...

  16. Exemplary Vocational Education Programs Serving Postsecondary Special Needs Populations.

    ERIC Educational Resources Information Center

    Maddy-Bernstein, Carolyn; Burac, Zipura T.

    In 1989, the Technical Assistance for Special Populations Program (TASPP) developed a process to identify exemplary vocational education programs serving youth and adults with special needs. A national survey was conducted, with responses received from more than 350 professional vocational educators of special needs students in several states. In…

  17. 34 CFR 686.12 - Agreement to serve.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 34 CFR part 685. (Authority: 20 U.S.C. 1070g, et seq.) ..., DEPARTMENT OF EDUCATION (CONTINUED) TEACHER EDUCATION ASSISTANCE FOR COLLEGE AND HIGHER EDUCATION (TEACH... teaching service by— (1) Serving as a full-time teacher for a total of not less than four elementary...

  18. 40 CFR 791.34 - Serving of notice.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 31 2010-07-01 2010-07-01 true Serving of notice. 791.34 Section 791.34 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) TOXIC SUBSTANCES CONTROL ACT... address or by personal service, within or without the state wherein the arbitration is to be held...

  19. On the losses of dissolved CO(2) during champagne serving.

    PubMed

    Liger-Belair, Gérard; Bourget, Marielle; Villaume, Sandra; Jeandet, Philippe; Pron, Hervé; Polidori, Guillaume

    2010-08-11

    Pouring champagne into a glass is far from being consequenceless with regard to its dissolved CO(2) concentration. Measurements of losses of dissolved CO(2) during champagne serving were done from a bottled Champagne wine initially holding 11.4 +/- 0.1 g L(-1) of dissolved CO(2). Measurements were done at three champagne temperatures (i.e., 4, 12, and 18 degrees C) and for two different ways of serving (i.e., a champagne-like and a beer-like way of serving). The beer-like way of serving champagne was found to impact its concentration of dissolved CO(2) significantly less. Moreover, the higher the champagne temperature is, the higher its loss of dissolved CO(2) during the pouring process, which finally constitutes the first analytical proof that low temperatures prolong the drink's chill and helps it to retain its effervescence during the pouring process. The diffusion coefficient of CO(2) molecules in champagne and champagne viscosity (both strongly temperature-dependent) are suspected to be the two main parameters responsible for such differences. Besides, a recently developed dynamic-tracking technique using IR thermography was also used in order to visualize the cloud of gaseous CO(2) which flows down from champagne during the pouring process, thus visually confirming the strong influence of champagne temperature on its loss of dissolved CO(2). PMID:20681665

  20. 77 FR 58299 - National Hispanic-Serving Institutions Week, 2012

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-09-19

    ... Sig.) [FR Doc. 2012-23302 Filed 9-18-12; 11:15 am] Billing code 3295-F2-P ... Documents#0;#0; ] Proclamation 8866 of September 14, 2012 National Hispanic-Serving Institutions Week, 2012... many Hispanic students and their families, and this week, we celebrate the critical role these...

  1. Trainer Guide: Serving Campers With Special Needs. Camp Administration Series.

    ERIC Educational Resources Information Center

    Brookhiser, Judy

    Part of the materials developed for Project STRETCH (Strategies to Try out Resources to Enhance the Training of Camp directors serving the Handicapped), this guide consists of three sections: an introduction, the managerial trainer guide, and appendices. Section I addresses the rise of organized camping as big business, the need to provide camping…

  2. Small Public Libraries Can Serve Big. ERIC Digest.

    ERIC Educational Resources Information Center

    Parry, Norm

    Small public libraries can deliver service like big libraries, without sacrificing hometown warmth and charm. By borrowing strategies used by successful small businesses in the private sector, defining goals and exploiting low cost technologies, small public libraries can serve customer wants as well as much larger institutions. Responding to just…

  3. 27 CFR 31.42 - Restaurants serving liquors with meals.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 27 Alcohol, Tobacco Products and Firearms 1 2010-04-01 2010-04-01 false Restaurants serving liquors with meals. 31.42 Section 31.42 Alcohol, Tobacco Products and Firearms ALCOHOL AND TOBACCO TAX AND TRADE BUREAU, DEPARTMENT OF THE TREASURY LIQUORS ALCOHOL BEVERAGE DEALERS Activities Subject to This Part Certain Organizations, Agencies,...

  4. ASSIGNING PYRAMID SERVINGS TO USDA NUTRIENT DATABASE CODES

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The Continuing Survey of Food Intakes by Individuals utilizes the USDA Nutrient Database (NDB) for Standard Reference and the Survey Recipe Database to calculate the nutrient values for USDA survey foods. The Community Nutrition Research Group (CNRG) has assigned Pyramid servings to USDA survey foo...

  5. 34 CFR 686.12 - Agreement to serve.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 34 CFR part 685. (Authority: 20 U.S.C. 1070g, et seq.) ..., DEPARTMENT OF EDUCATION (CONTINUED) TEACHER EDUCATION ASSISTANCE FOR COLLEGE AND HIGHER EDUCATION (TEACH... teaching service by— (1) Serving as a full-time teacher for a total of not less than four elementary...

  6. 34 CFR 686.12 - Agreement to serve.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 34 CFR part 685. (Authority: 20 U.S.C. 1070g, et seq.) ..., DEPARTMENT OF EDUCATION (CONTINUED) TEACHER EDUCATION ASSISTANCE FOR COLLEGE AND HIGHER EDUCATION (TEACH... teaching service by— (1) Serving as a full-time teacher for a total of not less than four elementary...

  7. Using Title XX to Serve Children and Youth.

    ERIC Educational Resources Information Center

    Twiname, John D.; And Others

    With the passage in early 1975 of the social service amendments to the Social Security Act, referred to as Title XX, a major new opportunity to serve children and youth has emerged. Seizing the opportunity will be largely dependent on the well-prepared presentation of a case for the needs of young people by dedicated advocates in every state.…

  8. Reducing societal vulnerability to drought: A methodology

    SciTech Connect

    Wilhite, D.A.

    1995-12-31

    Given worldwide experience with drought during the past several decades and the magnitude of associated impacts, it is apparent that vulnerability to extended periods of water shortage is escalating. Developing a national or provincial drought policy and preparedness plan is a complicated but essential first step toward reducing societal vulnerability. Until recently, nations had devoted little effort to drought preparedness, preferring instead the reactive or crisis management approach. Presently, an increasing number of nations are pursuing a more proactive approach that emphasizes the principles of risk management and sustainable development. Because of the multitude of impacts associated with drought and the numerous governmental agencies that have responsibility for some aspect of monitoring, assessment, mitigation, and planning, developing a policy and plan must be an integrated process within and between levels of government. This paper outlines a generic process that can be adopted by governments that desire to develop a more comprehensive and long-term approach to drought management and planning. Countries and states or provincial authorities that have adopted this approach is presented as case studies. This process is timely, given the declaration of the 1990s as the International Decade for Natural Disaster Reduction and the recent International Convention to Combat Desertification and Drought (June, 1994), an offshoot of deliberations at the United Nations Conference on Environment and Development.

  9. Airport vulnerability assessment: an analytical approach

    NASA Astrophysics Data System (ADS)

    Lazarick, Richard T.

    1998-12-01

    The Airport Vulnerability Assessment Project (AVAP) is the direct result of congressional funding of recommendation 3.13 of the White House Commission on Aviation Safety and Security. This project takes a new approach to the assessment of U.S. commercial airports. AVAP uses automation, analytical methods and tools to evaluate vulnerability and risk, and to analyze cost/benefits in a more quantitative manner. This paper addresses both the process used to conduct this program, as well as a generalized look at the results, which have been achieved for the initial airport assessments. The process description covers the acquisition approach, the project structure, and a review of the various methodologies and tools being used by the sever performing organizations (Abacus Technology, Battelle, CTI, Lockwood Greene, Naval Facilities Engineering Service Center, SAIC, and Science & Engineering Associates). The tools described include ASSESS, SAM, RiskWatch, CASRAP, and AVAT. Included in the process is the utilization of an advisory panel made up predominantly of experts from the National Laboratories 9Sandia, Oak Ridge, Argonne and Brookhaven). The results portion addresses the findings and products resulting from the initial airport assessments. High level (unrestricted) summaries of the results are presented, along with initial trends in commonly recommended security improvements (countermeasures). Opportunities for the application of optics technology are identified.

  10. Mapping of earthquakes vulnerability area in Papua

    NASA Astrophysics Data System (ADS)

    Muhammad Fawzy Ismullah, M.; Massinai, Muh. Altin

    2016-05-01

    Geohazard is a geological occurrence which may lead to a huge loss for human. A mitigation of these natural disasters is one important thing to be done properly in order to reduce the risks. One of the natural disasters that frequently occurs in the Papua Province is the earthquake. This study applies the principle of Geospatial and its application for mapping the earthquake-prone area in the Papua region. It uses earthquake data, which is recorded for 36 years (1973-2009), fault location map, and ground acceleration map of the area. The earthquakes and fault map are rearranged into an earthquake density map, as well as an earthquake depth density map and fault density map. The overlaid data of these three maps onto ground acceleration map are then (compiled) to obtain an earthquake unit map. Some districts area, such as Sarmi, Nabire, and Dogiyai, are identified by a high vulnerability index. In the other hand, Waropen, Puncak, Merauke, Asmat, Mappi, and Bouven Digoel area shows lower index. Finally, the vulnerability index in other places is detected as moderate.

  11. Framework for Vulnerability Assessment of Coastal Infrastructure

    NASA Astrophysics Data System (ADS)

    Obrien, P. S.; Moritz, H. R.; White, K. D.

    2015-12-01

    Coastal infrastructure can be highly vulnerable to changing climate, including increasing sea levels and altered frequency and intensity of coastal storms. Existing coastal infrastructure may be of a sufficient age that it is already experiencing noticeable impacts from global sea level rise, and require a variety of potential preparedness and resilience measures to adapt to changing climate. Methods to determine vulnerability to changing sea level and support planning of potential future adaptation measures are needed for application to projects having multiple purposes (e.g., navigation, coastal risk reduction). Here we describe a potential framework for assessing projects with several components typical of existing coastal infrastructure spanning a range of engineering disciplines (e.g., hydrology, geotechnical, structural, electrical, and mechanical). The US Army Corps of Engineers (USACE) Climate Preparedness and Resilience Register (CPRR) framework is currently under development. It takes a tiered approach as described in earlier USACE guidance (Engineer Technical Letter 1100-2-1) using the three scenarios prescribed by Engineer Regulation ER 1100-2-8162. Level 1 is a qualitative assessment defining the major sea level change-related impacts and ranks them in order of soonest occurrence. Level 2 is a quantitative evaluation that analyzes current and future performance of individual project components, including electrical, mechanical and structural components and functions using the sea level change scenarios prescribed by ER 1100-2-8162. Level 3 proposes adaptation measures per ETL 1100-2-1 and evaluates changes in sea level change-related impacts.

  12. A network approach to evaluate ecosystem vulnerability

    NASA Astrophysics Data System (ADS)

    Goodwell, Allison; Kumar, Praveen

    2016-04-01

    Ecohydrologic systems exhibit shifts in behavior due to natural or human induced perturbations or stresses. These shifts result from changes in dependencies between many interacting components. A framework that defines a system based on these shifting interactions is needed to holistically evaluate properties such as resilience, vulnerability, or health that cannot be reached through the isolated study of component behaviors. This study uses a network approach in which ecohydrologic time-series data are nodes, and information theoretic measures that capture various aspects of time dependencies are links. It has been shown that an information decomposition approach can be used to determine the relative redundant (shared by multiple source nodes to a target), synergistic (arising only from the knowledge of multiple source nodes), or unique (only provided by an individual source node) information within a given detected link. We construct networks from flux tower and ecohydrologic model output nodes and evaluate how these evolve in terms of connectivity, dominant time scales of interactions, link uniqueness, and link stability over time windows ranging from several hours to several weeks as ecosystems respond to shifting environmental conditions. We associate these network properties with simulated and observed vegetation responses, and show that a network framework can be used to detect critical interactions that dictate ecosystem vulnerabilities to extremes.

  13. Evaluating operating system vulnerability to memory errors.

    SciTech Connect

    Ferreira, Kurt Brian; Bridges, Patrick G.; Pedretti, Kevin Thomas Tauke; Mueller, Frank; Fiala, David; Brightwell, Ronald Brian

    2012-05-01

    Reliability is of great concern to the scalability of extreme-scale systems. Of particular concern are soft errors in main memory, which are a leading cause of failures on current systems and are predicted to be the leading cause on future systems. While great effort has gone into designing algorithms and applications that can continue to make progress in the presence of these errors without restarting, the most critical software running on a node, the operating system (OS), is currently left relatively unprotected. OS resiliency is of particular importance because, though this software typically represents a small footprint of a compute node's physical memory, recent studies show more memory errors in this region of memory than the remainder of the system. In this paper, we investigate the soft error vulnerability of two operating systems used in current and future high-performance computing systems: Kitten, the lightweight kernel developed at Sandia National Laboratories, and CLE, a high-performance Linux-based operating system developed by Cray. For each of these platforms, we outline major structures and subsystems that are vulnerable to soft errors and describe methods that could be used to reconstruct damaged state. Our results show the Kitten lightweight operating system may be an easier target to harden against memory errors due to its smaller memory footprint, largely deterministic state, and simpler system structure.

  14. Vulnerability analysis methods for road networks

    NASA Astrophysics Data System (ADS)

    Bíl, Michal; Vodák, Rostislav; Kubeček, Jan; Rebok, Tomáš; Svoboda, Tomáš

    2014-05-01

    Road networks rank among the most important lifelines of modern society. They can be damaged by either random or intentional events. Roads are also often affected by natural hazards, the impacts of which are both direct and indirect. Whereas direct impacts (e.g. roads damaged by a landslide or due to flooding) are localized in close proximity to the natural hazard occurrence, the indirect impacts can entail widespread service disabilities and considerable travel delays. The change in flows in the network may affect the population living far from the places originally impacted by the natural disaster. These effects are primarily possible due to the intrinsic nature of this system. The consequences and extent of the indirect costs also depend on the set of road links which were damaged, because the road links differ in terms of their importance. The more robust (interconnected) the road network is, the less time is usually needed to secure the serviceability of an area hit by a disaster. These kinds of networks also demonstrate a higher degree of resilience. Evaluating road network structures is therefore essential in any type of vulnerability and resilience analysis. There are a range of approaches used for evaluation of the vulnerability of a network and for identification of the weakest road links. Only few of them are, however, capable of simulating the impacts of the simultaneous closure of numerous links, which often occurs during a disaster. The primary problem is that in the case of a disaster, which usually has a large regional extent, the road network may remain disconnected. The majority of the commonly used indices use direct computation of the shortest paths or time between OD (origin - destination) pairs and therefore cannot be applied when the network breaks up into two or more components. Since extensive break-ups often occur in cases of major disasters, it is important to study the network vulnerability in these cases as well, so that appropriate

  15. Vulnerability of housing buildings in Bucharest, Romania

    NASA Astrophysics Data System (ADS)

    Bostenaru, M.

    2009-04-01

    The author participates to the World Housing Encyclopedia project (www.world-housing.net), an internet based database of housing buildings in earthquake prone areas of the world. This is a voluntary project run by the Earthquake Engineering Research Institute, Oakland, California and the International Association of Earthquake Engineering, financial means being available only for the website where the information is shared. For broader dissemination in 2004 a summary publication of the reports to date was published. The database can be querried for various parameters and browsed after geographic distribution. Participation is open to any housing experts. Between 2003 and 2006 the author was also member of the editorial board. The author contributed numerous reports about building types in Romania, and each one about building types in Germany and Switzerland. This presentation will be about the contributed reports on building types in Romania. To the Encyclopedia eight reports on building types from Bucharest were contributed, while in further research of the author one more was similarly described regarding the vulnerability and the seismic retrofit. The selection of these types was done considering the historic development of the built substance in Bucharest from 1850 on, time from which a representative amount of housing buildings which can be classified in typologies can be found in Bucharest. While the structural types are not necessarily characteristic for the style, since the style has other time limits, often appearing before the type became common and then remaining being practiced also after another style gained ground, a historic succession can be seen also in this case. The nine types considered can be grouped in seven time categories: - the time 1850-1880, for a vernacular housing type with masonry load bearing walls and timber floors, - the time 1880-1920, for the type of two storey or multi-storey house with masonry walls and timber floors (in which

  16. Biomechanics of the serve in tennis. A biomedical perspective.

    PubMed

    Elliott, B C

    1988-11-01

    Epidemiological studies have indicated that the serve, arguably the most important facet of the game of tennis, is also the most likely stroke to cause injury, particularly to the elbow and back. A review of the kinematic and kinetic studies on the service action fails to clearly identify the reason(s) for these injuries. Data from these studies does, however, allow possible causes of injury to be postulated. Electromyographic data from the prime mover muscles involved in the serve have shown that muscle action was greater for beginners, whose muscles were active for longer periods than those of advanced players. Ground reaction forces associated with different serving techniques were small compared to those recorded from activities involving running or jumping. The potential to cause injury seems to be related to high internal forces (combination of muscle and joint reaction forces), particularly where these forces are associated with poor technique and high segment accelerations. These situations occur when the racket moves behind the body and the vertebral column is laterally flexed and hyperextended. The pronation of the forearm and the forces associated with the swing to the ball, the impact and the early follow through are also factors that have the potential to cause injury. The action of serving induces strains and pressures upon the body. A sensible approach to the number of serves, particularly when practising (overuse), appropriate physical preparation and a technique that does not introduce excessive forces to selected body parts (misuse) will greatly reduce the potential for injury from this activity. PMID:3064237

  17. Shoulder joint kinetics of the elite wheelchair tennis serve

    PubMed Central

    Reid, Machar; Elliott, Bruce; Alderson, Jacque

    2007-01-01

    Background The shoulder is a key joint in wheelchair locomotion and commonly implicated in injury among virtually all wheelchair populations. In tennis, quantification of the shoulder joint kinetics that characterise the wheelchair serve could enhance injury prevention and rehabilitation practices as well as assist coaches evaluate the efficacy of their current technical instruction. Methods A 12‐camera, 250 Hz Vicon motion analysis system (Oxford Metrics Inc., UK) recorded the 3D flat (WFS) and kick serve (WKS) motions of two male top 30‐ranked international wheelchair players. Mechanical comparisons between wheelchair players, as well as to the previously captured data of 12 high‐performance able‐bodied players executing the same types of serves, were undertaken. Results Without the benefit of a propulsive leg action, wheelchair players developed lower peak absolute (∼32 m/s) and horizontal (∼28 m/s) pre‐impact racquet velocities than able‐bodied players (∼42 m/s, ∼38 m/s). Wheelchair serve tactics nevertheless necessitated that higher pre‐impact horizontal and right lateral racquet velocities characterised the WFS (∼29 m/s, WKS: ∼26 m/s) and WKS (∼4 m/s, WFS: ∼11 m/s) respectively. The shoulder joint kinetics that contributed to the differential racquet velocity profiles were mostly developed independent of wheelchair serve type, but varied with and were likely related to the level and severity of spinal cord injury of the individual players. Conclusions Compared with able‐bodied players, wheelchair players experienced matching pre‐ and post‐impact shoulder joint loads, such that wheelchair and able‐bodied playing populations appear subject to similar shoulder joint injury risk. PMID:17957009

  18. Circulating MiRNA biomarkers serve as a fingerprint for diabetic atherosclerosis

    PubMed Central

    Zhang, Jing-Yun; Gong, Ying-Lan; Li, Chun-Jun; Qi, Qi; Zhang, Qiu-Mei; Yu, De-Min

    2016-01-01

    Type 2 diabetes mellitus induced atherosclerosis (DA) is regarded as a major cause of disability and death in diabetic patients. The early prediction of atherosclerosis in patients DM is necessary. Therefore, we aimed to identify special plasma microRNAs that can serve as a novel non-invasive screening signature of DA patients with atherosclerosis and test its specificity and sensitivity in the early diagnosis of DA. In total, we obtained plasma samples from 285 diabetic atherosclerosis patients and matched diabetic retinopathy (DR) patients, diabetic nephropathy (DN) patients, diabetes mellitus without complication (DM) and healthy controls. An initial screening of miRNA expression was performed through TaqMan Low Density Array (TLDA). Three miRNAs were significantly increased in patients with DA compared with other groups after the multiple stages. The areas under the receiver operating characteristic (AUC) curves of the validated three-plasma miRNAs signature in DA comparing with NC were 0.881, 0.709 and 0.842 while the merged was 0.940 while DA comparing with DM was 0.879, 0.663, 0.731 and the merged was 0.928. The three miRNA could also distinguish DA from DN with an AUC of 0.894, 0.782, 0.910 and 0.963 (merged) as well as from DR with an AUC of 0.876, 0.815, 0.850 and 0.925 (merged). In conclusion, these data provide evidence that plasma miRNAs have the potential to be sensitive, cost-effective biomarkers for the early detection of DA. These biomarkers could serve as a dynamic monitoring factor for detecting the progression of DA from DR, DN, DM patients. PMID:27398148

  19. Circulating MiRNA biomarkers serve as a fingerprint for diabetic atherosclerosis.

    PubMed

    Zhang, Jing-Yun; Gong, Ying-Lan; Li, Chun-Jun; Qi, Qi; Zhang, Qiu-Mei; Yu, De-Min

    2016-01-01

    Type 2 diabetes mellitus induced atherosclerosis (DA) is regarded as a major cause of disability and death in diabetic patients. The early prediction of atherosclerosis in patients DM is necessary. Therefore, we aimed to identify special plasma microRNAs that can serve as a novel non-invasive screening signature of DA patients with atherosclerosis and test its specificity and sensitivity in the early diagnosis of DA. In total, we obtained plasma samples from 285 diabetic atherosclerosis patients and matched diabetic retinopathy (DR) patients, diabetic nephropathy (DN) patients, diabetes mellitus without complication (DM) and healthy controls. An initial screening of miRNA expression was performed through TaqMan Low Density Array (TLDA). Three miRNAs were significantly increased in patients with DA compared with other groups after the multiple stages. The areas under the receiver operating characteristic (AUC) curves of the validated three-plasma miRNAs signature in DA comparing with NC were 0.881, 0.709 and 0.842 while the merged was 0.940 while DA comparing with DM was 0.879, 0.663, 0.731 and the merged was 0.928. The three miRNA could also distinguish DA from DN with an AUC of 0.894, 0.782, 0.910 and 0.963 (merged) as well as from DR with an AUC of 0.876, 0.815, 0.850 and 0.925 (merged). In conclusion, these data provide evidence that plasma miRNAs have the potential to be sensitive, cost-effective biomarkers for the early detection of DA. These biomarkers could serve as a dynamic monitoring factor for detecting the progression of DA from DR, DN, DM patients. PMID:27398148

  20. Susceptibility to mountain hazards in Austria - paradigms of vulnerability revisited

    NASA Astrophysics Data System (ADS)

    Fuchs, Sven

    2010-05-01

    The concept of vulnerability is pillared by multiple disciplinary theories underpinning either a technical or a social origin of the concept and resulting in a range of paradigms for either a qualitative or quantitative assessment of vulnerability. However, efforts to reduce susceptibility to hazards and to create disaster-resilient communities require intersections among these theories, since human activity cannot be seen independently from the environmental setting. Acknowledging different roots of disciplinary paradigms, issues determining structural, economic, institutional and social vulnerability are discussed with respect to mountain hazards in Austria. The underlying idea of taking such an integrative viewpoint was the cognition that human action in mountain environments affects the state of vulnerability, and the state of vulnerability in turn shapes the possibilities of human action. It is argued that structural vulnerability as originator results in considerable economic vulnerability, generated by the institutional settings of dealing with natural hazards and shaped by the overall societal framework. Hence, the vulnerability of a specific location and within a considered point of time is triggered by the hazardous event and the related physical susceptibility of structures, such as buildings located on a torrent fan. Depending on the specific institutional settings, economic vulnerability of individuals or of the society results, above all with respect to imperfect loss compensation mechanisms in the areas under investigation. While this potential for harm can be addressed as social vulnerability, the concept of institutional vulnerability has been developed with respect to the overall political settings of governmental risk management. As a result, the concept of vulnerability, as being used in natural sciences, can be extended by integration of possible reasons why such physical susceptibility of structures exists, and by integration of compensation

  1. Social vulnerability indicators as a sustainable planning tool

    SciTech Connect

    Lee, Yung-Jaan

    2014-01-15

    In the face of global warming and environmental change, the conventional strategy of resource centralization will not be able to cope with a future of increasingly extreme climate events and related disasters. It may even contribute to inter-regional disparities as a result of these events. To promote sustainable development, this study offers a case study of developmental planning in Chiayi, Taiwan and a review of the relevant literature to propose a framework of social vulnerability indicators at the township level. The proposed framework can not only be used to measure the social vulnerability of individual townships in Chiayi, but also be used to capture the spatial developmental of Chiayi. Seventeen social vulnerability indicators provide information in five dimensions. Owing to limited access to relevant data, the values of only 13 indicators were calculated. By simply summarizing indicators without using weightings and by using zero-mean normalization to standardize the indicators, this study calculates social vulnerability scores for each township. To make social vulnerability indicators more useful, this study performs an overlay analysis of social vulnerability and patterns of risk associated with national disasters. The social vulnerability analysis draws on secondary data for 2012 from Taiwan's National Geographic Information System. The second layer of analysis consists of the flood potential ratings of the Taiwan Water Resources Agency as an index of biophysical vulnerability. The third layer consists of township-level administrative boundaries. Analytical results reveal that four out of the 18 townships in Chiayi not only are vulnerable to large-scale flooding during serious flood events, but also have the highest degree of social vulnerability. Administrative boundaries, on which social vulnerability is based, do not correspond precisely to “cross-administrative boundaries,” which are characteristics of the natural environment. This study adopts

  2. Social vulnerability assessment: a growing practice in Europe?

    NASA Astrophysics Data System (ADS)

    Tapsell, S.; McC arthy, S.

    2012-04-01

    This paper builds upon work on social vulnerability from the CapHaz-Net consortium, an ongoing research project funded by the European Commission in its 7th Framework Programme. The project focuses on the social dimensions of natural hazards, as well as on regional practices of risk prevention and management, and aims at improving the resilience of European societies to natural hazards, paying particular attention to social capacity building. The topic of social vulnerability is one of seven themes being addressed in the project. There are various rationales for examining the relevance of social vulnerability to natural hazards. Vulnerability assessment has now been accepted as a requirement for the effective development of emergency management capability, and assessment of social vulnerability has been recognised as being integral to understanding the risk to natural hazards. The aim of our research was to examine social vulnerability, how it might be understood in the context of natural hazards in Europe, and how social vulnerability can be addressed to increase social capacity. The work comprised a review of research on social vulnerability to different natural hazards within Europe and included concepts and definitions of social vulnerability (and related concepts), the purpose of vulnerability assessment and who decides who is vulnerable, different approaches to assessing or measuring social vulnerability (such as the use of 'classical' quantitative vulnerability indicators and qualitative community-based approaches, along with the advantages and disadvantages of both), conceptual frameworks for assessing social vulnerability and three case studies of social vulnerability studies within Europe: flash floods in the Italian Alps, fluvial flooding in Germany and heat waves in Spain. The review reveals variable application of social vulnerability analysis across Europe and there are indications why this might be the case. Reasons could range from the scale of

  3. Spatial econometric model of natural disaster impacts on human migration in vulnerable regions of Mexico.

    PubMed

    Saldaña-Zorrilla, Sergio O; Sandberg, Krister

    2009-10-01

    Mexico's vast human and environmental diversity offers an initial framework for comprehending some of the prevailing great disparities between rich and poor. Its socio-economic constructed vulnerability to climatic events serves to expand this understanding. Based on a spatial econometric model, this paper tests the contribution of natural disasters to stimulating the emigration process in vulnerable regions of Mexico. Besides coping and adaptive capacity, it assesses the effects of economic losses due to disasters as well as the adverse production and trade conditions of the 1990s on emigration rates in 2000 at the municipality level. Weather-related disasters were responsible for approximately 80 per cent of economic losses in Mexico between 1980 and 2005, mostly in the agricultural sector, which continues to dominate many parts of the country. It is dramatic that this sector generates around only four per cent of gross domestic product but provides a livelihood to about one-quarter of the national population. It is no wonder, therefore, that most emigration from this country arises in vulnerable rural areas. PMID:19207538

  4. Individual differences and vulnerability to drug addiction: a focus on the endocannabinoid system.

    PubMed

    Sagheddu, Claudia; Melis, Miriam

    2015-01-01

    Vulnerability to drug addiction depends upon the interactions between the biological makeup of the individual, the environment, and age. These interactions are complex and difficult to tease apart. Since dopamine is involved in the rewarding effects of drugs of abuse, it is postulated that innate differences in mesocorticolimbic pathway can influence the response to drug exposure. In particular, higher and lower expression of dopamine D2 receptors in the ventral striatum (i.e. a marker of dopamine function) has been considered a putative protective and a risk factor, respectively, that can influence one's susceptibility to continued drug abuse as well as the transition to addiction. This phenomenon, which is phylogenetically preserved, appears to be a compensatory change to increased impulse activity of midbrain dopamine neurons. Hence, dopamine neuronal excitability plays a fundamental role in the diverse stages of the drug addiction cycle. In this review, a framework for the evidence that modulation of dopamine neuronal activity plays in the context of vulnerability to drug addiction will be presented. Furthermore, since endogenous cannabinoids serve as retrograde messengers to shape afferent neuronal activity in a short- and long-lasting fashion, their role in individual differences and vulnerability to drug addiction will be discussed. PMID:25714966

  5. Childhood physical abuse and aggression: Shame and narcissistic vulnerability.

    PubMed

    Keene, Amanda C; Epps, James

    2016-01-01

    This study examined narcissistic vulnerability and shame-proneness as potential mediators between childhood physical abuse (CPA) and adult anger and aggression. Participants were 400 undergraduate students, 134 of whom had a history of CPA. All participants completed self-report questionnaires assessing history of CPA, shame-proneness, narcissistic vulnerability, physical aggression, trait anger, and hostility. Results indicated abused participants were more angry and aggressive and experienced higher levels of shame-proneness and narcissistic vulnerability than nonabused participants. Multiple mediation analyses showed that narcissistic vulnerability, but not shame-proneness, partially mediated the relation between abuse and physical aggression. However, narcissistic vulnerability and shame-proneness both emerged as partial mediators between abuse and the anger and hostility variables. These findings suggest that narcissistic vulnerability and shame-proneness may function as mediators of adjustment following childhood maltreatment. Study limitations and recommendations for future research are discussed. PMID:26560235

  6. [Regulation (EU) No 536/2014 on Clinical Trials and Vulnerable Groups].

    PubMed

    Mariño Hernández, Eduardo L

    2015-01-01

    A complete review of the normative established for clinical trials in vulnerable patient is performed. To do that, the basis is the last European norm, that is, the Regulation (EU) No 536/2014 of the European Parliament and of the Council of 16 April 2014 on clinical trials on medicinal products for human use, and repealing Directive 2001/20/EC (Text with EEA relevance). It is checked all related to vulnerable patients from the previous European norm. Directive 2001/20/EC of the European Parliament and of the Council of 4 April 2001 and the corresponding transpositions into Spanish law by Royal Decree 223/2004 , of February 6, 2004 , whereby clinical drug trials and Law 29/2006 of 26 July, on guarantees and regulates use rational use of medicines and health products. PMID:26546797

  7. IFLA General Conference, 1985. Division on Libraries Serving the General Public. Section on Libraries Serving Disadvantaged People. Papers.

    ERIC Educational Resources Information Center

    International Federation of Library Associations, The Hague (Netherlands).

    This document contains two papers on library services in prisons which were presented at the 1985 International Federation of Library Associations (IFLA) conference. In the paper, "Library Service in Prisons/Correctional Institutions," Phyllis I. Dalton (United States) proposes that the IFLA Section on Libraries Serving Disadvantaged Persons…

  8. Evaluation of three-ram cohort serving capacity tests as a substitute for individual serving capacity tests

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Alternatives to time consuming, laborious individual serving capacity tests (ISCT) are needed to classify ram sexual behavior. The objective for Study 1 was to evaluate the relationship between the first, 3-ram cohort test (COSCT) scores and the average of 5 ISCT scores. Objective for Study 2 was t...

  9. Comparative reproducibility of defibrillation threshold and upper limit of vulnerability.

    PubMed

    Swerdlow, C D; Davie, S; Ahern, T; Chen, P S

    1996-12-01

    The upper limit of vulnerability (ULV) is the strength at or above which VF is not induced when a stimulus is delivered during the vulnerable phase of the cardiac cycle. Previous studies have demonstrated a statistically significant correlation between the ULV and the defibrillation threshold (DFT) in groups of patients. However, the correlation between ULV and DFT may not be close in individual patients. This imperfect correlation may be due to physiological factors or to limitations of the measurement methods. The reproducibility of either DFT or ULV has not been studied critically. The purpose of this study was to compare the reproducibility of clinically applicable methods for determination of DFT and ULV. We prospectively studied 25 patients with a transvenous implantable cardioverter defibrillator (Medtronic 7219D) at postoperative electrophysiological study. DFT was defined as the lowest energy that defibrillated after 10 seconds of VF. The ULV was defined as the lowest energy that did not induce VF with three shocks at 0, 20, and 40 ms before the peak of the T wave in ventricular paced rhythm at a cycle length of 500 ms. Both the DFT and the ULV were determined twice for biphasic pulses using a three-step, midpoint protocol. There was no significant difference between the two determinations of DFT (10.1 +/- 5.9 J vs 10.4 +/- 5.8 J), the two determinations of ULV (13.4 +/- 6.8 J vs 13.8 +/- 6.6) or the DFT-ULV Pearson correlation coefficients for each determination (0.84, P < 0.001 vs 0.75, P < 0.001). To analyze reproducibility, Lin concordance coefficients for second determination versus first determination were constructed for both ULV and DFT. This coefficient is similar to the Pearson correlation coefficient, but measures closeness to the line of identity rather than the line of regression. The Lin concordance coefficient for ULV was higher than that for DFT (0.93, 95% CI 0.85-0.97 vs 0.64, 95% CI 0.33-0.82; P < 0.01). For paired comparison of

  10. Intravascular probe for detection of vulnerable plaque

    NASA Astrophysics Data System (ADS)

    Patt, Bradley E.; Iwanczyk, Jan S.; MacDonald, Lawrence R.; Yamaguchi, Yuko; Tull, Carolyn R.; Janecek, Martin; Hoffman, Edward J.; Strauss, H. William; Tsugita, Ross; Ghazarossian, Vartan

    2001-12-01

    Coronary angiography is unable to define the status of the atheroma, and only measures the luminal dimensions of the blood vessel, without providing information about plaque content. Up to 70% of heart attacks are caused by minimally obstructive vulnerable plaques, which are too small to be detected adequately by angiography. We have developed an intravascular imaging detector to identify vulnerable coronary artery plaques. The detector works by sensing beta or conversion electron radiotracer emissions from plaque-binding radiotracers. The device overcomes the technical constraints of size, sensitivity and conformance to the intravascular environment. The detector at the distal end of the catheter uses six 7mm long by 0.5mm diameter scintillation fibers coupled to 1.5m long plastic fibers. The fibers are offset from each other longitudinally by 6mm and arranged spirally around a guide wire in the catheter. At the proximal end of the catheter the optical fibers are coupled to an interface box with a snap on connector. The interface box contains a position sensitive photomultiplier tube (PSPMT) to decode the individual fibers. The whole detector assembly fits into an 8-French (2.7 mm in diameter) catheter. The PSPMT image is further decoded with software to give a linear image, the total instantaneous count rate and an audio output whose tone corresponds to the count rate. The device was tested with F-18 and Tl-204 sources. Spectrometric response, spatial resolution, sensitivity and beta to background ratio were measured. System resolution is 6 mm and the sensitivity is >500 cps / micrometers Ci when the source is 1 mm from the detector. The beta to background ratio was 11.2 for F-18 measured on a single fiber. The current device will lead to a system allowing imaging of labeled vulnerable plaque in coronary arteries. This type of signature is expected to enable targeted and cost effective therapies to prevent acute coronary artery diseases such as: unstable angina

  11. Cyber / Physical Security Vulnerability Assessment Integration

    SciTech Connect

    MacDonald, Douglas G.; Simpkins, Bret E.

    2012-07-28

    Abstract Both physical protection and cyber security domains offer solutions for the discovery of vulnerabilities through the use of various assessment processes and software tools. Each vulnerability assessment (VA) methodology provides the ability to identify and categorize vulnerabilities, and quantifies the risks within their own areas of expertise. Neither approach fully represents the true potential security risk to a site and/or a facility, nor comprehensively assesses the overall security posture. The technical approach to solving this problem was to identify methodologies and processes that blend the physical and cyber security assessments, and develop tools to accurately quantify the unaccounted for risk. SMEs from both the physical and the cyber security domains developed the blending methodologies, and cross trained each other on the various aspects of the physical and cyber security assessment processes. A local critical infrastructure entity volunteered to host a proof of concept physical/cyber security assessment, and the lessons learned have been leveraged by this effort. The four potential modes of attack an adversary can use in approaching a target are; Physical Only Attack, Cyber Only Attack, Physical Enabled Cyber Attack, and the Cyber Enabled Physical Attack. The Physical Only and the Cyber Only pathway analysis are two of the most widely analyzed attack modes. The pathway from an off-site location to the desired target location is dissected to ensure adversarial activity can be detected and neutralized by the protection strategy, prior to completion of a predefined task. This methodology typically explores a one way attack from the public space (or common area) inward towards the target. The Physical Enabled Cyber Attack and the Cyber Enabled Physical Attack are much more intricate. Both scenarios involve beginning in one domain to affect change in the other, then backing outward to take advantage of the reduced system effectiveness, before

  12. Assessing Vulnerability to Drought on a pan-European scale

    NASA Astrophysics Data System (ADS)

    Urquijo, Julia; De Stefano, Lucia; González-Tánago, Itziar; Blauhut, Veit; Stahl, Kerstin

    2014-05-01

    During the past decade, a number of theoretical frameworks have been defined within the Disaster Risk Reduction and Climate Change communities to assess drought vulnerability at different scales, sectors, socio-political contexts, and geo-climatic conditions. However, there is still little consensus around the criteria, dimensions and factors used in these assessments; and none of them has been applied at a pan-European scale. This is due to a triple complexity. Firstly, drought as a natural hazard is a complex phenomenon due to the difficulty of determining its onset and its multiscale, multifaceted and dynamic nature. Secondly, there is an on-going debate regarding the concept of vulnerability and its constitutive elements, together with an important diversity of theoretical approaches to assess it. Finally, Europe's diversity in bioclimatic conditions, national water use practice and water use policies adds a challenging characteristic for working on pan-European scale. This work addresses the challenge of defining a methodological approach to the assessment of vulnerability factors to drought at a pan-European scale. For this purpose, we first review existing conceptual frameworks as well as of past initiatives for drought vulnerability assessment. The literature review showed that the high complexity of drought vulnerability assessment requires a clear definition of the concept of vulnerability and the associated terms, and that, before undertaking any assessment, it is necessary to clearly define the "vulnerable unit" i.e. replying to the questions 'whose vulnerability is being assessed?' and 'vulnerability to what type of impact?'. In this context, this work proposes the application of a factor-based approach, consisting in the analysis of significant factors that influence vulnerability in the context of specific situations of potential vulnerability. Those situations are framed within the specific drought characteristics of four different geoclimatic macro

  13. Global analysis of urban surface water supply vulnerability

    NASA Astrophysics Data System (ADS)

    Padowski, Julie C.; Gorelick, Steven M.

    2014-10-01

    This study presents a global analysis of urban water supply vulnerability in 71 surface-water supplied cities, with populations exceeding 750 000 and lacking source water diversity. Vulnerability represents the failure of an urban supply-basin to simultaneously meet demands from human, environmental and agricultural users. We assess a baseline (2010) condition and a future scenario (2040) that considers increased demand from urban population growth and projected agricultural demand. We do not account for climate change, which can potentially exacerbate or reduce urban supply vulnerability. In 2010, 35% of large cities are vulnerable as they compete with agricultural users. By 2040, without additional measures 45% of cities are vulnerable due to increased agricultural and urban demands. Of the vulnerable cities in 2040, the majority are river-supplied with mean flows so low (1200 liters per person per day, l/p/d) that the cities experience ‘chronic water scarcity’ (1370 l/p/d). Reservoirs supply the majority of cities facing individual future threats, revealing that constructed storage potentially provides tenuous water security. In 2040, of the 32 vulnerable cities, 14 would reduce their vulnerability via reallocating water by reducing environmental flows, and 16 would similarly benefit by transferring water from irrigated agriculture. Approximately half remain vulnerable under either potential remedy.

  14. Modelling homogeneous regions of social vulnerability to malaria in Rwanda.

    PubMed

    Bizimana, Jean Pierre; Kienberger, Stefan; Hagenlocher, Michael; Twarabamenye, Emmanuel

    2016-01-01

    Despite the decline in malaria incidence due to intense interventions, potentials for malaria transmission persist in Rwanda. To eradicate malaria in Rwanda, strategies need to expand beyond approaches that focus solely on malaria epidemiology and also consider the socioeconomic, demographic and biological/disease-related factors that determine the vulnerability of potentially exposed populations. This paper analyses current levels of social vulnerability to malaria in Rwanda by integrating a set of weighted vulnerability indicators. The paper uses regionalisation techniques as a spatially explicit approach for delineating homogeneous regions of social vulnerability to malaria. This overcomes the limitations of administrative boundaries for modelling the trans-boundary social vulnerability to malaria. The utilised approach revealed high levels of social vulnerability to malaria in the highland areas of Rwanda, as well as in remote areas where populations are more susceptible. Susceptibility may be due to the populations' lacking the capacity to anticipate mosquito bites, or lacking resilience to cope with or recover from malaria infection. By highlighting the most influential indicators of social vulnerability to malaria, the applied approach indicates which vulnerability domains need to be addressed, and where appropriate interventions are most required. Interventions to improve the socioeconomic development in highly vulnerable areas could prove highly effective, and provide sustainable outcomes against malaria in Rwanda. This would ultimately increase the resilience of the population and their capacity to better anticipate, cope with, and recover from possible infection. PMID:27063738

  15. Empirical Estimates of 0Day Vulnerabilities in Control Systems

    SciTech Connect

    Miles A. McQueen; Wayne F. Boyer; Sean M. McBride; Trevor A. McQueen

    2009-01-01

    We define a 0Day vulnerability to be any vulnerability, in deployed software, which has been discovered by at least one person but has not yet been publicly announced or patched. These 0Day vulnerabilities are of particular interest when assessing the risk to well managed control systems which have already effectively mitigated the publicly known vulnerabilities. In these well managed systems the risk contribution from 0Days will have proportionally increased. To aid understanding of how great a risk 0Days may pose to control systems, an estimate of how many are in existence is needed. Consequently, using the 0Day definition given above, we developed and applied a method for estimating how many 0Day vulnerabilities are in existence on any given day. The estimate is made by: empirically characterizing the distribution of the lifespans, measured in days, of 0Day vulnerabilities; determining the number of vulnerabilities publicly announced each day; and applying a novel method for estimating the number of 0Day vulnerabilities in existence on any given day using the number of vulnerabilities publicly announced each day and the previously derived distribution of 0Day lifespans. The method was first applied to a general set of software applications by analyzing the 0Day lifespans of 491 software vulnerabilities and using the daily rate of vulnerability announcements in the National Vulnerability Database. This led to a conservative estimate that in the worst year there were, on average, 2500 0Day software related vulnerabilities in existence on any given day. Using a smaller but intriguing set of 15 0Day software vulnerability lifespans representing the actual time from discovery to public disclosure, we then made a more aggressive estimate. In this case, we estimated that in the worst year there were, on average, 4500 0Day software vulnerabilities in existence on any given day. We then proceeded to identify the subset of software applications likely to be used in some

  16. Data Gathering Bias: Trait Vulnerability to Psychotic Symptoms?

    PubMed Central

    Catalan, Ana; Simons, Claudia J. P.; Bustamante, Sonia; Olazabal, Nora; Ruiz, Eduardo; Gonzalez de Artaza, Maider; Penas, Alberto; Maurottolo, Claudio; González, Andrea; van Os, Jim; Gonzalez-Torres, Miguel Angel

    2015-01-01

    Background Jumping to conclusions (JTC) is associated with psychotic disorder and psychotic symptoms. If JTC represents a trait, the rate should be (i) increased in people with elevated levels of psychosis proneness such as individuals diagnosed with borderline personality disorder (BPD), and (ii) show a degree of stability over time. Methods The JTC rate was examined in 3 groups: patients with first episode psychosis (FEP), BPD patients and controls, using the Beads Task. PANSS, SIS-R and CAPE scales were used to assess positive psychotic symptoms. Four WAIS III subtests were used to assess IQ. Results A total of 61 FEP, 26 BPD and 150 controls were evaluated. 29 FEP were revaluated after one year. 44% of FEP (OR = 8.4, 95% CI: 3.9–17.9) displayed a JTC reasoning bias versus 19% of BPD (OR = 2.5, 95% CI: 0.8–7.8) and 9% of controls. JTC was not associated with level of psychotic symptoms or specifically delusionality across the different groups. Differences between FEP and controls were independent of sex, educational level, cannabis use and IQ. After one year, 47.8% of FEP with JTC at baseline again displayed JTC. Conclusions JTC in part reflects trait vulnerability to develop disorders with expression of psychotic symptoms. PMID:26147948

  17. Imaging Coronary Atherosclerosis and Vulnerable Plaques with Optical Coherence Tomography

    NASA Astrophysics Data System (ADS)

    Tearney, Guillermo J.; Jang, Ik-Kyung; Kashiwagi, Manubu; Bouma, Brett E.

    Intracoronary optical coherence tomography (OCT) is an invasive microscopic imaging technology that has been developed for the identification of vulnerable plaque. OCT acquires cross-sectional images of tissue reflectance and, since it may be implemented through an optical fiber probe, it is readily adaptable to coronary catheters for insertion into coronary arteries and circumferential imaging of arterial pathology. The first investigation of vascular optical coherence tomography ex vivo demonstrated the potential of this technique to identify arterial microstructure. Subsequent development of OCT technology enabled image acquisition at rates sufficient for intracoronary imaging in human patients. In this chapter, we review studies conducted with this technology at the Massachusetts General Hospital (MGH). Results from these studies show that a wide variety of microscopic features, including those associated with TCFAs, can be identified by OCT imaging both ex vivo and in living human patients. These findings suggest that this technology will play an important role in improving our understanding of coronary artery disease, guiding local therapy, and decreasing themortality of AMI.

  18. Computational discovery of pathway-level genetic vulnerabilities in non-small-cell lung cancer

    PubMed Central

    Young, Jonathan H.; Peyton, Michael; Seok Kim, Hyun; McMillan, Elizabeth; Minna, John D.; White, Michael A.; Marcotte, Edward M.

    2016-01-01

    Motivation: Novel approaches are needed for discovery of targeted therapies for non-small-cell lung cancer (NSCLC) that are specific to certain patients. Whole genome RNAi screening of lung cancer cell lines provides an ideal source for determining candidate drug targets. Results: Unsupervised learning algorithms uncovered patterns of differential vulnerability across lung cancer cell lines to loss of functionally related genes. Such genetic vulnerabilities represent candidate targets for therapy and are found to be involved in splicing, translation and protein folding. In particular, many NSCLC cell lines were especially sensitive to the loss of components of the LSm2-8 protein complex or the CCT/TRiC chaperonin. Different vulnerabilities were also found for different cell line subgroups. Furthermore, the predicted vulnerability of a single adenocarcinoma cell line to loss of the Wnt pathway was experimentally validated with screening of small-molecule Wnt inhibitors against an extensive cell line panel. Availability and implementation: The clustering algorithm is implemented in Python and is freely available at https://bitbucket.org/youngjh/nsclc_paper. Contact: marcotte@icmb.utexas.edu or jon.young@utexas.edu Supplementary information: Supplementary data are available at Bioinformatics online. PMID:26755624

  19. Radiological impact of composite food served at PINSTECH.

    PubMed

    Jabbar, T; Akhter, P; Khan, K; Jabbar, A; Saleem, K

    2009-06-01

    To determine radiological impact of composite food served at Pakistan Institute of Nuclear Science and Technology (PINSTECH) on its worker, cooked meals were collected during 2000-2007 and analysed by gamma and beta radiometry techniques for naturally occurring radionuclides and fission fragments. The only measurable radionuclide was naturally occurring (40)K. Its activity range was 40+/-1.5 to 182.4+/-3.8 Bq kg(-1) with cumulative average value of 89.4+/-35.1 Bq kg(-1). Based on annual meals taken by the worker in cafeteria, the measured value gives committed effective dose of 74 microSv and estimated cancer risk factor of 1.5 x 10(-4) that is a minor fraction of the total risk of 5 x 10(-3). It depicts that food served at PINSTECH cafeteria is radiologically safe for consumption. PMID:19233243

  20. Strategic bidding for load serving entity in electricity markets

    NASA Astrophysics Data System (ADS)

    AlZahrani, Hashim A.

    The objective of this thesis is to study different options of load serving entities (LSEs) in electricity markets. Two models of pool-based electricity market have been studied. The difference between them is in the effect of transmission constraints. Transmission Constraints are neglected in the first model. Various bidding scenarios are presented in the first model to study the effect of retail, interruptible, and bidding prices on the profit of single LSE utilizing Monte Carlo simulation method. Genetic algorithm optimization tool is used to get the optimal bidding. In the second model, a new approach is presented to study the impact of transmission constraints (TCs) on the profit of LSE and its bidding strategy utilizing IEEE 30 bus system. Different pricing settlements then tested the effects of TCs to investigate the best pricing option. It has been shown that the first rejected bid settlement is the best selection for load serving entity.