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Sample records for adjusted medical loss

  1. 45 CFR 158.340 - Process for submitting request for adjustment to the medical loss ratio.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... the medical loss ratio. 158.340 Section 158.340 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES REQUIREMENTS RELATING TO HEALTH CARE ACCESS ISSUER USE OF PREMIUM REVENUE: REPORTING AND REBATE REQUIREMENTS... by the Secretary. (b) Submission by mail. A State may also submit by overnight delivery service or...

  2. Medications for Memory Loss

    MedlinePlus

    ... memory loss, confusion, and problems with thinking and reasoning) of Alzheimer's disease. As Alzheimer’s progresses, brain cells ... the latest Alzheimer's medications available today, and the clinical trials that may bring us closer to new ...

  3. 45 CFR 800.203 - Medical loss ratio.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 45 Public Welfare 3 2014-10-01 2014-10-01 false Medical loss ratio. 800.203 Section 800.203 Public... PROGRAM Premiums, Rating Factors, Medical Loss Ratios, and Risk Adjustment § 800.203 Medical loss ratio. (a) Required medical loss ratio. An MSPP issuer must attain: (1) The medical loss ratio...

  4. 45 CFR 800.203 - Medical loss ratio.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 45 Public Welfare 3 2013-10-01 2013-10-01 false Medical loss ratio. 800.203 Section 800.203 Public... PROGRAM Premiums, Rating Factors, Medical Loss Ratios, and Risk Adjustment § 800.203 Medical loss ratio. (a) Required medical loss ratio. An MSPP issuer must attain: (1) The medical loss ratio...

  5. Weight-loss medications

    MedlinePlus

    ... this page: //medlineplus.gov/ency/patientinstructions/000346.htm Weight-loss medicines To use the sharing features on this page, please enable JavaScript. Several weight-loss medicines are available. Ask your health care provider ...

  6. 45 CFR 1160.10 - Loss adjustment.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 45 Public Welfare 3 2014-10-01 2014-10-01 false Loss adjustment. 1160.10 Section 1160.10 Public Welfare Regulations Relating to Public Welfare (Continued) NATIONAL FOUNDATION ON THE ARTS AND THE HUMANITIES FEDERAL COUNCIL ON THE ARTS AND THE HUMANITIES INDEMNITIES UNDER THE ARTS AND ARTIFACTS...

  7. 45 CFR 1160.10 - Loss adjustment.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 45 Public Welfare 3 2012-10-01 2012-10-01 false Loss adjustment. 1160.10 Section 1160.10 Public Welfare Regulations Relating to Public Welfare (Continued) NATIONAL FOUNDATION ON THE ARTS AND THE HUMANITIES FEDERAL COUNCIL ON THE ARTS AND THE HUMANITIES INDEMNITIES UNDER THE ARTS AND ARTIFACTS...

  8. 45 CFR 1160.10 - Loss adjustment.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 45 Public Welfare 3 2013-10-01 2013-10-01 false Loss adjustment. 1160.10 Section 1160.10 Public Welfare Regulations Relating to Public Welfare (Continued) NATIONAL FOUNDATION ON THE ARTS AND THE HUMANITIES FEDERAL COUNCIL ON THE ARTS AND THE HUMANITIES INDEMNITIES UNDER THE ARTS AND ARTIFACTS...

  9. 45 CFR 1160.10 - Loss adjustment.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 45 Public Welfare 3 2010-10-01 2010-10-01 false Loss adjustment. 1160.10 Section 1160.10 Public Welfare Regulations Relating to Public Welfare (Continued) NATIONAL FOUNDATION ON THE ARTS AND THE HUMANITIES FEDERAL COUNCIL ON THE ARTS AND THE HUMANITIES INDEMNITIES UNDER THE ARTS AND ARTIFACTS...

  10. 45 CFR 1160.10 - Loss adjustment.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 45 Public Welfare 3 2011-10-01 2011-10-01 false Loss adjustment. 1160.10 Section 1160.10 Public Welfare Regulations Relating to Public Welfare (Continued) NATIONAL FOUNDATION ON THE ARTS AND THE HUMANITIES FEDERAL COUNCIL ON THE ARTS AND THE HUMANITIES INDEMNITIES UNDER THE ARTS AND ARTIFACTS...

  11. Medical Adjustment Services for the Severely Handicapped

    ERIC Educational Resources Information Center

    Carter, R. Edward

    1978-01-01

    Management of a spinal cord injury is used as a model to discuss the medical adjustment problems occurring with severe physical handicaps. Topics include the stages of preadmission/admission rehabilitation evaluation, comprehensive rehabilitation treatment, patient communication, patient and family conference, and discharge and follow-up. This…

  12. Revenge and psychological adjustment after homicidal loss.

    PubMed

    van Denderen, Mariëtte; de Keijser, Jos; Gerlsma, Coby; Huisman, Mark; Boelen, Paul A

    2014-01-01

    Feelings of revenge are a common human response to being hurt by others. Among crime victims of severe sexual or physical violence, significant correlations have been reported between revenge and Posttraumatic Stress Disorder (PTSD). Homicide is one of the most severe forms of interpersonal violence. It is therefore likely that individuals bereaved by homicide experience high levels of revenge, which may hamper efforts to cope with traumatic loss. The relationship between revenge and psychological adjustment following homicidal loss has not yet been empirically examined. In the current cross-sectional study, we used self-report data from 331 spouses, family members and friends of homicide victims to examine the relationships between dispositional revenge and situational revenge on the one hand and symptom-levels of PTSD and complicated grief, as well as indices of positive functioning, on the other hand. Furthermore, the association between revenge and socio-demographic and offense-related factors was examined. Participants were recruited from a governmental support organization, a website with information for homicidally bereaved individuals, and members of support groups. Levels of both dispositional and situational revenge were positively associated with symptoms of PTSD and complicated grief, and negatively with positive functioning. Participants reported significantly less situational revenge in cases where the perpetrator was a direct family member than cases where the perpetrator was an indirect family member, friend, or someone unknown. Homicidally bereaved individuals reported more situational revenge, but not more dispositional revenge than a sample of students who had experienced relatively mild interpersonal transgressions. PMID:24910007

  13. 48 CFR 49.203 - Adjustment for loss.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... Convenience 49.203 Adjustment for loss. (a) In the negotiation or determination of any settlement, the TCO... contract been completed. The TCO shall negotiate or determine the amount of loss and make an adjustment in... complete, the TCO shall consider expected production efficiencies and other factors affecting the cost...

  14. 48 CFR 49.203 - Adjustment for loss.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... Convenience 49.203 Adjustment for loss. (a) In the negotiation or determination of any settlement, the TCO... contract been completed. The TCO shall negotiate or determine the amount of loss and make an adjustment in... complete, the TCO shall consider expected production efficiencies and other factors affecting the cost...

  15. 7 CFR 400.405 - Agent and loss adjuster responsibilities.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... Regulations; Collection and Storage of Social Security Account Numbers and Employer Identification Numbers... establishing a database for the purposes of: (1) Identifying agents and loss adjusters on an individual...

  16. 7 CFR 400.405 - Agent and loss adjuster responsibilities.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... Regulations; Collection and Storage of Social Security Account Numbers and Employer Identification Numbers... establishing a database for the purposes of: (1) Identifying agents and loss adjusters on an individual...

  17. 42 CFR 412.322 - Indirect medical education adjustment factor.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 2 2013-10-01 2013-10-01 false Indirect medical education adjustment factor. 412... HUMAN SERVICES MEDICARE PROGRAM PROSPECTIVE PAYMENT SYSTEMS FOR INPATIENT HOSPITAL SERVICES Prospective... Capital-Related Costs § 412.322 Indirect medical education adjustment factor. (a) Basic data....

  18. 42 CFR 412.322 - Indirect medical education adjustment factor.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 2 2011-10-01 2011-10-01 false Indirect medical education adjustment factor. 412... HUMAN SERVICES MEDICARE PROGRAM PROSPECTIVE PAYMENT SYSTEMS FOR INPATIENT HOSPITAL SERVICES Prospective... Capital-Related Costs § 412.322 Indirect medical education adjustment factor. (a) Basic data....

  19. 42 CFR 412.322 - Indirect medical education adjustment factor.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 2 2012-10-01 2012-10-01 false Indirect medical education adjustment factor. 412... HUMAN SERVICES MEDICARE PROGRAM PROSPECTIVE PAYMENT SYSTEMS FOR INPATIENT HOSPITAL SERVICES Prospective... Capital-Related Costs § 412.322 Indirect medical education adjustment factor. (a) Basic data....

  20. 42 CFR 412.322 - Indirect medical education adjustment factor.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 2 2014-10-01 2014-10-01 false Indirect medical education adjustment factor. 412... HUMAN SERVICES MEDICARE PROGRAM PROSPECTIVE PAYMENT SYSTEMS FOR INPATIENT HOSPITAL SERVICES Prospective... Capital-Related Costs § 412.322 Indirect medical education adjustment factor. (a) Basic data....

  1. 42 CFR 412.322 - Indirect medical education adjustment factor.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... Payment System for Inpatient Hospital Capital Costs Basic Methodology for Determining the Federal Rate for Capital-Related Costs § 412.322 Indirect medical education adjustment factor. (a) Basic data. CMS... 42 Public Health 2 2010-10-01 2010-10-01 false Indirect medical education adjustment factor....

  2. Recovering from Loss: A Qualitative Study Examining Student Loss While in Medical School

    ERIC Educational Resources Information Center

    Yokota, Mitsue

    2011-01-01

    Recovering from the loss of a loved one can be difficult for anyone, but it can be especially trying for individuals already dealing with elevated levels of stress. Various studies have looked at the causes of stress in medical school students, but little has been done to understand the adjustments these students undergo after experiencing the…

  3. 7 CFR 400.405 - Agent and loss adjuster responsibilities.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 6 2010-01-01 2010-01-01 false Agent and loss adjuster responsibilities. 400.405 Section 400.405 Agriculture Regulations of the Department of Agriculture (Continued) FEDERAL CROP INSURANCE CORPORATION, DEPARTMENT OF AGRICULTURE GENERAL ADMINISTRATIVE REGULATIONS General Administrative Regulations; Collection and Storage of...

  4. Sleep loss and fatigue in medical training.

    PubMed

    Owens, J A

    2001-11-01

    The effects of sleep loss and fatigue in the context of medical training is a topic that has generated considerable interest, as well as controversy, over the past two decades. The sleep deprived state in medical trainees potentially impacts on a variety of domains relevant to medical care, including performance on neurobehavioral and work-related tasks, mood and affect, learning, risk for and commission of medical errors, and the health and well-being of medical students and residents. The following review provides a summary of research conducted on this topic in the past decade, including the relation of sleep loss and fatigue to medical errors and the quality of patient care. Those few studies that have analyzed the use of operational alertness management strategies, countermeasures, and educational interventions to address and mitigate the effects of sleep loss and fatigue are also reviewed. There is clearly a need for additional research to further explore the complex interaction between sleep and fatigue and medical care, and to support the development and implementation of regulatory policies based on sound science. PMID:11706318

  5. Medical loss ratio regulation under the Affordable Care Act.

    PubMed

    Harrington, Scott E

    2013-01-01

    The minimum medical loss ratio (MLR) regulations in the Affordable Care Act guarantee that a specific percentage of health insurance premiums is spent on medical care and specified activities to improve health care quality. This paper analyzes the regulations' potential unintended consequences and incentive effects, including: higher medical costs and premiums for some insurers; less innovation to align consumer, provider, and health plan incentives, less consumer choice and increased market concentration; and the risk that insurers will pay rebates if claim costs are lower than projected when premiums are established, despite the regulations' permitted "credibility adjustments." The paper discusses modifications and alternatives to the MLR regulations to help achieve their stated goals with less potential for adverse effects. PMID:23720876

  6. Nonlinear optical losses in medical fibers

    NASA Astrophysics Data System (ADS)

    Ozols, Andris O.; Ivanovs, Girts; Coders, Guntars

    1997-02-01

    Attenuation intensity dependences of 1064 nm and 532 nm picosecond pulses in multimode optical fibers produced for medical purposes by 'Anda' factory in Livani, Latvia are experimentally studied. A strong linear growth of inverse transmittance with intensity is found. The possible mechanism of nonlinear losses are analyzed and the conclusion is made that the observed effect is mainly due to the two-photon absorption involving defects levels. Strong attenuation intensity dependence can be used to make such fiber optical devices as light power limiters, optically driven light modulators and dynamic holographic frequency filters.

  7. Irrational Thinking and Adjustment to Loss of Vision.

    ERIC Educational Resources Information Center

    Needham, Walter E.; Ehmer, Marjy N.

    1980-01-01

    Individual differences in adjusting to or coping with blindness appear related to the presence or absence of certain irrational belief statements about this disability. Mythology regarding blind people is discussed and methods by which individuals can rid themselves of or be helped to eliminate these irrational beliefs are described. (Author)

  8. 45 CFR 158.210 - Minimum medical loss ratio.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 45 Public Welfare 1 2014-10-01 2014-10-01 false Minimum medical loss ratio. 158.210 Section 158.210 Public Welfare Department of Health and Human Services REQUIREMENTS RELATING TO HEALTH CARE ACCESS... § 158.210 Minimum medical loss ratio. Subject to the provisions of § 158.211 of this subpart: (a)...

  9. 45 CFR 158.210 - Minimum medical loss ratio.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 45 Public Welfare 1 2011-10-01 2011-10-01 false Minimum medical loss ratio. 158.210 Section 158.210 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES REQUIREMENTS RELATING TO HEALTH CARE ACCESS... § 158.210 Minimum medical loss ratio. Subject to the provisions of § 158.211 of this subpart: (a)...

  10. 45 CFR 158.210 - Minimum medical loss ratio.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 45 Public Welfare 1 2012-10-01 2012-10-01 false Minimum medical loss ratio. 158.210 Section 158.210 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES REQUIREMENTS RELATING TO HEALTH CARE ACCESS... § 158.210 Minimum medical loss ratio. Subject to the provisions of § 158.211 of this subpart: (a)...

  11. Locus of Control and School Adjustment Following the Loss of a Parent.

    ERIC Educational Resources Information Center

    Enos, Thomas A.; Hartman, Bruce W.

    This study investigates whether students experiencing difficulty adapting to parental loss also feel they have little or no control over life events; whether an inability to adapt to the stress of parental loss surfaces as a school adjustment problem; and whether these relationships are stronger for students losing a parent through death than…

  12. Pattern hair loss in men: diagnosis and medical treatment.

    PubMed

    Banka, Nusrat; Bunagan, M J Kristine; Shapiro, Jerry

    2013-01-01

    Androgenetic alopecia is a common cause of hair loss in both men and women. The exact pathogenesis of androgenetic alopecia is not well understood. As the name implies, the role of androgens and genetic susceptibility predisposes to pattern hair loss due to gradual conversion of terminal hair into vellus hair. Male and female pattern hair loss are clinically distinct entities but histologically indistinguishable. The role of sex hormones in females is less understood. This article discusses current understanding of the etiopathogenesis of hair loss in men, diagnostic tests available, and its medical management. PMID:23159182

  13. 38 CFR 10.4 - Loss, destruction, or mutilation of adjusted service certificate while in possession of...

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2011-07-01 2011-07-01 false Loss, destruction, or mutilation of adjusted service certificate while in possession of Department of Veterans Affairs. 10.4... Adjusted Compensation; General § 10.4 Loss, destruction, or mutilation of adjusted service...

  14. 38 CFR 10.4 - Loss, destruction, or mutilation of adjusted service certificate while in possession of...

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2014-07-01 2014-07-01 false Loss, destruction, or mutilation of adjusted service certificate while in possession of Department of Veterans Affairs. 10.4... Adjusted Compensation; General § 10.4 Loss, destruction, or mutilation of adjusted service...

  15. 38 CFR 10.4 - Loss, destruction, or mutilation of adjusted service certificate while in possession of...

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Loss, destruction, or mutilation of adjusted service certificate while in possession of Department of Veterans Affairs. 10.4... Adjusted Compensation; General § 10.4 Loss, destruction, or mutilation of adjusted service...

  16. 38 CFR 10.4 - Loss, destruction, or mutilation of adjusted service certificate while in possession of...

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2012-07-01 2012-07-01 false Loss, destruction, or mutilation of adjusted service certificate while in possession of Department of Veterans Affairs. 10.4... Adjusted Compensation; General § 10.4 Loss, destruction, or mutilation of adjusted service...

  17. 38 CFR 10.4 - Loss, destruction, or mutilation of adjusted service certificate while in possession of...

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2013-07-01 2013-07-01 false Loss, destruction, or mutilation of adjusted service certificate while in possession of Department of Veterans Affairs. 10.4... Adjusted Compensation; General § 10.4 Loss, destruction, or mutilation of adjusted service...

  18. Gender, Pre-loss Marital Dependence, and Older Adults Adjustment to Widowhood

    ERIC Educational Resources Information Center

    Carr, Deborah

    2004-01-01

    I examine how pre-loss emotional and instrumental dependence on one's spouse affects older adults psychological adjustment to widowhood. Analyses are based on 297 persons from the Changing Lives of Older Couples CLOC study, a prospective study of widowhood among adults aged 65 and older. Women who were most emotionally dependent on their spouses…

  19. Spouse Adjustment to Spinal Cord Injury: Long-Term Medical and Psychosocial Factors.

    ERIC Educational Resources Information Center

    Kester, Barbara L.; And Others

    1988-01-01

    Examined female's adjustment (N=25) to a partner's spinal cord injury (SCI) as a function of time since injury. Found that spouse adjustment to the effects of living with a partner who had a SCI was a highly stressful process with major medical and psychosocial consequences. (Author/ABL)

  20. Denial and External Locus of Control as Mechanisms of Adjustment in Chronic Medical Illness

    ERIC Educational Resources Information Center

    Goldstein, Alan M.

    1976-01-01

    Adjustment of patients with a serious medical condition to psychological stress accompanying their disorder was investigated. Long-term hemodialysis patients (N=22) and 24 patients in recovery stages of minor medical problems were experimental and control subjects. A significant relationship was found between denial and external locus of control…

  1. Adjusting Treatment for an Inmate-Patient Receiving Medication Involuntarily.

    PubMed

    Williams, Joseph B

    2015-06-01

    Correctional psychiatrists can pursue authorization for forcible medication of pretrial detainees housed in a federal prison hospital through two pathways: an administrative process based upon the U.S. Supreme Court decision in Washington v. Harper and a judicial process founded on the Court's ruling in Sell v. United States. The pathway associated with Harper pertains to the involuntary treatment of a mentally ill inmate believed to be dangerous or gravely disabled, or both, to protect the inmate-patient and others from harm, whereas the avenue linked with Sell involves the forcible treatment of an incompetent pretrial defendant to restore competence to stand trial. Given the difference in objectives between these two processes, there is rarely confusion regarding which pathway the correctional psychiatrist should pursue. However, circumstances can arise that blur the distinction between the Harper and Sell processes. I present a composite case highlighting such a scenario and provide discussion and commentary to assist the correctional psychiatrist in deciding on the most appropriate course of action. PMID:26071513

  2. Sleep Loss in Resident Physicians: The Cause of Medical Errors?

    PubMed Central

    Kramer, Milton

    2010-01-01

    This review begins with the history of the events starting with the death of Libby Zion that lead to the Bell Commission, that the studied her death and made recommendations for improvement that were codified into law in New York state as the 405 law that the ACGME essentially adopted in putting a cap on work hours and establishing the level of staff supervision that must be available to residents in clinical situations particularly the emergency room and acute care units. A summary is then provided of the findings of the laboratory effects of total sleep deprivation including acute total sleep loss and the consequent widespread physiologic alterations, and of the effects of selective and chronic sleep loss. Generally the sequence of responses to increasing sleep loss goes from mood changes to cognitive effects to performance deficits. In the laboratory situation, deficits resulting from sleep deprivation are clearly and definitively demonstrable. Sleep loss in the clinical situation is usually sleep deprivation superimposed on chronic sleep loss. An examination of questionnaire studies, the literature on reports of sleep loss, studies of the reduction of work hours on performance as well as observational and a few interventional studies have yielded contradictory and often equivocal results. The residents generally find they feel better working fewer hours but improvements in patient care are often not reported or do not occur. A change in the attitude of the resident toward his role and his patient has not been salutary. Decreasing sleep loss should have had a positive effect on patient care in reducing medical error, but this remains to be unequivocally demonstrated. PMID:21188260

  3. Pesticide residues in eggs of wild birds: Adjustment for loss of moisture and lipid

    USGS Publications Warehouse

    Stickel, L.F.; Wiemeyer, Stanley N.; Blus, L.J.

    1973-01-01

    Eggs of wild birds collected for the purpose of measuring concentrations of pesticides or other pollutants vary from nearly fresh to nearly dry so that objective comparisons cannot be made on the basis of weight of the contents at the time of collection. Residue concentrations in the nearly dry eggs can be greatly exaggerated by this artifact. Valid interpretation of residue data depends upon compensation for these losses. A method is presented for making adjustments on the basis of volume of the egg, and formulas are derived for estimating the volume of eggs of eagles, ospreys, and pelicans from egg measurements. The possibility of adjustments on the basis of percentage of moisture, solids, or fat in fresh eggs is discussed also.

  4. Adjusting to Hearing Loss during High School: Preparing Students for Successful Transition to Postsecondary Education or Training. Tipsheet

    ERIC Educational Resources Information Center

    Brooks, Dianne

    2009-01-01

    Completion of postsecondary education frequently builds upon a student's successful academic and personal experience during high school. For students with hearing loss, healthy adjustment to hearing loss is a key lifelong developmental process. The vast majority (94%) of approximately 1.1 million K-12 students with hearing loss are educated in…

  5. Masculinity, Femininity, and Psychosocial Adjustment in Medical Students: Two-Year Follow-Up.

    ERIC Educational Resources Information Center

    Zeldow, Peter B.; And Others

    Although research on masculinity and femininity has increased over the past decade, longitudinal studies addressing predictive elements are lacking. The Rush Medical College Longitudinal Study examines the correlation between masculinity and femininity on the one hand and adjustment, interpersonal functioning, and impairment on the other. During…

  6. 78 FR 27873 - Computation of, and Rules Relating to, Medical Loss Ratio

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-13

    ... Internal Revenue Service 26 CFR Part 1 RIN 1545-BL05 Computation of, and Rules Relating to, Medical Loss... applying the medical loss ratio added to the Internal Revenue Code by the Patient Protection and Affordable... Public Health Service Act), a ratio referred to for this purpose as the medical loss ratio (MLR), is...

  7. The "How" and "When" of Parental Loss in Adulthood: Effects on Grief and Adjustment.

    PubMed

    Hayslip, Bert; Pruett, Jessica H; Caballero, Daniela M

    2015-01-01

    In order to evaluate the role of cause of death on the grief responses of parentally bereaved young and middle-aged adults, 400 individuals completed measures assessing their experiences and feelings surrounding the loss of a parent. Respondents included 247 young adults and 155 middle-aged adults. Cause of death was categorized as acute or anticipated with 209 participants reporting the parent's death as acute, while anticipated death was reported by 191 individuals. Results suggested that gender of the adult child and age level of the participant were important factors contributing to the grief response, and women were found to have more difficulty adjusting to the loss of a parent as well as demonstrating a more intense grief response. Young adults were found to be more impacted by the loss of a parent than were middle-aged adults. Those who were single or separated were similarly more impacted versus those who were married, where more young adults were single/separated and more middle-aged adults were married. Cause of death was only mildly influential in influencing responses to parental loss and did not interact with other studied variables. These results point to the importance of support from others in coping with a parent's death as well as for the counseling of bereaved persons who may be at risk for difficulties in coping with the death of a parent and enable a more precise understanding of individual grief processes across the adult lifespan. PMID:26152024

  8. Beam filling loss adjustments for ASR-9 weather channel reflectivity estimates

    NASA Astrophysics Data System (ADS)

    Engholm, Cynthia D.; Troxel, Seth W.

    1990-10-01

    The FAA is deploying over 100 new airport surveillance radars (ASR-9) across the country. In contrast to earlier ASRs, the ASR-9 utilizes a separate digital weather processing channel to provide air traffic controllers with timely, calibrated displays of precipitation intensity. The ASR-9 utilizes dual selectable fan shaped elevation beams designed to track aircraft over a large volume. As a consequence, weather echoes received from these fan shaped beams represent vertically averaged quantities. If the precipitation only partially or nonuniformly fills the beam, then the vertically integrated reflectivity may underestimate the actual intensity of the storm. The ASR-9 weather channel corrects for this by adjusting the range dependent six level reflectivity thresholds. The appropriateness of the currently implemented correction has not been carefully examined and may require modification to take into account regional and morphological variability in storm structure. The method used to derive new beam filling loss adjustments is discussed. An extensive database of volumetric pencil beam radar data were used in conjunction with the ASR-9 simulation facility to derive adjustments aimed at calibrating the precipitation intensity reports to the maximum perceived hazard. Results from this calibration indicate that a single correction is appropriate for all sites and intensities. The new corrections yield substantially improved results over the current corrections in producing these reflectivity reports.

  9. Do Afterlife Beliefs Affect Psychological Adjustment to Late-Life Spousal Loss?

    PubMed Central

    2014-01-01

    Objectives. We explore whether beliefs about the existence and nature of an afterlife affect 5 psychological symptoms (anxiety, anger, depression, intrusive thoughts, and yearning) among recently bereaved older spouses. Method. We conduct multivariate regression analyses using data from the Changing Lives of Older Couples (CLOC), a prospective study of spousal loss. The CLOC obtained data from bereaved persons prior to loss and both 6 and 18 months postloss. All analyses are adjusted for health, sociodemographic characteristics, and preloss marital quality. Results. Bleak or uncertain views about the afterlife are associated with multiple aspects of distress postloss. Uncertainty about the existence of an afterlife is associated with elevated intrusive thoughts, a symptom similar to posttraumatic distress. Widowed persons who do not expect to be reunited with loved ones in the afterlife report significantly more depressive symptoms, anger, and intrusive thoughts at both 6 and 18 months postloss. Discussion. Beliefs in an afterlife may be maladaptive for coping with late-life spousal loss, particularly if one is uncertain about its existence or holds a pessimistic view of what the afterlife entails. Our findings are broadly consistent with recent work suggesting that “continuing bonds” with the decedent may not be adaptive for older bereaved spouses. PMID:23811692

  10. 38 CFR 10.2 - Evidence required of loss, destruction or mutilation of adjusted service certificate.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ..., destruction or mutilation of adjusted service certificate. 10.2 Section 10.2 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS ADJUSTED COMPENSATION Adjusted Compensation; General § 10.2... an adjusted service certificate issued pursuant to the provisions of section 501 of the World...

  11. 38 CFR 10.2 - Evidence required of loss, destruction or mutilation of adjusted service certificate.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ..., destruction or mutilation of adjusted service certificate. 10.2 Section 10.2 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS ADJUSTED COMPENSATION Adjusted Compensation; General § 10.2... an adjusted service certificate issued pursuant to the provisions of section 501 of the World...

  12. Tropical cyclone losses in the USA and the impact of climate change - A trend analysis based on data from a new approach to adjusting storm losses

    SciTech Connect

    Schmidt, Silvio; Hoeppe, Peter

    2009-11-15

    Economic losses caused by tropical cyclones have increased dramatically. Historical changes in losses are a result of meteorological factors (changes in the incidence of severe cyclones, whether due to natural climate variability or as a result of human activity) and socio-economic factors (increased prosperity and a greater tendency for people to settle in exposed areas). This paper aims to isolate the socio-economic effects and ascertain the potential impact of climate change on this trend. Storm losses for the period 1950-2005 have been adjusted to the value of capital stock in 2005 so that any remaining trend cannot be ascribed to socio-economic developments. For this, we introduce a new approach to adjusting losses based on the change in capital stock at risk. Storm losses are mainly determined by the intensity of the storm and the material assets, such as property and infrastructure, located in the region affected. We therefore adjust the losses to exclude increases in the capital stock of the affected region. No trend is found for the period 1950-2005 as a whole. In the period 1971-2005, since the beginning of a trend towards increased intense cyclone activity, losses excluding socio-economic effects show an annual increase of 4% per annum. This increase must therefore be at least due to the impact of natural climate variability but, more likely than not, also due to anthropogenic forcings.

  13. Rates of Bone Loss Among Women Initiating Antidepressant Medication Use in Midlife

    PubMed Central

    Ruppert, Kristine; Cauley, Jane A.; Lian, YinJuan; Bromberger, Joyce T.; Finkelstein, Joel S.; Greendale, Gail A.; Solomon, Daniel H.

    2013-01-01

    Context: Concern has been raised that medications that block serotonin reuptake may affect bone metabolism, resulting in bone loss. Objective: The aim of the study was to compare annual bone mineral density (BMD) changes among new users of selective serotonin reuptake inhibitors (SSRIs), new users of tricyclic antidepressants (TCAs), and nonusers of antidepressant medications. Design and Setting: We conducted a prospective cohort study at five clinical centers in the United States. Participants: The study included 1972 community-dwelling women, aged 42 years and older, enrolled in the Study of Women's Health Across the Nation (SWAN). Exposure: The use of antidepressant medications was assessed by interview and verified from medication containers at annual visits. Subjects were categorized as nonusers (no SSRI or TCA use at any examination), SSRI users (initiated SSRI use after the baseline SWAN visit), or TCA users (initiated TCA use after the baseline visit), using a computerized dictionary to categorize type of medication. Main Outcome Measures: BMD at the lumbar spine, total hip, and femoral neck was measured using dual-energy x-ray absorptiometry at annual visits. Results: BMD was compared among 311 new users of SSRIs, 71 new users of TCAs, and 1590 nonusers. After adjustment for potential confounders, including age, race, body mass index, menopausal status, and hormone therapy use, mean lumbar spine BMD decreased on average 0.68% per year in nonusers, 0.63% per year in SSRI users (P = .37 for comparison to nonusers), and 0.40% per year in TCA users (P = .16 for comparison to nonusers). At the total hip and femoral neck, there was also no evidence that SSRI or TCA users had an increased rate of bone loss compared with nonusers. Results were similar in subgroups of women stratified by the Center for Epidemiologic Studies Depression Scale (<16 vs ≥16). Conclusions: In this cohort of middle-aged women, use of SSRIs and TCAs was not associated with an increased

  14. 78 FR 53702 - Computation of, and Rules Relating to, Medical Loss Ratio; Hearing Cancellation

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-30

    ... 13, 2013 (78 FR 27873) announced that a public hearing was scheduled for September 17, 2013, at 10 a... Internal Revenue Service 26 CFR Part 1 RIN 1545-BL05 Computation of, and Rules Relating to, Medical Loss... health care organizations, on computing and applying the medical loss ratio added to the Internal...

  15. 78 FR 43820 - Medicare Program; Medical Loss Ratio Requirements for the Medicare Advantage and the Medicare...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-07-22

    ... Program; Medical Loss Ratio Requirements for the Medicare Advantage and the Medicare Prescription Drug...; Medical Loss Ratio Requirements for the Medicare Advantage and the Medicare Prescription Drug Benefit... In FR Doc. 2013-12156 of May 23, 2013 (78 FR 31284), there were a number of technical,...

  16. 42 CFR 422.2420 - Calculation of the medical loss ratio.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 3 2013-10-01 2013-10-01 false Calculation of the medical loss ratio. 422.2420 Section 422.2420 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM (CONTINUED) MEDICARE ADVANTAGE PROGRAM Requirements for a Minimum Medical Loss Ratio § 422.2420 Calculation...

  17. 48 CFR 1602.170-14 - FEHB-specific medical loss ratio threshold calculation.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 48 Federal Acquisition Regulations System 6 2011-10-01 2011-10-01 false FEHB-specific medical loss... OFFICE OF PERSONNEL MANAGEMENT FEDERAL EMPLOYEES HEALTH BENEFITS ACQUISITION REGULATION GENERAL DEFINITIONS OF WORDS AND TERMS Definitions of FEHBP Terms 1602.170-14 FEHB-specific medical loss...

  18. 75 FR 82277 - Health Insurance Issuers Implementing Medical Loss Ratio (MLR) Requirements Under the Patient...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-12-30

    ... HUMAN SERVICES 45 CFR Part 158 RIN 0950-AA06 Health Insurance Issuers Implementing Medical Loss Ratio... comments that appeared in the December 1, 2010 Federal Register (FR Doc 2010-29596 (75 FR 74864)) entitled ``Health Insurance Issuers Implementing Medical Loss Ratio (MLR) Requirements Under the Patient...

  19. 77 FR 28788 - Health Insurance Issuers Implementing Medical Loss Ratio (MLR) Under the Patient Protection and...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-05-16

    ... HUMAN SERVICES 45 CFR Part 158 Health Insurance Issuers Implementing Medical Loss Ratio (MLR) Under the... Federal Register on December 1, 2010, entitled ``Health Insurance Issuers Implementing Medical Loss Ratio... published in the Federal Register on December 30, 2010, entitled ``Health Insurance Issuers...

  20. The Effect of Undergraduate GPA Selectivity Adjustment on Pre-interview Ranking of Rural Medical School Applicants.

    ERIC Educational Resources Information Center

    Gilbert, Gregory Eastham; Blue, Amy Victoria; Basco, William Thomas, Jr.

    2003-01-01

    Almost all U.S. medical schools adjust applicants' GPAs based on the selectivity of applicants' undergraduate institutions. Analysis of data from 2,033 in-state applicants to the Medical University of South Carolina, 1996-99, found that this practice did not adversely affect the number of rural applicants offered admission interviews. (SV)

  1. Disaster-Driven Evacuation and Medication Loss: a Systematic Literature Review

    PubMed Central

    Ochi, Sae; Hodgson, Susan; Landeg, Owen; Mayner, Lidia; Murray, Virginia

    2014-01-01

    AIM: The aim of this systematic literature review was to identify the extent and implications of medication loss and the burden of prescription refill on medical relief teams following extreme weather events and other natural hazards. METHOD: The search strategy followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Key health journal databases (Medline, Embase, PsycINFO, Maternity and Infant Care, and Health Management Information Consortium (HMIC)) were searched via the OvidSP search engine. Search terms were identified by consulting MeSH terms. The inclusion criteria comprised articles published from January 2003 to August 2013, written in English and containing an abstract. The exclusion criteria included abstracts for conferences or dissertations, book chapters and articles written in a language other than English. A total of 70 articles which fulfilled the inclusion criteria were included in this systematic review. RESULTS: All relevant information was collated regarding medication loss, prescription loss and refills, and medical aids loss which indicated a significant burden on the medical relief teams. Data also showed the difficulty in filling prescriptions due to lack of information from the evacuees. People with chronic conditions are most at risk when their medication is not available. This systematic review also showed that medical aids such as eye glasses, hearing aids as well as dental treatment are a high necessity among evacuees. DISCUSSION: This systematic review revealed that a considerable number of patients lose their medication during evacuation, many lose essential medical aids such as insulin pens and many do not bring prescriptions with them when evacuated.. Since medication loss is partly a responsibility of evacuees, understanding the impact of medication loss may lead to raising awareness and better preparations among the patients and health care professionals. People who are not prepared could have

  2. Adjustable Gastric Band Surgery or Medical Management in Patients With Type 2 Diabetes: A Randomized Clinical Trial

    PubMed Central

    Ding, Su-Ann; Simonson, Donald C.; Wewalka, Marlene; Halperin, Florencia; Foster, Kathleen; Goebel-Fabbri, Ann; Hamdy, Osama; Clancy, Kerri; Lautz, David; Vernon, Ashley

    2015-01-01

    Context: Recommendations for surgical, compared with lifestyle and pharmacologically based, approaches for type 2 diabetes (T2D) management remain controversial. Objective: The objective was to compare laparoscopic adjustable gastric band (LAGB) to an intensive medical diabetes and weight management (IMWM) program for T2D. Design: This was designed as a prospective, randomized clinical trial. Setting: The setting was two Harvard Medical School-affiliated academic institutions. Interventions and Participants: A 12-month randomized trial comparing LAGB (n = 23) vs IMWM (n = 22) in persons aged 21–65 years with body mass index of 30–45 kg/m2, T2D diagnosed more than 1 year earlier, and glycated hemoglobin (HbA1c) ≥ 6.5% on antihyperglycemic medication(s). Main Outcome Measure: The proportion meeting the prespecified primary glycemic endpoint, defined as HbA1c < 6.5% and fasting glucose < 7.0 mmol/L at 12 months, on or off medication. Results: After randomization, five participants did not undergo the surgical intervention. Of the 40 initiating intervention (22 males/18 females; age, 51 ± 10 y; body mass index, 36.5 ± 3.7 kg/m2; diabetes duration, 9 ± 5 y; HbA1c, 8.2 ± 1.2%; 40% on insulin), the proportion meeting the primary glycemic endpoint was achieved in 33% of the LAGB patients and 23% of the IMWM patients (P = .457). HbA1c reduction was similar between groups at both 3 and 12 months (−1.2 ± 0.3 vs −1.0 ± 0.3%; P = .496). Weight loss was similar at 3 months but greater 12 months after LAGB (−13.5 ± 1.7 vs −8.5 ± 1.6 kg; P = .027). Systolic blood pressure reduction was greater after IMWM than LAGB, whereas changes in diastolic blood pressure, lipids, fitness, and cardiovascular risk scores were similar between groups. Patient-reported health status, assessed using the Short Form-36, Impact of Weight on Quality of Life, and Problem Areas in Diabetes, all improved similarly between groups. Conclusions: LAGB and a multidisciplinary IMWM program

  3. Optical sensors for therapeutic drug monitoring of antidepressants for a better medication adjustment

    NASA Astrophysics Data System (ADS)

    Krieg, Anne K.; Hess, Stefan; Gauglitz, Günter

    2013-05-01

    Therapeutic drug monitoring provides the attending physicians with detailed information on a patient's individual serum level especially during long-term medication. Due to the fact that each patient tolerates drugs or their metabolites differently a medication adjustment can reduce the number and intensity of noticeable side-effects. In particular, psychotropic drugs can cause unpleasant side-effects that affect a patient's life almost as much as the mental disease itself. The tricyclic antidepressants amitriptyline is commonly used for treatment of depressions and was selected for the development of an immunoassay using the direct optical sensor technique Reflectometric Interference Spectroscopy (RIfS). RIfS is a simple, robust and label-free method for direct monitoring of binding events on glass surfaces. Binding to the surface causes a shift of the interference spectrum by a change of the refractive index or physical thickness. This technique can be used for time-resolved observation of association and dissociation of amitriptyline (antigen) and a specific antibody using the binding inhibition test format. An amitriptyline derivative is immobilized on the sensor surface and a specific amount of antibodies can bind to the surface unless the binding is inhibited by free amitriptyline in a sample. No fluorescent label is needed making the whole assay less expensive than label-based methods. With this recently developed immunoassay amitriptyline concentrations in buffer (PBS) can easily be detected down to 500 ng/L.

  4. Use and abuse of the medical loss ratio to measure health plan performance.

    PubMed

    Robinson, J C

    1997-01-01

    This paper examines the use and abuse of the medical loss ratio in the contemporary health care system and health policy debate. It begins with a survey of the ways in which the medical loss ratio has been interpreted to be something it is not, such as a measure of quality or efficiency. It then analyzes key organizational features of the emerging health care system that complicate measures of financial performance, including integration between payers and providers, diversification of payers across multiple products and distribution channels, and geographic expansion across metropolitan and state lines. These issues are illustrated using medical loss ratios from a range of nonprofit and for-profit health plans. The paper then sketches a strategy for improving the public's understanding of health plan performance as an alternative to continued reliance on the flawed medical loss ratio. This strategy incorporates data on structure and process, service quality, and financial performance. PMID:9248162

  5. 42 CFR 31.15 - Continuance of medical relief after loss of status.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ..., PUBLIC HEALTH SERVICE, AND FORMER LIGHTHOUSE SERVICE Provisions Applicable to Personnel of Former Lighthouse Service § 31.15 Continuance of medical relief after loss of status. If a person is separated...

  6. 42 CFR 31.15 - Continuance of medical relief after loss of status.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ..., PUBLIC HEALTH SERVICE, AND FORMER LIGHTHOUSE SERVICE Provisions Applicable to Personnel of Former Lighthouse Service § 31.15 Continuance of medical relief after loss of status. If a person is separated...

  7. 42 CFR 31.15 - Continuance of medical relief after loss of status.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ..., PUBLIC HEALTH SERVICE, AND FORMER LIGHTHOUSE SERVICE Provisions Applicable to Personnel of Former Lighthouse Service § 31.15 Continuance of medical relief after loss of status. If a person is separated...

  8. 42 CFR 31.15 - Continuance of medical relief after loss of status.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ..., PUBLIC HEALTH SERVICE, AND FORMER LIGHTHOUSE SERVICE Provisions Applicable to Personnel of Former Lighthouse Service § 31.15 Continuance of medical relief after loss of status. If a person is separated...

  9. 42 CFR 31.15 - Continuance of medical relief after loss of status.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ..., PUBLIC HEALTH SERVICE, AND FORMER LIGHTHOUSE SERVICE Provisions Applicable to Personnel of Former Lighthouse Service § 31.15 Continuance of medical relief after loss of status. If a person is separated...

  10. Parental Job Loss and Early Adolescent Adjustment in Black and White Families. JCPR Working Paper.

    ERIC Educational Resources Information Center

    Kalil, Ariel; DeLeire, Thomas

    This study examined the effects of paternal and maternal job loss on changes in Black and White early adolescents' academic achievement, school attendance, locus of control, and self-concept. It also investigated whether the effects of parental job loss could be explained by contemporaneous changes in parental behavior. Analysis of data on 8th…

  11. Modeling Quality-Adjusted Life Expectancy Loss Resulting from Tobacco Use in the United States

    ERIC Educational Resources Information Center

    Kaplan, Robert M.; Anderson, John P.; Kaplan, Cameron M.

    2007-01-01

    Purpose: To describe the development of a model for estimating the effects of tobacco use upon Quality Adjusted Life Years (QALYs) and to estimate the impact of tobacco use on health outcomes for the United States (US) population using the model. Method: We obtained estimates of tobacco consumption from 6 years of the National Health Interview…

  12. Surviving Job Loss: Motivation among Second Year Trade Adjustment Assistance (TAA) Students

    ERIC Educational Resources Information Center

    Karnes, Sandra Lee

    2012-01-01

    This ethnographic case study investigated second year college students who participated in the Trade Adjustment Assistance (TAA) program at a technical college in northeastern Pennsylvania. In order to understand how learners stayed motivated in a college setting, I selected participants who were in their second year of the TAA program. A total of…

  13. 38 CFR 10.2 - Evidence required of loss, destruction or mutilation of adjusted service certificate.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... an adjusted service certificate issued pursuant to the provisions of section 501 of the World War... their knowledge and belief. These statements should be supplemented by affidavits of any persons having personal knowledge of additional facts and circumstances concerning the matter, and the Secretary...

  14. 38 CFR 10.2 - Evidence required of loss, destruction or mutilation of adjusted service certificate.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... an adjusted service certificate issued pursuant to the provisions of section 501 of the World War... their knowledge and belief. These statements should be supplemented by affidavits of any persons having personal knowledge of additional facts and circumstances concerning the matter, and the Secretary...

  15. 38 CFR 10.2 - Evidence required of loss, destruction or mutilation of adjusted service certificate.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... an adjusted service certificate issued pursuant to the provisions of section 501 of the World War... their knowledge and belief. These statements should be supplemented by affidavits of any persons having personal knowledge of additional facts and circumstances concerning the matter, and the Secretary...

  16. Retrospective: Adjusting contaminant concentrations in bird eggs to account for moisture and lipid Loss during their incubation

    USGS Publications Warehouse

    Rattner, Barnett A.; Wiemeyer, Stanley N.; Blus, Lawrence J.

    2016-01-01

    By the 1960s, research and monitoring efforts on chlorinated pesticide residues in tissues of wildlife were well underway in North America and Europe. Conservationists and natural resource managers were attempting to resolve whether pesticide exposure and accumulated residues were related to population declines in several species of predatory and scavenging birds (e.g., bald eagle Haliaeetus leucocephalus, peregrine falcon Falco peregrinus, brown pelican Pelecanus occidentalis and osprey Pandion haliaetus). The avian egg was a favored sampling matrix even before the realization that eggshell thinning was linked to population declines (Ratcliffe 1967; Hickey and Anderson 1968) and that the concentration of p,p’-DDE in an egg was associated with the shell thinning phenomenon (e.g., Blus et al. 1972; Wiemeyer et al. 1988). The necessity for making wet-weight concentration adjustments to account for natural moisture loss during incubation of viable eggs was realized. Correction for the more dramatic moisture loss in non-viable decaying eggs was recognized as being paramount. For example, the ∑DDT residues in osprey eggs were reported to vary by as much as eightfold without accounting for moisture loss adjustments (Stickel et al. 1965). In the absence of adjusting concentrations to the fresh wet-weight that was present at the time of egg laying, the uncorrected values exaggerated contaminant concentrations, yielding artifactual results and ultimately incorrect conclusions. The adjustment to fresh wet-weight concentration is equally important for many other persistent contaminants including PCBs, dioxins, furans, and brominated diphenyl ethers.

  17. Adjusting Measured Weight Loss of Aged Graphite Fabric/PMR-15 Composites

    NASA Technical Reports Server (NTRS)

    Bowles, Kenneth J.

    1998-01-01

    The purposes of this study were to evaluate the growth of the surface damage layer in polymer matrix composites (PMC's) fabricated with graphite fabric reinforcement and to determine the effects of the cut-surface degradation on the overall thermo-oxidative (TOS) stability of these materials. Four important conclusions were made about the TOS behavior of T650-35/PNIR- 15 fabric-reinforced composites: (1) Three stages of composite weight loss were seen on the plot of weight loss versus aging time; (2) the depth of the cut-edge damage is related to the composite thickness; (3) the actual weight loss realized by a mechanical test specimen that has had all the aging-induced cut-edge damage removed during the preparation process is significantly less than the weight loss measured using specimens with a high percentage of cut edges exposed to the damaging environment; and (4) an extrapolation of a section of the weight loss curve can be used to obtain a more correct estimate of the actual weight loss after extended periods of aging at elevated temperatures.

  18. 76 FR 5811 - Adjusted Federal Medical Assistance Percentage (FMAP) Rate for the First Quarter of Fiscal Year...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-02-02

    ...This notice provides the adjusted Federal Medical Assistance Percentage (FMAP) rate for the first quarter of Fiscal Year 2011 (FY11) as required under Section 5001 of the American Recovery and Reinvestment Act of 2009 (ARRA). Section 5001 of the ARRA provides for temporary increases in the FMAP rates to provide fiscal relief to states and to protect and maintain state Medicaid and certain......

  19. 20 CFR 404.1562 - Medical-vocational profiles showing an inability to make an adjustment to other work.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 20 Employees' Benefits 2 2014-04-01 2014-04-01 false Medical-vocational profiles showing an inability to make an adjustment to other work. 404.1562 Section 404.1562 Employees' Benefits SOCIAL SECURITY ADMINISTRATION FEDERAL OLD-AGE, SURVIVORS AND DISABILITY INSURANCE (1950- ) Determining Disability and...

  20. 20 CFR 404.1562 - Medical-vocational profiles showing an inability to make an adjustment to other work.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 20 Employees' Benefits 2 2012-04-01 2012-04-01 false Medical-vocational profiles showing an inability to make an adjustment to other work. 404.1562 Section 404.1562 Employees' Benefits SOCIAL SECURITY ADMINISTRATION FEDERAL OLD-AGE, SURVIVORS AND DISABILITY INSURANCE (1950- ) Determining Disability and...

  1. 20 CFR 404.1562 - Medical-vocational profiles showing an inability to make an adjustment to other work.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 20 Employees' Benefits 2 2011-04-01 2011-04-01 false Medical-vocational profiles showing an inability to make an adjustment to other work. 404.1562 Section 404.1562 Employees' Benefits SOCIAL SECURITY ADMINISTRATION FEDERAL OLD-AGE, SURVIVORS AND DISABILITY INSURANCE (1950- ) Determining Disability and...

  2. 20 CFR 404.1562 - Medical-vocational profiles showing an inability to make an adjustment to other work.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 20 Employees' Benefits 2 2013-04-01 2013-04-01 false Medical-vocational profiles showing an inability to make an adjustment to other work. 404.1562 Section 404.1562 Employees' Benefits SOCIAL SECURITY ADMINISTRATION FEDERAL OLD-AGE, SURVIVORS AND DISABILITY INSURANCE (1950- ) Determining Disability and...

  3. 20 CFR 404.1562 - Medical-vocational profiles showing an inability to make an adjustment to other work.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Medical-vocational profiles showing an inability to make an adjustment to other work. 404.1562 Section 404.1562 Employees' Benefits SOCIAL SECURITY ADMINISTRATION FEDERAL OLD-AGE, SURVIVORS AND DISABILITY INSURANCE (1950- ) Determining Disability and...

  4. 48 CFR 1602.170-14 - FEHB-specific medical loss ratio threshold calculation.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... determined by OPM, as defined by the Department of Health and Human Services in 45 CFR part 158. (b) The FEHB... the beginning of plan year 2013. (c) In place of the credibility adjustment at 45 CFR 158.230-158.232... 48 Federal Acquisition Regulations System 6 2012-10-01 2012-10-01 false FEHB-specific medical...

  5. 45 CFR 158.322 - Proposal for adjusted medical loss ratio.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... practicable; (c) An estimate of the rebates that would be paid if the issuers offering coverage in the... estimate of the rebates that would be paid if the issuers offering coverage in the individual market in...

  6. 45 CFR 158.322 - Proposal for adjusted medical loss ratio.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... practicable; (c) An estimate of the rebates that would be paid if the issuers offering coverage in the... estimate of the rebates that would be paid if the issuers offering coverage in the individual market in...

  7. Impact of medical loss regulation on the financial performance of health insurers.

    PubMed

    McCue, Michael; Hall, Mark; Liu, Xinliang

    2013-09-01

    The Affordable Care Act's regulation of medical loss ratios requires health insurers to use at least 80-85 percent of the premiums they collect for direct medical expenses (care delivery) or for efforts to improve the quality of care. To gauge this rule's effect on insurers' financial performance, we measured changes between 2010 and 2011 in key financial ratios reflecting insurers' operating profits, administrative costs, and medical claims. We found that the largest changes occurred in the individual market, where for-profit insurers reduced their median administrative cost ratio and operating margin by more than two percentage points each, resulting in a seven-percentage-point increase in their median medical loss ratio. Financial ratios changed much less for insurers in the small- and large-group markets. PMID:24019358

  8. Quantifying and Adjusting for Disease Misclassification Due to Loss to Follow-Up in Historical Cohort Mortality Studies

    PubMed Central

    Scott, Laura L. F.; Maldonado, George

    2015-01-01

    The purpose of this analysis was to quantify and adjust for disease misclassification from loss to follow-up in a historical cohort mortality study of workers where exposure was categorized as a multi-level variable. Disease classification parameters were defined using 2008 mortality data for the New Zealand population and the proportions of known deaths observed for the cohort. The probability distributions for each classification parameter were constructed to account for potential differences in mortality due to exposure status, gender, and ethnicity. Probabilistic uncertainty analysis (bias analysis), which uses Monte Carlo techniques, was then used to sample each parameter distribution 50,000 times, calculating adjusted odds ratios (ORDM-LTF) that compared the mortality of workers with the highest cumulative exposure to those that were considered never-exposed. The geometric mean ORDM-LTF ranged between 1.65 (certainty interval (CI): 0.50–3.88) and 3.33 (CI: 1.21–10.48), and the geometric mean of the disease-misclassification error factor (εDM-LTF), which is the ratio of the observed odds ratio to the adjusted odds ratio, had a range of 0.91 (CI: 0.29–2.52) to 1.85 (CI: 0.78–6.07). Only when workers in the highest exposure category were more likely than those never-exposed to be misclassified as non-cases did the ORDM-LTF frequency distributions shift further away from the null. The application of uncertainty analysis to historical cohort mortality studies with multi-level exposures can provide valuable insight into the magnitude and direction of study error resulting from losses to follow-up. PMID:26501295

  9. The sea level fingerprint of 21st Century ice mass loss and Glacial Isostatic Adjustment

    NASA Astrophysics Data System (ADS)

    Riva, R. E.; Bamber, J. L.

    2009-12-01

    The sea level contribution from glacial sources has been accelerating over the last decade. This contribution is not distributed uniformly across the world’s oceans due to both oceanographic and gravitational effects. We compute the sea level signature of 21st Century ice mass fluxes due to changes in the gravity field and Earth’s rotation. The combined pattern of wastage from the largest sources results in maxima of > 1.5 mm/yr at low latitudes across most of the Pacific Ocean, affecting particularly vulnerable land masses. However, sea level changes induced by Glacial Isostatic Adjustment (GIA), representing the viscoelastic deformation of the Solid Earth in response to the past glacial history, are still the dominating signal in many regions, particularly at high latitudes. As a consequence, the instrumental detection of fingerprints requires careful modelling of GIA, which is still subject to large uncertainties. We will compare fingerprints of current melt to those induced by various GIA models, and elaborate on the actual possibility of separating the two signals from the analysis of different datasets.

  10. Attitude and knowledge of hearing loss among medical doctors selected to initiate a residency in Mexico.

    PubMed

    López-Vázquez, M; Berruecos, P; Lopez, L E; Cacho, J

    2009-03-01

    Early diagnosis and intervention of hearing loss are directly influenced by the knowledge and attitude towards this condition among medical personnel, particularly in countries where screening is not performed routinely. The objective of this paper was to evaluate the attitude and knowledge of hearing loss in a group of physicians. A questionnaire with five Likert-type items and five multiple choice and fill-in-the-blank items was completed by 2727 physicians selected to start a medical residency. Results suggested that physicians' knowledge level on the matter is deficient and their attitude is far from the ideal; however, physicians selected for a residency in audiology showed slightly better results. PMID:19283581

  11. 42 CFR 31.7 - Continuance of medical relief after loss of status.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ..., PUBLIC HEALTH SERVICE, AND FORMER LIGHTHOUSE SERVICE Provisions Applicable to Coast Guard, National Ocean... 42 Public Health 1 2010-10-01 2010-10-01 false Continuance of medical relief after loss of status. 31.7 Section 31.7 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN...

  12. The federal medical loss ratio rule: implications for consumers in year 2.

    PubMed

    McCue, Michael J; Hall, Mark A

    2014-05-01

    For the past two years, the Affordable Care Act has required health insurers to pay out a minimum percentage of premiums in the form of medical claims or quality improvement expenses--known as a medical loss ratio (MLR). Insurers with MLRs below the minimum must rebate the difference to consumers. This issue brief finds that total rebates for 2012 were $513 million, half the amount paid out in 2011, indicating greater compliance with the MLR rule. Spending on quality improvement remained low, at less than 1 percent of premiums. Insurers continued to reduce their administrative and sales costs, such as brokers' fees, without increasing profit margins, for a total reduction in overhead of $1.4 billion. In the first two years under this regulation, total consumer benefits related to the medical loss ratio--both rebates and reduced overhead--amounted to more than $3 billion. PMID:24881098

  13. The federal medical loss ratio rule: implications for consumers in year 3.

    PubMed

    McCue, Michael J; Hall, Mark A

    2015-03-01

    For the past three years, the Affordable Care Act has required health insurers to pay out a minimum percentage of premiums in medical claims or quality improvement expenses--known as a medical loss ratio (MLR). Insurers with MLRs below the minimum must rebate the difference to consumers. This issue brief finds that total rebates for 2013 were $325 million, less than one-third the amount paid out in 2011, indicating much greater compliance with the MLR rule. Insurers' spending on quality improvement remained low, at less than 1 percent of premiums. Insurers' administrative and sales costs, such as brokers' fees, and profit margins have reduced slightly but remain fairly steady. In the first three years under this regulation, total consumer benefits related to the medical loss ratio--both rebates and reduced overhead--amounted to over $5 billion. This was achieved without a great exodus of insurers from the market. PMID:25890979

  14. Adjusted hospital death rates: a potential screen for quality of medical care.

    PubMed Central

    Dubois, R W; Brook, R H; Rogers, W H

    1987-01-01

    Increased economic pressure on hospitals has accelerated the need to develop a screening tool for identifying hospitals that potentially provide poor quality care. Based upon data from 93 hospitals and 205,000 admissions, we used a multiple regression model to adjust the hospitals crude death rate. The adjustment process used age, origin of patient from the emergency department or nursing home, and a hospital case mix index based on DRGs (diagnostic related groups). Before adjustment, hospital death rates ranged from 0.3 to 5.8 per 100 admissions. After adjustment, hospital death ratios ranged from 0.36 to 1.36 per 100 (actual death rate divided by predicted death rate). Eleven hospitals (12 per cent) were identified where the actual death rate exceeded the predicted death rate by more than two standard deviations. In nine hospitals (10 per cent), the predicted death rate exceeded the actual death rate by a similar statistical margin. The 11 hospitals with higher than predicted death rates may provide inadequate quality of care or have uniquely ill patient populations. The adjusted death rate model needs to be validated and generalized before it can be used routinely to screen hospitals. However, the remaining large differences in observed versus predicted death rates lead us to believe that important differences in hospital performance may exist. PMID:3113272

  15. Survey of Keyword Adjustment of Published Articles Medical Subject Headings in Journal of Mazandaran University of Medical Sciences (2009-2010)

    PubMed Central

    Kabirzadeh, Azar; Abadi, Ebrahim Bagherian Farah; Saravi, Benyamin Mohseni

    2013-01-01

    CONFLICT OF INTEREST: NONE DECLARED Introduction Keywords are the most important tools for Information retrieval. They are usually used for retrieval of articles based on contents of information reserved from printed and electronic resources. Retrieval of appropriate keywords from Medical Subject Headings (MeSH) can impact with exact, correctness and short time on information retrieval. Regarding the above mentioned matters, this study was done to compare the Latin keywords was in the articles published in the Journal of Mazandaran University of Medical Sciences. Method This is a descriptive study. The data were extracted from the key words of Englsih abstracts of articles published in the years 2009–2010 in the Journal of Mazandaran University of Medical Sciences by census method. Checklist of data collection is designed, based on research objectives and literature review which has face validity. Compliance rate in this study was to determine if the keywords cited in this article as a full subject of the main subject headings in a MeSH (Bold and the selected word) is a perfect adjustment. If keywords were cited in the article but the main heading is not discussed in the following main topics to be discussed with reference to See and See related it has considered has partial adjustment. Results Out of 148 articles published in 12 issues in proposed time of studying, 72 research papers were analyzed. The average numbers of authors in each article were 4 ± 1. Results showed that most of specialty papers 42 (58. 4%), belonging to the (Department of Clinical Sciences) School of Medicine, 11 (15.3%) Basic Science, 6(8.4%) Pharmacy, Nursing and Midwifery 5(6.9%), 4(5.5%) Health, paramedical Sciences 3(4.2%), and non medical article 1(1.3%) school of medicine. In general, results showed that 80 (30%) of key words have been used to complete the adjustment. Also, only 1(1.4%) had complete adjustment with all the MeSH key words and in 8 articles(11.4%) key words of had no

  16. Estimated Lifetime Medical and Work-Loss Costs of Fatal Injuries--United States, 2013.

    PubMed

    Florence, Curtis; Simon, Thomas; Haegerich, Tamara; Luo, Feijun; Zhou, Chao

    2015-10-01

    Injury-associated deaths have substantial economic consequences. In 2013, unintentional injury was the fourth leading cause of death, suicide was the tenth, and homicide was the sixteenth; these three causes accounted for approximately 187,000 deaths in the United States. To assess the economic impact of fatal injuries, CDC analyzed death data from the National Vital Statistics System for 2013, along with cost of injury data using the Web-Based Injury Statistics Query and Reporting System. This report updates a previous study that analyzed death data from the year 2000, and employs recently revised methodology for determining the costs of injury outcomes, which uses the most current economic data and incorporates improvements for estimating medical costs associated with injury. Number of deaths, crude and age-specific death rates, and total lifetime work-loss costs and medical costs were calculated for fatal injuries by sex, age group, intent (intentional versus unintentional), and mechanism of injury. During 2013, the rate of fatal injury was 61.0 per 100,000 population, with combined medical and work-loss costs exceeding $214 billion. Costs from fatal injuries represent approximately one third of the total $671 billion medical and work-loss costs associated with all injuries in 2013. The magnitude of the economic burden associated with injury-associated deaths underscores the need for effective prevention. PMID:26421530

  17. Primary and Secondary Control among Children Undergoing Medical Procedures: Adjustment as a Function of Coping Style.

    ERIC Educational Resources Information Center

    Weisz, John R.; And Others

    1994-01-01

    Obtained reports of coping and goals from 33 children being treated for leukemia. Coping strategies were classified as primary control coping (attempts to alter objective conditions), secondary control coping (attempts to adjust to objective conditions), or relinquished control (no attempt to cope). Secondary control coping was positively…

  18. Treatment of Nonalcoholic Fatty Liver Disease: The Role of Medical, Surgical, and Endoscopic Weight Loss

    PubMed Central

    Popov, Violeta B.; Lim, Joseph K.

    2015-01-01

    Nonalcoholic fatty liver disease (NAFLD) represents a rapidly growing cause of chronic liver disease in the United States and is associated with significant morbidity and mortality, including progression to liver cirrhosis and hepatocellular carcinoma. NAFLD comprises a spectrum of liver conditions, ranging from simple steatosis to steatosis with inflammation (steatohepatitis) and progressive fibrosis. Weight loss represents a first line therapeutic modality for the management of NAFLD. Herein, we review the evidence base for medical, surgical, and endoscopic approaches to weight loss and their potential impact on the natural history of NAFLD. PMID:26623270

  19. Medical and Genetic Differences in the Adverse Impact of Sleep Loss on Performance: Ethical Considerations for the Medical Profession

    PubMed Central

    Czeisler, Charles A.

    2009-01-01

    The Institute of Medicine recently concluded that-on average-medical residents make more serious medical errors and have more motor vehicle crashes when they are deprived of sleep. In the interest of public safety, society has required limitations on work hours in many other safety sensitive occupations, including transportation and nuclear power generation. Those who argue in favor of traditional extended duration resident work hours often suggest that there are inter- individual differences in response to acute sleep loss or chronic sleep deprivation, implying that physicians may be more resistant than the average person to the detrimental effects of sleep deprivation on performance, although there is no evidence that physicians are particularly resistant to such effects. Indeed, recent investigations have identified genetic polymorphisms that may convey a relative resistance to the effects of prolonged wakefulness on a subset of the healthy population, although there is no evidence that physicians are over-represented in this cohort. Conversely, there are also genetic polymorphisms, sleep disorders and other inter-individual differences that appear to convey an increased vulnerability to the performance-impairing effects of 24 hours of wakefulness. Given the magnitude of inter-individual differences in the effect of sleep loss on cognitive performance, and the sizeable proportion of the population affected by sleep disorders, hospitals face a number of ethical dilemmas. How should the work hours of physicians be limited to protect patient safety optimally? For example, some have argued that, in contrast to other professions, work schedules that repeatedly induce acute and chronic sleep loss are uniquely essential to the training of physicians. If evidence were to prove this premise to be correct, how should such training be ethically accomplished in the quartile of physicians and surgeons who are most vulnerable to the effects of sleep loss on performance

  20. Medical and genetic differences in the adverse impact of sleep loss on performance: ethical considerations for the medical profession.

    PubMed

    Czeisler, Charles A

    2009-01-01

    The Institute of Medicine recently concluded that-on average-medical residents make more serious medical errors and have more motor vehicle crashes when they are deprived of sleep. In the interest of public safety, society has required limitations on work hours in many other safety sensitive occupations, including transportation and nuclear power generation. Those who argue in favor of traditional extended duration resident work hours often suggest that there are inter- individual differences in response to acute sleep loss or chronic sleep deprivation, implying that physicians may be more resistant than the average person to the detrimental effects of sleep deprivation on performance, although there is no evidence that physicians are particularly resistant to such effects. Indeed, recent investigations have identified genetic polymorphisms that may convey a relative resistance to the effects of prolonged wakefulness on a subset of the healthy population, although there is no evidence that physicians are over-represented in this cohort. Conversely, there are also genetic polymorphisms, sleep disorders and other inter-individual differences that appear to convey an increased vulnerability to the performance-impairing effects of 24 hours of wakefulness. Given the magnitude of inter-individual differences in the effect of sleep loss on cognitive performance, and the sizeable proportion of the population affected by sleep disorders, hospitals face a number of ethical dilemmas. How should the work hours of physicians be limited to protect patient safety optimally? For example, some have argued that, in contrast to other professions, work schedules that repeatedly induce acute and chronic sleep loss are uniquely essential to the training of physicians. If evidence were to prove this premise to be correct, how should such training be ethically accomplished in the quartile of physicians and surgeons who are most vulnerable to the effects of sleep loss on performance

  1. Weight Maintenance Following the STRIDE Weight Loss and Lifestyle Intervention for Individuals taking Antipsychotic Medications

    PubMed Central

    Green, Carla A.; Yarborough, Bobbi Jo H.; Leo, Michael C.; Stumbo, Scott P.; Perrin, Nancy A.; Nichols, Gregory A.; Stevens, Victor J.

    2015-01-01

    Objective Individuals taking antipsychotic medications have increased risk of obesity-related early morbidity/mortality. This report presents weight maintenance results from a successful weight loss and behavioral lifestyle change program developed for people taking antipsychotic medications. Design and Methods STRIDE was a 2-arm, randomized controlled trial. Intervention participants attended weekly group meetings for 6 months, then monthly group meetings for 6 months. Assessments were completed at baseline, 6, 12, and 24 months. Results At 24-months, intervention participants lost 3.7% of baseline weight and control participants 2.1%, a non-significant difference. Fasting glucose results followed a similar pattern. There was a statistically significant difference, however, for fasting insulin—the intervention group’s levels decreased between the end of the intensive intervention (at 6 months) and 24 months (10.1 to 7.91μU/mL); control participants’ levels increased (11.66 to 12.92μU/mL) during this period. There were also fewer medical hospitalizations among intervention participants (5.7%) than controls (21.1%; Χ2=8.47, p=0.004) during the 12 to 24-month post-intervention maintenance period. Conclusions Weight-change differences between arms diminished following the intervention period, though fasting insulin levels continued to improve. Reduced hospitalizations suggest that weight loss, even with regain, may have long-term positive benefits for people taking antipsychotic medications and may reduce costs. PMID:26334929

  2. Attitude adjustment: shaping medical students' perceptions of older patients with a geriatrics curriculum.

    PubMed

    Bensadon, Benjamin A; Teasdale, Thomas A; Odenheimer, Germaine L

    2013-11-01

    For more than half a century, scientific research has documented widespread avoidance and even denial of aging. Though nothing new, aversive reactions to the elderly are not only unfortunate but dangerous today, as increasing life expectancy and consequent demand for specialized geriatric medical care vastly outpace the supply of qualified clinicians equipped to provide it. This discrepancy has led to a crisis that is not easily resolved. At the same time, geriatrics reports the highest level of physician satisfaction among medical specialties. How can this apparent disconnect be explained, and what can be done about it? Citing evidence from medicine and other health care disciplines, the authors address these questions by emphasizing the role of aging-related attitudes, a complex but theoretically modifiable construct. Successful educational interventions are described, including the authors' experience at the helm of a monthlong geriatrics clerkship for fourth-year medical students. Novel suggestions are provided to combat the daunting challenges to achieving a workforce that is sufficient both in number and training to effectively meet the needs of the fastest-growing segment of the U.S. population. As patients continue to age across most medical specialties, the importance of geriatric curricula, particularly those sensitizing learners to the need for a systems-based, biopsychosocial (i.e., interdisciplinary) model of care, cannot be overemphasized. Such training, it is argued, should be a standard component of medical education, and future research should focus on identifying specific curricular content and teaching methods that most effectively achieve this end. PMID:24072114

  3. Biocompatible Fe-Si Nanoparticles with Adjustable Self-Regulation of Temperature for Medical Applications.

    PubMed

    Jing, Ying; Liu, Jinming; Ji, Wei-Hang; Wang, Wei; He, Shi-Hai; Jiang, Xiao-Ze; Wiedmann, Timothy; Wang, Chun; Wang, Jian-Ping

    2015-06-17

    Because of the noninvasive, locally selective potential of thermal energy, considerable effort has been focused on the use of an external, alternating magnetic field for conversion of magnetic work to heat with iron oxide nanoparticles. However, proper regulation of thermal energy remains a challenge because of the lack of feedback from the local temperature change to the external power supply. Here, we show development of smart magnetic nanoparticles composed of Fe and Si with intrinsically tunable heat generation capability. They were engineered to possess an adjustable magnetic transition temperature through tuning the exchange between Fe atoms by incorporation of silicon atoms. They show relatively high magnetic moment. Moreover, their biocompatibility was established in several cell lines. The nanoparticles were also combined with a thermosensitive polymer, which had the capability to release of molecules with a magnetic stimulus, thereby providing a platform for locally controlled, drug release. PMID:25996162

  4. Parental loss, trusting relationship with current caregivers, and psychosocial adjustment among children affected by AIDS in China.

    PubMed

    Zhao, Junfeng; Li, Xiaoming; Barnett, Douglas; Lin, Xiuyun; Fang, Xiaoyi; Zhao, Guoxiang; Naar-King, Sylvie; Stanton, Bonita

    2011-08-01

    The objective of this study was to examine the relationship between parental loss, trusting relationship with current caregivers, and psychosocial adjustment among children affected by AIDS in China. In this study, cross-sectional data were collected from 755 AIDS orphans (296 double orphans and 459 single orphans), 466 vulnerable children living with HIV-infected parents, and 404 comparison children in China. The trusting relationship with current caregivers was measured with a 15-item scale (Cronbach's α = 0.84) modified from the Trusting Relationship Questionnaire developed by Mustillo et al. in 2005 (Quality of relationships between youth and community service providers: Reliability and validity of the trusting relationship questionnaire. Journal of Child and Family Studies, 14, 577-590). The psychosocial measures include rule compliance/acting out, anxiety/withdrawal, peer social skills, school interest, depressive symptoms, loneliness, self-esteem, future expectation, hopefulness about future, and perceived control over the future. Group mean comparisons using analysis of variance suggested a significant association (p < 0.0001) between the trusting relationship with current caregivers and all the psychosocial measures, except anxiety and depression. These associations remained significant in General Linear Model analysis, controlling for children's gender, age, family socioeconomic status, orphan status (orphans, vulnerable children, and comparison children), and appropriate interaction terms among factor variables. The findings in the current study support the global literature on the importance of attachment relationship with caregivers in promoting children's psychosocial development. Future prevention intervention efforts to improve AIDS orphans' psychosocial well-being will need to take into consideration the quality of the child's attachment relationships with current caregivers and help their current caregivers to improve the quality of care for

  5. Parental Loss, Trusting Relationship with Current Caregivers and Psychosocial Adjustment among Children Affected by AIDS in China

    PubMed Central

    Zhao, Junfeng; Li, Xiaoming; Barnett, Douglas; Lin, Xiuyun; Fang, Xiaoyi; Zhao, Guoxiang; Naar-King, Sylvie; Stanton, Bonita

    2011-01-01

    Objective to examine the relationship between parental loss, trusting relationship with current caregivers, and psychosocial adjustment among children affected by AIDS in China. Methods Cross-sectional data were collected from 755 AIDS orphans (296 double orphans and 459 single orphans), 466 vulnerable children living with HIV-infected parents, and 404 comparison children in China. The trusting relationship with current caregivers was measured with a 15-item scale (Cronbach alpha=.84) modified from the Trusting Relationship Questionnaire (TRQ) developed by Mustillo and colleagues (2005). The psychosocial measures include rule compliance/acting out, anxiety/withdrawal, peer social skills, school interest, depressive symptoms, loneliness, self-esteem, future expectation, hopefulness about future, and perceived control over the future. Results Group mean comparisons using ANOVA suggested a significant association (p<.0001) between the trusting relationship with current caregivers and all the psychosocial measures except anxiety and depression. These associations remained significant in General Linear Model analysis, controlling for children's gender, age, family SES, orphan status (orphans, vulnerable children, and comparison children), and appropriate interaction terms among factor variables. Discussion The findings in the current study support the global literature on the importance of attachment relationship with caregivers in promoting children's psychosocial development. Future prevention intervention efforts to improve AIDS orphans' psychosocial well-being will need to take into consideration the quality of the child's attachment relationships with current caregivers and help their current caregivers to improve the quality of care for these children. Future study is needed to explore the possible reasons for the lack of association between a trusting relationship and some internalizing symptoms such as anxiety and depression among children affected by HIV

  6. [Continuity--adjustment--autonomy--physician--patient--an overview of medical cultural philosophy in former East Germany].

    PubMed

    Belau, D

    1991-12-01

    The author probes into the "culture" of medical thinking in the former GDR in respect of the interlinking of socialisation of the doctor, within the framework of socialism, with the fate of the patient; the fundamentals of the development of science and of the pattern of cultural life; and the development of moral consciousness and health policy under the influence of Marxist-Leninist teachings. (One should not neglect the difference made by the author between "official Marxism-Leninism as decreed by the state" and "Marxist theory" as well as "public level of consciousness".) Errors of judgment, illusions, so-called "noble" ideals of the medical profession such as ambitiousness, engagedness, and readiness to shoulder responsibilities, were interwoven with the trend to functionalism, to keep the party bureaucracy of the SED in power. One of the thematic points of emphasis was the "changing of paradigms in medicine", such as the hostility to psychology as a feature of GDR socialism, or the sociopolitically dictated condemnation of non-institutional or "alternative" medicine. The author sees a basic trend to technocracy in GDR medicine. He shows up trends to "moral remote control" of the doctor, to a deliberately practised illusionment, a systematically engineered demounting of decisions based on moral constraints--such demounting being promoted both in the doctor's mind and in actual practice--and to eliminating emotional obstacles officially construed as "interfering" with a strictly objectified doctor-patient relationship. Nothing in this context can be soft-pedalled and excused. The author points specifically to the officially promoted vision of a "successful repair and construction of a New Man". Within the context of socialist ideal views and actual socialisation of the doctor there are similarities between the balance-sheets of 1945 and 1989 in Germany without attempting to suggest that this amounts to a comparison on the same level with the genocide and war

  7. Longitudinal regional brain volume loss in schizophrenia: Relationship to antipsychotic medication and change in social function

    PubMed Central

    Guo, Joyce Y.; Huhtaniska, Sanna; Miettunen, Jouko; Jääskeläinen, Erika; Kiviniemi, Vesa; Nikkinen, Juha; Moilanen, Jani; Haapea, Marianne; Mäki, Pirjo; Jones, Peter B.; Veijola, Juha; Isohanni, Matti; Murray, Graham K.

    2015-01-01

    Background Progressive brain volume loss in schizophrenia has been reported in previous studies but its cause and regional distribution remains unclear. We investigated progressive regional brain reductions in schizophrenia and correlations with potential mediators. Method Participants were drawn from the Northern Finland Birth Cohort 1966. A total of 33 schizophrenia individuals and 71 controls were MRI scanned at baseline (mean age = 34.7, SD = 0.77) and at follow-up (mean age = 43.4, SD = 0.44). Regional brain change differences and associations with clinical mediators were examined using FSL voxelwise SIENA. Results Schizophrenia cases exhibited greater progressive brain reductions than controls, mainly in the frontal and temporal lobes. The degree of periventricular brain volume reductions were predicted by antipsychotic medication exposure at the fourth ventricular edge and by the number of days in hospital between the scans (a proxy measure of relapse duration) at the thalamic ventricular border. Decline in social and occupational functioning was associated with right supramarginal gyrus reduction. Conclusion Our findings are consistent with the possibility that antipsychotic medication exposure and time spent in relapse partially explain progressive brain reductions in schizophrenia. However, residual confounding could also account for the findings and caution must be applied before drawing causal inferences from associations demonstrated in observational studies of modest size. Less progressive brain volume loss in schizophrenia may indicate better preserved social and occupational functions. PMID:26189075

  8. Baseline observations from the POSSIBLE EU® study: characteristics of postmenopausal women receiving bone loss medications

    PubMed Central

    Cooper, Cyrus; Roux, Christian; Díez-Pérez, Adolfo; Guillemin, Francis; Jonsson, Bengt; Ortolani, Sergio; Pfeilschifter, Johannes; Horne, Rob; Kakad, Shilpa; Shepherd, Susan; Möller, Gerd; Marciniak, Anne; Martinez, Luc

    2010-01-01

    Summary Prospective Observational Scientific Study Investigating Bone Loss Experience in Europe (POSSIBLE EU®) is an ongoing longitudinal cohort study that utilises physician- and patient-reported measures to describe the characteristics and management of postmenopausal women on bone loss therapies. We report the study design and baseline characteristics of 3,402 women recruited from general practice across five European countries. Purpose The POSSIBLE EU® is a study describing the characteristics and management of postmenopausal women receiving bone loss medications. Methods Between 2005 and 2008, general practitioners enrolled postmenopausal women initiating, switching or continuing treatment with bone loss treatment in France, Germany, Italy, Spain and the UK. Patients and physicians completed questionnaires at study entry and at 3-month intervals, for 1 year. Results Of 3,402 women enrolled (mean age 68.2 years [SD] 9.83), 96% were diagnosed with low bone mass; 55% of these using dual energy X-ray absorptiometry. Most women (92%) had comorbidities. Mean minimum T score (hip or spine) at diagnosis was −2.7 (SD 0.89; median −2.7 [interquartile range, −3.2, −2.2]) indicating low bone mineral density. Almost 40% of the women had prior fractures in adulthood, mostly non-vertebral, non-hip in nature, 30% of whom had at least two fractures and more than half experienced moderate/severe pain or fatigue. Bisphosphonates were the most common type of bone loss treatment prescribed in the 12 months preceding the study. Conclusions POSSIBLE EU® characterises postmenopausal women with low bone mass, exhibiting a high rate of prevalent fracture, substantial bone fragility and overall comorbidity burden. Clinical strategies for managing osteoporosis in this population varied across the five participating European countries, reflecting their different guidelines, regulations and standards of care. PMID:21258637

  9. Continuous monitoring of haemoglobin concentration after in-vivo adjustment in patients undergoing surgery with blood loss.

    PubMed

    Frasca, D; Mounios, H; Giraud, B; Boisson, M; Debaene, B; Mimoz, O

    2015-07-01

    Non-invasive monitoring of haemoglobin concentration provides real-time measurement of haemoglobin concentration (SpHb) using multi-wavelength pulse co-oximetry. We hypothesised that in-vivo adjustment using the mean of three haemoglobinometer (HemoCue®) measurements from an arterial blood sample at the first SpHb measurement (HCueART) would increase the accuracy of the monitor. The study included 41 adults for a total of 173 measurements of haemoglobin concentration. In-vivo adjusted SpHb was automatically calculated by the following formula: in-vivo adjusted SpHb = unadjusted SpHb - (SpHb - HCueART). The accuracy of in-vivo adjusted SpHb was compared with SpHb retrospectively adjusted using the same formula, except for haemoglobin level which was assessed at the central laboratory and then compared with all other available invasive methods of haemoglobin measurement (co-oximetry, HbSAT; arterial HemoCue, HCueART; capillary HemoCue, HCueCAP). Compared with laboratory measurement of haemoglobin concentration, bias (precision) for unadjusted SpHb, in-vivo adjusted SpHb, retrospectively adjusted SpHb, HbSAT, HCueART and HCueCAP were -0.4 (1.4), -0.3 (1.1), -0.3 (1.1), -0.6 (0.7), 0.0 (0.4) and -0.5 (1.2) g.dl(-1) , respectively. In-vivo adjustment of SpHb values using the mean of three arterial HemoCue measurements improved the accuracy of the device similar to those observed after a retrospective adjustment using central laboratory haemoglobin level. PMID:25676902

  10. Colon Ischemia After Weight-Loss Medication in a 36-Year-Old Woman.

    PubMed

    Sharma, Prabin; Krishnamoorthy, Parasuram

    2016-04-01

    Weight-loss medications have been associated with many conditions, including valvular heart disease, ischemic colitis, and pulmonary hypertension. There is a constant increase in the use of these drugs, especially new medications with better efficacy. Phentermine is one such drug, approved for short-term use to lose weight. We report a case of ischemic colitis in a female patient linked to inappropriate phentermine intake. The patient presented with symptoms of severe abdominal pain and repeated bowel movement associated with rectal bleeding for two weeks. Initial blood work was unremarkable for infectious and inflammatory causes. A CT scan was performed which revealed findings of ischemic colitis extending from transverse to descending colon. A biopsy study confirmed the same. Upon further questioning, the patient admitted to taking 37.5 mg of phentermine for two years beyond her prescribed period of 12 weeks. Hence, we propose that inappropriate use of phentermine caused ischemic colitis. With the widespread use of these medications, there is a need for heightened awareness among clinicians regarding adverse effects of phentermine. PMID:27265924

  11. Department of Veterans Affairs compensation and medical care benefits accorded to veterans with major limb loss.

    PubMed

    Maynard, Charles; Flohr, Brad; Guagliardo, Tony A; Martin, Chris H; McFarland, Lynne V; Pruden, Jonathan D; Reiber, Gayle E

    2010-01-01

    Veterans injured in theaters of combat operations are eligible for benefits, including medical care and compensation. This article describes veterans with service-connected disability for major lower- and/or upper-limb loss resulting from combat-field-associated injuries sustained in the Vietnam war, Operation Desert Shield/Operation Desert Storm, and Operation Iraqi Freedom/Operation Enduring Freedom (OIF/OEF). Using the Department of Veterans Affairs (VA) Compensation and Pension Mini-Master file, we identified 2,690 veterans who in August 2007 received compensation for loss of one or more limbs. More than 97% sustained their injuries in Vietnam; most were young men who served in the U.S. Army or Marine Corps. All but 5% had at least 50% combined service-connected disability and nearly half had a 100% rating. In addition to limb loss, one of the most prevalent compensable conditions was posttraumatic stress disorder, present in 46% of OIF/OEF and 20% of Vietnam veterans. Of these veterans, 82% visited VA outpatient clinics in 2007, although only 4% were hospitalized. A special obligation exists to those who have sustained serious injuries related to combat; this responsibility extends for the life of the servicemember and beyond to his or her spouse and dependents. PMID:20803407

  12. THE AFFORDABLE CARE ACT AND MEDICAL LOSS RATIOS: NO IMPACT IN FIRST THREE YEARS.

    PubMed

    Day, Benjamin; Himmelstein, David U; Broder, Michael; Woolhandler, Steffie

    2015-01-01

    The Patient Protection and Affordable Care Act (ACA) set limits on insurers' overhead, mandating a medical loss ratio (MLR) of at least 80 percent in the individual and small-group markets and 85 percent in the large-group market starting in 2011. In implementing the law, the Obama administration introduced new rules that changed (and inflated) how insurers calculate MLRs, distorting time trends. We used insurers' filings with the U.S. Securities and Exchange Commission to calculate the largest insurers' MLRs before and after the ACA regulations took effect, using a constant definition of MLR. MLRs averaged 83.04 percent in the three years before reform and 83.05 percent in the three years after reform. We conclude that the ACA had no impact on insurance industry overhead spending. PMID:26460451

  13. Comparing Maternal Services Utilization and Expense Reimbursement before and after the Adjustment of the New Rural Cooperative Medical Scheme Policy in Rural China

    PubMed Central

    You, Hua; Gu, Hai; Ning, Weiqing; Zhou, Hua; Dong, Hengjin

    2016-01-01

    Background The New Rural Cooperative Medical Scheme (NCMS) includes a maternal care benefits package that is associated with increasing maternal health services. The local compensation policies have been frequently adjusted in recent years. This study examined the association between the NCMS maternal-services policy adjustment and expense reimbursement in Yuyao, China. Methods Two household surveys were conducted in Yuyao in 2008 and 2011 (before and after the NCMS policy adjustment, respectively). Local women (N = 154) who had delivery history in the past three years were recruited. A questionnaire was used to collect information about delivery history, maternal health services utilization (prenatal care, postnatal care, and the grade of delivery institutions), NCMS participation, and reimbursement status. Logistic regression analyses were used to predict the association between policy adjustment and maternal health utilization and the association between policy adjustment and out-of-pocket proportion. Next, t-tests and covariance analyses adjusting for household income were used to compare the out-of-pocket proportion between 2008 and 2011. Results Results revealed that compensation policy adjustment was associated with an increase in postnatal visits (adjusted OR = 3.32, p = 0.009) and the use of second level or above institutions for delivery (adjusted OR = 2.32, p = 0.03) among participants. In 2008, only 9.1% of pregnant women received reimbursement from the NCMS; however, this rate increased to 36.8% in 2011. After policy adjustment, there were no significant changes in the proportion of out-of-pocket expenses shared in delivery fee (F = 0.24, p = 0.63) and in household income (F = 0.46, p = 0.50). Conclusions Financial compensation increase improved maternal health services utilization; however, this effect was limited. Although the reimbursement rate was raised, the out-of-pocket proportion was not significant changed; therefore, the compensation design

  14. Distribution and medical impact of loss-of-function variants in the Finnish founder population.

    PubMed

    Lim, Elaine T; Würtz, Peter; Havulinna, Aki S; Palta, Priit; Tukiainen, Taru; Rehnström, Karola; Esko, Tõnu; Mägi, Reedik; Inouye, Michael; Lappalainen, Tuuli; Chan, Yingleong; Salem, Rany M; Lek, Monkol; Flannick, Jason; Sim, Xueling; Manning, Alisa; Ladenvall, Claes; Bumpstead, Suzannah; Hämäläinen, Eija; Aalto, Kristiina; Maksimow, Mikael; Salmi, Marko; Blankenberg, Stefan; Ardissino, Diego; Shah, Svati; Horne, Benjamin; McPherson, Ruth; Hovingh, Gerald K; Reilly, Muredach P; Watkins, Hugh; Goel, Anuj; Farrall, Martin; Girelli, Domenico; Reiner, Alex P; Stitziel, Nathan O; Kathiresan, Sekar; Gabriel, Stacey; Barrett, Jeffrey C; Lehtimäki, Terho; Laakso, Markku; Groop, Leif; Kaprio, Jaakko; Perola, Markus; McCarthy, Mark I; Boehnke, Michael; Altshuler, David M; Lindgren, Cecilia M; Hirschhorn, Joel N; Metspalu, Andres; Freimer, Nelson B; Zeller, Tanja; Jalkanen, Sirpa; Koskinen, Seppo; Raitakari, Olli; Durbin, Richard; MacArthur, Daniel G; Salomaa, Veikko; Ripatti, Samuli; Daly, Mark J; Palotie, Aarno

    2014-07-01

    Exome sequencing studies in complex diseases are challenged by the allelic heterogeneity, large number and modest effect sizes of associated variants on disease risk and the presence of large numbers of neutral variants, even in phenotypically relevant genes. Isolated populations with recent bottlenecks offer advantages for studying rare variants in complex diseases as they have deleterious variants that are present at higher frequencies as well as a substantial reduction in rare neutral variation. To explore the potential of the Finnish founder population for studying low-frequency (0.5-5%) variants in complex diseases, we compared exome sequence data on 3,000 Finns to the same number of non-Finnish Europeans and discovered that, despite having fewer variable sites overall, the average Finn has more low-frequency loss-of-function variants and complete gene knockouts. We then used several well-characterized Finnish population cohorts to study the phenotypic effects of 83 enriched loss-of-function variants across 60 phenotypes in 36,262 Finns. Using a deep set of quantitative traits collected on these cohorts, we show 5 associations (p<5×10⁻⁸) including splice variants in LPA that lowered plasma lipoprotein(a) levels (P = 1.5×10⁻¹¹⁷). Through accessing the national medical records of these participants, we evaluate the LPA finding via Mendelian randomization and confirm that these splice variants confer protection from cardiovascular disease (OR = 0.84, P = 3×10⁻⁴), demonstrating for the first time the correlation between very low levels of LPA in humans with potential therapeutic implications for cardiovascular diseases. More generally, this study articulates substantial advantages for studying the role of rare variation in complex phenotypes in founder populations like the Finns and by combining a unique population genetic history with data from large population cohorts and centralized research access to National Health Registers. PMID

  15. An Economic Evaluation of a Weight Loss Intervention Program for People with Serious Mental Illnesses Taking Antipsychotic Medications.

    PubMed

    Meenan, Richard T; Stumbo, Scott P; Yarborough, Micah T; Leo, Michael C; Yarborough, Bobbi Jo H; Green, Carla A

    2016-07-01

    Individuals with serious mental illnesses suffer from obesity and cardiometabolic diseases at high rates, and antipsychotic medications exacerbate these conditions. While studies have shown weight loss and lifestyle interventions can be effective in this population, few have assessed intervention cost-effectiveness. We present results from a 12-month randomized controlled trial that reduced weight, fasting glucose, and medical hospitalizations in intervention participants. Costs per participant ranged from $4365 to $5687. Costs to reduce weight by one kilogram ranged from $1623 to $2114; costs to reduce fasting glucose by 1 mg/dL ranged from $467 to $608. Medical hospitalization costs were reduced by $137,500. PMID:26149243

  16. Derivation of a new continuous adjustment function for correcting wind-induced loss of solid precipitation: results of a Norwegian field study

    NASA Astrophysics Data System (ADS)

    Wolff, M. A.; Isaksen, K.; Petersen-Øverleir, A.; Ødemark, K.; Reitan, T.; Brækkan, R.

    2015-02-01

    Precipitation measurements exhibit large cold-season biases due to under-catch in windy conditions. These uncertainties affect water balance calculations, snowpack monitoring and calibration of remote sensing algorithms and land surface models. More accurate data would improve the ability to predict future changes in water resources and mountain hazards in snow-dominated regions. In 2010, a comprehensive test site for precipitation measurements was established on a mountain plateau in southern Norway. Automatic precipitation gauge data are compared with data from a precipitation gauge in a Double Fence Intercomparison Reference (DFIR) wind shield construction which serves as the reference. A large number of other sensors are provided supporting data for relevant meteorological parameters. In this paper, data from three winters are used to study and determine the wind-induced under-catch of solid precipitation. Qualitative analyses and Bayesian statistics are used to evaluate and objectively choose the model that best describes the data. A continuous adjustment function and its uncertainty are derived for measurements of all types of winter precipitation (from rain to dry snow). A regression analysis does not reveal any significant misspecifications for the adjustment function, but shows that the chosen model does not describe the regression noise optimally. The adjustment function is operationally usable because it is based only on data available at standard automatic weather stations. The results show a non-linear relationship between under-catch and wind speed during winter precipitation events and there is a clear temperature dependency, mainly reflecting the precipitation type. The results allow, for the first time, derivation of an adjustment function based on measurements above 7 m s-1. This extended validity of the adjustment function shows a stabilization of the wind-induced precipitation loss for higher wind speeds.

  17. 75 FR 19297 - Medical Loss Ratios; Request for Comments Regarding Section 2718 of the Public Health Service Act

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-04-14

    ... at 64 FR 70164, December 15, 1999. B. Public Reporting of the Ratio of Incurred Claims to Earned... Medical Loss Ratios; Request for Comments Regarding Section 2718 of the Public Health Service Act AGENCY... information. ] SUMMARY: This document is a request for comments regarding Section 2718 of the Public...

  18. 45 CFR 158.240 - Rebating premium if the applicable medical loss ratio standard is not met.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 45 Public Welfare 1 2011-10-01 2011-10-01 false Rebating premium if the applicable medical loss ratio standard is not met. 158.240 Section 158.240 Public Welfare DEPARTMENT OF HEALTH AND HUMAN... ratio standard is not met. (a) General requirement. For each MLR reporting year, an issuer must...

  19. 45 CFR 158.240 - Rebating premium if the applicable medical loss ratio standard is not met.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 45 Public Welfare 1 2012-10-01 2012-10-01 false Rebating premium if the applicable medical loss ratio standard is not met. 158.240 Section 158.240 Public Welfare DEPARTMENT OF HEALTH AND HUMAN... ratio standard is not met. (a) General requirement. For each MLR reporting year, an issuer must...

  20. 45 CFR 158.240 - Rebating premium if the applicable medical loss ratio standard is not met.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 45 Public Welfare 1 2014-10-01 2014-10-01 false Rebating premium if the applicable medical loss ratio standard is not met. 158.240 Section 158.240 Public Welfare Department of Health and Human... ratio standard is not met. (a) General requirement. For each MLR reporting year, an issuer must...

  1. 45 CFR 158.240 - Rebating premium if the applicable medical loss ratio standard is not met.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 45 Public Welfare 1 2013-10-01 2013-10-01 false Rebating premium if the applicable medical loss ratio standard is not met. 158.240 Section 158.240 Public Welfare DEPARTMENT OF HEALTH AND HUMAN... ratio standard is not met. (a) General requirement. For each MLR reporting year, an issuer must...

  2. 20 CFR 416.962 - Medical-vocational profiles showing an inability to make an adjustment to other work.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... inability to make an adjustment to other work. 416.962 Section 416.962 Employees' Benefits SOCIAL SECURITY... adjustment to other work. (a) If you have done only arduous unskilled physical labor. If you have no more than a marginal education (see § 416.964) and work experience of 35 years or more during which you...

  3. 20 CFR 416.962 - Medical-vocational profiles showing an inability to make an adjustment to other work.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... inability to make an adjustment to other work. 416.962 Section 416.962 Employees' Benefits SOCIAL SECURITY... adjustment to other work. (a) If you have done only arduous unskilled physical labor. If you have no more than a marginal education (see § 416.964) and work experience of 35 years or more during which you...

  4. Prediction of individual differences in adjustment to loss: Acceptance and valued-living as critical appraisal and coping strengths.

    PubMed

    Davis, Esther L; Deane, Frank P; Lyons, Geoffrey C B

    2016-04-01

    Our strengths-based model of coping with death and dying proposes acceptance and valued-living as key coping and appraisal strengths for the bereaved. These are core components of Acceptance and Commitment Therapy (ACT). The aim of this study was to provide an initial exploration of the theorized relationships via a survey of 97 bereaved university students. Using hierarchical regression analysis it was found that acceptance and valued-living were significant predictors of grief, while controlling for other model variables and loss characteristics. Results have implications for ACT-based approaches in supporting those bereaved who are struggling with their grief. PMID:26681151

  5. Derivation of a new continuous adjustment function for correcting wind-induced loss of solid precipitation: results of a Norwegian field study

    NASA Astrophysics Data System (ADS)

    Wolff, M. A.; Isaksen, K.; Petersen-Øverleir, A.; Ødemark, K.; Reitan, T.; Brækkan, R.

    2014-09-01

    Precipitation measurements exhibit large cold-season biases due to under-catch in windy conditions. These uncertainties affect water balance calculations, snowpack monitoring and calibrations of remote sensing algorithms and land surface models. More accurate data would improve the ability to predict future changes in water resources and mountain hazards in snow-dominated regions. In 2010, an extensive test-site for precipitation measurements was established at a mountain plateau in Southern Norway. Precipitation data of automatic gauges were compared with a precipitation gauge in a Double Fence Intercomparison Reference (DFIR) wind shield construction which served as the reference. Additionally, a large number of sensors were monitoring supportive meteorological parameters. In this paper, data from three winters were used to study and determine the wind-induced under-catch of solid precipitation. Qualitative analyses and Bayesian statistics were used to evaluate and objectively choose the model that is describing the data best. A continuous adjustment function and its uncertainty were derived for measurements of all types of winter precipitation (from rain to dry snow). A regression analysis did not reveal any significant misspecifications for the adjustment function, but showed that the chosen model uncertainty is slightly insufficient and can be further optimized. The adjustment function is operationally usable based only on data available at standard automatic weather stations. Our results show a non-linear relationship between under-catch and wind speed during winter precipitation events and there is a clear temperature dependency, mainly reflecting the precipitation type. The results allowed for the first time to derive an adjustment function with a data-tested validity beyond 7 m s-1 and proved a stabilisation of the wind-induced precipitation loss for higher wind speeds.

  6. Resolving Trends in Antarctic Ice Sheet Mass Loss and Glacio-isostatic Adjustment Through Spatio-temporal Source-separation

    NASA Astrophysics Data System (ADS)

    Bamber, J. L.; Schoen, N.; Zammit-Mangion, A.; Rougier, J.; Flament, T.; Luthcke, S. B.; Petrie, E. J.; Rémy, F.

    2013-12-01

    There remains considerable inconsistency between different methods and approaches for determining ice mass trends for Antarctica from satellite observations. There are three approaches that can provide near global coverage for mass trends: altimetry, gravimetry and mass budget calculations. All three approaches suffer from a source separation problem where other geophysical processes limit the capability of the method to resolve the origin and magnitude of a mass change. A fourth approach, GPS vertical motion, provides localised estimates of mass change due to elastic uplift and an indirect estimate of GIA. Each approach has different source separation issues and different spatio-temporal error characteristics. In principle, it should be possible to combine the data and process covariances to minimize the uncertainty in the solution and to produce robust, posterior errors for the trends. In practice, this is a challenging problem in statistics because of the large number of degrees of freedom, the variable spatial and temporal sampling between the different observations and the fact that some processes remain under-sampled, such as firn compaction. Here, we present a novel solution to this problem using the latest methods in statistical modelling of spatio-temporal processes. We use Bayesian hierarchical modelling and employ stochastic partial differential equations to capture our physical understanding of the key processes that influence our observations. Due to the huge number of observations involved (> 10^8) methods are required to reduce the dimensionality of the problem and care is required in treatment of the observations as they are not independent. Here, we focus mainly on the results rather than the full suite of methods and we present time evolving fields of surface mass balance, ice dynamic-driven mass loss, and firn compaction for the period 2003-2009, derived from a combination of ICESat, ENVISAT, GRACE, InSAR, GPS and regional climate model output

  7. 78 FR 53700 - Revised Medical Criteria for Evaluating Hearing Loss and Disturbances of Labyrinthine-Vestibular...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-30

    ... revise the criteria in our Listing of Impairments (listings) for evaluating hearing loss and disturbances... 6, 1985.\\2\\ \\1\\ 75 FR 30693. \\2\\ 50 FR 50068. On which rules are we inviting comments and... evaluating hearing loss or disturbances of labyrinthine-vestibular function contain technical language...

  8. Hearing Loss Tied to Bigger Medical Bills for Late Middle-Aged

    MedlinePlus

    ... at the Medical University of South Carolina, in Charleston. The researchers said more study is needed to ... the views of MedlinePlus, the National Library of Medicine, the National Institutes of Health, the U.S. Department ...

  9. The Central Role of Meaning in Adjustment to the Loss of a Child to Cancer: Implications for the Development of Meaning-Centered Grief Therapy

    PubMed Central

    Lichtenthal, Wendy G.; Breitbart, William

    2015-01-01

    Purpose of review This review describes research on meaning and meaning-making in parents who lost a child to cancer, suggesting the need for a meaning-centered therapeutic approach to improve their sense of meaning, purpose, and identity and to help with management of prolonged grief symptoms. Recent findings Several studies have demonstrated that parents bereaved by cancer experience unique meaning related challenges associated with the caregiving and illness experience, including struggles with making sense of their loss, benefit-finding, their sense of identity and purpose, disconnection from sources of meaning, and sustaining a sense of meaning in their child’s life. Meaning-Centered Grief Therapy, adapted from Meaning-Centered Psychotherapy, directly addresses these issues, highlighting the choices parents have in how they face their pain, how they honor their child and his/her living legacy, the story they create, and how they live their lives. Summary Given the important role that meaning plays in adjustment to the loss of a child to cancer, a meaning-focused approach such as Meaning-Centered Grief Therapy, may help improve parents’ sense of meaning and grief symptoms. It seems particularly appropriate for parents who lost a child to cancer because it does not pathologize their struggles and directly targets issues they frequently face. PMID:25588204

  10. School Adjustment of Taiwanese Aborigine Girls at Jen-Te Junior College of Medical Nursing and Management.

    ERIC Educational Resources Information Center

    Chung, Hsueh-Yu

    A study explored the school experiences of aboriginal female students (n=5) at Jen-Te Junior College of Medical Nursing and Management School in Miao-Li, Taiwan. The following research questions were addressed: (1) do aboriginal girls feel that their culture and background influences their schooling experiences? (2) what problems do aboriginal…

  11. [Recovery of hearing: results of delayed medical treatment in patients with idiopathic sudden hearing loss].

    PubMed

    Maassen, M M; Pfister, M; Plontke, S; Koitschev, A; Vögler, A; Löwenheim, H

    2002-12-01

    For the treatment of idiopathic sudden sensorineural hearing loss (ISSNHL), a variety of studies about intravenous drug administration with the beginning of treatment in the early period of less then one week after the onset of hearing loss have been performed. In contrast, very little information is available about the efficacy of intravenous drug therapy for ISSNHL with the beginning of treatment later than four weeks after the onset of hearing loss. In a retrospective chart review we studied the treatment results of 57 patients with ISSNHL with beginning of treatment later than four weeks after the onset of hearing loss with no spontaneous recovery of hearing. Patients received a treatment with intravenous administration of Dextran (concentration 40 g/l with NaCl 0.9%) and Procain-HCl (a derivative of the local anaesthetic lidocaine,400-800 mg in a 500 ml rheologic infusion of Dextran 40). 25% of the patients showed a significant improvement of 10 dB or more in hearing threshold at 1000 Hz measured in bone-conducted pure tone audiometry. In a subjective evaluation 53% of the patients noticed a subjective improvement of their individual hearing thresholds. PMID:12474128

  12. Estimated Lifetime Medical and Work-Loss Costs of Emergency Department-Treated Nonfatal Injuries--United States, 2013.

    PubMed

    Florence, Curtis; Haegerich, Tamara; Simon, Thomas; Zhou, Chao; Luo, Feijun

    2015-10-01

    A large number of nonfatal injuries are treated in U.S. emergency departments (EDs) every year. CDC's National Center for Health Statistics estimates that approximately 29% of all ED visits in 2010 were for injuries. To assess the economic impact of ED-treated injuries, CDC examined injury data from the National Electronic Injury Surveillance System--All Injury Program (NEISS-AIP) for 2013, as well as injury-related lifetime medical and work-loss costs from the Web-Based Injury Statistics Query and Reporting System (WISQARS). NEISS-AIP collects data from a nationally representative sample of EDs, using specific guidelines for recording the primary diagnosis and mechanism of injury. Number of injuries, crude- and age-specific injury rates, and total lifetime work-loss costs and medical costs were calculated for ED-treated injuries, stratified by sex, age groups, and intent and mechanism of injury. ED-treated injuries were further classified as those that were subsequently hospitalized or treated and released. The rate of hospitalized injuries was 950.8 per 100,000, and the rate of treated and released injuries was 8,549.8 per 100,000. Combined medical and work-loss costs for all ED-treated injuries (both hospitalized and treated and released) were $456.9 billion, or approximately 68% of the total costs of $671 billion associated with all fatal and ED-treated injuries. The substantial economic burden associated with nonfatal injuries underscores the need for effective prevention strategies. PMID:26421663

  13. A Longitudinal Study on the Relationship between Weight Loss, Medical Expenditures, and Absenteeism among Overweight Employees in the WAY to Health Study

    PubMed Central

    Finkelstein, Eric A.; Linnan, Laura A.; Tate, Deborah F.; Leese, Peter J.

    2010-01-01

    Objective To quantify the extent to which successful weight loss among overweight/obese employees translates into subsequent savings in medical expenditures and absenteeism. Methods This analysis relied on medical claims and absenteeism data collected from overweight/obese employees at 17 community colleges in North Carolina. Results We find no evidence that participants achieving at least a 5% weight loss experienced reduced medical expenditures or lower absenteeism during the 12 month weight loss intervention or in the subsequent 2 years. Conclusions These results suggest that a quick return on investment from weight loss programs, even effective ones, is unlikely. However, as with other employee benefit decisions, the decision about whether to offer weight loss programs should take into account many factors, such as employee health, in addition to the potential for a quick return on investment. PMID:19952786

  14. Introducing a system for automated control of rotation axes, collimator and laser adjustment for a medical linear accelerator

    NASA Astrophysics Data System (ADS)

    Winkler, Peter; Bergmann, Helmar; Stuecklschweiger, Georg; Guss, Helmuth

    2003-05-01

    Mechanical stability and precise adjustment of rotation axes, collimator and room lasers are essential for the success of radiotherapy and particularly stereotactic radiosurgery with a linear accelerator. Quality assurance procedures, at present mainly based on visual tests and radiographic film evaluations, should desirably be little time consuming and highly accurate. We present a method based on segmentation and analysis of digital images acquired with an electronic portal imaging device (EPID) that meets these objectives. The method can be employed for routine quality assurance with a square field formed by the built-in collimator jaws as well as with a circular field using an external drill hole collimator. A number of tests, performed to evaluate accuracy and reproducibility of the algorithm, yielded very satisfying results. Studies performed over a period of 18 months prove the applicability of the inspected accelerator for stereotactic radiosurgery.

  15. Statistical clues to postoperative blood loss: moving averages applied to medical data.

    PubMed

    Hay, Karen L; Bull, Brian S

    2009-01-01

    With the advent of computerized databases, medical data has become easy to accumulate; however, effective use of this data continues to pose significant problems. In other circumstances, smoothing algorithms have been used to uncover non-obvious correlations, trends and relationships in noisy data. We have applied four such algorithms to a large dataset of postoperative blood replacement in cardiopulmonary bypass patients. When applied to this dataset, one of the algorithms proved surprisingly effective. It confirmed several previously observed correlations, and also provided an additional series of counterintuitive and apparently unrelated associations. These associations have been explored in an accompanying paper. PMID:19699664

  16. Anti-anxiety self-medication induced by incentive loss in rats.

    PubMed

    Manzo, Lidia; Gómez, M José; Callejas-Aguilera, José E; Fernández-Teruel, Alberto; Papini, Mauricio R; Torres, Carmen

    2014-01-17

    Ethanol can be used to ameliorate negative emotion in anxiety-inducing situations. Two experiments tested whether rats would increase preference for ethanol immediately after anxiogenic sessions of appetitive extinction. It was predicted that preference for ethanol would be greater in inbred Roman low-avoidance rats (RLA-I) than in inbred Roman high-avoidance rats (RHA-I), given previous research demonstrating that the former strain exhibits greater sensitivity to incentive loss. Experiment 1 used a consummatory extinction task (22-to-0% sucrose downshift), whereas Experiment 2 used an instrumental extinction task (12-to-0 pellet downshift). In both experiments, postsession ethanol consumption was higher in RLA-I rats than in RHA-I rats. No strain differences in ethanol preference were found after acquisition sessions or in groups given postsession access to water. Because ethanol is an anti-anxiety drug, the present results suggest that rats are capable of changing their consummatory behavior to correct for an aversive emotional state induced by incentive loss. PMID:24148853

  17. The STRIDE Weight Loss and Lifestyle Intervention for Individuals taking Antipsychotic Medications: A Randomized Trial

    PubMed Central

    Green, Carla A.; Yarborough, Bobbi Jo H.; Leo, Michael C.; Yarborough, Micah T.; Stumbo, Scott P.; Janoff, Shannon L.; Perrin, Nancy A.; Nichols, Greg A.; Stevens, Victor J.

    2014-01-01

    Objectives STRIDE assessed whether a lifestyle intervention, tailored for individuals with serious mental illnesses, reduced weight and diabetes risk. Methods A multi-site, parallel, two-arm randomized controlled trial in community settings and an integrated health plan. Inclusion criteria: Age ≥18; taking antipsychotic medication for ≥30 days; BMI ≥27. Exclusions: significant cognitive impairment; pregnancy/breastfeeding; recent psychiatric hospitalization, bariatric surgery, cancer, heart attack or stroke. The intervention emphasized moderate caloric reduction, DASH diet, and physical activity. Blinded staff collected data at baseline, 6, and 12 months. Results Participants (56 men, 144 women), mean age = 47.2(SD =10.6), were randomized to usual care (n =96) or a 6-month weekly group intervention plus 6 monthly maintenance sessions (n =104). 181 participants (90.5%) completed 6-month, and 170 (85%) completed 12-month assessments, without differential attrition. Participants attended 14.5 of 24 sessions over 6 months. Intent-to-treat analyses found intervention participants lost 4.4 kg more than control participants from baseline to 6 months (95% CI [−6.96 kg, −1.78 kg]), and 2.6 kg more than controls (95% CI −5.14 kg, −0.07 kg] from baseline to 12 months. At 12 months, fasting glucose levels in controls had increased from 106.0 mg/dL to 109.5 mg/dL and decreased in intervention participants, from 106.3 mg/dL to 100.4 mg/dL. No serious adverse events were study-related; medical hospitalizations were reduced in the intervention group (6.7%) compared to controls (18.8%)(χ2= 6.66, p = 0.01). Conclusions Individuals taking antipsychotic medications can lose weight and improve fasting glucose levels. Increasing reach of the intervention is an important future step. Funding Source National Institute of Diabetes and Digestive and Kidney Diseases, Grant R18DK076775 Trial Registration Clinical Trials.gov, NCT00790517; http://clinicaltrials.gov/ct2/show

  18. Retrospective adjustment of self-assessed medical competencies – noteworthy in the evaluation of postgraduate practical training courses

    PubMed Central

    Nagler, Michael; Feller, S.; Beyeler, Christine

    2012-01-01

    Aim: The efficacy of postgraduate practical training courses is frequently evaluated by self-assessment instruments. The present study analyses the effect of a basic course in laparoscopic surgery on self-assessed medical competencies. Methods: The 3-day course included teaching of knowledge and training of practical skills. In relation to course evaluation, a questionnaire for self-assessment was applied at the beginning of the course ('pre-course'), at the end of the course ('post-course') and at the end of the course to reassess pre-course competencies ('retrospective pre-course'). Results: 89 out of 110 participants (81%) attending 10 courses completed all the questionnaires; 83% were postgraduate trainees in surgery and 82% were inexperienced as an independent surgeon. At the beginning of the course most trainees rated themselves as 'moderately competent' or 'fully competent' with respect to the various task levels as well as to specific areas of medical competencies. At the end of the course however pronounced retrospective revisions of self-assessment to lower ratings became apparent. Statistically significant differences were seen for the task 'performing surgical procedures under supervision' and for most of the practical skills trained during the course (p <0.01). In contrast, no significant differences were observed for knowledge taught during the course as well as for 'ability to work in a team' and 'ability to concentrate', which were not foci of the course. Conclusions: Surgeons with little experience change their self-assessment of pre-course competencies to a lower level after participation in a practical postgraduate training course. Evaluations comparing 'pre-course' and 'post-course' ratings only – without 'retrospective pre-course' ratings – may underestimate the training effects. This phenomenon needs to be taken into account when evaluations are dependent exclusively on self-assessment instruments. PMID:22737200

  19. Antarctic ice sheet mass loss, glacio-isostatic adjustment and surface processes from ENVISAT, ICESat, CryoSat-2, GRACE and GPS

    NASA Astrophysics Data System (ADS)

    Bamber, Jonathan L.; Martin-Espanol, Alba; Schoen, Nana; Zammit-Mangion, Andrew; Luthcke, Scott; Petrie, Liz; Remy, Frederique; Wouters, Bert; King, Matt; Rougier, Jonty

    2015-04-01

    Constraining past ice mass changes, identifying their cause(s) and determining rigorous error estimates, is important for closing the sea level budget and as an input for and test of numerical models. For the Antarctic ice sheet, considerable uncertainty remains between different methods and groups. Estimates obtained from altimetry, gravimetry, and mass-budget methods can yield conflicting results with error estimates that do not always overlap, while the, commonly adopted, use of different forward models to isolate and remove the effects of glacio-isostatic adjustment (GIA) and surface mass balance (SMB) processes introduces another source of uncertainty which is hard to quantify. To address both these issues, we present a statistical modelling approach to the problem. We combine the observational data, including satellite altimetry, GRACE, GPS and InSAR, and use the different degrees of spatial and temporal smoothness to constrain the underlying geophysical processes. This is achieved via a spatio-temporal Bayesian hierarchical model, employing dimensionality reduction methods to allow the solution to remain tractable in the presence of the large number (> 10^7) of observations involved. The resulting trend estimates are only dependent on length and smoothness properties obtained from numerical models, but are otherwise entirely data-driven. As a consequence, the solutions provide a valuable independent test of the forward models. Here, we present the annually-resolved spatial fields for i) dynamic ice loss, ii) SMB anomaly, iii) firn compaction and iv) (the time invariant) GIA, using a combination of GRACE, ICESat, ENVISat, CryoSat 2 and GPS vertical uplift rates, for 2003-2013. The elastic flexure of the crust is also determined simultaneously. We focus here primarily on the mass trends rather than solid earth effects. We obtain a mean rate of -97+-16 Gt/yr for the 11 year period with a statstically significant positive trend for East Antarctica and negative

  20. Block selective redaction for minimizing loss during de-identification of burned in text in irreversibly compressed JPEG medical images

    PubMed Central

    Clunie, David A.; Gebow, Dan

    2015-01-01

    Abstract. Deidentification of medical images requires attention to both header information as well as the pixel data itself, in which burned-in text may be present. If the pixel data to be deidentified is stored in a compressed form, traditionally it is decompressed, identifying text is redacted, and if necessary, pixel data are recompressed. Decompression without recompression may result in images of excessive or intractable size. Recompression with an irreversible scheme is undesirable because it may cause additional loss in the diagnostically relevant regions of the images. The irreversible (lossy) JPEG compression scheme works on small blocks of the image independently, hence, redaction can selectively be confined only to those blocks containing identifying text, leaving all other blocks unchanged. An open source implementation of selective redaction and a demonstration of its applicability to multiframe color ultrasound images is described. The process can be applied either to standalone JPEG images or JPEG bit streams encapsulated in other formats, which in the case of medical images, is usually DICOM. PMID:26158090

  1. Reach of Effective, Nationally-Available, Low-Cost, Nonprofit Weight Loss Program in Medically Underserved Areas (MUAs).

    PubMed

    Mitchell, Nia S; Nassel, Ariann F; Thomas, Deborah

    2015-12-01

    Obesity rates are higher for ethnic minority, low-income, and rural communities. Programs are needed to support these communities with weight management. We determined the reach of a low-cost, nationally-available weight loss program in Health Resources and Services Administration medically underserved areas (MUAs) and described the demographics of the communities with program locations. This is a cross-sectional analysis of Take Off Pounds Sensibly (TOPS) chapter locations. Geographic information systems technology was used to combine information about TOPS chapter locations, the geographic boundaries of MUAs, and socioeconomic data from the Decennial 2010 Census. TOPS is available in 30 % of MUAs. The typical TOPS chapter is in a Census Tract that is predominantly white, urban, with a median annual income between $25,000 and $50,000. However, there are TOPS chapters in Census Tracts that can be classified as predominantly black or predominantly Hispanic; predominantly rural; and as low or high income. TOPS provides weight management services in MUAs and across many types of communities. TOPS can help treat obesity in the medically underserved. Future research should determine the differential effectiveness among chapters in different types of communities. PMID:26072259

  2. Is the medical loss ratio a good target measure for regulation in the individual market for health insurance?

    PubMed

    Karaca-Mandic, Pinar; Abraham, Jean M; Simon, Kosali

    2015-01-01

    Effective January 1, 2011, individual market health insurers must meet a minimum medical loss ratio (MLR) of 80%. This law aims to encourage 'productive' forms of competition by increasing the proportion of premium dollars spent on clinical benefits. To date, very little is known about the performance of firms in the individual health insurance market, including how MLRs are related to insurer and market characteristics. The MLR comprises one component of the price-cost margin, a traditional gauge of market power; the other component is percent of premiums spent on administrative expenses. We use data from the National Association of Insurance Commissioners (2001-2009) to evaluate whether the MLR is a good target measure for regulation by comparing the two components of the price-cost margin between markets that are more competitive versus those that are not, accounting for firm and market characteristics. We find that insurers with monopoly power have lower MLRs. Moreover, we find no evidence suggesting that insurers' administrative expenses are lower in more concentrated insurance markets. Thus, our results are largely consistent with the interpretation that the MLR could serve as a target measure of market power in regulating the individual market for health insurance but with notable limited ability to capture product and firm heterogeneity. PMID:24123608

  3. A prospective trial for laparoscopic adjustable gastric banding in morbidly obese adolescents: an interim report of weight loss, metabolic and quality of life outcomes.

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The outcome of patients completing 12 months of follow-up in a prospective longitudinal trial of the safety/efficacy of laparoscopic adjustable gastric banding (LAGB), for morbidly obese adolescents aged 14 to 17 years using a Food and Drug Administration Institutional Device Exemption for the use o...

  4. Novel Multiplexer to Enable Multiple-Module Imaging with Adjustable High Spatial Resolution and Predetermined Display Bandwidth for Array Medical Imaging Systems.

    PubMed

    Sharma, P; Titus, A H; Qu, B; Huang, Y; Wang, W; Kuhls-Gilcrist, A; Cartwright, A N; Bednarek, D R; Rudin, S

    2010-01-01

    We describe a custom multiple-module multiplexer integrated circuit (MMMIC) that enables the combination of discrete Electron multiplying charge coupled devices (EMCCD) based imaging modules to improve medical imaging systems. It is highly desirable to have flexible imaging systems that provide high spatial resolution over a specific region of interest (ROI) and a field of view (FOV) large enough to encompass areas of clinical interest. Also, such systems should be dynamic, i.e. should be able to maintain a specified acquisition bandwidth irrespective of the size of the imaged FOV. The MMMIC achieves these goals by 1) multiplexing the outputs of an array of imaging modules to enable a larger FOV, 2) enabling a number of binning modes for adjustable high spatial resolution, and 3) enabling selection of a subset of modules in the array to achieve ROI imaging at a predetermined display bandwidth. The MMMIC design also allows multiple MMMICs to be connected to control larger arrays. The prototype MMMIC was designed and fabricated in the ON-SEMI 0.5μm CMOS process through MOSIS (www.mosis.org). It has three 12-bit inputs, a single 12-bit output, three input enable bits, and one output enable, so that one MMMIC can control the output from three discrete imager arrays. The modular design of the MMMIC enables four identical chips, connected in a two-stage sequential arrangement, to readout a 3×3 collection of individual imaging modules. The first stage comprises three MMMICs (each connected to three of the individual imaging module), and the second stage is a single MMMIC whose 12-bit output is then sent via a CameraLink interface to the system computer. The prototype MMMIC was successfully tested using digital outputs from two EMCCD-based detectors to be used in an x-ray imaging array detector system.Finally, we show how the MMMIC can be used to extend an imaging system to include any arbitrary (M×N) array of imaging modules enabling a large FOV along with ROI imaging

  5. STRIDE: a randomized trial of a lifestyle intervention to promote weight loss among individuals taking antipsychotic medications

    PubMed Central

    2013-01-01

    Background Individuals diagnosed with serious mental illnesses are at increased risk of obesity- and cardiovascular-related morbidity and early mortality. Lifestyle interventions aimed at weight loss, even those adapted to suit the needs of this particular subgroup, have rarely produced clinically meaningful reductions in weight. Methods/design The STRIDE study is a multi-site, parallel, two-arm randomized controlled translational trial. Participants were recruited from community mental health clinics and an integrated not-for-profit health system. Participants were randomized either to usual care or to a 12-month intervention that consisted of: 1) weekly group participation for six months covering topics on nutrition, physical activity and lifestyle changes; 2) monthly group participation for an additional six month maintenance period; and 3) individual monthly contacts from intervention group facilitators during the second six month phase. All participants are assessed at baseline, 6, 12, and 24 months post-enrollment. Process and implementation evaluations are included and the study design includes a cost-utility analysis. Participants include 200 individuals with serious mental illness with an average age of 47.1 years, a mean body-mass index of 38.3 kg/m2 and taking an average of 3.2 psychiatric medications at baseline. Baseline physiological measures included mean blood pressure (SBP/DBP) measurements of 119.2 (SD = 14.7)/79.4 (SD = 10.1); 35% reported a hypertension diagnosis and 11% took antihypertensive medications. Average lipid levels (mg/dL) were: a) triglycerides 188.0 (SD = 138.6), ranged from 43 to 1145; b) LDL 101.4 (SD = 32.9) and ranged from 17 to 185; c) HDL 45.8 (SD = 12.7) and ranged from 22 to 89; and d) total cholesterol 181.6 (SD = 39.7) and ranged from 50 to 324. Average fasting glucose levels were 108.9 (SD = 32.5) and ranged from 24 to 289. Average fasting insulin levels were 13.0 (SD=11.9) and ranged from 2

  6. Memory loss

    MedlinePlus

    ... usually include asking questions of family members and friends. For this reason, they should come to the appointment. Medical history questions may include: Type of memory loss, such as short-term or long-term ...

  7. Additional double-wall roof in single-wall, closed, convective incubators: Impact on body heat loss from premature infants and optimal adjustment of the incubator air temperature.

    PubMed

    Delanaud, Stéphane; Decima, Pauline; Pelletier, Amandine; Libert, Jean-Pierre; Stephan-Blanchard, Erwan; Bach, Véronique; Tourneux, Pierre

    2016-09-01

    Radiant heat loss is high in low-birth-weight (LBW) neonates. Double-wall or single-wall incubators with an additional double-wall roof panel that can be removed during phototherapy are used to reduce Radiant heat loss. There are no data on how the incubators should be used when this second roof panel is removed. The aim of the study was to assess the heat exchanges in LBW neonates in a single-wall incubator with and without an additional roof panel. To determine the optimal thermoneutral incubator air temperature. Influence of the additional double-wall roof was assessed by using a thermal mannequin simulating a LBW neonate. Then, we calculated the optimal incubator air temperature from a cohort of human LBW neonate in the absence of the additional roof panel. Twenty-three LBW neonates (birth weight: 750-1800g; gestational age: 28-32 weeks) were included. With the additional roof panel, R was lower but convective and evaporative skin heat losses were greater. This difference can be overcome by increasing the incubator air temperature by 0.15-0.20°C. The benefit of an additional roof panel was cancelled out by greater body heat losses through other routes. Understanding the heat transfers between the neonate and the environment is essential for optimizing incubators. PMID:27387899

  8. Adjustment disorder

    MedlinePlus

    American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 5th ed. Arlington, Va: American Psychiatric Publishing. 2013. Powell AD. Grief, bereavement, and adjustment disorders. In: Stern TA, Rosenbaum ...

  9. Early Pregnancy Loss

    MedlinePlus

    ... is called early pregnancy loss , miscarriage , or spontaneous abortion . How common is early pregnancy loss? Early pregnancy ... testes that can fertilize a female egg. Spontaneous Abortion: The medical term for early pregnancy loss. Trimester: ...

  10. [Psychological changes in intensive care patients with acute Guillain-Barré syndrome--psychoanalytic aspects of loss of communication and adjustment].

    PubMed

    Weiss, H

    1991-04-01

    Ten patients who had been hospitalized with acute Guillain-Barré-syndrome (GBS) were monitored during their course of treatment and were asked in short intervals through semi-structured interviews how they experienced their illness. States of anxiety were especially evident at the initial phase of the disease, during the dissemination and maximum intensity of paralysis. In contrast, depressive symptoms were primarily noticeable during the phase of remission. As a rule, the degree of anxiety correlated in intensity and duration with the degree of severity of the neurological deficit. Five patients experienced a temporary derealization, among those, three patients showed productive-psychotic symptoms (optical and acoustical hallucinations, delusional reactions). Frequently, dreams were reported, which were associated with elementary experiences of anxiety and in part took on an overwhelming realistic character. Finally, the psychic changes are interpreted in context with the extreme condition of the disease which does not only signify a situation of forced dependence and regression for the patient but also results in--through loss of mobility and communication (cranial nerve dysfunction, artificial respiration)--a fundamental change in the perception of reality. PMID:2055586

  11. [Forensic medical assessment of vascular and neuronal lesions in the brain associated with acute blood loss and anemia].

    PubMed

    Indiaminov, S I

    2010-01-01

    Brain tissues available for examination in the present study were obtained from 30 subjects who died from the blood loss following injuries to blood vessels and internal organs inflicted by sharp objects. The study revealed variable character of tanatogenesis induced by acute blood loss and anemia. Tanatogenesis associated with injuries to the heart and major blood vessels is most likely due to the deficiency of blood in the microcirculatory system developing in the terminal period. The main tanatogenic factors in subjects with multiple injuries to peripheral vessels are vascular dystonia and abnormal rheological properties of blood. PMID:20394188

  12. Medical services of Croat people in Bosnia and Herzegovina during 1992-1995 war: losses, adaptation, organization, and transformation.

    PubMed

    Bagaric, I

    2000-06-01

    During the 1992-1995 war in Bosnia and Herzegovina (BH), Croatian people in BH had 19,600 (2.6%) killed and 135,000 (17.6%) displaced persons, and 222,500 (28.9%) refugees. They lost around two thirds of both physicians and other health personnel, and were left with 8. 5% of prewar patient beds. Fortunately, the organized defence against Serbs was initiated in time and Croats defended the territories where they formed majority. The first defense unit established was the Medical Corps Headquarters (MCH), caring for soldiers and civilians alike. The MCH was soon incorporated in the Croatian Defense Council (CDC, armed forces of Croatian people in BH). The MCH had two chains of command. One went through the district commanders of medical services and their subordinated physicians to paramedics in military units, and the other directly to the commanders of 14 war hospitals. After its formation in 1993, the Ministry of Health took the jurisdiction over the civilian medical services and after the Washington Peace Agreement (April 1994) over the war hospitals, too, whereas the medical services within military units remained under control of the Ministry of Defense. Dayton Peace Agreement divided BH into the Federation of BH and Republic Srpska, each with their own army. The Federation of BH Army is composed of the CDC and Bosniac-controlled Army of BH, with overall numerical ratio 1:2.3 for Bosniacs, and organized in accordance with NATO standards. Military medical services are provided by the Logistics Sector of both Ministry of Defense and Military Corps Headquarters (Joint Command). PMID:10853039

  13. Adjustable microforceps.

    PubMed

    Bao, J Y

    1991-04-01

    The commonly used microforceps have a much greater opening distance and spring resistance than needed. A piece of plastic ring or rubber band can be used to adjust the opening distance and reduce most of the spring resistance, making the user feel more comfortable and less fatigued. PMID:2051437

  14. Adjustable Optical-Fiber Attenuator

    NASA Technical Reports Server (NTRS)

    Buzzetti, Mike F.

    1994-01-01

    Adjustable fiber-optic attenuator utilizes bending loss to reduce strength of light transmitted along it. Attenuator functions without introducing measurable back-reflection or insertion loss. Relatively insensitive to vibration and changes in temperature. Potential applications include cable television, telephone networks, other signal-distribution networks, and laboratory instrumentation.

  15. Shaft adjuster

    DOEpatents

    Harry, Herbert H.

    1989-01-01

    Apparatus and method for the adjustment and alignment of shafts in high power devices. A plurality of adjacent rotatable angled cylinders are positioned between a base and the shaft to be aligned which when rotated introduce an axial offset. The apparatus is electrically conductive and constructed of a structurally rigid material. The angled cylinders allow the shaft such as the center conductor in a pulse line machine to be offset in any desired alignment position within the range of the apparatus.

  16. Quantifying Morbidity Burdens and Medical Utilization of Children with Intellectual Disabilities in Taiwan: A Nationwide Study Using the ACG Case-Mix Adjustment System

    ERIC Educational Resources Information Center

    Lee, Wui-Chiang; Chen, Tzeng-Ji

    2012-01-01

    The purpose of this study was to quantify morbidity burdens of children with intellectual disability (ID) and to examine its association with total medical utilization and expenditure on a national basis in Taiwan. People under 18 years of age that had been continuously enrolled in the National Health Insurance (NHI) between year 2008 and 2010…

  17. Dissonant Role Perception and Paradoxical Adjustments: An Exploratory Study on Medical Residents' Collaboration with Senior Doctors and Head Nurses

    ERIC Educational Resources Information Center

    Fiordelli, Maddalena; Schulz, Peter J.; Caiata Zufferey, Maria

    2014-01-01

    A good collaboration between health professionals is considered to have benefits for patients, healthcare staff, and organizations. Nevertheless, effective interprofessional collaboration is difficult to achieve. This is particularly true for collaboration between Medical Residents (MRs) and the immediate colleagues they interact with, as Senior…

  18. Ways Children Adjust to Limb Loss

    MedlinePlus

    ... 2: Emotional Response and Early Management . http://www.amputee-coalition.org/inmotion/mar_apr_06/congenital_part2. ... 05/2009 Back to Top © Copyrighted by the Amputee Coalition . Local reproduction for use by Amputee Coalition ...

  19. Estimating the Roles of Genetic Risk, Perinatal Risk, and Marital Hostility on Early Childhood Adjustment: Medical Records and Self-Reports.

    PubMed

    Neiderhiser, Jenae M; Marceau, Kristine; De Araujo-Greecher, Marielena; Ganiban, Jody M; Mayes, Linda C; Shaw, Daniel S; Reiss, David; Leve, Leslie D

    2016-05-01

    A wide variety of perinatal risk factors have been linked to later developmental outcomes in children. Much of this work has relied on either birth/medical records or mothers' self-reports collected after delivery, and there has been an ongoing debate about which strategy provides the most accurate and reliable data. This report uses a parent-offspring adoption design (N = 561 families) to (1) examine the correspondence between medical record data and self-report data, (2) examine how perinatal risk factors may influence child internalizing and externalizing behavior at age 4.5 years, and (3) explore interactions among genetic, perinatal risk, and rearing environment on child internalizing and externalizing behavior during early childhood. The agreement of self-reports and medical records data was relatively high (51-100 %), although there was some variation based on the construct. There were few main effects of perinatal risk on child outcomes; however, there were several 2- and 3-way interactions suggesting that the combined influences of genetic, perinatal, and rearing environmental risks are important, particularly for predicting whether children exhibit internalizing versus externalizing symptoms at age 4.5 years. PMID:27075497

  20. Adjustment to College in Students with ADHD

    ERIC Educational Resources Information Center

    Rabiner, David L.; Anastopoulos, Arthur D.; Costello, Jane; Hoyle, Rick H.; Swartzwelder, H. Scott

    2008-01-01

    Objective: To examine college adjustment in students reporting an ADHD diagnosis and the effect of medication treatment on students' adjustment. Method: 1,648 first-semester freshmen attending a public and a private university completed a Web-based survey to examine their adjustment to college. Results: Compared with 200 randomly selected control…

  1. Physiological adjustments of sand gazelles (Gazella subgutturosa) to a boom-or-bust economy: standard fasting metabolic rate, total evaporative water loss, and changes in the sizes of organs during food and water restriction.

    PubMed

    Ostrowski, Stephane; Mesochina, Pascal; Williams, Joseph B

    2006-01-01

    To test the hypothesis that desert ungulates adjust their physiology in response to long-term food and water restriction, we established three groups of sand gazelles (Gazella subgutturosa): one that was provided food and water (n = 6; CTRL) ad lib. for 4 mo, one that received ad lib. food and water for the same period but was deprived of food and water for the last 4.5 d (n = 6; EXPT(1)), and one that was exposed to 4 mo of progressive food and water restriction, an experimental regime designed to mimic conditions in a natural desert setting (n = 6; EXPT(2)). At the end of the 4-mo experiment, we measured standard fasting metabolic rate (SFMR) and total evaporative water loss (TEWL) of all sand gazelles and determined lean dry mass of organs of gazelles in CTRL and EXPT(2). Gazelles in CTRL had a mean SFMR of 2,524 +/- 194 kJ d(-1), whereas gazelles in EXPT(1) and EXPT(2) had SFMRs of 2,101+/- 232 and 1,365 +/- 182 kJ d(-1), respectively, values that differed significantly when we controlled for differences in body mass. Gazelles had TEWLs of 151.1 +/- 18.2, 138.5 +/- 17.53, and 98.4 +/- 27.2 g H(2)O d(-1) in CTRL, EXPT(1), and EXPT(2), respectively. For the latter group, mass-independent TEWL was 27.1% of the value for CTRL. We found that normally hydrated sand gazelles had a low mass-adjusted TEWL compared with other arid-zone ungulates: 13.6 g H(2)O kg(-0.898) d(-1), only 17.1% of allometric predictions, the lowest ever measured in an arid-zone ungulate. After 4 mo of progressive food and water restriction, dry lean mass of liver, heart, and muscle of gazelles in EXPT(2) was significantly less than that of these same organs in CTRL, even when we controlled for body mass decrease. Decreases in the dry lean mass of liver explained 70.4% of the variance of SFMR in food- and water-restricted gazelles. As oxygen demands decreased because of reduced organ sizes, gazelles lost less evaporative water, probably because of a decreased respiratory water loss. PMID

  2. Young child with severe brain volume loss easily passes the word memory test and medical symptom validity test: implications for mild TBI.

    PubMed

    Carone, Dominic A

    2014-01-01

    The Word Memory Test (WMT) and Medical Symptom Validity Test (MSVT) are two commonly used free-standing measures of test-taking effort. The use of any test as a measure of effort is enhanced when evidence shows that it can be easily passed by patients with severe neurological conditions. The opportunity arose to administer the WMT and MSVT to a 9-year-old girl (referred to as CJ) with severe congenital bilateral brain tissue loss (shown via a compelling brain MRI image), chronic epilepsy, an extremely low Full Scale IQ, extremely low adaptive functioning, developmental delays, numerous severe cognitive impairments, and treatment with multiple high-dose benzodiazepines. She received extensive early intervention services and numerous academic accommodations. Despite this set of problems, CJ passed the WMT and MSVT at perfect to near perfect levels. Implications for failure on these tests among patients with known or alleged mild traumatic brain injury are discussed. PMID:24266623

  3. Management of type 2 diabetes mellitus in self-motivated patients: optimized diet, exercise, and medication for weight loss and cardiometabolic fitness.

    PubMed

    Nadeau, Daniel A

    2014-11-01

    Type 2 diabetes mellitus (T2DM) is a growing public health problem with significant lifetime health care costs. The majority of Americans do not achieve minimal targets for exercise, and individuals with T2DM typically engage in less exercise than the general adult population. However, those patients with T2DM who are sufficiently self-motivated to manage their condition have the potential to reverse diabetes and prevent its complications through behavioral and pharmacologic interventions. Marked improvements are possible through increased awareness and selection of healthy eating options, a willingness to incorporate vigorous exercise into their lifestyle, and the use of newer medications that essentially eliminate the risk of hypoglycemia while facilitating weight loss and the achievement of ideal glucose targets. For self-motivated patients, daily aerobic activity of 45 to 60 minutes per day may be a suitable target. For those who have cardiovascular clearance, high-intensity interval training accomplishes high levels of cardiometabolic fitness with shorter training periods by alternating moderate and intense exertion. Suitable medications that have a low risk of hypoglycemia during exercise include metformin, glucagon-like peptide-1 receptor agonists, dipeptidyl peptidase-4 inhibitors, and sodium-glucose linked transporter-2 inhibitors. Specific daily caloric goals and incorporation of a mainly plant-based diet should be considered as a primary target for diabetes management. Self-management is important to achieving diabetes treatment goals, and mobile applications can be useful tools to support lifestyle changes in patients with T2DM. PMID:25419888

  4. Synthesis and magnetic properties of platelet γ-Fe 2O 3 particles for medical applications using hysteresis-loss heating

    NASA Astrophysics Data System (ADS)

    Kishimoto, Mikio; Minagawa, Makoto; Yanagihara, Hideto; Oda, Tatsuya; Ohkochi, Nobuhiro; Kita, Eiji

    2012-04-01

    Platelet γ-Fe2O3 particles of particle size less than 100 nm were prepared for medical applications that use the hysteresis-loss heating of ferromagnetic particles. The γ-Fe2O3 particles were obtained through the dehydration, reduction, and oxidation of platelet α-FeOOH particles, which were synthesized by the precipitation of ferric ions in an alkaline solution containing ethanolamine, and the crystals grown using a hydrothermal treatment. The γ-Fe2O3 particles contained dimples formed by the dehydration of α-FeOOH particles. The coercive force and the saturation magnetization of the γ-Fe2O3 particles were in the ranges 11.9 to 12.7 kA/m (150 to 160 Oe), and 70 to 72 Am2/kg (70 to 72 emu/g), respectively. The specific loss power of the γ-Fe2O3 particles, estimated from their temperature-raising property measured under a peak magnetic field of 50.9 kA/m (640 Oe) and at a frequency of 117 kHz, was 590 W/g. This value is higher than that of spherical cobalt-containing iron oxide particles having equivalent coercive force and saturation magnetization, reflecting the larger area of the minor hysteresis loop measured under a peak magnetic field of 50.9 kA/m (640 Oe).

  5. Drugs and hair loss.

    PubMed

    Patel, Mansi; Harrison, Shannon; Sinclair, Rodney

    2013-01-01

    Hair loss is a common complaint, both in men and women, and use of prescription medications is widespread. When there is a temporal association between the onset of hair loss and commencement of a medication, the medication is commonly thought to have caused the hair loss. However, hair loss and in particular telogen effluvium may occur in response to a number of triggers including fever, hemorrhage, severe illness, stress, and childbirth, and a thorough exclusion of these potential confounders is necessary before the hair loss can be blamed on the medication. Certain medications are known to cause hair loss by a variety of mechanisms including anagen arrest, telogen effluvium, or accentuation of androgenetic alopecia by androgens. PMID:23159177

  6. Association of Weight Loss and Medication Adherence Among Adults With Type 2 Diabetes Mellitus: SHIELD (Study to Help Improve Early evaluation and management of risk factors Leading to Diabetes)☆

    PubMed Central

    Grandy, Susan; Fox, Kathleen M.; Hardy, Elise

    2013-01-01

    Background Adherence to prescribed diabetes medications is suboptimal, which can lead to poor glycemic control and diabetic complications. Treatment-related weight gain is a side effect of some oral antidiabetic agents and insulin, which may negatively affect adherence to therapy. Objective This study investigated whether adults with type 2 diabetes mellitus (T2DM) who lost weight had better medication adherence than those who gained weight. Methods Weight change over 1 year (2007 to 2008) was assessed among respondents in the US Study to Help Improve Early evaluation and management of risk factors Leading to Diabetes (SHIELD). Weight loss of >1.0%, ≥3%, and ≥5% of weight was compared with weight gain of ≥1.0%. Medication adherence was assessed using the Morisky 4-item questionnaire for medication-taking behavior, with lower scores representing better adherence. Results There were 746 T2DM respondents who lost >1.0%, 483 who lost ≥3%, 310 who lost ≥5%, and 670 who gained ≥1.0% of weight. Each weight-loss group had significantly lower Morisky scores than the weight-gain group; mean scores of 0.389 versus 0.473 (P = 0.050) for the >1.0% weight-loss group, 0.365 versus 0.473 (P = 0.026) for the ≥3% weight-loss group, and 0.334 versus 0.473 (P = 0.014) for the ≥5% weight-loss group. Significantly fewer respondents who lost weight had received insulin, sulfonylurea, or thiazolidinedione therapy (57%) compared with respondents who gained weight (64%) (P = 0.002). Demographics, exercise habits, and dieting were similar between weight-loss and weight-gain groups. Conclusions T2DM respondents with weight loss had significantly better medication adherence and were less likely to be on treatment regimens that increase weight than T2DM respondents with weight gain. These findings suggest that strategies that lead to weight loss, including use of diabetes medications associated with weight loss, may improve medication adherence. PMID:24465048

  7. The End-of-Life Experience: Modifiable Predictors of Caregivers’ereavement Adjustment

    PubMed Central

    Garrido, Melissa M.; Prigerson, Holly G.

    2013-01-01

    Background The objective of this study is to determine the best set of predictors of psychological disorders, regrets, health-related quality of life, and mental health function among bereaved caregivers of patients with cancer, thereby identifying promising targets for interventions to improve bereavement adjustment. Methods Coping with Cancer is a longitudinal study of patients with advanced cancer and informal caregivers who were enrolled from 2002–2008. Our main outcome measure was bereavement adjustment of 245 caregivers (e.g., depression, anxiety, regrets) six months post-loss. The Structured Clinical Interview of the Diagnostic and Statistical Manual of Mental Disorders determined if caregivers met criteria for Major Depressive Disorder (MDD) or an anxiety disorder. Changes in health-related quality of life and mental health function from baseline to post-loss were assessed with the Medical Outcomes Study Short Form (SF-36). Results Over half the caregivers reported regret about the cancer patient’s end-of-life care; better patient quality of death (Adjusted Odds Ratio [AOR]= 0.77, 95% Confidence Interval [CI]= 0.67–0.88) reduced the risk of bereavement regret. The incidence of MDD or anxiety among the bereaved caregivers was 12.6% and was less likely for caregivers with better mental health pre-loss (AOR=0.03, 95% CI=0.004–0.25). Better patient quality of death also predicted improved caregiver health-related quality of life (adjusted standardized beta=0.28, p<.001). Do not resuscitate order completion predicted improved mental health from pre-loss to post-loss (adjusted standardized beta=0.29, p<.001). Conclusions Reducing caregiver distress, encouraging patient advance care planning, and improving patients’ quality of death appear promising targets of interventions to improve caregiver bereavement adjustment. PMID:24301644

  8. Hearing Loss

    MedlinePlus

    ... version of this page please turn Javascript on. Hearing Loss What is Hearing Loss? Hearing loss is a common problem caused by ... sec Click to watch this video Types of Hearing Loss Hearing loss comes in many forms. It can ...

  9. Medical Issues: Equipment

    MedlinePlus

    ... Pool Living With SMA Medical Issues Palliative Breathing Orthopedics Nutrition Equipment Daily Life At School At Home ... Diagnosed Living With SMA Medical Issues Palliative Breathing Orthopedics Nutrition Equipment Daily Life Grief & Loss Community & Local ...

  10. 21 CFR 880.5110 - Hydraulic adjustable hospital bed.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Hydraulic adjustable hospital bed. 880.5110... Therapeutic Devices § 880.5110 Hydraulic adjustable hospital bed. (a) Identification. A hydraulic adjustable hospital bed is a device intended for medical purposes that consists of a bed with a hydraulic...

  11. 21 CFR 880.5110 - Hydraulic adjustable hospital bed.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Hydraulic adjustable hospital bed. 880.5110... Therapeutic Devices § 880.5110 Hydraulic adjustable hospital bed. (a) Identification. A hydraulic adjustable hospital bed is a device intended for medical purposes that consists of a bed with a hydraulic...

  12. 21 CFR 880.5110 - Hydraulic adjustable hospital bed.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Hydraulic adjustable hospital bed. 880.5110... Therapeutic Devices § 880.5110 Hydraulic adjustable hospital bed. (a) Identification. A hydraulic adjustable hospital bed is a device intended for medical purposes that consists of a bed with a hydraulic...

  13. 21 CFR 880.5120 - Manual adjustable hospital bed.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Manual adjustable hospital bed. 880.5120 Section... Therapeutic Devices § 880.5120 Manual adjustable hospital bed. (a) Identification. A manual adjustable hospital bed is a device intended for medical purposes that consists of a bed with a manual...

  14. 21 CFR 880.5110 - Hydraulic adjustable hospital bed.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Hydraulic adjustable hospital bed. 880.5110... Therapeutic Devices § 880.5110 Hydraulic adjustable hospital bed. (a) Identification. A hydraulic adjustable hospital bed is a device intended for medical purposes that consists of a bed with a hydraulic...

  15. ADJUSTABLE DOUBLE PULSE GENERATOR

    DOEpatents

    Gratian, J.W.; Gratian, A.C.

    1961-08-01

    >A modulator pulse source having adjustable pulse width and adjustable pulse spacing is described. The generator consists of a cross coupled multivibrator having adjustable time constant circuitry in each leg, an adjustable differentiating circuit in the output of each leg, a mixing and rectifying circuit for combining the differentiated pulses and generating in its output a resultant sequence of negative pulses, and a final amplifying circuit for inverting and square-topping the pulses. (AEC)

  16. Adjustable sutures in children.

    PubMed

    Engel, J Mark; Guyton, David L; Hunter, David G

    2014-06-01

    Although adjustable sutures are considered a standard technique in adult strabismus surgery, most surgeons are hesitant to attempt the technique in children, who are believed to be unlikely to cooperate for postoperative assessment and adjustment. Interest in using adjustable sutures in pediatric patients has increased with the development of surgical techniques specific to infants and children. This workshop briefly reviews the literature supporting the use of adjustable sutures in children and presents the approaches currently used by three experienced strabismus surgeons. PMID:24924284

  17. 7 CFR 981.401 - Adjusted kernel weight.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... weight of delivery 10,000 10,000 2. Percent of edible kernel weight 53.0 84.0 3. Less weight loss in... 7 Agriculture 8 2013-01-01 2013-01-01 false Adjusted kernel weight. 981.401 Section 981.401... Administrative Rules and Regulations § 981.401 Adjusted kernel weight. (a) Definition. Adjusted kernel...

  18. The reliability of a 10-test package for patients with prolonged back and neck pain: could an examiner without formal medical education be used without loss of quality? A methodological study

    PubMed Central

    Lindell, Odd; Eriksson, Lars; Strender, Lars-Erik

    2007-01-01

    Background In the rehabilitation of patients with prolonged back and neck pain, the physical impairment should be assessed. Previous research has exclusively engaged medically educated examiners, mostly physiotherapists. However, less biased evaluations of efforts at rehabilitation might be achieved by personnel standing outside the treatment work itself. Therefore, if medically untrained examiners could be used without cost to the quality, this might produce a better evaluation at defensible cost and could also be useful in a research context. The aim of this study was to answer the question: given a 10-test package for patients with prolonged back and neck pain, could an examiner without formal medical education be used without loss of quality? Five of the ten tests required the examiner to keep a firm hold against the foundation of those parts of the participant's body that were not supposed to move during the test. Methods Examination by an experienced physiotherapist (A) in performing the package was compared with that by a research assistant (B) without formal medical education. The reliability, including inter- and intra-rater reliability, was assessed. In the inter-rater reliability study, 50 participants (30 patients + 20 healthy subjects) were tested once each by A and B. In the intra-rater reliability study, the 20 healthy subjects were tested twice by A or B. One-way ANOVA intra-class-correlation coefficient (ICC) was calculated and its possible systematic error was determined using a t-test. Results All five tests that required no manual fixation had acceptable reliability (ICC > .60 and no indication of systematic error). Only one of the five tests that required fixation had acceptable reliability. The difference (five vs. one) was significant (p = .01). Conclusion In a 10-test package for patients with prolonged back and neck pain, an examiner without formal medical education could be used without loss of quality, at least for the five tests

  19. PreDictor Research in Obesity during Medical care - weight Loss in children and adolescents during an INpatient rehabilitation: rationale and design of the DROMLIN study

    PubMed Central

    2014-01-01

    Background Obesity in adults and children is increasing worldwide at alarming rates. Obese children and adolescents are likely to become obese adults with increased risk of a number of comorbidities. In addition to preventing the development of obesity at young age, it is necessary to individualize the therapy of already obese children and adolescents in order to increase the likelihood of weight loss and maintenance. Therefore, the aim of this study is to identify predictors which play a significant role in successful weight loss and weight loss maintenance in children and adolescents. Methods/Design Over a one year period, 60 obese children and adolescents between 9 to 17 years of age shall be recruited at an inpatient children rehabilitation facility in Germany. They will be investigated twice within a few days following admission and prior to discharge. The study will be an integrated component of an established inpatient weight-loss and in part psychosomatic therapy. The collected data can be grouped into four clusters: 1) demographic, sociometric and psychometric data, 2) objective and subjective parameters of body condition, 3) autonomic nervous system regulated functions and 4) objective and subjective parameters for eating behavior. Primary outcome is the change of the body mass index standard deviation score (BMI-SDS). In order to evaluate the data appropriately, all examinations will be also conducted in a normal-weight reference group, matched for age and gender. Discussion For some of the collected parameters the time span between measures may be too short. Therefore, a 6 months, 1 year and 2 year follow-up will be performed for evaluating the different predictors and their influence in regard to a successful intervention. Further middle- and long-term follow-up studies are planned. Trial Registration The study protocol was approved by the Ethics Committee of the University Hospital Tübingen, Germany. This study is registered at the German Clinical

  20. Systemic Antibiotics and Tooth Loss in Periodontal Disease

    PubMed Central

    Cunha-Cruz, J.; Hujoel, P.P.; Maupome, G.; Saver, B.

    2008-01-01

    Systemic antibiotics have been recommended for the treatment of destructive periodontal disease. Our goal was to relate antibiotic use for medical or dental reasons to subsequent tooth loss in a cohort of 12,631 persons with destructive periodontal disease. After adjustment for age, smoking, and other confounders, the dispensing of antibiotics for 1-13 days, 14-20 days, or 21 or more days was not associated with reduced tooth loss [Adjusted rate ratio (RR) = 1.0; 95% Confidence Interval (CI) = 0.8-1.1; RR = 1.2; 95% CI = 0.9-1.4, and RR =1.2, 95% CI =1.0-1.3, respectively]. Numerous subgroup analyses were consistent with these overall null findings, with two exceptions: Longer courses of tetracyclines were associated with reduced tooth loss among persons receiving periodontal care, and penicillin was associated with reduced tooth loss among persons with more severe disease. Long-term, larger randomized trials are needed to provide evidence that antibiotics reduce tooth loss when used in the management of destructive periodontal disease. PMID:18719216

  1. Adjusting the Chain Gear

    NASA Astrophysics Data System (ADS)

    Koloc, Z.; Korf, J.; Kavan, P.

    The adjustment (modification) deals with gear chains intermediating (transmitting) motion transfer between the sprocket wheels on parallel shafts. The purpose of the adjustments of chain gear is to remove the unwanted effects by using the chain guide on the links (sliding guide rail) ensuring a smooth fit of the chain rollers into the wheel tooth gap.

  2. Adjustment to Recruit Training.

    ERIC Educational Resources Information Center

    Anderson, Betty S.

    The thesis examines problems of adjustment encountered by new recruits entering the military services. Factors affecting adjustment are discussed: the recruit training staff and environment, recruit background characteristics, the military's image, the changing values and motivations of today's youth, and the recruiting process. Sources of…

  3. Factors Affecting Psychosocial Adjustment of Deaf Students.

    ERIC Educational Resources Information Center

    Polat, Filiz

    2003-01-01

    A study involving 1,097 elementary and secondary students who are deaf found that degree of hearing loss, additional disability, and age at onset were negatively related to psychosocial adjustment. However, there was a positive relationship with the use of hearing aids, speech intelligibility, academic achievement, parental hearing status, and…

  4. Perioperative blood loss in total hip and knee arthroplasty: Outcomes associated with intravenous tranexamic acid use in an academic medical center

    PubMed Central

    Hogan, Craig A; Golightly, Larry K; Phong, Suzanne; Dayton, Michael R; Lyda, Clark; Barber, Gerard R

    2016-01-01

    Objectives: Clinical trials have reported decreased blood loss with the use of tranexamic acid during joint reconstruction. The purpose of this study was to assess the individual practice implications of tranexamic acid use in joint replacement surgery. Methods: Health records of adults undergoing total knee arthroplasty and total hip arthroplasty over a 12-month period were retrospectively reviewed. The treatment group comprised patients who received intravenous tranexamic acid perioperatively. The control group comprised patients who did not receive tranexamic acid. Results: Patients in the treatment group (n = 64) and the control group (n = 99) were well matched for demographics, orthopedic diagnosis, and comorbidities. In-hospital postsurgical mean decreases in hemoglobin concentrations were −4.05 g/dL and −4.94 g/dL in the treatment and control groups, respectively (p < 0.001). Postsurgical mean decreases in hematocrit levels were −11.2% and −14.2% in the treatment and control groups, respectively (p < 0.001). Three patients in the treatment group (5%) and 21 patients in the control group (21%) received red blood cell transfusions (p = 0.006). As compared to control, the relative risk of transfusion in the treatment group was 0.23 (95% confidence interval = 0.07–0.76) and the number needed to treat to avoid one transfusion was 7.0 (95% confidence interval = 3.8–14.4). No evidence of thromboembolism or other serious complications were observed in either group. Conclusions: In patients undergoing joint replacement surgery, perioperative administration of tranexamic acid was associated with diminished blood loss and lesser resource utilization. PMID:27026800

  5. Personality, attrition and weight loss in treatment seeking women with obesity.

    PubMed

    Dalle Grave, R; Calugi, S; Compare, A; El Ghoch, M; Petroni, M L; Colombari, S; Minniti, A; Marchesini, G

    2015-10-01

    Studies on small samples or in single units applying specific treatment programmes found an association between some personality traits and attrition and weight loss in individuals treated for obesity. We aimed to investigate whether pre-treatment personality traits were associated with weight loss outcomes in the general population of women with obesity. Attrition and weight loss outcomes after 12 months were measured in 634 women with obesity (mean age, 48; body mass index (BMI), 37.8 kg m(-2)) seeking treatment at eight Italian medical centres, applying different medical/cognitive behavioural programmes. Personality traits were assessed with the Temperament and Character Inventory (TCI), eating disorder features with the Binge Eating Scale (BES) and Night Eating Questionnaire (NEQ). Within the 12-month observation period, 32.3% of cases were lost to follow-up. After adjustment for demographic confounders and the severity of eating disorders, no TCI personality traits were significantly associated with attrition, while low scores of the novelty seeking temperament scale remained significantly associated with weight loss ≥ 10% (odds ratio, 0.983; 95% confidence interval, 0.975-0.992). Additional adjustment for education and job did not change the results. We conclude that personality does not systematically influence attrition in women with obesity enrolled into weight loss programmes in the community, whereas an association is maintained between novelty seeking and weight loss outcome. Studies adapting obesity interventions on the basis of individual novelty seeking scores might be warranted to maximize the results on body weight. PMID:26256916

  6. SLIT ADJUSTMENT CLAMP

    DOEpatents

    McKenzie, K.R.

    1959-07-01

    An electrode support which permits accurate alignment and adjustment of the electrode in a plurality of planes and about a plurality of axes in a calutron is described. The support will align the slits in the electrode with the slits of an ionizing chamber so as to provide for the egress of ions. The support comprises an insulator, a leveling plate carried by the insulator and having diametrically opposed attaching screws screwed to the plate and the insulator and diametrically opposed adjusting screws for bearing against the insulator, and an electrode associated with the plate for adjustment therewith.

  7. CMS Frailty Adjustment Model

    PubMed Central

    Kautter, John; Pope, Gregory C.

    2004-01-01

    The authors document the development of the CMS frailty adjustment model, a Medicare payment approach that adjusts payments to a Medicare managed care organization (MCO) according to the functional impairment of its community-residing enrollees. Beginning in 2004, this approach is being applied to certain organizations, such as Program of All-Inclusive Care for the Elderly (PACE), that specialize in providing care to the community-residing frail elderly. In the future, frailty adjustment could be extended to more Medicare managed care organizations. PMID:25372243

  8. Mass loss

    NASA Technical Reports Server (NTRS)

    Goldberg, Leo

    1987-01-01

    Observational evidence for mass loss from cool stars is reviewed. Spectra line profiles are used for the derivation of mass-loss rates with the aid of the equation of continuity. This equation implies steady mass loss with spherical symmetry. Data from binary stars, Mira variables, and red giants in globular clusters are examined. Silicate emission is discussed as a useful indicator of mass loss in the middle infrared spectra. The use of thermal millimeter-wave radiation, Very Large Array (VLA) measurement of radio emission, and OH/IR masers are discussed as a tool for mass loss measurement. Evidence for nonsteady mass loss is also reviewed.

  9. Remotely Adjustable Hydraulic Pump

    NASA Technical Reports Server (NTRS)

    Kouns, H. H.; Gardner, L. D.

    1987-01-01

    Outlet pressure adjusted to match varying loads. Electrohydraulic servo has positioned sleeve in leftmost position, adjusting outlet pressure to maximum value. Sleeve in equilibrium position, with control land covering control port. For lowest pressure setting, sleeve shifted toward right by increased pressure on sleeve shoulder from servovalve. Pump used in aircraft and robots, where hydraulic actuators repeatedly turned on and off, changing pump load frequently and over wide range.

  10. Weighted triangulation adjustment

    USGS Publications Warehouse

    Anderson, Walter L.

    1969-01-01

    The variation of coordinates method is employed to perform a weighted least squares adjustment of horizontal survey networks. Geodetic coordinates are required for each fixed and adjustable station. A preliminary inverse geodetic position computation is made for each observed line. Weights associated with each observed equation for direction, azimuth, and distance are applied in the formation of the normal equations in-the least squares adjustment. The number of normal equations that may be solved is twice the number of new stations and less than 150. When the normal equations are solved, shifts are produced at adjustable stations. Previously computed correction factors are applied to the shifts and a most probable geodetic position is found for each adjustable station. Pinal azimuths and distances are computed. These may be written onto magnetic tape for subsequent computation of state plane or grid coordinates. Input consists of punch cards containing project identification, program options, and position and observation information. Results listed include preliminary and final positions, residuals, observation equations, solution of the normal equations showing magnitudes of shifts, and a plot of each adjusted and fixed station. During processing, data sets containing irrecoverable errors are rejected and the type of error is listed. The computer resumes processing of additional data sets.. Other conditions cause warning-errors to be issued, and processing continues with the current data set.

  11. When the library is located in prime real estate: a case study on the loss of space from the Duke University Medical Center Library and Archives.

    PubMed

    Thibodeau, Patricia L

    2010-01-01

    The Duke University Medical Center Library and Archives is located in the heart of the Duke Medicine campus, surrounded by Duke Hospital, ambulatory clinics, and numerous research facilities. Its location is considered prime real estate, given its adjacency to patient care, research, and educational activities. In 2005, the Duke University Library Space Planning Committee had recommended creating a learning center in the library that would support a variety of educational activities. However, the health system needed to convert the library's top floor into office space to make way for expansion of the hospital and cancer center. The library had only five months to plan the storage and consolidation of its journal and book collections, while working with the facilities design office and architect on the replacement of key user spaces on the top floor. Library staff worked together to develop plans for storing, weeding, and consolidating the collections and provided input into renovation plans for users spaces on its mezzanine level. The library lost 15,238 square feet (29%) of its net assignable square footage and a total of 16,897 (30%) gross square feet. This included 50% of the total space allotted to collections and over 15% of user spaces. The top-floor space now houses offices for Duke Medicine oncology faculty and staff. By storing a large portion of its collection off-site, the library was able to remove more stacks on the remaining stack level and convert them to user spaces, a long-term goal for the library. Additional space on the mezzanine level had to be converted to replace lost study and conference room spaces. While this project did not match the recommended space plans for the library, it underscored the need for the library to think creatively about the future of its facility and to work toward a more cohesive master plan. PMID:20098649

  12. Hair Loss

    MedlinePlus

    ... may cause hair loss in women. If your hair loss has occurred gradually with advancing age, FOLLICULAR DEGENERATION may be the cause. Post-pregnancy hormone changes usually reverse themselves without any treatment. While follicular degeneration cannot ...

  13. Seven-Day Mortality Can Be Predicted in Medical Patients by Blood Pressure, Age, Respiratory Rate, Loss of Independence, and Peripheral Oxygen Saturation (the PARIS Score): A Prospective Cohort Study with External Validation

    PubMed Central

    Brabrand, Mikkel; Lassen, Annmarie Touborg; Knudsen, Torben; Hallas, Jesper

    2015-01-01

    Background Most existing risk stratification systems predicting mortality in emergency departments or admission units are complex in clinical use or have not been validated to a level where use is considered appropriate. We aimed to develop and validate a simple system that predicts seven-day mortality of acutely admitted medical patients using routinely collected variables obtained within the first minutes after arrival. Methods and Findings This observational prospective cohort study used three independent cohorts at the medical admission units at a regional teaching hospital and a tertiary university hospital and included all adult (≥15 years) patients. Multivariable logistic regression analysis was used to identify the clinical variables that best predicted the endpoint. From this, we developed a simplified model that can be calculated without specialized tools or loss of predictive ability. The outcome was defined as seven-day all-cause mortality. 76 patients (2.5%) met the endpoint in the development cohort, 57 (2.0%) in the first validation cohort, and 111 (4.3%) in the second. Systolic blood Pressure, Age, Respiratory rate, loss of Independence, and peripheral oxygen Saturation were associated with the endpoint (full model). Based on this, we developed a simple score (range 0–5), ie, the PARIS score, by dichotomizing the variables. The ability to identify patients at increased risk (discriminatory power and calibration) was excellent for all three cohorts using both models. For patients with a PARIS score ≥3, sensitivity was 62.5–74.0%, specificity 85.9–91.1%, positive predictive value 11.2–17.5%, and negative predictive value 98.3–99.3%. Patients with a score ≤1 had a low mortality (≤1%); with 2, intermediate mortality (2–5%); and ≥3, high mortality (≥10%). Conclusions Seven-day mortality can be predicted upon admission with high sensitivity and specificity and excellent negative predictive values. PMID:25867881

  14. Partial covariate adjusted regression

    PubMed Central

    Şentürk, Damla; Nguyen, Danh V.

    2008-01-01

    Covariate adjusted regression (CAR) is a recently proposed adjustment method for regression analysis where both the response and predictors are not directly observed (Şentürk and Müller, 2005). The available data has been distorted by unknown functions of an observable confounding covariate. CAR provides consistent estimators for the coefficients of the regression between the variables of interest, adjusted for the confounder. We develop a broader class of partial covariate adjusted regression (PCAR) models to accommodate both distorted and undistorted (adjusted/unadjusted) predictors. The PCAR model allows for unadjusted predictors, such as age, gender and demographic variables, which are common in the analysis of biomedical and epidemiological data. The available estimation and inference procedures for CAR are shown to be invalid for the proposed PCAR model. We propose new estimators and develop new inference tools for the more general PCAR setting. In particular, we establish the asymptotic normality of the proposed estimators and propose consistent estimators of their asymptotic variances. Finite sample properties of the proposed estimators are investigated using simulation studies and the method is also illustrated with a Pima Indians diabetes data set. PMID:20126296

  15. 47 CFR 80.769 - Shadow loss.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 47 Telecommunication 5 2014-10-01 2014-10-01 false Shadow loss. 80.769 Section 80.769... MARITIME SERVICES Standards for Computing Public Coast Station VHF Coverage § 80.769 Shadow loss. Where the transmission path is obstructed the received signal must be adjusted to include shadow loss. Attenuation due...

  16. 47 CFR 80.769 - Shadow loss.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 47 Telecommunication 5 2012-10-01 2012-10-01 false Shadow loss. 80.769 Section 80.769... MARITIME SERVICES Standards for Computing Public Coast Station VHF Coverage § 80.769 Shadow loss. Where the transmission path is obstructed the received signal must be adjusted to include shadow loss. Attenuation due...

  17. 47 CFR 80.769 - Shadow loss.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 47 Telecommunication 5 2013-10-01 2013-10-01 false Shadow loss. 80.769 Section 80.769... MARITIME SERVICES Standards for Computing Public Coast Station VHF Coverage § 80.769 Shadow loss. Where the transmission path is obstructed the received signal must be adjusted to include shadow loss. Attenuation due...

  18. 47 CFR 80.769 - Shadow loss.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 47 Telecommunication 5 2010-10-01 2010-10-01 false Shadow loss. 80.769 Section 80.769... MARITIME SERVICES Standards for Computing Public Coast Station VHF Coverage § 80.769 Shadow loss. Where the transmission path is obstructed the received signal must be adjusted to include shadow loss. Attenuation due...

  19. 47 CFR 80.769 - Shadow loss.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 47 Telecommunication 5 2011-10-01 2011-10-01 false Shadow loss. 80.769 Section 80.769... MARITIME SERVICES Standards for Computing Public Coast Station VHF Coverage § 80.769 Shadow loss. Where the transmission path is obstructed the received signal must be adjusted to include shadow loss. Attenuation due...

  20. 7 CFR 400.405 - Agent and loss adjuster responsibilities.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... her correct SSN to FCIC or the insurance provider, whichever is applicable, to be eligible to... the crop insurance program does not provide his or her correct SSN on forms or contracts where such... contracting with an insurance provider, who is also a private insurance company, to participate in the...

  1. 7 CFR 400.405 - Agent and loss adjuster responsibilities.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... her correct SSN to FCIC or the insurance provider, whichever is applicable, to be eligible to... the crop insurance program does not provide his or her correct SSN on forms or contracts where such... contracting with an insurance provider, who is also a private insurance company, to participate in the...

  2. African Refugees in Egypt: Trauma, Loss, and Cultural Adjustment

    ERIC Educational Resources Information Center

    Henry, Hani M.

    2012-01-01

    This study examined the influence of pre-immigration trauma on the acculturation process of refugees, as reflected in the manifestations of their continuing bonds with native cultures. Six African refugees who sought refuge in Egypt because of wars and political persecution were interviewed about the circumstances of their departure from their…

  3. The post-adjustable gastric band abdominoplasty.

    PubMed

    Wu, Allan Y; Coon, John L; Huerta, Sergio; Condé-Green, Alexandra; Morrow, David M

    2012-07-01

    Serious complications associated with post-laparoscopic adjustable gastric band (LAGB) abdominoplasty have been reported in the medical literature. Furthermore, others have noted aesthetic problems with closure of the umbilicus due to apparatus port proximity. Currently, no clinical protocol or formal industry guidance for LAGB apparatus management during abdominoplasty is available in the medical literature. In this article, the authors describe their procedure for safe LAGB apparatus management during abdominoplasty and illustrate key surgical principles by presenting unique cases from their series of 20 patients treated with this technique. PMID:22745453

  4. Risk adjustment for pediatric quality indicators.

    PubMed

    Kuhlthau, Karen; Ferris, Timothy G G; Iezzoni, Lisa I

    2004-01-01

    The movement to measure medical care quality has been accelerating, spurred on by evidence of poor quality of care and trials of interventions to improve care. Appropriate measurement of quality of care is an essential aspect of improving the quality of care, yet some quality measures may be influenced by patients' attributes unrelated to quality of care. Risk adjustment is the term commonly applied to those methods that account for patient-related attributes, making measurement of health care quality as comparable as possible across providers or organizations seeing different mixes of patients. The measurement of quality of care for children poses specific challenges. In addition to these measurement challenges, analysts must ensure that quality comparisons among doctors, groups of doctors, hospitals, or health plans are not adversely affected by the likelihood that different types of patients seek care in different places. Although some techniques designed to adjust performance measures for case mix were developed for both adults and children, other systems are specific to childhood circumstances. The theoretical issues involved in risk-adjusting childhood outcomes measures for newborns in the neonatal intensive care unit were reviewed recently. Here, we go beyond the neonatal intensive care unit setting to consider risk adjustment for pediatric quality measures more broadly. In particular, we 1) review the conceptual background for risk-adjusting quality measures, 2) present policy issues related to adjusting pediatric quality measures, and 3) catalog existing risk-adjustment methodologies for pediatric quality measures. We conclude with an overall assessment of the status of risk adjustment for pediatric quality measures and recommendations for additional research and application. PMID:14702503

  5. Rural to Urban Adjustment

    ERIC Educational Resources Information Center

    Abramson, Jane A.

    Personal interviews with 100 former farm operators living in Saskatoon, Saskatchewan, were conducted in an attempt to understand the nature of the adjustment process caused by migration from rural to urban surroundings. Requirements for inclusion in the study were that respondents had owned or operated a farm for at least 3 years, had left their…

  6. Self adjusting inclinometer

    DOEpatents

    Hunter, Steven L.

    2002-01-01

    An inclinometer utilizing synchronous demodulation for high resolution and electronic offset adjustment provides a wide dynamic range without any moving components. A device encompassing a tiltmeter and accompanying electronic circuitry provides quasi-leveled tilt sensors that detect highly resolved tilt change without signal saturation.

  7. Self Adjusting Sunglasses

    NASA Technical Reports Server (NTRS)

    1986-01-01

    Corning Glass Works' Serengeti Driver sunglasses are unique in that their lenses self-adjust and filter light while suppressing glare. They eliminate more than 99% of the ultraviolet rays in sunlight. The frames are based on the NASA Anthropometric Source Book.

  8. 26 CFR 1.1502-78 - Tentative carryback adjustments.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... respect to the consolidated net operating loss, X, the common parent, must file an application under section 6411. If a tentative carryback adjustment is desired with respect to Z's loss, X must file an....1502-78 in effect prior to June 28, 2002, as contained in 26 CFR part 1 revised April 1, 2002....

  9. Precision adjustable stage

    DOEpatents

    Cutburth, Ronald W.; Silva, Leonard L.

    1988-01-01

    An improved mounting stage of the type used for the detection of laser beams is disclosed. A stage center block is mounted on each of two opposite sides by a pair of spaced ball bearing tracks which provide stability as well as simplicity. The use of the spaced ball bearing pairs in conjunction with an adjustment screw which also provides support eliminates extraneous stabilization components and permits maximization of the area of the center block laser transmission hole.

  10. Adjustable Autonomy Testbed

    NASA Technical Reports Server (NTRS)

    Malin, Jane T.; Schrenkenghost, Debra K.

    2001-01-01

    The Adjustable Autonomy Testbed (AAT) is a simulation-based testbed located in the Intelligent Systems Laboratory in the Automation, Robotics and Simulation Division at NASA Johnson Space Center. The purpose of the testbed is to support evaluation and validation of prototypes of adjustable autonomous agent software for control and fault management for complex systems. The AA T project has developed prototype adjustable autonomous agent software and human interfaces for cooperative fault management. This software builds on current autonomous agent technology by altering the architecture, components and interfaces for effective teamwork between autonomous systems and human experts. Autonomous agents include a planner, flexible executive, low level control and deductive model-based fault isolation. Adjustable autonomy is intended to increase the flexibility and effectiveness of fault management with an autonomous system. The test domain for this work is control of advanced life support systems for habitats for planetary exploration. The CONFIG hybrid discrete event simulation environment provides flexible and dynamically reconfigurable models of the behavior of components and fluids in the life support systems. Both discrete event and continuous (discrete time) simulation are supported, and flows and pressures are computed globally. This provides fast dynamic simulations of interacting hardware systems in closed loops that can be reconfigured during operations scenarios, producing complex cascading effects of operations and failures. Current object-oriented model libraries support modeling of fluid systems, and models have been developed of physico-chemical and biological subsystems for processing advanced life support gases. In FY01, water recovery system models will be developed.

  11. Weight Loss

    MedlinePlus

    ... decisions about when and where they should receive healthcare. Unfortunately, most people lack the medical knowledge needed to make these decisions safely. FreeMD.com is powered by a computer program that performs symptom triage. The goal of ...

  12. Managing Hearing Loss | NIH MedlinePlus the Magazine

    MedlinePlus

    ... certain medications, or long-term exposure to loud noises. Sensorineural hearing loss occurs when there is damage ... Many people may have a combination of both noise-induced hearing loss and hearing loss from aging. ...

  13. Ototoxic Medications (Medication Effects)

    MedlinePlus

    ... Toggle navigation Careers Certification Publications Events Advocacy Continuing Education Practice Management Research Home / Information for the Public / Hearing and Balance Ototoxic Medications ( ...

  14. Catastrophic medical expenditure risk.

    PubMed

    Flores, Gabriela; O'Donnell, Owen

    2016-03-01

    We propose a measure of household exposure to particularly onerous medical expenses. The measure can be decomposed into the probability that medical expenditure exceeds a threshold, the loss due to predictably low consumption of other goods if it does and the further loss arising from the volatility of medical expenses above the threshold. Depending on the choice of threshold, the measure is consistent with a model of reference-dependent utility with loss aversion. Unlike the risk premium, the measure is only sensitive to particularly high expenses, and can identify households that expect to incur such expenses and would benefit from subsidised, but not actuarially fair, insurance. An empirical illustration using data from seven Asian countries demonstrates the importance of taking account of informal insurance and reveals clear differences in catastrophic medical expenditure risk across and within countries. In general, risk is higher among poorer, rural and chronically ill populations. PMID:26812650

  15. Hair loss

    MedlinePlus

    ... that is applied to the scalp to stimulate hair growth. Other medicines, such as hormones, may be prescribed to decrease hair loss and promote hair growth. Drugs such as finasteride and dutasteride can be ...

  16. Hair Loss

    MedlinePlus

    ... Common baldness" usually means male-pattern baldness, or permanent-pattern baldness. It is also called androgenetic alopecia. ... will grow back normally. However, scarring can cause permanent hair loss. Hot oil hair treatments or chemicals ...

  17. Hair Loss

    MedlinePlus

    ... are stress, a low protein diet, a family history, or poor nutrition. Treatment for hair loss depends on the cause. In some cases, treating the underlying cause will correct the problem. Other treatments include medicines and hair restoration.

  18. Hearing Loss

    MedlinePlus

    ... Devices Can Help? Hearing aids. Hearing aids are electronic, battery-run devices that make sounds louder. There ... to turn up the volume. Cochlear implants. These electronic devices are for people with severe hearing loss. ...

  19. Hearing Loss in HIV-Infected Children in Lilongwe, Malawi

    PubMed Central

    Hrapcak, Susan; Kuper, Hannah; Bartlett, Peter; Devendra, Akash; Makawa, Atupele; Kim, Maria; Kazembe, Peter; Ahmed, Saeed

    2016-01-01

    Introduction With improved access to antiretroviral therapy (ART), HIV infection is becoming a chronic illness. Preliminary data suggest that HIV-infected children have a higher risk of disabilities, including hearing impairment, although data are sparse. This study aimed to estimate the prevalence and types of hearing loss in HIV-infected children in Lilongwe, Malawi. Methods This was a cross-sectional survey of 380 HIV-infected children aged 4–14 years attending ART clinic in Lilongwe between December 2013-March 2014. Data was collected through pediatric quality of life and sociodemographic questionnaires, electronic medical record review, and detailed audiologic testing. Hearing loss was defined as >20 decibels hearing level (dBHL) in either ear. Predictors of hearing loss were explored by regression analysis generating age- and sex-adjusted odds ratios. Children with significant hearing loss were fitted with hearing aids. Results Of 380 patients, 24% had hearing loss: 82% conductive, 14% sensorineural, and 4% mixed. Twenty-one patients (23% of those with hearing loss) were referred for hearing aid fitting. There was a higher prevalence of hearing loss in children with history of frequent ear infections (OR 7.4, 4.2–13.0) and ear drainage (OR 6.4, 3.6–11.6). Hearing loss was linked to history of WHO Stage 3 (OR 2.4, 1.2–4.5) or Stage 4 (OR 6.4, 2.7–15.2) and history of malnutrition (OR 2.1, 1.3–3.5), but not to duration of ART or CD4. Only 40% of caregivers accurately perceived their child’s hearing loss. Children with hearing impairment were less likely to attend school and had poorer emotional (p = 0.02) and school functioning (p = 0.04). Conclusions There is an urgent need for improved screening tools, identification and treatment of hearing problems in HIV-infected children, as hearing loss was common in this group and affected school functioning and quality of life. Clear strategies were identified for prevention and treatment, since most

  20. Medical Readers' Theater: Relevance to Geriatrics Medical Education

    ERIC Educational Resources Information Center

    Shapiro, Johanna; Cho, Beverly

    2011-01-01

    Medical Readers' Theater (MRT) is an innovative and simple way of helping medical students to reflect on difficult-to-discuss topics in geriatrics medical education, such as aging stereotypes, disability and loss of independence, sexuality, assisted living, relationships with adult children, and end-of-life issues. The authors describe a required…

  1. Medical vest broadens treatment capability

    NASA Technical Reports Server (NTRS)

    Johnson, G. S.

    1970-01-01

    Universal sized vest, with specially tailored pockets designed to hold medical supplies, provides first aid/first care medical teams with broadened on-site capability. Vest is made of nylon, tough fibrous materials, and polyvinyl chloride. Design facilitates rapid donning, doffing, and adjustment.

  2. Continuously adjustable Pulfrich spectacles

    NASA Astrophysics Data System (ADS)

    Jacobs, Ken; Karpf, Ron

    2011-03-01

    A number of Pulfrich 3-D movies and TV shows have been produced, but the standard implementation has inherent drawbacks. The movie and TV industries have correctly concluded that the standard Pulfrich 3-D implementation is not a useful 3-D technique. Continuously Adjustable Pulfrich Spectacles (CAPS) is a new implementation of the Pulfrich effect that allows any scene containing movement in a standard 2-D movie, which are most scenes, to be optionally viewed in 3-D using inexpensive viewing specs. Recent scientific results in the fields of human perception, optoelectronics, video compression and video format conversion are translated into a new implementation of Pulfrich 3- D. CAPS uses these results to continuously adjust to the movie so that the viewing spectacles always conform to the optical density that optimizes the Pulfrich stereoscopic illusion. CAPS instantly provides 3-D immersion to any moving scene in any 2-D movie. Without the glasses, the movie will appear as a normal 2-D image. CAPS work on any viewing device, and with any distribution medium. CAPS is appropriate for viewing Internet streamed movies in 3-D.

  3. Subsea adjustable choke valves

    SciTech Connect

    Cyvas, M.K. )

    1989-08-01

    With emphasis on deepwater wells and marginal offshore fields growing, the search for reliable subsea production systems has become a high priority. A reliable subsea adjustable choke is essential to the realization of such a system, and recent advances are producing the degree of reliability required. Technological developments have been primarily in (1) trim material (including polycrystalline diamond), (2) trim configuration, (3) computer programs for trim sizing, (4) component materials, and (5) diver/remote-operated-vehicle (ROV) interfaces. These five facets are overviewed and progress to date is reported. A 15- to 20-year service life for adjustable subsea chokes is now a reality. Another factor vital to efficient use of these technological developments is to involve the choke manufacturer and ROV/diver personnel in initial system conceptualization. In this manner, maximum benefit can be derived from the latest technology. Major areas of development still required and under way are listed, and the paper closes with a tabulation of successful subsea choke installations in recent years.

  4. Psychosocial adjustment to ALS: a longitudinal study

    PubMed Central

    Matuz, Tamara; Birbaumer, Niels; Hautzinger, Martin; Kübler, Andrea

    2015-01-01

    For the current study the Lazarian stress-coping theory and the appendant model of psychosocial adjustment to chronic illness and disabilities (Pakenham, 1999) has shaped the foundation for identifying determinants of adjustment to ALS. We aimed to investigate the evolution of psychosocial adjustment to ALS and to determine its long-term predictors. A longitudinal study design with four measurement time points was therefore, used to assess patients' quality of life, depression, and stress-coping model related aspects, such as illness characteristics, social support, cognitive appraisals, and coping strategies during a period of 2 years. Regression analyses revealed that 55% of the variance of severity of depressive symptoms and 47% of the variance in quality of life at T2 was accounted for by all the T1 predictor variables taken together. On the level of individual contributions, protective buffering, and appraisal of own coping potential accounted for a significant percentage in the variance in severity of depressive symptoms, whereas problem management coping strategies explained variance in quality of life scores. Illness characteristics at T2 did not explain any variance of both adjustment outcomes. Overall, the pattern of the longitudinal results indicated stable depressive symptoms and quality of life indices reflecting a successful adjustment to the disease across four measurement time points during a period of about two years. Empirical evidence is provided for the predictive value of social support, cognitive appraisals, and coping strategies, but not illness parameters such as severity and duration for adaptation to ALS. The current study contributes to a better conceptualization of adjustment, allowing us to provide evidence-based support beyond medical and physical intervention for people with ALS. PMID:26441696

  5. Medical Transcriptionists

    MedlinePlus

    ... equipment or software that is connected to their computer. However, technological advances have changed the way medical ... this section Medical transcriptionists must be comfortable using computers. Medical transcriptionists typically need postsecondary education. Prospective medical ...

  6. Medical marijuana

    MedlinePlus

    ... this page: //medlineplus.gov/ency/patientinstructions/000899.htm Medical marijuana To use the sharing features on this page, ... have legalized marijuana for medical use. How Does Medical Marijuana Work? Medical marijuana may be: Smoked Vaporized Eaten ...

  7. 77 FR 40387 - Price Adjustment

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-07-09

    ... Price Adjustment AGENCY: Postal Regulatory Commission. ACTION: Notice. SUMMARY: The Commission is noticing a recently filed Postal Service request to adjust prices for several market dominant products... announcing its intent to adjust prices for several market dominant products within First-Class Mail...

  8. Hair Loss

    MedlinePlus

    ... psychosocial impact of hair loss have found patients’ self-esteem, body image and self-confidence to be negatively ... 1-2 Known psychosocial complications include depression, low self-esteem, altered self-image, and less frequent and enjoyable ...

  9. Unpleasant odors increase aversion to monetary losses.

    PubMed

    Stancak, Andrej; Xie, Yuxin; Fallon, Nicholas; Bulsing, Patricia; Giesbrecht, Timo; Thomas, Anna; Pantelous, Athanasios A

    2015-04-01

    Loss aversion is the tendency to prefer avoiding losses over acquiring gains of equal nominal values. Unpleasant odors not only influence affective state but have also been shown to activate brain regions similar to those mediating loss aversion. Therefore, we hypothesized a stronger loss aversion in a monetary gamble task if gambles were associated with an unpleasant as opposed to pleasant odor. In thirty human subjects, unpleasant (methylmercaptan), pleasant (jasmine), and neutral (clean air) odors were presented for 4 s. At the same time, uncertain gambles offering an equal chance of gain or loss of a variable amount of money, or a prospect of an assured win were displayed. One hundred different gambles were presented three times, each time paired with a different odor. Loss aversion, risk aversion, and logit sensitivity were evaluated using non-linear fitting of individual gamble decisions. Loss aversion was larger when prospects were displayed in the presence of methylmercaptan compared to jasmine or clean air. Moreover, individual differences in changes in loss aversion to the unpleasant as compared to pleasant odor correlated with odor pleasantness but not with odor intensity. Skin conductance responses to losses during the outcome period were larger when gambles were associated with methylmercaptan compared to jasmine. Increased loss aversion while perceiving an unpleasant odor suggests a dynamic adjustment of loss aversion toward greater sensitivity to losses. Given that odors are biological signals of hazards, such adjustment of loss aversion may have adaptive value in situations entailing threat or danger. PMID:25711689

  10. Noise-induced hearing loss.

    PubMed

    McReynolds, Michael C

    2005-01-01

    Noise-induced hearing loss is a major hazard in many workplaces and in society. The National Institute for Occupational Safety and Health estimates that more than 30 million workers (almost 1 in 10) are exposed to unsafe noise levels on the job. Helicopter emergency medical services crews work in an environment in which exposure to aviation noise makes the issue of hearing loss and prevention strategies salient. Applying the Occupational Safety and Health Administration standard for a regulated hearing conservation program through controlling noise exposure will benefit helicopter emergency medical services professionals. PMID:15741953

  11. A membrane-type acoustic metamaterial with adjustable acoustic properties

    NASA Astrophysics Data System (ADS)

    Langfeldt, F.; Riecken, J.; Gleine, W.; von Estorff, O.

    2016-07-01

    A new realization of a membrane-type acoustic metamaterial (MAM) with adjustable sound transmission properties is presented. The proposed design distinguishes itself from other realizations by a stacked arrangement of two MAMs which is inflated using pressurized air. The static pressurization leads to large nonlinear deformations and, consequently, geometrical stiffening of the MAMs which is exploited to adjust the eigenmodes and sound transmission loss of the structure. A theoretical analysis of the proposed inflatable MAM design using numerical and analytical models is performed in order to identify two important mechanisms, namely the shifting of the eigenfrequencies and modal residuals due to the pressurization, responsible for the transmission loss adjustment. Analytical formulas are provided for predicting the eigenmode shifting and normal incidence sound transmission loss of inflated single and double MAMs using the concept of effective mass. The investigations are concluded with results from a test sample measurement inside an impedance tube, which confirm the theoretical predictions.

  12. [Psychological adjustment following lower limb amputation].

    PubMed

    Panyi, Lilla Krisztina; Lábadi, Beatrix

    2015-09-27

    Rehabilitation of lower limb amputees and the fitting of their prosthesis depend highly on the psychological adjustment process and motivational state of the patient. The loss of a limb is extremely challenging and can cause various physical and psychological problems. Depression, anxiety, decreased well-being and quality of life, body image dissatisfaction and changes in self-concept and identity are frequent after lower limb amputation. In the interest of adjustment patients have to cope with the emerging changes and difficulties in their lifes as well as the problems in psychological functioning. It is important for them to accept the alterations in their body and identity, and integrate them in a new self-concept in which process motivation is a fundamental issue. The aim of this article is to review the literature on psychological consequences of lower limb amputation, and to propose an integrative way of rehabilitation for lower limb amputees. PMID:26550913

  13. Adjusting capitation rates using objective health measures and prior utilization

    PubMed Central

    Newhouse, Joseph P.; Manning, Willard G.; Keeler, Emmett B.; Sloss, Elizabeth M.

    1989-01-01

    Several analysts have proposed adding adjusters based on health status and prior utilization to the adjusted average per capita cost formula. The authors estimate how well such adjusters predict annual medical expenditures among non-elderly adults. Both measures substantially improve on the variables currently used. If only health measures are added, 20-30 percent of the predictable variance is explained; if only prior use is added, more than 40 percent is explained; if both are added, about 60 percent is explained. The results support including some measure of use in the formula until better health measures are developed. PMID:10313096

  14. Pregnancy loss.

    PubMed

    Robinson, Gail Erlick

    2014-01-01

    Women who lose desired pregnancies by miscarriage, stillbirth, or genetic termination are at risk of suffering from grief, anxiety, guilt and self-blame that may even present in subsequent pregnancies. It is important to find effective means of helping women deal with these losses. The approach to stillbirth has shifted from immediately removing the child from the mother to encouraging the parents to view and hold the baby. This approach has been questioned as possibly causing persistent anxiety and post-traumatic stress disorder. Women who miscarry are currently encouraged to find ways to memorialise the lost fetus. Couples who decide to terminate a pregnancy after discovering a defect may deal not only with sadness but also guilt. Immediate crisis intervention and follow-up care should be available, recognising that individual women may experience different reactions and their specific post-loss needs must be assessed. PMID:24047642

  15. Beam loss

    NASA Astrophysics Data System (ADS)

    VanGinneken, A.; Edwards, D.; Harrison, M.

    1989-04-01

    This paper presents results from simulations of beam losses during the operation of a superconducting accelerator. The calculations use a combination of hadron/electromagnetic cascade plus elastic scattering codes with accelerator tracking routines. These calculations have been used in conjunction with the design of the Fermilab Tevatron. First accelerator geometry is described. The rest of the paper discusses a detailed attempt to simulate a fast extraction cycle, essentially in chronological order. Beginning with an unperturbed beam, the simulation generates proton phase-space distributions incident on the electrostatic septum. These interact either elastically or inelastically with the septum wires, and the products of these interactions are traced through the machine. Where these leave the accelerator, energy deposition levels in the magnets are calculated together with the projected response of the beam-loss monitors in this region. Finally, results of the calculation are compared with experimental data. (AIP)

  16. Control with anorexiant medications.

    PubMed Central

    Volume, C. I.; Farris, K. B.

    1998-01-01

    OBJECTIVE: To show why women are still seeking anorexiant medications despite current concerns over their use. DESIGN: In-depth interviews using grounded theory methodology. SETTING: Participants chose where they were to be interviewed. PARTICIPANTS: Women older than 18 years who had previously taken or were currently taking anorexiant medications for the purpose of losing weight. METHOD: Nine women completed two semistructured in-depth interviews during which they described their experiences from the time they began pharmacologic therapy for obesity until they discontinued the medications. Interview data were compiled and analyzed until saturation was reached. MAIN OUTCOME FINDINGS: Control was an important factor for the women. Their previous lack of control was due to frustration with failed dieting attempts and feeling pressure from others to lose weight. Prescription medications controlled physiologic hunger while the women sought to lose weight. Increased control over hunger and a decrease in weight gave participants confidence to continue their weight-loss efforts without the medications. Once the medications were discontinued, the women were able to maintain weight control through various lifestyle modifications. CONCLUSIONS: Anorexiant medications provide some women with a perception of control that helps them lose weight and not regain it. Health care professionals should be aware of their patients' struggles with weight loss and understand the importance of these medications for some patients. PMID:9839060

  17. Female pattern hair loss.

    PubMed

    Singal, Archana; Sonthalia, Sidharth; Verma, Prashant

    2013-01-01

    Female pattern hair loss (FPHL) is a common cause of hair loss in women characterized by diffuse reduction in hair density over the crown and frontal scalp with retention of the frontal hairline. Its prevalence increases with advancing age and is associated with significant psychological morbidity. The pathophysiology of FPHL is still not completely understood and seems to be multifactorial. Although androgens have been implicated, the involvement of androgen-independent mechanisms is evident from frequent lack of clinical or biochemical markers of hyperandrogenism in affected women. The role of genetic polymorphisms involving the androgen and estrogen receptors is being increasingly recognized in its causation and predicting treatment response to anti-androgens. There are different clinical patterns and classifications of FPHL, knowledge of which facilitates patient management and research. Chronic telogen effluvium remains as the most important differential diagnosis. Thorough history, clinical examination, and evaluation are essential to confirm diagnosis. Patients with clinical signs of androgen excess require assessment of biochemical parameters and imaging studies. It is prudent to screen the patients for metabolic syndrome and cardiovascular risk factors. The treatment comprises medical and/or surgical modalities. Medical treatment should be initiated early as it effectively arrests hair loss progression rather than stimulating regrowth. Minoxidil continues to be the first line therapy whereas anti-androgens form the second line of treatment. The progressive nature of FPHL mandates long-term treatment for sustained effect. Medical therapy may be supplemented with cosmetic concealment in those desirous of greater hair density. Surgery may be worthwhile in some carefully selected patients. PMID:23974580

  18. Delay Adjusted Incidence Infographic

    Cancer.gov

    This Infographic shows the National Cancer Institute SEER Incidence Trends. The graphs show the Average Annual Percent Change (AAPC) 2002-2011. For Men, Thyroid: 5.3*,Liver & IBD: 3.6*, Melanoma: 2.3*, Kidney: 2.0*, Myeloma: 1.9*, Pancreas: 1.2*, Leukemia: 0.9*, Oral Cavity: 0.5, Non-Hodgkin Lymphoma: 0.3*, Esophagus: -0.1, Brain & ONS: -0.2*, Bladder: -0.6*, All Sites: -1.1*, Stomach: -1.7*, Larynx: -1.9*, Prostate: -2.1*, Lung & Bronchus: -2.4*, and Colon & Rectum: -3/0*. For Women, Thyroid: 5.8*, Liver & IBD: 2.9*, Myeloma: 1.8*, Kidney: 1.6*, Melanoma: 1.5, Corpus & Uterus: 1.3*, Pancreas: 1.1*, Leukemia: 0.6*, Brain & ONS: 0, Non-Hodgkin Lymphoma: -0.1, All Sites: -0.1, Breast: -0.3, Stomach: -0.7*, Oral Cavity: -0.7*, Bladder: -0.9*, Ovary: -0.9*, Lung & Bronchus: -1.0*, Cervix: -2.4*, and Colon & Rectum: -2.7*. * AAPC is significantly different from zero (p<.05). Rates were adjusted for reporting delay in the registry. www.cancer.gov Source: Special section of the Annual Report to the Nation on the Status of Cancer, 1975-2011.

  19. 8 CFR 245.5 - Medical examination.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 8 Aliens and Nationality 1 2011-01-01 2011-01-01 false Medical examination. 245.5 Section 245.5... THAT OF PERSON ADMITTED FOR PERMANENT RESIDENCE § 245.5 Medical examination. Pursuant to section 232(b) of the Act, an applicant for adjustment of status shall be required to have a medical examination...

  20. 8 CFR 245.5 - Medical examination.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 8 Aliens and Nationality 1 2013-01-01 2013-01-01 false Medical examination. 245.5 Section 245.5... THAT OF PERSON ADMITTED FOR PERMANENT RESIDENCE § 245.5 Medical examination. Pursuant to section 232(b) of the Act, an applicant for adjustment of status shall be required to have a medical examination...

  1. 8 CFR 245.5 - Medical examination.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 8 Aliens and Nationality 1 2010-01-01 2010-01-01 false Medical examination. 245.5 Section 245.5... THAT OF PERSON ADMITTED FOR PERMANENT RESIDENCE § 245.5 Medical examination. Pursuant to section 232(b) of the Act, an applicant for adjustment of status shall be required to have a medical examination...

  2. 8 CFR 245.5 - Medical examination.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 8 Aliens and Nationality 1 2014-01-01 2014-01-01 false Medical examination. 245.5 Section 245.5... THAT OF PERSON ADMITTED FOR PERMANENT RESIDENCE § 245.5 Medical examination. Pursuant to section 232(b) of the Act, an applicant for adjustment of status shall be required to have a medical examination...

  3. 8 CFR 245.5 - Medical examination.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 8 Aliens and Nationality 1 2012-01-01 2012-01-01 false Medical examination. 245.5 Section 245.5... THAT OF PERSON ADMITTED FOR PERMANENT RESIDENCE § 245.5 Medical examination. Pursuant to section 232(b) of the Act, an applicant for adjustment of status shall be required to have a medical examination...

  4. Weight Loss Nutritional Supplements

    NASA Astrophysics Data System (ADS)

    Eckerson, Joan M.

    Obesity has reached what may be considered epidemic proportions in the United States, not only for adults but for children. Because of the medical implications and health care costs associated with obesity, as well as the negative social and psychological impacts, many individuals turn to nonprescription nutritional weight loss supplements hoping for a quick fix, and the weight loss industry has responded by offering a variety of products that generates billions of dollars each year in sales. Most nutritional weight loss supplements are purported to work by increasing energy expenditure, modulating carbohydrate or fat metabolism, increasing satiety, inducing diuresis, or blocking fat absorption. To review the literally hundreds of nutritional weight loss supplements available on the market today is well beyond the scope of this chapter. Therefore, several of the most commonly used supplements were selected for critical review, and practical recommendations are provided based on the findings of well controlled, randomized clinical trials that examined their efficacy. In most cases, the nutritional supplements reviewed either elicited no meaningful effect or resulted in changes in body weight and composition that are similar to what occurs through a restricted diet and exercise program. Although there is some evidence to suggest that herbal forms of ephedrine, such as ma huang, combined with caffeine or caffeine and aspirin (i.e., ECA stack) is effective for inducing moderate weight loss in overweight adults, because of the recent ban on ephedra manufacturers must now use ephedra-free ingredients, such as bitter orange, which do not appear to be as effective. The dietary fiber, glucomannan, also appears to hold some promise as a possible treatment for weight loss, but other related forms of dietary fiber, including guar gum and psyllium, are ineffective.

  5. Losses in Ferroelectric Materials

    PubMed Central

    Liu, Gang; Zhang, Shujun; Jiang, Wenhua; Cao, Wenwu

    2015-01-01

    Ferroelectric materials are the best dielectric and piezoelectric materials known today. Since the discovery of barium titanate in the 1940s, lead zirconate titanate ceramics in the 1950s and relaxor-PT single crystals (such as lead magnesium niobate-lead titanate and lead zinc niobate-lead titanate) in the 1980s and 1990s, perovskite ferroelectric materials have been the dominating piezoelectric materials for electromechanical devices, and are widely used in sensors, actuators and ultrasonic transducers. Energy losses (or energy dissipation) in ferroelectrics are one of the most critical issues for high power devices, such as therapeutic ultrasonic transducers, large displacement actuators, SONAR projectors, and high frequency medical imaging transducers. The losses of ferroelectric materials have three distinct types, i.e., elastic, piezoelectric and dielectric losses. People have been investigating the mechanisms of these losses and are trying hard to control and minimize them so as to reduce performance degradation in electromechanical devices. There are impressive progresses made in the past several decades on this topic, but some confusions still exist. Therefore, a systematic review to define related concepts and clear up confusions is urgently in need. With this objective in mind, we provide here a comprehensive review on the energy losses in ferroelectrics, including related mechanisms, characterization techniques and collections of published data on many ferroelectric materials to provide a useful resource for interested scientists and engineers to design electromechanical devices and to gain a global perspective on the complex physical phenomena involved. More importantly, based on the analysis of available information, we proposed a general theoretical model to describe the inherent relationships among elastic, dielectric, piezoelectric and mechanical losses. For multi-domain ferroelectric single crystals and ceramics, intrinsic and extrinsic energy

  6. Efficient Adjustable Reflectivity Smart Window

    SciTech Connect

    D. Morgan Tench

    2005-12-01

    This project addressed the key technical issues for development of an efficient smart window based on reversible electrochemical transfer of silver between a mirror electrode and a localized counter electrode. Effort to provide uniform switching over large areas focused on use of a resistive transparent electrode innerlayer to increase the interelectrode resistance. An effective edge seal was developed in collaboration with adhesive suppliers and an electrochromic device manufacturer. Work to provide a manufacturable counter electrode focused on fabricating a dot matrix electrode without photolithography by electrodeposition of Pt nuclei on inherent active sites on a transparent oxide conductor. An alternative counter electrode based on a conducting polymer and an ionic liquid electrolyte was also investigated. Work in all of these areas was successful. Sputtered large-bandgap oxide innerlayers sandwiched between conductive indium tin oxide (ITO) layers were shown to provide sufficient cross-layer resistance (>300 ohm/cm{sup 2}) without significantly affecting the electrochemical properties of the ITO overlayer. Two edge seal epoxies, one procured from an epoxy manufacturer and one provided by an electrochromic device manufacturer in finished seals, were shown to be effective barriers against oxygen intrusion up to 80 C. The optimum density of nuclei for the dot matrix counter electrode was attained without use of photolithography by electrodeposition from a commercial alkaline platinum plating bath. Silver loss issues for cells with dot matrix electrodes were successfully addressed by purifying the electrolyte and adjusting the cell cycling parameters. More than 30K cycles were demonstrated for a REM cell (30-cm square) with a dot matrix counter electrode. Larger cells (30-cm square) were successfully fabricated but could not be cycled since the nucleation layers (provided by an outside supplier) were defective so that mirror deposits could not be produced.

  7. Preventing and responding to medical identity theft.

    PubMed

    Amori, Geraldine

    2008-01-01

    Medical identity theft is a crime with two victims: patients and providers. It is easy to commit and lucrative because healthcare record keeping and business interactions are complex and mainly electronic. Patients whose identity has been stolen are vulnerable to both medical error and financial loss. Providers may suffer both reputation loss and financial loss. There are steps to help prevent and to respond appropriately to medical identity theft. PMID:20200908

  8. Pediatric Sudden Sensorineural Hearing Loss.

    PubMed

    Kizilay, Ahmet; Koca, Çiğdem Firat

    2016-06-01

    Sudden sensorineural hearing loss is defined as sudden unilateral or bilateral sensorineural hearing loss with at least 30 dB decrease in threshold in 3 contiguous test frequencies occurring over 72 hours or less. It is rare among children. The mechanism of the process and prognosis of the disorder remains unclear. The current incidence of sudden sensorineural hearing loss among pediatric population is unknown. The authors carried out a retrospective chart analysis of patients under 15 years of age from 2004 to 2015, who consulted to the Otolaryngology Head and Neck Surgery Department of Inonu University Medical Faculty. Age, sex, number of affected ear and side, audiometric evaluations, medical follow-up, treatment method, duration of treatment recovery, associated complaints; tinnitus and/or vertigo, presence of mumps disease were recorded for each patient. A 4-frequency pure-tone average (500, 1000, 2000, and 4000 Hz) was calculated for each ear. Complete recovery, defined as some hearing level compared with the nonaffected ear, was observed in 3 patients (21.4 %) and there was no partial hearing recovery. The hearing loss of 11 patient remained unchanged after prednisolone treatment. Two of the 11 patients had bilaterally total sensorineural hearing loss and evaluated as appropriate for cochlear implantation. Sex of patient and laterality of hearing loss were not correlated with hearing recovery. Sensorineural hearing loss among pediatrics has been the issue of otolaryngologists. The incidence, etiology, and treatment methods should be more studied. PMID:27171971

  9. Living productively with sensory loss.

    PubMed

    Kinderknecht, C H; Garner, J D

    1993-01-01

    As the avenues for fully perceiving and experiencing life, our sensory organs are the bridge between Self and the outside world. Of the many disorders affecting the senses of the older woman, those that affect vision and hearing have the greatest potential for disrupting her activities of daily living, and diminishing her quality of life and level of independence. While adapting to and coping successfully with sensory loss may require significant effort and adjustment on the part of the afflicted older woman, strategies designed to maximize the older woman's function, her sense of personal control, and her social support system can mediate the negative effects of the sensory loss. PMID:23077999

  10. Medical marijuana

    MedlinePlus

    ... Possession of marijuana is illegal under federal law. Medical marijuana refers to using marijuana to treat certain medical ... Medical marijuana may be: Smoked Vaporized Eaten Taken as a liquid extract Marijuana leaves and buds contain substances ...

  11. Abortion - medical

    MedlinePlus

    Therapeutic medical abortion; Elective medical abortion; Induced abortion; Nonsurgical abortion ... A medical, or nonsurgical, abortion can be done within 7 weeks from the first day of the woman's last ...

  12. Discharges Against Medical Advice

    PubMed Central

    Franks, Peter; Meldrum, Sean; Fiscella, Kevin

    2006-01-01

    BACKGROUND Prior literature suggests that blacks are more likely to be discharged against medical advice (DAMA). OBJECTIVE We examined whether DAMA from general hospitals varies by race/ethnicity and whether this variation is explained by individual and hospital factors. DESIGN, SUBJECTS, AND MEASUREMENTS We conducted cross-sectional analyses of 1998 to 2000 hospital discharge data, linked to the American Hospital Association data, on adults admitted for acute general hospital care in California, Florida, and New York. A series of hierarchical logistic regression analyses explored factors associated with DAMA, initially adjusting for age and gender, then sequentially adding adjustment for comorbidities, individual socio-economic factors, and finally hospital characteristics. RESULTS Compared with whites, blacks had a 2-fold higher age-gender adjusted odds of DAMA, a risk that progressively diminished with increasing adjustment (final adjusted odds ratio [OR]=0.95, 95% confidence interval [CI]=0.91, 1.00). While Hispanics had an increased risk of DAMA in age-gender-adjusted analyses, the final model revealed a protective effect (adjusted OR=0.66, 95% CI=0.62, 0.70), similar to that observed for Asians. CONCLUSIONS Disparities in DAMA affecting minority patients in general hospitals are largely accounted for by individual and hospital socio-economic factors. The absence of any adjusted disparity affecting blacks, and the protective effect observed for Hispanics and other minorities suggest that individual discrimination and poor communication are not primary determinants of DAMA, but where patients are admitted does contribute to disparities in DAMA. PMID:16918741

  13. Gray matter loss correlates with mesial temporal lobe neuronal hyperexcitability inside the human seizure onset zone

    PubMed Central

    Staba, Richard J.; Ekstrom, Arne D.; Suthana, Nanthia A.; Burggren, Alison; Fried, Itzhak; Engel, Jerome; Bookheimer, Susan Y.

    2011-01-01

    Summary Purpose Patient studies have not provided consistent evidence for interictal neuronal hyperexcitability inside the seizure onset zone (SOZ). We hypothesized that gray matter (GM) loss could have important effects on neuronal firing, and quantifying these effects would reveal significant differences in neuronal firing inside versus outside the SOZ. Methods MRI and computational unfolding of mesial temporal lobe (MTL) subregions was used to construct anatomical maps to compute GM loss in presurgical patients with medically intractable focal seizures in relation to control subjects. In patients, these same maps were used to locate the position of microelectrodes that recorded interictal neuronal activity. Single neuron firing and burst rates were evaluated in relation to GM loss and MTL subregions inside and outside the SOZ. Key findings MTL GM thickness was reduced inside and outside the SOZ in patients with respect to control subjects, yet GM loss was associated more strongly with firing and burst rates in several MTL subregions inside the SOZ. Adjusting single neuron firing and burst rates for the effects of GM loss revealed significantly higher firing rates in the subregion consisting of dentate gyrus and CA2 and CA3 (CA23DG), as well as CA1 and entorhinal cortex (EC) inside versus outside the SOZ where normalized MRI GM loss was ≥1.40 mm. Firing rates were higher in subicular cortex inside the SOZ at GM loss ≥1.97 mm, while burst rates were higher in CA23DG, CA1, and EC inside than outside the SOZ at similar levels of GM loss. Significance The correlation between GM loss and increased firing and burst rates suggests GM structural alterations in MTL subregions are associated with interictal neuronal hyperexcitability inside the SOZ. Significant differences in firing rates and bursting in areas with GM loss inside compared to outside the SOZ indicate that synaptic reorganization following cell loss could be associated with varying degrees of

  14. Secondhand Smoke Exposure and the Risk of Hearing Loss

    PubMed Central

    Fabry, David A.; Davila, Evelyn P.; Arheart, Kristopher L.; Serdar, Berrin; Dietz, Noella A.; Bandiera, Frank C.; Lee, David J.

    2011-01-01

    Background Hearing loss has been associated with tobacco smoking, but its relationship with secondhand smoke is not known. We sought to investigate the association between secondhand smoke exposure and hearing loss in a nationally representative sample of adults. Methods The National Health and Nutrition Examination Survey, a nationally representative cross-sectional dataset, was utilized to investigate the association between secondhand smoke exposure and hearing loss. Data collected from non-smoking participants aged 20-69 years were included in the analysis if they had completed audiometric testing, had a valid serum cotinine value, and provided complete smoking, medical co-morbidity and noise exposure histories (n=3,307). Hearing loss was assessed from averaged pure-tone thresholds over low- or mid-frequencies (500, 1,000, and 2,000 Hz) and high-frequencies (3,000, 4,000, 6,000, and 8,000 Hz), and was defined as mild or greater severity (pure-tone average in excess of 25 dB HL). Results SHS exposure was significantly associated with increased risk of hearing loss for low-/mid-frequencies (Adjusted Odds Ratio = 1.14; 95% CI = 1.02-1.28 for never smokers and 1.30; 1.10-1.54 for former smokers) and high-frequencies (1.40; 1.22-1.81 for former smokers), after controlling for potential confounders. Conclusions Findings from the present analysis indicate that SHS exposure is associated with hearing loss in non-smoking adults. PMID:21081307

  15. Abortion - medical

    MedlinePlus

    Therapeutic medical abortion; Elective medical abortion; Induced abortion; Nonsurgical abortion ... The pregnancy is harmful to the woman's health (therapeutic abortion). The pregnancy resulted after a traumatic event ...

  16. Social-psychological adjustment to multiple sclerosis. A longitudinal study.

    PubMed

    Brooks, N A; Matson, R R

    1982-01-01

    This study employs a longitudinal design to analyze the adjustment process of 103 people diagnosed with multiple sclerosis and in the middle and later stages of their illness careers. The mean age of the sample at Time 2 is 52 years, and mean duration since diagnosis is 17 years. A highly reliable self concept measure is the indicator of adjustment and changes in adjustment from T1 (1974) to T2 (1981). Four sets of variables are analyzed in their relationship to adjustment: (1) socio-demographic; (2) disease-related; (3) medical; and (4) social-psychological. Females are more likely than males to show positive adjustment (improving self concepts). Hours of employment and living arrangement are also related to the adjustment process. The vast majority of respondents show only slight decline in mobility, but among the disease related variables, number of episodes (exacerbations) in past seven years is the strongest predictor of changes in adjustment. Nearly half the respondents seek medical attention for their M.S. once a year or less, and the choice of health care professional is related to changes in the course of the disease. Subjects with an internal locus of control have more positive adjustment scores. Those who say they cope through acceptance of the disease show improvements in self concept while those reporting religion or family as major coping strategies have decreasing self concepts. Results indicate that the majority make satisfactory adjustment as indicated by maintenance of positive self concepts over the 7 year period, although the disease is chronic and progressive. For patients in the middle and later stages of illness careers, the data suggest comprehensive rehabilitation efforts that enhance autonomy and develop the social-psychological resources of the lifestyle. PMID:7157043

  17. Dealing with our losses.

    PubMed

    Mount, B M

    1986-07-01

    The repeated losses experienced by a clinical oncologist may constitute a significant source of personal stress. Studies documenting high stress levels on oncology services and the prevalence among physicians of alcoholism, cirrhosis, suicide, and marital discord lend urgency to the need to examine etiologic factors, clinical manifestations, and strategies for the management of job-related stress. Significant etiologic factors include death as an existential fact emphasizing our finite nature, the cumulative grief associated with repeated unresolved losses, the pressure of a health care system fueled by the medical information explosion, the inability to achieve the idealistic goals embraced by holistic medical care, stresses inherent in working as a "team," and an undermined context of meaning as an outcome of treatment failures. Clinical manifestations of stress are reviewed as an aid to early diagnosis. Strategies useful in the prevention and management of stress include the encouragement of increased awareness of stress in self and colleagues, the clarification of appropriate goals and priorities, encouragement of appropriate limit setting, the mobilization of collaborative input, the clarification of team roles and organizational patterns, the establishment of team support meetings and favorable working conditions, exercise, and the clarification and working through of previously unresolved personal psychodynamic issues. Differences between the work-related stress involved in clinical oncology as compared with hospice care are examined. PMID:3723168

  18. [Progressive hearing loss].

    PubMed

    Reiss, M; Reiss, G

    2000-01-01

    Progressive sensorineural hearing loss (SNHL) is defined as hearing loss of unknown etiology with fairly high-speed progression. Its diagnostic criteria consist of the following: that it is 1) progressive, 2) with bilateral involvement, and 3) of unknown etiology. Due to recent advances in diagnostics, imaging and management, SNHL has gained much interest from otologists in the last few years. They provide new insight into the physiology and pathophysiology of hearing. SNHL which is sudden in onset, fluctuating, and/or progressive complicates medical management, hearing aid selection, and individualized educational planning for a hearing-impaired patient. Existing hypotheses on the etiology of SNHL are judged on experimental, clinical, laboratory and radiological evidence. Cardiovascular and rheologic diseases, hereditary disorders, immunological phenomena, infections, environmental causes like noise, ototoxic drugs and industrial substances and systemic maladies must be included in the diagnostic reflections. Potential concepts of treatment include rheologic medications and corticosteroids. Hearing aids and timely cochlear implant operation are further possible forms of treatment. PMID:10893764

  19. 21 CFR 880.5110 - Hydraulic adjustable hospital bed.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Hydraulic adjustable hospital bed. 880.5110 Section 880.5110 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES... hospital bed is a device intended for medical purposes that consists of a bed with a hydraulic...

  20. 21 CFR 880.5120 - Manual adjustable hospital bed.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Manual adjustable hospital bed. 880.5120 Section 880.5120 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES... hospital bed is a device intended for medical purposes that consists of a bed with a manual...

  1. 10 CFR 35.605 - Installation, maintenance, adjustment, and repair.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 10 Energy 1 2013-01-01 2013-01-01 false Installation, maintenance, adjustment, and repair. 35.605 Section 35.605 Energy NUCLEAR REGULATORY COMMISSION MEDICAL USE OF BYPRODUCT MATERIAL Photon Emitting Remote Afterloader Units, Teletherapy Units, and Gamma Stereotactic Radiosurgery Units §...

  2. 10 CFR 35.605 - Installation, maintenance, adjustment, and repair.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 10 Energy 1 2010-01-01 2010-01-01 false Installation, maintenance, adjustment, and repair. 35.605 Section 35.605 Energy NUCLEAR REGULATORY COMMISSION MEDICAL USE OF BYPRODUCT MATERIAL Photon Emitting Remote Afterloader Units, Teletherapy Units, and Gamma Stereotactic Radiosurgery Units §...

  3. 10 CFR 35.605 - Installation, maintenance, adjustment, and repair.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 10 Energy 1 2014-01-01 2014-01-01 false Installation, maintenance, adjustment, and repair. 35.605 Section 35.605 Energy NUCLEAR REGULATORY COMMISSION MEDICAL USE OF BYPRODUCT MATERIAL Photon Emitting Remote Afterloader Units, Teletherapy Units, and Gamma Stereotactic Radiosurgery Units §...

  4. 10 CFR 35.605 - Installation, maintenance, adjustment, and repair.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 10 Energy 1 2011-01-01 2011-01-01 false Installation, maintenance, adjustment, and repair. 35.605 Section 35.605 Energy NUCLEAR REGULATORY COMMISSION MEDICAL USE OF BYPRODUCT MATERIAL Photon Emitting Remote Afterloader Units, Teletherapy Units, and Gamma Stereotactic Radiosurgery Units §...

  5. 10 CFR 35.605 - Installation, maintenance, adjustment, and repair.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 10 Energy 1 2012-01-01 2012-01-01 false Installation, maintenance, adjustment, and repair. 35.605 Section 35.605 Energy NUCLEAR REGULATORY COMMISSION MEDICAL USE OF BYPRODUCT MATERIAL Photon Emitting Remote Afterloader Units, Teletherapy Units, and Gamma Stereotactic Radiosurgery Units §...

  6. Physical Status and Psychosocial Adjustment in Children with Spina Bifida.

    ERIC Educational Resources Information Center

    Wallander, Jan L.; And Others

    1989-01-01

    The study, in which mothers of 62 children with spina bifida completed the Child Behavior Checklist, found that children with differing degrees of physical problems and disability (determined from medical charts) did not differ significantly in their psychosocial adjustment. (Author/DB)

  7. 78 FR 62712 - Rate Adjustment

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-10-22

    ... Rate Adjustment AGENCY: Postal Regulatory Commission. ACTION: Notice. SUMMARY: The Commission is noticing a recent Postal Service filing seeking postal rate adjustments based on exigent circumstances... On September 26, 2013, the Postal Service filed an exigent rate request with the Commission...

  8. Adjustable holder for transducer mounting

    NASA Technical Reports Server (NTRS)

    Deotsch, R. C.

    1980-01-01

    Positioning of acoustic sensor, strain gage, or similar transducer is facilitated by adjustable holder. Developed for installation on Space Shuttle, it includes springs for maintaining uniform load on transducer with adjustable threaded cap for precisely controlling position of sensor with respect to surrounding structure.

  9. Spousal Adjustment to Myocardial Infarction.

    ERIC Educational Resources Information Center

    Ziglar, Elisa J.

    This paper reviews the literature on the stresses and coping strategies of spouses of patients with myocardial infarction (MI). It attempts to identify specific problem areas of adjustment for the spouse and to explore the effects of spousal adjustment on patient recovery. Chapter one provides an overview of the importance in examining the…

  10. Mood Adjustment via Mass Communication.

    ERIC Educational Resources Information Center

    Knobloch, Silvia

    2003-01-01

    Proposes and experimentally tests mood adjustment approach, complementing mood management theory. Discusses how results regarding self-exposure across time show that patterns of popular music listening among a group of undergraduate students differ with initial mood and anticipation, lending support to mood adjustment hypotheses. Describes how…

  11. Enlarged Vestibular Aqueducts and Childhood Hearing Loss

    MedlinePlus

    ... Health Info » Hearing, Ear Infections, and Deafness Enlarged Vestibular Aqueducts and Childhood Hearing Loss On this page: ... more information about enlarged vestibular aqueducts? What are vestibular aqueducts? The inner ear Credit: NIH Medical Arts ...

  12. Predictors and Correlates of Follow-up Visit Adherence among Adolescents Receiving Laparoscopic Adjustable Gastric Banding

    PubMed Central

    Sysko, Robyn; Hildebrandt, Tom B.; Kaplan, Simona; Brewer, Stephanie K.; Zitsman, Jeffrey L.; Devlin, Michael J.

    2014-01-01

    Background Adherence behaviors have not been examined among adolescents undergoing laparoscopic adjustable gastric banding (LAGB). In addition, studies of youth receiving bariatric surgery have not considered the influence of psychopathology on postoperative adherence. Objective The purpose of this study was to evaluate predictors and correlates of adherence to post-surgery visits among a sample of adolescents undergoing LAGB. Setting Psychiatry Department, University Medical Center, United States. Methods Postoperative visits with surgical staff were analyzed over the two years following surgery (n= 101 adolescents). Growth mixture modeling examined trends in adherence. Results A three-class solution provided the best fit to the data. The classes from the final model were characterized by class 1 (61.6%) demonstrating high levels of adherence over the 24 months following LAGB, class 2 (28.5%) showing a more gradual decline in adherence, and class 3 (9.9%) with an accelerated decline in adherence. Higher levels of preoperative depressive symptoms and more preoperative episodes of loss of control over eating decreased the likelihood of adherence. Class 3 adolescents had significantly higher estimated 24-month body mass indices than Classes 1 or 2. Conclusions Variable patterns of follow-up visit adherence were identified among adolescents receiving LAGB, which were predicted by depressive symptoms and loss of control over eating. The trajectory characterized by a rapid decline in adherence to follow-up visits was also associated with less weight loss. PMID:25066443

  13. Denying Medical Students' Emotions.

    ERIC Educational Resources Information Center

    USA Today, 1984

    1984-01-01

    Medical educators nationwide are questioning the process that leads to the denial of the emotional side of medicine by its practitioners. Emotional dilemmas are often verbally suppressed by most students, but they surface in many ways, such as depression, insomnia, loss of appetite, and anxiety. (RM)

  14. Rapid weight loss

    MedlinePlus

    ... loss-rapid weight loss; Overweight-rapid weight loss; Obesity-rapid weight loss; Diet-rapid weight loss ... for people who have health problems because of obesity. For these people, losing a lot of weight ...

  15. Early Parental Adjustment and Bereavement after Childhood Cancer Death

    ERIC Educational Resources Information Center

    Barrera, Maru; O'connor, Kathleen; D'Agostino, Norma Mammone; Spencer, Lynlee; Nicholas, David; Jovcevska, Vesna; Tallet, Susan; Schneiderman, Gerald

    2009-01-01

    This study comprehensively explored parental bereavement and adjustment at 6 months post-loss due to childhood cancer. Interviews were conducted with 18 mothers and 13 fathers. Interviews were transcribed verbatim and analyzed based on qualitative methodology. A model describing early parental bereavement and adaptation emerged with 3 domains:…

  16. Laparoscopic Greater Curve Plication as an Outpatient Weight Loss Procedure

    PubMed Central

    Pacheco, Ilvia

    2015-01-01

    Background and Objectives: Laparoscopic greater curve plication is emerging as a weight loss procedure that avoids many of the complications of other surgeries that require gastrointestinal division, amputation, or use of a foreign body. Cost savings and affordability have also been promoted, as plication does not require the use of stapling devices, adjustable gastric bands, or prolonged hospitalization. The ability to predictably perform plication as an outpatient surgery may further define its role as a therapeutic option for treating morbid obesity. We present the 30-day outcomes and supplementary 12-month data in a series of 141 laparoscopic greater curve plication surgeries performed as outpatient procedures. Methods: Laparoscopic greater curve plication was performed as outpatient surgery in 141 consecutive patients. Outcomes including perioperative complications, incidental 12-month follow-up for weight loss, and change in diabetic and hypertensive medication are reported. Results: Of the 141 plications performed, 138 patients were discharged from the recovery room and 6 were readmitted. There was no conversion to open surgery and no mortality. Conclusions: The ability to reliably perform greater curve plication as an outpatient surgery may further define its role as an additional weight loss surgery technique. PMID:26508824

  17. Social Constraints are Associated with Negative Psychological and Physical Adjustment in Bereavement.

    PubMed

    Juth, Vanessa; Smyth, Joshua M; Carey, Michael P; Lepore, Stephen J

    2015-07-01

    Losing a loved one is a normative life event, yet there is great variability in subsequent interpersonal experiences and adjustment. The Social-Cognitive Processing (SCP) model suggests that social constraints (i.e. limited opportunities to disclose thoughts and feelings in a supportive context) impede emotional and cognitive processing of stressful life events, which may lead to maladjustment. This study investigates personal and loss-related correlates of social constraints during bereavement, the links between social constraints and post-loss adjustment, and whether social constraints moderate the relations between loss-related intrusive thoughts and adjustment. A community sample of bereaved individuals (n = 238) provided demographic and loss-related information and reported on their social constraints, loss-related intrusions, and psychological and physical adjustment. Women, younger people, and those with greater financial concerns reported more social constraints. Social constraints were significantly associated with more depressive symptoms, perceived stress, somatic symptoms, and worse global health. Individuals with high social constraints and high loss-related intrusions had the highest depressive symptoms and perceived life stress. Consistent with the SCP model, loss-related social constraints are associated with poorer adjustment, especially psychological adjustment. In particular, experiencing social constraints in conjunction with loss-related intrusions may heighten the risk for poor psychological health. PMID:25708231

  18. Memory loss.

    PubMed

    Flicker, Leon A; Ford, Andrew H; Beer, Christopher D; Almeida, Osvaldo P

    2012-02-01

    Most older people with memory loss do not have dementia. Those with mild cognitive impairment are at increased risk of progressing to dementia, but no tests have been shown to enhance the accuracy of assessing this risk. Although no intervention has been convincingly shown to prevent dementia, data from cohort studies and randomised controlled trials are compelling in indicating that physical activity and treatment of hypertension decrease the risk of dementia. There is no evidence that pharmaceutical treatment will benefit people with mild cognitive impairment. In people with Alzheimer's disease, treatment with a cholinesterase inhibitor or memantine (an N-methyl- D-aspartate receptor antagonist) may provide symptomatic relief and enhance quality of life, but does not appear to alter progression of the illness. Non-pharmacological strategies are recommended as first-line treatments for behavioural and psychological symptoms of dementia, which are common in Alzheimer's disease. Atypical antipsychotics have modest benefit in reducing agitation and psychotic symptoms but increase the risk of cardiovascular events. The role of antidepressants in managing depressive symptoms in patients with mild cognitive impairment is uncertain and may increase the risk of delirium and falls. PMID:22304604

  19. Hearing Loss Prevalence and Risk Factors Among Older Adults in the United States

    PubMed Central

    Thorpe, Roland; Gordon-Salant, Sandra; Ferrucci, Luigi

    2011-01-01

    Background. Hearing loss has been associated with cognitive and functional decline in older adults and may be amenable to rehabilitative interventions, but national estimates of hearing loss prevalence and hearing aid use in older adults are unavailable. Methods. We analyzed data from the 2005–2006 cycle of the National Health and Nutritional Examination Survey, which is the first cycle to ever incorporate hearing assessment in adults aged 70 years and older. Audiometry was performed in 717 older adults, and data on hearing aid use, noise exposure, medical history, and demographics were obtained from interviews. Analyses incorporated sampling weights to account for the complex sampling design and yield results that are generalizable to the U.S. population. Results. The prevalence of hearing loss defined as a speech frequency pure tone average of more than 25 dB in the better ear was 63.1% (95% confidence interval: 57.4–68.8). Age, sex, and race were the factors most strongly associated with hearing loss after multivariate adjustment, with black race being substantially protective against hearing loss (odds ratio 0.32 compared with white participants [95% confidence interval: 0.19–0.53]). Hearing aids were used in 40.0% (95% confidence interval: 35.1–44.8) of adults with moderate hearing loss, but in only 3.4% (95% confidence interval: 0.8–6.0) of those with a mild hearing loss. Conclusion. Hearing loss is prevalent in nearly two thirds of adults aged 70 years and older in the U.S. population. Additional research is needed to determine the epidemiological and physiological basis for the protective effect of black race against hearing loss and to determine the role of hearing aids in those with a mild hearing loss. PMID:21357188

  20. 77 FR 37837 - Overall Foreign Loss Recapture on Property Dispositions

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-06-25

    ... Internal Revenue Service 26 CFR Part 1 RIN 1545-BK55 Overall Foreign Loss Recapture on Property... coordination of these rules with the capital gains adjustments under section 904(b) and loss allocations and loss account recapture under section 904(f) and (g). The proposed regulations at Sec....

  1. Medication supply for people evacuated during disasters.

    PubMed

    Ochi, Sae; Hodgson, Susan; Landeg, Owen; Mayner, Lidia; Murray, Virginia

    2015-02-01

    Medication loss is a major problem in disaster settings, and it is crucial for patients to bring their medication and healthcare items with them when they leave their homes during an evacuation. This article is based on a systematic literature review on medication loss, the objectives of which were to identify the extent and implications of medication loss, to identify the burden of prescription refill, and to make recommendations on effective preparedness. The review revealed that medication loss, prescription loss and refills, and the loss of medical aids are a significant burden on the medical relief teams. The medical aids are not limited to drugs, but include routine medications, medical/allergy records, devices for specific care and daily life, and emergency medications. One possible solution is to make a personal emergency pack and for people to carry this with them at all times. To ensure that patients are adequately prepared, stakeholders, especially health professionals, need to be actively involved in the preparation plans. Since our findings have little impact on disaster risk reduction unless shared broadly, we are now taking actions to spread our findings, such as presenting in conferences and via posters, in order to raise awareness among patients and healthcare professionals. As part of these activities, our findings were presented at the Evidence Aid Symposium on 20 September 2014, at Hyderabad, India. PMID:25594870

  2. Adjustable Induction-Heating Coil

    NASA Technical Reports Server (NTRS)

    Ellis, Rod; Bartolotta, Paul

    1990-01-01

    Improved design for induction-heating work coil facilitates optimization of heating in different metal specimens. Three segments adjusted independently to obtain desired distribution of temperature. Reduces time needed to achieve required temperature profiles.

  3. Weighing the value of memory loss in the surgical evaluation of left temporal lobe epilepsy: A decision analysis

    PubMed Central

    Akama-Garren, Elliot H.; Bianchi, Matt T.; Leveroni, Catherine; Cole, Andrew J.; Cash, Sydney S.; Westover, M. Brandon

    2016-01-01

    SUMMARY Objectives Anterior temporal lobectomy is curative for many patients with disabling medically refractory temporal lobe epilepsy, but carries an inherent risk of disabling verbal memory loss. Although accurate prediction of iatrogenic memory loss is becoming increasingly possible, it remains unclear how much weight such predictions should have in surgical decision making. Here we aim to create a framework that facilitates a systematic and integrated assessment of the relative risks and benefits of surgery versus medical management for patients with left temporal lobe epilepsy. Methods We constructed a Markov decision model to evaluate the probabilistic outcomes and associated health utilities associated with choosing to undergo a left anterior temporal lobectomy versus continuing with medical management for patients with medically refractory left temporal lobe epilepsy. Three base-cases were considered, representing a spectrum of surgical candidates encountered in practice, with varying degrees of epilepsy-related disability and potential for decreased quality of life in response to post-surgical verbal memory deficits. Results For patients with moderately severe seizures and moderate risk of verbal memory loss, medical management was the preferred decision, with increased quality-adjusted life expectancy. However, the preferred choice was sensitive to clinically meaningful changes in several parameters, including quality of life impact of verbal memory decline, quality of life with seizures, mortality rate with medical management, probability of remission following surgery, and probability of remission with medical management. Significance Our decision model suggests that for patients with left temporal lobe epilepsy, quantitative assessment of risk and benefit should guide recommendation of therapy. In particular, risk for and potential impact of verbal memory decline should be carefully weighed against the degree of disability conferred by continued

  4. Medication Errors

    MedlinePlus

    ... to reduce the risk of medication errors to industry and others at FDA. Additionally, DMEPA prospectively reviews ... List of Abbreviations Regulations and Guidances Guidance for Industry: Safety Considerations for Product Design to Minimize Medication ...

  5. 78 FR 61396 - Investigations Regarding Eligibility To Apply for Worker Adjustment Assistance

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-10-03

    ... Employment and Training Administration Investigations Regarding Eligibility To Apply for Worker Adjustment... to determine whether the workers are eligible to apply for adjustment assistance under Title II...). 83070 Harrison Medical Ctr. Bremerton, WA......... 09/09/13 08/14/13 (Workers). 83071 Applied...

  6. 42 CFR 417.588 - Computation of adjusted average per capita cost (AAPCC).

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 3 2011-10-01 2011-10-01 false Computation of adjusted average per capita cost... MEDICAL PLANS, AND HEALTH CARE PREPAYMENT PLANS Medicare Payment: Risk Basis § 417.588 Computation of adjusted average per capita cost (AAPCC). (a) Basic data. In computing the AAPCC, CMS uses the U.S....

  7. 42 CFR 417.588 - Computation of adjusted average per capita cost (AAPCC).

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Computation of adjusted average per capita cost... MEDICAL PLANS, AND HEALTH CARE PREPAYMENT PLANS Medicare Payment: Risk Basis § 417.588 Computation of adjusted average per capita cost (AAPCC). (a) Basic data. In computing the AAPCC, CMS uses the U.S....

  8. Psychological Adjustment to Spinal Cord Injury as Related to Manner of Onset of Disability.

    ERIC Educational Resources Information Center

    Athelstan, Gary T.; Crewe, Nancy M.

    1979-01-01

    People with spinal cord injury have behavioral tendencies that place them at-risk of such injuries. This study investigated the relationship between personality characteristics as suggested by manner of onset of injury and long-term medical, vocational, and psychological adjustment. Imprudent subjects tended to be better adjusted at follow-up than…

  9. Weight loss and progressive left ventricular remodelling: The Multi-Ethnic Study of Atherosclerosis (MESA)

    PubMed Central

    Shah, Ravi V; Murthy, Venkatesh L; Abbasi, Siddique A; Eng, John; Wu, Colin; Ouyang, Pamela; Kwong, Raymond Y; Goldfine, Allison; Bluemke, David A; Lima, Joao; Jerosch-Herold, Michael

    2016-01-01

    Aims Impact of weight loss on cardiac structure has not been extensively investigated in large, multi-ethnic, community-based populations. We investigated the longitudinal impact of weight loss on cardiac structure by cardiac magnetic resonance (CMR). Methods and results 2351 participants in the Multi-Ethnic Study of Atherosclerosis (MESA) who underwent CMR at Exam 1 (2002) and Exam 5 (2011) were included. Primary outcomes were percentage change in LV mass (indexed to height) and LV mass-to-volume ratio (concentric LV remodelling). Multivariable linear regression was used to measure the association between outcomes and weight change. At median 9.4 years' follow-up, 639 individuals (27%) experienced >5% weight loss (median 6.9 kg) and 511 (22%) had >5% weight gain (median 6.4 kg). A >5% weight gain was associated with the greatest increase in LV mass (+5.4% median) and LV mass-to-volume ratio (+12.2% median). Adjusting for medications, hypertension/diabetes (and change in these risk factors), age, race and other risk factors, every 5% weight loss was associated with a 1.3% decrease in height-indexed LV mass and 1.3% decrease in LV mass-to-volume ratio (p <0.0001). There was no effect modification/confounding by age, race, gender or baseline BMI. Change in LV mass-to-volume ratio was roughly linear, specifically for modest degrees of weight loss (−10% to +10%). Change in LV mass was linear with weight loss, suggesting no threshold of weight loss is needed for LV mass regression. Conclusions In a large multi-ethnic population, weight loss is associated with beneficial effects on cardiac structure, independent of age, race, gender, BMI and obesity-related cardiometabolic risk. There is no threshold of weight loss required to produce these effects. PMID:25009171

  10. 7 CFR 251.7 - Formula adjustments.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 4 2010-01-01 2010-01-01 false Formula adjustments. 251.7 Section 251.7 Agriculture... GENERAL REGULATIONS AND POLICIES-FOOD DISTRIBUTION THE EMERGENCY FOOD ASSISTANCE PROGRAM § 251.7 Formula adjustments. Formula adjustments. (a) Commodity adjustments. The Department will make annual adjustments...

  11. 12 CFR 1209.80 - Inflation adjustments.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 12 Banks and Banking 10 2014-01-01 2014-01-01 false Inflation adjustments. 1209.80 Section 1209.80... PROCEDURE Civil Money Penalty Inflation Adjustments § 1209.80 Inflation adjustments. The maximum amount of... thereafter adjusted in accordance with the Inflation Adjustment Act, on a recurring four-year cycle, is...

  12. 12 CFR 1209.80 - Inflation adjustments.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 12 Banks and Banking 9 2012-01-01 2012-01-01 false Inflation adjustments. 1209.80 Section 1209.80... PROCEDURE Civil Money Penalty Inflation Adjustments § 1209.80 Inflation adjustments. The maximum amount of... thereafter adjusted in accordance with the Inflation Adjustment Act, on a recurring four-year cycle, is...

  13. 12 CFR 1209.80 - Inflation adjustments.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 12 Banks and Banking 9 2013-01-01 2013-01-01 false Inflation adjustments. 1209.80 Section 1209.80... PROCEDURE Civil Money Penalty Inflation Adjustments § 1209.80 Inflation adjustments. The maximum amount of... thereafter adjusted in accordance with the Inflation Adjustment Act, on a recurring four-year cycle, is...

  14. 42 CFR 412.525 - Adjustments to the Federal prospective payment.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... its estimated costs for a patient exceed the adjusted LTC-MS-DRG payment plus a fixed-loss amount. For...-term care hospital prospective payment system payment year, as defined in § 412.503, using the...

  15. Medical Appointments

    MedlinePlus

    ... trouble concentrating, stomach problems or emotional issues like anxiety. New or increasing side effects or reactions to your medications. Again, for how long? How serious are they? Medication compliance: How well you’ve been taking your medications. Have you missed doses? If so, ...

  16. MEDICAL "DEPRIVATION."

    ERIC Educational Resources Information Center

    SUCHMAN, EDWARD A.

    THE SOCIAL AND MEDICAL PROBLEM TODAY HAS SHIFTED FROM PROVIDING FOR THE EMERGENCY MEDICAL NEEDS OF THE INDIGENT SICK TO RAISING THE LEVEL OF LOWER CLASS PARTICIPATION IN THE BENEFITS OF MODERN MEDICINE. GREATER ATTENTION IS BEING FOCUSED ON MEDICAL DEPRIVATION SUFFERED BY LARGE SEGMENTS OF THE POPULATION WHO DO NOT SHARE EQUALLY IN MEDICAL…

  17. Vision Loss, Sudden

    MedlinePlus

    ... of age-related macular degeneration. Spotlight on Aging: Vision Loss in Older People Most commonly, vision loss ... Some Causes and Features of Sudden Loss of Vision Cause Common Features* Tests Sudden loss of vision ...

  18. [Parental attitude and adjustment to childhood epilepsy].

    PubMed

    Ju, S H; Chang, P F; Chen, Y J; Huang, C C; Tsai, J J

    1990-01-01

    Parental attitude and adjustment were examined in 20 epileptic children (ages 6.8-16.6 yrs), using semi-structured interview. The results indicated that parental understandings of epilepsy were generally poor and incorrect. Fifteen (75%) of 20 parents had their own interpretations of causality and 19 (95%) had unrealistic hope for early and complete cure. Parents tended to overprotect and overrestrict their children. Sixteen (80%) concealed the illness for fear of social prejudice, therefore the social support systems were generally poorly utilized. As in other chronic diseases, all parents went through feelings of shock, denial, anger, guilt, fear, anxiety and depression. Family relationships were not affected much, however, poor communications were commonly found between parents and children. Thirteen (65%) parents never talked to their children about epilepsy. We concluded that parents of epileptic children showed negative attitudes toward their children and had difficulties in their psychosocial adjustment probably related to social stigmata and misunderstanding of the illness. Therefore, communication between physician and parents in both medical and psychosocial aspects should be encouraged. PMID:2275364

  19. Medical Management

    MedlinePlus

    ... them powered by the flip of a switch. Sensory loss Combined with the regular abrasions caused by ... check your feet regularly for injuries. Paradoxically, despite sensory loss, some people with CMT experience pain — a ...

  20. Adjustment Issues Affecting Employment for Immigrants from the Former Soviet Union.

    ERIC Educational Resources Information Center

    Yost, Anastasia Dimun; Lucas, Margaretha S.

    2002-01-01

    Describes major issues, including culture shock and loss of status, that affect general adjustment of immigrants and refugees from the former Soviet Union who are resettling in the United States. Issues that affect career and employment adjustment are described and the interrelatedness of general and career issues is explored. (Contains 39…

  1. Final RQ adjustments rule issued

    SciTech Connect

    Bergeson, L.L.

    1995-08-01

    On June 12, 1995, the US Environmental Protection Agency (EPA) issued its long awaited final rule adjusting certain reportable quantities (RQs) for hazardous substances under the Comprehensive Environmental Response, Compensation, and Liability Act (CERCLA). The rule: revises the table of hazardous substances to add 47 individual Clean Air Act (CAA) hazardous air pollutants (HAPs); adjustments their statutory one-pound RQs; adds five other CAA HAPs that are categories of substances and assigns no RQ to the categories; and adjusts RQs for 11 Resource Conservation and Recovery Act (RCRA) listed hazardous wastes. EPA made conforming changes to the Clean Water Act table of hazardous substances and the Emergency Planning and Community Right-to-Know Act (EPCRA) table of extremely hazardous substances. The rule became effective July 12, 1995.

  2. MCCB warm adjustment testing concept

    NASA Astrophysics Data System (ADS)

    Erdei, Z.; Horgos, M.; Grib, A.; Preradović, D. M.; Rodic, V.

    2016-08-01

    This paper presents an experimental investigation in to operating of thermal protection device behavior from an MCCB (Molded Case Circuit Breaker). One of the main functions of the circuit breaker is to assure protection for the circuits where mounted in for possible overloads of the circuit. The tripping mechanism for the overload protection is based on a bimetal movement during a specific time frame. This movement needs to be controlled and as a solution to control this movement we choose the warm adjustment concept. This concept is meant to improve process capability control and final output. The warm adjustment device design will create a unique adjustment of the bimetal position for each individual breaker, determined when the testing current will flow thru a phase which needs to trip in a certain amount of time. This time is predetermined due to scientific calculation for all standard types of amperages and complies with the IEC 60497 standard requirements.

  3. Contrast Enhancement Algorithm Based on Gap Adjustment for Histogram Equalization.

    PubMed

    Chiu, Chung-Cheng; Ting, Chih-Chung

    2016-01-01

    Image enhancement methods have been widely used to improve the visual effects of images. Owing to its simplicity and effectiveness histogram equalization (HE) is one of the methods used for enhancing image contrast. However, HE may result in over-enhancement and feature loss problems that lead to unnatural look and loss of details in the processed images. Researchers have proposed various HE-based methods to solve the over-enhancement problem; however, they have largely ignored the feature loss problem. Therefore, a contrast enhancement algorithm based on gap adjustment for histogram equalization (CegaHE) is proposed. It refers to a visual contrast enhancement algorithm based on histogram equalization (VCEA), which generates visually pleasing enhanced images, and improves the enhancement effects of VCEA. CegaHE adjusts the gaps between two gray values based on the adjustment equation, which takes the properties of human visual perception into consideration, to solve the over-enhancement problem. Besides, it also alleviates the feature loss problem and further enhances the textures in the dark regions of the images to improve the quality of the processed images for human visual perception. Experimental results demonstrate that CegaHE is a reliable method for contrast enhancement and that it significantly outperforms VCEA and other methods. PMID:27338412

  4. Contrast Enhancement Algorithm Based on Gap Adjustment for Histogram Equalization

    PubMed Central

    Chiu, Chung-Cheng; Ting, Chih-Chung

    2016-01-01

    Image enhancement methods have been widely used to improve the visual effects of images. Owing to its simplicity and effectiveness histogram equalization (HE) is one of the methods used for enhancing image contrast. However, HE may result in over-enhancement and feature loss problems that lead to unnatural look and loss of details in the processed images. Researchers have proposed various HE-based methods to solve the over-enhancement problem; however, they have largely ignored the feature loss problem. Therefore, a contrast enhancement algorithm based on gap adjustment for histogram equalization (CegaHE) is proposed. It refers to a visual contrast enhancement algorithm based on histogram equalization (VCEA), which generates visually pleasing enhanced images, and improves the enhancement effects of VCEA. CegaHE adjusts the gaps between two gray values based on the adjustment equation, which takes the properties of human visual perception into consideration, to solve the over-enhancement problem. Besides, it also alleviates the feature loss problem and further enhances the textures in the dark regions of the images to improve the quality of the processed images for human visual perception. Experimental results demonstrate that CegaHE is a reliable method for contrast enhancement and that it significantly outperforms VCEA and other methods. PMID:27338412

  5. 8 CFR 1245.5 - Medical examination.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... the Act and § 214.2(k) of 8 CFR chapter I if the applicant was medically examined prior to, and as a... 8 Aliens and Nationality 1 2010-01-01 2010-01-01 false Medical examination. 1245.5 Section 1245.5... REGULATIONS ADJUSTMENT OF STATUS TO THAT OF PERSON ADMITTED FOR PERMANENT RESIDENCE § 1245.5...

  6. 8 CFR 1245.5 - Medical examination.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... the Act and § 214.2(k) of 8 CFR chapter I if the applicant was medically examined prior to, and as a... 8 Aliens and Nationality 1 2013-01-01 2013-01-01 false Medical examination. 1245.5 Section 1245.5... REGULATIONS ADJUSTMENT OF STATUS TO THAT OF PERSON ADMITTED FOR PERMANENT RESIDENCE § 1245.5...

  7. 8 CFR 1245.5 - Medical examination.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... the Act and § 214.2(k) of 8 CFR chapter I if the applicant was medically examined prior to, and as a... 8 Aliens and Nationality 1 2011-01-01 2011-01-01 false Medical examination. 1245.5 Section 1245.5... REGULATIONS ADJUSTMENT OF STATUS TO THAT OF PERSON ADMITTED FOR PERMANENT RESIDENCE § 1245.5...

  8. 8 CFR 1245.5 - Medical examination.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... the Act and § 214.2(k) of 8 CFR chapter I if the applicant was medically examined prior to, and as a... 8 Aliens and Nationality 1 2012-01-01 2012-01-01 false Medical examination. 1245.5 Section 1245.5... REGULATIONS ADJUSTMENT OF STATUS TO THAT OF PERSON ADMITTED FOR PERMANENT RESIDENCE § 1245.5...

  9. 8 CFR 1245.5 - Medical examination.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... the Act and § 214.2(k) of 8 CFR chapter I if the applicant was medically examined prior to, and as a... 8 Aliens and Nationality 1 2014-01-01 2014-01-01 false Medical examination. 1245.5 Section 1245.5... REGULATIONS ADJUSTMENT OF STATUS TO THAT OF PERSON ADMITTED FOR PERMANENT RESIDENCE § 1245.5...

  10. Judging hospitals by severity-adjusted mortality rates: the influence of the severity-adjustment method.

    PubMed Central

    Iezzoni, L I; Ash, A S; Shwartz, M; Daley, J; Hughes, J S; Mackiernan, Y D

    1996-01-01

    OBJECTIVES: This research examined whether judgments about a hospital's risk-adjusted mortality performance are affected by the severity-adjustment method. METHODS: Data came from 100 acute care hospitals nationwide and 11880 adults admitted in 1991 for acute myocardial infarction. Ten severity measures were used in separate multivariable logistic models predicting in-hospital death. Observed-to-expected death rates and z scores were calculated with each severity measure for each hospital. RESULTS: Unadjusted mortality rates for the 100 hospitals ranged from 4.8% to 26.4%. For 32 hospitals, observed mortality rates differed significantly from expected rates for 1 or more, but not for all 10, severity measures. Agreement between pairs of severity measures on whether hospitals were flagged as statistical mortality outliers ranged from fair to good. Severity measures based on medical records frequently disagreed with measures based on discharge abstracts. CONCLUSIONS: Although the 10 severity measures agreed about relative hospital performance more often than would be expected by chance, assessments of individual hospital mortality rates varied by different severity-adjustment methods. PMID:8876505

  11. Adjustable spacer with rotational lock

    SciTech Connect

    Bowyer, M.L.

    1984-02-28

    A spacing apparatus for tubing conduit in a subterranean well, normally for use with an electric component with a longitudinally extending external electrical cable, permits irrotational adjustment of the length of the tubing conduit. The spacing apparatus comprises telescoping members which are keyed to prevent rotation therebetween. A threaded member, longitudinally fixed relative to one longitudinal member, normally engages threads extending substantially along the entire length of the other telescoping member. Movement of a retaining sleeve permits disengagement of the threaded segments which ratchet along the threads during telescoping movement. The length of the conduit can thus be irrotationally adjusted to remove slack from the electrical cable.

  12. Convective adjustment in baroclinic atmospheres

    NASA Technical Reports Server (NTRS)

    Emanuel, Kerry A.

    1986-01-01

    Local convection in planetary atmospheres is generally considered to result from the action of gravity on small regions of anomalous density. That in rotating baroclinic fluids the total potential energy for small scale convection contains a centrifugal as well as a gravitational contribution is shown. Convective adjustment in such an atmosphere results in the establishment of near adiabatic lapse rates of temperature along suitably defined surfaces of constant angular momentum, rather than in the vertical. This leads in general to sub-adiabatic vertical lapse rates. That such an adjustment actually occurs in the earth's atmosphere is shown by example and the magnitude of the effect for several other planetary atmospheres is estimated.

  13. Low-Loss Fuel and Oxidizer Injector

    NASA Technical Reports Server (NTRS)

    Pragemau, G. L.

    1985-01-01

    Pressure losses reduced without degrading combustion stability. Injection Posts form forest in cavity between oxygen manifold and secondary faceplate. Cavity is fuel manifold; fuel floods post forest and enters each post through side holes in shroud. Injector designed for improved assembly and maintenance. Posts accessible from primary combustion chamber side and changed for flow adjustment.

  14. Structural adjustment: the wrong prescription for Africa?

    PubMed

    Logie, D E; Woodroffe, J

    1993-07-01

    The medical and social consequences and the wide effects of the African structural adjustment program (SAP), specifically for women and children, and examples of the impact in Zimbabwe, Zambia, and Senegal, are discussed. Structural adjustment is defined and the history of its inception is provided. Significant economic and social welfare improvement occurred during the 1960s and 1970s, and considerable decline occurred during the 1980s. The present reality is that Africa,m contrary to popular myths about being a "bottomless pit of Western charity," transfers $10 billion/year to the rich North. Debtor countries are 61% more indebted in 1990 than they were in 1982. During the 1980s, oil prices and interest rates rose dramatically, African export prices dropped, and industrialized countries set up protectionist policies. In addition, there was civil war, drought, poor leadership which put military spending before poverty reduction, and the AIDS epidemic. The Western response was to restructure debt payments in return for implementation of SAPs. Structural adjustment involved a package of trade liberalization, devaluation, removal of government subsidies and price controls, privatization, credit shortages, higher interest rates, and "cost recovery" in health and education. The theory is that economic growth will "ultimately" lead to poverty reduction. A critical view is that SAP insures debt repayment, export of cheap raw materials to the North, and may not sustain longterm economic growth. The results for the poor have been high prices for food, transportation, school and medical fees, and a decline in wages and unemployment. Land is used for exports. A solution is to reduce the debt burden, to place the needs of the poor as a top priority in SAPs, and to put pressure on the World Bank, the International Monetary Fund, and governments to consider health outcomes. Other alternatives noted in the African Framework to SAPs are to place well being and self-reliance as

  15. 75 FR 33379 - Railroad Cost Recovery Procedures-Productivity Adjustment; Quarterly Rail Cost Adjustment Factor

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-06-11

    ... Surface Transportation Board Railroad Cost Recovery Procedures--Productivity Adjustment; Quarterly Rail... Railroads that the Board restate the previously published productivity adjustment for the 2003-2007 averaging period (2007 productivity adjustment) so that it tracks the 2007 productivity adjustment...

  16. Corps of Engineers considers adjustable-speed generation

    SciTech Connect

    Not Available

    1993-04-01

    The US Army Corps of Engineers and the Bonneville Power Administration recently commissioned a study to assess the various aspects of adjustable-speed generation (also called variable-speed generation). Electronic Power Conditioning Inc., of Corvallis, Oregon, studied the cost, efficiency, and other operating implications of installing the necessary hardware to enable adjustable-speed generation at four Corps hydroelectric plants on the lower Snake River (Ice Harbor, Lower Monumental, Little Goose, and Lower Granite). Results of the study indicate that, while costly, five adjustable-speed options could be installed and operated on a practical basis. The Corps initiated the study to determine the cost for adding adjustable-speed generation at the four projects to improve fish survival. The Northwest Power Planning Council currently is considering proposals to modify operating procedures for hydroelectric projects on the Columbia River and its tributaries, including seasonal adjustments of pool levels behind dams to flush fish through the river system more rapidly. However, dropping pool levels significantly below normal levels may cause a loss in generating efficiency and a corresponding increase in fish mortality. Adjustable-speed generation is seen as a method for solving both problems

  17. Visual adjustments to temporal blur

    NASA Astrophysics Data System (ADS)

    Bilson, Aaron C.; Mizokami, Yoko; Webster, Michael A.

    2005-10-01

    After observers have adapted to an edge that is spatially blurred or sharpened, a focused edge appears too sharp or blurred, respectively. These adjustments to blur may play an important role in calibrating spatial sensitivity. We examined whether similar adjustments influence the perception of temporal edges, by measuring the appearance of a step change in the luminance of a uniform field after adapting to blurred or sharpened transitions. Stimuli were square-wave alternations (at 1 to 8 Hz) filtered by changing the slope of the amplitude spectrum. A two-alternative-forced-choice task was used to adjust the slope until it appeared as a step change, or until it matched the perceived transitions in a reference stimulus. Observers could accurately set the waveform to a square wave, but only at the slower alternation rates. However, these settings were strongly biased by prior adaptation to filtered stimuli, or when the stimuli were viewed within temporally filtered surrounds. Control experiments suggest that the latter induction effects result directly from the temporal blur and are not simply a consequence of brightness induction in the fields. These results suggest that adaptation and induction adjust visual coding so that images are focused not only in space but also in time.

  18. Self-Adjusting Fluency Therapy.

    ERIC Educational Resources Information Center

    Schneider, Phillip

    1998-01-01

    Presents a rationale and methodology for a self-adjusting "fluency sensitive" approach to working with children who exhibit overt speech-fluency interruptions and a minimal amount of avoidance behavior. The approach emphasizes repeated experiences of volitional increases and decreases in loudness and pauses. Case examples demonstrate how several…

  19. Adjustable Walker for the Handicapped

    NASA Technical Reports Server (NTRS)

    Kitts, R. G.

    1984-01-01

    Front legs adjust at touch of lever for use on stairs or ramps. Spring loaded legs extend when lever is depressed by user. Legs lock in position when lever is released. Lever mounted on either side of walker or on both sides, so legs operated independently.

  20. Adjustable-Angle Drill Block

    NASA Technical Reports Server (NTRS)

    Gallimore, F. H.

    1986-01-01

    Adjustable angular drill block accurately transfers hole patterns from mating surfaces not normal to each other. Block applicable to transfer of nonperpendicular holes in mating contoured assemblies in aircraft industry. Also useful in general manufacturing to transfer mating installation holes to irregular and angular surfaces.

  1. Economic Pressures and Family Adjustment.

    ERIC Educational Resources Information Center

    Haccoun, Dorothy Markiewicz; Ledingham, Jane E.

    The relationships between economic stress on the family and child and parental adjustment were examined for a sample of 199 girls and boys in grades one, four, and seven. These associations were examined separately for families in which both parents were present and in which mothers only were at home. Economic stress was associated with boys'…

  2. Integrating Risk Adjustment and Enrollee Premiums in Health Plan Payment

    PubMed Central

    McGuire, Thomas G.; Glazer, Jacob; Newhouse, Joseph P.; Normand, Sharon-Lise; Shi, Julie; Sinaiko, Anna D.; Zuvekas, Samuel

    2013-01-01

    In two important health policy contexts – private plans in Medicare and the new state-run “Exchanges” created as part of the Affordable Care Act (ACA) – plan payments come from two sources: risk-adjusted payments from a Regulator and premiums charged to individual enrollees. This paper derives principles for integrating risk-adjusted payments and premium policy in individual health insurance markets based on fitting total plan payments to health plan costs per person as closely as possible. A least squares regression including both health status and variables used in premiums reveals the weights a Regulator should put on risk adjusters when markets determine premiums. We apply the methods to an Exchange-eligible population drawn from the Medical Expenditure Panel Survey (MEPS). PMID:24308878

  3. Integrating risk adjustment and enrollee premiums in health plan payment.

    PubMed

    McGuire, Thomas G; Glazer, Jacob; Newhouse, Joseph P; Normand, Sharon-Lise; Shi, Julie; Sinaiko, Anna D; Zuvekas, Samuel H

    2013-12-01

    In two important health policy contexts - private plans in Medicare and the new state-run "Exchanges" created as part of the Affordable Care Act (ACA) - plan payments come from two sources: risk-adjusted payments from a Regulator and premiums charged to individual enrollees. This paper derives principles for integrating risk-adjusted payments and premium policy in individual health insurance markets based on fitting total plan payments to health plan costs per person as closely as possible. A least squares regression including both health status and variables used in premiums reveals the weights a Regulator should put on risk adjusters when markets determine premiums. We apply the methods to an Exchange-eligible population drawn from the Medical Expenditure Panel Survey (MEPS). PMID:24308878

  4. A new look at national medical workforce strategy.

    PubMed

    Paterson, J

    1994-01-01

    The efforts of governments in medical workforce policy have been unimpressive, and this has had serious consequences. Political compromise, theoretical error and administrative laxity have all contributed. It is demonstrated that market evidence, viewed through the prism of orthodox price theory, allows useful prescriptions to be made. These can be implemented through vigorous continuing maintenance and adjustment work on the Commonwealth Medical Benefits Schedule, together with periodic adjustments to rates of undergraduate and specialist medical education and training. PMID:10135096

  5. Hearing Loss in Adults.

    ERIC Educational Resources Information Center

    House, John W.

    1997-01-01

    This article discusses hearing loss in adults. It begins with an explanation of the anatomy of the ear and then explains the three types of hearing loss: conductive hearing loss, sensorineural hearing loss, and mixed conductive-sensorineural hearing loss. Tinnitus, hearing aids, and cochlear implants are also addressed. (CR)

  6. 12 CFR 19.240 - Inflation adjustments.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 12 Banks and Banking 1 2010-01-01 2010-01-01 false Inflation adjustments. 19.240 Section 19.240... PROCEDURE Civil Money Penalty Inflation Adjustments § 19.240 Inflation adjustments. (a) The maximum amount... Civil Penalties Inflation Adjustment Act of 1990 (28 U.S.C. 2461 note) as follows: ER10NO08.001 (b)...

  7. 12 CFR 19.240 - Inflation adjustments.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 12 Banks and Banking 1 2011-01-01 2011-01-01 false Inflation adjustments. 19.240 Section 19.240... PROCEDURE Civil Money Penalty Inflation Adjustments § 19.240 Inflation adjustments. (a) The maximum amount... Civil Penalties Inflation Adjustment Act of 1990 (28 U.S.C. 2461 note) as follows: ER10NO08.001 (b)...

  8. 12 CFR 19.240 - Inflation adjustments.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 12 Banks and Banking 1 2012-01-01 2012-01-01 false Inflation adjustments. 19.240 Section 19.240... PROCEDURE Civil Money Penalty Inflation Adjustments § 19.240 Inflation adjustments. (a) The maximum amount... Civil Penalties Inflation Adjustment Act of 1990 (28 U.S.C. 2461 note) as follows: ER10NO08.001 (b)...

  9. Cultural Adjustment and the Puerto Rican.

    ERIC Educational Resources Information Center

    Prewitt-Diaz, Joseph O.

    This review of the literature on cultural adjustment is divided into four sections: the nature of cultural adjustment; acculturation as a model of cultural adjustment; psychological responses to acculturation; and a model of cultural adjustment developed by the author as a result of his immigration from Puerto Rico to the United States mainland.…

  10. Adjusting to University: The Hong Kong Experience

    ERIC Educational Resources Information Center

    Yau, Hon Keung; Sun, Hongyi; Cheng, Alison Lai Fong

    2012-01-01

    Students' adjustment to the university environment is an important factor in predicting university outcomes and is crucial to their future achievements. University support to students' transition to university life can be divided into three dimensions: academic adjustment, social adjustment and psychological adjustment. However, these…

  11. Vision Loss and Psychological Distress among Ethiopians Adults: A Comparative Cross-Sectional Study

    PubMed Central

    Abateneh, Aemero; Tesfaye, Markos; Bekele, Sisay; Gelaw, Yeshigeta

    2013-01-01

    Background Vision loss causes major changes in lifestyle and habits that may result in psychological distress and further reduction in the quality of life. Little is known about the magnitude of psychological distress in patients with vision loss and its variation with the normal. The aim of this study is, therefore, to investigate the psychological effects of vision loss and its determinants among Ethiopians. Methods A comparative cross-sectional study was conducted on adults attending the Eye clinic of Jimma University Hospital. One hundred fifteen consecutive adults with visual loss at least in one eye and 115 age-and sex-matched controls with normal vision were studied. The psychological distress was measured using standardized Self-Reporting Questionnaire (SRQ-20). Chi-square test and logistic regression were carried out and associations were considered significant at P<0.05. Results The overall prevalence of psychological distress was 33.4%. While psychological distress was found in 49.8% of patients who had loss of vision at least in one eye, only 18.3% of the controls had it. In the adjusted analysis, patients with vision loss had 4.6 times higher risk of suffering from psychological distress compared to patients with normal vision (AOR 4.56; 95% CI 2.16-9.62). Moreover, patients with vision loss in both eyes (AOR 4.00; 95% CI 1.453-11.015) and with worse visual acuity in the better eye (AOR 3.66; 95% CI 1.27-10.54) were significantly more likely to have psychological distress than those patients with vision loss in one eye only and good visual acuity in the better eye respectively. The cause of visual loss, pattern of visual loss, duration of visual loss and sociodemographic variables did not influence the likelihood of having psychological distress. Conclusion Prevalence of psychological distress was significantly higher in patients with visual loss compared to patients with normal vision. There is a need for integration of psychosocial care into the

  12. Cardiac Medications

    MedlinePlus

    ... Diovan) What the Medication Does Rather than lowering levels of angiotensin II (as ACE inhibitors do) angiotensin II receptor blockers prevent this chemical from having any effects on the heart and blood vessels. This keeps blood pressure from rising. Reason for Medication Used to treat or improve ...

  13. Medication reviews.

    PubMed

    Blenkinsopp, Alison; Bond, Christine; Raynor, David K

    2012-10-01

    Recent years have seen a formalization of medication review by pharmacists in all settings of care. This article describes the different types of medication review provided in primary care in the UK National Health Service (NHS), summarizes the evidence of effectiveness and considers how such reviews might develop in the future. Medication review is, at heart, a diagnostic intervention which aims to identify problems for action by the prescriber, the clinician conducting the review, the patient or all three but can also be regarded as an educational intervention to support patient knowledge and adherence. There is good evidence that medication review improves process outcomes of prescribing including reduced polypharmacy, use of more appropriate medicines formulation and more appropriate choice of medicine. When 'harder' outcome measures have been included, such as hospitalizations or mortality in elderly patients, available evidence indicates that whilst interventions could improve knowledge and adherence they did not reduce mortality or hospital admissions with one study showing an increase in hospital admissions. Robust health economic studies of medication reviews remain rare. However a review of cost-effectiveness analyses of medication reviews found no studies in which the cost of the intervention was greater than the benefit. The value of medication reviews is now generally accepted despite lack of robust research evidence consistently demonstrating cost or clinical effectiveness compared with traditional care. Medication reviews can be more effectively deployed in the future by targeting, multi-professional involvement and paying greater attention to medicines which could be safely stopped. PMID:22607195

  14. Academic and Social Adjustment among Deaf and Hard of Hearing College Students in Taiwan

    ERIC Educational Resources Information Center

    Liu, Chia-fen

    2013-01-01

    This study was conducted to identify the factors that may influence the academic and social adjustment of college students with hearing loss in Taiwan. These factors included age, gender, degree of hearing loss, primary communication mode, amplification, high school educational experience, and family relationship. The instruments used to address…

  15. Somali Women's Reflections on the Adjustment of Their Children in the United States

    ERIC Educational Resources Information Center

    Nilsson, Johanna E.; Barazanji, Danah M.; Heintzelman, Ashley; Siddiqi, Mubeena; Shilla, Yasmine

    2012-01-01

    Somali women were interviewed regarding their children's adjustment. Qualitative analysis revealed 5 themes: cultural comparisons, concerns about children, parents' loss of disciplinary authority, available support, and the future. The women discussed changes in their children, such as loss of respect and threats to use law enforcement against…

  16. (Re)Discovering Meaning: A Tale of Two Losses

    ERIC Educational Resources Information Center

    Smith, Claire

    2012-01-01

    Can the two narrative autoethnographic stories I perform here help me to therapeutically deal with the losses they describe? The first story speaks of my PhD defense and its aftermath. I consider the event a loss that is clothed in accomplishment; I work through my feelings by writing about them. The second story describes a medical loss. After…

  17. Mining machine with adjustable jib

    SciTech Connect

    Hart, D.

    1987-05-26

    A mining machine is described having a pair of crawler tracks, a means for individually driving each of the crawler tracks, a frame mounted on the crawler tracks, an elongated jib carrying a sprocket at each end, an endless cutting chain supported on the sprockets, cutters and loading flights mounted on the endless cutting chain, and means on the frame supporting the elongated jib. The means support the elongated jib consisting of a bridge on the frame, at least one scissors linkage pivotally mounted on the bridge, and arm having a first end attached to the scissors linkage, a front plate mounted on the second end of the arm and means adjustably mounting the elongated jib on the front plate. The means adjustably mount the elongated jib on the front plate including a first means for rotating the elongated jib between a vertical position and a horizontal position.

  18. Living with Hearing Loss

    MedlinePlus

    ... Issues Special Section: Focus on Communication Living with Hearing Loss Past Issues / Fall 2008 Table of Contents For ... Fast Facts There are two main types of hearing loss. Permanent hearing loss (called sensorineural) usually involves damage ...

  19. Living with vision loss

    MedlinePlus

    Diabetes - vision loss; Retinopathy - vision loss; Low vision; Blindness - vision loss ... Low vision is a visual disability. Wearing regular glasses or contacts does not help. People with low vision have ...

  20. Coverage-adjusted entropy estimation.

    PubMed

    Vu, Vincent Q; Yu, Bin; Kass, Robert E

    2007-09-20

    Data on 'neural coding' have frequently been analyzed using information-theoretic measures. These formulations involve the fundamental and generally difficult statistical problem of estimating entropy. We review briefly several methods that have been advanced to estimate entropy and highlight a method, the coverage-adjusted entropy estimator (CAE), due to Chao and Shen that appeared recently in the environmental statistics literature. This method begins with the elementary Horvitz-Thompson estimator, developed for sampling from a finite population, and adjusts for the potential new species that have not yet been observed in the sample-these become the new patterns or 'words' in a spike train that have not yet been observed. The adjustment is due to I. J. Good, and is called the Good-Turing coverage estimate. We provide a new empirical regularization derivation of the coverage-adjusted probability estimator, which shrinks the maximum likelihood estimate. We prove that the CAE is consistent and first-order optimal, with rate O(P)(1/log n), in the class of distributions with finite entropy variance and that, within the class of distributions with finite qth moment of the log-likelihood, the Good-Turing coverage estimate and the total probability of unobserved words converge at rate O(P)(1/(log n)(q)). We then provide a simulation study of the estimator with standard distributions and examples from neuronal data, where observations are dependent. The results show that, with a minor modification, the CAE performs much better than the MLE and is better than the best upper bound estimator, due to Paninski, when the number of possible words m is unknown or infinite. PMID:17567838

  1. Achromatic and uncoupled medical gantry

    DOEpatents

    Tsoupas, Nicholaos; Kayran, Dmitry; Litvinenko, Vladimir; MacKay, William W.

    2011-11-22

    A medical gantry that focus the beam from the beginning of the gantry to the exit of the gantry independent of the rotation angle of the gantry by keeping the beam achromatic and uncoupled, thus, avoiding the use of collimators or rotators, or additional equipment to control the beam divergence, which may cause beam intensity loss or additional time in irradiation of the patient, or disadvantageously increase the overall gantry size inapplicable for the use in the medical treatment facility.

  2. User preference and reliability of bilateral hearing aid gain adjustments.

    PubMed

    Hornsby, Benjamin W Y; Mueller, H Gustav

    2008-02-01

    The purpose of the current study was to evaluate the consistency and reliability of user adjustments to hearing aid gain and the resulting effects on speech understanding. Sixteen bilaterally aided individuals with hearing loss adjusted their hearing aid gain to optimize listening comfort and speech clarity while listening to speech in quiet and noisy backgrounds. Following these adjustments, participants readjusted their aids to optimize clarity and comfort while listening to speech in quiet. These final gain settings were recorded and compared to those provided by NAL-NL1 prescriptive targets. In addition, speech understanding was tested with the hearing aids set at target and user gain settings. Performance differences between the gain settings were then assessed. Study results revealed that although some listeners preferred more or less gain than prescribed, on average, user and prescribed gain settings were similar in both ears. Some individuals, however, made gain adjustments between ears resulting in "gain mismatches." These "mismatches" were often inconsistent across trials suggesting that these adjustments were unreliable. Speech testing results, however, showed no significant difference across the different gain settings suggesting that the gain deviations introduced in this study were not large enough to significantly affect speech understanding. PMID:18669129

  3. Adjustable link for kinematic mounting systems

    DOEpatents

    Hale, L.C.

    1997-07-01

    An adjustable link for kinematic mounting systems is disclosed. The adjustable link is a low-cost, passive device that provides backlash-free adjustment along its single constraint direction and flexural freedom in all other directions. The adjustable link comprises two spheres, two sockets in which the spheres are adjustable retain, and a connection link threadly connected at each end to the spheres, to provide a single direction of restraint and to adjust the length or distance between the sockets. Six such adjustable links provide for six degrees of freedom for mounting an instrument on a support. The adjustable link has applications in any machine or instrument requiring precision adjustment in six degrees of freedom, isolation from deformations of the supporting platform, and/or additional structural damping. The damping is accomplished by using a hollow connection link that contains an inner rod and a viscoelastic separation layer between the two. 3 figs.

  4. Adjustable link for kinematic mounting systems

    DOEpatents

    Hale, Layton C.

    1997-01-01

    An adjustable link for kinematic mounting systems. The adjustable link is a low-cost, passive device that provides backlash-free adjustment along its single constraint direction and flexural freedom in all other directions. The adjustable link comprises two spheres, two sockets in which the spheres are adjustable retain, and a connection link threadly connected at each end to the spheres, to provide a single direction of restraint and to adjust the length or distance between the sockets. Six such adjustable links provide for six degrees of freedom for mounting an instrument on a support. The adjustable link has applications in any machine or instrument requiring precision adjustment in six degrees of freedom, isolation from deformations of the supporting platform, and/or additional structural damping. The damping is accomplished by using a hollow connection link that contains an inner rod and a viscoelastic separation layer between the two.

  5. Early Results of Recently Introduced Laparoscopic Adjustable Gastric Banding Procedure for Morbid Obesity in Croatia

    PubMed Central

    Franjic, B. D.; Glavan, E.; Bekavac-Beslin, M.

    2006-01-01

    Introduction: Morbid obesity is a growing medical problem that has become of epidemic proportions. Various dietary and pharmaceutical approaches do not obtain acceptable long-term results. Surgery, however, especially gastric restriction, represents a viable therapeutic solution. Individuals with a body mass index (BMI) >40 kg/m2 or >35 kg/m2 with at least one severe comorbidity are considered morbidly obese and generally qualify for weight-loss surgery. Laparoscopic adjustable gastric banding (LAGB) is currently the most commonly performed procedure, because it is minimally invasive, does not cause metabolic complications, is completely reversible, and is adjustable. In Croatia, the first LAGB was performed in May 2004 at Clinical Hospital “Sestre Milosrdnice.” The aim of this report is to illustrate a newly performed surgical treatment and its results for morbid obesity in Croatia. Methods: Within a 12-month period, the adjustable gastric band was implanted in 15 morbidly obese patients (female, 8; male, 7; mean age, 46.67 years; range, 26 –59 years). The so-called “pars flaccida” technique was used. Results: One operation required conversion to laparotomy due to a gastric lesion, and 1 laparoscopy operation was terminated due to massive postoperative adhesions. The average duration of surgery was 90±30 minutes. Mean length of stay was 4.9 days (range, 3–9). An average BMI at the time of surgery was 52.21 kg/m2 (range, 45.29 to 61.59; mean body weight was 155.58 kg (range, 127 to 204). Throughout 1-, 3-, 6-, 9-, and 12-month follow-ups, an average of 18.71%, 25.06%, 34.37%, 41.23%, and 47.32% of excessive weight loss (EWL) was observed. Good tolerance and a low complication rate were noted. Conclusion: LAGB resulted in good early results and a low complication rate. LAGB appears to be a quality surgical procedure for the management of morbid obesity. PMID:17575750

  6. Medical Imaging.

    ERIC Educational Resources Information Center

    Barker, M. C. J.

    1996-01-01

    Discusses four main types of medical imaging (x-ray, radionuclide, ultrasound, and magnetic resonance) and considers their relative merits. Describes important recent and possible future developments in image processing. (Author/MKR)

  7. Medical Scientists

    MedlinePlus

    ... scientists typically have a Ph.D., usually in biology or a related life science. Some medical scientists ... specialize in this field seek to understand the biology of aging and investigate ways to improve the ...

  8. Correlates of household seismic hazard adjustment adoption.

    PubMed

    Lindell, M K; Whitney, D J

    2000-02-01

    This study examined the relationships of self-reported adoption of 12 seismic hazard adjustments (pre-impact actions to reduce danger to persons and property) with respondents' demographic characteristics, perceived risk, perceived hazard knowledge, perceived protection responsibility, and perceived attributes of the hazard adjustments. Consistent with theoretical predictions, perceived attributes of the hazard adjustments differentiated among the adjustments and had stronger correlations with adoption than any of the other predictors. These results identify the adjustments and attributes that emergency managers should address to have the greatest impact on improving household adjustment to earthquake hazard. PMID:10795335

  9. Medical Acoustics

    NASA Astrophysics Data System (ADS)

    Beach, Kirk; Dunmire, Barbrina

    Medical acoustics can be subdivided into diagnostics and therapy. Diagnostics are further separated into auditory and ultrasonic methods, and both employ low amplitudes. Therapy (excluding medical advice) uses ultrasound for heating, cooking, permeablizing, activating and fracturing tissues and structures within the body, usually at much higher amplitudes than in diagnostics. Because ultrasound is a wave, linear wave physics are generally applicable, but recently nonlinear effects have become more important, even in low-intensity diagnostic applications.

  10. Adjustable extender for instrument module

    DOEpatents

    Sevec, J.B.; Stein, A.D.

    1975-11-01

    A blank extender module used to mount an instrument module in front of its console for repair or test purposes has been equipped with a rotatable mount and means for locking the mount at various angles of rotation for easy accessibility. The rotatable mount includes a horizontal conduit supported by bearings within the blank module. The conduit is spring-biased in a retracted position within the blank module and in this position a small gear mounted on the conduit periphery is locked by a fixed pawl. The conduit and instrument mount can be pulled into an extended position with the gear clearing the pawl to permit rotation and adjustment of the instrument.

  11. Blood loss estimation in epistaxis scenarios.

    PubMed

    Beer, H L; Duvvi, S; Webb, C J; Tandon, S

    2005-01-01

    Thirty-two members of staff from the Ear, Nose and Throat Department at Warrington General Hospital were asked to estimate blood loss in commonly encountered epistaxis scenarios. Results showed that once the measured volume was above 100 ml, visual estimation became grossly inaccurate. Comparison of medical and non-medical staff showed under-estimation was more marked in the non-medical group. Comparison of doctors versus nurses showed no difference in estimation, and no difference was found between grades of staff. PMID:15807956

  12. Hair loss in women.

    PubMed

    Harfmann, Katya L; Bechtel, Mark A

    2015-03-01

    Hair loss is a common cause of morbidity for many women. As a key member of the woman's health care team, the obstetrician/gynecologist may be the first person to evaluate the complaint of hair loss. Common types of nonscarring hair loss, including female pattern hair loss and telogen effluvium, may be diagnosed and managed by the obstetrician/gynecologist. A systematic approach to diagnosis and management of these common forms of hair loss is presented. PMID:25517757

  13. Adjustable fetal phantom for pulse oximetry

    NASA Astrophysics Data System (ADS)

    Stubán, Norbert; Niwayama, Masatsugu

    2009-05-01

    As the measuring head of a fetal pulse oximeter must be attached to the head of the fetus inside the mother's uterus during labor, testing, and developing of fetal pulse oximeters in real environment have several difficulties. A fetal phantom could enable evaluation of pulse oximeters in a simulated environment without the restrictions and difficultness of medical experiments in the labor room. Based on anatomic data we developed an adjustable fetal head phantom with three different tissue layers and artificial arteries. The phantom consisted of two arteries with an inner diameter of 0.2 and 0.4 mm. An electronically controlled pump produced pulse waves in the arteries. With the phantom we investigated the sensitivity of a custom-designed wireless pulse oximeter at different pulsation intensity and artery diameters. The results showed that the oximeter was capable of identifying 4% and 2% changes in diameter between the diastolic and systolic point in arteries of over 0.2 and 0.4 mm inner diameter, respectively. As the structure of the phantom is based on reported anatomic values, the results predict that the investigated custom-designed wireless pulse oximeter has sufficient sensitivity to detect the pulse waves and to calculate the R rate on the fetal head.

  14. Practical management of hair loss.

    PubMed Central

    Shapiro, J.; Wiseman, M.; Lui, H.

    2000-01-01

    OBJECTIVE: To describe an organized diagnostic approach for both nonscarring and scarring alopecias to help family physicians establish an accurate in-office diagnosis. To explain when ancillary laboratory workup is necessary to confirm the diagnosis. QUALITY OF EVIDENCE: Current diagnostic and therapeutic interventions for hair loss are based on randomized controlled studies, uncontrolled studies, and case series. MEDLINE was searched from January 1966 to December 1998 with the MeSH words alopecia, hair, and alopecia areata. Articles were selected on the basis of experimental design, with priority given to the most current large multicentre controlled studies. Overall global evidence for therapeutic intervention for hair loss is quite strong. MAIN MESSAGE: The most common forms of nonscarring alopecias are androgenic alopecia, telogen effluvium, and alopecia areata. Other disorders include trichotillomania, traction alopecia, tinea capitis, and hair shaft abnormalities. Scarring alopecia is caused by trauma, infections, discoid lupus erythematosus, or lichen planus. Key to establishing an accurate diagnosis is a detailed history, including medication use, systemic illnesses, endocrine dysfunction, hair-care practices, and family history. All hair-bearing sites should be examined. A 4-mm punch biopsy of the scalp is useful, particularly to diagnose scarring alopecias. Once a diagnosis has been established, specific therapy can be initiated. CONCLUSIONS: Diagnosis and management of hair loss is an interesting challenge for family physicians. An organized approach to recognizing characteristic differential features of hair loss disorders is key to diagnosis and management. Images Figure 1 Figure 2 Figure 5 Figure 6 PMID:10925761

  15. Adjusting the Contour of Reflector Panels

    NASA Technical Reports Server (NTRS)

    Palmer, W. B.; Giebler, M. M.

    1984-01-01

    Postfabrication adjustment of contour of panels for reflector, such as parabolic reflector for radio antennas, possible with simple mechanism consisting of threaded stud, two nuts, and flexure. Contours adjusted manually.

  16. 48 CFR 1450.103 - Contract adjustments.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 48 Federal Acquisition Regulations System 5 2010-10-01 2010-10-01 false Contract adjustments. 1450.103 Section 1450.103 Federal Acquisition Regulations System DEPARTMENT OF THE INTERIOR CONTRACT... Contract adjustments....

  17. Medical Device Safety

    MedlinePlus

    ... Vaccines, Blood & Biologics Animal & Veterinary Cosmetics Tobacco Products Medical Devices Home Medical Devices Medical Device Safety Medical Device Safety Share Tweet Linkedin Pin it More sharing ...

  18. Structural adjustment, women, and agriculture in Cameroon.

    PubMed

    Fonchingong, C

    1999-11-01

    This article assesses the impact of economic structural programs on the agricultural activities of women's groups in Cameroon, and explores women's ways of coping with the reduction in individual and family income and the loss of public services. It examines the role of 25 women's groups in both rural and urban areas of Cameroon's northwest and southwest provinces in a study conducted from April to June 1999. Economic structural adjustment caused a tremendous increase in the workload of women that are farming usually in lots distant from their homes that yield poor returns. Land for food-crop cultivation has become increasingly scarce, and inputs have become substantially unaffordable. Income generated from the sale of crops is inadequate to supply the economic and social needs of the family. Moreover, the burden of their work has increased as they cope with housework, child-care, and food production, in addition to an expanded participation in paid employment. Moreover, women spend longer working hours than men, meeting both household responsibilities and their outside work. Women have devised strategies to cope with this economic crisis, but they need organizations that will support them with the important resources to be able to operate. Rural women seem to be coping better than urban women cope. In extreme cases, some women in urban areas resort to prostitution to cope with life in this crisis setting. PMID:12349481

  19. Medical migration.

    PubMed

    Loefler, I J

    2001-10-01

    The issue of professional migration, however emotional it may have become, ought not to be regarded in moralizing terms. The history of western medicine is the history of migrating physicians. A doctor who moves from a locality to another to take up a new assignment there cannot be said to have "abandoned his patients". This emotional bond has become the victim of specialization and of depersonalization of medical services and not of medical migration, brain drain or otherwise. The primary reason for medical migration is not financial; the desire to migrate usually begins with the desire to learn. Professionals crave in the first line for professional satisfaction. The migration of medical manpower cannot be stopped with administrative measures and will not be stopped by exhortations and appeals, moralization and condemnations. Brain drain is a global phenomenon and has always been so. A country which loses its professionals, its doctors, should examine the social relationships within the profession and should investigate whether the opportunities for deriving professional satisfaction from everyday work exist or whether these have been thwarted by the hierarchy, conservatism, cronyism and the general lack of comprehension of what good medical care is about. PMID:11593497

  20. Medical Renaissance.

    PubMed

    Toledo-Pereyra, Luis H

    2015-06-01

    The Medical Renaissance started as the regular Renaissance did in the early 1400s and ended in the late 1600s. During this time great medical personalities and scholar humanists made unique advances to medicine and surgery. Linacre, Erasmus, Leonicello and Sylvius will be considered first, because they fit the early classic Renaissance period. Andreas Vesalius and Ambroise Paré followed thereafter, making outstanding anatomical contributions with the publication of the "Human Factory" (1543) by Vesalius, and describing unique surgical developments with the publication of the "The Apologie and Treatise of Ambroise Paré." At the end of the Renaissance and beginning of the New Science, William Harvey, noted British medical doctor and cardiovascular researcher, discovered the general circulation. He published his findings in "The Motu Cordis" in 1628 (Figure 1). The Medical Renaissance, in summary, included a great number of accomplished physicians and surgeons who made especial contributions to human anatomy; Vesalius assembled detailed anatomical information; Paré advanced surgical techniques; and Harvey, a medical genius, detailed the circulatory anatomy and physiology. PMID:26065591

  1. 76 FR 4395 - Postal Service Price Adjustment

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-01-25

    ... Postal Service Price Adjustment AGENCY: Postal Regulatory Commission. ACTION: Notice. SUMMARY: The Commission is noticing a recently-filed Postal Service request to establish price adjustments for all market... with the Commission announcing price adjustments, effective April 17, 2011, affecting all...

  2. 12 CFR 1780.80 - Inflation adjustments.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 12 Banks and Banking 7 2010-01-01 2010-01-01 false Inflation adjustments. 1780.80 Section 1780.80... DEVELOPMENT RULES OF PRACTICE AND PROCEDURE RULES OF PRACTICE AND PROCEDURE Civil Money Penalty Inflation Adjustments § 1780.80 Inflation adjustments. The maximum amount of each civil money penalty within...

  3. 34 CFR 36.2 - Penalty adjustment.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 34 Education 1 2010-07-01 2010-07-01 false Penalty adjustment. 36.2 Section 36.2 Education Office of the Secretary, Department of Education ADJUSTMENT OF CIVIL MONETARY PENALTIES FOR INFLATION § 36.2..., Section 36.2—Civil Monetary Penalty Inflation Adjustments Statute Description New maximum (and minimum,...

  4. 19 CFR 201.205 - Salary adjustments.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 19 Customs Duties 3 2011-04-01 2011-04-01 false Salary adjustments. 201.205 Section 201.205 Customs Duties UNITED STATES INTERNATIONAL TRADE COMMISSION GENERAL RULES OF GENERAL APPLICATION Debt Collection § 201.205 Salary adjustments. Any negative adjustment to pay arising out of an employee's...

  5. 19 CFR 201.205 - Salary adjustments.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 19 Customs Duties 3 2010-04-01 2010-04-01 false Salary adjustments. 201.205 Section 201.205 Customs Duties UNITED STATES INTERNATIONAL TRADE COMMISSION GENERAL RULES OF GENERAL APPLICATION Debt Collection § 201.205 Salary adjustments. Any negative adjustment to pay arising out of an employee's...

  6. 34 CFR 36.2 - Penalty adjustment.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 34 Education 1 2011-07-01 2011-07-01 false Penalty adjustment. 36.2 Section 36.2 Education Office of the Secretary, Department of Education ADJUSTMENT OF CIVIL MONETARY PENALTIES FOR INFLATION § 36.2..., Section 36.2—Civil Monetary Penalty Inflation Adjustments Statute Description New maximum (and minimum,...

  7. 34 CFR 36.2 - Penalty adjustment.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 34 Education 1 2013-07-01 2013-07-01 false Penalty adjustment. 36.2 Section 36.2 Education Office of the Secretary, Department of Education ADJUSTMENT OF CIVIL MONETARY PENALTIES FOR INFLATION § 36.2..., Section 36.2—Civil Monetary Penalty Inflation Adjustments Statute Description New maximum (and minimum,...

  8. 34 CFR 36.2 - Penalty adjustment.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 34 Education 1 2014-07-01 2014-07-01 false Penalty adjustment. 36.2 Section 36.2 Education Office of the Secretary, Department of Education ADJUSTMENT OF CIVIL MONETARY PENALTIES FOR INFLATION § 36.2..., Section 36.2—Civil Monetary Penalty Inflation Adjustments Statute Description New maximum (and minimum,...

  9. 34 CFR 36.2 - Penalty adjustment.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 34 Education 1 2012-07-01 2012-07-01 false Penalty adjustment. 36.2 Section 36.2 Education Office of the Secretary, Department of Education ADJUSTMENT OF CIVIL MONETARY PENALTIES FOR INFLATION § 36.2..., Section 36.2—Civil Monetary Penalty Inflation Adjustments Statute Description New maximum (and minimum,...

  10. 12 CFR 1780.80 - Inflation adjustments.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 12 Banks and Banking 7 2011-01-01 2011-01-01 false Inflation adjustments. 1780.80 Section 1780.80... DEVELOPMENT RULES OF PRACTICE AND PROCEDURE RULES OF PRACTICE AND PROCEDURE Civil Money Penalty Inflation Adjustments § 1780.80 Inflation adjustments. The maximum amount of each civil money penalty within...

  11. Dimensions of Adjustment among College Women.

    ERIC Educational Resources Information Center

    Tomlinson-Clarke, Saundra

    1998-01-01

    Examines academic, social, and personal-emotional adjustment, as well as institutional attachment for women (N=198) attending a predominantly white coeducational research university. Significant main effects were found on academic achievement for year in college. Students differed on personal-emotional adjustment by race. Academic adjustment and…

  12. Blindness and vision loss

    MedlinePlus

    ... cause: With cataracts , vision may be cloudy or fuzzy, and bright light may cause glare With diabetes, ... used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed ...

  13. Chromospheric structure in relation to radiation losses

    NASA Technical Reports Server (NTRS)

    Athay, R. G.

    1981-01-01

    It is assumed that cool star chromospheres are heated by mechanical energy dissipation that depends quasilinearly on density and cooled by radiation loss and it is shown that the basic properties of chromospheres are determined by the ionization of hydrogen. It is hydrogen ionization that provides the freedom for chromospheres to adjust their radiation losses to balance the prescribed heat input, resulting in an extended region of low temperature gradient. Chromospheric radiation losses in cool stars occur mainly in the strongest spectral lines at wavelengths greater than about 2000 A and the fraction of the chromosphere is effectively thin. The most important lines include Ca II H and K and the infrared triplet and Mg II h and k. The strong lines of other abundant species, are less important because their high excitation energies reduce the collisional excitation rates. Lyman alpha losses are important because of the overwhelming abundance of hydrogen. However, the inability of chromospheres to adjust their Lyman alpha losses limits the geometrical thickness of the effectively thin region in Lyman alpha and limits the total Lyman alpha flux.

  14. COOPERATION MAINTAINED BY FITNESS ADJUSTMENT

    PubMed Central

    TAYLOR, CHRISTINE; CHEN, JANET; IWASA, YOH

    2008-01-01

    Questions Whether or not cooperation can be enhanced if players with a performance higher than the mean are forced to pay an additional cost in each generation? Mathematical Methods Analysis of replicator dynamics with mutation. The ESS distribution of cooperation level is obtained. Key Assumptions Players engage in cooperative dilemma game, and at the end of each generation, those with higher performance than the mean are forced to pay additional cost. Conclusions Without mutation, the entire population eventually conforms to a single cooperation level determined by the initial composition of the population. With mutation, there is an equilibrium distribution of cooperation level, which has a peak at an intermediate level of cooperation. Whether it is institutionalized such as tax or just a social custom, fitness adjustment based ultimately on people’s emtion of “envy” is able to maintain cooperation. PMID:19079742

  15. Medical marijuana and dronabinol.

    PubMed

    1996-11-01

    Many people living with HIV use marijuana to manage agitation, spasms, chronic pain, depression, nausea arising from chemotherapy, and loss of appetite. Concerns over the use of marijuana or dronabinol (a pharmaceutical version of tetrahydrocannabinol or THC) include potential contamination from pesticides or other chemicals used in the growing process, and the potential of increasing the likelihood of lung infections. Use of THC is associated with reduced levels of testosterone and may have similar effects on other hormones in women. THC can also interact with other mood-altering medications such as Valium, librium, Xanax, seconal, Nembutal, or phenobarbital, by exaggerating their effect. PMID:11363969

  16. Medical genetics

    SciTech Connect

    Jorde, L.B.; Carey, J.C.; White, R.L.

    1995-10-01

    This book on the subject of medical genetics is a textbook aimed at a very broad audience: principally, medical students, nursing students, graduate, and undergraduate students. The book is actually a primer of general genetics as applied to humans and provides a well-balanced introduction to the scientific and clinical basis of human genetics. The twelve chapters include: Introduction, Basic Cell Biology, Genetic Variation, Autosomal Dominant and Recessive Inheritance, Sex-linked and Mitochondrial Inheritance, Clinical Cytogenetics, Gene Mapping, Immunogenetics, Cancer Genetics, Multifactorial Inheritance and Common Disease, Genetic Screening, Genetic Diagnosis and Gene Therapy, and Clinical Genetics and Genetic Counseling.

  17. Medical leasing.

    PubMed

    Holden, Elizabeth A

    2012-01-01

    Leases for medical space can have far-reaching (and sometimes unintentional) consequences for the future of the practice and the costs of the business. In order to prevent hardship and expense down the line, it is especially important to review the lease to make sure that it reflects the practice's goals, needs, and structure. This article provides a number of provisions that are especially crucial to review and negotiate when leasing medical space, including use restrictions, assignment and subleasing clauses, build-out terms, and legal compliance requirements. PMID:22594070

  18. Turbo code carrier synchronization losses (Radio Losses)

    NASA Technical Reports Server (NTRS)

    Shanibayati, Shervin; Kinman, Peter; Tadjpour, Layla

    2001-01-01

    In this paper the radio loss results for (8920,1/3), (8920,1/6), (1783,1/3) and (1784,1/6) codes are presented. These radio losses were calculated through simulations for a range of data rates. These simulations included both suppressed carrier modulation and residual carrier modulation cases. The radio losses were calculated for a frame error rate of 3 x 10^-4 for (8920,1/3) and (8920,1/6) codes and 3 frame error rate of 6 x 10^-5 for (1764,1/3) and (1784,1/6) codes. The simulations for the residual carrier case were run for loop signal to noise ratios of 13dB, 15dB and 17dB with a loop bandwidth of 10Hz. The simulations for the suppressed carrier case were run for a loop of signal to noise ratio of 17dB. The results of these simulations indicate that the radio losses for turbo codes are low enough to warrant their use in deep space links (maximum of 1dB loss at 17dB loop signal to noise ratio for residual carrier and 1.3dB loss at 17dB loop signal to noise ratio for suppressed carrier at high data rates). Furthermore, these results indicate that by normalizing the radio losses for frame size, loop bandwidth and the loop signal to noise ratio, a single curve could be used for calculating the radio loss for any given data rate at any given loop signal to noise ratio.

  19. Weight Loss & Acute Porphyria

    MedlinePlus

    ... Sale You are here Home Diet and Nutrition Weight loss & acute Porphyria Being overweight is a particular problem ... one of these diseases before they enter a weight-loss program. Also, they should not participate in a ...

  20. Living with hearing loss

    MedlinePlus

    ... medlineplus.gov/ency/patientinstructions/000360.htm Living with hearing loss To use the sharing features on this page, please enable JavaScript. If you are living with hearing loss, you know that it takes extra effort to ...

  1. Hearing Loss: Screening Newborns

    MedlinePlus

    ... of this page please turn JavaScript on. Feature: Hearing Loss Screening Newborns Past Issues / Spring 2015 Table of ... of newborns in the U.S. are screened for hearing loss before they leave the hospital. Research improves the ...

  2. Loss and Recovery

    NASA Technical Reports Server (NTRS)

    Schwer, Ken

    2002-01-01

    The author recounts his experiences of the loss of the QuickTOMS (Total Ozone Mapping Spectrometer) spacecraft, for which he was project manager. He draws from the launch failure lessons on leadership, coping with loss and maintaining morale.

  3. Photovoltaic array loss mechanisms

    NASA Technical Reports Server (NTRS)

    Gonzalez, Charles

    1986-01-01

    Loss mechanisms which come into play when solar cell modules are mounted in arrays are identified. Losses can occur either from a reduction in the array electrical performance or with nonoptimal extraction of power from the array. Electrical performance degradation is caused by electrical mismatch, transmission losses from cell surface soiling and steep angle of reflectance, and electrical losses from field wiring resistance and the voltage drop across blocking diodes. The second type of loss, concerned with the operating points of the array, can involve nonoptimal load impedance and limiting the operating envelope of the array to specific ranges of voltage and current. Each of the loss mechanisms are discussed and average energy losses expected from soiling, steep reflectance angles and circuit losses are calculated.

  4. Genetics of Hearing Loss

    MedlinePlus

    ... in Latin America Information For... Media Policy Makers Genetics of Hearing Loss Language: English Español (Spanish) Recommend ... of hearing loss in babies is due to genetic causes. There are also a number of things ...

  5. Genes and Hearing Loss

    MedlinePlus

    ... Meeting Calendar Find an ENT Doctor Near You Genes and Hearing Loss Genes and Hearing Loss Patient ... mutation may only have dystopia canthorum. How Do Genes Work? Genes are a road map for the ...

  6. A Structural Model of Medical Student Achievement.

    ERIC Educational Resources Information Center

    Sheehan, T. Joseph; Sanford, Keat

    1990-01-01

    The theoretical model of medical student performance begins with 38 measures, reduced to 18 without loss of information. These measures are shown to reflect five underlying theoretical interrelated variables: medical knowledge; clinical performance; science aptitude; college achievement; and attitudes and values. Results should be useful in…

  7. Vision Loss in Older Adults.

    PubMed

    Pelletier, Allen L; Rojas-Roldan, Ledy; Coffin, Janis

    2016-08-01

    Vision loss affects 37 million Americans older than 50 years and one in four who are older than 80 years. The U.S. Preventive Services Task Force concludes that current evidence is insufficient to assess the balance of benefits and harms of screening for impaired visual acuity in adults older than 65 years. However, family physicians play a critical role in identifying persons who are at risk of vision loss, counseling patients, and referring patients for disease-specific treatment. The conditions that cause most cases of vision loss in older patients are age-related macular degeneration, glaucoma, ocular complications of diabetes mellitus, and age-related cataracts. Vitamin supplements can delay the progression of age-related macular degeneration. Intravitreal injection of a vascular endothelial growth factor inhibitor can preserve vision in the neovascular form of macular degeneration. Medicated eye drops reduce intraocular pressure and can delay the progression of vision loss in patients with glaucoma, but adherence to treatment is poor. Laser trabeculoplasty also lowers intraocular pressure and preserves vision in patients with primary open-angle glaucoma, but long-term studies are needed to identify who is most likely to benefit from surgery. Tight glycemic control in adults with diabetes slows the progression of diabetic retinopathy, but must be balanced against the risks of hypoglycemia and death in older adults. Fenofibrate also slows progression of diabetic retinopathy. Panretinal photocoagulation is the mainstay of treatment for diabetic retinopathy, whereas vascular endothelial growth factor inhibitors slow vision loss resulting from diabetic macular edema. Preoperative testing before cataract surgery does not improve outcomes and is not recommended. PMID:27479624

  8. Medical genetics

    SciTech Connect

    Nora, J.J.; Fraser, F.C.

    1989-01-01

    This book presents a discussion of medical genetics for the practitioner treating or counseling patients with genetic disease. It includes a discussion of the relationship of heredity and diseases, the chromosomal basis for heredity, gene frequencies, and genetics of development and maldevelopment. The authors also focus on teratology, somatic cell genetics, genetics and cancer, genetics of behavior.

  9. Glaucoma medications.

    PubMed

    Chae, Bora; Cakiner-Egilmez, Tulay; Desai, Manishi

    2013-01-01

    Glaucoma is a common eye condition that affects millions of individuals worldwide, making it the second-leading cause of blindness. Because glaucoma is associated with increased IOP level, the primary goal in treatment of glaucoma includes lowering IOP to prevent further progression of the disease. While various surgical interventions exist, medical therapy is currently the first line of treatment. Medical treatment of glaucoma includes topical beta-blockers, alpha-2 agonists, prostaglandins, parasympathomimetics and CAIs. Anti-glaucoma agents help reduce IOP by affecting the production of aqueous humor or increasing the outflow of aqueous through the trabecular or uveoscleral pathway. Choosing an appropriate medical regimen can be challenging and various factors such as efficacy, safety, cost and patient compliance must be considered. First-line treatment is often topical beta-blockers or prostaglandin analogs. However, beta-blocking agents can be associated with systemic side effects and need to be used cautiously in patients with serious concomitant cardiopulmonary disease. Alpha-2 agonists and parasympathomimetics are often considered second- or third-line treatment options but good adjunctive agents. Oral CAIs are often indicated for patients with elevated IOP in an acute setting or for patients resistant to other glaucoma medications and patients who are not good surgical candidates. PMID:23505792

  10. Proven Weight Loss Methods

    MedlinePlus

    Fact Sheet Proven Weight Loss Methods What can weight loss do for you? Losing weight can improve your health in a number of ways. It can lower ... at www.hormone.org/Spanish . Proven Weight Loss Methods Fact Sheet www.hormone.org

  11. Hearing loss in space

    NASA Technical Reports Server (NTRS)

    Buckey, J. C. Jr; Musiek, F. E.; Kline-Schoder, R.; Clark, J. C.; Hart, S.; Havelka, J.

    2001-01-01

    BACKGROUND: Temporary and, in some cases, permanent hearing loss has been documented after long-duration spaceflights. METHODS: We examined all existing published data on hearing loss after space missions to characterize the losses. RESULTS: Data from Russian missions suggest that the hearing loss, when it occurs, affects mainly mid to high frequencies and that using hearing protection often might prevent the loss. Several significant questions remain about hearing loss in space. While the hearing loss has been presumed to be noise-induced, no clear link has been established between noise exposure and hearing loss during spaceflight. In one documented case of temporary hearing loss from the Shuttle-Mir program, the pattern of loss was atypical for a noise-induced loss. Continuous noise levels that have been measured on the Mir and previous space stations, while above engineering standards, are not at levels usually associated with hearing loss in ground-based studies (which have usually been limited to 8-10 h exposure periods). Attempts to measure hearing in space using threshold-based audiograms have been unsuccessful in both the American and Russian programs due to noise interference with the measurements. CONCLUSIONS: The existing data highlight the need for reliable monitoring of both hearing and noise in long-duration spaceflight.

  12. Weight-loss surgery - after - what to ask your doctor

    MedlinePlus

    ... Loss Program, Penn State Milton S. Hershey Medical Center, Hershey, PA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team. Related MedlinePlus Health Topics ...

  13. Interface Circuit for Vibration Energy Harvesting with Adjustable Bias Voltage

    NASA Astrophysics Data System (ADS)

    Wei, J.; Lefeuvre, E.; Mathias, H.; Costa, F.

    2015-12-01

    This paper presents a new interface circuit for electrostatic vibration energy harvesting with adjustable bias voltage. An electronic switch is used to modify the circuit configuration so that the harvested energy increases the voltage across a biasing capacitor. Decrease of this biasing capacitor voltage occurs naturally due to the circuit imperfections. Such a control of the bias voltage enables to adjust the amount of energy converted by the variable capacitor on each cycle. This feature can be used to optimize the mechanical damping induced by the energy conversion process in order to maximize the harvested power. Another feature of this interface circuit is that it is capable to get high bias voltage whatever the battery voltage with low energy loss.

  14. Magnetic field adjustment structure and method for a tapered wiggler

    DOEpatents

    Halbach, Klaus

    1988-01-01

    An improved method and structure is disclosed for adjusting the magnetic field generated by a group of electromagnet poles spaced along the path of a charged particle beam to compensate for energy losses in the charged particles which comprises providing more than one winding on at least some of the electromagnet poles; connecting one respective winding on each of several consecutive adjacent electromagnet poles to a first power supply, and the other respective winding on the electromagnet pole to a different power supply in staggered order; and independently adjusting one power supply to independently vary the current in one winding on each electromagnet pole in a group whereby the magnetic field strength of each of a group of electromagnet poles may be changed in smaller increments.

  15. Magnetic field adjustment structure and method for a tapered wiggler

    SciTech Connect

    Halbach, Klaus

    1988-03-01

    An improved method and structure is disclosed for adjusting the magnetic field generated by a group of electromagnet poles spaced along the path of a charged particle beam to compensate for energy losses in the charged particles which comprises providing more than one winding on at least some of the electromagnet poles; connecting one respective winding on each of several consecutive adjacent electromagnet poles to a first power supply, and the other respective winding on the electromagnet pole to a different power supply in staggered order; and independently adjusting one power supply to independently vary the current in one winding on each electromagnet pole in a group whereby the magnetic field strength of each of a group of electromagnet poles may be changed in smaller increments.

  16. Magnetic field adjustment structure and method for a tapered wiggler

    SciTech Connect

    Halbach, K.

    1988-03-01

    An improved wiggler having means for adjusting the magnetic field generated by electromagnet poles spaced along the path of a charged particle beam to compensate for energy losses in the charge particles is described which comprises; (a) windings on at least some of the electromagnet poles in the wiggler; (b) one of the windings on each of a group of adjacent electromagnet poles connected to a first power supply, and another winding on the electromagnet poles having more than one winding connected to a second power supply; and (c) means for independently adjusting one power supply to independently vary the current in one of the windings on a group of adjacent electromagnet poles; whereby the magnetic field strength of a group of adjacent electromagnet poles in the wiggler may be changed in smaller increments.

  17. Debt and foregone medical care.

    PubMed

    Kalousova, Lucie; Burgard, Sarah A

    2013-06-01

    Most American households carry debt, yet we have little understanding of how debt influences health behavior, especially health care seeking. We examined associations between foregone medical care and debt using a population-based sample of 914 southeastern Michigan residents surveyed in the wake of the late-2000s recession. Overall debt and ratios of debt to income and debt to assets were positively associated with foregoing medical or dental care in the past 12 months, even after adjusting for the poorer socioeconomic and health characteristics of those foregoing care and for respondents' household incomes and net worth. These overall associations were driven largely by credit card and medical debt, while housing debt and automobile and student loans were not associated with foregoing care. These results suggest that debt is an understudied aspect of health stratification. PMID:23620501

  18. 42 CFR 412.88 - Additional payment for new medical service or technology.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... for new medical service or technology. (a) For discharges involving new medical services or... medical service or technology. Payment Adjustment for Certain Replaced Devices ... 42 Public Health 2 2014-10-01 2014-10-01 false Additional payment for new medical service...

  19. Determination of spallation neutron flux through spectral adjustment techniques

    NASA Astrophysics Data System (ADS)

    Mosby, M. A.; Engle, J. W.; Jackman, K. R.; Nortier, F. M.; Birnbaum, E. R.

    2016-08-01

    The Los Alamos Isotope Production Facility (IPF) creates medical isotopes using a proton beam impinged on a target stack. Spallation neutrons are created in the interaction of the beam with target. The use of these spallation neutrons to produce additional radionuclides has been proposed. However, the energy distribution and magnitude of the flux is not well understood. A modified SAND-II spectral adjustment routine has been used with radioactivation foils to determine the differential neutron fluence for these spallation neutrons during a standard IPF production run.

  20. Evolution by gene loss.

    PubMed

    Albalat, Ricard; Cañestro, Cristian

    2016-07-01

    The recent increase in genomic data is revealing an unexpected perspective of gene loss as a pervasive source of genetic variation that can cause adaptive phenotypic diversity. This novel perspective of gene loss is raising new fundamental questions. How relevant has gene loss been in the divergence of phyla? How do genes change from being essential to dispensable and finally to being lost? Is gene loss mostly neutral, or can it be an effective way of adaptation? These questions are addressed, and insights are discussed from genomic studies of gene loss in populations and their relevance in evolutionary biology and biomedicine. PMID:27087500

  1. Use of the Satisfaction With Amplification in Daily Life Questionnaire to Assess Patient Satisfaction Following Remote Hearing Aid Adjustments (Telefitting)

    PubMed Central

    Bento, Ricardo Ferreira; Battistella, Linamara Rizzo

    2014-01-01

    Background Hearing loss can affect approximately 15% of the pediatric population and up to 40% of the adult population. The gold standard of treatment for hearing loss is amplification of hearing thresholds by means of a hearing aid instrument. A hearing aid is an electronic device equipped with a topology of only three major components of aggregate cost. The gold standard of hearing aid fittings is face-to-face appointments in hearing aid centers, clinics, or hospitals. Telefitting encompasses the programming and adjustments of hearing aid settings remotely. Fitting hearing aids remotely is a relatively simple procedure, using minimal computer hardware and Internet access. Objective This project aimed to examine the feasibility and outcomes of remote hearing aid adjustments (telefitting) by assessing patient satisfaction via the Portuguese version of the Satisfaction With Amplification in Daily Life (SADL) questionnaire. Methods The Brazilian Portuguese version of the SADL was used in this experimental research design. Participants were randomly selected through the Rehabilitation Clinical (Espaco Reouvir) of the Otorhinolaryngology Department Medical School University of Sao Paulo. Of the 8 participants in the study, 5 were female and 3 were male, with a mean age of 71.5 years. The design consisted of two face-to-face sessions performed within 15 working days of each other. The remote assistance took place 15 days later. Results The average scores from this study are above the mean scores from the original SADL normative data. These indicate a high level of satisfaction in participants who were fitted remotely. Conclusions The use of an evaluation questionnaire is a simple yet effective method to objectively assess the success of a remote fitting. Questionnaire outcomes can help hearing stakeholders improve the National Policy on Hearing Health Care in Brazil. The results of this project indicated that patient satisfaction levels of those fitted remotely were

  2. Associations between smoking and tooth loss according to reason for tooth loss

    PubMed Central

    Mai, Xiaodan; Wactawski-Wende, Jean; Hovey, Kathleen M.; LaMonte, Michael J.; Chen, Chaoru; Tezal, Mine; Genco, Robert J.

    2013-01-01

    Background Smoking is associated with tooth loss. However, smoking's relationship to the specific reason for tooth loss in postmenopausal women is unknown. Methods Postmenopausal women (n = 1,106) who joined a Women's Health Initiative ancillary study (The Buffalo OsteoPerio Study) underwent oral examinations for assessment of the number of missing teeth, as well as the self-reported reasons for tooth loss. The authors obtained information about smoking status via a self-administered questionnaire. The authors calculated odds ratios (ORs) and 95 percent confidence intervals (CIs) by means of logistic regression to assess smoking's association with overall tooth loss, as well as with tooth loss due to periodontal disease (PD) and with tooth loss due to caries. Results After adjusting for age, education, income, body mass index (BMI), history of diabetes diagnosis, calcium supplement use and dental visit frequency, the authors found that heavy smokers (≥ 26 pack-years) were significantly more likely to report having experienced tooth loss compared with never smokers (OR = 1.82; 95 percent CI, 1.10-3.00). Smoking status, packs smoked per day, years of smoking, pack-years and years since quitting smoking were significantly associated with tooth loss due to PD. For pack-years, the association for heavy smokers compared with that for never smokers was OR = 6.83 (95 percent CI, 3.40-13.72). The study results showed no significant associations between smoking and tooth loss due to caries. Conclusions and Practical Implications Smoking may be a major factor in tooth loss due to PD. However, smoking appears to be a less important factor in tooth loss due to caries. Further study is needed to explore the etiologies by which smoking is associated with different types of tooth loss. Dentists should counsel their patients about the impact of smoking on oral health, including the risk of tooth loss due to PD. PMID:23449901

  3. Exploration adjustment by ant colonies

    PubMed Central

    2016-01-01

    How do animals in groups organize their work? Division of labour, i.e. the process by which individuals within a group choose which tasks to perform, has been extensively studied in social insects. Variability among individuals within a colony seems to underpin both the decision over which tasks to perform and the amount of effort to invest in a task. Studies have focused mainly on discrete tasks, i.e. tasks with a recognizable end. Here, we study the distribution of effort in nest seeking, in the absence of new nest sites. Hence, this task is open-ended and individuals have to decide when to stop searching, even though the task has not been completed. We show that collective search effort declines when colonies inhabit better homes, as a consequence of a reduction in the number of bouts (exploratory events). Furthermore, we show an increase in bout exploration time and a decrease in bout instantaneous speed for colonies inhabiting better homes. The effect of treatment on bout effort is very small; however, we suggest that the organization of work performed within nest searching is achieved both by a process of self-selection of the most hard-working ants and individual effort adjustment. PMID:26909180

  4. Exploration adjustment by ant colonies.

    PubMed

    Doran, Carolina; Stumpe, Martin C; Sendova-Franks, Ana; Franks, Nigel R

    2016-01-01

    How do animals in groups organize their work? Division of labour, i.e. the process by which individuals within a group choose which tasks to perform, has been extensively studied in social insects. Variability among individuals within a colony seems to underpin both the decision over which tasks to perform and the amount of effort to invest in a task. Studies have focused mainly on discrete tasks, i.e. tasks with a recognizable end. Here, we study the distribution of effort in nest seeking, in the absence of new nest sites. Hence, this task is open-ended and individuals have to decide when to stop searching, even though the task has not been completed. We show that collective search effort declines when colonies inhabit better homes, as a consequence of a reduction in the number of bouts (exploratory events). Furthermore, we show an increase in bout exploration time and a decrease in bout instantaneous speed for colonies inhabiting better homes. The effect of treatment on bout effort is very small; however, we suggest that the organization of work performed within nest searching is achieved both by a process of self-selection of the most hard-working ants and individual effort adjustment. PMID:26909180

  5. Hearing loss in shipyard employees

    PubMed Central

    Alexopoulos, Evangelos C.; Tsouvaltzidou, Thomaella

    2015-01-01

    Background: Noise-induced hearing loss (NIHL) is one of the most prevalent occupational illnesses, with a higher incidence in the heavy industry. Objectives of the Study: The aim of this study is to investigate the prevalence of NIHL in Greece and explore its correlations with other job and individual-related factors. Materials and Methods: Questionnaires were administered, and audiograms were conducted to 757 employees of a shipyard company in Greece, both white- and blue-collar, during the period 2006–2009. A modification of the 1979' equation of the American Academy of Otolaryngology was used to calculate hearing loss. Statistical analysis was conducted by means of the SPSS v. 17. Results: A 27.1% of the employees were hearing handicap. Hearing loss was correlated with age, past medical history of ear disease (Meniere's disease, acoustic neuroma, otosclerosis) or injury, hyperlipidemia, job title and level of education. A few questions on subjective hearing ability and symptoms showed strong discriminatory power of hearing pathology. Conclusions: The results of this study emphasize the burden of disease in the shipyard industry, and the need for continuous monitoring, implementation of preventive measures and hearing conservation programs. PMID:26023266

  6. Medical tourism.

    PubMed

    Reed, Christie M

    2008-11-01

    Searches of the literature or Internet using the term "medical tourism" produce two sets of articles: travel for the purpose of delivering health care or travel for the purpose of seeking health care. The first usage primarily appears in the medical literature and is beyond the scope of this article, which focuses on travel to seek health care. Still, there are some aspects these two topics have in common: both are affected by ease and speed of international travel and communication associated with globalization, and both raise questions about continuity of care as well as issues related to cultural, language, and legal differences; both also raise questions about ethics. This article describes some of the motivating factors, contributing elements, and challenges in elucidating trends, as well as implications for clinicians who provide pretravel advice and those who care for ill returning travelers. PMID:19061760

  7. Adjusting Permittivity by Blending Varying Ratios of SWNTs

    NASA Technical Reports Server (NTRS)

    Tour, James M.; Stephenson, Jason J.; Higginbotham, Amanda

    2012-01-01

    A new composite material of singlewalled carbon nanotubes (SWNTs) displays radio frequency (0 to 1 GHz) permittivity properties that can be adjusted based upon the nanotube composition. When varying ratios of raw to functionalized SWNTs are blended into the silicone elastomer matrix at a total loading of 0.5 percent by weight, a target real permittivity value can be obtained between 70 and 3. This has particular use for designing materials for microwave lenses, microstrips, filters, resonators, high-strength/low-weight electromagnetic interference (EMI) shielding, antennas, waveguides, and low-loss magneto-dielectric products for applications like radome construction.

  8. Interaction between weight and medications in psychological illnesses of children.

    PubMed

    Apter, Alan; Steingart, Lital

    2013-01-01

    Psychiatric medications have many implications on weight and growth. Stimulant medications may produce appetite loss and thus affect growth. Second-generation antipsychotics which are widely used for psychosis and many other indications may cause weight gain and subsequent metabolic disease. Weight loss such as that seen in anorexia nervosa may severely interfere with the efficacy of antidepressant agents. PMID:23428698

  9. Medical manslaughter.

    PubMed

    Lyons, B

    2013-01-01

    On November 29, 2011 Dr Conrad Murray was sentenced to four years in prison after being convicted of the involuntary manslaughter of Michael Jackson. Expert witness statements indicated that Murray's actions were an "extreme departure from the standard of care", particularly with regard to (1) inappropriately treating insomnia with a surgical anaesthetic (propofol); (2) failing to acquire sufficiently informed consent; (3) administering propofol without the necessary monitoring equipment; (4) delaying contacting the emergency services; and (5) making ineffective resuscitation efforts. Further medical evidence argued that Murray's care of Jackson contained "17 egregious violations", defined as acts that posed a foreseeable danger to the patient's life. These deficiencies, it was stated, constituted gross negligence. Such events might seem remote from daily medical practice in Ireland. However, medical errors resulting in patient death are reported to be unfortunately frequent, even if such fatalities are rarely as dramatic, or as public, as that of Michael Jackson. Medical care is not necessarily straightforward, and any treatment outcome is dependent on clinician skill, the nature of the intervention, and on the pathological condition of the patient. Regardless of these latter two factors, a poor outcome still may occur through physician omissions or the commission of errors or violations. Merry and McCall Smith distinguish between errors and violations on the following basis: (1) errors are not deliberate, and result in unintentional actions and consequences; (2) violations, on the other hand, entail a deliberate deviation from accepted rules or norms. It was alleged that much of Dr Murray's professional conduct in this case fell into the latter category. PMID:23472376

  10. The effect of adjustable suture (Khaw) trabeculectomy on intraocular pressure: a retrospective case series.

    PubMed

    Kaplan, Ahmet; Kocatürk, Tolga; Dayanır, Volkan

    2016-02-01

    The aim of the study is to investigate long-term intraocular pressure (IOP) outcome as well as complications associated with adjustable suture trabeculectomy in glaucoma patients who were uncontrolled under maximum medical therapy. In this retrospective case series, 35 eyes of 30 patients are included in the study. Adjustable suture trabeculectomy with 0.2 mg/cc mitomycin-C for 3 min was performed by the same surgeon. Subconjunctival 5-fluorouracil injection, transconjunctival suture adjustment, digital massage, and/or argon suturolysis were utilized postoperatively as needed. Complete success, qualified success, and failure were defined as IOP ≤ 18 mmHg without medication, IOP ≤ 18 mmHg with one or more medications, and IOP >18 mmHg with medication or need for additional glaucoma surgery, respectively. Of the 35 eyes, 13 had primary open angle, 18 had psuedoexfoliative, 1 had juvenile, 1 had pigmentary, 1 had uveitic, and 1 had chronic angle-closure glaucoma. Mean preoperative IOP of 30.1 ± 10.5 mmHg dropped to 10.8 ± 4.7 mmHg (p < 0.001) after a mean follow-up of 595 ± 435 days. Nine eyes had the desired IOP on first postoperative day where no transconjunctival suture adjustment was performed. Remaining 26 eyes required a mean of two adjustments (range 1-7) during the first postoperative 24 days in order to achieve a desirable IOP. Complete success, qualified success, and failure were observed in 28 (80 %), 5 (14 %), and 2 (6 %) eyes, respectively. There were no serious complications related to adjustable suture trabeculectomy. We believe adjustable suture trabeculectomy to be a safe and effective alternative to standard trabeculectomy where a desirable low IOP can be achieved. PMID:26002838

  11. Medical Applications

    NASA Astrophysics Data System (ADS)

    Boccara, A. Claude; Mordon, Serge

    2015-10-01

    In re-listening to the lectures of Charles Townes shortly after the invention of the laser (e.g., in the Boston Science Museum), one can already have a realistic vision of the potentialities of this new tool in the field of medical therapy, as evidenced by the use of the laser in ophthalmology to cure retinal detachment in the 1960's. Since then, applications have flourished in the domain of therapy. We will thus illustrate here only some of the main fields of application of medical lasers. On the opposite, the use of lasers in medical imaging is, with one exception in ophthalmology, still at the development level. It is becoming a diagnostic tool in addition to high performance imaging facilities that are often very expensive (such as CT scan, Magnetic Resonance Imaging (MRI) and nuclear imaging). Even if progress is sometimes slow, one can now image with light inside the human body, in spite of the strong scattering of light by tissues, in the same way as a pathologist sees surgical specimens.

  12. Medical Telemetry

    NASA Technical Reports Server (NTRS)

    1978-01-01

    Telemetry is the process whereby physiological or other data is acquired by instruments, translated into radio signals and j sent to a receiving station where the signals are decoded and recorded. Extensively used in I space operations, it is finding new Earth applications, among them transmission of medical data between emergency vehicles and hospitals. For example, transmission of an electrocardiogram from an ambulance to a hospital enables a physician to read the telemetered EKG and advise ambulance attendants on emergency procedures. Central Medical Emergency Dispatch (CMED) operates as a regional emergency medical communications center for Cleveland, Ohio and Cuyahoga County. The CMED system includes radio and telephone communications from hospital-to-hospital and from ambulance-to-hospital, but for improved emergency life support CMED sought to add a county-wide telemetry capability. The problem was that there were only eight radio frequencies available for telemetry and there were more than 30 potential users in Cleveland alone. NASA's Lewis Research Center volunteered its expert assistance. The Center's engineers studied the systems of other telemetry using cities, surveyed area hospitals to assure compatibility of telemetry equipment, and advised what types of equipment would be needed in emergency vehicles and at the various hospitals. The Lewis plan suggested that CMED be designated the central coordinating agency for the Cuyahoga County system, monitoring all telemetry frequencies and, when requested, assigning one not in use or one to be used at a sufficient distance that it would create no interference problem.

  13. Ergonomic evaluation of the Apple Adjustable Keyboard

    SciTech Connect

    Tittiranonda, P.; Burastero, S.; Shih, M.; Rempel, D.

    1994-05-01

    This study presents an evaluation of the Apple Adjustable Keyboard based on subjective preference and observed joint angles during typing. Thirty five keyboard users were asked to use the Apple adjustable keyboard for 7--14 days and rate the various characteristics of the keyboard. Our findings suggest that the most preferred opening angles range from 11--20{degree}. The mean ulnar deviation on the Apple Adjustable keyboard is 11{degree}, compared to 16{degree} on the standard keyboard. The mean extension was decreased from 24{degree} to 16{degree} when using the adjustable keyboard. When asked to subjectively rate the adjustable keyboard in comparison to the standard, the average subject felt that the Apple Adjustable Keyboard was more comfortable and easier to use than the standard flat keyboard.

  14. Three-dimensional adjustment of trilateration data

    NASA Technical Reports Server (NTRS)

    Sung, L.-Y.; Jackson, D. D.

    1985-01-01

    The three-dimensional locations of the monuments in the USGS Hollister trilateration network were adjusted to fit line length observations observed in 1977, using a Bayesian approach, and incorporating prior elevation estimates as data in the adjustment procedure. No significant discrepancies in the measured line lengths were found, but significant elevation adjustments (up to 1.85 m) were needed to fit the length data.

  15. Asian immigrant settlement and adjustment in Australia.

    PubMed

    Khoo, S; Kee, P; Dang, T; Shu, J

    1994-01-01

    "This article provides a broad assessment of the settlement and adjustment of people born in the many countries of Asia who are resident in Australia, based on recently available data from the 1991 Census of Population and Housing. It examines some indicators of economic adjustment such as performance in the labor market, and some indicators of social adjustment, such as acquisition of English language proficiency." PMID:12289777

  16. Rate adjusters for Medicare under capitation

    PubMed Central

    Newhouse, Joseph P.

    1986-01-01

    This article addresses three issues related to capitation. First, the average adjusted per capita cost (AAPCC) fluctuates with the mix of risks in the fee-for-service system. More sensitive adjusters in the AAPCC are needed. Second, the AAPCC, as now estimated, exhibits large geographic variance; so-called shrinkage estimators may help. Third, the AAPCC requires new adjusters to yield more homogeneous risk classes. Otherwise, the portion of the Medicare population under capitation may experience access problems at alternative delivery systems: Until such adjusters are developed, it seems better to rely upon a blend of capitation and fee-for-service than the present AAPCC. PMID:10311926

  17. Techniques and applications of adjustable sutures.

    PubMed

    Fells, P

    1987-02-01

    The 'rediscovery' of adjustable sutures some 10 years ago has given the ophthalmic surgeon much more confidence in his ability to correct strabismus. Three methods of use are described: during surgery under general anaesthesia with adjustment during the operation using the 'springback' test to centralise the eye; during surgery under general anaesthesia and subsequent adjustment under local anaesthesia using the patient's subjective responses to obtain optimal positioning; and performance of the operation and adjustment under topical local anaesthesia in one procedure. Full details are given of each technique and the indications for their application to particular problems are discussed. PMID:3297111

  18. Sensitivity Analysis of the Integrated Medical Model for ISS Programs

    NASA Technical Reports Server (NTRS)

    Goodenow, D. A.; Myers, J. G.; Arellano, J.; Boley, L.; Garcia, Y.; Saile, L.; Walton, M.; Kerstman, E.; Reyes, D.; Young, M.

    2016-01-01

    Sensitivity analysis estimates the relative contribution of the uncertainty in input values to the uncertainty of model outputs. Partial Rank Correlation Coefficient (PRCC) and Standardized Rank Regression Coefficient (SRRC) are methods of conducting sensitivity analysis on nonlinear simulation models like the Integrated Medical Model (IMM). The PRCC method estimates the sensitivity using partial correlation of the ranks of the generated input values to each generated output value. The partial part is so named because adjustments are made for the linear effects of all the other input values in the calculation of correlation between a particular input and each output. In SRRC, standardized regression-based coefficients measure the sensitivity of each input, adjusted for all the other inputs, on each output. Because the relative ranking of each of the inputs and outputs is used, as opposed to the values themselves, both methods accommodate the nonlinear relationship of the underlying model. As part of the IMM v4.0 validation study, simulations are available that predict 33 person-missions on ISS and 111 person-missions on STS. These simulated data predictions feed the sensitivity analysis procedures. The inputs to the sensitivity procedures include the number occurrences of each of the one hundred IMM medical conditions generated over the simulations and the associated IMM outputs: total quality time lost (QTL), number of evacuations (EVAC), and number of loss of crew lives (LOCL). The IMM team will report the results of using PRCC and SRRC on IMM v4.0 predictions of the ISS and STS missions created as part of the external validation study. Tornado plots will assist in the visualization of the condition-related input sensitivities to each of the main outcomes. The outcomes of this sensitivity analysis will drive review focus by identifying conditions where changes in uncertainty could drive changes in overall model output uncertainty. These efforts are an integral

  19. [Medical imaging: its medical economics and recent situation in Japan.].

    PubMed

    Imai, Keiko

    2006-01-01

    Two fields of radiology, medical imaging and radiation therapy, are coded separately in medical fee system, and the health care statistics of 2003 shows that expenditure on the former was 5.2% of the whole medical cost and the latter 0.28%. Introduction of DPC, an abbreviation of Diagnostic Procedure Combination, was carried out in 2003, which was an essential reform of medical fee payment system that have been managed on fee-for-service base throughout, and 22% of beds for acute patients care are under the control of DPC payment in 2006. As medical imaging procedures are basically classified in inclusive payment in DPC system, their accurate statistics cannot be figured out because of the lack of description of individual procedures in DPC bills. Policy-making of medical economics will suffer a great loss from the deficiency of detailed data in published statistics. Important role in clinical diagnoses of CT and MR results an increase of fee paid for them up to more than half of total expenditure on medical imaging. So, dominant reduction of examination fee has been done for MR imaging, especially in 2002, to reduce the total cost of medical imaging. Follows could be featured as major topics of medical imaging in health insurance system, (a) fee is newly assigned for electronic handling of CT-and-MR images, and nuclear medicine, and (b) there is still a mismatch between actual payment and quality of medical facilities. As matters related to medical imaging, the followings should be stressed; (a) numbers of CT and MR units per population are dominantly high among OECD countries, but, those controlled by qualified radiologists are at the average level of those countries, (b) there is a big difference of MR examination quality among medical facilities, and (c) 76% of newly-installed high-end MR units are supplied by foreign industries. Hopefully, there will be an increase in the concern to medical fee payment system and health care cost because they possibly

  20. Functional Visual Loss

    PubMed Central

    Bruce, Beau B; Newman, Nancy J

    2010-01-01

    Synopsis Neurologists frequently evaluate patients complaining of vision loss, especially when the patient has been examined by an ophthalmologist who has found no ocular disease. A significant proportion of patients presenting to the neurologist with visual complaints will have non-organic or functional visual loss. While there are examination techniques which can aid in the detection and diagnosis of functional visual loss, the frequency with which functional visual loss occurs concomitantly with organic disease warrants substantial caution on the part of the clinician. Furthermore, purely functional visual loss is never a diagnosis of exclusion, and must be supported by positive findings on examination that demonstrate normal visual function. The relationship of true psychological disease and functional visual loss is unclear and most patients respond well to simple reassurance. PMID:20638000

  1. The Integrated Medical Model: A Risk Assessment and Decision Support Tool for Space Flight Medical Systems

    NASA Technical Reports Server (NTRS)

    Kerstman, Eric; Minard, Charles; Saile, Lynn; deCarvalho, Mary Freire; Myers, Jerry; Walton, Marlei; Butler, Douglas; Iyengar, Sriram; Johnson-Throop, Kathy; Baumann, David

    2009-01-01

    The Integrated Medical Model (IMM) is a decision support tool that is useful to mission planners and medical system designers in assessing risks and designing medical systems for space flight missions. The IMM provides an evidence based approach for optimizing medical resources and minimizing risks within space flight operational constraints. The mathematical relationships among mission and crew profiles, medical condition incidence data, in-flight medical resources, potential crew functional impairments, and clinical end-states are established to determine probable mission outcomes. Stochastic computational methods are used to forecast probability distributions of crew health and medical resource utilization, as well as estimates of medical evacuation and loss of crew life. The IMM has been used in support of the International Space Station (ISS) medical kit redesign, the medical component of the ISS Probabilistic Risk Assessment, and the development of the Constellation Medical Conditions List. The IMM also will be used to refine medical requirements for the Constellation program. The IMM outputs for ISS and Constellation design reference missions will be presented to demonstrate the potential of the IMM in assessing risks, planning missions, and designing medical systems. The implementation of the IMM verification and validation plan will be reviewed. Additional planned capabilities of the IMM, including optimization techniques and the inclusion of a mission timeline, will be discussed. Given the space flight constraints of mass, volume, and crew medical training, the IMM is a valuable risk assessment and decision support tool for medical system design and mission planning.

  2. The Use of the Integrated Medical Model for Forecasting and Mitigating Medical Risks for a Near-Earth Asteroid Mission

    NASA Technical Reports Server (NTRS)

    Kerstman, Eric; Saile, Lynn; Freire de Carvalho, Mary; Myers, Jerry; Walton, Marlei; Butler, Douglas; Lopez, Vilma

    2011-01-01

    Introduction The Integrated Medical Model (IMM) is a decision support tool that is useful to space flight mission managers and medical system designers in assessing risks and optimizing medical systems. The IMM employs an evidence-based, probabilistic risk assessment (PRA) approach within the operational constraints of space flight. Methods Stochastic computational methods are used to forecast probability distributions of medical events, crew health metrics, medical resource utilization, and probability estimates of medical evacuation and loss of crew life. The IMM can also optimize medical kits within the constraints of mass and volume for specified missions. The IMM was used to forecast medical evacuation and loss of crew life probabilities, as well as crew health metrics for a near-earth asteroid (NEA) mission. An optimized medical kit for this mission was proposed based on the IMM simulation. Discussion The IMM can provide information to the space program regarding medical risks, including crew medical impairment, medical evacuation and loss of crew life. This information is valuable to mission managers and the space medicine community in assessing risk and developing mitigation strategies. Exploration missions such as NEA missions will have significant mass and volume constraints applied to the medical system. Appropriate allocation of medical resources will be critical to mission success. The IMM capability of optimizing medical systems based on specific crew and mission profiles will be advantageous to medical system designers. Conclusion The IMM is a decision support tool that can provide estimates of the impact of medical events on human space flight missions, such as crew impairment, evacuation, and loss of crew life. It can be used to support the development of mitigation strategies and to propose optimized medical systems for specified space flight missions. Learning Objectives The audience will learn how an evidence-based decision support tool can be

  3. [Medical writers in medical research].

    PubMed

    Burcharth, Jakob; Pommergaard, Hans-Christian; Danielsen, Anne Kjærgaard; Rosenberg, Jacob

    2013-08-19

    Larger research units often comprise persons of several professions in order to secure a high level of efficiency and quality in the different tasks. In Denmark, employees with special competencies within the field of writing and publication are rarely used in research units. The purpose of this study was to present the advantages and challenges associated with the involvement of medical writers in academic environments. PMID:23952980

  4. Computerized medication administration records decrease medication occurrences.

    PubMed

    Wilson, A L; Hill, J J; Wilson, R G; Nipper, K; Kwon, I W

    1997-04-01

    Studies have demonstrated that medication errors occur at a number of locations in the continuum between ordering of drug therapy and administration of the medication. Computer management of patient medication profiles offers the opportunity to enhance communication between pharmacists and nurses, and to decrease medication errors and delays in delivery of therapy. A number of authors have postulated that computerization of medication profiles would enhance medication delivery accuracy and timeliness, but no study has demonstrated this improvement. We report the results of a retrospective analysis undertaken to assess the improvements resulting from sharing a computerized medication record. We used a broader definition of medication occurrences that includes the more traditional definition, and averted errors, delays in delivery of medications and information, and disagreements between pharmacy and nursing medication profiles. We compared medication occurrences reported through an existing internal system between two periods; the first when separate pharmacy and nursing medication records were used, and the second period when a shared medication record was used by pharmacy and nursing. Average medication occurrences per admission decreased from 0.1084 to 0.0658 (p < 0.01). Medication occurrences per dose decreased from 0.0005 to 0.0003 (p < 0.01). The use of a shared medication record by pharmacy and nursing led to a statistically significant decrease in medication occurrences. Information shared between the two professions allowed timely resolution of discrepancies in medication orders, leading to better execution of drug therapy, decreased medication occurrences, and increased efficiency. PMID:10166241

  5. Commercializing medical technology

    PubMed Central

    Lieberman, Mark A.

    2007-01-01

    As medicine moves into the 21st century, life saving therapies will move from inception into medical products faster if there is a better synergy between science and business. Medicine appears to have 50-year innovative cycles of education and scientific discoveries. In the 1880’s, the chemical industry in Germany was faced with the dilemma of modernization to exploit the new scientific discoveries. The solution was the spawning of novel technical colleges for training in these new chemical industries. The impact of those new employees and their groundbreaking compounds had a profound influence on medicine and medical education in Germany between 1880 and 1930. Germany dominated international science during this period and was a training center for scientists worldwide. This model of synergy between education and business was envied and admired in Europe, Asia and America. British science soon after evolved to dominate the field of science during the prewar and post World War (1930’s–1970’s) because the German scientists fled Hitler’s government. These expatriated scientists had a profound influence on the teaching and training of British scientists, which lead to advances in medicine such as antibiotics. After the Second World War, the US government wisely funded the development of the medical infrastructure that we see today. British and German scientists in medicine moved to America because of this bountiful funding for their research. These expatriated scientists helped drive these medical advances into commercialized products by the 1980’s. America has been the center of medical education and advances of biotechnology but will it continue? International scientists trained in America have started to return to Europe and Asia. These American-trained scientists and their governments are very aware of the commercial potential of biotechnology. Those governments are now more prepared to play an active role this new science. Germany, Ireland, Britain

  6. Ratios as a size adjustment in morphometrics.

    PubMed

    Albrecht, G H; Gelvin, B R; Hartman, S E

    1993-08-01

    Simple ratios in which a measurement variable is divided by a size variable are commonly used but known to be inadequate for eliminating size correlations from morphometric data. Deficiencies in the simple ratio can be alleviated by incorporating regression coefficients describing the bivariate relationship between the measurement and size variables. Recommendations have included: 1) subtracting the regression intercept to force the bivariate relationship through the origin (intercept-adjusted ratios); 2) exponentiating either the measurement or the size variable using an allometry coefficient to achieve linearity (allometrically adjusted ratios); or 3) both subtracting the intercept and exponentiating (fully adjusted ratios). These three strategies for deriving size-adjusted ratios imply different data models for describing the bivariate relationship between the measurement and size variables (i.e., the linear, simple allometric, and full allometric models, respectively). Algebraic rearrangement of the equation associated with each data model leads to a correctly formulated adjusted ratio whose expected value is constant (i.e., size correlation is eliminated). Alternatively, simple algebra can be used to derive an expected value function for assessing whether any proposed ratio formula is effective in eliminating size correlations. Some published ratio adjustments were incorrectly formulated as indicated by expected values that remain a function of size after ratio transformation. Regression coefficients incorporated into adjusted ratios must be estimated using least-squares regression of the measurement variable on the size variable. Use of parameters estimated by any other regression technique (e.g., major axis or reduced major axis) results in residual correlations between size and the adjusted measurement variable. Correctly formulated adjusted ratios, whose parameters are estimated by least-squares methods, do control for size correlations. The size-adjusted

  7. [Medical nanodevices].

    PubMed

    Sugimachi, Masaru; Sunagawa, Kenji

    2006-02-01

    Development of implantable medical nanodevices enables us continuous automatic treatment of patients from inside of their body. Bionic devices, interfacing with neural systems and substituting native functions, such as bionic pacemaker, bionic pressure controller are candidates to miniaturize. For such miniaturization, efforts to reduce size of power supply (e.g., biological fuel cell) and to establish reliable high-throughput, low power telecommunication (e.g., spread spectrum telecommunication) are required. Simple devices such as pacemakers would benefit from miniaturization by lowering invasion and by developing a new usage such as ventricular resynchronization. PMID:16454192

  8. Medical electromechatronics

    NASA Astrophysics Data System (ADS)

    Osipov, Y. M.; Syryamkin, V. I.; Osipov, O. Y.

    2015-11-01

    The first part of the article presentsdevices of rehabilitation electromechatronics.As a research work, the author's team has performed sketch and technical developments on this subject, which are protected by patents of the Russian Federation. The second part providesan overview of medical robotic surgery, which is ideal for imperfections removing.It also describes capabilities of the author's team in development of active driveline based "iron" hands.Scalpels never tremble in the iron hands, which are not afraid of the aftershocks and never get tired.They can perform operations during not less than 48 consecutive hours.

  9. Medical clip

    NASA Technical Reports Server (NTRS)

    Baucom, R. M. (Inventor)

    1983-01-01

    An X-ray transparent and biological inert medical clip for treating aneurisms and the like is described. A graphite reinforced composite film is molded into a unitary structure having a pair of hourglass-like cavities hinged together with a pair of jaws for grasping the aneurism extending from the wall of one cavity. A silicone rubber pellet is disposed in the other cavity to exert a spring force through the hinge area to normally bias the jaws into contact with each other.

  10. 75 FR 30693 - Revised Medical Criteria for Evaluating Hearing Loss

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-06-02

    ... available on the date of publication in the Federal Register at http://www.gpoaccess.gov/fr/index.html... published in the Federal Register on August 13, 2008 (73 FR 47103). The preamble to the NPRM discussed the... rules revising the listings for visual disorders in the Federal Register on November 20, 2006 (71...

  11. Loss of work productivity due to illness and medical treatment.

    PubMed

    Cockburn, I M; Bailit, H L; Berndt, E R; Finkelstein, S N

    1999-11-01

    We examined the effects on work productivity of treatment with antihistamines in a retrospective study using linked health claims data and daily work output records for a sample of nearly 6000 claims processors at a large insurance company, between 1993 and 1995. We explained the variation in work output depending on the subjects' demographic characteristics, their jobs, and whether they were treated with "sedating" versus "nonsedating" antihistamines for nasal allergies. Differences of up to 13% in productivity were found after the subjects took sedating or nonsedating antihistamines. The observed effect suggests substantial indirect economic costs, which up to now have been largely overlooked because work productivity has proved difficult to measure objectively. PMID:10570499

  12. Adaptation and adjustment in children of transsexual parents.

    PubMed

    White, Tonya; Ettner, Randi

    2007-06-01

    It is a relatively uncommon event that children find themselves in a situation with a parent who undergoes a transition from one sex to another. Unlike situations of divorce or a parent with a medical or major psychiatric disorder, it is unlikely that the children will know of other children who encounter similar situations. There is very little literature that describes the adjustment of these children and the nature of their relationships with their parents and peers. Such information would be beneficial for clinicians assisting children and families in this situation. To better delineate the adjustment of these children, we interviewed 27 parents of 55 children. The interview took place on average 6 years after the gender transition. The measures obtained included the parent and child relationships at present and also at the time of the transition. We also inquired about academic function, peer relationships and social stigma. The results found that children who were younger at the time of the parent's transition tended to have better relationships and less adjustment difficulties. In addition, parental conflict that continues after the transition period tends to reflect greater family conflict between the transitioned parent and their child. PMID:17136300

  13. Medical foods for Alzheimer's disease.

    PubMed

    Shah, Raj C

    2011-06-01

    Alzheimer's disease (AD) is a neurodegenerative condition associated with cognitive loss, behavioural changes, functional ability decline and caregiver burden. Given the worldwide public health impact of AD, novel interventions to reduce suffering experienced by AD patients need to be developed. Foods may offer a mechanism for intervention complementary to drugs, devices, biologicals and vaccines. Apart from foods with health claims (including dietary supplements), medical foods are also being explored as an intervention option. The purpose of this article is to describe how medical foods may complement other interventions for AD patients by: (i) defining what a medical food is; (ii) discussing whether AD is a condition amenable to medical food intervention; (iii) reviewing current clinical trial data on medical foods used in participants with AD; and (iv) highlighting steps needed to establish a more comprehensive framework for developing medical foods for AD. While medical foods may be defined differently in other countries, the US Orphan Drug Act of 1998 defined a medical food as a food formulated for enteral intake, taken under physician supervision, and intended to meet the distinctive nutritional requirements identified for a disease or condition. For AD to be amenable to medical food intervention, it must: (i) result in limited or impaired capacity to ingest, digest, absorb or metabolize ordinary foodstuff or certain nutrients; or (ii) have unique, medically determined nutrient requirements; and (iii) require dietary management that cannot be achieved by modification of the normal diet alone. While these criteria are most likely met in advanced AD, identifying unique nutritional requirements in early AD that cannot be met by normal diet modification requires a better understanding of AD pathophysiology. A PubMed search using the terms 'medical food' and 'Alzheimer', limited to clinical trials published in English with human participants with AD aged >65

  14. 32 CFR 564.40 - Procedures for obtaining medical care.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... that failure to promptly report the occurrence of a disease or injury may result in the loss of medical... 32 National Defense 3 2010-07-01 2010-07-01 true Procedures for obtaining medical care. 564.40... RESERVES NATIONAL GUARD REGULATIONS Medical Attendance and Burial § 564.40 Procedures for obtaining...

  15. Anomalies in medical decision making: the preception of risk

    SciTech Connect

    Travis, C.; Tonn, B.

    1985-03-28

    This paper discusses risk perception in medical decision making. Biases in risk perception by physicians and patients could result in undue loss of life and unwarranted medical expenses. Possible biases include availability of information, framing of choices, and the fundamental attribution error. An example of an anomaly in medical decision making possibly related to biased decision making is elective hysterectomy. 25 refs.

  16. Implications of Sensorineural Hearing Loss With Hydrocodone/Acetaminophen Abuse

    PubMed Central

    Novac, Andrei; Iosif, Anamaria M.; Groysman, Regina; Bota, Robert G.

    2015-01-01

    Sensorineural hearing loss is an infrequently recognized side effect of pain medication abuse. Chronic pain patients treated with opiates develop different degrees of tolerance to pain medications. In many cases, the tolerance becomes the gateway to a variety of cycles of overuse and unmasking of significant psychiatric morbidity and mortality. An individualized approach utilizing combined treatment modalities (including nonopiate pharmaceuticals) is expected to become the norm. Patients can now be provided with multidisciplinary care that addresses an individual’s psychiatric, social, and medical needs, which requires close cooperation between physicians of varying specialties. This report describes a patient who experienced hearing loss from hydrocodone/acetaminophen abuse. PMID:26835162

  17. Implications of Sensorineural Hearing Loss With Hydrocodone/Acetaminophen Abuse.

    PubMed

    Novac, Andrei; Iosif, Anamaria M; Groysman, Regina; Bota, Robert G

    2015-01-01

    Sensorineural hearing loss is an infrequently recognized side effect of pain medication abuse. Chronic pain patients treated with opiates develop different degrees of tolerance to pain medications. In many cases, the tolerance becomes the gateway to a variety of cycles of overuse and unmasking of significant psychiatric morbidity and mortality. An individualized approach utilizing combined treatment modalities (including nonopiate pharmaceuticals) is expected to become the norm. Patients can now be provided with multidisciplinary care that addresses an individual's psychiatric, social, and medical needs, which requires close cooperation between physicians of varying specialties. This report describes a patient who experienced hearing loss from hydrocodone/acetaminophen abuse. PMID:26835162

  18. Energy losses in switches

    SciTech Connect

    Martin, T.H.; Seamen, J.F.; Jobe, D.O.

    1993-07-01

    The authors experiments show energy losses between 2 and 10 times that of the resistive time predictions. The experiments used hydrogen, helium, air, nitrogen, SF{sub 6} polyethylene, and water for the switching dielectric. Previously underestimated switch losses have caused over predicting the accelerator outputs. Accurate estimation of these losses is now necessary for new high-efficiency pulsed power devices where the switching losses constitute the major portion of the total energy loss. They found that the switch energy losses scale as (V{sub peak}I{sub peak}){sup 1.1846}. When using this scaling, the energy losses in any of the tested dielectrics are almost the same. This relationship is valid for several orders of magnitude and suggested a theoretical basis for these results. Currents up to .65 MA, with voltages to 3 MV were applied to various gaps during these experiments. The authors data and the developed theory indicates that the switch power loss continues for a much longer time than the resistive time, with peak power loss generally occurring at peak current in a ranging discharge instead of the early current time. All of the experiments were circuit code modeled after developing a new switch loss version based on the theory. The circuit code predicts switch energy loss and peak currents as a function of time. During analysis of the data they noticed slight constant offsets between the theory and data that depended on the dielectric. They modified the plasma conductivity for each tested dielectric to lessen this offset.

  19. Intentional Weight Loss and Longevity in Overweight Patients with Type 2 Diabetes: A Population-Based Cohort Study

    PubMed Central

    Køster-Rasmussen, Rasmus; Simonsen, Mette Kildevæld; Siersma, Volkert; Henriksen, Jan Erik; Heitmann, Berit Lilienthal; de Fine Olivarius, Niels

    2016-01-01

    Objective This study examined the influence of weight loss on long-term morbidity and mortality in overweight (BMI≥25kg/m2) patients with type 2 diabetes, and tested the hypothesis that therapeutic intentional weight loss supervised by a medical doctor prolongs life and reduces the risk for cardiovascular disease in these patients. Methods This is a 19 year cohort study of patients in the intervention arm of the randomized clinical trial Diabetes Care in General Practice. Weight and prospective intentions for weight loss were monitored every third month for six years in 761 consecutive patients (≥40 years) newly diagnosed with diabetes in general practices throughout Denmark in 1989–92. Multivariable Cox regression was used to estimate the association between weight change during the monitoring period (year 0 to 6) and the outcomes during the succeeding 13 years (year 6 to 19) in 444 patients who were overweight at diagnosis and alive at the end of the monitoring period (year 6). The analysis was adjusted for age, sex, education, BMI at diagnosis, change in smoking, change in physical activity, change in medication, and the Charlson comorbidity 6-year score. Outcomes were from national registers. Results Overall, weight loss regardless of intention was an independent risk factor for increased all-cause mortality (P<0.01). The adjusted hazard ratio for all-cause mortality, cardiovascular mortality, and cardiovascular morbidity attributable to an intentional weight loss of 1 kg/year was 1.20 (95%CI 0.97–1.50, P = 0.10), 1.26 (0.93–1.72, P = 0.14), and 1.06 (0.79–1.42, P = 0.71), respectively. Limiting the analysis to include only those patients who survived the first 2 years after the monitoring period did not substantially change these estimates. A non-linear spline estimate indicated a V-like association between weight change and all-cause mortality, suggesting the best prognosis for those who maintained their weight. Conclusions In this population

  20. 15 CFR 6.5 - Effective date of adjustments.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... INFLATION ADJUSTMENTS § 6.5 Effective date of adjustments. The adjustments made by § 6.4 of this part, of... December 11, 2008, and before the effective date of any future inflation adjustment thereto made...

  1. 15 CFR 6.5 - Effective date of adjustments.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... INFLATION ADJUSTMENTS § 6.5 Effective date of adjustments. The adjustments made by § 6.4 of this part, of... December 7, 2012, and before the effective date of any future inflation adjustment thereto made...

  2. 15 CFR 6.5 - Effective date of adjustments.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... INFLATION ADJUSTMENTS § 6.5 Effective date of adjustments. The adjustments made by § 6.4 of this part, of... December 11, 2008, and before the effective date of any future inflation adjustment thereto made...

  3. 15 CFR 6.5 - Effective date of adjustments.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... INFLATION ADJUSTMENTS § 6.5 Effective date of adjustments. The adjustments made by § 6.4 of this part, of... December 11, 2008, and before the effective date of any future inflation adjustment thereto made...

  4. 15 CFR 6.5 - Effective date of adjustments.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... INFLATION ADJUSTMENTS § 6.5 Effective date of adjustments. The adjustments made by § 6.4 of this part, of... December 7, 2012, and before the effective date of any future inflation adjustment thereto made...

  5. 77 FR 47674 - Investigations Regarding Eligibility To Apply for Worker Adjustment Assistance

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-08-09

    ... Employment and Training Administration Investigations Regarding Eligibility To Apply for Worker Adjustment... Works (Union). 81818 Mi-Lin Wood Products Paoli, IN 07/23/12 07/20/12 (Company). 81819 Medical Card... Mould, Inc. (Union) Washington, PA..... 07/24/12 07/13/12 81823 Champion Photochemistry Rochester,...

  6. 21 CFR 880.5100 - AC-powered adjustable hospital bed.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false AC-powered adjustable hospital bed. 880.5100 Section 880.5100 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GENERAL HOSPITAL AND PERSONAL USE DEVICES General Hospital and Personal Use Therapeutic Devices § 880.5100...

  7. 76 FR 9283 - Medicaid Program; Payment Adjustment for Provider-Preventable Conditions Including Health Care...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-02-17

    ... Medicaid Program; Payment Adjustment for Provider-Preventable Conditions Including Health Care-Acquired... amounts expended for providing medical assistance for health care-acquired conditions. It would also... Federal financial participation FY Fiscal year HAC Hospital-acquired condition HCAC Health...

  8. How Older Rural Adults Utilize Self-Directed Learning in Late Life Adjustments

    ERIC Educational Resources Information Center

    Roberson, Donald N., Jr.

    2003-01-01

    The increasing numbers and influence of older adults is causing many segments of western society to re-evaluate the concept of old age. Medical advances and personal lifestyles have resulted in older adults living longer and healthier lives. As one ages, adjustments in work, family, and health must be made. Self-directed learning (SDL) is one way…

  9. 7 CFR 718.110 - Adjustments.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 7 2010-01-01 2010-01-01 false Adjustments. 718.110 Section 718.110 Agriculture Regulations of the Department of Agriculture (Continued) FARM SERVICE AGENCY, DEPARTMENT OF AGRICULTURE FARM... Determination of Acreage and Compliance § 718.110 Adjustments. (a) The farm operator or other...

  10. 7 CFR 718.110 - Adjustments.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 7 Agriculture 7 2012-01-01 2012-01-01 false Adjustments. 718.110 Section 718.110 Agriculture Regulations of the Department of Agriculture (Continued) FARM SERVICE AGENCY, DEPARTMENT OF AGRICULTURE FARM... Determination of Acreage and Compliance § 718.110 Adjustments. (a) The farm operator or other...

  11. 7 CFR 718.110 - Adjustments.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 7 2014-01-01 2014-01-01 false Adjustments. 718.110 Section 718.110 Agriculture Regulations of the Department of Agriculture (Continued) FARM SERVICE AGENCY, DEPARTMENT OF AGRICULTURE FARM... Determination of Acreage and Compliance § 718.110 Adjustments. (a) The farm operator or other...

  12. 45 CFR 84.44 - Academic adjustments.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 45 Public Welfare 1 2012-10-01 2012-10-01 false Academic adjustments. 84.44 Section 84.44 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Postsecondary Education § 84.44 Academic adjustments. (a)...

  13. 22 CFR 142.44 - Academic adjustments.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 22 Foreign Relations 1 2014-04-01 2014-04-01 false Academic adjustments. 142.44 Section 142.44 Foreign Relations DEPARTMENT OF STATE CIVIL RIGHTS NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Postsecondary Education § 142.44 Academic adjustments. (a) Academic requirements. A...

  14. Family Adjustment Measure: Scale Construction and Validation

    ERIC Educational Resources Information Center

    Daire, Andrew P.; Dominguez, Vanessa N.; Carlson, Ryan G.; Case-Pease, Jenene

    2014-01-01

    We administered the Family Adjustment Measure to 368 parents of children with special needs to identify positive adjustment. We randomly split the sample to conduct exploratory factor analysis ("n" = 194) and confirmatory factor analysis ("n" = 174). Results indicated four possible subscales and that explain 51% of the variance.

  15. Marital Adjustment among Housestaff and New Attorneys.

    ERIC Educational Resources Information Center

    Spendlove, David C.; And Others

    1990-01-01

    This study, involving 116 housestaff physicians, 106 new attorneys, and the spouses of both groups, identified the factors that significantly affected their marital adjustments. No differences were found. The most important factor associated with adjustment was perceived level of emotional support from one's spouse. (Author/MLW)

  16. 15 CFR 6.6 - Subsequent adjustments.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 15 Commerce and Foreign Trade 1 2010-01-01 2010-01-01 false Subsequent adjustments. 6.6 Section 6.6 Commerce and Foreign Trade Office of the Secretary of Commerce CIVIL MONETARY PENALTY INFLATION... once every four years after October 23, 1996, make the inflation adjustment, described in Section...

  17. Religiousity, Spirituality and Adolescents' Self-Adjustment

    ERIC Educational Resources Information Center

    Japar, Muhammad; Purwati

    2014-01-01

    Religiuosity, spirituality, and adolescents' self-adjustment. The objective of this study is to test the correlation among religiosity, spirituality and adolescents' self-adjustment. A quantitative approach was employed in this study. Data were collected from 476 junior high schools students of 13 State Junior High Schools and one Junior High…

  18. Adjustable Optical Mount Is More Rigid

    NASA Technical Reports Server (NTRS)

    Asbury, Bill G.; Coombs, David S.; Jones, Irby W.; Moore, Alvah S., Jr.

    1994-01-01

    Improved mount for lens or mirror in laser offers rigidity similar to that of nonadjustable optical mount. In comparison with older adjustable optical mounts, this one less susceptible to movements and distortions caused by vibrations and by thermal expansions and contractions. Mount contains neither adjustment rods (which grow or shrink as temperature varies) nor springs (which transmit vibrations to mounted optic).

  19. 24 CFR 9.155 - Housing adjustments.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 24 Housing and Urban Development 1 2010-04-01 2010-04-01 false Housing adjustments. 9.155 Section 9.155 Housing and Urban Development Office of the Secretary, Department of Housing and Urban... THE DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT § 9.155 Housing adjustments. (a) The agency...

  20. 15 CFR 6.6 - Subsequent adjustments.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 15 Commerce and Foreign Trade 1 2013-01-01 2013-01-01 false Subsequent adjustments. 6.6 Section 6.6 Commerce and Foreign Trade Office of the Secretary of Commerce CIVIL MONETARY PENALTY INFLATION... once every four years after October 23, 1996, make the inflation adjustment, described in Section...

  1. 15 CFR 6.6 - Subsequent adjustments.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 15 Commerce and Foreign Trade 1 2011-01-01 2011-01-01 false Subsequent adjustments. 6.6 Section 6.6 Commerce and Foreign Trade Office of the Secretary of Commerce CIVIL MONETARY PENALTY INFLATION... once every four years after October 23, 1996, make the inflation adjustment, described in Section...

  2. 15 CFR 6.6 - Subsequent adjustments.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 15 Commerce and Foreign Trade 1 2012-01-01 2012-01-01 false Subsequent adjustments. 6.6 Section 6.6 Commerce and Foreign Trade Office of the Secretary of Commerce CIVIL MONETARY PENALTY INFLATION... once every four years after October 23, 1996, make the inflation adjustment, described in Section...

  3. 15 CFR 6.6 - Subsequent adjustments.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 15 Commerce and Foreign Trade 1 2014-01-01 2014-01-01 false Subsequent adjustments. 6.6 Section 6.6 Commerce and Foreign Trade Office of the Secretary of Commerce CIVIL MONETARY PENALTY INFLATION... once every four years after October 23, 1996, make the inflation adjustment, described in Section...

  4. 14 CFR 254.6 - Periodic adjustments.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 14 Aeronautics and Space 4 2013-01-01 2013-01-01 false Periodic adjustments. 254.6 Section 254.6 Aeronautics and Space OFFICE OF THE SECRETARY, DEPARTMENT OF TRANSPORTATION (AVIATION PROCEEDINGS) ECONOMIC REGULATIONS DOMESTIC BAGGAGE LIABILITY § 254.6 Periodic adjustments. The Department of Transportation...

  5. Affect and Status Dimensions of Marital Adjustment

    ERIC Educational Resources Information Center

    Fineberg, Beth L.; Joseph Lowman

    1975-01-01

    The interactions of 10 maritally adjusted and 10 maladjusted couples were compared using a coding system based on the Leary circumplex. Major findings are (1) adjusted couples communicated more affection and submission than did maladjusted ones, (2) all couples were more likely to show complementary sequencing patterns with some interesting…

  6. 24 CFR 902.24 - Database adjustment.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 24 Housing and Urban Development 4 2012-04-01 2012-04-01 false Database adjustment. 902.24 Section 902.24 Housing and Urban Development REGULATIONS RELATING TO HOUSING AND URBAN DEVELOPMENT (CONTINUED... PUBLIC HOUSING ASSESSMENT SYSTEM Physical Condition Indicator § 902.24 Database adjustment....

  7. 49 CFR 630.11 - Data adjustments.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 49 Transportation 7 2014-10-01 2014-10-01 false Data adjustments. 630.11 Section 630.11 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL TRANSIT ADMINISTRATION, DEPARTMENT OF TRANSPORTATION NATIONAL TRANSIT DATABASE § 630.11 Data adjustments. Errors in the data used...

  8. 24 CFR 902.24 - Database adjustment.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 24 Housing and Urban Development 4 2014-04-01 2014-04-01 false Database adjustment. 902.24 Section 902.24 Housing and Urban Development REGULATIONS RELATING TO HOUSING AND URBAN DEVELOPMENT (CONTINUED... PUBLIC HOUSING ASSESSMENT SYSTEM Physical Condition Indicator § 902.24 Database adjustment....

  9. 49 CFR 630.11 - Data adjustments.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 49 Transportation 7 2010-10-01 2010-10-01 false Data adjustments. 630.11 Section 630.11 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL TRANSIT ADMINISTRATION, DEPARTMENT OF TRANSPORTATION NATIONAL TRANSIT DATABASE § 630.11 Data adjustments. Errors in the data used...

  10. 49 CFR 630.11 - Data adjustments.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 49 Transportation 7 2011-10-01 2011-10-01 false Data adjustments. 630.11 Section 630.11 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL TRANSIT ADMINISTRATION, DEPARTMENT OF TRANSPORTATION NATIONAL TRANSIT DATABASE § 630.11 Data adjustments. Errors in the data used...

  11. 24 CFR 902.24 - Database adjustment.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 24 Housing and Urban Development 4 2011-04-01 2011-04-01 false Database adjustment. 902.24 Section 902.24 Housing and Urban Development REGULATIONS RELATING TO HOUSING AND URBAN DEVELOPMENT (CONTINUED... PUBLIC HOUSING ASSESSMENT SYSTEM Physical Condition Indicator § 902.24 Database adjustment....

  12. 49 CFR 630.11 - Data adjustments.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 49 Transportation 7 2012-10-01 2012-10-01 false Data adjustments. 630.11 Section 630.11 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL TRANSIT ADMINISTRATION, DEPARTMENT OF TRANSPORTATION NATIONAL TRANSIT DATABASE § 630.11 Data adjustments. Errors in the data used...

  13. 49 CFR 630.11 - Data adjustments.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 49 Transportation 7 2013-10-01 2013-10-01 false Data adjustments. 630.11 Section 630.11 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL TRANSIT ADMINISTRATION, DEPARTMENT OF TRANSPORTATION NATIONAL TRANSIT DATABASE § 630.11 Data adjustments. Errors in the data used...

  14. 24 CFR 902.24 - Database adjustment.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 24 Housing and Urban Development 4 2013-04-01 2013-04-01 false Database adjustment. 902.24 Section 902.24 Housing and Urban Development REGULATIONS RELATING TO HOUSING AND URBAN DEVELOPMENT (CONTINUED... PUBLIC HOUSING ASSESSMENT SYSTEM Physical Condition Indicator § 902.24 Database adjustment....

  15. 10 CFR 905.34 - Adjustment provisions.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 10 Energy 4 2010-01-01 2010-01-01 false Adjustment provisions. 905.34 Section 905.34 Energy DEPARTMENT OF ENERGY ENERGY PLANNING AND MANAGEMENT PROGRAM Power Marketing Initiative § 905.34 Adjustment... continue to take place based on existing contract/marketing criteria principles....

  16. 10 CFR 905.34 - Adjustment provisions.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 10 Energy 4 2013-01-01 2013-01-01 false Adjustment provisions. 905.34 Section 905.34 Energy DEPARTMENT OF ENERGY ENERGY PLANNING AND MANAGEMENT PROGRAM Power Marketing Initiative § 905.34 Adjustment... continue to take place based on existing contract/marketing criteria principles....

  17. 10 CFR 905.34 - Adjustment provisions.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 10 Energy 4 2011-01-01 2011-01-01 false Adjustment provisions. 905.34 Section 905.34 Energy DEPARTMENT OF ENERGY ENERGY PLANNING AND MANAGEMENT PROGRAM Power Marketing Initiative § 905.34 Adjustment... continue to take place based on existing contract/marketing criteria principles....

  18. 10 CFR 905.34 - Adjustment provisions.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 10 Energy 4 2014-01-01 2014-01-01 false Adjustment provisions. 905.34 Section 905.34 Energy DEPARTMENT OF ENERGY ENERGY PLANNING AND MANAGEMENT PROGRAM Power Marketing Initiative § 905.34 Adjustment... continue to take place based on existing contract/marketing criteria principles....

  19. 10 CFR 905.34 - Adjustment provisions.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 10 Energy 4 2012-01-01 2012-01-01 false Adjustment provisions. 905.34 Section 905.34 Energy DEPARTMENT OF ENERGY ENERGY PLANNING AND MANAGEMENT PROGRAM Power Marketing Initiative § 905.34 Adjustment... continue to take place based on existing contract/marketing criteria principles....

  20. Ergonomically Adjustable School Furniture for Male Students

    ERIC Educational Resources Information Center

    Al-Saleh, Khalid S.; Ramadan, Mohamed Z.; Al-Ashaikh, Riyad A.

    2013-01-01

    The need for adjustability in school furniture, in order to accommodate the variation in anthropometric measures of different genders, cultures and ages is becoming increasingly important. Four chair-table combinations, different in dimensions, with adjustable chair seating heights and table heights were designed, manufactured and distributed to…

  1. 7 CFR 1744.64 - Budget adjustment.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... for a contract that otherwise would be approved by RUS. See 7 CFR part 1753. ... 7 Agriculture 11 2011-01-01 2011-01-01 false Budget adjustment. 1744.64 Section 1744.64... Disbursement of Funds § 1744.64 Budget adjustment. (a) If more funds are required than are available in...

  2. 7 CFR 1744.64 - Budget adjustment.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... for a contract that otherwise would be approved by RUS. See 7 CFR part 1753. ... 7 Agriculture 11 2013-01-01 2013-01-01 false Budget adjustment. 1744.64 Section 1744.64... Disbursement of Funds § 1744.64 Budget adjustment. (a) If more funds are required than are available in...

  3. 7 CFR 1744.64 - Budget adjustment.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... for a contract that otherwise would be approved by RUS. See 7 CFR part 1753. ... 7 Agriculture 11 2014-01-01 2014-01-01 false Budget adjustment. 1744.64 Section 1744.64... Disbursement of Funds § 1744.64 Budget adjustment. (a) If more funds are required than are available in...

  4. 7 CFR 1744.64 - Budget adjustment.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... for a contract that otherwise would be approved by RUS. See 7 CFR part 1753. ... 7 Agriculture 11 2012-01-01 2012-01-01 false Budget adjustment. 1744.64 Section 1744.64... Disbursement of Funds § 1744.64 Budget adjustment. (a) If more funds are required than are available in...

  5. 7 CFR 1744.64 - Budget adjustment.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... for a contract that otherwise would be approved by RUS. See 7 CFR part 1753. ... 7 Agriculture 11 2010-01-01 2010-01-01 false Budget adjustment. 1744.64 Section 1744.64... Disbursement of Funds § 1744.64 Budget adjustment. (a) If more funds are required than are available in...

  6. 7 CFR 15b.32 - Academic adjustments.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 7 Agriculture 1 2013-01-01 2013-01-01 false Academic adjustments. 15b.32 Section 15b.32 Agriculture Office of the Secretary of Agriculture NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Postsecondary Education § 15b.32 Academic adjustments. (a) Academic requirements. A recipient...

  7. A Digital Game for International Students' Adjustment

    ERIC Educational Resources Information Center

    Bisadi, Maryam; Chua, Alton Y. K; Keong, Lee Chu

    2013-01-01

    Although digital games have been developed for various subject areas, little attention has been focused on using digital games to address international students' adjustment issues. For this reason, this paper endeavors to explore the use of a digital game in facilitating international students acquire adjustment-related information. Specifically,…

  8. Marital Adjustment Correlates in Young Couples.

    ERIC Educational Resources Information Center

    Haskell, Samuel D.

    The Locke-Wallace Marital Adjustment Scale was administered to 35 Caucasian, Protestant couples who were married an average of nine years, largely middle class, and lived in Knoxville, Tennessee. Significant correlates of marital adjustment were organized into groups of similar variables. Correlate groups that were the same for the husband and…

  9. 24 CFR 886.112 - Rent adjustments.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... Adjustment Factor most recently published by HUD in the Federal Register in accordance with 24 CFR part 888... unassisted housing in the area to ensure that adjustments in the Contract Rents shall not result in material differences between the rents charged for assisted and comparable unassisted units. Contract Rents may...

  10. 24 CFR 886.112 - Rent adjustments.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... Adjustment Factor most recently published by HUD in the Federal Register in accordance with 24 CFR part 888... unassisted housing in the area to ensure that adjustments in the Contract Rents shall not result in material differences between the rents charged for assisted and comparable unassisted units. Contract Rents may...

  11. 24 CFR 886.112 - Rent adjustments.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... Adjustment Factor most recently published by HUD in the Federal Register in accordance with 24 CFR part 888... unassisted housing in the area to ensure that adjustments in the Contract Rents shall not result in material differences between the rents charged for assisted and comparable unassisted units. Contract Rents may...

  12. 24 CFR 886.112 - Rent adjustments.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... Adjustment Factor most recently published by HUD in the Federal Register in accordance with 24 CFR part 888... unassisted housing in the area to ensure that adjustments in the Contract Rents shall not result in material differences between the rents charged for assisted and comparable unassisted units. Contract Rents may...

  13. 24 CFR 886.112 - Rent adjustments.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... Adjustment Factor most recently published by HUD in the Federal Register in accordance with 24 CFR part 888... unassisted housing in the area to ensure that adjustments in the Contract Rents shall not result in material differences between the rents charged for assisted and comparable unassisted units. Contract Rents may...

  14. 24 CFR 9.155 - Housing adjustments.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 24 Housing and Urban Development 1 2011-04-01 2011-04-01 false Housing adjustments. 9.155 Section 9.155 Housing and Urban Development Office of the Secretary, Department of Housing and Urban... THE DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT § 9.155 Housing adjustments. (a) The agency...

  15. 34 CFR 104.44 - Academic adjustments.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 34 Education 1 2011-07-01 2011-07-01 false Academic adjustments. 104.44 Section 104.44 Education... Postsecondary Education § 104.44 Academic adjustments. (a) Academic requirements. A recipient to which this subpart applies shall make such modifications to its academic requirements as are necessary to ensure...

  16. 45 CFR 84.44 - Academic adjustments.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 45 Public Welfare 1 2011-10-01 2011-10-01 false Academic adjustments. 84.44 Section 84.44 Public... Academic adjustments. (a) Academic requirements. A recipient to which this subpart applies shall make such modifications to its academic requirements as are necessary to ensure that such requirements do not...

  17. 45 CFR 605.44 - Academic adjustments.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 45 Public Welfare 3 2010-10-01 2010-10-01 false Academic adjustments. 605.44 Section 605.44 Public... Postsecondary Education § 605.44 Academic adjustments. (a) Academic requirements. A recipient to which this subpart applies shall make such modifications to its academic requirements as are necessary to ensure...

  18. 7 CFR 15b.32 - Academic adjustments.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 1 2010-01-01 2010-01-01 false Academic adjustments. 15b.32 Section 15b.32... ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Postsecondary Education § 15b.32 Academic adjustments. (a) Academic requirements. A recipient to which this subpart applies shall make such modifications to...

  19. 34 CFR 104.44 - Academic adjustments.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 34 Education 1 2010-07-01 2010-07-01 false Academic adjustments. 104.44 Section 104.44 Education... Postsecondary Education § 104.44 Academic adjustments. (a) Academic requirements. A recipient to which this subpart applies shall make such modifications to its academic requirements as are necessary to ensure...

  20. 7 CFR 15b.32 - Academic adjustments.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 1 2011-01-01 2011-01-01 false Academic adjustments. 15b.32 Section 15b.32... ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Postsecondary Education § 15b.32 Academic adjustments. (a) Academic requirements. A recipient to which this subpart applies shall make such modifications to...